Cancer | Medicine | Neoplastic | News about this disease: therapy, chemotherapy and radiotherapy by Maurizio Cavani | mom | colon | malignant tumors | | OPINION

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When we hear the phrase “such a person has cancer“We always imagine the worst. We clearly see the suffering and pain to come due to the tortuous invasive treatments known to all: surgery, chemotherapy y radiotherapy. But aren’t there other less invasive, more specific and modern treatments? In this column I want to explore the etiology of the disease in general terms and delve into some of the new treatments that are making headlines worldwide.

Cancer corresponds specifically to malignant tumors; That is, those groups of somatic cells of a specific tissue that grow degenerately. Let’s briefly explain the disease. This part of a single cell that contains some particular mutation that favors mitosis (cell division). These mutations can occur in pro-tumor genes (proto-oncogenes) that express proteins that deregulate the cell cycle, hyperactivating it, or also in tumor suppressor genes that express proteins that put a stop to regulate growth.

Starting from this premise and knowing the immensity of the human genome, there is a large number of genes that can be suppressed or activated by molecules of a protein nature or nucleic acids (micro RNA), and upregulated or downregulated, which refers exclusively to the genetic expression of “specific genes”. All of this leads to a single cell reproducing without control (that is, without regulation). This step is called “promotion.”

Next, the first mutated gene (oncogene) is accompanied by other mutated genes and growth intensifies. This step is called “progression.” The progression does not stop and other cells (from the innate and adaptive immune system) are added, as well as different molecules that make up a closed microenvironment that, finally, is known as a “tumor.”

Because certain tissues contain a greater blood supply, when the tumor progresses, certain specialized cells enter the bloodstream (which contain proteins in their outer membrane that will allow them to enter and exit the blood vessels, and are called “metastatic cells”). “) enter and migrate to other peripheral tissues. This process is called “metastasis” and can be seen as an internal infection in which the immigrant cancer cell forms another tumor.

Conventional therapies such as surgery, chemotherapy and radiotherapy consist of removing and attacking malignant cells, and are done invasively. In addition, they have an effect on healthy cells in the tissue in question. These are treatments that continue to be used to this day, especially in third world countries. However, there are new treatments every year. Many look very promising because they are less invasive, and others also because they are personalized.

To give some examples, in the breast cancer The monoclonal antibody called Trastuzumab Deruxtecan works like a Trojan horse that fulfills two functions: revealing cancer cells by adhering to their membrane receptors and internalizing them so that the cell enters apoptosis (type of cell death). In the case of colon cancer A monoclonal antibody called Dostarlimab has been produced, which has the function of overstimulating the immune system to specifically attack malignant cells. It is necessary to say that Dostarlimab has managed to eradicate the disease in clinical trials.

Finally, there are immunotherapies with drugs, molecular and cellular. Among the many targeted therapies with drugs that bind to DNA, the most promising is therapy with Omomyc, which penetrates the cell nucleus to inhibit the onocogene MYC. There is also Kymriah, which directly attacks tumor cells. In the near future this could be the main candidate to replace chemotherapy with cisplatin. Since tumor cells are clusters of different cells that mask their malignancy, another type of therapy is one with chimeric antigen receptors, also called CAR-T therapy. This consists of modifying T lymphocytes by adding the gene to express the receptor so that they can recognize cancer cells. This therapy is particularly useful and effective in leukemias, myelomas and lymphomas or other types of tumor that express the CD19 antigen (if it is not expressed, the treatment does not work).

All these new therapies, which are being finalized, are the hope of the future. As the years go by, being long-lived will no longer be strange. Added to the fact that tumors are a daily occurrence in clinics and hospitals, today there are opportunities to defeat this terrible and very ancient disease. There is nothing left, then, but to continue believing in science, which achieves invaluable feats day by day.

*El Comercio opens its pages to the exchange of ideas and reflections. In this plural framework, the Diario does not necessarily agree with the opinions of the columnists who sign them, although it always respects them.