In 2017 we published a study that identified the cells that are responsible for generating metastases. Before we did not know if all cells have metastatic competition. And what we discovered is that they are not all, fortunately, it is a very low percentage. Once we identified them, we were able to ask ourselves what distinguishes these cells from the rest, and there we began to see that those with metastatic capacity need a tremendous energy supply.
And what have they discovered now?
One of the big questions we've tried to answer is what fatty acids do you need and in what concentration. And what we have seen is that, fortunately, of the main fatty acids that we have in the diet, almost the only one that has this potential to promote metastasis is palmitic acid. While for example oleic acid, the main ingredient in olive oil, in some patients it is harmless and in others it has a protective effect against metastasis.
What else have they found out?
That once the metastatic cell ingests that palmitic acid, it uses a little to get energy and the rest to carry out a kind of uncontrolled regenerative state and signal the other cells to enter that state as well. The cells migrate in all directions and have a great capacity to survive, which for the patient is a horror. All this is orchestrated by palmitic acid. While we wish we understood it all, we are still on the tip of the iceberg as to what acid and other components generate in cells to give them this extraordinary ability. In human terms, a metastatic cell does the same as a human running to New York and once there, establishing a new city.
"A metastatic cell does the same as a human running to New York and founding a city there"
How have they carried out the investigation?
We use many techniques. For example, we take samples from patients and transplant them into mice, in the same area where the tumor appeared in the patient and normally the Cancer behaves practically the same. What happens in the mouse happens faster. We combine this with molecular biology technology to understand the tumor.
Does this finding affect only metastases or also early-stage cancer?
Objectively and although it surprises us, it seems that it only affects metastasis. Primary tumors need fat, but they do not have the dependency that metastatic cells show. Sugar and amino acids play a more important role in the primary tumor. But, for some reason, metastatic cells need palmitic acid, it is one of their great strengths but it is also one of their great weaknesses because they are like addicts, so if you prevent them from ingesting that fat, they are not able to survive.
Given this discovery, what do you recommend to consumers?
Palmitic acid is synonymous with life, it is present in the body because cells are capable of producing it to function properly. It is true that it is more present in dairy products, red meat, sausages and any product with palm oil. And we consume more fat than we should, so there is a problem of obesity in society. But I am reluctant to make recommendations because I am not a nutritionist. On a personal note, I recommend eating with common sense, not gorging yourself on cakes and greasy things. A healthy, balanced diet is good.
"Sugar and amino acids play a more important role in the initial tumor than palmitic acid"
Does the finding open the door to further research or possible blockage of metastases?
Yes, we are working on that. As we are pulling the thread, we discover more mechanisms of action of metastatic cells and we have seen that, if we block some proteins, the cell loses capacity. We have already identified five or six targets and in one of them we are very advanced to take the step of trying to transfer the findings in the laboratory to the clinic.
What are those targets?
We have developed different strategies that block the entry of palmitic oil into the cell and since it is almost addicted, it is no longer able to survive. We have also seen that when the cell enters a regenerative state and deceives the rest, it has to communicate and we are trying to block that communication. We have different strategies. And hopefully other researchers will do a clinical trial to see if it does indeed work to modify the diet of patients so that they ingest low levels of palmitic acid.
How has the research been funded?
Through money from the Generalitat, the central State, the EU and non-profit entities.
What is the next step?
We are at the tip of the iceberg. We have identified so many parts of the metastatic cell that we have a lot to understand. For example, how it detaches itself from the primary tumor, how it enters circulation both in the blood and in the lymphatic pathways, how it attacks the immune system, how it survives and why, once it reaches the metastatic area, there is a period sometimes latency and all of a sudden, for some reason, it kicks in and starts generating tumors.
"It remains for us to understand how the metastatic cell detaches from the primary tumor and how it survives"
Are investigations against covid will they help in the fight against cancer?
Much has been spent on mRNA vaccines and perhaps there will come a time when we realize that this can be beneficial in the fight against cancer. And society has realized the importance of research. Indirectly, everything helps so that there is more investment.