It is a worrying fact that more than half of us will get cancer in our lifetime.
Every year, around 385,000 people are diagnosed and 167,000 lives are lost to the disease in the UK. . . and experts have warned of a new alarming rise in the number of young people.
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But in the face of rising cases, there is good news: the future of cancer treatment looks brighter.
“Cancer” and “exciting” don’t tend to go hand in hand, but those are the words leaving scientists’ lips after a series of studies of new-age treatments.
Many emerged from the American Society of Clinical Oncology conference in Chicago, including research that claimed the drugs were “100% effective” or gave “remarkable” results.
Professor Lawrence Young, an oncologist who has worked in cancer research for 40 years, told Sun Health: “We are turning the corner on cancer, there is no doubt about that. We learned a lot about the basic mechanisms of cancer development and a lot about other processes, such as how the immune system works, but it took a long time to put it all together.
“With significant technological developments, we are entering a golden age of cancer diagnosis and treatment.”
Cancer survival has improved markedly in recent decades.
But it’s not going away – Cancer Research UK warned earlier this year that cases have risen over the last quarter of a century, partly due to screening programs but also due to population growth, obesity and other lifestyle habits.
Professor Young says new therapies mean “cancer is no longer a death sentence”.
He says: “There are many different approaches to treating cancer patients – and living a healthy life even if you have the disease, rather than trying to eradicate it completely.”
But it comes in a context that has been called a crisis in cancer treatment in the UK, with long waits for diagnoses and survival rates worse than in comparable countries.
The NHS is at the forefront of testing innovative therapies, but can it afford to roll them out across the country?
Professor Young says: “All these things are great in theory and very exciting, but they are expensive and the NHS will not be able to cover the cost of some things. But the hope is that these things will get cheaper as they are developed and become more standardized.”
Here, we look at the most promising developments in cancer treatments. . .
Personalized medicine
PERHAPS the most exciting new avenue of research is to adapt medicine to treat a patient’s cancer based on the genetic makeup of their own tumor.
Professor Young says: “We learned that when you profile genetics, you almost get a barcode for an individual’s cancer.
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“Just because someone has the same stage and grade of cancer does not mean they should be treated the same way or with a specific combination of medications.”
The NHS announced in May that it would trial personalized cancer vaccines developed by biotech giants BioNTech and Genentech.
Around 10,000 patients in England are expected to receive their own vaccine against the disease by 2030, through the NHS Cancer Vaccine Launch Platform.
Father-of-four Elliot Pfebve was the first to receive the vaccine, having had an intestinal tumor removed in what NHS England called a “landmark moment”.
Professor Young says: “Essentially, using AI you can identify the mutations that are most likely to generate a strong immune response and then you can create a vaccine.”
Unlike traditional vaccines, which prevent disease, these are being tested for their effectiveness in preventing relapses.
The results of previous studies published at the ASCO meeting were positively received.
A New York University study showed that a skin cancer shot halved the risk of death or relapse in patients with advanced melanoma.
Speaking at the conference, Cancer Research UK’s chief medical officer, Professor Charles Swanton, called the results “extremely impressive”.
He said: “I hope and expect that we will see data like this in solid tumors like bowel cancer and lung cancer.”
A second study from the University of Vienna found that the tecemotide vaccine reduced the risk of relapse in breast cancer survivors.
After seven years, 81 percent of the women were still alive, compared with 65 percent who only had standard chemotherapy.
Another study of 300 children in Australia, the results of which were published last week, had results that scientists called “remarkable,” showing that those who received personalized treatment had much better outcomes than those who did not.
Immunotherapy
Dubbed the “greatest advance since chemotherapy,” immunotherapy harnesses the power of the immune system to fight cancer.
Antibodies seek out and mark diseased cells for destruction but spare surrounding healthy tissue, unlike chemotherapy or radiation therapy.
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Professor Young says: “We’ve known for 100 years that the body tries to fight cancer with the immune system, but it doesn’t actually work. Cancer skillfully learns how to bypass the immune response. It can turn off the way the immune system recognizes you – but these antibodies can turn it back on.
“Antibodies are effective alone, but where they are most effective is in combination with another type of immunotherapy.”
Keytruda (pembrolizumab) brings cancer cells out of hiding. It has been approved for the treatment of several types of cancer on the NHS, including melanoma, cervical, breast and lung cancer.
But its use could be extended to bowel cancer.
A University College London study found that all 32 patients with highly mutated tumors who received Keytruda in a trial were cancer-free after treatment.
Professor Mark Saunders, from Christie Cancer Hospital in Manchester, said: “This is an interesting treatment for the ten to 15 per cent of patients who have the correct genetic makeup.
“In the future, immunotherapy could even replace the need for surgery.”
Similarly, Jemperli (dostarlimab) – which works in the same way as Keytruda and is used for some types of uterine cancer – was reported in a US trial to be “100 percent effective” in treating 42 patients with a type of rectal cancer. Cancer.
Targeted cancer drugs
THESE work more precisely to stop cancer cells from dividing and growing, while limiting damage to healthy cells – and their use is expanding.
Professor Young says: “This targets the mechanism of genetic mutations that lead to cancer.
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“Some are targets that we have known about for years, but for which it was difficult, until recently, to develop drugs.
“The normal growth of our cells is controlled by switches that mutate and are permanently turned on in cancer cells.
“Now, after years of research, we are targeting drugs that can turn off these growth signals.”
Kinase inhibitors are targeted drugs – small molecules that stop certain enzymes involved in cancer growth.
Lorlatinib, branded as Lorviqua, is used in some patients with ALK-positive non-small cell lung cancer.
But after May’s “groundbreaking” results, campaigners hope it will become a lifeline for the 350 people in the UK who are diagnosed with this type of cancer every year.
They are usually nonsmokers under 40, and about a quarter of patients’ tumors spread to the brain before they are diagnosed.
But scientists at the Peter MacCallum Cancer Center in Melbourne, Australia, found that 60% of patients who received this drug for five years did not see their cancer worsen, compared with just 8% of those who received the standard drug crizotinib.
Dr. David Spigel of the American Society of Clinical Oncology said: “These results are off the charts. They are among the best we have seen in advanced disease, in any setting. It really is a big step forward in the treatment of lung cancer.”
Bloodtests
EARLY diagnosis is still the best weapon against cancer and its devastating impacts.
Blood tests are becoming increasingly sensitive to detect the disease.
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Professor Young says: “Current blood tests are not that good. For example, we measure PSA proteins for prostate cancer or CEA proteins for ovarian cancer, but they are not very specific.
“We want to do our best to cure cancer with early diagnosis, and with these interesting blood tests, it may be possible to identify the cancer early and remove it before we go too far.”
These new blood tests can “identify tiny amounts of DNA shed from tumor cells in the blood”, says Professor Young.
The NHS has been trialling the Galleri blood test in England and Wales, using 140,000 volunteers so far, and will continue until 2026.
Research in the US suggested that Galleri’s blood test could detect more than 50 types of cancer, including pancreas and esophagus, which are normally difficult to detect early.
But in an update in May, the NHS said preliminary results from the first year of the trial were not convincing enough to start a pilot program of the test in clinical practice.
Professor Young says: “The recent data is not as encouraging as we had anticipated, but it is still early days. It will take at least another five years of research to get anywhere near these tests being routinely useful.”
Blood tests may also be used after treatment to identify people at risk of the disease recurring.
Around 11,000 people die from secondary breast cancer every year in the UK.
But findings presented at ASCO showed that in a trial of 78 women recovering from breast cancer, a blood test identified 100 percent of those who would relapse, raising the alarm up to 41 months earlier.
Simon Vincent, from Breast Cancer Now, which part-funded the study from the Institute of Cancer Research, said: “These initial findings, which suggest that new tests could detect signs of breast cancer recurrence more than a year before symptoms appear, are incredibly moving.”
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