Oncology Week 12: What's New in Oncology PDF

**ONCOLOGY WEEK 12: What's New in Oncology** **CAR T Cells** - You take the immune cells from the patient's own blood - You genetically manipulate them so they can attack the individual cancer - You give these cells in a transfusion to the patient and they can now attack the cancer...

**ONCOLOGY WEEK 12: What's New in Oncology** **CAR T Cells** - You take the immune cells from the patient's own blood - You genetically manipulate them so they can attack the individual cancer - You give these cells in a transfusion to the patient and they can now attack the cancer cells - City of Hope is at the forefront of CAR T therapy - The patient donated money to continue to develop CAR T therapy as it saved his life **CLINICAL TRIALS** - Start with zebrafish then mice Clinical trials - Gene Vision Preclinical: -Lab testing (rabbit, mice, monkeys) -Cellular manipulation -Make sure it helps, and animal didn't die Phase 1: -6-10 participants -Emphasis on safety -See what happens when we give drug -Judge if safe and side effects can be managed -Usually, people who have no other options -Never recommend if their cancer has returned Phase 2: -20-50 participants -Emphasis on effectiveness -Evaluate safety and efficacy of treatment Phase 3: -100-200 -Gather more info on safety and effectiveness (confirm benefit) -Will help see if there was research errors before or it is good -We want the treatment to be better than the current standard one -FDA will be involved Phase 4: -See how long it will be effective -Side effects are observed and recorded ***[Someone who only underwent basic cancer treatment does not qualify for clinical trials. They need to try every possible existing treatment first]*** **\#1 PRECISION ONCOLOGY** - Involves studying the genetic makeup and[ ](https://www.nature.com/articles/d41586-020-02673-y)molecular characteristics of cancer tumours in individual patients. - It identifies changes in cells that might be causing the cancer to grow and spread. Personalized treatments can then be developed. - **Treatments are targeted** -- as opposed to general treatments like chemotherapy -- it can mean less harm to healthy cells and fewer side effects as a result. - It involves turning up the immune system - ALK - ALK positive in lung cancer for example can be genetically treated with a new drug even if you are stage 4. it does not eradicate cancer, but it halts it in its place so you can live longer - ALK is very aggressive but with precision oncology, these people live good lives for years with their lung cancer - ALK is usually in young women who are non-smokers so this treatment is amazing **\# 2 ARTIFICIAL INTELLIGENCE (aka alternative intelligence)** - Artificial intelligence (AI) and machine learning to transform cancer care - Machine learning = taking a huge data base and program strings into AI to make them extract information from the data base - Repurposes old medications for new uses - Must ask very specific question - AI-based risk profiling can help to screen for common cancers like breast cancer, leading to early diagnosis. - AI technology can also be used to analyze X-rays to identify cancers - AI suggested we try thalidomide in cancer care and it actually worked **CRISPR-CAS9** - Methane gas is the biggest producer of methane gas **MetaGenomics**  **\#3 DNA OF CANCER** - Analyzing genomic data, oncologists are identifying different mutations that have contributed to each person's cancer - Scientists in the UK uncovered 58 new mutational signatures and broadened our knowledge of cancer **Can I find out if I have cancer?** - Galleri - Proactive tool - Scans for 50+ types of cancer - Cancers shed DNA into the blood stream - Very expensive and only in USA\* - Good example of using epigenetics to detect cancer - Complete Body Scan - Either MRI or CT - Risks and Benefits **\#4. LIQUID AND SYTHETIC BIOPSIES** - **Liquid biopsies **are an easier and less invasive solution where blood samples can be tested for signs of cancer.[ ](https://www.earli.com/post/beyond-liquid-biopsies-how-the-synthetic-biopsy-leads-the-next-generation-of-early-cancer-detection) (NOT clinically validated or histological evaluation) - **Synthetic biopsies** are another innovation that can force cancer cells to reveal themselves during the earliest stages of the disease \*A screening not a treatment! \*Can catch leukemia earlier (May be ethically wrong since pt might not want to know) **\#5 CAR-T**  -VERY expensive! -Special makers to detect cancer to stop them at checkpoints -T cells will now only attack cancer and not healthy cells \*Most benefits out of all current treatments **\#6 WEARABLE TECHNOLOGIES**  - Sends info to HCP - Used in clinical trials - Quicker identification of adverse effects and collects better data for clinical trials - HERO is technology used in pancreatic cancer - Ring can be used in hospital to take vitals and measure biorhythm **What Else?** - Personalized cancer vaccines - Identify early-stage cancers earlier - 7-minute infusions vs hours - 'Sybil'- using a low dose CT scan can forecast lung cancer in patients- AI - Study of the genome- 12,000 examples of cancer - Pancreatic cancer \~5%/5 yr survival- new test to detect it early - Using Aromatase Inhibitors in at risk women for BC- prevention - Giving chemo neoadjuvantly for all cervical cancers