Has chemotherapy come to an end? Will immunotherapy replace it? What does the dizzying speed of emergence of new targeting factors mean? Will mRNA technology vaccines give us the “magic bullet” for victory over the deadliest cancers? The news from the international scientific community about cancer is a lot and extremely encouraging. But what do the new treatments promise to each patient and how can their promises be fulfilled?
The end of chemotherapy?
“In the last decade, chemotherapy is used less and less but it still maintains an important place in our arsenal, mainly due to the speed with which it manifests its action. Another reason is that it is increasingly combined with immunotherapy in treatment programs. “In short, chemotherapy has lost a lot of ground compared to the past but it still remains useful.”
One of the new treatments for the benefit of which chemotherapy has “retreated” is the targeted treatment, which now occupies an important place in the therapeutic quiver. Because it has given results that no oncologist could have imagined a few years ago. If we take into account immunotherapy with its very encouraging results, conjugated antibodies and the fact that clinical trials of a vaccine against a specific type of cancer (melanoma) have begun, then we can now talk about a new era against cancer. An era in which there are so many effective weapons to treat cancer that it can no longer be considered a chronic disease such as diabetes and hypertension.
The era of personalized therapy
Scientific research in recent years has shown that every patient’s cancer is different. Patients with the same type of cancer and at the same stage may need different treatment. Each patient is now treated individually. The result of this treatment is that chemotherapy, as a more general form of treatment, gradually loses its place and importance, giving way to personalized medical treatment.
“Nowadays we have tools for analyzing the molecular profile of each tumor and each patient. We can easily and at a relatively low cost analyze the genes of each patient and identify those responsible for the creation and development of the specific tumor that afflicts him. To discover the or the basic mutation, the one that leads to carcinogenesis. Depending on the results we will find, we will proceed with therapeutic solutions. It can e.g. to find out that there is already a cure for this mutation or that in its treatment many molecules are involved that are already in research aiming for a reliable treatment, in a short time. “This form of treatment is easy but it has two problems: the high cost of drugs and the different form of toxicity in relation to chemotherapy,” says the doctor.
The contribution of immunotherapy
Today, a cure that used to be just a dream of humanity has become a reality. It is a treatment of various tumors with the help of the natural forces of the human body. This treatment is called immunotherapy. It consists of administering drugs that “liberate” our immune system in order for it to attack the cancer as many times as it needs to kill it. How does this happen? Cancer uses physiological mechanisms that suppress the body’s immune response after first being identified and attacked, so that the patient’s immune system can no longer neutralize the tumor.
Modern immunotherapy drugs have succeeded in recognizing cancer and not being able to stop the constant attack against it. And, although it still has several problems waiting to be solved, immunotherapy has in many cases achieved the impossible. It has given back their lives to many cancer patients.
This treatment is not without side effects. It affects, potentially, all organs, in the way that autoimmune diseases affect them.
However, it is generally well tolerated and in many cases patients do not even realize that they are receiving treatment. This is a huge improvement over the devastating side effects of chemotherapy in recent decades. In fact, the discussion about immunotherapy today is now about whether immunotherapy is worth giving preoperatively to earlier forms of cancer or immediately after surgery, when the patient is free of his disease.
The conjugated antibodies
They are monoclonal antibodies that “trick” the cancer cell that allows them to penetrate into it and release a toxic agent that is deadly to itself and to adjacent cells. The results are impressive while their biological toxicity is acceptable. This is the medical version of the Trojan Horse. A major concern regarding the generalization of their use is their potentially (very) high cost, due to the precise technology required for their production.
Cancer vaccines
For at least three decades, research has been done on the potential of mRNA (“messenger” ribosonucleic acid), with the aim of creating all kinds of vaccines, including vaccines against cancer. Although the technical problems that had to be addressed were many, the researchers successfully solved them and thus paved the way for the development of mRNA-based vaccines, initially against various infectious agents and, now, against specific forms of cancer. Clinical trials have already begun where such vaccines against melanoma and other solid tumors are being tested.
What is the message of cancer science today?
We are in an era of impressive discoveries and progress. In the fight against cancer, each person has in the service of their health three “weapons”, two known enhanced as never before by the great scientific achievements in the field of computing and imaging and a new and very promising one. These are:
• Primary prevention, which remains the No. 1 way to prevent many cancers.
• Early diagnosis (secondary prevention), which prevents cancer at its onset and often leads to its complete cure.
• Innovative new personalized treatments that, by jumping over their various problems, save more and more lives.
Writes:
Mr. Vassilios Barbounis, Pathologist – Oncologist,
Director of the DG Oncology Clinic of the Metropolitan Hospital
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