Engineered yeast could replace cancer drug-making plants

Hello Nature readers,
This week, we learn that an experimental blood test can detect precancerous polyps in the colon, hear why AI could help cancer patients navigate the healthcare system and discover that engineered yeast could save a cancer-drug-making flower.

Blood test detects colon polyps

A blood test for colorectal cancer is also highly sensitive for precancerous polyps, enabling the test to be both diagnostic and preventative. The study screened 1,500 adults in China, Japan and Spain and found that the test detected 92% of stage I, II or III colorectal cancers and 81% of advanced adenomas, or precancerous polyps. Colonoscopy remains the most effective way to screen for colorectal cancer, but the test could be used to identify those with the highest risk.

Twice-rejected melanoma drug okayed

The US Food and Drug administration has approved Replimune’s twice-rejected advanced melanoma drug, for adults with cancer that cannot be surgically removed or which has progressed after immunotherapy. The only other treatment for patients with this type of cancer is tumour-infiltrating lymphocyte therapy, which uses a patient’s cells to fight tumours and is difficult to provide broad access to, says medical oncologist Hussein Tawbi. Full approval of vusolimogene oderparepvec (Tudriqev) hinges on a successful phase III trial. The listed price of the drug will be US$450,000 per course of therapy.

A win for skin cancer vaccines

An mRNA vaccine combined with immunotherapy has succeeded in reducing recurrence of skin cancer and stopping its spread, according to interim trial results announced by the companies involved. The treatment combines the immunotherapy Keytruda with a personalized mRNA vaccine based on an analysis of a patient’s own tumour.

Yeast replaces cancer-drug-making flower

Researchers have found a way to replace the use of an endangered flower (Sinopodophyllum hexandrum) in the manufacturing of the common cancer drugs etoposide and teniposide. The team loaded more than 60 genetic edits and 45 new genes into baker’s yeast (Saccharomyces cerevisiae) to enable the fungus to produce a precursor that can be converted into both drugs with just one step. This method could be applied to other plant-derived medicines, say the researchers.

AI could help patients survive the system

“There are a lot of concerns about how AI can and should be used in healthcare,” write digital-health executive Jennifer Goldsack and physician Lee Fleisher. “But helping patients and their families navigate their care to ensure that all the benefits of modern cancer care are accessed is one that AI can address right now.” The paradox of modern cancer care is that despite the myriad of diagnostic and treatment advances, the healthcare system within which this life-changing science sits remains very tough to navigate, they write. “If AI is going to transform cancer care, its first test should be whether it can help patients access, understand and complete the care their clinicians recommend.”

Should newborns be screened for cancer?

The contrasting prognoses of two siblings both born with a cancer-causing genetic mutation, demonstrates the power of newborn screening for retinoblastoma, argues paediatric oncologist Lisa Diller. While one sibling, whose cancer was caught at two and a half, lost both eyes, the other, who was screened and monitored as a newborn for retinoblastoma, kept her vision without radiotherapy or chemotherapy. Newborn screening for cancer isn't generally offered, but Diller and others are looking to change that as part of a broader global effort to screen newborns for an array of genetic disorders. Babies are already screened for 40 conditions at birth in the United States, but deciding what should be included in a wider rollout is not straightforward.

Iron logic unites bacteria and cancer

Bacteria that evade antibiotics and cancer cells that survive treatment use the same iron-juggling trick to stay alive. Both cells slip into a sluggish survival-mode state in which they can wait out treatment, and then come back to life. That shared vulnerability could be a new target for drugs, argue chemical biologist Raphael Rodriguez and cell biologist Patrizia Agostinis. Both cell types capture enough iron to fuel their survival but lock away excess that would otherwise be toxic to them. Disrupting that balance with drugs could wipe out cells responsible for cancer relapse or antibiotic resistance, they say.