Cancer is one of the leading causes of death worldwide. The conventional treatments for cancer such as chemotherapy, radiation therapy and surgery have certain limitations and side effects. In recent years, cancer biologics have emerged as a promising treatment approach with the potential to overcome some of the limitations of conventional therapies.
What are Cancer Biologics?
Cancer biologics, also known as biological therapies or immunotherapy, are treatments that use the body's own immune system to fight cancer. Unlike chemotherapy which acts non-specifically, cancer biologics are designed to precisely target specific molecules on cancer cells or immune cells. They work by stimulating or restoring the ability of the immune system to fight the cancer growth and its spread in the body. Some of the major advantages of cancer biologics over chemotherapy include increased targeting precision, fewer side effects and the ability to produce long-lasting responses by "reprogramming" the immune system.
Types of Cancer Biologics
There are several types of cancer biologics currently available or under clinical research for different cancer types:
- Monoclonal antibodies: These are antibodies produced in the laboratory that can recognise and bind to specific molecules on cancer cells with Cancer Biologics. Examples include trastuzumab (Herceptin) for breast cancer and cetuximab (Erbitux) for colorectal cancer.
- Immune checkpoint inhibitors: These drugs target inhibitory checkpoint molecules like PD-1, PD-L1 and CTLA-4 that cancer cells use to evade immune detection. By blocking these pathways, they reprogram the immune system to mount a stronger anti-tumor response. Key examples are pembrolizumab (Keytruda) and nivolumab (Opdivo).
- Cytokines: These are protein mediators that can activate or attract immune cells. Interferon-alpha and interleukin-2 are examples of cytokines used to boost anti-tumor immunity.
- Cancer vaccines: They aim to stimulate the immune system to specifically target tumor antigens. Sipuleucel-T is an autologous cellular vaccine approved for prostate cancer.
-Oncolytic viruses: Genetically modified viruses are used to selectively infect and kill cancer cells while leaving normal cells unharmed. Talimogene laherparepvec (T-VEC) is an oncolytic virus therapy approved for melanoma.
Mechanisms of Action
Each type of cancer biologic works via distinct molecular mechanisms to unleash the immune system against cancer:
- Monoclonal antibodies directly bind to targeted molecules on cancer cells to induce apoptosis, block growth signals or recruit immune effector cells like natural killer cells to kill the cancer cell.
- Checkpoint inhibitors release the brakes on immune T cells by blocking inhibitory receptors and license them to vigorously attack cancer cells.
- Cytokines enhance proliferation, activation and migration of immune cells like T cells, natural killer cells and antigen-presenting cells.
- Vaccines activate tumor antigen-specific T cells to seek out and destroy cancer cells expressing those tumor antigens.
- Oncolytic viruses infect and selectively burst open cancer cells, thereby releasing tumor antigens to ignite anti-cancer immunity.
Future Prospects and Challenges
Cancer biologics have transformed cancer treatment paradigms in recent years, leading to durable remissions in various cancers. With unraveling tumor immunology and development of next-gen platforms, the potential of immuno-oncology is far from being realized yet. Combination therapies utilizing two or more Cancer Biologics acting through complementary mechanisms hold promise to achieve even better outcomes. Expanding the array of target antigens can also enhance clinical benefit across diverse cancer subtypes. However, challenges remain in terms of high cost, non-response in certain patients and acquired resistance over time that needs new immunotherapeutic strategies to overcome. Overall, Cancer Biologics are positioned to revolutionize cancer care in the coming decade if current progress sustains.
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