New methods of cancer treatment

New methods of cancer treatment: breakthrough technologies and prospects

Chapter 1: Immunotherapy – activation of your own immunity

Immunotherapy is a revolutionary approach to cancer, based on the use of the patient’s own immune system to combat the tumor. Instead of directly attacking cancer cells with chemotherapy or irradiation, immunotherapy is aimed at strengthening and modifying an immune response, allowing it to recognize and destroy malignant formations. This approach demonstrates significant success in the treatment of various types of cancer, especially in cases where traditional methods are ineffective.

1.1 control points inhibitors (Checkpoint Inhibitors)

One of the most promising areas of immunotherapy is the use of control points inhibitors. Control points are molecules that regulate the activity of immune cells, preventing excessive immune reaction and autoimmune diseases. However, cancer cells often use these control points to suppress the immune response and avoid destruction. Control points inhibitors block these molecules, freeing the immune system and allowing it to attack cancer cells.

• The mechanism of action: Control points inhibitors, such as anti-CTLA-4 (IPILIMUMAB), anti-PD-1 (pembrolizumab, nivolumab) and anti-PD-L1 (athezolyzumab, durvalumab, avelumab), work by blocking the interaction between control points on immune cells (for example, T-lymphocytes) and their ligands on cancer cells or antigen-representative cells. The blocking of these interactions leads to the activation of T-lymphocytes and the increase in their cytotoxic activity against cancer cells. For example, CTLA-4 usually suppresses the activation of T-lymphocytes in the early stages of the immune response, and PD-1 at the later stages, preventing excessive stimulation and autoimmune reactions. Inhibitors of these molecules cancel these restrictions, allowing the immune system to attack cancer cells.

• Application: Control points are approved for the treatment of a wide range of cancer, including melanoma, lung cancer, kidneys, bladder, head and neck, Hodgkin lymphoma and others. Their effectiveness varies depending on the type of cancer, stage of the disease and individual characteristics of the patient.

• Side effects: Although control points inhibitors can be very effective, they can also cause side effects associated with increasing the immune response. These side effects, known as immuno -mediated unwanted phenomena (IRAES), can affect any organism in the body, including skin, intestines, lungs, liver, kidneys, endocrine glands and nervous system. The severity of IRAES can vary from light to severe, and in some cases it may be necessary to stop treatment or use immunosuppressive drugs. It is important that patients receiving control points are carefully observed to detect and treat IRAES.

1.2 Car-T-cell therapy

CAR-T-cell therapy is another promising form of immunotherapy, which includes the genetic modification of the patient’s T-lymphocytes for the expression of a chime-thawed antigenic receptor (CAR). Car allows T-lymphocytes to recognize and attack cancer cells that express a specific antigen on their surface.

• Process: The Car-T-cell therapy process includes several stages:

  1. Collection of T-lymphocytes: The patient is taken away by his own T-lymphocytes by means of lecapheresis.
  2. Genetic modification: In the laboratory, T-lymphocytes are genetically modified using a viral vector for the introduction of a gene encoding Car. CAR consists of an extracellular domain that recognizes a specific antigen on cancer cells, a transmembrane domain and intracellular domains that activate T-lymphocytes after binding with the antigen.
  3. Propagation of T-lymphocytes: Modified Car-T cells are propagated in the laboratory until a sufficient amount is obtained.
  4. Chemotherapy: Before the introduction of Car-T cells, the patient is usually carried out by lymph defense chemotherapy to reduce the number of own immune cells and create a more favorable environment for Car-T cells.
  5. Introduction of Car-T cells: Car-T cells are administered intravenously. After the introduction of Car-T cells, they circulate in the body, recognize and associate with cancer cells expressing the target antigen, and destroy them.

• Application: Car-T-cell therapy has shown significant success in the treatment of some types of hematological malignant neoplasms, such as B-cell lymphoma and acute lymphoblastic leukemia. Several Car-T cell drugs are approved for the treatment of these diseases.

• Side effects: Car-T cell therapy can cause serious side effects, including cytokine release syndrome (CRS) and neurotoxicity. CRS is a systemic inflammatory reaction caused by the release of a large number of cytokines activated CAR-T cells. CRS symptoms can vary from fever and fatigue to hypotension, respiratory failure and organ dysfunction. Neurotoxicity can manifest itself in the form of headaches, confusion, seizures and other neurological symptoms. For the treatment of CRS and neurotoxicity, intensive therapy and immunosuppressive drugs may be required.

1.3 Oncolytic viruses (Oncolytic Viruses)

Oncolytic viruses are viruses that selectively infect and destroy cancer cells without damaging healthy tissues. They can be natural or genetically modified to increase their effectiveness and safety.

• The mechanism of action: Oncolytic viruses penetrate into cancer cells and multiply inside them. In the process of replication, the virus destroys cancer cells, causing their lysis (rupture). The lysis of cancer cells releases viral particles that can infect neighboring cancer cells, continuing the process of destroying the tumor. In addition, the infection of cancer cells can stimulate the immune response with oncolytic viruses, which leads to further destruction of the tumor.

• Application: Oncolytic viruses are used to treat various types of cancer, including melanoma, globor and hepatocellular carcinum. Some oncolytic viruses are approved for clinical use, while others are at the stage of clinical trials.

• Side effects: Oncolytic viruses are usually well tolerated, but can cause side effects, such as flu -like symptoms, fever, chills and fatigue. In rare cases, more serious side effects can occur, such as viral infection and inflammation.

1.4 vaccines against cancer (Cancer Vaccines)

Cancer vaccines are a type of immunotherapy that stimulates the patient’s immune system for recognition and attack of cancer cells. Cancer vaccines can be preventive (preventing cancer) or therapeutic (existing cancer treating).

• Preventive vaccines: Preventive vaccines against cancer, such as a vaccine against the human papillomavirus (HPV) and a vaccine against the hepatitis B (HCV) virus, prevent infections with viruses that can cause cancer. The HPV vaccine protects from HPV infections that can cause cervical cancer, anus cancer, vaginal cancer, vulva cancer and oropharynx cancer. The VGV vaccine protects against infection with VGV, which can cause liver cancer.

• Therapeutic vaccines: Therapeutic vaccines against cancer are designed to treat existing cancer. They work by stimulating an immune response against cancer cells. Therapeutic vaccines can be based on various types of antigens such as cancer antigens, peptides or DNA. They can also contain adjuvants that enhance the immune response.

• Application: Therapeutic vaccines against cancer are at the stage of clinical tests for the treatment of various types of cancer, including melanoma, lung cancer, prostate cancer and breast cancer.

• Side effects: Cancer vaccines are usually well tolerated, but can cause side effects, such as pain, redness and swelling at the injection site. In rare cases, more serious side effects can occur, such as allergic reactions.

Chapter 2: Targeted therapy – a blow exactly on the target

Targeted therapy is a type of cancer treatment that uses medicines or other substances for identifying and attacking specific cancer cells, usually blocking certain molecules or signaling paths that are necessary for the growth and survival of cancer cells. Unlike chemotherapy, which affects all rapidly dividing cells, targeted therapy is aimed at specific targets in cancer cells, which can lead to a smaller number of side effects.

2.1 Tyrosinkinaz inhibitors (Tyrosine Kinase Inhibitors – Tkis)

Tyrosinkinase is enzymes that play an important role in the regulation of cellular growth, differentiation and survival. They are often hyperactivated or mutated in cancer cells, contributing to uncontrolled growth and tumor spread. Tyrosinkinase inhibitors are a class of targeted drugs that block the activity of these enzymes, thereby suppressing the growth of cancer cells.

• The mechanism of action: TKIS bind to the active area of tyrosinkinase, preventing its phosphorylation and activation. This leads to a blocking of signal tracks adjusted by tyrosinkinase, and suppress the growth and survival of cancer cells.

• Application: TKIS are widely used for the treatment of various types of cancer, including chronic myelolecosis (KML), non-cell lung cancer (NMRL), renal cell cancer (PCR) and gastrointestinal stromal tumors (GISO). Examples of TKIS include Imatinib, Gephitinib, Erlotinib, Sorafenib and Sunitinib.

• Side effects: TKIS can cause side effects that vary depending on the specific drug and the patient. General side effects include fatigue, leather rash, diarrhea, nausea, vomiting, swelling and increasing blood pressure. In some cases, more serious side effects can occur, such as heart failure, pulmonary hypertension and perforation of the gastrointestinal tract.

2.2 inhibitors of many kinaz (Multi-Kinase Inhibitors)

Many kinaz inhibitors are a class of targeted preparations that block the activity of several tyrosyankinase at the same time. This approach can be useful for the treatment of crayfish that depend on several signaling pathways.

• The mechanism of action: Inhibitors of many kinaz are associated with active areas of several tyrosinkinase, preventing them of phosphorylation and activation. This leads to blocking several signaling tracks adjusted by these kinases, and to suppress the growth and survival of cancer cells.

• Application: Many kinaz inhibitors are used to treat various types of cancer, including renal cell cancer, hepatocellular carcinum and thyroid cancer. Examples of inhibitors of many kinaz include Sorafenib, Sunitinib, Regorafenib and Leninginib.

• Side effects: Many kinaz inhibitors can cause side effects that vary depending on the specific drug and the patient. General side effects include fatigue, leather rash, diarrhea, nausea, vomiting, swelling and increasing blood pressure. In some cases, more serious side effects can occur, such as heart failure, pulmonary hypertension and bleeding.

2.3 Inhibitor mTOR (mTOR Inhibitors)

MTOR (Michenen Rapamicin in mammals) is proteinquinase, which plays an important role in the regulation of cellular growth, proliferation, survival and metabolism. Mtor is often hyperactivated in cancer cells, contributing to uncontrolled growth and tumor spread. MTOR inhibitors are a class of targeted drugs that block the activity of MTOR, thereby suppressing the growth of cancer cells.

• The mechanism of action: MTOR inhibitors are associated with MTOR and prevent its activation. This leads to blocking the mtor signal path and suppress the growth and survival of cancer cells.

• Application: MTOR inhibitors are used to treat various types of cancer, including kidney cell cancer, breast cancer and neuroendocrine tumors. Examples of MTOR inhibitors include Everolimus and Temsirolimus.

• Side effects: MTOR inhibitors can cause side effects that vary depending on the specific drug and the patient. General side effects include fatigue, leather rash, diarrhea, nausea, vomiting, stomatitis, an increase in blood glucose and an increase in blood cholesterol. In some cases, more serious side effects can occur, such as pneumonitis and infections.

2.4 CDK inhibitors (Cyclin-Dependent Kinase Inhibitors)

CDK (cyclin-dependent kinase) is a family of proteinquinase, which play an important role in the regulation of the cell cycle. CDK is often hyperactivated in cancer cells, contributing to uncontrolled growth and tumor proliferation. CDK inhibitors are a class of targeted drugs that block the activity of CDK, thereby suppressing the growth of cancer cells.

• The mechanism of action: CDK inhibitors are associated with CDK and prevent its activation. This leads to blocking the cell cycle and suppressing growth and proliferation of cancer cells.

• Application: CDK inhibitors are used to treat various types of cancer, including breast cancer and mantle cell lymphoma. Examples of CDK inhibitors include Palbocyclib, Ribocyclib and Abemacyclib.

• Side effects: CDK inhibitors can cause side effects that vary depending on the specific drug and the patient. General side effects include neutropenia (a decrease in the amount of neutrophils in the blood), fatigue, nausea, vomiting and diarrhea. In some cases, more serious side effects can occur, such as pulmonary embolism.

2.5 PARP inhibitors (PARP Inhibitors)

PARP (Paul (Adf Ribose) of Polymerase) is a family of enzymes that play an important role in DNA reparation. PARP inhibitors are a class of targeted preparations that block the activity of PARP, thereby violating the ability of cancer cells to DNA reparation.

• The mechanism of action: PARP inhibitors are associated with PARP and prevent its participation in DNA reparations. This is especially effective in cancer cells with defects in other DNA reparations, such as mutations in BRCA1 or BRCA2 genes. When PARP is inhibited in these cells, they become more susceptible to DNA damage and cell death.

• Application: PARP inhibitors are used to treat various types of cancer, including ovarian cancer, breast cancer, pancreatic cancer and pancreatic cancer, especially in patients with mutations in BRCA1 or BRCA2 genes. Examples of PARP inhibitors include Olaparib, Rhparib and Talazoparib.

• Side effects: PARP inhibitors can cause side effects that vary depending on the specific drug and the patient. General side effects include nausea, fatigue, anemia (a decrease in the number of red blood cells in the blood) and thrombocytopenia (a decrease in the amount of platelets in the blood). In rare cases, more serious side effects can occur, such as myelodispheast syndrome (MDS) and acute myeloid leukemia (OML).

2.6 monoclonal antibodies (Monoclonal antibodies)

Monoclonal antibodies are antibodies that are produced by one cloned immune cell and are associated with a certain antigen on cancer cells. They can be used for various purposes, including blocking signal pathways, the delivery of toxic substances directly to cancer cells and stimulating the immune response against cancer cells.

• The mechanism of action: The mechanism of action of monoclonal antibodies varies depending on a particular antibody. Some monoclonal antibodies block the signaling paths necessary for the growth and survival of cancer cells. For example, Trustuumab is associated with the HER2 receptor on the cancer cells of the breast and blocks its activation, thereby suppressing the growth of cancer cells. Other monoclonal antibodies deliver toxic substances, such as radioactive isotopes or chemotherapeutic drugs, directly to cancer cells. For example, Brentuximab VediTin is a monoclonal antibody that binds to the CD30 antigen on lymphomic cells and delivers a chemotherapeutic drug Monomethylaistatin E (MMAE) directly to cells, causing their death. Some monoclonal antibodies stimulate the immune response against cancer cells. For example, a rituximab is associated with the antigen of CD20 on b-lymphocytes and causes their destruction by immune cells.

• Application: Monoclonal antibodies are used to treat various types of cancer, including breast cancer, colon cancer, lymphoma and leukemia. Examples of monoclonal antibodies include Trustuumab, Rituximab, Bevacizumab, Cetuximab and Pembroralizumab.

• Side effects: Monoclonal antibodies can cause side effects that vary depending on the specific antibodies and the patient. General side effects include flu -like symptoms, such as fever, chills and fatigue. In some cases, more serious side effects can occur, such as allergic reactions, infusion reactions and heart failure.

Chapter 3: New technologies in radiation therapy

Radiation therapy is an important method for treating cancer, which uses high-energy rays, such as x-rays, gamma rays or charged particles, to destroy cancer cells. New technologies in radiation therapy are aimed at increasing the effectiveness of treatment, reducing side effects and more accurate delivery of radiation to the tumor.

3.1 Stereotactic radiation therapy

Stereotactic radiation therapy (SRT) is a method of radiation therapy that uses high -precision visualization and positioning methods to deliver high doses of radiation to a small section of the tumor for a small number of sessions (usually from 1 to 5). SRT can be used to treat cancer and nonsense in various parts of the body, including the brain, lungs, liver, spine and prostate gland.

• Stereotactic Radiosurgery (SRS): SRS is a type of SRT, which is used to treat brain tumors and other intracranial formations. SRS is usually carried out in one session and uses very high doses of radiation to destroy the tumor. SRS can be carried out using various types of equipment, including gamma knife, cyber-knife (Cyberknife) and linear accelerators (Linacs).

• Stereotactic ablation of radiation therapy (stereotactic Body Radiation Therapy – SBRT): SBRT is a type of SRT, which is used to treat tumors in other parts of the body, in addition to the brain. SBRT is usually carried out in several sessions (usually from 3 to 5) and uses high doses of radiation to destroy the tumor. SBRT can be carried out using linear accelerators (Linacs).

• Advantages: The advantages of SRT include:

  • High accuracy: SRT allows you to deliver high doses of radiation directly to the tumor, minimizing the effect on the surrounding healthy tissues.
  • Less sessions: SRT is usually carried out for fewer sessions than traditional radiation therapy, which can be more convenient for patients.
  • Improved control over the tumor: SRT can be more effective for monitoring the tumor, especially in cases where the tumor is in an inaccessible place or when traditional radiation therapy turned out to be ineffective.

• Side effects: Side effects of SRT depend on the localization of the tumor and the dose of radiation. General side effects include fatigue, nausea, vomiting, leather rash and pain. In rare cases, more serious side effects can occur, such as damage to nerves, blood vessels or organs.

3.2 Proton Therapy (Proton Therapy)

Proton therapy is a type of radiation therapy that uses protons (positively charged particles) instead of x -rays to destroy cancer cells. Proton therapy has a unique property known as the Bragg Peak, which allows you to deliver most of the dose of radiation directly to the tumor, minimizing the effect on the surrounding healthy tissues.

• Advantages: The advantages of proton therapy include:

  • More accurate radiation delivery: The Bragg Peak allows you to deliver most of the dose of radiation directly to the tumor, minimizing the effect on the surrounding healthy tissues. This can be especially useful for the treatment of crayfish located near critical organs, such as the brain, spinal cord and heart.
  • Less side effects: Due to the more accurate delivery of radiation, proton therapy can cause less side effects than traditional radiation therapy.
  • A higher radiation dose: Proton therapy allows you to deliver higher doses of radiation to the tumor, which can be more effective for the destruction of cancer cells.

• Application: Proton therapy is used to treat various types of cancer, including prostate cancer, lung cancer, brain cancer, cancer of the head and neck, cancer in children and sarcoma.

• Flaws: Disadvantages of proton therapy include:

  • High cost: Proton therapy is more expensive than traditional radiation therapy.
  • Limited availability: Proton centers are not available in all countries and cities.
  • The need for accurate planning: Proton therapy requires very accurate planning to ensure the delivery of radiation to the tumor.

3.3 intense-modulated radiation therapy

Intensively modulated radiation therapy (IMRT) is an advanced technique of radiation therapy, which allows you to change the intensity of the beam in different parts of the tumor. This allows doctors to deliver high doses of radiation to the tumor, while minimizing the dose that the surrounding healthy tissues receive.

• The mechanism of action: IMRT uses computer planning to create an individual treatment plan, which optimizes the delivery of radiation to the tumor. The radiation beam is divided into many small rays, and the intensity of each beam is modulated (changed) during treatment. This allows doctors to deliver a high dose of radiation to the tumor, while avoiding critical organs.

• Advantages: IMRT has several advantages compared to traditional radiation therapy, including:

  • Improved sparing healthy tissues: IMRT avoids critical organs and deliver a larger amount of radiation to the tumor.
  • A higher radiation dose: Thanks to the better sparing of healthy tissues, you can increase the dose of radiation to the tumor, which can improve control over cancer.
  • Less side effects: Reducing the dose of radiation to healthy tissues can reduce the risk of side effects.

• Application: IMRT is used to treat a wide range of crayfish, including prostate cancer, cancer of the head and neck, breast cancer, lung cancer and brain cancer.

3.4 Radiation therapy under visual control (Image -guided radiation Therapy – IGRT)

Radiation therapy under visual control (IGRT) is the use of visualization methods (such as x -ray, CT, MRI or PET) to monitor the position of the tumor during radiation therapy. This allows doctors to adjust the position of the patient and radiation beam in order to ensure the delivery of radiation to the tumor, even if the tumor moves during treatment.

• The mechanism of action: IGRT uses visualization methods to determine the position of the tumor immediately before each session of radiation therapy and during it. This information is used to adjust the position of the patient and the radiation beam to ensure the delivery of radiation to the tumor.

• Advantages: IGRT has several advantages compared to traditional radiation therapy, including:

  • Increased accuracy: IGRT allows you to deliver radiation more accurately to the tumor, even if the tumor moves during treatment.
  • Improved control over the tumor: Increased radiation delivery can improve control over cancer.
  • Less side effects: Reducing the dose of radiation to healthy tissues can reduce the risk of side effects.

• Application: IGRT is used to treat a wide range of crayfish, including prostate cancer, lung cancer, liver cancer and pancreatic cancer.

Chapter 4: Minimum invasive surgical methods

Minimum invasive surgery (MIS) is a surgical approach that uses small incisions and specialized tools for operations. Compared to traditional open surgery, MIS usually leads to a smaller amount of pain, a shorter restoration time and a smaller number of scars.

4.1 Laparoscopic surgery.

Laparoscopic surgery is a type of MIS that uses a laparoscope (a thin tube with a camera and a light source) to view the abdominal cavity. The surgeon makes small cuts (usually from 0.5 to 1.5 cm) and inserts a laparoscope and other surgical instruments through these cuts. The surgeon looks at the monitor to see the image inside the abdominal cavity and manipulates the tools for the operation.

• Application: Laparoscopic surgery is used to treat various types of cancer, including colon cancer, stomach cancer, liver cancer, pancreatic cancer, kidney cancer, prostate cancer and ovarian cancer.

• Advantages: The advantages of laparoscopic surgery include:

  • Less pain: Laparoscopic surgery usually causes less pain than traditional open surgery.
  • Shorter recovery time: Patients who have undergone laparoscopic surgery are usually restored faster than patients who have undergone traditional open surgery.
  • Less scars: Laparoscopic surgery leaves less scars than traditional open surgery.
  • Less blood loss: Laparoscopic surgery usually leads to less blood loss than traditional open surgery.
  • Smaller risk of infection: Laparoscopic surgery can be associated with a lower risk of infection than traditional open surgery.

4.2 Robotic Surgery.

Robotized surgery is a type of MIS that uses a surgical robot to conduct operations. The surgeon sits behind the control console and uses joysticks and pedals to control robotic hands that hold surgical tools. The robot provides the surgeon with increased accuracy, dexterity and three -dimensional vision.

• System da Vinci: The most common system of robotic surgery is the DA Vinci system. The DA Vinci system consists of a control console, a robotic platform and a visualization system. The control console allows the surgeon to control robotic hands. The robotic platform holds surgical tools. The visualization system provides surgeon three -dimensional vision inside the patient’s body.

• Application: Robotized surgery is used to treat various types of cancer, including prostate cancer, kidney cancer, bladder cancer, uterine cancer, ovarian cancer and colon cancer.

• Advantages: The advantages of robotic surgery include:

  • Increased accuracy: The robot provides the surgeon with increased accuracy, which can be useful for complex operations.
  • Improved dexterity: The robot allows the surgeon to manipulate tools with greater dexterity, which can be useful for operations in hard -to -reach places.
  • Three -dimensional vision: The robot provides the surgeon with three -dimensional vision inside the patient’s body, which can help the surgeon better see anatomy.
  • Less pain: Robotized surgery usually causes less pain than traditional open surgery.
  • Shorter recovery time: Patients who have undergone robotic surgery are usually restored faster than patients who have undergone traditional open surgery.
  • Less scars: Robotized surgery leaves less scars than traditional open surgery.

4.3 Endoscopic surgery.

Endoscopic surgery is a type of MIS that uses an endoscope (a thin flexible tube with a camera and light source) to view the organ or body cavity. The surgeon makes small cuts and inserts an endoscope and other surgical instruments through these cuts. The surgeon looks at the monitor to see the image inside the organ or body cavity and manipulates tools for surgery.

• Application: Endoscopic surgery is used to treat various types of cancer, including esophagus cancer, stomach cancer, colon cancer, lung cancer and bladder cancer.

• Advantages: The advantages of endoscopic surgery include:

  • Less pain: Endoscopic surgery usually causes less pain than traditional open surgery.
  • Shorter recovery time: Patients who have undergone endoscopic surgery are usually restored