Cancer remains one of the leading causes of mortality all over the world, but the art and practice of cancer therapy have been advancing at a very high rate. The classical forms of cancer therapy, like surgery, chemotherapy, and radiotherapy, have remained cancer therapies for decades. However, with the introduction of cancer immunotherapy, the art and practice of cancer therapy have been revolutionized. Immunotherapy attacks the immune system to kill cancer, and it is a less toxic and more targeted therapy than traditional therapies. Unprecedented expansion has occurred in the area of cancer immunotherapy over the past few years, and it is now one of the most exciting and fast-moving fields of medical science.
In this blog post today, we will be discussing the recent breakthroughs in cancer immunotherapy, emerging drugs in the pipeline, and the growing importance of immunotherapy in India.
Understanding Cancer Immunotherapy
Let us find out first what cancer immunotherapy is and how it works. Cancer immunotherapy refers to treatment that employs the immune system of the body to recognize and destroy cancer cells. The immune system is trained in order for it to recognize foreign infectious agents like viruses and bacteria, as well as normal abnormal cells like cancer cells. But the majority of cancers discover ways to escape the immune system so that they can proliferate uncontrolled.
Immunotherapy does so either by enhancing the immune system’s function or by introducing the immune system to substances like engineered antibodies or engineered immune cells that are better able to locate and destroy cancer cells. The novel approach differs from traditional treatments administered directly to cancer cells, like chemotherapy, and has the potential to injure cancer cells and normal cells. Immunotherapy can be very targeted, though, to the cancer cells alone without affecting the normal tissue.
Principal Types of Cancer Immunotherapy
1. Checkpoint Inhibitors
Checkpoint inhibitors are among the best-recognized and most widely used types of cancer immunotherapy. They function by inhibiting the checkpoint proteins on the immune and cancer cells employed to act as “brakes” to stop the immune cell attack on normal cells. The checkpoint proteins are utilized by the majority of cancers by the cancer cells in attempting to evade immune killing. By inhibiting the checkpoints, the immune system can identify and kill the cancer cells more effectively.
The best-studied checkpoint inhibitors include pembrolizumab (Keytruda), nivolumab (Opdivo), and atezolizumab (Tecentriq). They attach themselves to proteins such as PD-1, PD-L1, and CTLA-4 used to hold the immune system in check. They have worked superbly in cancer therapies such as melanoma, non-small cell lung cancer, kidney cancer, and bladder cancer, to name but a few. The most recent study has expanded its applications even to other forms of cancer, opening up the door to more targeted treatment protocols.
One of the most notable improvements here is combination therapy, whereby the checkpoint inhibitors are used alongside other treatments such as chemotherapy, targeted therapy, or radiation. It can make the immune system more effective against cancer and possibly even prevent resistance.
2. CAR-T Cell Therapy
One of the most promising new areas in cancer immunotherapy is Chimeric Antigen Receptor T-cell (CAR-T) therapy. This treatment entails removing T-cells, a white blood cell, from a patient’s blood. The cells are then manufactured in the laboratory to include a receptor (chimeric antigen receptor, or CAR) that allows them to target and destroy cancer cells more effectively. The CAR-T cells, having been engineered, are infused into a patient’s blood, where they target and destroy cancer cells.
CAR-T cell therapy has been nothing short of marvelous in the treatment of some blood cancers, i.e., acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma. CAR-T treatment for ALL and non-Hodgkin lymphoma has been a runaway success, bringing renewed hope to patients who otherwise did not have it. CAR-T treatment for solid tumors hasn’t been that much of a success but continues as a line of ongoing research. Modification of the CAR-T cells to break the hurdle of solid tumors continues to be a key area of research for cancer immunotherapy.
3. Cancer Vaccines
Cancer vaccines are the new frontier of cancer immunotherapy innovation. They differ from infection-preventing vaccines in that they are employed for the treatment of cancer. They stimulate the immune system to destroy the cancer cells. Cancer vaccines contain either the patient’s cancer cells or proteins or antigens from cancer cells.
Cancer therapeutic vaccines have been promising in the treatment of cancers such as melanoma, cervical cancer, and prostate cancer. For example, the use of the Bacillus Calmette-Guerin (BCG) vaccine for the treatment of bladder cancer over decades to inhibited the recurrence of cancer. Now, scientists have also been involved in the development of custom-made cancer vaccines based on the genetic signature of a patient’s tumor. Such vaccines are intended to increase the body’s ability to recognize and destroy certain cancer cells.
Among the most hopeful of cancer vaccine candidates is the employment of vaccines against tumor-specific antigens. These will be employed to induce the immune system to destroy the cancer cells based on their distinct molecular characteristics. Several such vaccines have reached clinical trials and promise to introduce new, spectacularly potent cancer treatments for most cancers.
4. Oncolytic Virus Therapy
Oncolytic virus therapy is a new and innovative form of treatment wherein viruses are genetically engineered such that they invade and kill the cancer cells. The therapy infects and kills the cancer cells while also triggering an immune response, killing any residual cancer cells.
The initial oncolytic virus therapy, Talimogene laherparepvec (T-VEC), has been approved for the treatment of melanoma. Oncolytic virus therapy is in its early stages, but it promises a lot to cure a number of different types of cancers, such as glioblastoma, pancreatic cancer, and ovarian cancer.
One of the issues with oncolytic virus therapy is how to get the virus to infect the cancer but not normal tissue. But researchers are trying to genetically modify the viruses to make them less toxic and more specific. Furthermore, the oncolytic virus combined with other types of immunotherapy, like checkpoint inhibitors, might be more effective.
5. Monoclonal Antibodies
Monoclonal antibodies (mAbs) are bioengineered molecules that replicate the immune system to battle pathogenic attackers. Monoclonal antibodies, employed as cancer therapies, are employed to attach to targeted antigens on the cancer cells. Attaching to the cancer cell, the antibodies either initiate an immune response or bring along harmful substances that kill the cancer cells.
Monoclonal antibodies are already in widespread use to treat cancer. Rituximab and trastuzumab are just two of the monoclonal antibodies approved to treat non-Hodgkin lymphoma and HER2-positive breast cancer, respectively. Successive generations of monoclonal antibodies, such as bispecific antibodies, are now engineered to have two antigens locked together in tandem precisely, and this again enhances cancer drug selectivity.
Immunotherapy in India
India has witnessed growing cancer immunotherapy interest over the past decade because the country is struggling to deal with a growing burden of cancer. Immunotherapy is becoming a fast-evolving area of interest in India because more and more hospitals and cancer institutions are offering immunotherapy alongside other treatments as a part of the treatment protocol of patients, which was not limited to Western countries before.
India’s strong healthcare system, well-educated oncologists, and research centers have enabled India to keep up with international trends in cancer immunotherapy. Indian patients have access to more advanced types of cancer therapy as the medical fraternity keeps learning and getting better at immunotherapy procedures.
With increasing numbers of available immunotherapy treatments, Indian patients are a safer bet to receive effective and less toxic cancer therapy. Furthermore, India’s comparatively lower healthcare costs compared to Western nations make immunotherapy an affordable therapy for most patients, giving hope to patients who otherwise would not be able to receive such therapy.
The Role of Immunotherapy Doctors in India
With the growing popularity of immunotherapy in India, the services of skilled immunotherapy doctors in India are also in demand. Immunotherapy cancer specialists need to take the patient through the technicalities of the new form of treatment. They possess the skills to examine the individual type of cancer, genetic profile, and overall condition of each patient to prescribe the most suitable type of immunotherapy.
Dr. Vikesh Shah, being a top immunotherapy specialist in India, is an expert to such an extent that he has gained enough popularity based on his work in the specialty. Being a veteran oncologist and working on immunotherapy at large, Dr. Shah is engaged in assisting patients in gaining access to and benefits from the new treatments. He has proficiency in performing research on the intricacies of immunotherapy and trying to formulate the best treatment for his patients.
Future Directions in Cancer Immunotherapy
The future of cancer immunotherapy is truly promising. The research and clinical trials keep uncovering newer horizons to broaden ongoing treatments as well as develop new ones. Some of the most promising avenues to which immunotherapy is heading now are:
Combining Immunotherapies: As discussed above, a combination of novel immunotherapies (i.e., checkpoint inhibitors, CAR-T cell therapy, and cancer vaccines) with other therapies is of great interest. Combination therapy has the potential to result in higher response rates and lower resistance with improved cancer therapy.
Targeting Solid Tumors: Immunotherapy has been a huge success with blood cancers, but solid tumors are where the war continues. Researchers are trying to develop more potent immunotherapies against solid tumors, e.g., making immune cells more proficient at penetrating the microenvironment of a tumor.
Biomarker-Guided Immunotherapy: With each successive cancer genetics breakthrough, increasingly geneticized immunotherapies emerge. These will become even more powerful as they provide customized remedies for each patient.
Oncolytic Virus Therapy: Oncolytic virus therapies are becoming more common, and new viruses are being tested in clinical trials. They can be applied to the treatment of a large number of cancers and will most likely play an important part in the future of cancer immunotherapy.
Conclusion
Cancer immunotherapy is the biggest breakthrough in cancer therapy, providing the patient with less toxic and more targeted treatment. With research continuing to dominate, new treatments and combinations are being discovered, with better control of cancer. For patients in India and worldwide, access to immunotherapy is increasingly available, with access to life-saving treatments.
With Indian immunotherapy physicians increasingly gaining experience and bringing these new treatments into practice, India’s cancer treatment future becomes brighter and brighter. Because it is led by such as Dr. Vikesh Shah, never have Indian cancer patients had better access to today’s newest and most hopeful immunotherapies. In the future, the promise that immunotherapy holds in revolutionizing cancer treatment is immense, bringing hope to hundreds of millions of cancer patients worldwide. Contact us today for more information!