Chemotherapy: Open Access
Open Access

Chemotherapy: Key Foundation of Cancer Treatment Strategies

Sherry Brown^{* *}Correspondence: Sherry Brown, Department of Medicine, University of Tennessee Health and Science, Chicago, USA, Email:

Author info »

Description

Chemotherapy remains one of the primary treatments for cancer, with the goal of destroying cancer cells or slowing their growth. However, despite its long history of use, chemotherapy study continues to evolve, driven by the need to enhance efficacy, reduce side effects and overcome resistance. Cancer treatment study has made remarkable strides over the past few decades, driven by relentless investigations and groundbreaking innovations [1]. The primary goal is to improve patient outcomes through early detection, personalized therapies and more effective treatment modalities. Advances in genomic sequencing, for example, have revolutionized our understanding of cancer, allowing for the identification of specific genetic mutations and the development of targeted therapies that minimize harm to healthy cells.

Novel drug development

The quest for new chemotherapeutic agents is a fundamental of cancer study. Scientists are exploring various paths to discover and develop drugs that can target cancer cells more effectively and with fewer side effects [2].

Targeted chemotherapy agents: Targeted chemotherapy drugs are designed to specifically target molecular markers on cancer cells, sparing normal cells and reducing side effects.

HER2 inhibitors: Used in HER2-positive breast cancers, these drugs, such as trastuzumab, specifically target the HER2 receptor, inhibiting cancer cell growth.

ALK inhibitors: For non-small cell lung cancers with Anaplastic Lymphoma Kinase (ALK) gene rearrangements, drugs like crizotinib have shown significant efficacy by targeting the abnormal protein produced by the ALK gene.

Antibody-Drug Conjugates (ADCs): ADCs are a novel class of targeted cancer therapeutics that combine an antibody specific to cancer cells with a potent cytotoxic drug [3]. The antibody directs the drug to the cancer cells, where it is internalized and released to exert its lethal effect.

Brentuximab vedotin: Used in Hodgkin lymphoma, it combines an anti-CD30 antibody with a microtubule-disrupting agent.

Trastuzumab emtansine (T-DM1): For HER2-positive breast cancer, it links trastuzumab with a cytotoxic agent, delivering the drug directly to HER2-expressing cells.

Small molecule inhibitors: Small molecule inhibitors can penetrate cells easily and interfere with specific proteins or pathways that promote cancer cell growth and survival.

BRAF inhibitors: Such as vemurafenib, used in melanoma patients with BRAF V600E mutations.

Poly (ADP-ribose) Polymerase (PARP) inhibitors: Used in Breast Cancer susceptibility Associated (BRCA)-mutated ovarian and breast cancers, these drugs, like olaparib, exploit the DNA repair deficiencies in cancer cells to induce cell death.

Innovative drug delivery systems

The effectiveness of chemotherapy can be significantly influenced by how the drugs are delivered to the tumor site. Innovative delivery systems aim to enhance drug concentration at the target site while minimizing systemic exposure and side effects.

Nanoparticle-based delivery: Nanotechnology has revolutionized drug delivery, allowing for the encapsulation of chemotherapeutic agents in nanoparticles [4]. These nanoparticles can be engineered to target tumors specifically and release their payload in a controlled manner.

Liposomes: These are lipid-based nanoparticles that can encapsulate drugs, enhancing their solubility and stability. Doxil, a liposomal formulation of doxorubicin, is used for various cancers, including ovarian cancer.

Polymeric nanoparticles: These can be designed to release drugs in response to specific stimuli, such as pH changes in the tumor microenvironment.

Conjugated drug delivery: Conjugating chemotherapy drugs with molecules that specifically target cancer cells can enhance drug delivery and reduce off-target effects.

Albumin-bound Paclitaxel: Abraxane, an albumin-bound form of paclitaxel, improves drug solubility and delivery to tumors, used in breast, lung and pancreatic cancers.

PEGylation: Conjugating drugs with Polyethylene Gycol (PEG) can increase their circulation time and stability, enhancing their therapeutic efficacy.

Implantable drug delivery systems: Implantable devices can provide sustained and localized delivery of chemotherapy drugs, reducing systemic toxicity and improving efficacy.

Gliadel wafer: An implantable wafer impregnated with the chemotherapeutic agent carmustine, used for treating glioblastoma multiforme, delivering the drug directly to the brain tumor site. This approach aims to maximize efficacy and minimize toxicity by selecting the most appropriate drugs for each patient.

Genetic and molecular profiling

Advances in genomic sequencing and molecular profiling have enabled the identification of specific genetic mutations and molecular characteristics of tumors [5].

Next-Generation Sequencing (NGS): NGS can provide comprehensive genomic profiling, identifying actionable mutations that can be targeted with specific chemotherapeutic agents or targeted therapies.

Liquid biopsies: These non-invasive tests analyze circulating tumor Deoxyribose Nucleic Acid (ctDNA) in the blood, providing real-time information about tumor genetics and response to treatment [6].

Biomarker-driven therapy

The use of biomarkers to guide chemotherapy selection is becoming increasingly prevalent. Biomarkers can predict response to specific drugs, helping to customize treatment [7].

PD-L1 expression: PD-L1 testing in tumors can guide the use of immune checkpoint inhibitors, such as pembrolizumab, in cancers like non-small cell lung cancer and melanoma.

HER2 status: HER2 testing in breast cancer can determine the suitability of HER2-targeted therapies, such as trastuzumab and pertuzumab.

Conclusion

The panorama of cancer treatment is undergoing a profound transformation, driven by relentless study and innovative advancements. From the precision of genomic sequencing to the groundbreaking commitment of immunotherapy, these developments are revolutionizing our approach to cancer care. The integration of innovative technologies like artificial intelligence and nanotechnology is enhancing diagnostic accuracy and enabling targeted drug delivery, reducing side effects and improving patient outcomes.

The future of cancer treatment is bright, with ongoing study and innovation offering hope for more effective, personalized and compassionate care. Continued dedication to advancing our knowledge and developing new technologies will undoubtedly transform the lives of countless patients, paving the way for a world where cancer can be managed more successfully and ultimately, cured.

References

1. Luo Y, Sun M, Tan L, Li T, Min L. Nano-Based Drug Delivery Systems: Potential Developments in the Therapy of Metastatic Osteosarcoma—A Narrative Review. Pharmaceutics. 2023;15(12):2717.

   [Crossref] [Google Scholar] [PubMed]

2. Fenton OS, Olafson KN, Pillai PS, Mitchell MJ, Langer R. Advances in biomaterials for drug delivery. Adv Mater. 2018;30(29):1705328.

   [Crossref] [Google Scholar] [PubMed]

3. Fu Z, Li S, Han S, Shi C, Zhang Y. Antibody drug conjugate: the “biological missile” for targeted cancer therapy. Signal Transduct Target Ther. 2022;7(1):93.

   [Crossref] [Google Scholar] [PubMed]

4. Patra JK, Das G, Fraceto LF, Campos EV, Rodriguez-Torres MD, Acosta-Torres LS, et al. Nano based drug delivery systems: recent developments and future prospects. J Nanobiotechnology. 2018;16(1):71.

   [Crossref] [Google Scholar] [PubMed]

5. Li H, Yang Y, Hong W, Huang M, Wu M, Zhao X. Applications of genome editing technology in the targeted therapy of human diseases: mechanisms, advances and prospects. Signal Transduct Target Ther. 2020;5(1):1.

   [Crossref] [Google Scholar] [PubMed]  

6. Singh S, Podder PS, Russo M, Henry C, Cinti S. Tailored point-of-care biosensors for liquid biopsy in the field of oncology. Lab Chip. 2022;23(1):44-61.

   [Crossref] [Google Scholar] [PubMed]

7. Restrepo JC, Dueñas D, Corredor Z, Liscano Y. Advances in genomic data and biomarkers: revolutionizing NSCLC diagnosis and treatment. Cancers (Basel). 2023;15(13):3474.

   [Crossref] [Google Scholar] [PubMed]