New approaches to cancer treatment: international research

New approaches to cancer treatment: international research

1. Immunotherapy: Revolution in the fight against cancer

Immunotherapy, the approach to the treatment of cancer, which uses its own immune system of the body to combat cancer cells, has become one of the most promising achievements in oncology over the past decade. Instead of directly attacking cancer cells, like chemotherapy or radiation therapy, immunotherapy enhances the ability of the immune system to recognize and destroy cancer cells. Various types of immunotherapy have shown significant results in the treatment of a wide range of cancer, including melanoma, lung cancer, kidney cancer, Hodgkin lymphoma and many others.

1.1. Control points inhibitors:

One of the most successful types of immunotherapy is the use of control points inhibitors. The control points of the immune system are molecules that regulate the activity of immune cells, preventing an excessive reaction that can damage healthy tissues. Cancer cells sometimes use these control points to avoid detection and destruction of the immune system. Control points inhibitors are drugs that block these molecules, allowing immune cells to attack cancer cells.

• CTLA-4 inhibitors: CTLA-4 (Cytotoxic T-Lymphocyte-SSOCIETED PROTEIN 4) is a control point that regulates the activity of T cells in the early stages of activation. Ipilimumab, the first approved CTLA-4 inhibitor, demonstrated significant improvements in the survival of patients with metastatic melanoma. Studies show that the blocking of CTLA-4 enhances the activation and proliferation of T cells, which leads to a more efficient destruction of cancer cells. However, due to wide immune activation, CTLA-4 inhibitors can cause autoimmune side effects.

• PD-1/PD-L1 inhibitors: PD-1 (Programmed Cell Death Protein 1) is another control point that regulates the activity of T cells, mainly in the late stages of the immune response in the tissues. PD-L1 (Programmed Death-Ligand 1)-this is a protein that is often expressed by cancer cells, is associated with PD-1 on T cells and suppresses their activity. PD-1 inhibitors (for example, pembrolizumab, nivolumab) and PD-L1 inhibitors (for example, athelesolizumab, durvalumab) block this interaction, allowing T-cells to attack cancer cells. PD-1/PD-L1 inhibitors showed high efficiency in the treatment of various types of cancer, including lung cancer, melanoma, kidney cancer and Hodgkin lymphoma. They usually have less side effects than CTLA-4 inhibitors, but still can cause immuno-mediated side effects, such as colitis, pneumonitis and hepatitis.

• LAG-3 inhibitors: LAG-3 (Lymphocyte-Activation Gene 3) is another control point that attracts more and more attention as a potential goal for immunotherapy. It operates similarly to PD-1, suppressing the activation of T cells. Relagalimab, LAG-3 inhibitor, was approved in combination with nivolumab for the treatment of metastatic melanoma, resistant to anti-PD-1 therapy. Studies continue to assess the effectiveness of LAG-3 inhibitors at other types of cancer.

1.2. CAR-T cell therapy:

CAR-T CELIVERY ANTIGEN RECEPTOR T-CELL THEAPY) is a type of immunotherapy that includes the genetic modification of the patient’s T-cells so that they can recognize and attack cancer cells. T-cells are taken from the patient, genetically modified that they express the chimary antigenic receptor (CAR), which specifically binds to protein expressed on cancer cells, and then returned to the patient. When CAR-T cells bind to cancer cells, they activate and destroy them.

• CD19-controlled Car-T Therapy: Car-T cell therapy reached the greatest success in the treatment of hematological malignant neoplasms, such as B-cell lymphomas and leukemia. Several CD19-controlled CAR-T cell therapy (for example, TISAGENEXEL, Axycabtagen Tsiloleusel) were approved for the treatment of these diseases. CD19 is a protein that is expressed on the surface of most V-cells, including malignant B cells. Car-T cells aimed at CD19 showed high efficiency in achieving remission in patients with recurrent or refractory B-cell malignant neoplasms.

• Development of CAR-T therapy for solid tumors: Although CAR-T cell therapy has shown remarkable results in hematological malignant neoplasms, the development of CAR-T therapy for solid tumors is significant difficulties. Solid tumors have a complex microenvand that can suppress the activity of T cells. In addition, it is more difficult for solid tumors to find specific antigens that are expressed only by cancer cells and are not expressed by healthy tissues. Researchers develop various strategies for overcoming these problems, including the development of Car-T cells that secrete cytokines that destroy microenvisor of the tumors, the development of Car-T cells aimed at several antigens, and the development of CAR-T cells that can overcome physical barriers such as tumor stroma.

1.3. Oncolytic viruses:

Oncolytic viruses are viruses that selectively infect and destroy cancer cells without harming healthy cells. They act in two main ways: firstly, they directly lying cancer cells, tearing them from the inside. Secondly, they stimulate the immune system to attack cancer cells. When the oncolytic virus infects the cancer cell, it replicates inside the cell until the cell bursts and perishes. This process releases viral particles that can infect other cancer cells. In addition, the death of cancer cells releases antigens that can be recognized by the immune system, launching an antitumor immune response.

• T-century (Talimogen camp): T -century is an oncolytic virus approved for the treatment of metastatic melanoma. This is a genetically modified herpes simplex virus type 1, which was modified for the selective infection and destruction of melanoma cancer cells. It also expresses a granulocytic-macrophage colony-nestimulating factor (GM-CKF), which stimulates the immune system. Studies have shown that T-Hero can lead to long answers in some patients with metastatic melanoma.

• Development of new oncolytic viruses: Researchers are developing new oncolytic viruses for the treatment of a wide range of cancer. These viruses are modified to increase their selectivity in relation to cancer cells, increase their antitumor activity and stimulate the immune system. Some of the most promising oncolytic viruses include adenoviruses, osopovaccines virus, measles virus and vests of vesicular stomatitis.

1.4. Cancer vaccines:

Cancer vaccines are designed to stimulate the immune system to recognize and attack cancer cells. Unlike preventive vaccines that prevent infections, therapeutic vaccines against cancer are intended for the treatment of existing cancer. Cancer vaccines can be developed for aiming on specific antigens expressed by cancer cells, or to stimulate a general immune response against cancer.

• Sipuleusel-T: Sipuleusel -T is a cancer vaccine approved for the treatment of metastatic cancer of the prostate gland, resistant to castration. It is made by fence of the patient’s immune cells (dendritic cells), activation of their ex vivo antigen of prostatic acid phosphatase (PAP), which is expressed by prostate cancer cells, and then re -introduction of activated cells to the patient. This stimulates the immune system to attack prostate cancer cells.

• Personalized cancer vaccines: Personalized cancer vaccines are developed on the basis of unique mutations present in the patient’s cancer cells. First, sequencing of DNA of patient cancer cells is carried out to detect mutations that are not present in normal cells. Then, on the basis of these mutations, peptides are developed, which are used to stimulate the immune system. Preliminary results of the clinical tests of personalized vaccines against cancer showed promising results in the treatment of various types of cancer, including melanoma and glioblastoy.

2. Targeted therapy: accurate blow to cancer cells

Targeted therapy is a class of drugs that block the growth and spread of cancer, interfering in specific molecules (“targets”) involved in growth, progression and spread of cancer. Unlike chemotherapy, which affects all rapidly dividing cells, targeted therapy is designed for aiming only on cancer cells, which leads to a smaller number of side effects.

2.1. Tyrosinkinase inhibitors (ITK):

Tyrosinkinase is enzymes that play an important role in transmitting cell growth and differentiation signals. Many tyrosinkinase are superimposed in cancer cells, contributing to uncontrolled growth and survival. ITK is small molecules that block the activity of these enzymes, suppressing the growth and spread of cancer.

• Imatinib: Imatinib was one of the first and most successful ITK. It is aimed at BCR-Bl Tyrosinkinase, which is formed as a result of chromosomal translocation in chronic myelolecosis (CML). Imatinib revolutioned in the treatment of KML, allowing most patients to achieve prolonged remission.

• Erlotinib and Gefitinib: These ITKs are aimed at the receptor of the epidermal growth factor (EGFR), which is often surchactivated with lung cancer. They showed the effectiveness in the treatment of lung cancer non -cell -type (NMRL) with EGFR mutations.

• Crisinib: Crisotinib is aimed at the kinaz of anoplastic lymphoma (ALK), which is surchactivated with some types of lung cancer and lymphoma. It is approved for the treatment of NMRL with the restructuring of Alk gene.

2.2. BRAF and MEK inhibitors:

Braf and MEK are proteins in the MAPK signal path, which plays an important role in the growth and survival of cells. Mutations in the BRAF gene are often found in melanoma, as well as with some other types of cancer. BRAF inhibitors (for example, vemorafenib, dabrafenib) and MEK inhibitors (for example, trametinib, Kobimetinib) block the activity of these proteins, suppressing the growth of cancer cells with BRAF mutations. Often, BRAF and MEK inhibitors are used in combination to increase efficiency and prevent the development of resistance.

2.3. CDK4/6 inhibitors:

CDK4 and CDK6 are kinases that play an important role in the cellular cycle. CDK4/6 inhibitors (for example, Palbocyclib, Ribocyclib, Abemaclicclib) block the activity of these kinase, stopping the cell cycle and suppressing the growth of cancer cells. They showed the effectiveness in the treatment of hormonosopower, Her2-negative breast cancer.

2.4. PARP inhibitors:

PARP (Paul (Adf Ribose)-Polymerase) is an enzyme that is involved in DNA restoration. PARP inhibitors (for example, Olaparib, Talazoparib, Rhoparib) block the PARP activity, which makes cancer cells that already have defects in other DNA restoration paths (for example, BRCA1/2 mutations), more vulnerable to DNA damage and death. They are approved for the treatment of ovarian cancer, breast cancer, prostate cancer and pancreatic cancer with BRCA1/2 mutations.

2.5. Monoclonal antibodies:

Monoclonal antibodies are antibodies that are produced by a clone of identical immune cells. They are designed for aiming on specific proteins on the surface of cancer cells. When a monoclonal antibody binds to its target, it can block the protein function, stimulate the immune system to attack cancer cells or deliver medicines or radioactive substances directly to cancer cells.

• Trustuzumab: Trastuzumab is a monoclonal antibody, which is aimed at HER2 (receptor 2 of the epidermal factor of human growth), which is surchactic with breast cancer. It blocks HER2, suppressing the growth and spread of cancer cells.

• Rituximab: Rituximab is a monoclonal antibody, which is aimed at CD20, a protein that is expressed on the surface of the B cells. It is used to treat lymphoma, leukemia and autoimmune diseases.

• Bevacizumab: Bevacizumab is a monoclonal antibody, which is aimed at the growth factor of the vascular endothelium (VEGF), a protein that plays an important role in angiogenesis (the formation of new blood vessels). It blocks VEGF, depriving a tumor of nutrition and oxygen, which leads to the suppression of the tumor growth.

3. Gene therapy: Correction of genetic defects of cancer

Gene therapy is an approach to cancer treatment, which includes a change in the genetic material of the patient’s cells for the treatment of the disease. It can be used to correct genetic defects, add new genes to cells or inactivation of harmful genes. In oncology, genetic therapy is used for:

• Restoring the function of tumor-soup genes: Tumor -soup genes are genes that help control cell growth. Mutations in these genes can lead to cancer. Gene therapy can be used to make functional copies of tumor-tumors genes into cancer cells, restoring their ability to control cell growth.

• Strengthening the antitumor immune response: Gene therapy can be used to modify immune cells to make them more effective in the attack of cancer cells. For example, CAR-T cell therapy is a form of gene therapy, which includes the genetic modification of the patient T-cells so that they can recognize and attack cancer cells.

• Direct destruction of cancer cells: Gene therapy can be used to make genes encoding toxic proteins into cancer cells, which leads to their death. This approach is called genetic suicide therapy.

3.1. Viral vectors:

Viral vectors are the most common way to deliver genes to cells with genetic therapy. Viruses are genetically modified so that they can infect cells, but not cause disease. Then the genes that must be delivered to the cells are inserted into the viral genome. When the virus infects the cage, it delivers genes to the cage.

• Adenoviruses: Adenoviruses are a type of virus that is often used in genetic therapy. They are able to infect a wide range of types of cells and cause a strong immune response.

• Adenoassed viruses (AAV): AAV is another type of virus that is often used in genetic therapy. They are less immunogenic than adenoviruses, and can provide prolonged expression of genes.

• Retrovirus: Retrovirus is a type of virus that inserts its genetic material in the genome of the host cell. They can ensure prolonged expression of genes, but also have the risk of an insertion of the gene into a random place in the genome, which can lead to mutations.

3.2. Nevirus vectors:

Nevirus vectors are an alternative way to deliver genes to cells for genetic therapy. They include liposomes, plasmids and electrophy. Nevirus vectors are usually less effective than viral vectors, but they have a less risk of an immune response and random insertion of genes.

3.3. CRISPR-CAS9 Technology:

CRISPR-CAS9 (Clustered Regularly Interspaced Short Palindromic Repeats and Crispr-SSOSOCIETED PROTEIN 9) is a genes editing technology that allows scientists to accurately edit the DNA of living organisms. It is based on a system of protection against viruses used by bacteria. CRISPR-CAS9 can be used to inactivation of genes, introducing new genes in the genome or correcting genetic defects. CRISPR-CAS9 has a great potential for cancer treatment, but is still at an early stage of development.

4. Radiation therapy: new methods and strategies

Radiation therapy uses high -energy radiation to destroy cancer cells. Although radiation therapy is an established method for treating cancer, new methods and strategies are constantly being developed to increase its effectiveness and reduce side effects.

4.1. Stereotactic radiation therapy of the body (SBRT):

SBRT is a type of radiation therapy, which delivers high doses of radiation for exactly small tumors, sparing the surrounding healthy tissues. It is usually used to treat lung cancer, liver, prostate gland and other organs. SBRT allows you to deliver higher radiation doses than traditional radiation therapy, which leads to a more efficient destruction of cancer cells.

4.2. Proton therapy:

Proton therapy is a type of radiation therapy that uses protons instead of photons. Protons have a unique property called Bragg peak, which allows them to put off most of their energy at a certain point, and not pass through the body, like photons. This allows doctors to deliver higher doses of radiation to the tumor, sparing surrounding healthy tissues. Proton therapy is especially useful for the treatment of cancer in children and cancer located near important organs.

4.3. Adaptive radiation therapy:

Adaptive radiation therapy is a type of radiation therapy that adjusts the treatment plan in real time to take into account changes in the size and position of the tumor. This allows doctors to more accurately deliver radiation to the tumor, as well as reduce side effects. Adaptive radiation therapy is usually used to treat prostate cancer, bladder cancer and other organs.

4.4. Brachytherapy:

Brachitherapy is a type of radiation therapy in which radioactive sources are placed directly inside or next to the tumor. This allows doctors to deliver high doses of radiation to the tumor, sparing surrounding healthy tissues. Brachitherapy is usually used to treat prostate cancer, cervical cancer and breast cancer.

4.5. Radiation therapy using flash radio therapy:

Flash radio therapy is a new method of radiation therapy, which delivers radiation with ultra -high doses in a very short period of time. Preliminary studies show that Flash radio therapy can be more effective in destroying cancer cells and less toxic for healthy tissues than traditional radiation therapy. Flash radiotherapy is still at an early stage of development, but has great potential to improve cancer treatment.

5. Development of drugs: new approaches and molecules

The development of new drugs for cancer is a continuous process that includes the identification of new targets, the development of new molecules and conducting clinical trials. In recent years, significant success have occurred in the development of cancer drugs, which has led to new and more effective treatment methods.

5.1. Structure -based development:

The development of drugs based on a structure is a method of developing drugs that uses a three -dimensional structure of target protein to develop molecules that are associated with it and modulate its activity. This method can be used to develop more selective and effective drugs.

5.2. High -performance screening (HTS):

HTS is a method that is used to screening large libraries of molecules for activity against a certain target. HTS allows scientists to quickly identify molecules that have antitumor activity.

5.3. Pharmacokinetics and Pharmacodynamics (PK/PD):

PK/PD is a study of how the drugs are absorbed, distributed, metabolized and excreted from the body (pharmacokinetics), as well as how drugs affect the body (pharmacodynamics). PK/PD is used to optimize the dosage and medication mode to achieve maximum effectiveness and minimize side effects.

5.4. Conjugates ADC Medicine (ADC):

ADC is drugs that consist of antibodies associated with a cytotoxic agent. The antibody is aimed at a specific protein on the surface of cancer cells, delivering a cytotoxic agent directly to cancer cells. This allows you to deliver a high dose of a cytotoxic agent to cancer cells, sparing surrounding healthy tissues.

5.5. Printing:

Permanation is drugs that are administered in an inactive form and then turn into an active form in the body. This can be used to increase the bioavailability of drugs, reduce side effects or aiming drugs on certain tissues.

6. Cancer Diagnostics: Improved Methods and Biomarkers

Early and accurate diagnosis of cancer is crucial for improving the results of treatment. In recent years, significant success have occurred in the development of new and improved cancer diagnostics, as well as in identifying new biomarkers.

6.1. Liquid biopsy:

Liquid biopsy is a non -invasive method that allows you to analyze cancer cells or DNA circulating in blood or other biological fluids. Liquid biopsy can be used for early detection of cancer, monitor the response of the treatment and detection of drug stability.

• Circulating tumor cells (TsOC): TsOC is cancer cells that have come off the tumor and circulate in the blood. The analysis of the Central Department Store can be used to predict the response to the treatment and identify drug stability.

• Circulating tumor DNA (Central Department Store): Central Department Station is a DNA that is released with cancer cells into the blood. Analysis of the Central Administration can be used to identify genetic mutations that can be targets for targeted therapy, as well as for monitoring the response to treatment.

• Exosome: Exosomas are small bubbles that are released by cells and contain proteins, RNA and other molecules. Exosive analysis can be used to identify cancer biomarkers.

6.2. Molecular visualization:

Molecular visualization is a type of visualization that uses radioactive or magnetic probes to detect cancer cells or molecules associated with cancer. Molecular visualization can be used for early detection of cancer, monitor the response to treatment and determine the degree of cancer.

• PET/CT (positron emission tomography/computed tomography): PET/CT is a type of molecular visualization that uses a radioactive drug to detect metabolically active cells, such as cancer cells.

• MRI (magnetic resonance imaging): MRI is a type of visualization that uses magnetic fields and radio waves to create images of organs and tissues of the body. MRI can be used to identify tumors, determine their size and location, as well as to monitor the response to treatment.

6.3. Biomarkers:

Biomarkers are molecules that can be measured in the blood, urine or other biological fluids and which indicate the presence of cancer or risk of cancer. Biomarkers can be used for early detection of cancer, monitor a response to treatment and predicting the outcome of the disease.

• PSA (prostatic specific antigen): PSA is a biomarker that is used to detect prostate cancer.

• CA-125: CA -125 is a biomarker that is used to detect ovarian cancer.

• CEA (carcino -emblem antigen): CEA is a biomarker that is used to detect cancer of the colon and other types of cancer.

7. Personalized medicine: adaptation of treatment to the individual

Personalized medicine is an approach to cancer treatment, which takes into account the genetic composition, lifestyle and other factors specific to each patient. The goal of personalized medicine is to adapt treatment to the individual needs of each patient, which leads to more effective and safe treatment.

7.1. Genomic sequencing:

Genomic sequencing is a process of determining the sequence of human DNA. Genomic sequencing can be used to detect genetic mutations that can be targets for targeted therapy, as well as to predict the risk of cancer and response to treatment.

7.2. Gene expression profiling:

Profilation of genes expression is a process of measuring the level of expression of various genes in cells. Profile of genes expression can be used to identify cancer types, which will probably respond to certain treatment methods, as well as to predict the outcome of the disease.

7.3. Pharmacogenomy:

Pharmacogenomy is a study of how human genes affect his reaction to drugs. Pharmacogenomy can be used to select the most effective and safe medicine for each patient, as well as to determine the dose of the drug.

7.4. Integrative oncology:

Integrative oncology is an approach to the treatment of cancer, which combines traditional methods of cancer treatment, such as chemotherapy, radiation therapy and surgery, with additional and alternative treatment methods such as acupuncture, yoga and meditation. The purpose of integrative oncology is to improve the quality of life of patients, reduce side effects of treatment and increase the effectiveness of treatment.

8. International cooperation and research:

International cooperation and research play a vital role in promoting cancer treatment. The exchange of knowledge, resources and experience between researchers and clinicians around the world accelerates progress in the understanding, prevention, diagnosis and treatment of cancer.

8.1. International clinical trials:

International clinical trials make it possible to conduct research on new methods of cancer treatment in different countries and with the participation of various population groups. This helps to ensure the reliability and applicability of clinical test results.

8.2. Data and biobank exchange:

The exchange of data and biobanks allows researchers to access large sets of data and samples of tumors, which is necessary for large -scale research and identify new biomarkers and targets for drugs.

8.3. Joint research projects:

Joint research projects unite scientists from different countries to solve complex problems in the field of cancer treatment. These projects can lead to the development of new methods of diagnosis and treatment of cancer.

8.4. International scientific conferences and publications:

International scientific conferences and publications provide a platform for the exchange of knowledge and research results, which contributes to progress in the treatment of cancer.

9. The role of artificial intelligence (AI) in the treatment of cancer:

Artificial intelligence (AI) revolutionizes many aspects of healthcare, and cancer treatment is no exception. AI offers huge potential to improve the diagnosis, treatment and prevention of cancer.

9.1. Improving cancer diagnosis:

AI can be used to analyze images of medical research, such as x -rays, CT and MRI, to identify cancer or signs of cancer with greater accuracy and speed than is possible for humans.

9.2. Drug development:

AI can be used to analyze large data sets and identify new targets for drugs, as well as to predict the effectiveness of drugs and identify potential side effects.

9.3. Personalization of treatment:

AI can be used to analyze genetic information, lifestyle and other factors specific to each patient in order to adapt treatment to individual needs.

9.4. Patient monitoring:

AI can be used to monitor patients with cancer in real time to identify signs of the progression of the disease or side effects of treatment.

9.5. Robotized surgery:

Robotized surgery allows surgeons to perform operations with greater accuracy and less invasiveness.

10. Future of cancer treatment:

The future treatment of cancer looks promising. The development of new technologies and methods of treatment, such as immunotherapy, targeted therapy, gene therapy, radiation therapy and AI, opens up new opportunities to improve the results of treatment of cancer and the quality of life of patients.

The ongoing international research and cooperation will play a vital role in promoting cancer treatment and approaching us to a world without cancer.

11. Psychosocial support and quality of life:

Despite the achievements in the treatment of cancer, it is important to remember the effect of the diagnosis and treatment on the psychosocial well -being of patients. The integration of psychosocial support for cancer care is crucial for improving the quality of life of patients and their families.

11.1. Consulting and psychotherapy:

Consulting and psychotherapy can help patients cope with anxiety, depression and other emotional problems associated with cancer.

11.2. Support groups:

Support groups provide patients with the opportunity to communicate with other people who experience similar experience, which can help reduce the sense of isolation and improve emotional well -being.

11.3. Pain and symptoms management:

The management of pain and symptoms is an important aspect of cancer care, which can significantly improve the quality of life of patients.

11.4. Palliative help:

Palliative help is focused on relief of pain and symptoms, as well as to improve the quality of life of patients with severe diseases, such as cancer.

11.5. Physical activity and nutrition:

Physical activity and balanced nutrition can help patients maintain their physical strength and energy, as well as improve their emotional well -being.

12. Cancer Prevention: Risk reduction in the risk

Although achievements in cancer treatment are significant, cancer prevention remains the most effective way to combat this disease. The adoption of a healthy lifestyle and the passage of regular examinations can significantly reduce the risk of cancer.

12.1. Refusal of smoking:

Smoking is the main cause of lung cancer and many other types of cancer. Refusal of smoking is one of the most important steps that you can take to reduce the risk of cancer.

12.2. Healthy nutrition:

A balanced diet, rich in fruits, vegetables and whole grains, can help reduce the risk of cancer.

12.3. Physical activity:

Regular physical activity can help reduce the risk of developing colon cancer, breast cancer and other types of cancer.

12.4. Maintaining a healthy weight:

Excess weight or obesity increase the risk of developing colon cancer, breast cancer, endometrial cancer and other types of cancer.

12.5. Vaccination:

Vaccines against the virus PA