New Cancer Treatments and Research

Considerable progress has been made in reducing cancer rates and improving cancer survival in the United States since the 1990s. A greater understanding of the immune system, genetics, and cancer pathology has opened the doors to an ever-increasing range of new cancer treatments and diagnostic tools.

Advances in cancer care have been highly specific in terms of the diagnostic and treatment modalities that are recommended for each type of cancer. This article will describe these key treatments as well as the process of cancer treatment development.

Cancer Treatment Development

Throughout the years, there have been discoveries of drugs and treatment methods that prove to be more successful or reliable than previous ones. These treatment methods are discovered in different ways.

Some are found in nature through the testing and studying of plants, fungi, and animals. Others are found through the study of cancer cells and existing drugs or procedures. But before any type of treatment method is used on patients, there is an important process that ensures its safety and effectiveness.

New cancer drugs typically go through stages of clinical research. These stages are:

• Preclinical research: Preclinical research aims to ensure a form of treatment is safe for human use. Laboratory studies that include animal research and in vitro studies, or experiments usually done in test tubes and Petri dishes, are common in this research stage.
• Clinical research: After preclinical research is successful, clinical research focuses on testing the form of therapy on humans. This clinical research stage can be lengthy (up to 10 years or more) as the discovered treatment goes through phases of clinical trials.
• Post-clinical research: Post-clinical research involves studying a therapy that has gone through the clinical research phase and received approval for human use. This involves collecting data on effectiveness and safety in real-world use.

Surgery

Advances in and refinement of cancer surgery—including the use of targeted drugs and other medications before and after surgery—that can improve outcomes for cancer patients continue to emerge.

Studies comparing the outcomes of different surgical methods have helped guide doctors in selecting the technique that is most likely to result in a better long-term prognosis.

Video-Assisted Thoracoscopic Surgery (VATS) Lobectomy for Lung Cancer

During a lobectomy, a portion of a lobe of a lung that is affected by cancer is removed.

The minimally invasive technique known as VATS lobectomy, done with general anesthesia, often involves a shorter recovery time than open surgery for lung cancer. The American College of Chest Physicians identifies VATS lobectomy as the preferred method for treating early-stage lung cancer.

During the procedure, a thoracoscope, which is a small tube with a light and camera attached to the end, is inserted between the ribs through a small incision. The affected lung tissue is then removed using special tools.

Open Surgery for Cervical Cancer

In a clinical trial between 2008 and 2013, 631 women were enrolled to compare the efficacy of open surgery with that of minimally invasive surgery for the treatment of cervical cancer.

Postoperative quality of life for both groups was similar. But open surgery resulted in lower rates of cancer recurrence and higher disease-free survival.

Another study found that patients with early-stage cervical cancer who had minimally invasive surgery experienced higher recurrence rates than those who had open surgery, making open surgery a better option for some patients.

MinION Genetic Sequencing During Surgery

Cancer cells contain genetic mutations. Oxford Nanopore's MinION, a portable, long-read sequencing platform, enables the real-time detection of cancer cells during surgery.

When tissue is passed through a small hole, changes in current reflect differences in the cell's DNA material. By evaluating changes in ionic currents when the DNA molecules pass through the polymer membrane, the nanopore sequencer can detect the presence of cancer cells.

This test, which takes only one hour, can detect whether a sample contains cancer cells or normal cells. While it is not approved by FDA at this time, this test may be approved in the near future and help neurosurgeons determine the presence of tumor cells in brain samples.

Radiotherapy

Radiation therapy is used as an adjunct to cancer treatment. Newer, more effective, and targeted radiotherapies are now being used to treat early and advanced cancers.

Stereotactic Ablative Radiotherapy (SABR) for Metastatic Cancer

A study demonstrated that patients receiving SABR in addition to standard of care showed improved survival compared with patients receiving palliative standard of care.

SABR for Inoperable Early-Stage Lung Cancer

For patients who are not surgical candidates, SABR offers an alternative. This approach was shown to have excellent local control and well tolerated in a cohort of 273 patients.

Immunotherapy

Immunotherapy uses the body's immune system to fight cancer. Immunotherapy can boost or change how the immune system works so it can find and attack cancer cells. 

Molecular testing, which can help select patients most suitable for immunotherapy, has opened the door to this newer form of treatment. Some of the early and commonly used immunotherapy agents are vaccines, including the first FDA-approved cancer vaccine, sipuleucel-T, for prostate cancer.

Below are some of the more recent breakthrough agents grouped by category:

• Monoclonal antibodies, such as Trodelvy for metastatic triple-negative breast cancer
• Oncolytic virus therapy, including Imlygic for inoperable melanoma
• CAR T-cell therapy, such as CD22 for acute lymphoblastic leukemia relapse
• Cancer vaccines, such as Provenge for prostate cancer

Targeted Therapy

Targeted therapy is when drugs are directed at specific proteins or genes that promote cancer cell growth. It is designed to attack cancer cells directly.

Some of the targeted drugs commonly used to treat cancer are Tagrisso (osimertinib), Tarceva (erlotinib), and Iressa (gefitinib) for lung cancer, and Kadcyla (ado-trastuzumab), Tykerb (lapatinib), and Afinitor (everolimus) for breast cancer.

Kinase Inhibitors

Dysregulation of protein kinases is involved in many types of cancer, and this protein is the target of several cancer drugs.

Drugs like Rozlytrek (entrectinib) and Tabrecta (capmatinib) are used to treat metastatic non-small cell lung cancer.

• Rozlytrek (entrectinib) is used to treat non-small cell lung cancer that is positive for ROS1 and the neurotrophic receptor tyrosine kinases (NTRK) fusion-positive solid tumors. It inhibits cell-proliferation while targeting ROS1, a receptor tyrosine kinase.
• Tabrecta (capmatinib) is a tyrosine kinase inhibitor that can help to shrink tumors involving a MET mutation. The MET gene produces a receptor tyrosine kinase, which is involved in cell proliferation and cell survival.

PARP Inhibitors

Drugs such as Zejula are being used to treat ovarian cancer. The drug inhibits the enzymatic activity of enzyme poly (ADP-ribose) polymerase (PARP). In a study of 533 patients who had recurring ovarian cancer, Zejula increased the time experienced without symptoms compared with standard therapy.

Combination Therapies 

Combination therapy means using two forms of cancer therapy in conjunction. Newer classes of drugs are being combined with traditional chemotherapy to improve outcomes. This approach will likely become the standard of care for treating some types of cancer.

One recent example is the combination of Tecentriq and Avastin in the treatment of liver cancer.

Diagnostics

It is an ongoing area of critical research to develop better and more accurate diagnostic and screening techniques, some next-generation technologies are being developed.

Artificial Intelligence Mammograms

In a study that involved 28,296 independent interpretations, AI performance was comparable to radiologists' diagnostic ability for detecting breast cancer.

Liquid Biopsy for Breast Cancer

A liquid biopsy can detect circulating levels of cell-free DNA (cfDNA) and circulating tumor DNA (ctDNA).

In a meta-analysis that included 69 published research studies. with 5,736 breast cancer patients, researchers determined that the status of ctDNA mutation predicts disease recurrence and adverse survival results. They also found that the levels of cfDNA can predict metastasis of the axillary lymph node.

Monarch Robotic Endoscopy for Lung Cancer

This may be advantageous for patients with external lung lesions that need biopsy prior to surgery, radiation, targeted therapies, or immunotherapy.

Genomic Cancer Screening in Embryos

A polygenic risk score used by genomic prediction accurately distinguished which person in a set of siblings will inherit a medical condition. The accuracy was cited between 70% and 90%, depending upon the condition.

At-Home Urine Test for Prostate Cancer

A convenient, at-home urine test can be used to detect extracellular vesicle-derived RNA to provide prognostic information for men under active surveillance for prostate cancer.   

A Word From Verywell

Cancer research that is investigating better treatments and diagnostic tools is ongoing. Even if you have advanced metastatic cancer, it may be comforting to know that newer treatments are being studied and approved every year. As treatments become better and better, your chances of survival and remission will also improve. If you have been diagnosed with cancer, it may also help to seek a cancer support group to boost your mental well-being and resilience.