Written by Emma Winter, Head Medical and Scientific Services and Rosie Lobley, Communications Manager on Thursday 6th October 2022
Innovation in cancer diagnosis and treatment is evidence of a steadfast ambition to improve patient care and outcomes. In our article ‘Cancer Inequity: What is it and what can be done?’, we discussed the importance of competition in innovation to address issues of accessibility but also the need for reinvestment into the improvement of care. In this article, we explore the latest developments and current gaps in cancer diagnosis and treatment.
The continued integration of genomics, bioinformatics, and digital tools in oncology is driving a shift towards precision medicine based on patients’ individual disease profiles,1 and several recent developments are supporting this shift:
CRISPR/Cas9 genome editing has been shown to improve the safety and efficacy of CAR-T cell therapies and prevent resistance to chemotherapy and radiotherapy in tumor cells2
Despite the progress made so far, widespread implementation of a precision medicine approach remains contingent on international collaboration and investment to alleviate the inequalities in access to treatment.5
Trastuzumab deruxtecan, an antibody–drug conjugate sold under the name Enhertu®, is revolutionizing the treatment of human epidermal growth factor receptor 2 (HER2)-positive cancers, which are defined by an overexpression or amplification of HER2.6 To date, Enhertu® has been shown to be effective in treating HER2-positive breast,7 stomach,8 and lung cancer.9
There is a growing evidence base indicating that non-small cell lung cancer (NSCLC) may be treated more effectively by a combination of immunotherapies than by monotherapy.10,11
In addition to the promise shown by new life-extending agents in several tumor types, there is also important research being conducted to further understand and overcome treatment resistance. A Phase 1 trial demonstrated that combining the immunotherapy pembrolizumab and the hypomethylating agent guadecitabine may reverse resistance in patients with immunotherapy-resistant cancers.12
Fecal transplants may also potentially overcome resistance to immunotherapies, suggesting that by harnessing the power of the gut microbiome, it may be possible to improve the body’s response to certain treatments and reduce the severity of side effects.13 Elsewhere, emerging research has shown that treatment-resistant esophageal cancer responds well to phosphodiesterase type 5 (PDE5) inhibitors, which are currently used to treat erectile dysfunction.14
Cancer vaccines have shown promise in early research, although significant further investigation and development is needed before they can be integrated into cancer care pathways.15 The development of mRNA vaccines for COVID-19 showed that mRNA vaccines, which are easier to produce and deliver than DNA- or virus-based vaccines, are generally effective and have good safety profiles. The success of these COVID-19 vaccines has boosted interest and support for the development of vaccines against various cancers using the same mRNA platform.16
While recent innovations have made great strides towards improving cancer diagnosis and treatment, issues around implementation and treatment resistance mean that it may be a while before these innovations can have the intended impact on patient outcomes. Yet, this commitment to innovation represents the importance of maintaining patient centricity in everything we do.
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