- Scientists are working on a number of new cancer treatments they hope will be effective while producing fewer side effects.
- The new treatments include immunotherapies and targeted therapies.
- There’s also research looking into dermal approaches, where a patch is inserted through the skin to deliver cancer-fighting drugs.
Despite the many advancements made in cancer treatments in the past decade, many people with cancer still must endure a variety of unwelcome side effects.
Chemotherapy remains a valuable tool for oncologists and can provide people with long-term remission from the disease.
However, chemotherapy is often accompanied by nausea, dizziness, vomiting, diarrhea, and body aches.
There also can be more serious side effects from chemotherapy, such as internal bleeding, secondary cancers, and shorter life spans.
The platinum-based chemotherapy drugs cisplatin, carboplatin, and oxaliplatin, which are still regularly prescribed more than 40 years after they were introduced, are particularly hard on people receiving cancer treatment.
In a study published last month in the Journal of Clinical Oncology, people who received platinum-based chemotherapy or radiotherapy to treat testicular cancer were associated with an increased risk of “premature death” not directly due to their cancer.
The frequency of these side effects has prompted scientists to intensify their search for less toxic, more effective cancer treatments.
These new kinds of treatments include targeted therapies, which hone in on specific genes and proteins that are involved in the growth and survival of cancer cells, as well as immunotherapies, which harness the body’s immune system to fight cancer.
These treatments, which reflect a deeper understanding of how cancer works in the body, generally do not harm healthy cells.
“Broadly speaking, targeted therapies and immunotherapies typically have fewer side effects than chemotherapies,” Dr. Sandip P. Patel, a medical oncologist at UC San Diego Moores Cancer Center, told Healthline.
“By no means is that a guarantee for every patient, but for the average patient, that is generally true,” he said.
Here’s a look at a few cancers and their newer treatments.
Patel, who also directs Moores Cancer Center’s clinical trials office, said that for melanoma, the most serious type of skin cancer, the treatment used to be chemotherapy.
“But now, chemo is almost never used. Immunotherapy and targeted therapies are used instead,” he said.
“Sometimes there are side effects with immunotherapies as well, but they can often be mild, like skin or thyroid changes, or autoimmune side effects, which can often be treated with immunosuppressive drugs,” he added.
Mantle cell lymphoma
For people with mantle cell lymphoma, newer treatment options include Bruton tyrosine kinase (BTK) inhibitors.
These are targeted therapies that stop cancer cells from surviving and multiplying by blocking abnormal protein signaling.
There are three BTK inhibitors now approved by the Food and Drug Administration (FDA) for relapsed or refractory mantle cell lymphoma.
They are Imbruvica (generic name ibrutinib), Calquence (acalabrutinib), and Brukinsa (zanubrutinib).
Each of these drugs is effective and generally easier to tolerate than older therapies. However, they do have potential side effects, such as bleeding, infection, and secondary cancers.
And that can prevent some people from being able to continue treatment with these drugs.
In June, the FDA granted breakthrough therapy designation to orelabrutinib, a new BTK inhibitor, for mantle cell lymphoma.
Dr. Sean Zhang, FCP, chief medical officer at InnoCare Pharma, told Healthline that his company has designed “a unique structure to increase the selectivity of our BTK inhibitor, and therefore reduce the off-target adverse events of special interest of this class.”
The treatment is still in clinical trials, but it’s showing promising numbers, he said.
“With improved target selectivity, orelabrutinib demonstrated compelling efficacy with 88 percent overall response rate and 43 percent complete response, and a superior safety profile with significantly reduced rates of adverse events,” Zhang explained.
For ovarian cancer, chemotherapy is still the standard of care.
However, 70 percent of ovarian cancer cases come back and become resistant to platinum-based chemotherapy.
“It’s important to bring awareness to patients of the side effects of these types of chemotherapy,” Dr. Oliver Dorigo, a gynecologic oncologist at Stanford University in California, told Healthline.
Dorigo is principal investigator of a clinical trial of a new immunotherapy called maveropepimut-S. It’s being developed by IMV Inc., a pharmaceutical company focused on innovative immune cell activating approaches.
The treatment works by activating T cells that are survivin specific. Survivin is a cancer antigen found in more than 15 types of solid tumor and blood cancers.
Multiple myeloma and chronic lymphocytic leukemia
Revlimid is a new-generation chemotherapy from Bristol Myers Squibb that fights cancer by supporting the function of the immune system.
Revlimid, which is also described as an “immunomodulatory agent,” is sometimes given in combination with other drugs to treat multiple myeloma and mantle cell lymphoma.
It’s also a new treatment option for people with chronic lymphocytic leukemia.
Revlimid, which has proved to be effective in some cases, is reportedly the third highest-selling drug in the world.
But it, too, can have rather lengthy side effects, especially for people who take it for extended periods of time.
Pedro Lichtinger, CEO of Starton Therapeutics, is focused on making Revlimid less toxic and more effective.
He doesn’t want to get rid of the drug. He wants to make it safer and better.
His proprietary dermal (through the skin) technology deploys a patch to deliver Revlimid to the body.
The patch is designed to provide 24-hour delivery of the drug, and avoid high and low levels of the treatment in the bloodstream.
Oncologists and patient advocates say this method of delivery could greatly decrease side effects and enable people to use the drug for longer periods of time.
Dr. Rita Nanda, an oncologist, researcher, and director of breast oncology at the University of Chicago, supports the idea.
“Yes, something less toxic would be lovely,” she told Healthline. “A more continuous delivery system into the body by an oral agent or transdermal approach can get you to a steady state without peaks and valleys.”
Jenny Ahlstrom, a multiple myeloma survivor and founder of Myeloma Crowd, part of the patient-empowering CrowdCare Foundation, said dermal technology could make things better.
“A lot of patients just can’t tolerate Revlimid for long periods of time because of the side effects,” she told Healthline.
“The Starton approach evidently provides a more constant stream of the drug. I think it’s a terrific idea that could reduce side effects and improve quality of life for patients,” Ahlstrom said.