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Cancer de Pancreas
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Cancer de Pancreas

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Tiene una mala fama que hace triste honor a la realidad. Aunque el cáncer de páncreas no es de los más frecuentes, las estadísticas indican que la tasa de supervivencia apenas alcanza el 10% (en el caso del de mama, por ejemplo, supera el 50%). Ahora, un importante trabajo publicado en las páginas de la revista 'Science', acaba de apuntar una nueva clave que permite comprender el porqué de esta merecida mala prensa.

La clave podría estar en el tipo de vasculatura de este cáncer (que afecta cada año a unos 4.000 españoles). Imagine que el tumor es un enmarañado ovillo de vasos sanguíneos, a través de los cuales las células tumorales reciben el oxígeno y los nutrientes que necesitan para reproducirse. Pero también los fármacos que deben llegar hasta ellas para eliminarlas.

Según el trabajo dirigido por Kenneth P. Olive, de la organización Cancer Research, con sede en Cambridge (Reino Unido), en el caso del cáncer de páncreas, estas vías de abastecimiento están configuradas de tal manera que no permiten que la quimioterapia llegue hasta las células malignas, como si en lugar de tubos bien estructurados fuesen apenas unos hilillos débiles y fragmentados. Esto hace que en muchos casos la vida del fármaco (la gemcitabina es el más frecuente) por el organismo se 'apague' antes de haber podido alcanzar su objetivo.

Para tratar de remediarlo, el equipo formado por científicos de Reino Unido, EEUU, Australia y China, decidió combinar la quimioterapia con otro compuesto dirigido a incrementar y reforzar los vasos sanguíneos del tumor. Esta sustancia inhibe una vía de señalización bien conocida por los investigadores que se denomina Hedgehog (literalmente, 'erizo'), capaz de desencadenar una serie de eventos intracelulares que provocan la proliferación de las células.

Mejorar la administración de fármacos
La nueva combinación mejoró la llegada de la gemcitabina hasta los tumores pancreáticos, incluso retrasando la progresión de la enfermedad en los ratones de laboratorio empleados para el trabajo.

Como explica a Christopher Heeschen, un investigador alemán especializado en cáncer de páncreas que trabaja en el Centro Nacional de Investigaciones Oncológicas de Madrid (CNIO), el trabajo apunta importantes cuestiones en relación con esta enfermedad. "Comprender mejor el microambiente que rodea al tumor será clave para mejorar la administración de los fármacos", señala. Y esto es particularmente en el caso del cáncer de páncreas, cuyas células malignas están rodeadas por una amplia red de elementos extracelulares que se conoce como estroma (una especie de armazón de tejido conectivo, capaz de sustentar los órganos y glándulas del cuerpo humano; o bien una masa tumoral).

Debido a la importancia que cada vez adquieren los tejidos 'vecinos' al tumor, las conclusiones del estudio son para Heeschen, "de alguna manera predecibles, pero aún así de un gran valor científico". Aunque reconoce que es pronto para pensar en que este trabajo pueda tener alguna aplicación clínica por el momento, "puesto que aún debe probarse en un entorno clínico".

De hecho, Heeschen considera que además de mejorar la administración de los fármacos hará falta solventar otro escollo que participa en las recaídas, la existencia de un pequeño núcleo de células madre capaces de resistir al tratamiento con quimioterapia. "Por eso en los ratones sólo se vio una estabilización parcial de la enfermedad", explica, "porque incluso aunque seamos capaces de hacer llegar la gemcitabina de forma activa al tumor, ésta sólo ataca las células que se están diferenciando, pero no a estas células madre, capaces de sobrevivir al tratamiento". elmundosalud
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