Words by: James Ahern
The Egyptians were the first to diagnose cancer, 5,000 years ago. But their understanding of the disease was rudimentary at best, and they had no effective treatments. It wasn’t until the mid-1700s that doctors first attempted surgery on early-stage tumors. Pity the poor patients – it was almost a century before the first anesthetics. Marie Curie’s ground-breaking research led to the first use of radiotherapy in 1900. Forty years later doctors treating soldiers who had been exposed to mustard gas realized the treatment they were using was effective against cancer. And so, chemotherapy was born.
Our knowledge of cancer, in all its many forms, is increasing at an exponential rate. Landmark discoveries in oncology were once a rarity. Now we see a constant stream of significant advances. Radical mastectomy – the removal of entire breasts – was, for almost a century, the default treatment. Today most women with breast cancer undergo targeted surgery to remove the primary tumor instead, followed by radiation therapy. It was once common for patients with bone or soft tissue tumors to have limbs amputated. That’s now a rarity. Today far fewer patients with rectal cancer need a colostomy.
Diagnosis Without Surgery
We have the ability to diagnose cancer without the need for exploratory surgery – by using CT, MRI and PET scans and other imaging technologies. We have a whole range of non-invasive ways to destroy tumors, rather than surgically removing them. And even when surgery is required, we’re now developing robots that can carry it out with precision far beyond human eyes and hands.
Today we speak not just of treating cancer, but of curing it. We’re not there yet, but five-year survival rates for a number of cancers, notably melanoma, Hodgkin lymphoma, breast, prostate, testicular, cervical, and thyroid, are close to 100 percent. Having said that, cancer killed nearly 10 million people in 2020 and remains a leading cause of death globally, according to the World Health Organization. But the future of oncology promises a whole new generation of treatments.
Precision oncology identifies and targets the cells believed to be responsible for the cancer’s growth. Artificial intelligence can catch common cancers at an early stage, especially hard-to-detect lung cancer. Oncologists at Cambridge University are analyzing the DNA of cancer cells to understand the mutations that have contributed to each person’s cancer. Elsewhere a simple blood test is replacing biopsies, which require a section of tissue to be removed. And one of the biggest game changers is CAR-T-cell therapy, in which T-cells are genetically altered to hunt down and kill cancer cells, with particular success in treating leukaemia.
This is just a tiny snapshot of the vast amount of research currently being carried out. There are two notable treatments which should be addressed. One is a precision technology that will allow treatments to reach the parts beyond the blood brain barrier that other treatments cannot reach. The second is a cancer vaccine.
Potential Game Changer
The blood brain barrier is designed to protect a vital organ from harmful bacteria, fungi, viruses or parasites. But it also acts as a roadblock to benign agents. BRiTE (Brain Bispecific T-Cell Engager) is a potential game changer, effectively opening the gate to drugs or diagnostics that would otherwise be barred from entry. The first application of this technology could allow the body’s own specially-programmed T-cells – cancer-fighting elements of the immune system – to pass through the blood brain barrier and get to work attacking and eliminating malignant giloma, one of the most common brain cancers.
The technology was originally carried out by researchers at the Department of Neurosurgery at Duke University, in North Carolina, USA. It has been further developed under license at Centaur Bio, Inc., a Delaware corporation, and is now due to undergo clinical trials, in which patients will receive infusions of BRiTE and of activated T-cells. BRiTE focuses on transporting difficult-to-deliver T-cell targeting agents to improve the treatment of solid tumors and CNS (central nervous system) disorders in the “immunoprivileged” brain.
The second development is self-assembling vaccines (SAVs), at the cutting edge of cancer treatment. They are vaccines that can spontaneously assemble or organize their component nanoparticles without the need for a complex manufacturing process. Voltron Therapeutics, Inc., also a Delaware corporation, has developed an SAV designed to bolster the immune system against a validated oncology target. It has already demonstrated in pre-clinical tests that its SAV construct significantly increases both helper and cytotoxic (cancer killing) T-cell responses, and it is planning further tests.
Voltron improves cell-mediated responses to combat infectious diseases, including COVID-19. Its vaccine platform was designed by scientists at the Vaccine and Immunotherapy Center (VIC) at Massachusetts General Hospital (MGH) and Harvard Medical School.
Research and Investment
Advancements have surged over the past few years due to increased research and investment into multiple kinds of cancer. Globally last year (2022), over US$193 billion was invested across nearly 50,000 institutions and organizations, with a planned estimated increase funding to US$253 billion by 2024 – a 31 percent increase.
As these new technologies and biomedical advances continue, it could perhaps not be too long before we are approaching a true cure for this disease which affects one in three of us globally.
ABOUT JAMES AHERN
James Ahern is the founder of Laidlaw Venture Partners and managing partner of Laidlaw & Company UK. With over 15 years of expertise in capital formation, investment banking, and equity capital markets, Ahern has partnered with innovation labs across numerous academic institutions to cultivate multiple companies now within Laidlaw’s portfolio.
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