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You are here: Home Current RFAs and PQs What underlying causal events—e.g., genetic, epigenetic, biologic, behavioral, or environmental—allow certain individuals to survive beyond the expected limits of otherwise highly lethal cancers?

2012 RFA Links and Provocative Questions  


PQD - 3
What underlying causal events—e.g., genetic, epigenetic, biologic, behavioral, or environmental—allow certain individuals to survive beyond the expected limits of otherwise highly lethal cancers?

Background: In biological research, the study of an unusual or rare event sometimes allows the identification of key features of more common forms. This has been true in cancer research where the careful characterization of rare tumors has identified disease events that are common in other tumors. A good example of this has been the cloning and characterization of tumor suppressor genes in rare childhood cancers. The study of the genes and their protein products has greatly expanded our knowledge of similar events seen in many common tumors. Studying extreme variants in tumor development promises to provide a similarly powerful avenue to learn about key events in cancer. This Provocative Question focuses on the unusual cases of individuals who have survived well beyond the expected limits of otherwise lethal cancers. Understanding what features of the tumor or of the patient allow individuals to survive may identify biological mechanisms that will be useful in treating patients at earlier stages.

Feasibility: The types of disease and the clinical features that would form the basis for these studies are best left to the creativity and rigor of applicants. There may be many approaches to study these phenomena, but one general strategy that may be effective would be to compare various features either of the tumors or of the patients who survive with those who suffer normal tumor development patterns. Comparisons could be made using a number of strategies, but unless potentially interesting features are known from other work, large –"omic" scale comparisons may be useful experimental approaches to generate new hypotheses.

Implications of success: Identification of features that allow patients to survive with an otherwise devastating disease open two major avenues for future research. Such studies could be used to identify those who may be more likely to respond well to treatment or to live longer with cancer. In addition, these features could provide starting places to look for new treatment or prevention strategies for other patients.








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