Cancer: better understanding the disease to advance research

Driven by a new therapeutic arsenal and a better understanding of the disease, oncology has made tremendous progress in recent years, and the research field still looms large.

Cancer, caused by the transformation of cells that have become abnormal and proliferated excessively, is a scourge as old as life itself.

But progress in research has made it possible to better understand this disease, which is the cause of about 10 million deaths worldwide every year: now we know that cancer has “one” and not “one” for the same organ. And there can be different tumors for the same type of cancer.

“It doesn’t mean anything to talk about colon cancer or breast cancer; the challenge today is to define what cancer looks like at a biological level,” Dr. Fabrice André, director of research at the Gustave-Roussy anti-cancer center, explained to AFP.

For example, there are three main types of breast cancer that do not respond to the same treatments.

In recent years, “the development of molecular technologies has made it possible to better define which abnormal proteins to block for each type of tumor,” Professor André said.

This better understanding of the disease led to the emergence of targeted therapies that target a specific genetic mutation in the 2000s.

– Immunotherapy –

Previously, chemotherapy was often the only treatment offered: however, it aims to eliminate cancer cells, regardless of their location in the human body, and can cause side effects.

Professor Bruno Quesnel, director of research and innovation at the National Cancer Institute (INCA), emphasizes that “targeted therapies have been a revolution” for some types of cancer, such as certain forms of leukemia.

Over the past decade, immunotherapy has emerged as the most important advance in oncology.

Principle: the patient becomes his own medicine. Unlike chemotherapy, we no longer target cancer cells, but the immune cells that surround them to activate them. Re-amplified, it is the latter that destroys tumor cells.

This discovery won the 2018 Nobel Prize in Physiology or Medicine to James Allison of the University of Texas and Tasuku Honjo of Kyoto University.

For some cancers, this discovery was key. For example, until 2010, patients with metastatic melanoma (the most serious skin cancer) had a very low survival rate. Thanks to immunotherapy, life expectancy has increased to ten years compared to just a few months ago.

However, not all tumors respond to this treatment, which can cause side effects.

– Artificial Intelligence –

“We are only at the beginning of immunotherapy,” assures Professor Bruno Quesnel. The variations of this new therapeutic weapon are already many: bispecific antibodies, cell and gene therapies (CAR-T cell)…

Pierre Saintigny, an oncologist at the Léon Berard center in Lyon, notes: “We must now manage to combine treatments as intelligently as possible.” “We’ve made a step forward in treating cancer with immunotherapy, but there are still steps to climb for all patients who don’t benefit from it.”

Researchers can count on biotech’s ability to develop new, more specific and less toxic drugs.

Another pillar to rely on: the development of artificial intelligence (AI), which allows better cancer prognosis. Thanks to it, “we will be able to determine which patients can benefit from a short treatment”, assures Fabrice André. Advantage: therapeutic de-escalation for patients and lower costs for society.

Breast cancer pioneered the use of AI, which should now benefit other cancers.

Another hope lies in the ability to detect a tumor very early in the body. “We do this in the US by looking at DNA thanks to a simple blood test, but there are still a lot of false positives,” notes Fabrice André.

Before the generalization of such a technique, prevention remains the best way to prevent a large proportion of cancers.

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