In recent years, cancer treatments involving modern chemotherapy and radiotherapy are increasingly common, but cancers that are refractory to them do exist. In such cases, patients may choose a different regimen of chemotherapy, enrol in clinical trials for new treatments or pursue alternative, complementary medicine.
However, research in the field of cancer medicine has provided much needed insights into the molecular biology and genetics of many cancer types, which has driven development of novel therapeutics targeting the cancer biology, thus providing better “on-target and off-target” effects that could translate into better survival chances, according to Dr Tan Poh Lin, who is a senior consultant from the Department of Paediatrics at the National University Hospital (NUH) and an alumna of NUS Medicine.
Generally, new treatments that are undergoing clinical trials include high-dose chemotherapy with stem cell transplants, targeted therapy and most promisingly, immunotherapy, of which two forms exist. One uses drugs called biologics, and the other uses immune cells. These agents are designed to boost, redirect or restore the body’s natural defences against cancers, and clinician scientists are increasingly using combination therapy as well, which has proven very effective in early trials.
Notably, a childhood cancer patient that enrolled in a Phase II clinical trial that uses a healthy donor’s immune cells experienced sustained remission of her cancer after she followed up her therapy trial with a stem cell transplant, and managed to resume her life within a few weeks.
Such smarter medicines are being actively evaluated for refractory cancers or resistant cancers worldwide, and in time, some of these are likely to become part of mainstream therapy for cancers.