Pioneering trial targeting cancer-causing gene starts in Kenya

In a first in Africa, a clinical trial is underway in Kenya to study the effectiveness of a new treatment model that blocks the activity of a gene mutation that causes cancer in patients.

The gene under investigation at the Aga Khan University Hospital, Nairobi (AKUH,N) is known as the KRAS gene and is reportedly responsible for the development of lung cancer, colon cancers, and some other human cancers.

“The KRAS gene is what we call a housekeeping gene, present in all cells of the body and is responsible for growth and survival of normal cells. In normal conditions, the KRAS gene gets activated when parts of the human body grow and become functionally active.  After that, KRAS goes into the in-active state,” explains Prof Mansoor Saleh, the Director of the Aga Khan University’s Cancer Center and the Hospital’s Clinical Research Unit.

“Sometimes, however, KRAS activation becomes uncontrolled resulting in uncontrolled growth, which then leads in some cases to cancer.  In about 30 percent of cancer tumours, the KRAS gene is mutated and goes into an uncontrolled activation state making it a cancer-causing gene or anoncogene.”

Recently, scientists have developed inhibitor molecules that block the activation of the KRAS G12C oncogene, a mutated KRAS gene, which is reportedly responsible for the development of cancers. This inhibitor molecule has the potential to block cancer-causing properties of KRAS G12C.

The pioneering trial in Nairobi is a piece of welcome news in the healthcare industry, especially in the fight against cancer, the third leading cause of death after infectious and cardiovascular diseases according to the National Cancer Institute of Kenya.

Latest data shows that breast, cervix uteri, oesophagus, prostate, and colorectum are the leading types of new cancers in both men and women across all ages, with oesophageal cancer the leading cause of cancer deaths, followed by cervical and then breast cancer.

The novel study in Kenya follows the approval of a similar drug to treat lung cancer by the USA’s Food and Drug Administration two years ago.

“The Cancer Center at the Aga Khan University Hospital recently embarked on a clinical trial to test the anti-tumor property of GDC 6036, an experimental treatment that blocks the activation of the KRAS G12C oncogene in human tumours.  The pill developed by Roche Pharmaceuticals is intended to block the function of KRAS G12C and thereby stop the uncontrolled cell growth and division of cancer in those patients,” added Prof Saleh.

A similar gene blocker recently received FDA approval specifically for use in patients with lung cancer who carry the KRAS G12C mutation.

“When detected early, surgery, conventional chemotherapies and radiation therapy can be successful and curative. However, when conventional therapy fails, the outcome is often bleak. This gene blocking therapy is the first such precision oncology treatment on a patient with metastatic colon cancer, whose tumour carries the KRAS G12C mutation,” added Prof Saleh.

The first patient in the African continent on this trial is a Ugandan national who is currently receiving this experimental therapy.

AKUH,N’s CEO Rashid Khalani noted that the trial is in line with the hospital’s commitment to increase the participation of Africa in global cancer trials.

“To deal with the cancer menace, we must increase the research on the disease, invest more in public awareness and more importantly train more specialists to take care of the increasing number of cancer patients,” said Mr Khalani.

“Research has found that there are genetic differences between the African population and the rest of the world. This means that we have to study novel treatments on our population for they may respond differently or have more or less toxicity than patients from the West. This is exactly the reason why we at Aga Khan University have made the conduct of clinical trials and the establishment of the clinical research unit our mandate,” explained Prof Saleh.

The International Agency for Research in Cancer (IARC) GLOBOCAN 2018 report reported about 47,887 new cases of cancer per year with a mortality of 32,987 people, a 45 percent jump in incidence compared to the previous report that estimated 37,000 new cancer cases annually with a mortality of 28,500 in 2012.

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