Innovation in oncology: new treatment methods

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Innovation in oncology: new treatment methods

Section 1: Targeted therapy: A targeted blow to the tumor

Targeted therapy, also known as target therapy, is a class of anti -cancer drugs that block the growth and spread of cancer, interfering in specific molecules involved in growth, progression and spread of cancerous cells. Unlike traditional chemotherapy, which is aimed at all rapidly dividing cells, targeted therapy is more selective and aimed only at cancer cells, which leads to a smaller number of side effects.

1.1 mechanisms of action of targeted therapy

Targeted therapy works through various mechanisms of action, depending on the specific molecule at which it is aimed. Some common mechanisms include:

Inhibiting thyrosinkinase: Tyrosinkinase (TK) are enzymes that play a key role in transmitting signals inside cells, regulating growth, differentiation and cell survival. Many cancer cells have abnormally active tyrosinkinase, which contribute to uncontrolled growth. Tyrosinkinase (TKI) inhibitors block the activity of these enzymes, stopping the transmission of signals and leading to the death of cancer cells. Examples of TKI are imatinib (glyc -coil) for chronic myelolecosis (KML) and Gephitinib (Iessa) for non -alcoholic lung cancer (NMRL) with EGFR mutations.
Signaling inhibiting: Cancer cells often have defects in signal tracks that regulate the growth and survival of cells. Targeted drugs can block these signaling paths, depriving cancer cells of the necessary signals for survival and growth. An example is the inhibition of Pi3k/AKT/MTOR, which plays a key role in cell growth and survival.
Angiogenesis inhibiting: Angiogenesis is the process of the formation of new blood vessels, which is necessary for the growth and spread of tumors. Angiogenesis inhibitors, such as Bevacizumab (Avastin), block the formation of new blood vessels, depriving a tumor of oxygen and nutrients necessary for growth.
Proteas inhibiting: Proteasomes are the complexes of enzymes that break down proteins inside the cells. Cancer cells are especially sensitive to inhibiting proteas, since they produce a large amount of protein. Proteas inhibitors, such as Bortezomib (VELKAD), block activity with proteas, leading to the accumulation of damaged proteins and the death of cancer cells.
Monoclonal antibodies: Monoclonal antibodies (MKA) are artificially created antibodies that are aimed at specific proteins on the surface of cancer cells. MKA can work through various mechanisms, including the direct killing of cancer cells, blocking signal tracts or attracting immune cells to a cancer cell. Examples of MKA are TRUSTUZUMAB (heceptin) for Her2-positive breast cancer and rituximab (Mabter) for non-Hodgkin lymphoma (NHL).

1.2 use of targeted therapy in various types of cancer

Targeted therapy is successfully used to treat various types of cancer, including:

Breast cancer: Trastuzumab (heceptin) and pertuzumab (perjot) are used to treat HER2-positive cancer of the mammary gland. CDK4/6 inhibitors, such as Palbocyclib (Ibrans), Ribocyclib (Pussy) and Abemacclicb (Verizenio), are used in combination with hormonal therapy for the treatment of HR-positive, Her2-negative metastatic cancer of the mammary gland.
Lung cancer: Gephitinib (Isses), Erlotinib (Tartseva), Afatinib (Giitrif), Osimertinib (Tagrissso) and other EGFR inhibitors are used to treat NMRL with EGFR mutations. Crisotinib (Xalcori), Ceritinib (Zikadia), Alektinib (Aletsensa), Brigatinib (Alimunsa) and Lorlatinib (Lorbrene) are used to treat NMRL with restructuring Alk gene.
Melanoma: Vemurafenib (Zeleborf) and Dabrafenib (Tafinlar) are used to treat melanoma with the Braf V600E mutation. Trametinib (Mekinist) and Kobimetinib (Kutellik) are MEK inhibitors, which are used in combination with BRAF inhibitors for the treatment of melanoma with the Braf V600 mutation.
Chronic myelolecosis (KhML): Imatinib (Glute), Dazatinib (Sprixel), Nilotinib (Tasil), Bozutinib (Bosulif) and Ponatinib (Ilisig) are used to treat hml with philadelphia chromosome (PH+).
Colorectal cancer: Bevacizumab (avastin) is used to inhibit angiogenesis in colorectal cancer. Cetuximab (Erbitux) and Panitumab (Veratibix) are used to treat colorectal cancer with the wild type of RAS gene.

1.3 Advantages and disadvantages of targeted therapy

Advantages:

High specificity: Targeted therapy is aimed at specific molecules in cancer cells, which leads to a smaller number of side effects than with chemotherapy.
Increased efficiency: Targeted therapy is often more effective than traditional chemotherapy, especially in cases where cancer has specific mutations or anomalies.
The possibility of personalized treatment: Targeted therapy allows you to choose treatment depending on the molecular profile of the patient’s tumor.

Flaws:

Sustainability development: Cancer cells can develop resistance to targeted therapy, which limits its effectiveness.
Side effects: Although targeted therapy usually has less side effects than chemotherapy, it can still cause side effects, such as skin rashes, diarrhea, fatigue and increased blood pressure.
Price: Targeted therapy is often more expensive than traditional chemotherapy.
Not suitable for all types of cancer: Targeted therapy is effective only in cases where cancer has specific molecular anomalies that can be aimed on.

Section 2: Immunotherapy: stimulation of the immune system to combat cancer

Immunotherapy is a type of cancer treatment that uses the body’s immune system to combat cancer. It works, stimulating or suppressing the immune system so that it can more effectively recognize and destroy cancer cells. Unlike traditional chemotherapy and targeted therapy, which are directly aimed at cancer cells, immunotherapy uses the patient’s own immune system to combat the disease.

2.1 Types of immunotherapy

There are several types of immunotherapy, including:

Control points inhibitors: Control points are molecules on the surface of immune cells that help regulate the immune response. Cancer cells often use control points to avoid detection and destruction of the immune system. Control points inhibitors block these molecules, allowing immune cells to more effectively attack cancer cells. Examples of control points inhibitors are pembrolizumab (Cateure), Nivolumab (OPDIVO), athelesolizumab (aurcentrick), durvalumab (Imfinzy) and Ipilimumab (Erva). They are aimed at CTLA-4, PD-1 and PD-L1.
Cell therapy: Cell therapy includes extracting the patient’s immune cells, their modification in the laboratory for a more effective combat of cancer and then return to the patient. The most common type of cell therapy is CAR-T-cell therapy, in which the patient T-cells are genetically modified for the expression of a chimeric antigenic receptor (CAR), which is aimed at a specific protein on the surface of cancer cells. Car-T-cell therapy is approved for the treatment of some types of leukemia and lymphoma.
Therapeutic vaccines: Therapeutic vaccines stimulate the immune system to the attack of cancer cells. Unlike preventive vaccines that prevent infections, therapeutic vaccines are designed to treat existing cancer. An example of a therapeutic vaccine is Sipulecur-T, which is used to treat metastatic castration and resolution cancer of the prostate gland.
Cytokines: Cytokins are proteins that play an important role in the regulation of an immune response. Some cytokines, such as Interleukin-2 (IL-2) and Interferon-alpha (IFN-α), are used to treat some types of cancer, stimulating the immune system.
Oncolytic viruses: Oncolytic viruses are viruses that selectively infect and destroy cancer cells. They can also stimulate the immune response against cancer. An example of an oncolytic virus is Talimogen Lahergic, which is used to treat melanoma, which cannot be removed surgically.

2.2 The use of immunotherapy in various types of cancer

Immunotherapy is successfully used to treat various types of cancer, including:

Melanoma: Control points inhibitors, such as pembrolizumab (Cateure), Nivolumab (Oddivo) and Ipilimumab (Erva), are effective treatment for metastatic melanoma.
Lung cancer: Control points inhibitors, such as pembrolizumab (Cateure), Nivolumab (OPDIVO), athelesolizumab (aurcentrick) and durvalumab (Imfinzi), are used to treat NMRL.
Kidney cancer: Control points inhibitors, such as nivolumab (adipose), pembrolyzumab (Cateitrude) and athelesolizumab (aurcentride), are used to treat renal cell cancer.
Bladder cancer: Control points inhibitors, such as athezolyzumab (aurcentride), durvalumab (Imfinzy) and pemblizumab (Catetrude), are used to treat bladder cancer.
Hojkina lymphoma: Control points inhibitors, such as nivolumab (adipose) and pembrolyzumab (Cateure), are used to treat recurrent or refractory lymphoma of Hodgkin.
Leukemia and lymphoma: CAR-T-cell therapy is approved for the treatment of some types of leukemia and lymphoma, such as acute lymphoblastic leukemia (OLL) and diffuse B-circuit-skull lymphoma (DVKKL).

2.3 Advantages and disadvantages of immunotherapy

Advantages:

Potential for a long answer: Immunotherapy can lead to a long response when the immune system continues to control the cancer for many years after the end of treatment.
Efficiency in some types of cancer: Immunotherapy was especially effective for some types of cancer, such as melanoma, lung cancer and kidney cancer.
The possibility of combined treatment: Immunotherapy can be combined with other types of cancer treatment, such as chemotherapy and targeted therapy, to increase efficiency.

Flaws:

Side effects: Immunotherapy can cause side effects associated with the activation of the immune system, such as autoimmune reactions that can affect various organs and tissues. These side effects are called immuno -mediated side effects (IRAE).
Inefficiency for all patients: Immunotherapy is ineffective for all patients, and some patients may not respond to treatment.
Price: Immunotherapy is often more expensive than traditional chemotherapy.
Sustainability development: Cancer cells can develop resistance to immunotherapy.

Section 3: Genomatic tumor profiling: Personalization of cancer treatment based on genetic characteristics

Genomal tumor profiling is the process of analysis of DNA and RNA of cancer cells to detect genetic changes, which can contribute to the growth and spread of cancer. This information can be used to personalize cancer treatment by choosing the most effective treatment methods based on the genetic characteristics of the tumor.

3.1 Methods of genomic tumor profiling

There are several methods of genomic tumor profiling, including:

New generation sequencing (NGS): NGS is a high -performance method for sequencing DNA and RNA, which allows you to simultaneously analyze a large number of genes. NGS can be used to identify mutations, delections, inserts, copy changes and restructuring of genes in cancer cells.
Immunohistochemistry (IHC): IHC is a method that uses antibodies to detect specific proteins in tissue samples. IHC can be used to determine the level of expression of certain proteins, which can be associated with the growth and spread of cancer.
Fluorescence hybridization in situ (fish): Fish is a method that uses fluorescent probes to identify specific DNA sequences in cells. Fish can be used to identify copy changes and restructuring genes in cancer cells.
Polymerase chain reaction (PCR): PCR is a method that is used to amplifying specific DNA sequences. PCR can be used to identify mutations in cancer cells.

3.2 use of genomic profiling tumor in clinical practice

Genomatic tumor profiling is used in clinical practice for:

Choice of targeted therapy: The genomic profiling of the tumor can be used to identify specific mutations in cancer cells, which can be aimed at targeted drugs. For example, patients with the NMRL with the EGFR mutation can be candidates for treatment with EGFR inhibitors, such as Gephitinib (Isterma) or Osimertinib (Tagrissso).
Estimates forecast: Genomal tumor profiling can be used to evaluate the prognosis of the disease. For example, patients with breast cancer with a high risk of relapse can be candidates for more aggressive treatment.
Choice of immunotherapy: The genomic profiling of the tumor can be used to predict a response to immunotherapy. For example, patients with tumors with a high mutation load (TMB) or PD-L1 expression can be more susceptible to immunotherapy.
Diagnostics of rare types of cancer: Genomal tumor profiling can be used to diagnose rare types of cancer, which is difficult to diagnose using traditional methods.

3.3 Advantages and disadvantages of genomic tumor profiling

Advantages:

Personalized treatment: The genomic profiling of the tumor allows you to choose the treatment of cancer based on the genetic characteristics of the patient’s tumor.
Improvement of forecasts: Genomal tumor profiling can help doctors better evaluate the prognosis of the disease and choose the most effective treatment methods.
Development of new treatment methods: Genomal tumor profiling helps researchers to identify new goals to develop new cancer treatment methods.

Flaws:

Price: Genomatic tumor profiling can be expensive.
The difficulty of interpretation of the results: The interpretation of the results of the genomic profiling of the tumor can be complex and requires special knowledge.
Limited availability: Genomatic tumor profiling may not be available in all medical institutions.
Does not always lead to a change in treatment: Not always the results of genomic tumor profiling lead to a change in treatment.

Section 4: Radiation therapy: accuracy and innovation in the destruction of cancer cells

Radiation therapy is a type of cancer treatment that uses high -energy radiation to destroy cancer cells. It works, damaging the DNA of cancer cells, which leads to their death. Radiation therapy can be used to treat many types of cancer and can be used as an independent treatment or in combination with other types of treatment, such as surgery, chemotherapy and targeted therapy.

4.1 types of radiation therapy

There are several types of radiation therapy, including:

External radiation therapy: External radiation therapy (EBRT) is the most common type of radiation therapy. With EBRT, radiation is delivered to the tumor from the apparatus located outside the body.
Brachytherapy: Brachitherapy is a type of radiation therapy in which a radioactive source is placed directly in the tumor or next to it. Brachitherapy allows you to deliver a high dose of radiation directly to the tumor, minimizing damage to the surrounding healthy tissues.
Stereotactic radiation therapy: Stereotactic radiation therapy (SRT) is a type of radiation therapy that uses high -precision visualization methods to deliver a high dose of radiation to a small tumor. SRT can be used to treat tumors of the brain, lungs, liver and other organs.
Proton therapy: Proton therapy is a type of radiation therapy that uses protons instead of x -rays. Protons can deliver their energy more accurately to the tumor, minimizing damage to the surrounding healthy tissues.

4.2 Innovation in radiation therapy

In the field of radiation therapy, significant innovations have occurred, which improved the accuracy, effectiveness and safety of treatment. Some of these innovations include:

Radiation therapy with intensity modulation (IMRT): IMRT is an EBRT type that uses computer modeling to plan and deliver radiation to the tumor. IMRT allows you to deliver a different dose of radiation to different parts of the tumor, minimizing damage to the surrounding healthy tissues.
Volume-modulated arc therapy (VMAT): VMAT is a type of IMRT, in which the apparatus for radiation therapy rotates around the patient, delivering radiation to the tumor. VMAT allows you to deliver radiation faster and more efficiently than the traditional IMRT.
Cybernage: Cybernage is a type of SRT that uses a robotic hand to deliver radiation to the tumor. Cybernage allows you to treat tumors in hard -to -reach places with high accuracy.
Tomotherapy: Tomotherapy is an EBRT type that uses computed tomography (CT) to visualize the tumor in front of each session of radiation therapy. Tomotherapy allows you to adapt the treatment plan to changes in the size and shape of the tumor.
MRT-LINAC: MRI-Linak is an apparatus for radiation therapy, which combines a linear accelerator and apparatus for magnetic resonance imaging (MRI). MRI-Linak allows you to visualize the tumor in real time during radiation therapy, which allows you to accurately deliver radiation to the tumor.

4.3 The use of radiation therapy in various types of cancer

Radiation therapy is used to treat various types of cancer, including:

Breast cancer: Radiation therapy can be used after surgery to destroy the remaining cancer cells in the mammary gland and surrounding lymph nodes.
Lung cancer: Radiation therapy can be used to treat NMRL and small cell cancer.
Prostate cancer: Radiation therapy can be used to treat localized prostate cancer.
Brain cancer: Radiation therapy can be used to treat brain tumors, such as glioblastoma and meningiomas.
Cancer of the head and neck: Radiation therapy can be used to treat cancer of the head and neck, such as laryngeal cancer and tongue cancer.

4.4 Advantages and disadvantages of radiation therapy

Advantages:

Efficiency: Radiation therapy can be very effective for the destruction of cancer cells.
Localized treatment: Radiation therapy can be used to treat tumors in specific areas of the body.
The possibility of combined treatment: Radiation therapy can be combined with other types of cancer treatment, such as surgery, chemotherapy and targeted therapy.

Flaws:

Side effects: Radiation therapy can cause side effects, such as fatigue, skin reactions, nausea and vomiting.
The risk of damage to healthy tissues: Radiation therapy can damage the surrounding healthy tissues.
Development of secondary malignant neoplasms: Radiation therapy can increase the risk of secondary malignant neoplasms in the future.

Section 5: Surgery: minimally invasive methods and robotic surgery in oncology

Surgery is an important component of cancer treatment and includes the removal of a tumor and surrounding tissues. In recent years, surgery in oncology has undergone significant changes, including the development of minimally invasive methods and robotic surgery.

5.1 Minimum invasive surgery (Mikh)

Mih is a surgical approach that uses small cuts to access the tumor and its removal. MIH is usually performed using a laparoscope or a thoracoscope, which are thin, tubular tools with a camera at the end. The camera allows the surgeon to visualize internal organs and tissues on the monitor.

Advantages MIH:

Less pain and discomfort: Mih usually causes less pain and discomfort than traditional open surgery.
Smaller scars: Mich leaves smaller scars than traditional open surgery.
Shorter recovery time: Patients who have suffered MIH usually have a shorter recovery time than patients who have undergone traditional open surgery.
Smaller risk of complications: Mih can be associated with a lower risk of complications, such as infection and bleeding.

Application of MIH in oncology:

Mih is used to treat various types of cancer, including:

Tolstoy Cancer: Laparoscopic resection of the colon.
Lung cancer: Thoracoscopic resection of the lung.
Prostate cancer: Laparoscopic prostatectomy.
Kidney cancer: Laparoscopic nephrectomy.
Uterine cancer: Laparoscopic hysterectomy.

5.2 Robotized surgery

Robotized surgery is the type of mih that uses a robotic system to perform surgical procedures. The robotic system consists of a surgeon console, a surgical trolley with robotic hands and visualization systems. The surgeon controls robotic hands from the console, and robotic hands perform surgical movements.

Advantages of robotic surgery:

Increased accuracy and dexterity: Robotized hands have more accuracy and dexterity than a person’s hands, which allows surgeons to perform complex surgical procedures with greater accuracy.
Improved visualization: Robotized systems provide improved visualization of the surgical field, which allows surgeons to see details that are not visible in traditional surgery.
Reducing tremor: Robotized systems filter the tremor of the surgeon’s hands, which allows surgeons to perform surgical procedures with greater stability.
Shorter recovery time: Patients who have undergone robotic surgery usually have a shorter recovery time than patients who have undergone traditional open surgery.

The use of robotic surgery in oncology:

Robotized surgery is used to treat various types of cancer, including:

Prostate cancer: Robotized prostatectomy.
Kidney cancer: Robotized nephrectomy.
Uterine cancer: Robotized hysterectomy.
Tolstoy Cancer: Robotized resection of the colon.
Lung cancer: Robotic resection of the lung.

5.3 Advantages and disadvantages of surgery in oncology

Advantages:

The possibility of complete removal of the tumor: Surgery can be used to completely remove the tumor, which can lead to cure for cancer.
Cancer stadium: Surgery allows doctors to stage cancer, determining the size and distribution of a tumor.
Relief of symptoms: Surgery can be used to relieve symptoms of cancer, such as pain and obstruction.

Flaws:

Invasiveness: Surgery is an invasive procedure that can be associated with the risk of complications, such as infection, bleeding and pain.
The impossibility of removing all cancer cells: Surgery may not remove all cancer cells, which can lead to a relapse of cancer.
Restrictions depending on the location and size of the tumor: Surgery can be impossible in cases where the tumor is located in an inaccessible place or has a large size.
Side effects: Surgery can cause side effects, such as fatigue, pain and change in organ function.

Section 6: promising directions in oncology: liquid biopsy, artificial intelligence and nanotechnology

In the field of oncology, new promising areas appear that promise to revolutionize the diagnosis, treatment and monitoring of cancer. These include liquid biopsy, artificial intelligence (AI) and nanotechnology.

6.1 liquid biopsy

Liquid biopsy is a non -invasive method that allows you to analyze blood samples to detect cancer cells, DNA of cancer cells or other cancer biomarkers. Unlike traditional biopsy, which requires surgical intervention to obtain a tissue sample, liquid biopsy can be performed using a simple blood fence.

Advantages of liquid biopsy:

Non -invasiveness: Liquid biopsy is a non -invasive method, which makes it more safe and comfortable for patients than traditional biopsy.
Early diagnosis: Liquid biopsy can be used to detect cancer in the early stages, when it is more treated.
Monitoring of the response to treatment: Liquid biopsy can be used to monitor the response of cancer to the treatment and detection of relapse.
Personalized treatment: Liquid biopsy can be used to detect genetic mutations in cancer cells, which can be aimed at targeted drugs.

The use of liquid biopsy in oncology:

Liquid biopsy is used for:

Identification of cancer in the early stages: Detection of circulating tumor cells (CEC) and circulating tumor DNA (Central Center).
Monitoring the response to treatment: Assessment of changes in the level of data center after treatment.
Identification of resistance to treatment: Determination of new mutations that can cause resistance to treatment.
Personalization of treatment: The choice of the most effective treatment methods based on the genetic profile of the tumor obtained using the Central Administration.

6.2 Artificial intelligence (AI)

AI is an area of computer sciences that develops intellectual computer systems that can perform tasks that usually require human intelligence, such as training, reasoning and solving problems. In oncology, AI is used to analyze medical images, predicting a response to the treatment and development of new treatment methods.

The use of AI in oncology:

Cancer diagnostics: AI can be used to analyze medical images, such as x -rays, CT and MRI, to identify signs of cancer.
Prediction of the response to treatment: AI can be used to analyze patients data, such as genetic information and treatment history, to predict a response to treatment and select the most effective treatment methods.
Development of new treatment methods: AI can be used to identify new goals to develop new cancer treatment methods.
Personalization of treatment: AI can be used to develop personalized cancer treatment plans based on the individual characteristics of the patient.

6.3 nanotechnology

Nanotechnology is a field of science and technology that develops and use materials and devices on a nanometer scale (1-100 nanometers). In oncology, nanotechnology is used to deliver drugs directly to cancer cells, improve the visualization of tumors and develop new treatment methods.

The use of nanotechnologies in oncology:

Delivery of drugs: Nanoparticles can be used to deliver drugs directly to cancer cells, which allows you to increase the effectiveness of treatment and reduce side effects.
Tumor visualization: Nanoparticles can be used to improve tumors visualization, which allows doctors to more accurately strate cancer and plan treatment.
Hyperthermia: Nanoparticles can be used to heat cancer cells, which leads to their death.
Photodynamic therapy (FDT): Nanoparticles can be used to deliver photosensitizers to cancer cells, which are then activated by light, which leads to the death of cancer cells.

Conclusion

Innovations in oncology are constantly developing, offering new opportunities for the diagnosis, treatment and monitoring of cancer. Targeted therapy, immunotherapy, genomic tumor profiling, radiation therapy, surgery, liquid biopsy, artificial intelligence and nanotechnology – all these are promising areas that can improve the results of cancer treatment and extend the lives of patients. The continuation of research and development in these areas will lead to even more effective and personalized methods of cancer treatment in the future.

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