In late February, HBO aired a documentary, Killing Cancer, that sparked both excitement and controversy. There has also been skepticism, as it always seems as if the cure for cancer is almost at hand; even National Cancer Institute Director Andrew von Eschenbach predicted in 2003 that the NCI would “eliminate suffering and death” from cancer by the year 2015. Yet there have been some major breakthroughs in recent years to suggest that viable new treatments — if not an outright cure — are available. Buzz in the cancer research community and some promising early clinical trials suggest that effective new cancer treatments may be widely available by 2016. Here are some of the top new innovative techniques that are being used to combat cancer.
5. New Treatments Strike Cancer at the DNA Level
Could cancer become a manageable condition rather than a death sentence? One new technique promises an advance that would sequence the DNA of tumors, for an individualized approach to treatment. One of the major challenges of traditional radiation and chemotherapy treatments is the ability to selectively tailor and target the specific approach from patient to patient. The completion of the Human Genome Project in 2003 has allowed science to discover genes related to specific types of cancer, allowing physicians to prescribe specific types of treatment accordingly. Already, the identification of the BRCA1 and 2 genes associated with ovarian and breast cancer has allowed researchers to develop drugs that attack the related HER2 protein.
4. Therapies Train the Immune System to Kill Cancer
Could the body’s own immune system be trained to spot and kill cancer? Immunotherapy promises a unique approach for hard-to-treat cancers, and may even make chemo and radiation treatments unnecessary in some cases. Our immune system has a blind spot when it comes to cancer, as it ignores human tissue by design. This is ordinarily handy, as an immune system that attacks itself leads to autoimmune diseases. Researchers at the University of California San Francisco found a way to inhibit cell receptors that block the immune system using antibodies, and have effectively treated hard-to-cure metastatic melanomas and lung cancers. This sort of therapy would also have the added bonus of permanent immunity, as immune system T-cells can remember an infection for decades.
A new antibody drug named ipilimumab developed at UC Berkeley for use against melanoma was approved by the FDA in 2011; it is marketed under the name Yervoy. Immunotherapy was named the Top Breakthrough in 2013 by Science magazine.
3. FDA Has Approved ‘Small Molecule’ Fight Against Cancer
As cancer cells grow, they evade destruction by manipulating enzymes known as protein kinases. Now, a new line of lightweight “small molecule” drugs known as kinase inhibitors seeks to disrupt this signal and stop the growth of cancer in its tracks. As of 2014, 19 different kinase inhibitors had received FDA approval, and these may succeed where traditional chemotherapy drugs have failed. One small molecule kinase inhibitor named Afatinib (brand name: Gilotrif) approved by the FDA in 2013 shows great promise against certain types of carcinomas. Many more kinase inhibitor-type drugs are on the horizon, promising a new weapon in the arsenal on the war on cancer.
2. Epigenetic Drugs Show Promise in Leukemia Treatment
A major dilemma in cancer treatment is drug resistance. Epigenetics is the study of gene expression influenced by environment beyond our inherited genome. Many of our genes are simply switched off, and can be switched on by negative environmental influences, such as smoking. Epigenetic changes — reversible changes in gene expression that can regulate cancer cell metastasis — have been identified as the source of many diseases, including an inherited risk for cancer. A team at the Boston University School of Medicine has found that the use of epigenetic drugs in concert with traditional chemotherapy may prime cancer cells, leaving them open and vulnerable to other anti-cancer drugs. This sort of epigenetic treatment approach also has the added benefit of reducing complications due to drug resistance. This approach may be revolutionary in the case of treating leukemia, which is notorious for encouraging the development of cells that are drug-resistant. Studies have already shown reduced rates of relapse in cancer patients that have been pretreated with new epigenetic drugs.
1. Engineered Viruses Being Used to Target Cancer Cells
The use of viruses to treat cancer has generated a considerable amount of excitement in the cancer treatment community. Could measles, smallpox and even HIV actually be used to cure or create a vaccine for cancer? Viruses have evolved with us, and are armed with molecular keys that allow them to enter cells, where they proceed to hijack its inner machinery. Now, scientists may be able to hijack the viruses themselves and use them against cancers. In 2010, Dr. John Bell of the Ottawa Hospital Research Institute demonstrated how a reprogrammed smallpox virus could be used to target a protein specific to cancer cells. Such microscopic “smart missiles” also have a secondary benefit, as they also rally the body’s immune system, causing it to eliminate cancer cells disrupted by the designer viruses.
Viral therapy has long been suspected to be a possible cure for cancer. Early cases from 20th century medical literature suggested that cancer patients who received a rabies vaccine — which introduces a live virus that has been weakened — also had their cancers go into remission. Now, modern understanding of virus genomes may lead to an effective treatment for many types of cancer. Already, a laboratory-modified and disabled form of the HIV virus — which causes AIDS — has been utilized in what is termed T-cell therapy. This treatment is scheduled to be widely available in the United States in 2016. It would be an amazing tale of scientific wonder, if one of the great scourges of our time could be cured by using the afflictions of the past.