Advancing oncology

With so much going on last year, you might be forgiven if you missed a ground-breaking announcement in November 2020 about the ‘Galleri blood test’. This new technology, which is now being piloted in the UK in a program to detect more than 50 types of cancer with just one test, could revolutionize oncology screening for the masses. The test was developed by GRAIL, a healthcare company working to detect cancer at an early stage, when it can be cured. If the pilot program is successful, it will allow the detection of many types of cancer that are difficult to diagnose early, such as head and neck, ovarian, pancreatic, esophageal and some blood cancers. By enabling the detection of these early cancers, the program has the potential to increase survival rates by a factor of up to ten times.

This could be one of the important advances made in oncology in recent years. In other years, it might have made headlines across the globe. Just imagine being able to detect such a large range of cancers, with one simple blood test, before any symptoms show!

Another significant advance in oncology in 2020 was the progression of oncology vaccines. Generally designed to promote tumor specific immune responses, these agents elicit an immune response that induces protection against specific molecules (antigens) expressed on tumor cells. There are currently no vaccines that can prevent cancer from developing, but some agents have shown promise in the treatment of patients with selected cancers. This is a huge area of investigation, with a variety of avenues providing scope for productive research. Among agents being evaluated for potential vaccines are peptides, proteins, antigen presenting cells, tumor cells and viral vectors. For example, in May 2020, scientists from the Chinese Academy of Sciences announced the development of a new oncology vaccine based on self-healing polylactic acid microcapsules, which can activate the immune system and inhibit tumor development.

Also last year, a breakthrough was announced with a new vaccine that has the potential to treat a wide variety of blood cancers and malignancies. The vaccine, which is comprised of human antibodies fused with tumor-specific protein, was developed by a team based at The Translational Research Institute in collaboration with The University of Queensland, Australia. Clinical trials are now ongoing, following successful outcomes in preclinical studies, and it is hoped that the vaccine may eventually be used to treat blood cancers, such as myeloid leukemia, non-Hodgkin's lymphoma, multiple myeloma, and pediatric leukemias, as well as solid malignancies such as breast, lung, renal, ovarian and pancreatic cancers, and glioblastoma.

Another significant advance has been the progression of personalized cancer vaccines. This approach uses a patient's own cancer cells to develop a vaccine intended to teach the immune system how to recognize and destroy that cancer. The field is still young, but using antigens produced by a patient’s own cancer cells promises to yield successful treatments for a range of cancer types. For example, in November 2020, the University of Arizona (USA) reported encouraging preliminary data from a clinical trial evaluating the safety and effectiveness of a personalized mRNA vaccine in combination with pembrolizumab (a humanized antibody used in cancer immunotherapy) for patients with multiple cancer types, including head and neck cancers. The encouraging preliminary results have led the research team to expand the study to include a further 40 patients.

As I hope I have shown with the few examples chosen above, oncology is an active and exciting area of research. Testament to the strength of the field, oncology drugs represented the lion's share of the FDA’s new drug approvals in 2020, with 21 novel agents approved. In addition, health care products suppliers and medical supplies companies have made great contribution to the production of oncology drugs. Nevertheless, I think it’s fair to say that, as with many scientific discoveries in 2020, these advances were a little overlooked due to a world focus on COVID-19.

Our focus on the pandemic was understandable. However, while COVID-19 is thought to have caused around 1.9 million deaths worldwide so far, the World Health Organization (WHO) estimates that, in 2018, an estimated 9.6 million people died of cancer worldwide. In other words, by current estimates, it looks as if cancer might kill about five times as many people as COVID-19.

This makes me – and apparently a lot of other people – very worried by reports that cancer research, screening and treatment are being disrupted by the COVID-19 pandemic.

·        There are widespread concerns that screening programs have been disrupted, with many people worried about likely increases in the rates of undetected cancers.

·        In an article in Nature Reviews last year, a group of researchers expressed concerns that the pandemic was disrupting oncology clinical trials.

·        In November 2020, Cancer Research UK highlighted a “crisis in funding” and “irreparable damage” to their work without government intervention and support. The statement claimed that, as funding had been diverted from oncology to focus on the pandemic, a crisis in oncology research was looming.

Taking a long-term view, diverting resources from oncology to COVID-19 seems a little like running into a burning building to escape a street full of lava – either way, you’re going to get burnt.

When we have beaten COVID-19 (and I believe that we will), cancer will still be here, and we still need to beat that too.

Author biography

Sarah Harding, PhD

Editorial Director of Chemicals Knowledge

Sarah Harding worked as a medical writer and consultant in the pharmaceutical industry for 15 years, for the last 10 years of which she owned and ran her own medical communications agency that provided a range of services to blue-chip Pharma companies. She subsequently began a new career in publishing as Editor of Speciality Chemicals Magazine, and then Editorial Director at Chemicals Knowledge. She now focusses on providing independent writing and consultancy services to the pharmaceutical and speciality chemicals industry.