‘My mother’s death spurred on my research’
Dr Tatiana Tatarinova is a senior lecturer in the Faculty of Advanced Technology at the University of Glamorgan.
Five years ago, my mother lost a decade-long battle with kidney cancer – 10 horrible years between the initial diagnosis and mom’s death were an emotional rollercoaster for all of us.
The doctors tried different drugs, we hoped for a cure, then the drugs proved to be either ineffective or had life-threatening side effects.
With every new prescription our hopes were disappearing, and I was angry with the doctors and scientists.
I read research papers about successes of novel experimental treatments but nothing was available to save my mother’s life.
Cancer is one the most well-funded research areas, receiving almost £600m annually. As a result of this intensive research, the cancer survival rate has doubled over the past 40 years. But despite all this research at least 25% of the population will develop cancer in their lifetime and there is no vaccine to prevent it.
One of the biggest issues is that cancer is not one disease but rather a group of diseases caused by environmental factors – tobacco use, poor diet, obesity, infection, radiation, lack of physical activity, and pollutants – or genetics.
Adverse environmental factors may cause abnormalities in the genetic material of cells. Since these abnormalities differ from patient to patient, there are no two identical cancers.
There is currently no established way to fine tune treatments based on the molecular properties of cancer and patient’s genetic make-up.
The situation becomes even more complicated when a combined multi-drug therapy is needed. Some cancer drugs require pre-treatment with facilitating medications and can be delivered only when the concentration of the initial drug reaches a certain level.
Since different people metabolise drugs at different rates, this moment is hard to predict. The only reliable way at the moment is to measure drug concentration – this procedure is expensive and may be too invasive to be feasible.
For therapy with potentially toxic drugs, such as those used in infectious diseases, transplantation and cancer, the medical community routinely accepts enormous variability between patients in drug exposure that would be totally unacceptable in any other scientific or industrial discipline.
Doctors currently prescribe one-size-fits-all standard therapies, hoping they are efficient and have no side effects.
They assume the proposed dosage regimen will hit the target exactly – there is no way to evaluate, control, and minimise the error with which the target can be hit in the real world.
Ideally, a clinician should be able to develop individual treatment plans for each patient maximising drug effect and minimising toxicity.
The combination of patient-specific information and modern mathematical approaches has the potential to improve the quality of care, reduce complications, shorten hospital stays, and lower costs.
Earlier this year we developed a joint, five-year collaborative project between the University of Glamorgan and the Laboratory of Applied Pharmacokinetics, at the University of Southern California.
We will optimise patient drug exposure by combining control of the dose and the timing of the serum concentration measurements in software designed for use by clinicians.
This will be achieved by traditional pharmacokinetics measurements, analysis of patient DNA sequence and application of novel algorithms to process the combined information. We will also develop user-friendly software to be used in hospitals.
Nothing will bring my mother back but I would like my research to prevent tragedies in other families.
To contact Tatiana please email tvtatari@glam.ac.uk.
This article first appeared in the Western Mail‘s Health Wales supplement on the 28th November 2011, as part of the Welsh Crucible series of research profiles.