Cancer is one of humanity The greatest health challenge, it kills millions of people every year. For decades, the treatment of disease has mainly focused on surgery (removing it), chemotherapy and radiotherapy (attacking it). While these actions are still necessary in Comprehensive treatment of the patientRecently, new developments with a more personalized approach have been gaining momentum, with some treatments even going so far as to attempt to “re-educate” the body’s immune system.
Even just a couple of years ago, some of these treatments sounded like science fiction, but the field of oncology is advancing at an astonishing speed — with some developments happening here in Houston. From targeted immunotherapies such as oncolytic virus (OV) therapy and CAR-T cell therapy to the latest genetic testing, here are the top innovations that have the potential to fundamentally change the paradigm of cancer care in the years to come.
Over the past decade, immunotherapy has rapidly become what researchers call the “fifth pillar” of cancer treatment (the first four being surgery, radiation, chemotherapy, and targeted therapies), thanks in part to pioneering immune research led by MD Anderson’s Chair in Immunology, Jim Allison. , Ph.D.
Allison was also awarded the 2018 Nobel Prize in Physiology or Medicine for his fundamental discoveries in T cell biology and his invention of ipilimumab, the first FDA-approved immune checkpoint inhibitor for the treatment of cancer. According to the University of Texas MD Anderson Cancer Center, instead of attacking cancer cells directly (with chemicals and radiation), immunotherapy “trains” our immune system to attack the cancer.
Here’s how it works: Cells of the immune system (also known as white blood cells), such as T cells and antigen-presenting cells (APCs), defend and protect the body. Armored cells act as patrols, searching for cancer and other diseases, and T cells act as soldiers for the immune system. When the APC finds something suspicious, it sends a signal to the T cell, which multiplies and attacks the suspicious cells. But if the T cells are not stopped, they can destroy healthy cells. A security key, called a checkpoint, prevents this. Because cancer is so complex, T cells are often turned off before they are finished working.
With checkpoint inhibitors (also known as immune system-boosting drugs), the most common type of immunotherapy, these T cells can be prevented from stopping working, allowing them to finish their work. And the benefits of immunotherapy don’t stop when treatment ends; Instead, they help the immune system remember the cancer, so that T cells can quickly target the cancer if it comes back.
Immunotherapy is able to treat bladder cancer, head and neck cancer, Hodgkin lymphoma, kidney cancer, non-small cell lung cancer, and melanoma. In March of this year, the James P. Allison Institute was launched, a visionary research and innovation center within MD Anderson designed to advance groundbreaking science, develop new treatments, and bring the benefits of immunotherapy to all patients.
“Immunotherapy has changed cancer care over the past decade, but, unfortunately, not all patients benefit equally,” says Allison, M.D., chief of immunology and director of the Allison Institute. “Our goal is to change that.”
Oncogenic viral (OV) therapy
Viruses are known to be harmful invaders of the body. Usually, we try to avoid viral infections, as viruses can kill healthy cells and cause disease. But some viruses can actually be used to specifically target and infect cancer cells, while leaving nearby healthy cells and tissues intact. These viruses, called oncolytic viruses (OV), can be used as a form of and a trigger for immunotherapy.
There are two main ways that OVs help fight cancer. First, oncoviruses directly kill cancer cells when they infect those cells and cause them to explode. Second, when cancer cells die, they release telltale signs called antigens into the body. These cancer antigens are absorbed by cells of the immune system, which then alert the body’s attacking cells, T cells, to seek out and kill cancer elsewhere in the body.
Several OVs are under clinical testing. According to Shawn Chang, MD, director of the Center for Nuclear Receptor and Cell Signaling at the University of Houston and MD Anderson, different forms of immunotherapy, such as immune checkpoint blockers, have produced significant benefits, but only work on approximately 15 percent of cancers. The patients.
“In recent years, some new cancer treatment technologies have really revolutionized cancer treatment. The treatment I’m working on, called cancer virotherapy, has generated a lot of excitement for cancer treatment,” says Chang. Basically, you combine two of the best cancer treatments [OV and immunotherapy] together not only to increase the benefit for the majority of cancer patients, but also to enhance the benefits of immunotherapy for cancer patients.”
Another huge advantage of OV, Zhang says, is that it’s much less toxic than chemotherapy. These improvements are now being made in Zhang’s lab, which received a $1.8 million grant this year from the National Institutes of Health to support its work.
“Oncolytic viruses induce a robust immune response against viral components and tumor antigens, which is a promising strategy for targeting tumors lacking T cells that are not amenable to immunotherapy,” Zhang says.
CAR T-cell therapy
Another form of immunotherapy, called CAR-T cell therapy, has also generated enthusiasm among researchers and oncologists. The treatment, which stimulates immune cells to track down and kill cancer cells, was announced successful for leukemia patients this year after a 10-year follow-up of two of the first patients treated with CAR-T cells.
Treatment involves removing and genetically modifying T cells from cancer patients. The modified cells then produce proteins called chimeric antigen receptors (CARs). Six CAR-T cell therapies have been approved by the U.S. Food and Drug Administration to treat leukemias, and they hold tremendous promise in treating solid tumors.
Today there are hundreds of thousands of people at risk of developing cancer who do not know it and can benefit from targeted therapies. The frustrating point to learn about immunotherapies was the unpredictability of who would benefit from them and who would not.
While scientists have been able to successfully map a person’s genetic information to create more personalized treatments, it is now also possible to analyze a person’s tumor DNA and use treatments designed to target specific mutations present. By analyzing an individual’s DNA, doctors can identify mutations that put them at high risk of developing certain types of cancer. Patients can then be placed on specific treatments, customized to them, aimed at prevention.
As the largest “medical city” in the world, Houston is at the forefront of advancing the life sciences and setting standards for the medical field. From Memorial Hermann being one of the busiest Level 1 trauma centers in the country to Houston Methodist that has established itself as a leader in cardiovascular and transplant treatments, our hospital systems provide access to some of the best care anywhere. And now in terms of contemporary cancer care research, organizations like MD Anderson and its network of subsidiaries across the country are helping to make breakthroughs in the face of our greatest health challenge.
For more information about emerging cancer treatments, consult your doctor or visit cancer.gov.