![]() "It's a way for cancers to change their genome to adapt to stress," adds Ting, who had the idea to assess whether an HIV drug, lamivudine, might interfere with the process. The repeatome acts much like a virus does relying on reverse transcription to replicate itself and move in the genome. These repetitive elements spew out extraordinary levels of RNA which replicate in a viral-like life cycle through reverse transcription into what Ting describes at the repeatome. Colorectal cancers produce abundant amounts of repetitive elements, as do cancers of the esophagus, lung, and several others. The team discovered that up to 50% of a tumor's DNA was composed of "repetitive elements," which were previously considered "junk DNA." "Only cancer cells produced these repetitive element, not healthy cells," says Ting. The first clues to this unusual drug trial surfaced in Ting's lab and those of his collaborators over the past ten years. "If we see this kind of response with just one HIV drug, the next obvious trial is to see what else we can achieve with HAART, or highly active anti-retroviral therapy," adds Ting, referring to the standard three-drug regime for HIV treatment. ![]() While the research team did not see tumor shrinkage, the results are encouraging. "This provides evidence that an HIV drug can be repurposed as an anti-cancer therapy in metastatic cancer patients," says Ting. The research team observed that 9 of the 32 patients, or 28%, had disease stability or mixed response at the end of the trial. After adjusting the dosing four-fold, another 23 patients received lamivudine therapy where it was highly tolerated. Ting, MD, of the Mass General Cancer Center. "After giving them only this one drug - nothing else - we saw signs of disease stability," says co-senior author David T. ![]() The first nine patients received the standard HIV-approved dose of lamivudine. The trial included 32 patients with advanced metastatic colon cancer whose disease progressed despite four lines of previous cancer treatments.
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