Using Science to Change Cancer Treatment

When the National Cancer Institute (NCI) designated the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine a comprehensive cancer center in 2005, it did so in part because of the scientific advances in the treatment of cancer.

Nanotechnology is one of those areas and its great promise could radically change cancer treatment.

By definition, nanotechnology involves the development and use of materials and devices to manipulate matter at the level of molecules and atoms. To understand the incredibly small scale at which this occurs, imagine this—a nanometer is one billionth of a meter or 1/80,000 the width of a human hair.

Nanomedicine is a promising field of research related to nanotechnology. It uses nanoparticles – extremely small, bead-shaped carriers of medicinal agents – to locate, diagnose and treat disease. Injected into the bloodstream, these tiny spheres travel deep into the body to identify and highlight tumors undetectable by methods typically used today. The nanoparticles also can deliver therapeutic agents to destroy the tumor.

In the future, this advanced technology will replace numerous medical tests, scans or surgeries currently needed to treat cancer and other major health challenges.

As a leader in the field, the NCI recognized Washington University School of Medicine''s contribution to nanomedicine with a five-year, $16 million grant to establish the Siteman Center of Cancer Nanotechnology Excellence (SCCNE). It is one of seven such centers funded by the NCI in the United States.

Led by Samuel A. Wickline, MD, professor of medicine, biomedical engineering, physics and cellular biology; and Gregory M. Lanza, MD, PhD, associate professor of medicine, the two are co-inventors of a nanoparticle that has added another dimension to targeting internal disease sites.

The unique composition of their nanoparticle allows them to attach to it not only homing molecules, but also a large number of imaging molecules. The result is a strong signal that "lights up" the targeted cells. This strong illumination means the nanoparticle has great potential for spotting disease sites at the early stage when treatment is most effective and definitively highlighting areas where disease symptoms just begin to recur.

Although tiny—a few thousand times smaller than the dot above an "i"—each nanoparticle can carry hundreds of thousands of molecules on its surface. Medical researchers now have the ability to attach molecules to a nanoparticle''s surface that target cells within the body having complementary molecules on their surfaces. In addition to nanoparticles'' molecules targeting cancerous tumor cells, they also can be designed to target the plaque in arteries that can cause heart disease.

Nanomedicine is the next step in targeted, personalized medicine—the ultimate in patient care. For example, a nanoparticle''s ability to carry therapeutic agents—actual medicine—means drugs specifically designed to kill cancer cells or to dissolve plaques can be included along with homing and imaging agents. Once a nanoparticle reaches its target, the brightness of the image will show the physician the size of the tumor and the amount of drug that reached the site. That information can be used to adjust future treatments.

Another advantage of nanoparticles is that they are attracted to a particular disease site and have little effect on the rest of the body. In contrast, standard drug administration dilutes medication throughout a person''s system, which means it reaches areas where it is needed—and where it is not.

Led by Dr. Wickline, the SCCNE will research and apply nanotechnology for the diagnosis and treatment of cancer. In addition to developing general oncology applications, it will focus its efforts on breast cancer and melanoma detection and treatment. Some projects planned for the Center include targeting of multiple tumors for early detection of cancer, a nanoparticle-based contrast agent for ultrasound imaging and therapy of tumors, statistical tools to model the behavior of nanoparticles in the body, and novel nano-scale sensors for rapidly screening potential anticancer drugs in single cells.

Each of the seven centers around the country is a multi-institutional hub. The SCCNE is a collaboration among Washington University School of Medicine, the Siteman Cancer Center at the School of Medicine and Barnes-Jewish Hospital, the University of Illinois at Urbana-Champaign, several private sector companies including Kereos Inc., and large multinational corporations including Philips Medical Systems.