Drug Susceptibility and Drug Resistance in Cancer Is More Complicated Than Bacterial Resistance

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As far back as the 1950s, there has been an interest in developing technologies to better predict cancer drug susceptibility. The Initial hope was to measure drug sensitivity in cancer cells like that in infectious disease. It was a desire to develop a create a cancer assay similar to the routine test in clinical hospital laboratories by growing bacterial cultures and determine bacterial drug susceptibility and drug resistance. However, reproducing that same milestone for cancer has been difficult to achieve for several reasons. First, extracting cancer cells and growing cancer cells from tumors has been difficult. Second, early efforts to grow cancer in cultured system was initiated in traditional flat 2-dimensional (2-D) cultured systems. Cultured cells grown in 2-D cultured systems have failed to be predictive in evaluating drug susceptibility. Third, cancer cells grown under 2-D cultured conditions transform and lose their original properties rather quickly. Thus, the cancer field shifted towards different approaches by identifying gene mutations and expression of unique proteins measured in tumors.