Oncology in the blood
Screening programs for certain types of malignant diseases are offered to healthy (as many people think) people in order to detect cancer at the earliest stage and thus save lives. Until recently – despite the best efforts of scientists – only five types of cancer could be detected using this type of research. Most types of malignant diseases are not screened at all, since each individually is relatively rare in the general population, and preventive examinations for large groups of the population do not justify themselves.
But Grail has managed to develop a blood test that can detect more than 50 cancers at an early stage. Of these, 45 are currently not included in any screening program.
The innovation principle is as follows. All cells in the human body have access to the blood circulatory system. All cells, including cancer cells, release bits of DNA into the blood, as recent discoveries have proven. These DNA fragments contain invaluable information. That is, the biological codes of all cellular functions that make it possible to distinguish healthy cells from cancer cells. Based on an ordinary blood sample, the manufacturer has created a technology that allows to identify and analyze small pieces of DNA, thereby determining whether there are cancer cells in the body.
The study was led by Professor Mark Middleton, head of the oncology department at Oxford University. “These tests should change the protocol for managing cancer patients for 5 years,” the scientist explains. “They will increase patients’ chances of successful treatment and survival.”
Analysis for cancer recurrence
The biggest fear of cancer survivors is the recurrence of the disease after completing a course of treatment. And it’s not just psychological stress: knowing ahead of time that the cancer is likely to recur or the disease is progressing is crucial to saving a life. This is information that will enable you to quickly decide on choosing the most appropriate treatment plan.
The term “MRD” (minimum or molecular residual disease, “minimal residual disease”) means the presence of residual elements of cancer. A positive test indicates a relapse of the disease.
Cancers – even those in the same place – vary from patient to patient. Each malignant process has its own unique features, called “genetic signatures” or “genetic traces”.
The Signatera test is specially designed for each patient to recognize the genetic signature of the cancer in their body. The test begins with laboratory analysis of a tumor tissue biopsy that identifies the specific genetic characteristics of the patient’s cancer. In other words, we are talking about determining the genetic signature of this particular malignant neoplasm found in a patient.
Also, the manufacturer develops a personalized test that can identify this type of cancer in a blood sample at any time. It’s important to note that laboratories typically store cancer tissue samples for up to 7 years after diagnosis, so this test can be performed on all patients years after the biopsy.
The test can be done before and after surgery and chemotherapy. It allows you to diagnose, evaluate response to treatment, and most importantly, monitor possible cancer recurrence. To date, the test has only been applicable to diseases with solid malignancies.
Professor of cancer genetics research at Yale Cancer Center. “Detecting cancer recurrence before it becomes symptomatic requires very high-sensitivity testing,” explains Lajos Puszta. “The test allows us to confidently identify patients with molecular recurrence at a stage where the disease is not yet detectable by diagnostic imaging.”
New chemical weapon against cancer
Unlike traditional chemotherapy, which can damage healthy cells, ADC antibodies (antibody-drug conjugates) take a different approach – a targeted therapy that delivers a chemotherapy drug directly to cancer cells, leaving healthy cells unharmed, according to the developers.
The technology behind the therapy is based on the concept of antibodies and antigens. Antibodies are proteins that are naturally synthesized in the human body. Each is designed to communicate with one and only one specific antigen—for example, a key and a lock. Thus, targeted preparations are created containing an engineered antibody with a chemotherapeutic agent that can specifically bind to cancer cells and administer chemotherapy directly to them.
Similar drugs already treat blood, breast and brain cancers. Currently, more than 60 companies worldwide are working on new ADC drugs, many of which have passed clinical trials.
Researcher at the Israeli international company Gold Health, Dr. “ADC is a promising cancer treatment that can kill cancer cells without the dreaded side effects of conventional chemotherapy,” said Yael Gold-Zamir.
CAR-T therapy for patients with lymphoma and leukemia
Typically, T cells are responsible for recognizing and destroying “alien invaders”, which are infectious and even cancerous pathogens that can harm the body.
The problem is that some types of cancer can camouflage and “bypass” T cells and the immune system in general. The scientific basis behind CAR-T therapy is that human T cells can be reprogrammed to gain superpowers to kill cancer cells and prevent them from hiding from the immune system.
The treatment process begins with taking a blood sample from the patient. The blood is passed through a filtering system that separates the T cells. They then go through a reprogramming process that takes several weeks. During this procedure, cells change their genetic characteristics and gain the ability to effectively fight cancer attacking the host. The last step in the process is the infusion. The reprogrammed, “trained” T cells to kill the cancer are returned to the patient’s bloodstream.
CAR-T cell therapy is approved as second-line therapy for lymphomas and leukemias. It is currently only available in a few countries, including the US, UK, and Israel.
“We’ve developed treatments at all stages, from the lab to clinical use,” says Professor Wasim Kasim, a cell and gene therapy specialist at University College London, who was one of the first physicians to successfully use CAR-T cell therapy in difficult children. cancer treatment. “We now continue to treat children in the UK.”
Theranostics is a smart bomb in the fight against cancer
The name “Theranostics” is a combination of two words, “therapy” and “diagnosis”. This is a new approach that radically changes the idea of radiation therapy.
It is known that drugs cause some damage to healthy tissues while performing standard chemotherapy. At the same time, it is impossible to predict how much of the drug will reach cancer cells directly. In the case of theranostic, the situation is fundamentally different. In this case, the irradiation is aimed only at the destruction of cancer cells – that is, during this therapy all healthy tissues of the body are fully preserved.
When irradiated with this method, a drug is released into the bloodstream that only binds to specific targets of tumor cells. The radioactive substance contained in the theranostic preparation specifically targets cancer cells.
The first step of treatment is imaging. The doctor injects a drug that contains a very low dose of radiation – an isotope. The isotope binds to cancer cells and is easily visualized with a PET scan, allowing the precise location of the malignancy to be determined. The doctor then injects a therapeutic dose of a drug that will specifically bind to the cancer cells and release enough radiation to destroy them. This type of therapy has already been approved for the treatment of thyroid, prostate, and neuroendocrine malignancies. Scientists are currently working on applying theranostics to other types of cancer.
“Theranostics are a drug of the highest sensitivity with almost no side effects,” says François Lamouret, MD, a professor of nuclear medicine at the University of Montreal and a doctor of radiotherapy at Val-d’Or Hospital in Canada. – Absolutely personalized for each patient. That should be the standard by now.”
“It is important that all the above developments in the fight against cancer have passed the clinical trial phase. They can no longer be disposed of only by scientists in laboratories. All these last five developments are really five strong arguments in support of the fact that cancer is not a death sentence,” says Yael Gold-Zamir.
Currently, these techniques are used in England, Germany, Israel and the United States. However, all of these countries are now equally accessible and not “friendly” to Russians. And it’s not just about visas. Therefore, cancer treatment in Israel now, as before, seems to be the most viable option from those mentioned.