New treatments for lung cancer
As announced at the World Cancer Congress in recent months, advances in lung cancer treatments increase survival rates.
As announced at the World Cancer Congress in recent months, advances in lung cancer treatments increase survival rates. Anadolu Health Center Medical Oncology Specialist and Oncological Sciences Coordinator Prof. Dr. Necdet Üskent said, “There are many innovations in lung cancer treatments, including new immunotherapy agents, adoptive cell therapy, vaccines and smart drugs, where many branches act together.” Prof. Dr. Necdet Üskent gave important information on the subject…
Lung cancer is one of the top three most common types of cancer in both women and men. Lung cancer ranks first in cancer-related deaths in women and men. According to experts, the risk factor that is much stronger than environmental (such as air pollution, passive smoking) and genetic factors is the use of tobacco and tobacco products. The increase in smoking, especially in young age groups, also increases the incidence of lung cancer. Another increase is observed during the pandemic period. Since COVID-19 causes consequences such as pneumonia in the lungs, it also increases the use of CT scans in hospitals, so there are many cases of lung cancer diagnosed. There are great advances on the treatment side.
How high is the success rate in lung cancer treatment?
With technological and medical developments in recent years, lung cancer is no longer a type of cancer that is difficult to treat as it used to be. While the scientific world is getting to know the tumor cell better with the new treatment methods it has developed and the innovative medical technologies it uses, we are now in a period where more successful results are achieved in lung cancer compared to the past.
How are cancer cells destroyed?
By taking advantage of evolutionary survival mechanisms, cancer cells can evade treatments such as chemotherapy that target proliferating cells. For this reason, they have the ability to divide slowly and even go into a sleep mode that does not divide at all, called the G0 phase. While cancer cells in dormant mode are not affected by chemotherapy, they can also mutate by developing drug resistance during dormancy. Thus, they begin to divide again and continue to spread the disease. This is the main mechanism behind why tumors that initially respond well to chemotherapy and shrink, then reappear.
As is often seen in breast and lung cancers, a cancer cell that has remained dormant for years can suddenly become active. Dormant cancer cells consume their own cell components or their own proteins to survive (self-eating / Autophagy). However, the scientific world has also produced a cure for this sleep mode of the cancer cell. Thanks to new drugs that block autophagy, it is now possible to destroy dormant cancer cells.
Ways to activate immune system cells
Immunotherapy, which is based on directing immune system cells to tumor cells, is one of the important treatment approaches that has been studied for years. Many cancer cells use a mechanism known as checkpoint molecules to evade the immune system, which prevents warrior cells (T-Lymphocytes) from attacking normal body cells. Since cancer cells do not look different from normal cells, warrior cells do not attack cancer cells that they see as friends. However, with scientific studies conducted since 2011, it has now become possible for warrior cells to bypass the checkpoint and attack cancer cells. Today, 7 immunotherapy drugs, commonly called ‘Immune Checkpoint Suppressors’, are used successfully in many types of cancer, especially lung cancer.
“Adoptive cell therapy” in treatment
Adoptive cell therapy is a form of treatment based on the principle of inserting some genetic material into T-cells to increase the recognition of the cancer cell by immune cells and returning it to the patient after growing in the laboratory environment. Thanks to this method, known as CAR-T cell therapy, significant success has been achieved in resistant lymphomas and leukemias, while trials have also begun in lung cancers. These warrior T cells containing Chimeric Antigen Receptors (CAR) are able to recognize and destroy tumor-specific antigen. TIL cell therapy is another form of treatment. TILs are lymphocytes that gather around the cancer cell. These cells can be isolated from the person, activated in a laboratory environment to recognize the tumor, and given back to the patient.
How effective are cancer vaccines and personalized vaccines?
If there is a recognizable antigen specific to that cancer on the surface of the cancer cell, it is possible to activate the body’s immune system against that antigen. Vaccines developed against NeuGmc and EGFR antigens found on the cell surface of lung cancers are treatments recognized by some country ministries of health and used as maintenance therapy in selected cases in which the tumor burden has been reduced with chemotherapy. Additionally, Phase 1 and Phase 2 studies of various Peptide vaccines and messenger RNA vaccines are continuing.
Smart drugs for tumor-specific sensitive mutations
Genetic changes that are the target of treatment are encountered, especially in the non-small cell type of lung cancer called “Adenocarcinomas”. If these changes, which occur between 1 percent and 35 percent depending on the type of genetic mutations and changes, are detected, they can be blocked with drugs, usually in tablet form, taken orally. Thus, as the genetic target that activates the tumor is eliminated, the tumor begins to shrink rapidly. While the number of smart drugs, previously directed only at genetic targets such as EGFR, ALK and ROS-1, is increasing, new targets are also being identified. Thanks to these drugs, the tumor is controlled even in advanced stages in patients with a specific mutation and their lifespan is extended.