How Close Is The Cure?

Good Housekeeping (South Africa) - - YOUR BODY -

If it seems like the war against can­cer has dragged on for an ob­scenely long time, that’s be­cause can­cer is a for­mi­da­ble ad­ver­sary. Still, there’s so much hope. Al­ready there are tar­geted ther­a­pies on the mar­ket that in­hibit pro­teins on or in can­cer cells that cause the cells to grow. Com­pared with chemo­ther­apy, which is like killing a mos­quito with a brick, th­ese treat­ments are much more spe­cific. A drug called Gleevec, for ex­am­ple, blocks a mu­tant gene that causes leukaemia cells to form and spi­ral out of con­trol. Her­ceptin, mean­while, blocks a pro­tein that tends to grow or di­vide faster in the can­cer cells of women with HER2­pos­i­tive breast can­cer. There are even much stronger chemo­ther­a­pies for HER2-pos­i­tive breast can­cer and Hodgkin’s lym­phoma that use sim­i­lar pro­tein tar­get­ing. Most doc­tors agree that the next fron­tier in can­cer re­search, though, is im­munother­apy – get­ting the im­mune sys­tem to find and kill can­cer on its own, the same way it would tackle the flu. ‘It hap­pens to be what I study, but I would bet every­where you go you will hear that im­munother­apy is the next big thing and it will dom­i­nate the land­scape for the next decade,’ says Dr Crys­tal Mack­all, a pae­di­atric on­col­o­gist at Stan­ford Uni­ver­sity in the US. Can­cer hides from the im­mune sys­tem by pre­tend­ing it’s a nor­mal part of the body: un­like a splin­ter or a virus, can­cer cells con­tain ‘self’ pro­teins rather than for­eign anti­gens, mak­ing it more chal­leng­ing for white blood cells to at­tack. In check­point in­hibitor ther­apy, doc­tors re­move a brake from the im­mune sys­tem that would nor­mally pre­vent its killer cells (called T-cells) from go­ing af­ter can­cer. Keytruda – ap­proved for melanoma, non-small cell lung can­cer and sev­eral other can­cers – is one check­point in­hibitor drug that has helped some os­ten­si­bly ter­mi­nal pa­tients live for years. Up next is the first CAR T-cell ther­apy, in which doc­tors re­move T-cells from a pa­tient’s body, in­sert a mech­a­nism tar­get­ing can­cer (much like the ones that make your im­mune cells recog­nise chick­en­pox or measles) and then re­in­fuse them. In Au­gust last year, the Food and Drug Ad­min­is­tra­tion in the US ap­proved the first CAR T-cell ther­apy, called Kym­riah, to fight leukaemia in chil­dren and adults. – Jac­que­line Detwiler

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