New cancer drug targets accelerate path of precision medicine

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Researcher use CRISPR technology to discover key genes essential for cancer's survival

In one of the largest studies of its kind, researchers used CRISPR technology to disrupt every gene in over 300 cancer models from 30 cancer types and discover thousands of key genes essential for cancer's survival. The team, from the Wellcome Sanger Institute, Open Targets, and co-lead by Kosuke Yusa now at Kyoto University's Institute for Frontier Life and Medical Sciences, proceeded to develop a new system to prioritise and rank 600 drug targets that show the most promise for development into treatments.

The results, published in Nature , accelerate the development of targeted cancer treatments and bring researchers one step closer to producing the 'Cancer Dependency Map', a detailed rulebook of precision cancer treatments to help more patients receive effective therapies.

Surgery, chemotherapy, radiotherapy, and now immunotherapy are used to treat cancer, however while they can be effective at killing the cancer cells, some patients don't respond to treatment and healthy tissue can be damaged, leading to unwanted toxic side effects for patients.

Scientists and pharmaceutical companies are exploring new targeted therapies that selectively kill cancer cells, leaving healthy tissue unharmed. Currently, producing new effective treatments is very difficult; it costs approximately $1-2 billion to develop a single drug, but around 90 per cent of drugs fail during development. Therefore, selecting a good drug target at the beginning of the process can be seen as the most important part of drug discovery.

Researchers conducted one of the largest CRISPR screens of cancer genes to date, disrupting nearly 20,000 genes in over 300 cancer models from 30 cancer types to uncover which genes are critical for cancer survival. The team focused on common cancers, such as lung, colon, and breast, and cancers of particular unmet clinical need, such as lung, ovarian and pancreatic, where new treatments are urgently needed.

Scientists identified several thousand key cancer genes and developed a prioritisation system to narrow down the list to approximately 600 genes that showed the most promise for drug development.

A top-scoring target present in multiple different cancer types was Werner syndrome RecQ helicase, or WRN. The team found that cancer cells with a faulty DNA repair pathway, known as microsatellite unstable cancers, require WRN for survival. Microsatellite instability occurs in many different cancer types, including 15% of colon and 28% of stomach cancers. The new identification of WRN as a promising drug target offers an exciting opportunity to develop the first cancer treatments to target WRN.

Yusa explains "CRISPR is an incredibly powerful tool that enables us to do science at a scale and with a precision that we couldn't do five years ago. With CRISPR we have discovered a very exciting opportunity to develop new drugs targeting cancers."

Francesco Iorio, co-first author from the Wellcome Sanger Institute and Open Targets, said, "To give a new drug the best chance of succeeding in the very final phases of clinical trials, it is crucial to select the best and most promising drug target at the beginning of the drug development process. For the first time, in a data-driven way, we provide guidance at a genome-scale on which new therapeutic targets should be put forward for the development of new anti-cancer drugs."

The collaboration between researchers at Sanger, EMBL-EBI and GSK, the Open Targets partners, bolster the translation of these research results into new treatments.

"What makes this research so powerful, is the scale. CRISPR provides a unique tool to accelerate discovery of oncology drug targets, and this study is a salient leap in a positive direction," says Karen Vousden, Cancer Research UK's chief scientist.

"But we should remember that studying cells in the lab doesn't always reflect the complexities of cancer in the human body and so will not necessarily reflect how someone will respond to a drug. This work provides some excellent starting points and the next steps will be a thorough analysis of the genes that have been identified as weaknesses in this study, to determine if they will one day lead to the development of new treatments for patients."

Results summary. Cancer cell lines with microsatellite instability require the WRN gene for growth (Kyoto University/Kosuke Yusa)

Paper information


Fiona M. Behan, Francesco Iorio, Gabriele Picco, Emanuel Gonçalves, Charlotte M. Beaver, Giorgia Migliardi, Rita Santos, Yanhua Rao, Francesco Sassi, Marika Pinnelli, Rizwan Ansari, Sarah Harper, David Adam Jackson, Rebecca McRae, Rachel Pooley, Piers Wilkinson, Dieudonne van der Meer, David Dow, Carolyn Buser-Doepner, Andrea Bertotti, Livio Trusolino, Euan A. Stronach, Julio Saez-Rodriguez, Kosuke Yusa & Mathew J. Garnett (2019). Prioritization of cancer therapeutic targets using CRISPR-Cas9 screens. Nature, 568(7753), 511-516.