IT’S a worrying fact that more than half of us will get cancer in our lifetime.
Each year around 392,000 people are diagnosed and 167,000 lives are lost to the disease in the UK . . . and experts have warned of an alarming new surge in the young.
GettyThe horizon of cancer care looks glowing[/caption]
Abingdon HealthProf Lawrence Young, an oncologist who has been working in cancer research for 40 years, tells Sun Health: ‘We are turning a corner with cancer, there is no doubt about it’[/caption]
But, in the face of rising cases, there is good news — the future of cancer care looks brighter.
“Cancer “ and “exciting” don’t tend to go hand-in-hand yet those are the words on the lips of scientists following a series of studies of new-age treatments.
Many emerged from the American Society of Clinical Oncology conference in Chicago, including research that claimed drugs were “100-per- cent effective” or gave “remarkable” results.
Prof Lawrence Young, inset, an oncologist who has been working in cancer research for 40 years, tells Sun Health: “We are turning a corner with cancer, there is no doubt about it. We’ve learned a lot about the basic mechanisms of cancer development, and a lot about other processes, such as how the immune system works, but it has taken a long time to put all these things together.
“With significant technological developments, we are entering a golden age of cancer diagnosis and treatment. Cancer survival has improved markedly over the past few decades. But it’s not going away — Cancer Research UK warned earlier this year that cases have risen in the past quarter-century, partly because of screening programmes but also due to a growing population, obesity and other lifestyle habits. Prof Young says new therapies mean that “cancer is no longer a death sentence”.
He says: “There are lots of different approaches to treating patients with cancer — and living a healthy life even though you’ve got it, rather than trying to completely eradicate it.”
But it comes against a backdrop of what has been called a UK cancer-care crisis, with long waits for diagnoses, and survival rates worse than in comparable countries.
The NHS is at the forefront of trialling innovative therapies, but can it afford to roll them out nationwide?
Prof Young says: “All these things are great in theory and very exciting, but they’re costly and the NHS won’t be able to cover the cost of some things. But the hope is that these things will get cheaper as they are developed and become more standardised.”
Here, we look at the most promising developments in cancer treatments . . .
Personalised medicine
PERHAPS the most exciting new avenue of research is tailoring medicine to treat a patient’s cancer based on their own tumour’s genetic make-up.
Prof Young says: “We’ve learnt that by profiling the genetics, you almost get a barcode for an individual’s cancer.
PAMedicine can now be tailored to each patient’s cancer[/caption]
“Just because somebody’s got the same stage and grade of cancer, doesn’t mean it should be treated the same, or with a particular combination of drugs.”
The NHS announced in May that it would trial personalised cancer vaccines designed by biotech giants BioNTech and Genentech.
Some 10,000 patients in England are set to get their very own disease-busting jab by 2030, through the NHS Cancer Vaccine Launch Pad.
Dad-of-four Elliot Pfebve was the first to receive the vaccine, after having a bowel tumour removed in what NHS England called a “landmark moment”.
Prof Young says: “Essentially, using AI you can identify those mutations that are more likely to generate a strong immune response, and then you can create a vaccine.”
Unlike traditional vaccines, which prevent disease, these are being tested for their efficacy in preventing relapses.
Findings of prior studies published at the ASCO meeting were greeted positively.
A New York University study showed a skin-cancer jab halved the risk of death or relapse in patients with advanced melanoma.
Speaking at the conference, Cancer Research UK’s top doctor, Professor Charles Swanton, called the results “extremely impressive”.
He said: “I fully expect and hope that we’ll see data like this in solid tumours like bowel cancer and lung cancer.”
A second study from The University of Vienna revealed the vaccine tecemotide cut the risk of relapse in breast cancer survivors.
After seven years, 81 per cent of women were still alive compared to 65 per cent who only had standard chemotherapy.
Another study, of 300 children in Australia, with results published last week, had what scientists called “remarkable” findings, showing that those who received personalised treatment fared far better than those who did not.
Immunotherapy
DUBBED the “biggest breakthrough since chemo”, immunotherapy harnesses the power of the immune system to fight cancer.
Antibodies seek out and mark the diseased cells for destruction but spare surrounding healthy tissue, unlike chemotherapy or radiotherapy.
Merck and Co., Inc.Keytruda brings cancer cells out from hiding[/caption]
Prof Young says: “We’ve known for 100 years the body tries to fight cancer with the immune system but it doesn’t really work. Cancer cleverly learns how to get around the immune response. It can switch off the way the immune system recognises it – but these antibodies can switch it back on again.
“Antibodies are effective alone, but where they are most effective is in combination with another type of immunotherapy.”
Keytruda (pembrolizumab) brings cancer cells out from hiding. It has been approved for treating several cancers on the NHS, including melanoma, cervical, breast and lung cancer.
But its use could be extended to bowel cancer.
A University College London study found all 32 patients with highly mutated tumours given Keytruda in a trial were cancer-free after treatment.
Professor Mark Saunders, from The Christie cancer hospital in Manchester, said: “This is an exciting treatment for the ten to 15 per cent of patients who have the right genetic make-up.
“In the future, immunotherapy may even replace the need for surgery.”
Similarly, Jemperli (dostarlimab) – which works in the same way as Keytruda and is used for some types of womb cancer – was reported in a US trial to be “100-per-cent effective” at treating 42 patients with a type of rectal cancer.
Targeted cancer drugs
THESE work more precisely to stop cancer cells from dividing and growing, while limiting damage to healthy cells – and their uses are expanding.
Prof Young says: “This is targeting the machinery of the genetic mutations that drive cancer.
LorviquaLorlatinib, branded as Lorviqua, is used for a handful of patients with ALK-positive non-small cell lung cancer[/caption]
“Some are targets we’ve known about for years but were difficult, until recently, to develop drugs for.
“The normal growth of our cells is controlled by switches which become mutated and permanently switched on in cancer cells.
“Now, after years of research, we have targeted drugs which can switch off these growth signals.”
Kinase inhibitors are targeted drugs – small molecules that stop certain enzymes involved in cancer growth.
Lorlatinib, branded as Lorviqua, is used for a handful of patients with ALK-positive non-small cell lung cancer.
But after “groundbreaking” results in May, campaigners hope it will become a lifeline for the 350 people in the UK who are diagnosed with this type of cancer each year.
They are typically non-smokers under the age of 40 and about a quarter of patients’ tumours spread to their brain before they are diagnosed.
But scientists at the Peter MacCallum Cancer Centre in Melbourne, Australia, found that 60 per cent of patients given this drug for five years had not seen their cancer worsen, compared with just eight per cent of those with the standard drug crizotinib.
Dr David Spigel, from the American Society of Clinical Oncology, said: “These results are off the chart. They are among the best we’ve seen in advanced disease, in any setting. It really is a major step forward in lung cancer care.”
Blood tests
EARLY diagnosis is still the best weapon against cancer and its devastating impacts.
Blood tests are becoming increasingly sensitive in spotting the disease.
GettyBlood tests are becoming increasingly sensitive in spotting cancers[/caption]
Prof Young says: “Current blood tests aren’t that great. For example, we measure the proteins PSA, for prostate cancer, or CEA, for ovarian cancer, but they’re not very specific.
“We want to do our best to cure cancer with early diagnosis, and with these interesting blood tests it might be possible to identify cancer early and remove it before we get too far.”
These new blood tests can “identify minuscule amounts of DNA shed from tumour cells into the blood”, Prof Young says.
The NHS has been trialling the Galleri blood test in England and Wales, using 140,000 volunteers so far, and will continue until 2026.
Research in the US suggested the Galleri blood test could pick up more than 50 types of cancer, including pancreatic and oeso- phageal, which are typically hard to spot early.
But in an update in May, the NHS said preliminary results from the trial’s first year were not compelling enough to initiate a pilot programme of the test in clinical practice.
Prof Young says: “The recent data is not as encouraging as we had anticipated, but it is early days. It will take at least another five years of research to get anywhere near those tests being useful routinely.”
Blood tests could also be used post-treatment to identify those at risk of a disease recurrence.
Some 11,000 people die of secondary breast cancer each year in the UK.
But findings presented at ASCO showed that in a trial of 78 women recovering from breast cancer, a blood test identified 100 per cent of those who would relapse, sounding the alarm up to 41 months beforehand.
Dr Simon Vincent, of Breast Cancer Now, which part-funded the study by the Institute of Cancer Research, said: “These initial findings, which suggest new tests could be able to detect signs of breast cancer recurrence over a year before symptoms emerge, are incredibly exciting.”