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<div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Interdisciplinary medical specialty</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For the medical journal, see <a href="/wiki/Molecular_Oncology_(journal)" title="Molecular Oncology (journal)">Molecular Oncology (journal)</a>.</div> <p><b>Molecular oncology</b> is an <a href="/wiki/Interdisciplinary" class="mw-redirect" title="Interdisciplinary">interdisciplinary</a> medical specialty at the interface of <a href="/wiki/Medicinal_chemistry" title="Medicinal chemistry">medicinal chemistry</a> and <a href="/wiki/Oncology" title="Oncology">oncology</a> that refers to the investigation of the chemistry of <a href="/wiki/Cancer" title="Cancer">cancer</a> and <a href="/wiki/Tumor" class="mw-redirect" title="Tumor">tumors</a> at the <a href="/wiki/Molecule" title="Molecule">molecular</a> scale. Also the development and application of <a href="/wiki/Targeted_therapy" title="Targeted therapy">molecularly targeted therapies</a>. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Main_branches">Main branches</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Molecular_oncology&action=edit&section=1" title="Edit section: Main branches"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Molecular oncology has identified genes that are involved in the development of cancer. The research combined diverse techniques ranging from <a href="/wiki/Genomics" title="Genomics">genomics</a>, <a href="/wiki/Computational_biology" title="Computational biology">computational biology</a>, <a href="/wiki/Tumour" class="mw-redirect" title="Tumour">tumour</a> <a href="/wiki/Molecular_imaging" title="Molecular imaging">imaging</a>, <a href="/wiki/In_vitro" title="In vitro">in vitro</a> and <a href="/wiki/In_vivo" title="In vivo">in vivo</a> functional models to study biological and clinical <a href="/wiki/Phenotype" title="Phenotype">phenotypes</a>. The <a href="/wiki/Protein" title="Protein">proteins</a> produced by these <a href="/wiki/Gene" title="Gene">genes</a> may serve as <a href="/wiki/Drug_targeting" class="mw-redirect" title="Drug targeting">targets</a> for novel <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a> drugs and other cancer treatments, or imaging scans. Scientists use a range of techniques to validate the role of the novel candidate genes in the development of cancer. The ultimate aim is to translate these findings into improved treatment options for cancer patients.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Gene_targets">Gene targets</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Molecular_oncology&action=edit&section=2" title="Edit section: Gene targets"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are many different genes being researched for possible cancer therapies. Among the most studied are the <a href="/wiki/P53" title="P53">p53 gene</a> and the <a href="/wiki/PTEN_(gene)" title="PTEN (gene)">PTEN gene</a>.<sup id="cite_ref-:1_2-0" class="reference"><a href="#cite_note-:1-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> These genes are major regulators of the <a href="/wiki/Cell_cycle" title="Cell cycle">cell cycle</a> and other pathways involved in cellular and genomic integrity. By halting the cell cycle, these genes ensure that genetically damaged cells are not passing on that damage to daughter cells. The cell cycle may be paused and if the damage is severe enough, the p53 and PTEN gene pathways may signal for the death of the damaged cells.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Both the p53 and PTEN genes are classified as <a href="/wiki/Tumor_suppressor" class="mw-redirect" title="Tumor suppressor">tumor suppressors</a> because their pathways oversee the repair of cells that may replicate out of control with damaged genetic material, eventually leading to cancer growth if not kept in check.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Mutation" title="Mutation">Mutations</a> in these genes are seen in more than half of human cancers.<sup id="cite_ref-:1_2-1" class="reference"><a href="#cite_note-:1-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Molecular_oncolytic_therapies">Molecular oncolytic therapies</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Molecular_oncology&action=edit&section=3" title="Edit section: Molecular oncolytic therapies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Immunotherapy">Immunotherapy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Molecular_oncology&action=edit&section=4" title="Edit section: Immunotherapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Immune <a href="/wiki/Gene_therapy" title="Gene therapy">gene therapy</a> is a targeted approach to cancer therapy where actual immune cells of the patient and their genes are manipulated to produce an anti-tumor response.<sup id="cite_ref-:0_5-0" class="reference"><a href="#cite_note-:0-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The body's own <a href="/wiki/Immune_system" title="Immune system">immune system</a> is used to attack the tumor cells, therefore the immune system can naturally attack the specific cancer cells again to in the future if necessary.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Many types of <a href="/wiki/Immunotherapy" title="Immunotherapy">immunotherapies</a> exist including <a href="/wiki/Bone_marrow" title="Bone marrow">bone marrow</a> transplants, <a href="/wiki/Antibody" title="Antibody">antibody</a> therapies, and various manipulations of host immune cells to target and kill cancer cells. <a href="/wiki/Receptor_(biochemistry)" title="Receptor (biochemistry)">Cellular receptors</a>, antigens, and <a href="/wiki/Cofactor_(biochemistry)" title="Cofactor (biochemistry)">cofactor</a> molecules are some such cellular manipulations to target cancer cells.<sup id="cite_ref-:0_5-1" class="reference"><a href="#cite_note-:0-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Chimeric_antigen_receptor_T_Cell">Chimeric antigen receptor T Cell</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Molecular_oncology&action=edit&section=5" title="Edit section: Chimeric antigen receptor T Cell"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Chimeric_antigen_receptor_T_cell" class="mw-redirect" title="Chimeric antigen receptor T cell">Chimeric antigen receptor T cell</a> immunotherapy (CAR-T), possibly combined with <a href="/wiki/Cytokine" title="Cytokine">cytokines</a> and <a href="/wiki/Checkpoint_inhibitor" title="Checkpoint inhibitor">checkpoint inhibitors</a>, are a regularly used form of immune gene therapy.<sup id="cite_ref-:0_5-2" class="reference"><a href="#cite_note-:0-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> CAR-T involves manipulation of a patient's natural <a href="/wiki/T_cell" title="T cell">T cells</a> to express a chimeric antigen receptor. This receptor, now on millions of the patient's T cells, recognizes cancerous cells that express specific <a href="/wiki/Antigen" title="Antigen">antigens</a>.<sup id="cite_ref-:0_5-3" class="reference"><a href="#cite_note-:0-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Usually, the T cell antigen receptor is inactive but when the receptor recognizes a certain cancerous antigen, the physical structure of the T cell changes to destroy the cancer cell.<sup id="cite_ref-:12_7-0" class="reference"><a href="#cite_note-:12-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> This is a method of cancer treatment that works on the cellular and molecular level. </p> <div class="mw-heading mw-heading4"><h4 id="Combining_CAR-T_with_checkpoint_inhibitors,_cytokines"><span id="Combining_CAR-T_with_checkpoint_inhibitors.2C_cytokines"></span>Combining CAR-T with checkpoint inhibitors, cytokines</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Molecular_oncology&action=edit&section=6" title="Edit section: Combining CAR-T with checkpoint inhibitors, cytokines"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some <a href="/wiki/Regulation_of_gene_expression" title="Regulation of gene expression">regulatory proteins</a>, specifically immune <a href="/wiki/Checkpoint_inhibitor" title="Checkpoint inhibitor">checkpoint inhibitors</a>, have been found to reduce the ability of T cells to multiply within the body.<sup id="cite_ref-:12_7-1" class="reference"><a href="#cite_note-:12-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> In order to optimize the efficacy of CAR-T gene therapy, these checkpoint inhibitors can be blocked to stimulate a robust anti-tumor immune response, spearheaded by the CAR-T cells.<sup id="cite_ref-:12_7-2" class="reference"><a href="#cite_note-:12-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> There are various known inhibitory receptors on the CAR-T cell; through manipulation of these receptors and the molecules that bind them, expression of the CAR-T cell can be amplified.<sup id="cite_ref-:12_7-3" class="reference"><a href="#cite_note-:12-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>CAR-T cells can also be combined with <a href="/wiki/Cytokine" title="Cytokine">cytokines</a> to improve the efficacy of the immunotherapy method.<sup id="cite_ref-:12_7-4" class="reference"><a href="#cite_note-:12-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Cytokines are messenger molecules that can act on themselves, nearby cells, or distant cells.<sup id="cite_ref-:12_7-5" class="reference"><a href="#cite_note-:12-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The signal pathways of these cytokines can be used to enhance CAR-T anti-tumor characteristics.<sup id="cite_ref-:12_7-6" class="reference"><a href="#cite_note-:12-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> For example, <a href="/wiki/Interleukin_2" title="Interleukin 2">Interleukin 2</a> (IL2) is a cytokine that acts as a <a href="/wiki/Growth_factor" title="Growth factor">growth factor</a> for various immune system cells, including T cells. In regards to gene therapy, IL2 can be used to increase replication and dispersing of CAR-T cells throughout the body.<sup id="cite_ref-:12_7-7" class="reference"><a href="#cite_note-:12-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Issues_with_CAR-T_therapy">Issues with CAR-T therapy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Molecular_oncology&action=edit&section=7" title="Edit section: Issues with CAR-T therapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There is room for improvement with this gene therapy approach. Firstly, the antigens of interest expressed on the cancer cells may sometimes be expressed on regular body cells, too.<sup id="cite_ref-:0_5-4" class="reference"><a href="#cite_note-:0-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> This means the body's T cells will attack its own healthy cells instead of the cancer cells when the antigen is lacking specificity with just the cancer cell.<sup id="cite_ref-:0_5-5" class="reference"><a href="#cite_note-:0-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> A possible solution to this problem is to include two different antigen receptors on the CAR-T cells to make them even more specific.<sup id="cite_ref-:0_5-6" class="reference"><a href="#cite_note-:0-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The second issue with the CAR-T immunotherapy approach is that it can cause <a href="/wiki/Cytokine_release_syndrome" title="Cytokine release syndrome">cytokine release syndrome</a>. This is when an excess of <a href="/wiki/Pro-inflammatory" class="mw-redirect" title="Pro-inflammatory">pro-inflammatory</a> factors are released by the immune system and can cause unpleasant side effects for the patient like <a href="/wiki/Nausea" title="Nausea">nausea</a> and a high <a href="/wiki/Fever" title="Fever">fever</a>.<sup id="cite_ref-:0_5-7" class="reference"><a href="#cite_note-:0-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Gene_therapy">Gene therapy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Molecular_oncology&action=edit&section=8" title="Edit section: Gene therapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In the past few decades, gene therapy has emerged as a targeted way to treat cancer. Gene therapy introduces foreign <a href="/wiki/Nucleic_acid_sequence" title="Nucleic acid sequence">genetic sequences</a> to diseased cells in order to change the <a href="/wiki/Gene_expression" title="Gene expression">expression</a> of these cancerous cells that are functioning with severely damaged genomes.<sup id="cite_ref-:0_5-8" class="reference"><a href="#cite_note-:0-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Cancer cells do not behave like normal cells, so the methods for ridding the body of these cells are more complicated. Manipulation of the pathways controlled by certain genes and their regulators are a large branch of cancer research. </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Molecular_oncology&action=edit&section=9" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Oncology" title="Oncology">Oncology</a></li> <li><a href="/wiki/Molecular_medicine" title="Molecular medicine">Molecular medicine</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Molecular_oncology&action=edit&section=10" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="http://molonc.bccrc.ca/">Molecular oncology, University of British Columbia</a></span> </li> <li id="cite_note-:1-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-:1_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:1_2-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFTazawaKagawaFujiwara2013" class="citation journal cs1">Tazawa, Hiroshi; Kagawa, Shunsuke; Fujiwara, Toshiyoshi (November 2013). 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