As I was reading some articles on gene therapy, I was astonished at how far we have progressed in pursuing applications of this technology. Immunotherapy, oncolytic virotherapy, and gene transfer has been revolutionary, and there is no let-up in the number of researches being done. Using genetically modified cells or altered DNA sequences from different viruses, common cancers of the lung, pancreas, and prostate may be given another chance for survival. Considering that the 5-year survival rates of these diseases hover around 5 to 15 percent, any increase in the life span could mean a lot to these patients.
According to Christine Karim, “It is tremendously rewarding to see how our work, starting in the test tube, can positively impact society by creating the groundwork for new medical treatments.” The beauty of gene therapy is that it treats the problem right at its source. As current treatments have a lot of adverse effects, it offers a ray of hope for those who feel resigned to the ravages of tumor metastasis. These methods can alleviate death and suffering once they are developed and incorporated into mainstream medicine.
“It is tremendously rewarding to see how our work, starting in the test tube, can positively impact society by creating the groundwork for new medical treatments.”
Mechanisms to decrease cancer aggression include lysis of the tumor cells, decreasing the blood supply of the neoplastic cell, and introducing genes that will restore the normal phenotype. In other words, gene therapy may not kill the cell directly like chemotherapy does, but it will cause subtle changes that will annihilate the cancer. Gliomas, pancreatic cancer, and liver cancer are leading candidates for these types of treatment.
Just as in any new modality, there are safety concerns. Patients have died due to gene therapy in the past. While the death was not due to gene therapy for cancer, but due to a metabolic illness (a urea cycle deficiency called ornithine transcarbamoylase defect), safety remains of paramount importance. Flu-like symptoms, just like that being experienced by many who have taken the COVID-19 vaccine, are very common in gene therapy.
At present, gene therapy is being used to create recombinant cancer vaccines. Unlike for infectious diseases, these vaccines are meant to provide cure, not prevention. The immune system is trained to recognize the cancer cells by presenting it with highly antigenic and immunostimulatory cellular debris. Cancer cells may be harvested from the patient (autologous transfer) or from established cancer cell lines. Cytokines may also be enhanced by gene therapy to recognize the abnormal cells as foreign bodies. Hopefully the genes would produce proteins that will promote synthesis of antitumor antibodies.
The challenge in the medical community is to utilize these processes prudently. They give hope, but they are not yet accepted as mainstream treatment. The issues of safety and beneficence need to be revisited, not to mention the justification of the expense involved for such novel treatments. There are stories regarding unproven alternative methods which are quite expensive, and in the wrong hands, these genetic technologies may be manipulated for selfish motives. It is quite disturbing to think that one would take advantage of the desperation that hospice and palliative care patients are feeling, and giving them unwarranted treatments could erode their trust in the medical field.
In due time, targeted therapy for cancer will become the norm, changing the lives of patients with cancer and other chronic illnesses. We still have a long way to go to realize this, but it may be sooner than we expect. After all, the survival of the human race rests on the creativity of those who are in it.