Oncology has changed dramatically in the last 20 years. Until the beginning of the year 2000, surgery, radiotherapy and chemotherapy were the only treatments available to treat the different types of cancer. With the advance in the knowledge of the molecular biology of tumors, different treatments have been developed that target specific molecular alterations in what is known as precision therapy or personalized medicine. This allows treatments that are better tolerated and more effective than chemotherapy, although it is true that not all tumors present these types of alterations that can be treated in a targeted manner.
In addition, in the last decade what is known as “immunotherapy” has been incorporated into the therapeutic arsenal. These drugs are antibodies that target defense cells to reactivate them so that they recognize tumor cells as foreign cells and eliminate them. This has led to a second revolution in the treatment of many types of cancer.
New chemotherapy drugs
In addition to the above, there is a new family of chemotherapy treatments called “immunoconjugates”, a type of drug based on antibodies that have chemotherapy molecules associated with them.
The antibody acts by recognizing a specific protein on the cell surface of the tumor and enters the cell as a kind of “Trojan horse”, releasing the chemotherapy only in the tumor cells and not affecting normal cells. Such drugs are already a reality, for example for HER2-positive breast cancer, and we will see in the coming years how the use of more similar drugs for other types of cancers will spread.
The ultimate goal of oncology research is to eradicate cancer. With the Phase 1 clinical trials we are conducting, we are testing for the first time in patients drugs that have proven to be very effective in the laboratory. In Phase 1 clinical trials we try to find out the best way to administer the drug, the dose and frequency, as well as the preliminary efficacy.
Ultimately, we want to be able to administer highly effective and tolerable treatments in order to eliminate tumor cells. This is not yet possible in most metastatic cancers, but it is true that some patients are already getting very durable responses, particularly with targeted therapies and immunotherapy.
How is this type of research and trials conducted?
In our unit we make a comprehensive assessment of the patient, evaluating the type of cancer, previous treatments received and possible concomitant pathologies. We also carry out a complete molecular study in order to decide which clinical trial would be most beneficial for the patient and we propose participation.
If the patient accepts, we would carry out a series of tests, complete analytical tests, scans, etc., to ensure that it is safe to administer the treatment, and if the patient meets the inclusion and exclusion criteria of the trial, we would begin the treatment. Currently, we have treated more than 1,500 patients from all over Spain and we have more than 70 Phase 1 clinical trials in order to choose the one that can potentially work for the patient.