A new opportunity for cancer treatment? Experts are shocked: 1 therapy may turn cancer into a "chronic disease"
This year in 2022, the Taiwan Ministry of Health and Welfare announced that cancer has topped the top 10 causes of death in Taiwan for 40 consecutive years. Many people are still in fear of cancer. Once the doctor announces it, they are often at a loss and complain. Why me? In fact, cancer is not necessarily a terminal disease. Especially after the emergence of immunotherapy in recent years, it has become possible for cancer to become a “controllable chronic disease.”
Moreover, the Taiwan Ministry of Health and Welfare has also approved the inclusion of first-generation immunotherapy drugs in health insurance benefits and the opening of autologous immune cell therapy for specific cancer patients, announcing the entry into a new era of cancer immunotherapy. If human society is undergoing the fourth industrial revolution in various fields due to big data and artificial intelligence, then the game against cancer is also undergoing a medical revolution that subverts concepts due to immunotherapy!
Can traditional treatments eliminate the threat of cancer? Is controlling cancer more important than eradicating it?
Before talking about immunotherapy, let’s first look at the characteristics of cancer and how it is currently treated. Cancer is one of the diseases that humans still cannot defeat. The most important feature is that cancer originates from our own bodies, not foreign microorganisms or viruses. Cancer treatment has started with cutting off the tail to survive, using surgical methods to remove tumors, followed by non-specific chemotherapy and radiotherapy, and now targeted drugs, etc. All efforts are in the hope of “elimination” This enemy turned from “self”.
However, to this day, cancer cannot be completely eradicated and has not disappeared; patients often develop drug resistance after treatment, relapse and metastasize, and become more aggressive. Therefore, the strategy of “controlling cancer” may be more effective than “eliminating cancer”. Perhaps it is impossible to completely eliminate “oneself”, so learning to coexist peacefully with oneself may be a feasible method.
What is “cancer immunotherapy”? Not just boosting T cells?
In a broad sense, immunotherapy includes any method that can increase autoimmune function, such as correct work and rest diet, optimistic and happy mood, moderate exercise, health food, etc. Immunotherapy in a narrow sense mainly includes immune checkpoint inhibitors, T cell infusion therapy (ACT), cancer vaccines, oncolytic virus therapy, etc.
The success of immune checkpoint inhibitors comes from Dr. James Allison and Tasuku Honj, who won the Nobel Prize in Physiology and Medicine in 2018 and the Tang Prize in Biotechnology and Medicine in Taiwan in 2014. They respectively discovered that T cell surface Two types of immune checkpoint inhibitors: CTLA-4 and PD-1, and then develop inhibitors to reactivate the immune response; T cell infusion therapies include Chimeric Antigen Receptor T Cells (CAR-T), Induces endogenous anti-tumor ability. Simply put, healthy people need immunity to prevent cancer; for cancer patients, immunity suppressed by cancer cells must be restarted!
The war between humans and viruses never stops! Experts reveal the role and function of immune cells
The war between humans and viruses and bacteria has been going on since ancient times. If you want to understand the battle between vaccines and viruses, you must first understand how the immune system works. The immune system of the human body is like an army stationed in the body. It can be divided into innate immunity and acquired immunity (also called reactive immunity). It is a complex and exquisitely regulated defense system; all immune cells perform their own duties. The purpose is to destroy the enemy.
The most commonly talked about immune cells are: dendritic cells, natural killer cells, T cells and B cells, etc. Dendritic cells play a critical role in triggering T cell responses. It is a professional “antigen presenting cell”. When dendritic cells capture invading antigens, engulf them and break them down into small fragments, they will be presented to killer T cells and helper T cells to initiate a T cell response.
Does COVID-19 promote the advancement of mRNA technology and unexpectedly drive the development of cancer immunotherapy?
T cell infusion therapy in cancer immunotherapy is based on methods to enhance T cell function. Broadly speaking, vaccines are also a type of immunotherapy. Cancer vaccines can be divided into “preventive” and “therapeutic”. Preventive cancer vaccines are used for cervical cancer and liver cancer caused by human papillomavirus (HPV) and hepatitis B/C virus; while therapeutic vaccines are Find out the “gene mutation characteristics” of cancer to design vaccines to fight cancer.
In the past two years, due to the outbreak of the new coronavirus pneumonia (COVID-19), mRNA technology vaccines have become a new technology platform that has subverted the current situation. This has led to the “re-emergence” of cancer vaccines, covering the field of cancer immunotherapy. mRNA cancer vaccines also use “neoantigens” to induce the body’s immune response. Therefore, as long as you understand the “neoantigen”, you can synthesize a piece of mRNA based on this sequence information and then send it into the human body to produce the neoantigen.
Immunotherapy has a bright future? Expert: It’s not a panacea!
Although cancer immunotherapy has a promising future, there are still many problems to be solved. For example, checkpoint inhibitors are only effective in about 20 to 30% of patients, while CAR-T cell therapy often costs tens of millions of Taiwan dollars and has fatal side effects, such as cytokine storm and cardiotoxicity. The point is, the most difficult thing about immunotherapy is that cancer cells originate from our own tissues, and the immune system often treats them as its own. Not to mention, cancer cells will also modify the surrounding “tumor microenvironment” to deceive, avoid or suppress Recognition and pursuit by the immune system.
The unfavorable tumor microenvironment is like a golden bell protecting it. The acidic and chronic inflammatory environment inside, coupled with the suppression of immune cells, makes the drug only act on the peripheral cancer cells, just like scratching an itch, reducing the risk of cancer. treatment effect. So how can immunotherapy kill enemies along the way, go straight to the Huanglong, and treat tumors? Only by fully understanding the tumor microenvironment and understanding how cancer evades the immune system can we have better chances of preventing and controlling cancer.
A person’s biggest enemy is himself; and the body’s biggest enemy is cancer! Until today, it may still be impossible to completely remove cancer. We look forward to accepting new concepts in the future to use personalized immunotherapy to control cancer rather than eliminate cancer. Under the trend of personalized medicine, big data-assisted genes and immune markers will progress rapidly. In the future, cancer classification 4.0 may appear: site + pathology + gene mutation + immune score to achieve personalized immunotherapy and reduce side effects.
Maybe one day, when we face cancer, we can control it with drugs, “coexist with cancer” and continue to maintain a quality of life, just like we treat chronic diseases such as diabetes and hypertension. Perhaps this is the best treatment for cancer. Strategy.
This article is reproduced with permission from the 30th issue of the Lifelong Micro-Learning Information Station of the Taipei Municipal Library. Any reproduction or excerpts are prohibited without permission.
Further reading:
