Cancer treatment has improved over the past two decades by leveraging the body's immune system or immunotherapy to combat the disease. A study published in the journal Molecular Cancer describes promising results in cancer treatment using a combination of immunotherapy and Danish technology.
Researchers from Odense University Hospital and the University of Southern Denmark have collaborated with a Danish biotech company, CytoVac, to develop a novel approach for optimizing cancer treatment effectiveness. The strategy utilized in the study the isolation and maturing T-cells (a type of white blood cell involved with immunity) from a patient's blood in a laboratory and reintroducing them back into their body. This approach markedly helps to prevent the spread of cancer cells if the patient also receives drugs that prevent cancer cells from inhibiting T-cell activity. This therapy has yielded positive results in initial animal studies focusing on triple-negative breast cancer, a form of the disease that has limited treatment options. While further research is needed to validate these findings in human trials, the potential for this combined treatment to improve outcomes in various types of cancer offers hope for future advancements in oncology.
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Immunotherapy for cancer treatments involves facilitating the body’s immune system to suppress the growth of cancer cells. A recent discovery in this area unearthed a protein that might be assisting tumor cells with hiding from the immune system.
A Columbia University-led team of researchers discovered that tumors repurpose a single-cell protein, using it to hide tumor cells from the immune system. According to a February 2024 Medical Express article, drugs could potentially target this protein to significantly curb the growth of tumor cells while also making immunotherapy more effective. Cancer growth is characterized by genome instability, where mutations are created during cell division. This instability also results in sensors in the cell being triggered. The cells are then alerted that something is happening when genetic material leaks outside the nucleus and cytoplasm (area in the cell excluding the nucleus). This is important in cancer treatment because these processes can release chemokines (signaling proteins), attracting immune cells into the tumor. Ultimately, these immune cells would kill the tumor before it grows. Immunotherapy would be used in cases where cancers hide by activating an immune checkpoint response, which says there is nothing here to worry about to the body's immune system and then evades the immune system's initial response to stop the cancer. Immunotherapies would act as checkpoint inhibitors, subduing the cancer checkpoint response. Researchers are focusing on a couple of proteins, including SMARCAL1, which the February 2024 Medical Express article referred to as a one-molecule immune evasion system. Researchers state that therapies that use SMARCAL1 inhibitors to target SMARCAL1 can potentially boost innate immunity (the body’s ability to boost immune function) and prevent cancers from getting around the body’s immune system through immune checkpoints. In a study led by Yale Cancer Center researchers, the findings published in January 2024 saw an increasing trend of initiating immunotherapy near the end of a patient's life. However, it raises questions about its benefits in advanced-stage cancer. The study emphasizes the transformative impact of immunotherapy in oncology but calls for a more discerning approach.
While immunotherapy has enhanced survival rates for various cancers, the study reveals a rise in initiating these treatments within the final month of a patient's life. The retrospective analysis focused on patients with metastatic melanoma, non-small cell lung, and renal cell carcinoma, with two and three percent receiving immunotherapy within the last 30 days of life. Its cost-effectiveness raises concern since a single dose costs $10,000 to $20,000. The study underscores that starting immunotherapy late proves ineffectual and incurs substantial costs. It highlights better survival outcomes when academic and high-volume cancer hospitals administer immunotherapy, suggesting the importance of specialized care in managing severe adverse events. The findings stress the necessity for further investigation into the implications of end-of-life immunotherapy, aiming to refine treatment guidelines for metastatic cancer patients. Overall, the study prompts a critical re-evaluation of the timing and value of immunotherapy in advanced-stage cases, focusing on the importance of tailored clinical approaches. The body's immune system, composed of special cells, proteins, and organs, helps destroy harmful cells, including cancer cells, at their earliest stages, preventing the spread of viruses and cancerous tumors. Researchers discovered about ten years ago that cancer slows or stops immune cells, making it harder for the body to fight against the disease aggressively.
A novel approach to treating cancer called immunotherapy changes or boosts the immune system's capacity to identify and attack cancer-causing cells. There are several types of immunotherapies, including checkpoint inhibitors medications that fight cancer's ability to slow the immune system and make it more resilient to the illness. Immunotherapy has proved successful in treating 15 types of cancer, including lung, kidney, bladder, skin, and neck cancers. It can be used alone or in combination with other traditional cancer treatments, such as chemotherapy and radiation therapy, to rev up the immune system. For example, former president Jimmy Carter, whose brain and liver were found to have metastatic melanoma in 2015, was able to overcome his melanoma after undergoing combination therapy that included the immunotherapy drug pembrolizumab. Cancer patients can receive immunotherapy for a long time while retaining a high quality of life since it is typically well-tolerated, in contrast to chemotherapy and radiation, which can have immediate, long-term, and severe side effects. A chief fellow in hematology and medical oncology from the Oregon Health and Science University, Natasha Tiffany, MD is a physician and business partner at Oregon Oncology Specialists. Natasha Tiffany, MD is heavily involved in the advances in cancer care, especially immunotherapy and personalized cancer medicine.
Personalized cancer medicine is one of the latest advances in the management and treatment of cancer. The customized aspect is that the medication and care are tailored to your genetic disposition, specific disease, and other unique identifiers. The genetic information instructs the body cells how to develop, grow, divide, and have longevity. In this aspect, some cancers target specific genes. This knowledge helps researchers formulate customized treatment regimens and develop more effective tests, prevention and diagnosis measures. Precise targeting means fewer side effects than other modes of treatment. Also, the doctors, especially the family physicians, have a chance of learning your susceptibility to developing cancer, and thus schedule screening tests early and engage mitigation measures on time. Lastly, the vulnerability enables doctors to gauge the risk of recurrence and integrate efforts to prevent cancer from returning. Before personalized medication, cancer patients all received the same treatment and management regimens. There was noticeable treatment effectiveness in some people, while others had severe side effects. Research pointed towards genetic differences as the primary variable in the variation. Examples of personalized cancer medicine include targeted therapy and pharmacogenetics. The latter is research on how genes affect the body’s response to drugs. Natasha Tiffany, MD treats cancer patients at Oregon Oncology Specialists in Salem. To provide better care, Natasha Tiffany, MD keeps up with developments in the field, such as in immunology, a process by which doctors use cells from the patient's body to fight the disease.
One up-and-coming type of immunological measure is Car T-cell therapy. Also known as chimeric antigen receptor therapy, this technique was first tried in the 2010s on children with acute lymphoblastic leukemia (ALL), a cancer found most frequently in that age group. In most cases, chemotherapy will cure patients with ALL, but unfortunately, some relapse. In a clinical trial, Car T-cell therapy led to a 60 percent chance the relapsing children would be cancer-free for five years. The process begins by removing T-cells from the patient. (T-cells are a category of white blood cells.) Scientists then add a gene containing a molecule that attacks a particular kind of cancer. After multiplying the cells to millions of copies - which takes several weeks - the newly armed cells are injected into the bloodstream. In addition to ALL, the technique has shown good results with other types of leukemia, lymphomas, and multiple myeloma. Car-T cell therapy has risks. Their presence may trigger chemicals that overstimulate the immune system and produce side effects such as rapid heartbeat, high fever, nausea and vomiting, and strong fatigue. Nervous system problems such as seizures and loss of balance are possible, as are allergic reactions and reductions in various types of blood cells. For this reason, close monitoring of patients is required for several weeks after the Car-T cells are reintroduced. As a former chief fellow in Hematology and Medical Oncology at Oregon Health and Science University in Portland, Oregon, Natasha Tiffany, MD is a now a physician in private practice at Oregon Oncology Specialists. She holds several notable board certifications and license status, including medical oncology, hematology, internal medicine, and an Oregon medical license. A career oncologist, Natasha Tiffany, MD always keeps up with new trends in managing cancer, especially personalized medicine (PM).
Also known as precision medicine, PM is a relatively new method to treat and prevent tumors. It considers the variability of genes and the differences in morbidity and lifestyle of people with cancer. Personalization allows researchers and drug manufacturers to customize the approach to the tumor and the environment, thus offering better patient care. People with cancer are often in pain. Increasing quality of life forms a primary facet of care for those on anti-cancer treatment, such as chemotherapy, and those at the end-of-life stage where the treatment does not work anymore. PM in oncology is used to optimize anti-cancer therapy and is applicable in offering supportive care for patients with malignancies. An example is the use of targeted therapy such as Osimertinib (Tagrisso) in lung cancer with EGFR mutations. Patients with EGFR mutated lung cancer can benefit from targeted therapy for years, delaying the need for chemotherapy. Chemotherapy is harder to tolerate and can cause nausea, vomiting, and hair loss. Personalized medicine significantly reduces these issues. Natasha Tiffany MD studied Neuroscience and Piano Performance at Oberlin College and Conservatory of Music, graduating with a bachelor's in arts and music in 1992. By 1998, she had completed her doctorate of medicine from Oregon Health and Science University. Natasha Tiffany, MD, earned her clinical fellow in medicine at Harvard Medical School in Boston and is an affiliate assistant professor at Oregon Health Sciences University. Outside work, she enjoys hiking and playing the piano.
Individuals can teach themselves to play the piano because it is one of the most versatile instruments. Here are the steps for those who want to start learning the fundamentals. Before you try teaching yourself to play, you must have a basic understanding of the piano. Take some time to familiarize yourself with the different parts of the piano and how they work together. Learn the difference between the middle keys, the flat keys (left black keys), the sharp keys (right black keys), the low tones, and the high tones. When starting on the piano, begin in Middle C. Positioned in the keyboard's middle is a white key to the left of two black keys. Then practice proper hand technique, including correct hand position and finger placement. One of the biggest mistakes people make when they try to teach themselves piano is starting by trying to learn too much too soon. It is essential to focus on only a few simple concepts when starting. In music, there are two types of chords: major and minor. Each major chord has a root note, a third note, and a fifth note. The minor chords include the root key, the flat third key, and the fifth key. When teaching yourself anything, it is essential to use quality resources to ensure you are learning accurate information. Research and choose wisely before spending money on books or courses. A Salem, Oregon-based physician board-certified in oncology, hematology, and internal medicine, Natasha Tiffany, MD, serves as an affiliate assistant professor at Oregon Health Sciences University. In addition, Natasha Tiffany, MD, is a physician partner with Oregon Oncology Specialists of Salem, Oregon, where she provides personalized treatments for patients with cancer.
Researchers at the University of Lisbon and Tel Aviv University are pushing the envelope of cancer immunotherapy with a cheaper and more efficient alternative to existing antibody-based cancer immunotherapy. Immunotherapy is the medical term for a treatment that focuses on optimizing the immune system or altering how it works to combat a disease. Existing antibody-based immunotherapy treatments for some cancers work on cancers attributed to the PD-L1 protein. Cancer cells with the PD-L1 gene create antibodies that render white blood cells (disease-fighting blood cells of the immune system) useless against cancer. With PD-L1 antigens (proteins), cancer cells circumvent the disease-fighting mechanism of the natural immune system. Antibody-based immunotherapy was developed to combat this problem. Antibody immunotherapy restores the immune system's ability to detect cancer cells by blocking the PD-L1 mechanism of action. A major problem with antibody immunotherapy for cancer is cost. They are typically expensive to make. According to a report on SciTechDaily.com, one year of immunotherapy treatment for cancer used to cost roughly $200,000 per patient. Another significant issue is that antibodies (the immunotherapy agents) are large molecules and can only gain entry into some cells (meaning they are not universally applicable for all cancers). The international researchers from Tel Aviv University and the University of Lisbon address the issues above with their synthetic alternative to cancer immunotherapy. According to the researchers, the novel therapy (a small synthetic molecule) is much cheaper. It can enter different cancer and white blood cells due to its relatively smaller size than antibodies. The therapy has demonstrated remarkable effects in trials involving mammals engineered to exhibit human-like immune systems. The researchers also reported that the novel therapy could be used orally, mitigating the need for IV administration. Natasha Tiffany, MD, has spent more than 15 years with Oregon Oncology Specialists in Salem. Since 2008, she has also served as an affiliate assistant professor at Oregon Health Sciences University in Portland. Over the course of her career in medicine, Natasha Tiffany, MD, has focused on a number of cancer-related topics, including advances in immunotherapy for cancer treatment.
Major advances in immunotherapy over the past decade have played a role in the development of treatments for select types of cancer, including melanoma. Traditional chemotherapy has not been particularly effective in treating melanoma. Now, with the advent of immunotherapy, the prognosis for patients with melanoma has been significantly improved. With immunotherapy, which harnesses the power of the body’s natural immune system, the toxicity of tradiational chemotherapy and radiation is avoided. Instead of receiving toxic chemotherapy, patients receive a stimulator that helps immune cells identify and destroy cancerous tumor cells. The core principle behind immunotherapy treatments for cancer involves alerting immune cells to the presence of cancer cells, which can block communications between the brain and the immune system, effectively cloaking the presence of cancer in the body. In some cases, the positive results of immunotherapy have been dramatic. Patients dealing with a melanoma diagnosis, or other forms of cancer, should discuss the potential benefits of immunotherapy with a trusted medical professional. |
AuthorNatasha Tiffany, MD, is a physician, educator, and research scientist currently working in Oregon. A Partner and Physician in a private practice located in the state’s capital city of Salem, Dr. Tiffany teaches at her alma mater, Oregon Health & Science University, where she is an Affiliate Assistant Professor in the Hematology and Medical Oncology Division. Archives
October 2019
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