Immuno-oncology: A Saving Grace in Cancer Treatment
Posted 10th April 2019 by Joshua Sewell
Technology is constantly changing the healthcare industry. Scientists and physicians are hard at work doing everything they can to enhance treatment options for patients battling many different types of diseases and cancers. Immuno-oncology (I-O) is a subarea of immunotherapy that is uncovering new ways that cancer can be treated. This type of treatment allows patients to participate in less invasive and taxing procedures all while finding newer treatment options on a more niche or case by case level. Immunotherapy treatments and supporting procedures are making their way into everyday cancer care to change the playing field for the better.
An initial biopsy is recommended after doctors find an area of the body to be concerned or suspicious about. It is one of the more common ways doctors diagnose many forms of cancer. Traditionally, this procedure is completed by taking a small sample of the body’s soft tissue, however, clinicians are discovering new ways to make them less intrusive.
One of these relatively new processes is liquid biopsies. Physicians are able to take liquid rather than solid samples from a patient to determine what is going on in the body. Samples can be taken from patients blood cells near tumours. Blood cells around tumours have a similar DNA that makes up the tumour itself. By analyzing the cells near a growth, one can find out many of the characteristics of the tumour. The test only requires 5 milliliters of blood to be drawn, which is easier to tolerate than a surgical biopsy. Then the sample is spun down into 2 milliliters of plasma for DNA analysis.
For physicians treating cancer patients, this innovative technique can help diagnose many cancers sooner, detect mutations faster, and see overall treatment effectiveness. While this method is still in its trial stages, the idea behind this type of testing is that one day doctors will be able to take a blood sample and screen for cancers before you show any symptoms. As we all know, early detection is crucial for beating cancer, and physicians have high hopes for these tests to help with early cancer intervention.
Researchers at John Hopkins Kimmel Cancer Center ran a study to see if a single blood test could screen for several types of cancers. They created a noninvasive blood test called CancerSEEK, that has the ability to detect eight different cancer types by assessing protein biomarkers and tumour-specific mutations in DNA surrounding tissue. The study tested 1,000 patients previously diagnosed with cancer and 850 control group individuals who had never tested positive for cancer.
CancerSEEK is able to find eight common cancer types with a sensitivity of 69 to 98 percent, however, results were dependent on cancer type and had a 99% specificity. Since this new technology has the accuracy that it does, it could one day help physicians accurately detect cancer and pinpoint exactly where it is just from a simple blood sample.
According to the National Cancer Institute (NCI), flow cytometry (FC) is one way that clinicians can measure characteristics of cells in a certain sample. By taking cell sample types from a patient, whether it be from blood, bone marrow, or tissue, physicians are able to use them to get the percentage of cells in the sample, the size of the cells, the shape of the cells, and the presence of tumour markers on a cell’s surface.
Once a sample is taken, an individual’s cells are stained with a light-sensitive dye. The cells are placed in a fluid and passed through a stream of light, such as a laser. In order to determine the characteristics of the cells, physicians will take measurements based on how the light-sensitive dye reacts to the light. In a single-cell suspension sample, it is important for each individual cell to be observed independently in order to obtain the most efficient and effective analysis.
The modern cytometer has made many improvements over time. For instance, today’s cytometer has the ability to measure cell characteristics as they pass through the instrument’s laser at a rate of 10,000 cells per second. The abilities of this machine combined with the speed and potential accuracy that it has been giving the ability to rapidly analyze cells which will allow doctors to provide treatment before any further mutations occur.
This treatment is utilized to detect cancer while monitoring the effectiveness of a specific treatment. Having the ability to analyze thousands of cells per second has made this innovation a true timesaver for oncologists. Rapid result turnover allows for prompter treatment in order to produce overall better outcomes for patients.
One specific test that cytometry has proven useful in the study of oncology is the detection of tumour cell DNA aneuploidy. According to a study posted in the Scandinavian Journal of Clinical and Laboratory Investigation, the presence of DNA aneuploidy and high levels of S-phase tumour cells in the sample usually suggest that a malignant tumour is present.
This technology has proved to be effective when treating complex cases like leukemia. Cytometry can test for the presence of leukemia and how far along the illness might be, along with determining the subtype of cancer. According to the Leukemia Research Foundation, leukemia is aggressive cancer affecting blood and bone marrow. Every three minutes, someone is diagnosed with blood cancer and more than 201,870 new cases are expected this year in the United States, alone. With innovations that produce results as rapidly as FC, it can be groundbreaking for leukemia patients whose health is declining quickly.
Adoptive Cell Transfer
Adoptive Cell Transfer (ACT) is a popular therapy that many cancer patients have utilized in their treatment. ACT is a type of immunotherapy where T-cells are extracted from the patient through blood samples, multiplied in large numbers, and then put back into the patient’s body to help the immune system fight off cancer. Some T-cells are even genetically modified so that they are stronger and do a better job of supporting a cancer patient’s immune system. One specific type of this therapy includes chimeric antigen receptor T-cell ( or CAR T-cells), which is when T-cells are modified to produce the chimeric antigen receptors on the surface of the T-cells.
Another is tumour infiltrating lymphocytes (TIL) treatment, in which clinicians modify and isolate autologous tumour-infiltrating lymphocytes from tumour tissue in vitro and infuse them into a patient. This type of treatment helps to induce lysis of tumour cells and thus begin tumour regression. With this treatment, it is important to recognize that lymphodepletion is vital to making these options possible. Through tactful elimination of cells that regulate the immune system, the body is able to better identify and destroy cancer cells.
According to a study in Nature Reviews Cancer, ACT has become one of the most effective treatments for patients with metastatic melanoma. It has even proven to promote cancer regression in about 50 percent of patients. In the Journal of Translational Medicine, a study showed that diseases as incurable as malignant pleural mesothelioma can benefit from adoptive cell transfer.
The disease caused by asbestos fibers creates tumours in the lungs nearly 30 years after initial exposure. The survival rate is said to have the potential to be improved with a fibroblast activation protein (FAP). FAP is on the surface of the reactive tumour-associated fibroblasts as well as on some specific cancer types. The study showed that FAP was present in all subtypes of pleural mesothelioma. The results discovered that FAP re-directed CD8+ T cells and proved to have antigen-specific functionality. Concluding that mesothelioma patients are able to benefit from this type of treatment.
Anna Dussing is Health Journalist for Mesothelioma.com. Their work focuses on awareness and advocacy for mesothelioma cancer. Her focus is on raising awareness of toxin exposure and the potential health impacts it causes.
The Research & Technology Series: Immuno-oncology will be a place to discover the latest scientific and technological advances in novel cancer targets, biomarker detection, and large molecule immuno-oncology. To see what is on offer across the five events, visit the series page now.
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