Chemotherapy side-effects preventing hormone identified

A naturally occurring hormone could help make chemotherapy treatments more effective for lung cancer patients and even prevent kidney damage, a serious side effect of cancer therapies, a study has found.

Despite advances in immunotherapy for lung cancer, most patients are still treated with chemotherapy based on a drug called cisplatin.

However, less than a third of these patients will see benefits, and they often develop serious side effects including kidney damage.

In an effort to improve outcomes for lung cancer patients, researchers from Garvan Institute for Medical Research and the Hudson Institute of Medical Research in Australia discovered that a protein called activin is a culprit in both chemotherapy resistance and chemotherapy-induced kidney damage.

"In chemotherapy-resistant tumours in mice, activin gets switched on in response to the damage caused by chemotherapy," said Neil Watkins, who began the research at Hudson Institute.

"Cancer cells can then enlist activin to protect themselves. At the same time, when activin is switched on, it promotes kidney injury," Watkins said.

Researchers put a hormone known as follistatin to the test. They found that, in mice, treatment of follistatin in combination with platinum chemotherapy caused lung tumours to shrink and more animals to survive longer.

Remarkably, they found that kidney damage was also prevented.

"Discoveries like this one - a combination therapy that actually reduces damage while improving effectiveness of chemotherapy - are exceedingly rare in cancer research," said Marini, who undertook the research as part of his PhD at Hudson Institute.

"Many of us have heard about the devastating side effects of chemotherapy in cancer patients. Our discovery has the potential to not only increase the effectiveness of platinum chemotherapy, but also give patients a better quality of life by preventing kidney damage," said Marini.

Use of follistatin is likely to be a safe and effective approach to making chemotherapy more effective in lung cancer, Watkins said.

"Because follistatin is a hormone already found in the human body, there is much less potential for toxicity than with other drugs used to reduce chemoresistance," he said.

Watkins plans to study other tumours where platinum chemotherapy is commonly used, such as bladder and head and neck cancers.