Fighting cancer is tough enough, but when a patient’s body begins to rebel against the drugs intended to kill the cancer that’s a whole new level of stress, physically and mentally, that no one needs. Yet up to 27 percent of the people receiving chemotherapies using platinum-based antineoplastic agents (platins) experience drug hypersensitivity reactions. “That’s almost one in three patients,” says Basar Bilgicer, associate professor of chemical and biomolecular engineering, affiliated faculty member of Advanced Diagnostics and Therapeutics at Notre Dame and leader of a team of researchers addressing this issue.
The most common drugs used in chemotherapy treatments today are platins. They are used to treat a variety of cancers — from ovarian and endometrial to colorectal and pancreatic. In general, these drugs have been proven very effective. However, they are also the source of drug hypersensitivity (allergic) reactions that are much more severe than the watery eyes or runny noses associated with hay fever, such as life-threatening anaphylactic reactions.
There are two approaches to prevent these allergic reactions: change the treatment regimen to another chemotherapeutic or run a rapid drug desensitization (RDD). “RDD was developed by Dr. Mariana Castells at the Brigham and Women’s Hospital, one of the members of our team,” says Bilgicer. “It induces temporary tolerance by delivering frequent partial doses in a short period of time. Patients eventually receive a full therapeutic dose of the platin but experience minimal reactions or none at all.” While effective, RDD does nothing to help identify patients at risk of a platin reaction. Nevertheless, a physician needs to be aware of the condition in order to implement the RDD procedure at the time of treatment.
Until recently, no predictive diagnostic tests had been developed to help identify patients who were sensitive to platins other than traditional skin testing. One problem with skin testing, although highly effective, is that it requires a two-week delay between the time of testing and the first chemotherapy treatment. Time that is critical to many cancer patients. The other concern is that even skin testing can induce a severe reaction in some allergic patients.
This was the challenge for Bilgicer and his team — Castells, Dr. Marina Labella and Ather Adnan [Brigham and Women’ Hospital at Harvard Medical School]; Dr. Leticia De las Vecillas [Marques de Valdecilla University Hospital-IDIVAL, Spain]; and Peter E. Deak and Baksun Kim [Department of Chemical and Biomolecular Engineering at Notre Dame] — as they worked in conjunction with the Mike and Josie Cancer Research Institute at Notre Dame. Their solution was published recently in the Journal of Allergy and Clinical Immunology.
The paper “Nanoallergen Platform for Detection of Platin Drug Allergies” describes the nanoparticle-based diagnostic method developed by Bilgicer and his team that identifies cancer patients who are sensitive to platin drugs in a more rapid and reliable way. In essence they engineered nanoallergens that identify platin allergies using a patient’s blood samples without exposing the patient to the risks or delays of skin testing.
Bilgicer focuses his work on understanding the dynamic principles of multivalent biomolecular interactions, specifically as they relate to diagnostic and therapeutic molecules, in order to deliver novel solutions to complex diseases, such as cancer, autoimmune diseases and allergies. For more information about his research, visit https://www3.nd.edu/~bbgroup/
Originally published by at conductorshare.nd.edu on March 15, 2019.