Chemotherapy would have damaged the cancer cells and made them less likely to live on in lab cultures, which is a rare scientific achievement. But chemotherapy also might have boosted Koss’ chances of survival.
"She is very brave and self-sacrificing," Keith Jones, PhD, says in a press statement. Jones is leading the research team culturing the cells. He is chair of the Department of Molecular Pharmacology and Therapeutics at the Loyola University Chicago Stritch School of Medicine.
"I think we can unlock the secrets of these deadly cells," Koss says in the statement. "I have a daughter and three granddaughters. I hope they never get this disease. But if they do, new treatments could be their salvation, as well as the salvation of many other women."
A Tale of Two Women
Koss, who recently retired from the University of Cincinnati, has an especially aggressive case of triple-negative breast cancer, which is hard to treat, even in less severe cases. Triple-negative tumors don’t respond to some standard medications. Ironically, the very aggressiveness that threatens Koss' life also makes her cells good candidates to multiply in cell cultures.
"Dr. Koss' tumor is highly invasive and measured abnormally high” for growth, Jones says in an e-mail to Medscape Medical News. "This means that her cells undergo cell division rapidly. This is a characteristic of cancer cells that have been successfully grown in culture in the past."
Most cancer cells are not as aggressive as Koss', and thus cannot continue to reproduce outside the body in the less hospitable host of a lab culture. Cancer cell lines have been used for decades in research, but were little known outside of laboratories until a book about them became a bestseller. The Immortal Life of Henrietta Lacks, by Rebecca Skloot, described the genesis, long life, and wide use of the now famous HeLa cell line.
But there is a big difference between Henrietta Lacks and Koss.
Lacks' cells were cultured and reproduced without her knowledge or consent, and were later exploited by medical institutions and companies. It's been pointed out, though, that patient consent was not commonplace at the time.
One of the consequences of the publicity created by the book was a "unique agreement" reached in 2013 between the National Institutes of Health and the Lacks family.
Any successful cell line from Koss would not be exploitive or without consent. It was her idea.
'An Opportunity We Did Not Have Before'
Koss suggested entrusting her tumor cells to Jones, her former colleague, when he visited her in an oncology critical care unit.
"Dr. Jones is absolutely the smartest researcher I've ever met," Koss says. "I trust him on every level."
Jones and Koss control the rights to her cells. In the next 6 months or so, Jones and his Loyola team should know if the cells can live on in lab cultures.
There is an outstanding need for more immortal breast cancer cell lines, Jones says.
Cancer cell lines are valuable because they aid basic research and set the stage for clinical advancements, Jones says.
In the case of triple-negative breast cancer, basic questions are unanswered, such as the source of the cells' abnormality, rapid growth, and invasiveness.
The development of cancer cell lines has entered a new era, Jones suggests. And Koss' contribution takes advantage of that.
He explains that technologic advancements now allow for more thorough analysis of a tumor. Researchers "can therefore repeat these analyses in the cell lines to confirm their gene structure and expression," he says.
The result is better scientific evidence.
"This will allow us to confirm that the cell lines used for study reflect the actual tumor tissue the way it was in the body, before it was extracted," he says. "This is an opportunity we did not have before."