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HomeBlogGenetics and big tech bring immunity from cancer a few steps closer

Genetics and big tech bring immunity from cancer a few steps closer

By: Medix Team
Genetics and big tech bring immunity from cancer a few steps closer

It’s all about the immune system: the past decade has been a game changer as scientists deploy genetics and technology to aid the body’s natural ability to seek and destroy cancer cells.

The very essence of what distinguishes us as individuals lies in our DNA. It’s therefore not very surprising that the full sequencing of the genome was such a pivotal moment in human history back in 2003.

 

Since then, scientists have been able to examine our individual molecular “instruction sets” to gain an ever-deeper understanding of why some people are more genetically pre-disposed to get cancer and how the disease learns to evade the immune system’s ability to find and destroy it.

 

The first decade of the 21st century was all about applying this burgeoning understanding to clinical trials. The second centred on the drugs, which this knowledge brought to bear. Here we list some of the key milestones of the past 10 years:

 

1. Immunotherapy

 

In 2018, American scientist Jim Allison won the Nobel Prize for switching the focus of cancer treatment away from blasting tumours with chemotherapy and radiation to targeting the immune system, which exists to defend us from foreign invaders like viruses and mutant cells (cancer).

 

What better way to beat cancer than to make sure our body’s natural protection system can fulfil the job it was born to do. Allison discovered that cancer had learned to “hide” from the immune system.  

 

He found that certain proteins on T-cells (a type of white blood cell) act like a brake, or an off-switch preventing these foot soldiers of the immune system from finding and killing cancerous cells. He called them checkpoint proteins and the first one he targeted is called CTLA-4.

 

In 2011, the US Food & Drug Administration approved the first immunotherapy drug to combat it: Yervoy (ipilimumab). This is a monoclonal antibody (a manmade version of an immune system protein), which is used against late-stage skin cancer (melanoma). 

 

In 2015, the FDA approved its first combination therapy – Yervoy and Opdivo (nivolumab) as a first line treatment for patients with metastatic non-small cell lung cancer whose tumours express PD-L1, a protein that acts as a brake on T-cells.

 

A second type of immunotherapy is called CAR-T (chimeric antigen receptor) therapy. This involves re-programming T-cells to target individual cancers. A patient’s own T-cells are harvested and then genetically altered with a new gene coding for a specific protein (a chimeric antigen receptor). When they’re re-administered into the body these modified T-cells are primed to find and kill the cancer in question.

 

The FDA-approved the first gene cell therapy in 2017 - Kymriah (tisagenlecleucel), which targets blood cancers such as leukaemia and lymphoma.

 

2. Precision medicine

 

Genetics have enabled scientists to move beyond where a tumour is located in the body to an examination of its specific genes and molecular features. This has also given them a much better understanding about whether a patient’s DNA make-up will make them more or less likely to respond to certain treatments and drugs.

 

More personalised and tailored treatments are replacing, or being used in tandem with, standard courses of chemotherapy and radiation, which damages healthy as well as cancerous tissues.

 

Scientists have developed tumour-agnostic therapies that have been particularly successful for hard-to-treat cancers such as lung, pancreatic, brain and triple negative breast cancer. The FDA approved the first treatment for a cancer based on its biomarker rather than its location in May 2017: Keytruda (pembrolizumab). 

 

3. Liquid biopsies

 

In 2016, the FDA approved the first diagnostic molecular cancer test based on a liquid biopsy (blood test). Examining blood samples for cancer’s DNA fragments is far cheaper than a surgical or needle biopsy and also simpler to perform.

 

Taking tissue samples will continue to remain important until liquid biopsies become more sophisticated. But the other great advantage of liquid biopsies is that they can be performed multiple times. This enables physicians to stay one step ahead of a disease that’s continually evolving and mutating.

 

4. Artificial Intelligence

 

In 2017, researchers at Stanford University provided the first proof that machines could perform almost the same level of diagnostics as humans. They did it by creating a neural network (the computer version of a human brain) using a large dataset of benign and malignant skin lesions. The machine used this data to learn how to distinguish between the two.

 

Since then, artificial intelligence (AI) has been used to detect other cancers including breast and brain to nearly the same level as trained clinicians. Cancer has traditionally been diagnosed through histopathology (under a microscope). AI opens the door to ever more sophisticated and standardized diagnoses that do not rely on an individual human’s ability.

 

5. Lifestyle factors

 

We rely on medicine to save us, but more and more clinical research is being produced to show just how much we can do to help ourselves with simple lifestyle changes. Smoking is still the leading cause of preventable death from cancer.

 

However, in the past decade the focus has switched to obesity as well. Losing weight reduces cancer risk.  Eating a well-balanced diet that feeds and nourishes the beneficial bacteria, which live in our large intestines (the microbiome), might also help to prevent both cancer and obesity.

 

In 2013, two studies highlighted how the microbiome might impact the potency of cancer therapies as well. In one study, researchers from America’s National Cancer Institute demonstrated that gut bacteria does not revert to its initial state after antibiotics are administered: any decrease in the effectiveness of the innate immune system potentially decreases the effectiveness of chemotherapy too.



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