1. Introduction
Cancer is a pervasive global health issue that accounts for around one-sixth of all deaths globally. Global cancer incidence in 2020 reached around 19.3 million, resulting in over 10 million cancer-related fatalities. Cancer is a complex and progressive series of illnesses and disorders characterized by a widespread lack of control over growth.
For several decades, patients with cancer had limited treatment choices, such as radiation therapy, surgery, and chemotherapy, either used individually or in combination. However, there has been a significant advancement in understanding the various pathways involved in the progression of cancer medical care and how they can be specifically targeted.
This progress has been achieved through the use of combinatorial strategies, which involve the simultaneous application of multiple targeted treatments or conventional chemotherapeutic agents like taxanes and platinum substances. It has been discovered that these combinations have a synergistic effect, meaning that their combined action is greater than the sum of their individual effects.
Novel strategies, including pharmaceuticals, bioactive compounds, and immunotherapies, are being employed to treat metastatic cancer, despite the fact that they have not yet achieved the desired therapeutic efficacy in terms of reducing death rates and prolonging life.
The development of a novel revolution in the treatment of neoplastic cancer or the design of medications that specifically target it relies on understanding the pathways and unique properties of various tumor types. Chemotherapy is largely regarded as the most efficacious and often employed treatment technique for malignancies, either as a standalone therapy or in conjunction with radiation.
Genotoxicity refers to the mechanism by which chemotherapy medications primarily target tumor cells, causing the production of reactive oxygen species that effectively eliminate these cells.
Hormonal treatments are commonly employed for cancer malignancies and are classified as cytostatic due to blocking hormone receptors, their ability to inhibit tumor growth by restricting the activity of hormonal growth factors through the regulation of the hypothalamic-pituitary-gonadal axis (HPGA), and restricting the synthesis of adrenal steroids.
2. Cutting-edge and groundbreaking cancer treatments
The primary challenges in cancer therapy are drug resistance and the efficacy of drug delivery methods, which hinder the effectiveness of cancer cures and symptom reduction. However, there are currently several authorized therapeutic options and medications available. The efficacy of traditional cancer treatment is diminished as a result of tumor pathology and the structural irregularities of the blood vessels inside the tumor tissue.
3. Stem cells therapy
3.1 Adult stem cells
Commonly utilized categories of adult stem cells (ASCs) in tumor therapy encompass mesenchymal stem cells (MSCs), hematopoietic stem cells (HSCs), and neural stem cells (NSCs). Hematopoietic stem cells (HSCs), which are found in the bone marrow, have the ability to generate all types of fully developed blood cells in the human body.
At present, the only treatment method authorized by the Food and Drug Administration (FDA) is the administration of HSCs obtained from umbilical cord blood for the purpose of treating multiple myeloma and leukemia. Mesenchymal stem cells (MSCs) are present in various tissues and organs, and they have significant functions in the process of tissue healing and regeneration, giving rise to specialized cell types such as adipocytes, osteocytes, and chondrocytes.
MSCs possess unique biological attributes and are employed in conjunction with other methods to complement the treatment of malignancies. NSCs have the ability to undergo self-renewal and produce fresh neurons and glial cells. They are employed in the treatment of primary as well as metastatic breast cancers and other types of malignancies.
3.2 Pluripotent stem cells
Embryonic stem cells (ESCs), derived from the homogeneous inner mass cells of the embryo, have the capacity to differentiate into all cell types except those found in the placenta.
The discovery of Yamanaka factors in 2006 revolutionized cell biology by enabling the generation of pluripotent stem cells (iPSCs) from somatic cells in a laboratory setting. ESCs and iPSCs have identical properties, hence circumventing ethical concerns associated with embryo destruction. iPSCs and hematopoietic embryonic stem cells (hESCs) are being employed for generating natural killer cells, effector T cells, and anti-tumor vaccines.
3.3 Targeted drug treatment
Targeted cancer treatments, also known as molecularly targeted pharmaceuticals, treatment options, or precision pharmaceuticals, refer to chemicals or substances specifically designed to attack cancer cells with precision. The medications function by disrupting the activity of growth molecules, therefore inhibiting the proliferation and metastasis of cancer cells.
The origin and progression of a tumor are governed by the tumor microenvironment. Tumor microenvironment-forming cells engage in several signaling processes and pathways to interact dynamically with malignant cells, facilitating sustained and significant cellular growth. Therefore, the research focuses on using tumor microenvironment circumstances to facilitate precision.
Targeted administration of conventional chemotherapy is challenging due to its similarity to normal cells. Cellular processes, such as apoptosis induction, proliferation prevention, cell cycle arrest, and interference with metabolic reprogramming, are involved in addressing these disorders using targeted pharmacological treatment agents.
Two tactics that can be employed for the treatment of cancer are the modification of the tumor microenvironment and the direct targeting of the tumor for drug delivery, both aimed at enhancing therapeutic efficacy. Targeted therapy medications employ distinct mechanisms compared to conventional chemotherapy treatments, namely by selectively targeting cancer cells while minimizing harm to healthy cells. This unique characteristic distinguishes them from healthy cells.
The use of targeted treatment significantly enhanced the survival rate for some diseases. For instance, in patients suffering from advanced pancreatic cancer, the inclusion of erlotinib alongside conventional chemotherapy resulted in a notable improvement in survival rate, rising from 17% to 24%. Imatinib has significantly impacted the management of chronic myeloid leukemia, whereas sunitinib, rituximab, and trastuzumab have brought about a revolutionary change in the medical management of renal cell carcinoma and breast cancer, respectively.
3.4 Radiofrequency Ablation (RFA) therapy
RFA is a method that is performed with minimum invasion and uses image guidance to apply high-frequency electrical currents in order to eliminate cancer cells. Imaging modalities, such as ultrasonography, magnetic resonance imaging (MRI), or computed tomography, are utilized to direct needle electrodes towards a tumor cell.
In general, radiofrequency ablation (RFA) is the most efficient method for treating tumors that are less than 3 cm in diameter. RFA can be employed in conjunction with other established therapeutic modalities for cancer. RFA may effectively treat medium-sized tumors (up to 5 cm in diameter) by utilizing deployable instruments or multiple-electrode setups.
3.5 Gene therapy
Gene therapy is the introduction of a functional version of a faulty gene into the genetic material to treat a particular condition. In 1990, the first instance of using a retroviral vector to transport the adenosine deaminase (ADA) gene to T cells in individuals with severe combined immunodeficiency (SCID) occurred.
Currently, there are over 2900 ongoing clinical studies for gene therapy, with around two-thirds of them being cancer-related. Strategies for cancer gene therapy include the assessment of several approaches, such as the activation of genes that can stimulate particular immune responses against tumors, the activation of genes that promote cell death and increase sensitivity to chemotherapy, the activation of normal tumor suppressor genes, and the targeted suppression of cancer-causing genes.
4. Conclusion
The current approaches in the field of oncology mostly concentrate on the advancement of cancer nanomedicines that are both safe and effective. Targeted medical care improved the distribution of newly developed or previously tested chemotherapeutic medicines within the targeted tissue being treated.
Various techniques, including sequential medical treatment, therapy, siRNA delivery, and inhibitor compounds, provide new possibilities for cancer patients. Gene therapy functions by the direct insertion of foreign genes into tumors that are harmless in their original location.
Stem cells possess distinct biological properties that make them suitable for many applications, such as regenerative healthcare, therapeutic delivery systems, targeted drug delivery, and the production of immune cells. However, thermal ablation and hyperthermia using magnets provide potential alternatives to traditional surgical procedures for growth treatment.
Radionics and pathomics techniques are utilized to effectively handle extensive knowledge collections from cancer patients, thereby improving prognosis and outcomes. Considerable advancements have been achieved, although it is quite probable that several other ad hoc-tailored medicines may emerge in the near future. The advancement and enhancement of medication delivery systems are crucial for enhancing therapeutic results.
References
Positron emission tomography as an imaging biomarker, Wolfgang A Weber, DOI: 10.1200/JCO.2006.06.6068
Thermal tumor ablation in clinical use, C Brace, PMCID: PMC4226271
Retrospective cohort study evaluating clinical, biochemical and pharmacological prognostic factors for prostate cancer progression using primary care data, Samuel William David Merriel et.al, DOI: 10.1136/bmjopen-2020-044420
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