Cancer is estimated to cause around 10 million deaths around the world each year, impacting not just cancer patients but also their families and friends. This is why cancer research and the development of new treatments are crucial.
In this article, we will focus on innovative cancer therapies that are emerging in cancer treatment, considering the vital role clinical trials play in advancing our understanding of the disease and how it can be managed.
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The evolution of cancer treatments
Traditional cancer treatments can be effective, depending on how early they are administered and the type of cancer that is being treated, but this is not always the case, emphasizing the need for new, more targeted treatments.
To fully understand the advancements in cancer treatment, let’s first consider three traditional forms of treatment.
- Surgery - Surgery is often performed to remove the cancerous tissue completely, or as much of it as possible. This is usually combined with another treatment such as chemotherapy or radiation therapy.
- Chemotherapy - Chemotherapy involves powerful medication being used to kill the fast-growing, cancerous cells in the body.
- Radiation Therapy - This type of therapy uses high-powered beams of radiation (E.G. X-rays or protons) to kill the cancer cells. Radiation can be administered in two ways, external beam radiation or radiation inside the body (brachytherapy).
Why clinical trials are the backbone of medical advancements in cancer research
New medical breakthroughs cannot be possible without oncological clinical trials and studies which are a key component of medical research and the development of new treatments and drugs. Each clinical trial is designed with the safety of the participants in mind, using insights and data from previous trials to constantly improve.
Successful clinical trials can result in new drugs and treatments being approved for public use by the FDA, potentially having a positive impact on millions of lives.
Interested in learning more about clinical trials for cancer? Read everything about the importance of oncology clinical trials in evaluating the effectiveness of new and experimental treatments for cancer in our comprehensive guide.
Immunotherapy
Immunotherapy is a new treatment that differs from traditional treatments, helping to boost the body’s natural defenses, while targeting and killing specific cancer cells. It works alongside a patient’s natural immune system and is often recommended when treatments such as surgery, chemotherapy, and radiation therapy have failed to work.
However, unfortunately, immunotherapy is not successful for everyone, with some tumors building a resistance to the treatment.
Types of Immunotherapy
Immunotherapy is available in different forms that are specific to the type of cancer that is being treated. Each type of immunotherapy has its own mechanisms and can be applied to certain scenarios, making it a versatile option.
Some of the most promising and widely-researched types of immunotherapy for cancer treatment are:
- Checkpoint Inhibitors - This type of drug is designed to interfere with specific proteins in the patient’s body that help cancer cells go undetected by the natural immune system. Referred to as checkpoints, inhibiting these proteins boosts the immune system so that it can identify and target cancer cells effectively.
- Cancer Vaccines - Different from traditional vaccines, cancer vaccines target existing cancer and stimulate the immune system by focusing on antigens that are specific to cancer cells.
- Adoptive T Cell Transfer - Adoptive T cell transfer (ACT) collects T cells from a patient, a type of white blood cell called lymphocytes which are then modified in a lab. These modified cells are then reintroduced to the patient’s body to target cancer cells.
- Monoclonal Antibodies - These molecules are produced in a laboratory and recreate the functionality of the immune system in fighting harmful pathogens, such as cancer or a virus. In the case of cancer, monoclonal antibodies target specific antigens that are found in cancer cells.
- Cytokines - Cytokines are proteins that help to control cell signaling and there are two types that are used in cancer treatment - interferons and interleukins, both regulating immune responses to tackle cancer cells.
The importance of clinical trials in advancing Immunotherapy
Clinical trials are effectively the ‘gold standard’ in terms of the evaluation of new treatments, and assessing their efficacy in combating a range of diseases and conditions, including immunotherapy and its effects on cancer patients.
Each clinical trial is robustly designed to better guarantee the success of a study, allowing for a full understanding of the benefits of immunotherapy and any possible side effects or its limitations when dealing with certain cancer types. Clinical trials provide comprehensive, scientific evidence to assist the FDA in approving treatments for clinical use, evidence that could not be obtained with standard laboratory testing.
Targeted therapy
Targeted therapy attacks specific molecules within cancer cells, unlike chemotherapy which takes a much less targeted approach. Instead, targeted therapy focuses on a weak area of the tumor such as a genetic mutation. The benefit of this is that the amount of damage caused to healthy tissue can be significantly reduced.
Targeted immunotherapy displays significant promise in the treatment of a wide range of cancer types. Small molecule inhibitors and monoclonal antibodies are the two most common forms of treatment, offering different benefits and drawbacks.
Small molecule inhibitors are lightweight chemical compounds that can penetrate the cell membrane to interfere with proteins that can make cancer hard to detect. Typically, this type of treatment would be recommended for blood cancers or solid tumors.
Meanwhile, monoclonal antibodies work similarly to immunotherapy, attaching themselves to specific antigens in a cancer cell. This then stops the cancer cells from growing and dividing into new cells, while also boosting the immune system so it can successfully destroy cancerous cells. Monoclonal antibodies can also treat solid tumors, as well as liquid tumors.
Clinical trials and targeted therapy
Clinical trials provide validation for targeted therapy designs and approaches, showing how they can adapt. During a clinical trial, procedures can be modified, such as dosage adjustments to make a treatment more effective.
Clinical trials that assess the effectiveness of targeted therapy generally combine the treatment with another form of treatment like immunotherapy or chemotherapy, determining whether they can work in synergy and offer tangible benefits.
Precision medicine & personalized treatments
Precision medicine is based on genetic and molecular profiling to create personalized treatments for individual patients. The aim of this is to increase the efficacy of treatments while also limiting any side effects.
With personalized cancer treatments, a patient’s treatment plan is modified based on their individual characteristics E.G. their lifestyle, general health, or genetics, in addition to the molecular profile of the tumor. Customizing treatment for each individual allows for a better standard of care while increasing the chances of recovery.
Benefits of personalized treatments
Clinical studies have shown the numerous benefits of personalized treatments in terms of combating cancer. These benefits include:
- Delivering more effective treatments by matching a patient’s unique cellular makeup with specific genetic mutations.
- Reducing side effects by minimizing any damage caused to healthy tissue helps to improve a patient’s quality of life. As such, precision medicine and personalized treatments are considered much less invasive than treatments such as chemotherapy or radiation therapy.
- Quicker recovery times due to the absence of significant adverse effects and a more targeted approach.
Nanomedicine and drug delivery systems
Nanomedicine is a treatment that is based on using nanoparticles to improve the delivery of drugs, targeting cancer cells with more precision. It is often used to effectively deliver chemotherapy medication or other drugs to the correct cells, limiting the contact with healthy tissue.
Oncolytic virus therapy
Oncolytic virus therapy involves the use of viruses that are engineered to destroy cancer cells while preventing any harm to healthy cells. There are several types of oncolytic viruses that can be considered including herpes simplex viruses, adenoviruses, and measles viruses. Each virus has its own unique benefits when it comes to targeting specific types of cancer.
Oncolytic viruses are often combined with therapies like immunotherapy and chemotherapy to increase the chance of success. Research shows that this therapy can result in improved targeting of cancer cells and reduced side effects.
Clinical trials in oncolytic virus therapy
The engineered viruses used in oncolytic virus therapy target cancer cells in a precise way and have shown considerable promise in preclinical studies. Without such studies, the benefits and risks of this type of treatment would not be properly evaluated, meaning they could not be approved for clinical use.
This is a new treatment that faces a number of challenges including safety concerns and ethical considerations. Therefore, clinical trials are crucial to the development of oncolytic virus treatment so it can be rolled out to the public and become an accessible form of cancer treatment.
Tumor Treating Fields (TTF)
Tumor treating fields (TTF) is a type of electromagnetic field therapy that prevents cancer cells from dividing into new cells. This is a non-invasive form of treatment for specific types of cancer such as glioblastoma multiforme, a type of brain cancer.
Using electric fields, rapid cell division can be disrupted to stop tumors from growing. It is delivered continuously through a wearable device meaning a hospital stay is not required. Adhesive patches or a skin array are the most common delivery devices, placed directly on the skin in the area of the tumor.
As well as being non-invasive, the side effects of TTF are also minimal, however, depending on the type of tumor, the effectiveness of this treatment can be limited.
The future of cancer treatment
Clinical trials explore countless ways of improving emerging therapies and the technology that is used. This offers insights into the future of cancer treatment, helping to improve their effectiveness and become less invasive.
Artificial Intelligence and Machine Learning in cancer care
Artificial intelligence (AI) can be used to optimize diagnostic methods which can result in cancerous cells being detected earlier using advanced imaging and complex algorithms. AI is able to analyze
large quantities of data to recommend personalized treatment options, making it easier for medical professionals to decide on the best solution.
AI and machine learning (ML) models work in unison to analyze vast datasets containing a patient’s medical history, genetic markers, and treatment outcomes. This data-driven approach can help researchers achieve the following outcomes:
- Predicting how an individual patient may respond to a treatment
- Recommending personalized treatments based on the patient’s unique profile
- Identifying which drug combinations or sequences may offer the most effective results.
Many clinical trials now incorporate AI and ML to assess how it can be used in real-life scenarios, creating optimal treatment plans, and predicting accurate patient outcomes.
How AI is used in clinical trials
AI can be used in clinical trials in several ways:
- Patient Recruitment and Stratification - AI can be used to evaluate electronic health records, medical history, and other relevant sources of data to identify individuals who meet the criteria of specific clinical trials.
- Data Analysis and Monitoring - Clinical trials create significant amounts of data that can take a very long time to analyze using traditional methods. AI can automate this process, making intelligent, real-time assessments and highlighting any anomalies in the data so they can be rectified.
- Predictive Modeling - AI technology can also be utilized to predict how cancer cells are likely to respond to a treatment, using advanced simulation techniques and machine learning. Due to the sheer number of variables, this is often not viable using manual processes due to the poor level of accuracy. This is where predictive modeling can assist researchers in the design of clinical trials so that they can choose which treatments should be tested and the possible challenges that may be faced.
CRISPR and gene editing
Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) technology can potentially edit genes so that genetic mutations can be effectively treated. In theory, this groundbreaking technology could eliminate any genetic anomalies that could cause cancer to develop.
Although there are ethical considerations that need to be taken into account, ongoing clinical trials are assessing how CRISPR can be deployed in a safe way to achieve targeted gene editing that could have a monumental impact on cancer treatment.
Increasing diversity in clinical trials for cancer treatments
Cancer treatments and the clinical trials that explore new treatments face a significant challenge when it comes to participant diversity. Diseases and the treatments administered can vary greatly based on a person’s ethnicity, race, genetics, age, or sexual orientation.
This can impact the effectiveness of treatment, making it impossible to devise a ‘one-size-fits-all’ solution. To gain a better understanding, clinical trials need to become more diverse, including people from a wide range of ethnicities and age groups. As it stands, the majority of participants enrolled in a clinical study are white, meaning very little can be learned about the wider population.
Interested in participating in a clinical trial? Our guide offers all the information you need about volunteering for clinical research, helping you make an informed choice. Get to know the process, expectations, and benefits of becoming a trial volunteer.
The Importance of prevention and early detection
Although advancement in cancer treatment is vital, prevention and early detection are key to reducing the mortality rate in people who develop cancer. Prevention and early detection are proven to increase survival rates, while also ensuring a better quality of life by addressing the adverse effects as soon as possible.
Thankfully, the improvement in screening technologies has helped researchers gain more insights into potential risk factors, allowing proactive measures to be taken to minimize the impact of cancer and its dangers.
Genetic testing
Scientists first successfully mapped the human genome back in 2003, paving the way for personalized treatment based on the patient’s genetic makeup. This allowed doctors to lessen their dependence on traditional treatments like chemotherapy as it was possible to analyze the DNA of a patient’s tumor so that specially designed therapies could target the mutations specifically.
This analysis of the patient’s individual DNA allowed medical teams to identify mutations that could potentially lead to cancer. Once identified, the patient could then go through the screening process to prevent the cancer’s development.
Cancer disparities
Cancer disparities are caused by a range of factors that combine to create complex barriers. These factors may include:
- A lack of access to healthcare
- A lack of access to medical resources
- Institutional barriers
- Structural racism
- Ancestry-related genetics
- Biological issues
For example, there is a very broad hypothesis relating to genetic ancestry-related changes that could play a key role in disparate clinical outcomes and potentially drive treatment decisions. To address this, clinical trials must consider all factors that could impact the success of a cancer patient’s treatment.
Conclusion
New cancer treatment is continually evaluated in clinical trials across the world, with innovative technologies and modern approaches making treatment less invasive, more effective, and with reduced side effects. Although this discovery process is ongoing and there are many hurdles that need to be overcome, there is much optimism.
For clinical trials involving new treatments for cancer to be even more successful, public awareness and support for clinical research needs to increase, ensuring new drugs and treatments can be approved.