Immunotherapy

WE ARE IN A NEW ERA IN OUR GLOBAL WAR AGAINST CANCER

Cancers are able to develop protective shields, thus rendering our body immune system unable to recognize and fight cancer cells. Cancer immunotherapy breaks down these shields and trains our body own defenses to find and destroy cancer cells.

Immunotherapy has become an established pillar of cancer treatment at Onco Life Centre with significantly improved treatment outcomes for our patients with a broad variety of cancers. Our Oncologists at Onco Life Centre work in close collaboration with Cancer Genomics Experts in the US to perform cancer gene mapping and DNA sequencing on our patients’ cancer tissue. Regular teleconferencing and live exchange of information with the US Genomics Experts allows our Oncologists to specifically design unique treatment plans that have resulted in significant improvements in the cancer responses and survival of our patients.

 

How does immunotherapy help the immune system fight cancer?

Antigens are toxins or foreign substances that trigger an immune response, especially in the production of antibodies. Antigens are targeted by antibodies. Each antibody is specifically produced by the immune system to precisely match an antigen, and this leads to the initiation of a tailored immune response.

Immune checkpoints are regulators of the immune system. These pathways prevent the immune system from attacking your own healthy cells indiscriminately. However, cancer can find ways to hide from the immune system by activating these immune checkpoint targets. Checkpoint inhibitor is a form of immunotherapy that can block inhibitory checkpoints, which will amplify your body’s immune system to help destroy cancer cells. Common checkpoints that these inhibitors affect are the PD-1/PD-L1 and CTLA-4 pathways. Immunotherapy treatments can be used as a monotherapy or in combination with other cancer treatments.

 

What cancers are treated with immune checkpoint inhibitors?

Last year capped an incredible decade for cancer immunotherapy. Patients with more than a dozen types of cancer can now receive FDA-approved immunotherapies.

At Onco Life Centre, our oncologists will specifically design your treatment plan, using such latest breakthroughs in cancer therapy.

Immune checkpoint inhibitors are approved to a variety of cancer types, including:

  • Breast cancer
  • Bladder cancer
  • Cervical cancer
  • Colorectal cancer
  • Head and neck cancer
  • Liver cancer
  • Lung cancer
  • Renal cell cancer (Kidney)
  • Skin cancer
  • Stomach cancer
  • Oesophageal cancer
  • Prostate cancer
  • Mesothelioma

 

TARGETED THERAPIES

How does targeted cancer therapy work?

  1. Targeted cancer therapy interferes with proteins on cancer cell surface to block cancer cell growth.
  2. Targeted cancer therapy interferes with signals to make new blood vessels so as to interrupt blood supply to cancer cells.
  3. Targeted cancer therapy can attach to targets on cancer cell surface and the cell-killing substances are subsequently taken up into the cell, leading to cell death.
  4. Targeted cancer therapy can cause cancer cells to go through the process of cell death.
  5. Breast and prostate cancers require growth hormone to grow. Targeted cancer therapy can prevent your body from making specific hormones or prevent hormones from being taken up by cancer cells.

 

CANCER GENOMICS PROFILING AND PRECISION MEDICINE

Precision medicine is the use of genetic changes in a patient’s tumour to determine a cancer treatment most likely for the tumour to respond to.

Cancer genomics profiling helps our Oncologists at Onco Life Centre to identify the best targeted therapy for your cancer illness.

  1. Helps us identify the overexpression of a certain gene/protein, which directly promotes the growth of cancer cells.
  2. Positive predictors of certain genes help us identify tumours that are most likely to respond to a specific targeted therapy.
  3. Negative predictor of certain genes help us identify tumours that are unlikely to respond to a specific targeted therapy and spare our patients from the side effects of that therapy.

 

TYPES OF CANCER TARGETED THERAPY

Once specific changes in your cancer genes and proteins have been identified, our Oncologist will discuss with you on the best treatment strategies, as well as help you understand the treatment tolerability and estimated drug cost.

1) Types of targeted cancer therapy based on mechanism of action

Monoclonal antibodies

Targeted cancer therapy

Mechanism of action

EGFR inhibitors

Some cancers make too much of a protein called EGFR. EGFR inhibitors work by attaching to the end of EGFR (a cell surface receptor) to block the action of EGF

HER2 inhibitors and conjugates

20–25% of breast cancers have too much of a protein called HER2. HER2 inhibitors work by attaching to the end of HER2 (a transmembrane receptor) to stop HER2 from attaching to other receptors

Small molecules

Targeted cancer therapy

Mechanism of action

Kinase inhibitors

Kinases are molecules that help send growth signals in cancer cells. Kinase inhibitors work by blocking the action of receptor tyrosine kinases

mTOR inhibitors

mTOR is a protein kinase within a cell. In cancer cells, they may be actively promoting their growth. mTOR inhibitors enter the cells and block the activity of mTOR

PARP inhibitors

PARP protein helps repair damaged DNA in cancer cells. PARP inhibitors act by stopping PARP proteins from repairing DNA in cancer cells

Others

Targeted cancer therapy

Mechanism of action

VEGF inhibitors

Cancer cells release VEGF to form new blood vessels for growth. VEGF inhibitors attach to VEGF to stop it from attaching to VEGF receptor on cancer cells, stopping them from growing

2) Types of cancer that respond to targeted therapy based on the specific changes identified in your cancer genes and proteins

NSCLC (Non-small cell lung cancer)

Gene / protein identified: ALK, BRAF, EGFR, MET, RET, ROS1, PDL1, TNB, KRAS G12C ,NTRK 1-3, HER-2

Breast cancer

Gene / protein identified: BRCA1, BRCA2, ER/PR, erBB2/HER-2, PIK3CA, PDL1, MSI, TNB, PALB2, PTEN

Colorectal cancer

Gene / protein identified: RAS (negative predictor), HER2, BRAF, MSI, TNB, KRAS G12C, NTRK 1-3

Prostate cancer

Gene / protein identified: Androgen receptor, BRCA1, BRCA2, PALB2, MSI, TNB, CDK12, NTRK 1-3

Ovarian cancer

Gene / protein identified: BRCA1, BRCA2, PALB2, RAD51 C/D, BRIP1

Gastrointestinal stromal tumour

Gene / protein identified: C-KIT, PDGFR

Gastric cancer & Oesophageal

Gene / protein identified: erBB2/HER-2, PDL1, MSI, TNB, BRCA1, BRCA2, PALB2

Bladder cancer

Gene / protein identified: FGFR2/3, PIK3CA, TSC1

MSI-H or dMMR solid tumours and colorectal cancer

Gene / protein identified: MSI-H or dMMR

Pancreatic cancer

Gene / protein identified: BRCA1, BRCA2, PALB2, ATM, MSI, PDL1, TMB, KRAS, NRAS, NTRK 1-3, ALK

Medullary thyroid cancer

Gene / protein identified: RET

Biliary tract cancer (Cholangiocarcinomas)

Gene / protein identified: BRAF, FGFR 1-3, MSI, TMB, NTRK 1-3, PIK3CA, BRCA1, BRCA2, PALB2, ATM, MET

Solid tumors with NTRK fusions

Gene / protein identified: NTRK

Cervical cancer

Gene / protein identified: PDL1, TMB, MSI, HER-2, NTRK 1-3

Anaplastic thyroid cancer

Gene / protein identified: BRAF

Uterine (Endometrial) cancer

Gene / protein identified: HER-2, PIK3CA, NTRK 1-3, BRCA1, BRCA2, PALB2, ATM, PDL1, TMB, MSI

Kidney (Renal) cancer

Gene / protein identified: CMET, BRCA1, BRCA2, PALB2, ATM, NTRK 1-3

Soft Tissue Sarcoma

Gene / protein identified: BRCA1, BRCA2, PALB2, ATM, NTRK 1-3, ALK, PDL1, TMB, MSI

 


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