“If not always possible remove the cancer however, it is possible live with it – with a good quality of life – for a long time “. If this phrase, until more or less 10 years ago, could have seemed a heresy, today more and more people are able to live with a long time after metastatic tumor. become chronic in fact the disease is no longer a utopia. We still die of cancer and the challenge is far from overcome but if we look at the past we cannot fail to note the enormous progress in terms of treatment. Successes largely attributable toimmunotherapy, that approach that allows you to awaken your immune system to fight and control disease. What has been for the melanoma – today 20% of metastatic patients are alive 10 years later, compared to a few months before the advent of immunotherapy – chronicization is also becoming reality in the lung cancer. If with alone chemotherapy only the 5% of the sick was alive 5 years after diagnosis, today withimmunotherapy we got to 25-30%. A percentage destined to increase.
COMBINING MULTIPLE STRATEGIES
Precisely because the challenge is far from overcome, research is now heading towardsoptimization of therapies already available. In fact, immunotherapy is not effective in all patients and one of the main challenges is to identify the factors that cause this lack of response. In the meantime, however, several studies are trying to increase the proportion of people who respond positively to therapies. Combine chemotherapy and immunotherapy and modifying “modifying” the tumor so as to make it more visible to the eyes of the immune system are the current strategies that oncologists are following. Without forgetting the use of molecular target drugs, particularly effective in those tumors in which particular mutations are present that make them sensitive to these treatments.
This year’s ASCO will also be remembered especially for the great progress of the therapies adjuvants. If most of the studies presented always have to do with metastatic tumors, clinical research also proceeds in an attempt to identify new approaches to avoid that the tumor, when it is surgically removed, leads in a short time to recur in the form of relapse. From the data presented at the American congress, the use of molecular target drugs for melanoma at high risk of recurrence and for lung cancer has been shown to significantly reduce the likelihood of this happening.
Among the “frontier” therapies, the Car-T. If only 5 years ago this type of experimental therapy was counted on the fingers of one hand, today a good portion of the studies presented at ASCO concern this type of approach. Car-T are the most advanced form of tailored therapy: the technique consists in taking the patient’s T lymphocytes to genetically modify them so that on the surface they express a receptor capable of recognizing cancer cells. Once reinfused in the patient, the modified lymphocytes attack the tumor until it is eliminated. An approach that is working mainly in blood cancers when the weapons available are finished and the disease is no longer controllable. On solid tumors, however, research continues but there is still much work to be done.
Last point, impossible not to face, is the link between COVID-19 and the care of tumors. Seven out of ten centers continued their activity, protecting the cancer patients from the possible contagion of Covid-19 and from the possible progression of the tumor if the therapies had been interrupted. But 20% of patients have preferred to postpone an appointment in recent months. In addition, due to the pandemic, the block total of screening programs. In the coming months it will be more important than ever to evaluate the impact of the pandemic on the diagnosis and treatment of tumors and make up for lost time on the street.