– The future of cancer treatment, part two
The Promise of Chimeric Antigen Receptor T-Cell Therapy
Chimeric antigen receptors (CARs) are engineered molecules that can be introduced into T cells to enable them to target specific tumor antigens. CAR T cells targeting CD19 have shown promise in patients with relapsed and refractory B-cell neoplasms, including those with acute lymphoblastic leukemia, chronic lymphocytic leukemia, and non-Hodgkin lymphomas.
Cancer immunotherapy aims to harness the antitumor potential of the immune system and translate it into effective therapies for patients. One such approach, chimeric antigen receptor (CAR) T-cell therapy, has yielded promising initial clinical results. CAR T-cell therapy employs gene transfer techniques to reprogram endogenous T cells to target a specific tumor antigen.
Dr. Stegall’s comments: While immunotherapy is an exciting development in the treatment of cancer, it is a double-edged sword. While the idea of stimulating the immune system is generally a good thing, we must be careful that we do not overstimulate the immune system and cause it to become overactive. As with all things in the body, there is a balance we must achieve. More is not necessarily better, and this is certainly true with regard to CARs.
Epigenetic Therapy: Setting Cancer Cells Straight
For decades, scientists and doctors assumed that cancer was caused by damage to some critical stretch of DNA within one’s genome. But recently, a more complex picture has emerged, one that shows that some cancers are caused by epigenetic changes—tiny chemical tags that accumulate over time and can turn genes on or off. Unlike genetic damage, epigenetic changes can sometimes be reversed, and with treatments that are less toxic than conventional chemotherapy.
Dr. Stegall’s comments: One of the recent developments in cancer research which excites me the most is the field of epigenetics. We know that genes have a switch, much like an on-off switch, which is influenced by environmental factors. The environment in which we bathe our cells – including the food we eat, the air we breathe, the chemicals inside our homes – has a significant impact on the development and spread of cancer. As we further our knowledge of epigenetics and cancer, I predict that we will confirm my theory that the genetic changes we see in cancer cells are not the cause of cancer, but rather the result of the environmental and metabolic stimuli to which our cells have been exposed.
Novel insight into metastasis could offer new treatments
Researchers from the United Kingdom may have made a breakthrough in cancer treatment, after discovering an unusual mechanism by which cancer cells spread and survive in the body. Researchers have uncovered a new mechanism by which cancer cells break away from tumors and spread to other parts of the body. In a study published in Nature Communications, researchers reveal how two molecules join forces to help cancer cells survive as they metastasize.
Metastasis is the process by which cancer cells break away from the primary tumor and spread to other parts of the body through the bloodstream or lymph system.
Once cancer has spread, the disease becomes much more challenging to treat. Chemotherapy, hormone therapy, radiotherapy, and other treatments can yield success for some metastatic cancers, but for most, the prognosis is poor.
Dr. Stegall’s comments: Our goal in early stage cancers is to prevent metastasis, as prognosis is significantly worse when cancer has spread to distant sites. However, all hope is not lost when metastasis has occurred. Regardless of the cancer stage, we must better understand and predict metastasis. One way I do this in my office is through an innovative blood test which identifies the number of circulating tumor cells (CTCs) and also subjects those cells to testing in the lab to uncover which chemotherapy agents and nutritional supplements showed the most effectiveness. This is essential in my opinion, because our war against cancer consists of two battles being fought simultaneously: one against solid tumors, and one against the systemic effects of cancer (i.e., the circulating tumor cells).