Surgery, chemotherapy and radiation are the most common types of treatments available for cancer. Depending on the stage and grade of cancer, these treatments can be very successful, especially when used in combination. Many cancers, however, have the ability to evolve and resist treatment.
Immunotherapy and targeted therapies are two of the most promising options in dealing with advanced and resistant cancers. Ongoing research and clinical trials are focussing on developing powerful new drugs and therapies that can combat the spread of cancer.
T-cells are a vital part of the immune system as they destroy virally infected cells and cancer cells. Cancer cells produce a molecule which stops T-cells from recognising them as a threat, which allows the cancer to grow. Immunotherapy drugs attach themselves to T-cells, blocking the cancer's ability to evade detection. The cancer is then attacked and destroyed.
Immunotherapy can save lives when other treatment options, such as surgery, radiotherapy or chemotherapy, have failed. However, it cannot help all patients, and some cancers are resistant to immunotherapy.
Because cancers have the ability to evolve and become resistant to immunotherapy, new treatment options are constantly been developed. New two-pronged cancer treatments combine immunotherapy with revolutionary new drugs which has the ability to combat the cancer’s resistance.
Examples of modified immunotherapy include:
- The use of DNA hypomethylating agents
- Immunotherapy with Guadecitabine
- Immunotherapy Drug Pembrolizumab
DNA Hypomethylating Agents
They work by switching off an enzyme (DNMT) which prevents gene transcription. The hypomethylating agent works by removing methyl groups which allows gene transcription to continue including genes that increase immunotherapy response.
Immunotherapy With Guadecitabine
The dual combination could become an effective new treatment against several forms of cancer and can stop cancer from advancing in patients who are resistant to immunotherapy.
When immunotherapy is combined with a next-generation DNA hypomethylating agent drug called guadecitabine, it can reverse cancer’s resistance to immunotherapy. Patients expected to die after exhausting all treatment options survive much longer.
Patients involved in the trial for this combination therapy included those with lung, breast, prostate, and bowel cancer. The new treatment seems particularly beneficial for lung cancer patients.
Immunotherapy Drug For Treating Advanced Cervical Cancer
About 2,600 women are diagnosed with cervical cancer every year in England. A new immunotherapy drug has recently been made available on the NHS for incurable forms of advanced cervical cancer. About 400 women with advanced forms of the disease will now benefit from the treatment.
Given in combination with chemotherapy, the immunotherapy drug pembrolizumab stimulates the body’s immune system to fight cancer. It targets a specific protein that enables the drug to wipe out cancer cells. It can help extend patients’ lives by as much as eight months on average.
Targeted therapies are drugs that can find and attack cancer cells. Most types of targeted therapy treat cancer by interfering with specific proteins that help tumours grow and spread throughout the body. This is different to chemotherapy, which kills all cells that grow and divide quickly.
Many cancers that respond to targeted therapies eventually become resistant to the drugs. When these drugs stop working, patients often have few, if any, treatment options.
As researchers learn more about the DNA changes and proteins that drive cancer, they are better able to design more effective treatments. New targeted therapies are currently being studied in clinical trials with promising results.
Examples of revolutionary new targeted therapies include:
- The drug Mobocertinib is used for treating a rare and aggressive form of lung cancer. Mobocertinib specifically targets the cancer cell mutation to slow the growth of cancer cells.
- New targeted therapy using 'armed' antibodies to treat prostate cancer. This treatment targets a protein found on the surface of the most lethal prostate cancers.
Nuclear medicine has been used for decades but is constantly being advanced. Radiopharmaceutical therapy (RPT) has emerged as a safe and effective targeted method of treating many types of cancer.
Nuclear medicine is used in diagnosing and treating certain illnesses. It combines the precision of targeted therapy with the power of radiation therapy. It uses radioactive drugs called radiopharmaceuticals to target cancer cells and bombard them with radiation, causing them to die or stop growing. Radiopharmaceuticals are administered to patients in different ways. For example, they may be given by mouth, given by injection, or placed into the bladder.
Molecular radiotherapy (MRT) is a rapidly expanding area of nuclear medicine. It uses radionuclides to treat benign thyroid disease (hyperthyroidism), thyroid cancer, lymphomas, and bone pain from some types of cancer.
Blood Cancer Therapy
Blood cancer is the 5th most common type of cancer in the UK. Diffuse large B-cell lymphoma (DLBCL) is the most common form of blood cancer affecting around 5,000 people each year in the UK. Primary mediastinal B-cell lymphoma (PMBCL) is much rarer, with up to 300 people affected a year. Up to 450 patients with both these lymphomas could benefit from the new therapy each year.
The blood cancer CAR-T therapy, which uses the drug axicabtagene ciloleucel, has recently been approved for routine use on the NHS in England. The drug can treat those with DLBCL or PMBCL cancer who relapse after two or more different types of treatment.
CAR-T is a type of cancer treatment that uses the immune system to kill cancer cells. Samples of immune cells are taken from the patient and genetically modified before putting them back into the patient’s blood system to fight cancer.