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Prior works and History
The article 'Immuno-Oncology Agents for Cancer Therapy' by Sophie Carter and David E. Thurston explores the development and impact of immuno-oncology (IO) therapies as a transformative approach to cancer treatment."Over the past 20 years, cancer incidence rates have increased steadily, while mortality rates have shown a constant decline. This is due to the advancing technology, treatments and early diagnosis of cancer that allows the mortality rate to decrease even though 200 more cancer types have been discovered.
Currently, there are 4 treatments that are used for cancer, which are surgery, radiotherapy, chemotherapy, and precision therapy.Surgery (made possible after the discovery of general anesthetics in the late 1800s), was revolutionary. As long as the tumor was small and clearly defined, surgeons could extract it and get rid of the tumor in its entirety.
Radiotherapy is another one of these treatments which utilizes X-rays/G-rays to damage the DNA within cancerous cells. These ultraviolet rays can kill cells easily hence they can kill the cancerous cells but may kill human cells as well.Chemotherapy, discovered in the 1940’s uses toxic gasses like mustard gas to kill rapidly dividing cells. Although this used to be able to kill WBC (White Blood Cells), it can also be used to kill leukemia cells that cause cancer that affects the blood and bone marrow.
Precision therapy, also called targeted therapies, are a more recent development in the 1990’s, with the development of certain drugs such as imatinib. These drugs target and kill mutated proteins in cancerous cells, but not the healthy proteins in regular cells, making them an effective solution especially early on in cancer.
Immuno-oncology agents and methodology
In the past 8-10 years, a new method of cancer prevention and treatment has been developed. This method is called Immuno-oncology (IO). As the word suggests, this method relies on harnessing the body's own immune system to recognize and destroy cancer cells. IO agents, such as immune checkpoint inhibitors (ICIs), block the mechanisms that tumors use to avoid immune detection, leaving them open to face our immune systems. The development of drugs like pembrolizumab (Keytruda) for non-small-cell lung cancer (NSCLC) have been revolutionary because these drugs can effectively be used to treat and prevent cancer.
Other than ICI’s, Monoclonal Antibodies (mAbs) are other agents that contain antibodies that bind specifically to tumor cells and can either initiate an immune response, or kill the tumor cell itself. Chimeric Antigen Receptor (CAR) T-cell Therapy is another one of the IO methods in which a patient's T-cells (Lymphocytes, a specific white blood cell), are collected and genetically engineered to express chimeric antigen receptors (CARs) that can recognize specific antigens on cancer cells. These modified T-cells are then re-infused into the patient to seek out and destroy the cancer cells.
Biomarkers
Biomarkers are compounds that doctors use to find out how well the patient will respond to a certain treatment. Although, it is important to note that they’re very complicated to deal with. The article talks mainly about PD-L1 expression, a protein that is expressed on the surface of both tumor cells and immune cells in the tumor microenvironment. It binds to PD-1 receptors on T-cells, effectively switching them off and allowing cancer cells to evade immune detection. IO therapies require the testing of the presence of these biomarkers, because they give a good indication of aspects like the strength and abilities of the immune system.
Secondly, the article talks about Tumor Mutational Burden (TMB), which refers to the number of mutations present in a tumor's genome. A higher mutational burden increases the chance of the tumor producing neo(new)antigens, which the immune system can recognize as foreign. This can make tumors more susceptible to immune attack when treated with IO agents. This is a helpful biomarker as it is an indicator that IO treatments will be the best against these kinds of tumors.
Conclusions
The article in its essence comments upon this new emerging field of Immuno-oncology. It shows the potential effectiveness of this type of treatment and how it can benefit the patient whilst causing minimal or no damage to healthy cells.The article also talks about the potential threats of these therapies. IO agents can lead to severe immune-related adverse events (irAEs), such as colitis, dermatitis, and pneumonitis, due to their mechanism of boosting immune activity. They are also very high cost to produce hence cannot cater to the majority of cancer patients.
Works Cited:
Carter, Sophie, and David E. Thurston. "Immuno-Oncology Agents for Cancer Therapy." The Pharmaceutical Journal, vol. 304, no. 7937, May 2020, pp. S1-S17. Pharmaceutical Journal Publications, doi:10.1211/PJ.2020.20207825
Dhakad, Ganesh G., et al. “Review on Immuno-Oncology Agents for Cancer Therapy.” Asian Journal of Pharmaceutical Research, Mar. 2022, pp. 110–15. https://doi.org/10.52711/2231-5691.2022.00017.
Cancer Research Institute. “What Is Immunotherapy? | Cancer Research Institute.” Cancer Research Institute, 6 Oct. 2023, www.cancerresearch.org/what-is-immunotherapy.
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