In the dynamic landscape of cancer medicine, the relentless pursuit of innovative treatments has led to significant breakthroughs. Dr Baswantrao Malipatil, a Medical Oncologist at Manipal Hospital, sheds light on the newer advances in cancer treatment that are transforming the way we combat this formidable disease.
Traditionally, cancer treatment comprised radiation therapy, surgery, and chemotherapy. However, with advancements in scientific understanding, researchers have delved into the nuanced differences among various cancers in terms of growth and spread. Identifying specific markers expressed by cancer cells has paved the way for the development of targeted drugs, ushering in a new era of more effective and less side-effect-prone treatments.
Targeted Therapies: Dr Malipatil outlines the impact of targeted therapies by citing examples. In breast cancer patients who are HER2 positive, targeted therapies like trastuzumab, pertuzumab, TDM1, etc., have significantly increased chances of cure and improved overall survival. Similar breakthroughs are witnessed in lung cancer, where drugs like gefitinib, dacomitinib, and osimertinib specifically target EGFR-positive cancer cells.
Enhanced Effectiveness: Compared to conventional chemotherapy, these targeted therapies have shown heightened efficacy, elevating the chances of cure and overall survival for many cancer patients. For instance, drugs designed for chronic myeloid leukaemia (CML), such as imatinib, dasatinib, and nilotinib, effectively target specific mutations, leading to a remarkable improvement in patient's life expectancy.
Advancements in Early Stages: While initially explored in advanced cancers, these targeted therapies are now making strides in early-stage cancers. Notably, HER2-positive breast cancers see the approval of these drugs for treatment in the early stages, signalling a shift towards proactive intervention.
Immunotherapy: Dr Malipatil delves into the realm of immunotherapy, where drugs like nivolumab, pembrolizumab, and atezolizumab work by blocking markers, such as PD-L1, that cancer cells use to evade detection by the immune system. By unmasking cancer cells as potential threats he says these drugs can empower the immune system to recognise and eliminate them.
Tumour Agnostic Therapy: A groundbreaking concept in cancer treatment, tumor-agnostic therapy involves drugs approved to target specific features, irrespective of cancer's origin. Pembrolizumab, for instance, is greenlit for MSI-H cancers, regardless of their source.
Promising Approvals: Dr Malipatil highlights the approvals and ongoing processes for drugs in tumor-agnostic therapies. Noteworthy examples include the combination of dabrafenib + trametinib, initially developed for melanoma, now approved for any cancer with BRAF V600E mutation. Additionally, selpercatinib gains approval for RET-mutated tumours, showcasing the broadening horizons of targeted treatments.
In a landscape where each discovery adds a layer to our understanding of cancer, these advancements represent significant strides towards more effective, personalised, and accessible cancer care.