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When Jesus Christ learned of the death of Lazarus, he informed his faithful disciples: "Our friend sleeps, the more I am going to wake him up."

And, once he arrived at the grave of his friend, four days after his death, he resurrected him.

Two thousand years after the biblical episode, the miracle has not been repeated.

No one has yet returned from the dead, but there have been those who have escaped it in a prodigious way.

The patients are called Lazaro, in memory of the character of the Gospel, and are those who suffer from a very advanced cancer, with metastasis or disseminated.

Statistically, people with such an aggressive tumor have a very short life expectancy.

A fatal outcome awaits most in a matter of a few months.

However, and here lies the extraordinary thing about the fact,

10% of these patients seem to be resurrected when they receive the treatment

, which causes an effect with which the tumor stops growing or even disappears.

Until now, there was no reason to explain why this small percentage of patients responded so well to chemotherapy, but research, published a few days ago in

Cancer Cell

and led by the National Cancer Institute (NCI, for its acronym in English) , has discovered the causes of this phenomenon.

"

We have selected more than 100 Lázaro patients and we have studied them molecularly at all levels

. We have analyzed their genetic material, their DNA, RNA, etc. The objective was to later compare them with the rest of the patients with an evolution of the disease as expected ", declared to this newspaper Dr. Manell Esteller, director of the Josep Carreras Leukemia Research Institute (IJC) and co-author of the study.

Esteller affirms that these patients are special because inside they are going through a complicated and serious illness, they are lucky.

In this sense, he details that, unlike other patients who do not resist equally aggressive cancers,

they have a tumor that acquires a series of lesions

(genetic, molecular, epigenetic ...) that makes it very sensitive to the drugs that they are used to combat it.

"To give us an idea, it is as if a person bought almost all the lottery numbers. It is likely that he will win. The same happens with these patients: they have accumulated three or four injuries that make, given

the treatment received, the tumor cell cannot respond, cannot escape and then dies

", he summarizes.

"An example: a high-grade brain tumor has a genetic lesion in a DNA repair gene and a mutation in a different gene that also repairs DNA. That patient, if he receives a drug that damages DNA, will not be able to fix that defect and that tumor will not be able to grow ", explains the researcher.

In short, genetic defects to win the battle.

Defects, moreover,

that develop by chance

, the miracle of the 21st century.

The specialist states that this clinical picture "is practically by chance because the tumor does not know that it is going to receive the drug. There are other patients who have added injuries in other parts, but who have nothing to do with the treatment" and, therefore , this is not going to have the same effect as in the sick Lazarus.

Strengthen precision medicine

Research results help strengthen precision medicine.

A detailed analysis of tumors at the molecular and cellular level

will be able to predict responses to treatments

.

As Esteller exemplifies, "a patient who has a mutation in gene A must receive a drug against this particular gene."

The expert adds that this is not only applicable to Lazaro patients, but also to other cases with more normal and frequent cancers.

In addition, another of the aims pursued by the study, begun three years ago, is to

transfer the success of this 10% of cancer patients to the remaining 90%

: "We want to find out if, instead of chance that causes these lesions , we can induce them externally through drugs that cause cell change and, once this occurs (that is, a patient turned into Lazarus), give another treatment against that injury ", says the expert.

According to the latest data from the National Institute of Statistics, tumors were the second leading cause of death in Spain (26.4% of deaths) and the Global Cancer Observatory estimated approximately

18.1 million new cases in the world in the year 2018

.

Esteller says that globally, there was until recently an annual increase in survival of 2%, a percentage that has been increasing and is currently close to 3%.

"I think we are on the right track. Obviously, that requires good research and the practical application of these discoveries," he defends.

Of the 111 Lazaro patients analyzed, the researchers found an explanation for the exceptional response that occurred when receiving treatment in 26. Eight of them had a brain tumor;

six, in the intestine;

four, on the chest;

and two suffered from a tumor in the bile duct and two others had lung cancer.

And finally, there were four cases of cancer of the pancreas, endometrium, ovary and bladder.

Therefore,

the exact reasons why the remaining 85 survived have not yet been ascertained

.

"For these cases we have to study other molecular levels such as proteins or metabolism", comments Esteller, who indicates that, in addition to continuing to deepen the investigation, another of the next steps to be carried out is to carry out clinical trials that demonstrate the results published.

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