New methods of cancer treatment: Breakthrough in oncology

New methods of cancer treatment: Breakthrough in oncology

I. Immunotherapy: Revolution in the fight against cancer

Immunotherapy is perhaps the most exciting breakthrough in oncology over the past decades. Instead of directly attacking cancer cells, it mobilizes its own immune system of the body for recognition and destruction of tumors. This approach differs from traditional methods such as chemotherapy and radiation therapy, which often damage both cancer and healthy cells.

A. Immune Checkpoint Inhibitors: Removing the brakes from the immune system

The immune system has built -in mechanisms called control points, which prevent excessive activity and autoimmune reactions. Cancer cells often use these control points to evade attacks of the immune system. Inhibitors of control points of immunity are drugs that block these signals, allowing T-cells (the main immune cells that destroy cancer cells) to effectively attack the tumor.

1. The mechanism of action:

   • CTLA-4 (Cytotoxic T-Lymphocyte-Associated Protein 4): CTLA-4 is a control point that regulates the activation of T cells in the early stages. CTLA-4 inhibitors, such as Ipilimumab, block CTLA-4, enhancing the activation of T cells and allowing them to more effectively attack cancer cells. However, due to the wide range of CTLA-4, CTLA-4 inhibitors can cause significant side effects associated with autoimmune reactions.
   • PD-1 (Programmed Cell Death Protein 1) и PD-L1 (Programmed Death-Ligand 1): PD-1 is another important control point, which regulates the activity of T cells in later stages. Cancer cells often express PD-L1, which binds to PD-1 on T cells, suppressing their activity and allowing the tumors to avoid destruction. PD-1 inhibitors (for example, pembrolyzumab, nivolumab) and PD-L1 inhibitors (for example, atisolizumab, durvalumab) block this interaction, restoring the activity of T-cells and allowing them to attack cancer.

2. Clinical application: Inhibitors of control points of immunity were effective in the treatment of a wide range of cancerous diseases, including:

   • Melanoma: CTLA-4 and PD-1 inhibitors significantly improved the survival of patients with metastatic melanoma.
   • Lung cancer: PD-1 and PD-L1 inhibitors have become the standard for patients with non-coclic lung cancer, especially those whose tumors express PD-L1.
   • Kidney cancer: PD-1 inhibitors, both in the form of monotherapy and in combination with other drugs, significantly improved the treatment of patients with metastatic kidney cancer.
   • Hojkina lymphoma: PD-1 inhibitors turned out to be effective for patients with Hodgkin lymphoma, in whom the disease has recurrent or did not respond to other treatment methods.
   • Bladder cancer: PD-1 and PD-L1 inhibitors are approved for the treatment of patients with progressive bladder cancer.
   • Other types of cancer: Studies show the potential of inhibitors of control points of immunity in the treatment of other types of cancer, such as cancer of the head and neck, cancer of the stomach and breast cancer.

3. Side effects: Although inhibitors of control points of immunity are often tolerated better than chemotherapy, they can cause immuno -mediated side effects, since the immune system becomes over -over. These side effects may include:

   • Colitis: Inflammation of the colon, causing diarrhea and abdominal pain.
   • Pneumonite: Elive inflammation, causing shortness of breath and cough.
   • Hepatitis: Inflammation of the liver, causing jaundice and increasing the level of liver enzymes.
   • Endocrinopathy: Problems with hormones, such as hypothyroidism (lack of thyroid hormones) or diabetes.
   • Skin reactions: Raw, itching and other skin problems.

   Early detection and treatment of these side effects is crucial for preventing serious complications.

B. Car-T Therapy: Engineering T cells for cancer attack

Car-T Therapy (Chimeric Antigen Receptor T-Cell Therapy) is an innovative type of immunotherapy, which includes the genetic modification of the patient’s own T-cells for recognition and destruction of cancer cells.

1. CAR-T therapy process:

   • Collection of T cells: The patient is collected through a scam, a process similar to a blood donation.
   • Genetic modification: In the laboratory, T-cells are genetically modified by introducing a gene encoding a chimary antigenic receptor (CAR). Car allows T-cells to recognize a specific antigen present on the surface of cancer cells.
   • Propagation of T cells: Modified CAR-T cells multiply in the laboratory in large quantities.
   • CAR-T CAR-T infusion: Car-T cells are introduced back to the patient by infusion. Before infusion, the patient is usually carried out chemotherapy to reduce the number of immune cells and create a favorable environment for Car-T cells.
   • Brush cell attack: After CAR-T infusion, cells are circulated in the body and can be cancer cells expressing the target antigen. Car-T cells bind to cancer cells and destroy them.

2. Clinical application: CAR-T Therapy was especially effective in the treatment of certain types of blood cancer, including:

   • Acute lymphoblastic leukemia (all) in children and young adults: Car-T Therapy revolutionized Oll, offering a chance for remission to patients in whom other treatment methods were ineffective.
   • Diffuse B-circuit-skull lymphoma (DVKL): CAR-T Therapy also turned out to be effective in the treatment of DVKL, such as non-Hodgkin lymphoma, in patients in whom the disease recova or did not respond to other methods of treatment.
   • Multiple myeloma: Several CAR-T Therapies are currently under developmental processes for the treatment of multiple myeloma, and preliminary results are encouraging.

3. Side effects: CAR-T Therapy can cause serious side effects, including:

   • Cytokine release syndrome (SVC): SVC arises when Car-T cells are activated and a large number of cytokines are released, which can lead to fever, hypotension (low blood pressure), shortness of breath and neurological problems.
   • Neurological toxicity: Car-T Therapy can cause neurological problems, such as confusion, cramps and encephalopathy.
   • Cytopenia: CAR-T Therapy can cause a decrease in the number of blood cells, which can lead to infections and bleeding.

   Management of these side effects requires experience and specialized assistance.

C. Oncolytic viruses: the use of viruses to destroy cancer cells

Oncolytic viruses are viruses that selectively infect and destroy cancer cells without harming healthy cells.

1. The mechanism of action:

   • Electoral infection: Oncolytic viruses are modified so that they can selectively infect and replicate in cancer cells, using their weakened protective mechanisms.
   • Lisis of cancer cells: After infection of cancer cells, oncolytic viruses are replicated inside the cells, which leads to their lysis (destruction).
   • Immune answer: The destruction of cancer cells releases antigens that stimulate the immune response against the remaining cancer cells.

2. Clinical application: Talimogene laherparepvac (T-VEC) is an oncolytic virus approved for the treatment of melanoma, which cannot be removed surgically. Oncolytic viruses are also studied for the treatment of other types of cancer, such as brain cancer, breast cancer and prostate cancer.

3. Advantages: Oncolytic viruses have several potential advantages over other methods of cancer treatment, including:

   • Selectivity: They are selectively aimed at cancer cells without harming healthy cells.
   • Immunostimulation: They stimulate the immune response against cancer cells.
   • Combination potential: They can be combined with other methods of cancer treatment, such as chemotherapy and radiation therapy.

D. Waccines against cancer: Learning the immune system to attack cancer

Cancer vaccines are a type of immunotherapy, which is designed to teach the immune system to recognize and attack cancer cells.

1. Types of cancer vaccines:

   • Preventive vaccines: These vaccines are designed to prevent cancer development. An example is a vaccine against the human papilloma virus (HPV), which prevents cervical cancer, anal canal cancer and other types of cancer associated with HPV.
   • Therapeutic vaccines: These vaccines are designed to treat existing cancer. They work, stimulating the immune response against cancer cells.

2. The mechanism of action: Cancer vaccines usually contain antigens that are present on the surface of cancer cells. When the vaccine is introduced, the immune system recognizes antigens as alien and triggers the immune response. This immune response includes the activation of T cells that can kill cancer cells, and the production of antibodies that can be aimed at cancer cells.

3. Clinical application: Sipuleucel-T (Provenge) is a therapeutic vaccine against cancer, approved for the treatment of metastatic cancer of the prostate gland. Other vaccines against cancer are currently being developed to treat various types of cancer.

II. Targeted therapy: accurate blow to cancer cells

Targeted therapy is a type of cancer treatment that is aimed at specific molecules involved in growth, development and distribution of cancer. Unlike chemotherapy, which affects all rapidly dividing cells, targeted therapy is more selective and can be more effective with fewer side effects.

A. Inhibitors Tyrosinkinase (TKI): blocking of signal growth pathways

Tyrosinkinase (TC) is enzymes that play an important role in transmitting signals inside the cells. Many cancer cells have abnormal TC, which contribute to their growth and survival. Tyrosinkinase inhibitors (TKI) are drugs that block the activity of these abnormal TC, thereby suppressing the growth and spread of cancer.

1. The mechanism of action: TKI bind to the ATP-binding domain of tyrosinkinase, blocking the phosphorylation of substrates and, therefore, interrupting the transmission of the signals below in the flow. This can lead to inhibiting cell proliferation, apoptosis (programmed death of cells) and a decrease in angiogenesis (the formation of new blood vessels that feed the tumor).

2. Clinical application: TKI is widely used to treat various types of cancer, including:

   • Chronic myelolecosis (KhML): Imatinib (Glute) revolutioned in the treatment of KML, blocking the activity of BCR-BL, abnormal tyrosinkinase, which is present in the CML cells.
   • Nemelcoclet lung cancer (NMRL): Gephitinib, Erlotinib and Osimertinib are aimed at the receptor of the epidermal growth factor (EGFR), which often mutates with the NMRL.
   • Gastrointestinal stromal tumors (GISO): Imatinib is also effective in the treatment of GISO, aiming at KIT, another tyrosinkinase, which often mutates in these tumors.
   • Renal cell cancer (PCR): Sunitinib and Sorafenib are aimed at VEGF receptors, which play the role in angiogenesis, thereby suppressing the growth of PCR.

3. Side effects: The side effects of TKI vary depending on the specific drug and dose, but may include:

   • Skin rash: Many TKI cause a skin rash that can be light or heavy.
   • Diarrhea: Diarya is a common side effect of TKI.
   • Fatigue: Fatigue is also a common side effect of TKI.
   • Hypertension: Some TKI can cause hypertension (high blood pressure).
   • Heart problems: Some TKI can cause heart problems, such as heart failure.

B. MAPK-Puti inhibitors: interruption of cancer growth signals

MAPK Put (mitogen-activated proteinquine alarm) is an important signaling way that regulates the growth, proliferation and differentiation of cells. Mutations in genes encoding the components of the MAPK-Poute are often found in cancer. Mapp-out inhibitors are medicines that block the activity of this path, thereby suppressing the growth of cancer.

1. The mechanism of action: The MAPK Put consists of a cascade of kinaz, including RAS, RAF, MEK and ERK. MAPK-toe inhibitors can aim at various components of this path, such as Braf and MEK. By blocking these kinases, MAPK-Putes inhibitors can inhibit signal transmission below by flow and suppress the growth of cancer cells.

2. Clinical application: MAPK-Puti inhibitors are used to treat various types of cancer, including:

   • Melanoma: Vemorafenib and Dabrafenib are BRAF inhibitors, which are effective in the treatment of melanoma with the Braf V600E mutation. Trametinib and Kobimetinib are MEK inhibitors, which are also used to treat melanoma with the BRAF V600E mutation in combination with BRAF inhibitor.
   • Lung cancer: Some MEK inhibitors are studied for the treatment of lung cancer.

3. Side effects: Side effects of MAPK-tobular inhibitors vary depending on the specific drug and dose, but may include:

   • Skin rash: The skin rash is a common side effect of MAPK Puti inhibitors.
   • Photo sensitivity: MAPK-sides inhibitors can increase the sensitivity of the skin to sunlight.
   • Arthralgia: Arthralgia (joint pain) is a common side effect of MAPK Puti inhibitors.
   • Fever: The fever is also a common side effect of MAPK Puti inhibitors.

C. CDK inhibitors: cell cycle control

Cyclin-dependent kinase (CDK) are enzymes that play an important role in the regulation of the cell cycle. The abnormal activity of the CDK can lead to uncontrolled proliferation of cells and cancer. CDK inhibitors are drugs that block the activity of CDK, thereby stopping the growth of cancer cells.

1. The mechanism of action: CDK form complexes with cyclines, which leads to activation of CDK. Activated CDK phosphorylation, which are involved in the regulation of the cell cycle. CDK inhibitors bind to CDK and block their activity, thereby stopping the progression of the cell cycle.

2. Clinical application: CDK inhibitors are used to treat various types of cancer, including:

   • Breast cancer: Ribocyclib, Palbocyclib and Abemaclicclib are CDK4/6 inhibitors, which are used to treat hormone receptor-positive, HER2-negative breast cancer.
   • Mantorocleocletochnachnai lymphoma: Mantic -cell lymphoma (MKL) is a type of non -podzhkinsky lymphoma, which is characterized by translocation t (11; 14), which leads to the super -expression of the cycle D1. The abnormal regulation of the cell cycle is a characteristic feature of MKL, and inhibition of CDK can effectively induce the stopping of the cell cycle and apoptosis in MKL cells.
   • Glioblastoma: Selicyclib, CDK inhibitor, is in the development stage for the treatment of glioblastoma.

3. Side effects: Side effects of CDK inhibitors vary depending on a particular drug and dose, but may include:

   • Mylospgress: CDK inhibitors can cause myelosupression, which leads to a decrease in the number of blood cells.
   • Fatigue: Fatigue is a common side effect of CDK inhibitors.
   • Nausea: Nausea is also a common side effect of CDK inhibitors.
   • Diarrhea: Diarya is a common side effect of CDK inhibitors.

D. PARP inhibitors: operation of DNA reparation defects

PARP (Paul (Adf Ribose)-Polymerase) is a family of enzymes that play an important role in DNA reparation. Cancer cells with DNA reparation defects, such as BRCA1 or BRCA2 mutations, are especially sensitive to PARP inhibitors.

1. The mechanism of action: PARP inhibitors block PARP activity, preventing the restoration of damaged DNA. In cells with DNA reparation defects, PARP inhibition leads to the accumulation of DNA damage and cell death. This principle is known as “synthetic mortality.”

2. Clinical application: PARP inhibitors are approved for the treatment of various types of cancer, including:

   • Ovary cancer: Olaparib, RoParib and Niraparib are PARP inhibitors, which are used to treat ovarian cancer with BRCA1 or BRCA2 mutations.
   • Breast cancer: Olaparib is also approved for the treatment of Her2-negative breast cancer with BRCA1 or BRCA2 mutations.
   • Prostate cancer: Olaparib and Rudparib are approved for the treatment of metastatic castration-resisted prostate cancer (MCRPC) with some mutations in DNA reparation genes.

3. Side effects: Side effects of PARP inhibitors vary depending on a particular drug and dose, but may include:

   • Mylospgress: PARP inhibitors can cause myelosupression, which leads to a decrease in the number of blood cells.
   • Fatigue: Fatigue is a common side effect of PARP inhibitors.
   • Nausea: Nausea is also a common side effect of PARP inhibitors.

E. Monoclonal antibodies: point delivery of drugs to cancer cells

Monoclonal antibodies (MAB) are laboratory -created antibodies that are designed to bind to specific antigens on the surface of cancer cells. MAB can be used for various purposes, including:

1. Direct aiming on cancer cells: Some MAB can directly contact antigens on cancer cells and run their death.

2. Signaling track locks: Some MAB can block the signaling paths that are necessary for the growth and survival of cancer cells.

3. Delivery of drugs to cancer cells: Some MAB can be conjugated with drugs, chemotherapeutic agents or radioactive isotopes, which allows you to deliver these drugs directly to cancer cells.

4. Clinical application: Mab is widely used to treat various types of cancer, including:

   • Breast cancer: Trastuzumab (heceptin) is aimed at HER2, growth factor receptor, which is super -explosive in about 20% of cases of breast cancer. Pertuzumab is also aimed at HER2 and is used in combination with trastuzumab for the treatment of HER2-positive cancer of the mammary gland.
   • Lymphoma: Rituximab (Mabter) is aimed at CD20, a protein that is expressed on the surface of the B cells. Rituximab is used to treat various types of B cell lymphomas.
   • Tolstoy Cancer: Bevacizumab (Avastin) is aimed at VEGF, growth factor, which plays a role in angiogenesis. Bevacizumab is used to treat cancer of the colon, lung cancer and other types of cancer.
   • Lung cancer: Cetuximab is aimed at EGFR, a growth factor receptor, which is super-explosive in about 40-80% of cases of flat cell cancer of the head and neck.

5. Side effects: Side effects of MAB vary depending on a particular drug and dose, but may include:

   • Infusion reactions: Some MAB can cause infusion reactions such as fever, chills and itching.
   • Allergic reactions: Some MAB can cause allergic reactions.
   • Fatigue: Fatigue is a common side effect of MAB.

III. Other innovative cancer treatment methods

In addition to immunotherapy and targeted therapy, there are a number of other innovative methods of cancer treatment that are under development.

A. Adaptive radiation therapy (ART): accurate radiation delivery

Adaptive radiation therapy (ART) is a type of radiation therapy that adapts the treatment plan depending on changes in the size, form or position of the tumor. This allows you to deliver more accurate doses of radiation to the tumor, sparing surrounding healthy tissues.

1. The mechanism of action: ART uses images, such as CT or MRI, to monitor changes in the tumor during treatment. The treatment plan is then adjusted depending on these changes. This may include a change in the shape of the beam, the intensity of the beam or the dose of radiation.

2. Clinical application: ART is used to treat various types of cancer, including prostate cancer, lung cancer and head and neck cancer.

3. Advantages: ART has several advantages over traditional radiation therapy, including:

   • Increasing accuracy: ART delivers more accurate doses of radiation to the tumor.
   • Reduced toxicity: ART spares the surrounding healthy tissues, which reduces the toxicity of treatment.
   • Improved results: ART can improve the treatment results for some types of cancer.

B. Brachitherapy: internal irradiation of the tumor

Brachitherapy is a type of radiation therapy in which a radioactive source is placed directly inside or next to the tumor. This allows you to deliver high doses of radiation directly to the tumor, sparing surrounding healthy tissues.

1. The mechanism of action: Brachitherapy uses radioactive sources, such as Irididia-192 or Cesius-137, which radiation radiation. The source is placed inside or next to the tumor using applicators, such as needles or tubes. Radiation destroys cancer cells.

2. Clinical application: Brachitherapy is used to treat various types of cancer, including prostate cancer, cervical cancer and breast cancer.

3. Advantages: Brachitherapy has several advantages over external radiation therapy, including:

   • High doses of radiation: Brachitherapy allows you to deliver high doses of radiation directly to the tumor.
   • Reduced toxicity: Brachitherapy spares the surrounding healthy tissues, which reduces the toxicity of treatment.
   • Convenience: Brachitherapy can be completed for fewer sessions than external radiation therapy.

C. High -intensive focused ultrasound (HIFU): destruction of the tumor ultrasound

High -intensive focused ultrasound (HIFU) is a non -invasive treatment method that uses ultrasonic waves to heat and destroy cancer cells.

1. The mechanism of action: HIFU uses ultrasonic waves of high intensity, which focus on tumors. This creates heat that destroys cancer cells.

2. Clinical application: HIFU is used to treat various types of cancer, including prostate cancer, kidney cancer and liver cancer.

3. Advantages: HIFU has several advantages over other methods of cancer treatment, including:

   • Non -invasiveness: HIFU is a non -invasive treatment method that does not require surgical intervention.
   • Reduced toxicity: Hifu spares the surrounding healthy tissues, which reduces the toxicity of treatment.
   • Quick recovery: Recovery after HIFU is usually fast.

D. Nanotechnology in the treatment of cancer: Delivery of drugs directly to cancer cells

Nanotechnologies are the use of materials and devices in the nan-scale (1-100 nanometers). Nanotechnologies have great potential to improve cancer treatment.

1. The use of nanotechnologies in the treatment of cancer:

   • Delivery of drugs: Nanoparticles can be developed for the delivery of drugs directly to cancer cells. This can increase the effectiveness of treatment and reduce side effects.
   • Diagnosis: Nanoparticles can be used to improve tumor visualization.
   • Therapy: Nanoparticles can be used to destroy cancer cells using hyperthermia or photodynamic therapy.

2. Examples:

   • Liposomal drugs: Liposomes are nanoparticles consisting of lipids. They are used to deliver chemotherapeutic drugs, such as doxorubicin and paclitaksel, to cancer cells.
   • Gold nanoparticles: Gold nanoparticles can be used for hyperthermia of cancer cells. Nanoparticles absorb light and turn it into heat, which destroys cancer cells.

IV. Conclusion

Oncology continues to develop rapidly, offering new and promising methods of cancer. Immunotherapy, targeted therapy, adaptive radiation therapy, brachytherapy, HIFU and nanotechnology are just some of the innovative approaches that change the landscape of cancer treatment. Understanding these new methods of treatment is crucial for doctors, patients and researchers in order to provide the most effective and personalized treatment options for each person. Continuing research and development will undoubtedly lead to even greater progress in the fight against cancer in the coming years.