Using epigenetic editing as cancer therapy

Gene editing has become a rather popular concept these days. We have all heard about gene editing in some form or the other. However, do we all understand how it actually works and how many lives we may be able to save by just using this one technology?

As you may have heard, gene editing uses something called CRISPR-cas9 to edit genes and make genetic changes in one’s DNA. sgRNA-dCas9 can be used as a versatile epigenetic editing tool. In vivo and in vitro studies with RNA and Cas9 in cancer are limited. Several technical factors are crucial for targeting cancer with RNA-dCas9 effectively. However, RNA-dCas9 shows tremendous promise as a therapeutic tool against cancer.

CRISPR can be used as an emerging version of precision cancer therapy. It has been adapted from the prokaryotic CRISPR-Cas system. Once ligated to epigenetic effectors, CRISPR-dCas9 can work as a gene editing tool. CRISPR can be exploited to alter cancerous epigenetic features as well as other cancer hallmarks. This technology targets these tumor-suppressor genes to reduce the tumorigenesis by restoring the activities of tumor-suppressor genes. CRISPR technology is also used to identify the cancer heterogeneity and its therapeutic targets against different cancer cells.

So now that you have this background information about how CRISPR technology works, let’s move on and see how effective it can be when used to treat lung cancer. In lung cancer models, survival benefits have been found and demonstrated by using gene therapy to create cancer vaccines, target viruses to cancer cells for lysis and death, decrease the blood supply to the tumor, and introduce genes into the cancer cells that cause death or restore normal cellular phenotype. In fact, in a study recently published in Nature Medicine, You Lu (a prominent doctor who specializes in gene editing) and his team examined the feasibility and safety of using CRISPR-engineered T cells to treat late-stage lung cancer.

In this study, PBMCs were isolated from late-stage NSCLC patients and electroporated with plasmids encoding Cas9 and a pair of RNAs targeting the second exon of PD-1 gene. The edited T cells were expanded in vitro for 17–40 days before being re-infused back into patients. Treated patients were monitored for up to 96 weeks for in vivo persistence of edited T cells, treatment-related AEs, and disease progression.

The image above is a perfect example of how genetic editing is used on lung cancer patients. First, the cancerous T cells are taken out, and then they are modified with the cas9 and RNA technology. This turns the cells into edited T cells which go back into the patient’s body and serve as a cure. This is how patients with lung cancer can potentially receive life-saving treatment.

In Canada, around 21,200 people die from lung cancer each year. This is a large number. Imagine how many lives we could save using this technology. Wouldn’t that be something amazing?