Pharma and Health from Ingredients to Pills: Cancer Therapeutics Today(1)

Treatment of oncologic patients has progressed greatly in the last few years with the development of novel technologies and drugs Anti-Cancer War to Date Since President Nixon (1971).

The War on Cancer can claim countless successes against one of the most resilient and recalcitrant enemies mankind has faced in its 49-year history.  Since then, we have made major strides against cancers. Some cancers that were once certainly fatal, such as pediatric leukemia, now have a high survivability rate. Another example: renal cancer, the 5-year survival rate has increased from about 50 percent in 1971 to more than 70 percent at present. Colon cancer has seen similar success over the years, experiencing a rate increase from 52 to more than 66 percent. (1) Death rates have been declining for 25 years. Breakthrough treatments and cures are now coming at breakneck speeds.

Fighting cancer is like going through a war. From pharmaceutical, therapeutic, technological and even immuno-advancements, the war on cancer has been an ever-evolving fight that we are slowly winning.

Curing cancer is certainly one of the largest challenges of the 21st century. Our knowledge of cancer has greatly improved just over the last two decades, revealing a massive variability that can be found between not only different types of cancer but also between patients with the same type of cancer.

Novel Technologies and Drugs for Cancers

Treatment of cancer patients has progressed greatly in the past few years with the development of new technologies aiming to help a patient’s immune system identify and attack tumors, which could make a big advancement in the way we treat cancer, bringing us closer to being able to cure this disease.  

Personalized Cancer Vaccines 

To create a personalized cancer vaccine, scientists must identify cancer-specific peptides called neoantigens, then use a cell-, protein-, or nucleic acid–based platform to deliver those neoantigens to patients to prime the immune system to attack the tumor.

Somatic mutations can generate cancer-specific neoepitopes that are recognized by autologous T cells as foreign and constitute ideal cancer vaccine targets, which are often at the center of new therapies.  Technological advances in genomics, data science, and cancer immunotherapy now enable the rapid mapping of the mutations within a genome, rational selection of vaccine targets, and on-demand production of a therapy customized to each individual tumor. By comparing the DNA sequences of the tumor to those of healthy cells, researchers can identify specific cancer related mutations and select the ones that are more likely to provoke a strong reaction from the immune system.  First-in-human clinical trials of personalized cancer vaccines have shown the safety, feasibility, and immunotherapeutic activity of targeting individual tumor mutation signatures. (2) 

Personalized cancer vaccines represent a potential new class of cancer immunotherapy. There are currently more than two dozen ongoing Phase 1 and Phase 2 clinical trials using different vaccine platforms such as DNA, RNA, synthetic long peptides, and dendritic cells. The field is still young, but predicting antigens produced by patients’ cancer cells could yield successful treatments for individuals with a range of cancer types without severe adverse events.

Immune Cell Engineering

The last few years have been an era of exuberance in cancer immunotherapy in general and in the use of engineered immune cells more specifically such as CAR-T cell therapy. A chimeric antigen receptor (CAR) is a synthetic antibody on the surface of T cells that enables T cells to target and kill cancer cells. The CAR combines the specificity of a monoclonal antibody with the cytotoxic and memory functions of T cells. The emergence of synthetic biology approaches for cellular engineering is providing us with a broadly expand the applications of immune cell engineering for therapeutic purposes. (3)

The most successful CAR-T cell therapy to date is targets CD19 (CAR-T19), which was approved by the Food and Drug Administration (FDA) in 2017 for the treatment of B cell malignancies. (4) However, the technology has also shown some severe side effects that led to patient deaths. The optimism about T cell cancer therapies remains tempered by concerns about safety and off-target toxicity, as well as the development of resistance.  Another issue with the technology is its six-figure price. (5) Moreover, individual cancer types present different challenges, and thus, the types of engineered behaviors that they need will be different. Currently, several companies are developing the next new generation of CAR-T treatments that can target a wider range of cancers.

Read More:

Pharma and Health from Ingredients to Pills: Cancer Therapeutics Today(2)

About the Author:

Lin Zhang, M.D., senior director of a health care industry company in the United States. With the experience in clinical medicine, biotechnology, health industry and other fields, he is responsible for the research and development of plant medicine, functional food and health products. He was a clinician and worked for the National Cancer Institute, FDA and the National Cancer Center of Japan for many years.

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