Cancer Immunotherapy in India

Cancer is an umbrella term used for describing various diseases of the body tissues. The most common distinguishing feature of cancer is the uncontrollable and unregulated growth of cells. Since these cancerous cells outgrow, they invade other cell’s territory by taking up the resources like oxygen, nutrients, and space.

As per WHO reports, in 2020 alone nearly 10 million deaths were reported due to cancer. The newest of them are due to:-

  • Breast cancer(2.26 million cases)
  • Lung (2.21 million cases)
  • Colon and rectum (1.93 million cases)
  • Prostate(1.41 million cases)
  • Skin(1.20 million cases)
  • Stomach (1.09 million cases)

SYMPTOMS:-

Cancer symptoms can vary widely depending on which area of the body is affected.

However, here’s how to self-check for any signs of cancer(but not specified):-

  • Unexplained bleeding.
  • Lump or thickening of skin.
  • Difficulty in swallowing.
  • Pain in the affected area or any part of the body.
  • Irregular bowel movement.
  • Nausea.
  • Fatigue.
  • Frequent changes in the weight.

CAUSES:-

Cancer can be caused when there is the activation of oncogenes( cancer genes) or any kind of mutation. The mutation is the changes in the genetic material of the cell, can be caused by exposure to UV radiation, cancer-causing chemicals, congenital defects, viruses, and chronic inflammation.

These mutated genes disable contact inhibition and turn them into invading/phagocytic cells, these cells fail to stop uncontrollable cell growth. This spreading of cancer is known as metastasis and is the cause of death.

THERAPY FOR CANCER:-

Cancerous cells declare molecular war on the normal 6cells of our body. Our immune system’s first response is to protect our normal cells.

This is a fresh approach for treating cancer as previously cancer patients were exposed to chemotherapy and radiation therapy which destroy the cancer cells but often damages healthy tissues in the process.

One approach is to augment our immune cells causing them to degrade cancerous cells and thus, eliminate cancer. This is the primary goal of cancer immunotherapy. To augment or supplement our immune cells, we must first investigate our immune cells, make clonal expansion of them and deploy them to destroy the cancerous cells.

Types of cancer immunotherapy:-

The immune systems can be augmented in various ways and many of them are still being studied on. Some of the prominent ways are:-

MONOCLONAL ANTIBODIES:-

Monoclonal antibodies are man-made antibodies that circulate throughout the body until they detect any antigen. Once attached to the antigen, they deploy our immune system to destroy cells with the specific antigen.

There are 4 different ways to produce antibodies:-

  • Murine:- These antibodies are made from mouse proteins and their treatments end with -omab.
  • Chimeric:- These are made from part mouse and part human proteins and their treatments end with -ximab.
  • Humanized:- These are made by attaching small mouse proteins with human proteins and their treatments end with -zumab.
  • Human :- These are fully human proteins and their treatments end with -umab.

VACCINES TO TREAT CANCER:-

Cancer vaccines are different from virus vaccines.-Vaccines pave a way for counterattacks on the already existing cancer cells. Vaccines are made from either part of proteins on cancer cells or pure antigens.

 Some vaccines can also be developed by taking patient’s immune cells and exposing them to the proteins on cancer cells. Because the immune system has special memory cells, it is thought that vaccine might work long after being injected.

Sipuleucel-T(Provence) was approved by FDA in 2010 for metastatic hormone-refractory Prostate cancer. It is marketed by Dendreon Corp. Side effects include mild fever, fatigue, back pain, and joint pain.

Talimogene laherparepvec(T-Vec) was approved to treat advanced melanoma skin cancer.

Many vaccines have shown promising results in the initial trials and are yet to be approved.

ADJUVANTS MEDIATED IMMUNITY BOOSTERS:-

Adjuvants are certain type of cells that boost our immune systems, for e.g.; attenuated strains of Mycobacterium bovis.

Adjuvant-mediated activation is rapid because adjuvant activates macrophages even faster than tumor antigens can. These activated macrophages, in turn, increase the responsiveness of our immune system.

CYTOKINES:-

Cytokines can boost our immune system and help in eliminating cancer cells. Isolation and culturing of cytokinesis made easier by recombinant DNA technology. Other way is to inject certain genes than can amplify the expression of cytokines such as Interferon alpha, beta and gamma; Interleukin 1, 2 ,4 ,5 and 12.

Cytokines help in the communication of T-helper cells and macrophages, as a result of which Tumor Necrosis Factor(TNF) . This factor blocks the growth of tumor cells, finally leading to apoptosis of tumor cells, along with anti-inflammatory functions.

SAFETY:-

Most of the immunological drugs are novel, hence, it is very hard to say anything about the long term side effects about them. Many experts in the field of cancer research have even stated these drugs as “hazardous” especially when used in combination with other cancer therapy.

Very little is known about the handling and disposal of these drugs and vaccines. Few drugs must be administered while donning protective clothing such as hand gloves. Few of them need to be disposed in a certain way at the medical store.

Therefore, it is always best to take these treatments under the guidance of the cancer care team and following guidelines strictly.

Researches are diligently focusing on how to distinguish which therapy will work for whom, as it may be that cancer vaccines can work for some and not all.

In general, immunotherapy is a novel approach towards developing therapy and drugs for cancer treatment. The therapies explained in this article does not include every therapy, as further research are going on and they need to be approved as well for clinical studies. Furthermore, taking a step or two from our side is always helpful as there goes a saying “Prevention is better than cure” .

Many are well aware that smoking causes cancer and other lifestyle diseases. Hence, it is always best to avoid smoking under any circumstances. Regular health checkups with your medical professional is recommended.

SOURCES:-

https://www.hopkinsmedicine.org/inhealth/about-us/immunotherapy-precision-medicine-action-policy-brief.html
https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/what-is-immunotherapy.html