Cancer: the latest research and development

I. Cancer genomics: revealing molecular mechanisms

The genomes of cancer, which studies the full set of genes of cancer cells, revolutionized in our understanding of cancer biology. Analysis of the genome of cancer cells allows you to identify specific genetic mutations, driver genes and signaling paths involved in the development and progression of the tumor. This, in turn, opens up opportunities for the development of new, more effective and personalized treatment methods.

A. Sectiments of a new generation (NGS): Golden standard of genomic analysis

NGS, which includes various technologies for sequencing DNA and RNA, has become a powerful tool for a comprehensive analysis of the cancer cell genome. NGS allows you to identify:

Somatic mutations: Mutations acquired throughout life and present only in cancer cells, and not in the normal cells of the body.
Variations of the number of copies (CNV): Changes among copies of genes that can lead to increased or suppress the expression of genes involved in the development of cancer.
Structural perestroika: Changes in the structure of chromosomes, such as translocations, inversions and deletions, which can disrupt the normal function of genes.
Epigenetic modifications: Changes in DNA and histones that do not change the sequence of DNA, but affect the expression of genes.
Genes expression: The level of activity of various genes in cancer cells, which allows you to identify genes that are excessively active or suppressed into tumors.

The identification of these genetic and epigenetic changes allows you to determine the subtype of cancer, predict the response to treatment and develop personalized treatment strategies.

B. Classification of cancer at the molecular level: from traditional histology to genomics

Traditionally, cancer is classified on the basis of histological characteristics, such as the type of cells, the degree of differentiation and the presence of metastases. However, the genomic analysis showed that cancer of the same histological classification can be heterogeneous at the molecular level, i.e. have various genetic mutations and signaling paths.

For example, breast cancer, traditionally classified as an estrogen receptor positive (ER+), can be divided into various molecular subtypes based on genes expression, such as luminal A, luminal B, Her2-positive and three times negative. These subtypes have a different prognosis and require various treatment strategies.

The genomic allows you to classify cancer based on molecular characteristics, which provides more accurate diagnosis, forecasting and the choice of the most effective treatment.

C. The role of micro -angle of the tumor in the genomic evolution of cancer

Micro -angle of the tumor, which includes various types of cells, such as fibroblasts, immune cells and endothelial cells, as well as extracellular matrix and growth factors, plays an important role in the development and progression of cancer.

Micro -angle of the tumor can affect the genomic evolution of cancer cells, stimulating mutations, changing the expression of genes and contributing to treatment resistance. For example, immune cells in micro -inforation tumors can exert selective pressure on cancer cells, leading to the development of mutations that allow cancer cells to evade the immune response.

Understanding the interaction between cancer cells and tumor micro -inflection is important for the development of new treatment methods aimed at modulating tumor micro -infection and preventing the genomic evolution of cancer.

D. Liquid biopsy: non -invasive monitoring of genomic changes

Liquid biopsy, which is a blood test or other biological fluids for the presence of cancer cells or their components, has become a promising tool for non -invasive monitoring of genomic changes in cancer.

Liquid biopsy allows you to detect:

Circulating tumor cells (CTC): Cancer cells separated from the primary tumor and circulating in the blood.
Circulating tumor DNA (CTDNA): DNA released from cancer cells into the blood.
Exosome: Small vesicals secreted by cancer cells containing DNA, RNA and proteins.

The analysis of these components allows you to identify genetic mutations, predict the response to treatment and control the progression of the disease without the need for invasive biopsies.

II. Cancer immunotherapy: revealing the strength of the immune system

Cancer immunotherapy, aimed at stimulating the immune system to combat cancer, revolutionized many types of cancer. Immunotherapy uses various strategies, such as inhibitors of control points of the immune response, car-T cell therapy and oncolytic viruses to activate the immune system and destroy cancer cells.

A. Inhibitors of control points of the immune response: removal of brakes from the immune system

Inhibitors of control points of the immune response, such as anti-CTLA-4, anti-PD-1 and anti-PD-L1 antibodies, block molecules that suppress the activity of immune cells. These drugs allow the immune system to more effectively recognize and destroy cancer cells.

CTLA-4 (Cytotoxic T-lymphocyte-associated protein 4): Protein expressed on T cells that suppresses their activation. Anti-CTLA-4 antibodies block CTLA-4, allowing T-cells to more effectively activate and attack cancer cells.
PD-1 (Programmed cell death protein 1): Protein expressed on T cells, which suppresses their activity when interacting with PD-L1, protein expressed in cancer cells. Anti-PD-1 and anti-PD-L1 antibodies block this interaction, allowing T-cells to more effectively attack cancer cells.

Inhibitors of control points of the immune response showed impressive results in the treatment of many types of cancer, including melanoma, lung cancer, kidney cancer and bladder cancer.

B. Car-T-cell therapy: reprogramming immune cells to combat cancer

CAR-T-cell therapy is a personalized approach to immunotherapy, which includes the genetic modification of the patient’s T-cells for the expression of a chimeric antigenic receptor (CAR). Car allows T-cells to recognize and attack cancer cells expressing a specific antigen.

Car-T-cell therapy has shown high efficiency in the treatment of some types of leukemia and lymphoma. However, Car-T-cell therapy can cause serious side effects, such as cytokine release syndrome (CRS) and neurotoxicity.

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

Oncolytic viruses are viruses that selectively infect and destroy cancer cells without harming normal cells. Oncolytic viruses can kill cancer cells directly, as well as stimulate the immune response against the tumor.

Oncolytic viruses showed promising results in the treatment of various types of cancer, including melanoma, glyoblastoy and liver cancer.

D. Waccines against cancer: training the immune system for recognition and destruction of cancer cells

Cancer vaccines are aimed at training the immune system for recognition and destruction of cancer cells. Cancer vaccines can be preventive (preventing cancer) or therapeutic (treating already existing cancer).

Preventive vaccines: For example, a vaccine against the human papilloma virus (HPV) prevents the development of cervical cancer, vagina and anus caused by HPV.
Therapeutic vaccines: They are used to stimulate an immune response against cancer cells in patients with existing cancer.

The development of effective cancer vaccines is a difficult task, but research in this area continues, and there is a hope that in the future, cancer vaccines will become an important tool in the fight against this disease.

E. Immunotherapy resistance: mechanisms and strategies for overcoming

Despite the impressive results, immunotherapy is not effective for all patients with cancer. Many patients develop resistance to immunotherapy. Immunotherapy resistance mechanisms include:

Loss or decrease in antigens expression: Cancer cells can lose or reduce the expression of antigens recognized by the immune system, which makes them invisible to immune cells.
Increased expression of immunosuppressive molecules: Cancer cells can increase the expression of immunosuppressive molecules, such as PD-L1 and TGF-β, which inhibit the activity of immune cells.
Violation of the function of antigen -presenting cells (APC): APC, such as dendritic cells, play an important role in the activation of T cells. Disruption of the APC function can lead to an inadequate immune response against cancer.
The exclusion of T cells from the tumor: T-cells can be excluded from the tumor due to barriers created by microtrape of the tumor.

The development of strategies for overcoming resistance to immunotherapy is an important field of research. These strategies include:

Combined immunotherapy: The use of several immunotherapeutic drugs at the same time.
Targeted therapy in combination with immunotherapy: The use of targeted preparations to influence specific molecules in cancer cells in combination with immunotherapy.
Modulating tumor micro -infection: The use of drugs aimed at modulating tumor micro -infection and increasing the efficiency of immunotherapy.
Development of new immunotherapeutic drugs: The development of new immunotherapeutic drugs aimed at other control points of the immune response or stimulating the immune system in other ways.

III. Cancer Targeter Therapy: attack on specific molecular targets

Targeted therapy of cancer aimed at specific molecular targets in cancer cells, such as mutating genes, proteins and signaling paths, has become an important tool in the treatment of many types of cancer. Targeted drugs can block the activity of these targets, which leads to the death of cancer cells or a slowdown in their growth.

A. Inhibitors Tyrosinkinase: blocking signal tracts that promote cancer

Tyrosinkinase (TKI) inhibitors block the activity of tyrosinkinase, enzymes that play an important role in transmitting signals that control growth, proliferation and cell survival. Many cancer cells have abnormally active tyrosinkinase, which contributes to their uncontrolled growth.

TKI are used to treat various types of cancer, including chronic myelolecosis (KML), non -alcoholic lung cancer (NMRL) and gastrointestinal stromal tumors (GISO).

B. MTOR inhibitors: suppressing the signaling path that regulates the growth and metabolism of cells

Mtor (Mammalian Target of Rapamycin) is a protein that plays an important role in the regulation of growth, proliferation, survival and metabolism of cells. Activation of the MTOR signal path is often observed in cancer cells and contributes to their uncontrolled growth.

MTOR inhibitors, such as sylolymus and everolymus, are used to treat various types of cancer, including kidney cancer, breast cancer and neuroendocrine tumors.

C. CDK4/6 inhibitors: blocking the cell cycle and preventing the division of cancer cells

CDK4/6 (Cyclin-Dependent Kinases 4 and 6) is enzymes that play an important role in the regulation of the cell cycle. CDK4/6 inhibitors, such as Palbocyclib, Ribocyclib and Abemaclicclib, block the activity of CDK4/6, which leads to the stopping of the cell cycle and prevent the division of cancer cells.

CDK4/6 inhibitors are used to treat the hormone receptor of a positive (HR+), HER2-negative (HER2-) breast cancer.

D. PARP inhibitors: FAILITING on cells with DNA reparation defects

PARP (Poly (Adp-Ribose) Polymerase) is an enzyme that plays an important role in DNA reparation. PARP inhibitors, such as Olaparib, Rhoparib and Talazoparib, block the PARP activity, which leads to the accumulation of DNA damage and the death of cancer cells with DNA reparation defects, such as mutations in the BRCA1 and BRCA2 genes.

PARP inhibitors are used to treat ovarian cancer, breast cancer, prostate cancer and pancreatic cancer in patients with mutations in BRCA1 and BRCA2 genes.

E. Monoclonal antibodies: aiming on specific antigens on cancer cells

Monoclonal antibodies (mat) are antibodies that are associated with specific antigens on cancer cells. mat can act in various ways, including:

Blocking signal tracks: The mat can block the signaling paths that contribute to the growth and survival of cancer cells.
Stimulation of the immune response: The mat can stimulate the immune system for the destruction of cancer cells.
Delivery of toxic substances: The mat can be conjugated with toxic substances such as chemotherapeutic drugs or radioactive isotopes, and deliver them directly to cancer cells.

The mat is used to treat various types of cancer, including breast cancer, lung cancer, colon cancer and lymphoma.

F. Targeted therapy resistance: mechanisms and strategies for overcoming

Cancer cells often develop resistance to targeted therapy. Targeted therapy resistance mechanisms include:

Mutations in targets: Cancer cells can develop mutations in the target of a targeted drug, which makes the drug ineffective.
Activation of alternative signaling ways: Cancer cells can activate alternative signaling paths that go around the blocked path.
Increased expression of proteins, pumping medications: Cancer cells can increase the expression of proteins that pump the medicines from the cell, which reduces the concentration of a targeted drug in cancer cells.

The development of strategies for overcoming resistance to targeted therapy is an important field of research. These strategies include:

Combined targeted therapy: The use of several targeted drugs at the same time.
Targeted therapy in combination with chemotherapy or immunotherapy: The use of targeted drugs in combination with chemotherapy or immunotherapy.
Development of new targeted drugs: Development of new targeted drugs aimed at other molecular targets or to overcome resistance mechanisms.

IV. New technologies and approaches in the treatment of cancer

In addition to genomics, immunotherapy and targeted therapy, new technologies and approaches in the treatment of cancer are being developed, which open up new prospects for combating this disease.

A. Crispr-Cas9: editing genes for cancer treatment

CRISPR-CAS9 is a genes editing technology that allows you to accurately change the DNA sequence in the cells. CRISPR-CAS9 can be used to treat cancer in various ways, including:

Inactivation of genes that contribute to the growth of cancer: CRISPR-CAS9 can be used to inactivation of genes that contribute to the growth and survival of cancer cells.
Restoration of the function of tumor-supervisors: CRISPR-CAS9 can be used to restore the function of the tumor genes, which were inactivated in cancer cells.
Modification of immune cells: CRISPR-CAS9 can be used to modify immune cells to increase their ability to recognize and destroy cancer cells.

CRISPR-CAS9 is a promising technology for the treatment of cancer, but its use in clinical practice is still at an early stage.

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

Nanotechnologies allow you to develop nanoparticles that can be used to deliver drugs directly into cancer cells. Nanoparticles can be designed in such a way that they selectively accumulate in cancer cells and release the medicine, minimizing toxicity for healthy cells.

Nanotechnologies are used to deliver various types of drugs, including chemotherapeutic drugs, small interferring RNA (Sirna) and gene therapy.

C. Proton therapy: more accurate radiation therapy with less damage to healthy tissues

Proton therapy is a type of radiation therapy that uses protons, and not x -rays, to destroy cancer cells. Protons have unique physical properties that allow them to deliver most of their energy to the tumor, minimizing damage to surrounding healthy tissues.

Proton therapy can be especially useful for the treatment of cancer in children, as well as cancer located near critical organs.

D. Artificial intelligence (AI) in the diagnosis and treatment of cancer: Improving accuracy and effectiveness

Artificial intelligence (AI) is used in various areas of diagnosis and treatment of cancer, including:

Analysis of medical images: AI can be used to analyze medical images, such as x-rays, computed tomography (CT) and magnetic resonance imaging (MRI), to detect cancer in the early stages.
Drug development: AI can be used to analyze large volumes of data and identify new targets for drugs and develop new drugs.
Personalized medicine: AI can be used to analyze genomic data and develop personalized treatment strategies for each patient.

AI has the potential for the revolution in the diagnosis and treatment of cancer, but its use in clinical practice is still at an early stage.

V. Final considerations

Studies and development in the field of cancer continue to develop rapidly. New technologies and approaches, such as genomics, immunotherapy, targeted therapy, CRISPR-CAS9, nanotechnology, proton therapy and artificial intelligence, open up new prospects for combating this disease. It is important to note that success in the treatment of cancer requires a multidisciplinary approach that combines the efforts of scientists, doctors and patients. The continuation of research and development, as well as the widespread introduction of new technologies and approaches into clinical practice, will improve the treatment of cancer and improve the quality of life of patients.