Cancer cells can become treatment-resistant, acquiring mutations that aid their survival and lead to disease relapse. But now scientists studying T-cell leukaemia [a type of blood cancer] have found that cells can acquire a potent survival mutation spontaneously. By allowing cancerous cells with different mutations (two types shown in blue and yellow on the right) to compete for survival in zebrafish (pictured) they identified which mutations caused the most cases of relapse. Lasting more than five years and involving over 6,000 fish, the study found that the majority of relapse-causing cells had a mutation in a gene called AKT, which opened up a pathway for cells to signal each other. When this pathway was active there was resistance to chemotherapy. Blocking AKT allowed the treatment to kill cancerous human cells. Identifying patients with an AKT-mutated tumour could help doctors prescribe the most effective treatment, curbing the risk of relapse.
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