Cancer Therapeutics: The State Right Now - Darshit Jain

Historically cancer is one of the oldest diseases known to humans. The cure for cancer is still not present and there are a variety of reasons for it. Basically, any cancer, be it breast, lung, prostate or any other for that matter primarily occurs due to genetic mutation of the cells in our body.

Think of a person who has cut one of his limbs. He doesn’t grow another limb. Then think of a cut on your forearm. The cells grow and seal that wound again. The reason behind that being that the process of the multiplication of cells is genetically designed in such a way that they always know when to stop growing. This information is stored as genetic code in the cells and the growth is only triggered when a combination of genetic signals arises. However, if somehow these genetic information gets mutated in a way that there is no trigger to stop the growth of the cells and it results in a tumor or a cancer. So the historic way to deal with any cancer and also the most effective way would be to cut the entire tumor out. So we can easily conclude that any cancer is caused by mutation of primary genetic information.

These mutations occur due to some primary causes. The first cause might be heredity. Once a gene is mutated there is very high probability that even the off-springs of these genes would carry the mutation. This has been proven as cancer has been seen running in families. The other cause of cancer might be external carcinogens which carry the capability to mutate or genetically alter our cells. Carcinogens like Smoke, Tobacco to name a few. The third cause can be viruses in the body which also possess the capability to alter our cells genetically. The final cause might be just because of chance. That basically means the when our cells divide the also get mutated. So some combination might be such that the cell might be cancerous.

With the evolution in medical science and technology we have now started understanding these genetic mutations and the so called cancerous cells at a molecular level. But still there is no possible way to cure cancer in most cases. Even though in some specific cancer we have made tremendous progress with the use of technologies like chemotherapy and radiation therapy, like in the case of childhood leukemia we have been able to bring down the mortality rates from almost 100 percent down to a very attractive fifteen percent. But still with more cancers treatment still remains a problem.

The reason behind that being that cancer is such a diverse disease. It is directly related to genetic mutations and with one human carrying billions of genes it is practically impossible to come up with drugs that would heal all mutations. Every patient that walks in has a different set of mutations that might cause a cancer.

So with this we can now come down to the conclusion that the host of the cancer is just as important as the cancer cells itself. By that we mean that there might be a combination of conditions in the physiology of the genes of the host itself which might put him into a higher risk for developing a cancer.

But now with technologies such as ML, AI and supercomputers we might actually be able to predict these mutations way before they happen. This can be done through a process called genome sequencing in which we predict the next million iterations of mutations and then can derive probabilities of a person running the risk of cancer. So how people have gone about this process is that they have simulated and created organoids and through that they can actually predict the exact probabilities of the gene sequence that would lead to the cell being cancerous. So the way out to treat cancer would be to detect it early and deploy personalized medicine for that particular mutation. So with a combination of personally designed medicine and early detection of risk we might actually have personalized therapy. This is the trigger that would bring out a revolution in the space of cancer treatment.

The problem with chemotherapy today is that it is too generic rather than personalized. Think of a human body as a machine and think of the cancer cells as a dysfunctional part of the machine. Generic Chemotherapy is like throwing a rock at the machine. Generic radiations might heal the cancer but will also cause the other cells to mutate. So there is a higher chance of mutations of the other normal functioning cells and this is exactly why most chemotherapy fails or leads to another reoccurring cancer some years later.

But with modern technology we can now detect what part of the machine is likely to fail and prevent it from failing beforehand. So a combination of the genetic physiology of the host and precisely developing antigens and deployment of those antigens into their immune system way before the cancer is developed would actually make the human immune to cancer. This is called the latest stage of modern medicine and is termed as immunology.

The problem with that is that this process today costs around 417 K USD per patient. This is a ridiculous number for just anyone and scale and deployment of this sort of a treatment would be an issue which if solved would bring a revolution to the technology and medical landscape for humans. In the future we just might be able to assign humans into their quadrilles of risks of developing cancers and treat them with their antigens just accordingly if the cost of manufacture of these drugs which now is 30 K USD could be reduced by a factor 10 or 100.

-     Darshit Jain