Cancer treatment has come a long way, evolving from traditional therapies to the latest innovations that offer a new ray of hope for those who have been diagnosed. With groundbreaking advancements in immunotherapy, targeted treatments, and precision medicine, patients today have access to more effective and personalized care than ever before.

In this blog, we explore the latest developments in cancer treatment, shedding light on how science is transforming lives and shaping the future of oncology. Stay with us as we uncover the breakthroughs bringing us closer to a world where cancer is not just treatable—but beatable.

Recent advances in Medical Oncology

1. Immunotherapy: 

This approach harnesses the body's immune system to recognize and destroy cancer cells.

Checkpoint inhibitors, a type of immunotherapy, have shown remarkable success in treating various cancers, including melanoma, lung cancer, and kidney cancer. CAR T-cell therapy, another form of immunotherapy, involves genetically modifying a patient's immune cells to target and attack cancer cells with enhanced efficiency

  Checkpoint inhibitors: These help the immune system recognize and attack cancer cells. Drugs like pembrolizumab (Keytruda) and nivolumab (Opdivo) have been approved for various cancers.

  CAR T-cell therapy: T-cells are modified to better target cancer cells and then reintroduced into the patient. This has shown remarkable success in treating blood cancers like leukemia and lymphoma.

1. Targeted therapy: This treatment targets specific molecules or genes involved in cancer cell growth and survival. By blocking these targets, targeted therapies can inhibit cancer progression and improve patient outcomes. They often have fewer side effects than traditional chemotherapy because they specifically target cancer cells while leaving healthy cells relatively unharmed.
2. Precision oncology: This approach uses genetic and molecular information about a patient's tumor to guide treatment decisions.

By identifying specific genetic mutations or biomarkers driving cancer growth, precision oncology enables the selection of therapies most likely to be effective for an individual patient. This personalized approach maximizes treatment benefits and minimizes unnecessary side effects.

3. Liquid biopsies: These tests analyze blood samples to detect circulating tumor DNA (ctDNA) or other cancer-related biomarkers.

Liquid biopsies offer a less invasive alternative to traditional tissue biopsies and can be used for early cancer detection, monitoring treatment response, and identifying potential resistance mechanisms.

4. Artificial intelligence (AI): AI is being used to improve various aspects of cancer care, from early detection and diagnosis to treatment planning and monitoring.

AI-powered image analysis can help radiologists identify suspicious lesions on medical images, while AI algorithms can analyze large datasets to predict treatment responses and personalize treatment strategies. AI is helping to accelerate drug discovery and improve early detection by analyzing complex medical data more quickly and accurately than humans can.

5. Novel Drug Delivery Systems: Nanotechnology is being used to develop more effective drug delivery systems.

Nanoparticles can be designed to deliver drugs directly to tumor cells, minimizing damage to healthy tissues and reducing side effects.

6. CRISPR gene editing: CRISPR technology is being researched for its potential to directly alter cancer-causing genes or to enhance immune cells for better targeting of tumors.

CRISPR-Cas9 gene editing has emerged as a game-changer in cancer therapy, offering the potential to revolutionize how we treat this complex disease. Here are some of the key applications of CRISPR in cancer treatment:

2. Enhancing CAR T-cell therapy:

• CAR T-cell therapy involves genetically modifying a patient's T cells to express chimeric antigen receptors (CARs) that recognize and target cancer cells. CRISPR can be used to improve CAR T-cell therapy in several ways: 
  • Improving CAR design: CRISPR can be used to precisely insert CAR genes into specific locations in the T cell genome, ensuring optimal expression and function.   
  • Enhancing T cell persistence: CRISPR can knock out genes that inhibit T cell activity or promote T cell exhaustion, leading to more durable responses. 
  • Reducing side effects: CRISPR can be used to remove genes that contribute to side effects like cytokine release syndrome (CRS), making the therapy safer.
  • Creating "off-the-shelf" CAR T cells: CRISPR can be used to engineer universal CAR T cells from healthy donors, eliminating the need for patient-specific cells and reducing manufacturing time and costs.

3. Developing new cancer immunotherapies:

• CRISPR can be used to identify and validate new targets for immunotherapy, such as immune checkpoint molecules or tumor-associated antigens.   
• CRISPR can also be used to engineer immune cells with enhanced anti-tumor activity, such as NK cells or macrophages.

4. cancer-causing mutations:

• In some cases, CRISPR can be used to directly correct genetic mutations that drive cancer development. This approach is still in its early stages but holds promise for cancers with well-defined genetic drivers.   

5. Developing personalized cancer vaccines:

• CRISPR can be used to identify neoantigens, which are unique mutations present only in cancer cells. These neoantigens can then be used to create personalized cancer vaccines that stimulate the immune system to specifically target and destroy cancer cells.   

6. Studying cancer biology and drug resistance:

• CRISPR is a powerful tool for studying the underlying mechanisms of cancer development and progression. It can be used to create cancer models with specific genetic alterations, allowing researchers to investigate the role of individual genes in cancer.   
• CRISPR can also be used to study how cancer cells develop resistance to therapies, leading to the development of new strategies to overcome drug resistance.   

Advances in Radiotherapy: 

1. Precision Radiotherapy

  Improved tumor control: By precisely targeting the tumor, precision radiotherapy increases the chances of destroying all cancer cells while minimizing the risk of recurrence. 

  Reduced side effects: Sparing healthy tissues from unnecessary radiation exposure leads to fewer side effects, improving patients' quality of life during and after treatment.   

  Personalized treatment: Precision radiotherapy allows for tailoring treatment plans to each patient's specific needs and tumor characteristics, optimizing outcomes 

Intensity-Modulated Radiotherapy (IMRT): A more sophisticated form of 3D-CRT, IMRT further refines radiation delivery by adjusting the intensity of the beams within each field. This allows for even greater precision in targeting the tumor while minimizing dose to surrounding critical structures.

Image-Guided Radiotherapy (IGRT): Incorporates real-time imaging (e.g., X-rays, ultrasound) during treatment to verify the tumor's position and make any necessary adjustments to ensure accurate targeting. This is particularly valuable for tumors that may move during treatment, such as those in the lungs or abdomen.

2. Stereotactic Body Radiotherapy (SBRT):

A highly precise technique that delivers very high doses of radiation to small, well-defined tumors in a limited number of sessions. SBRT is often used for tumors that are difficult to reach surgically or for patients who are not candidates for surgery.

3. Proton Therapy

Uses protons instead of X-rays to deliver radiation. Protons have the unique property of depositing most of their energy at a specific depth, allowing for even greater precision in targeting the tumor while minimizing damage to surrounding tissues. Proton therapy is particularly beneficial for tumors located near critical organs or in children, where minimizing long-term radiation effects is crucial.

Innovations in surgical oncology

Cancer surgery is constantly evolving, with new techniques and technologies emerging regularly. Here are some of the notable advancements and new trends in cancer surgery:

1. Minimally Invasive Surgery (MIS):

• Laparoscopic and Robotic Surgery: These techniques continue to expand their application across various cancer types. They involve smaller incisions, resulting in reduced pain, faster recovery, and shorter hospital stays. Robotic surgery, in particular, offers enhanced precision, dexterity, and visualization for surgeons.
• Single-Port Surgery: A further refinement of MIS, this involves performing the entire surgery through a single, small incision, often hidden within the navel. This leads to even less scarring and potentially faster recovery.
• Natural Orifice Transluminal Endoscopic Surgery (NOTES): This emerging technique accesses the abdominal cavity through natural orifices (e.g., mouth, vagina, rectum) instead of skin incisions, potentially leading to scarless surgery. It is still largely experimental but holds great promise.

2. Robotic Surgery Advancements:

• Expanded Applications: Robotic surgery is becoming increasingly common in various cancers, including prostate, kidney, colorectal, gynecologic, head and neck, and thoracic cancers.
• Improved Technology: Newer robotic systems are becoming more sophisticated, offering improved imaging, smaller instruments, and greater flexibility.
• Single-port robotic systems are also becoming more prevalent, further reducing the invasiveness of surgeries.
• Haptic Feedback: Some newer systems incorporate haptic feedback, which allows surgeons to "feel" tissues and resistance, improving the tactile experience during surgery.

3. Image-Guided Surgery:

• Intraoperative Imaging: Techniques like intraoperative ultrasound, MRI, and CT are used during surgery to provide real-time visualization of the tumor and surrounding structures, helping surgeons achieve more complete tumor removal and avoid damaging vital organs.
• Fluorescence-Guided Surgery: This technique uses fluorescent dyes that accumulate in cancer cells, making them glow under specific light. This helps surgeons identify and remove cancerous tissue more accurately, including microscopic diseases that might otherwise be missed.
• Augmented Reality (AR) and Virtual Reality (VR): AR and VR are being explored to overlay pre-operative imaging data onto the surgical field, providing surgeons with a 3D roadmap during the procedure.

4. Precision and Personalized Surgery:

• Molecular Profiling: Analyzing the genetic and molecular makeup of a tumor helps tailor surgical approaches. For example, some tumors may be more amenable to certain types of surgery or may require a combination of surgery and other therapies like targeted therapy or immunotherapy.
• Neoadjuvant Therapy: Administering chemotherapy, radiation therapy, or immunotherapy before surgery can shrink the tumor, making it easier to remove completely and potentially improving outcomes. This is becoming increasingly common in various cancer types.
• Sentinel Lymph Node Biopsy: This technique identifies and removes the first lymph nodes that drain a tumor. If these nodes are cancer-free, it suggests the cancer hasn't spread, potentially sparing patients from more extensive lymph node removal and its associated side effects.

5. Other Innovations:

• Hyperthermic Intraperitoneal Chemotherapy (HIPEC): This technique involves delivering heated chemotherapy directly into the abdominal cavity during surgery to kill any remaining cancer cells. It is primarily used for certain types of abdominal cancers, like peritoneal mesothelioma and some cases of ovarian and colorectal cancer.
• Electroporation: This involves using electrical pulses to create temporary pores in cell membranes, allowing for more effective delivery of chemotherapy drugs or potentially destroying cancer cells directly (irreversible electroporation).
• Cryoablation and Radiofrequency Ablation: These techniques use extreme cold or heat, respectively, to destroy tumors. They may be used as alternatives to surgery for small tumors or for patients who are not surgical candidates.

6. Focus on Organ Preservation:

• Partial Organ Removal: Whenever possible, surgeons aim to remove only the cancerous portion of an organ rather than the entire organ. This is becoming more common in kidney, liver, and lung cancers, among others.
• Sphincter-Sparing Surgery: For rectal cancer, advances in surgical techniques and neoadjuvant therapy allow surgeons to preserve the anal sphincter in more cases, avoiding the need for a permanent colostomy.

Revolutionizing Cancer Treatment: Breakthroughs Offering New Hope

The fight against cancer is witnessing remarkable progress, with innovations in treatment offering renewed hope and better outcomes. From precision medicine to revolutionary therapies, the future of oncology is more promising than ever before. As the research continues to push boundaries, access to advanced, personalized care becomes crucial.

At Amrita Hospital, Kochi, we are committed to delivering world-class cancer treatment with the latest technology and expert care. If you or a loved one seek compassionate and comprehensive cancer care, visit Amrita Hospital - where the latest technology in healthcare meets healing.