In medicine there are three principles or criteria to make a decision, first to safeguard the life of the patient, then quality of life and function or aesthetics. In the case of cancer diseases, until a few years ago trying to think about the three criteria seemed impossible, they practically seemed death sentences, but “today oncological diseases are becoming chronic diseases, today an oncological patient can live many years with treatment, ”says Dr. José Manuel Celaya, specialist in internal medicine and medical director of Bristol Myers.
In the early 1990s, global cancer mortality was 23% higher than today. Currently the chances that a patient with this disease will live five years or more have increased 39 percent.
One of the milestones that has allowed this change in the way of seeing and attacking cancer is immunotherapy, a finding that in 2018 gave the Nobel Prize in Medicine to biologist James P. Allison and physician and immunologist Tasuko Honjo. Thanks to his revolutionary contributions in the fight against cancer, based on his studies of the immune system in the 90s, today we can see important benefits in patients who did not have high expectations of survival, such as lung cancer and melanoma. the most serious type of skin cancer.
Since the first decade of the 21st century, specialists were already talking about a revolution based on immunotherapy and what this would represent for the future, they talked about the modification of medical programs, guides and treatments. In Mexico, it has been used for ten years, so Dr. Celaya talks to El Economista about the importance of having this type of treatment and research in the country.
“Immunotherapy can be understood as a before and after in cancer treatment. In melanoma, for example, a disease that when detected in early stages, the ability to survive five years is 90%, however (for) that same melanoma with metastases the possibility is reduced to 20%, which achieves the immunotherapy is that survival capacity is doubled ”.
Bristol Myers Medical Director says that immunotherapy has grown rapidly, “it is one of the most developed and applied areas for various types of cancer.” In Mexico, in recent years, pharmaceutical companies like the one he represents have invested in clinical research, from immunoncology, hematology, cardiovascular, in total 50 clinical protocols have been run and thanks to that Mexican patients had access to treatments.
Today, various treatments in this regard are approved in the country, and included in the compendiums and basic tables of the main public institutions such as the Institute of Social Security and Services for State Workers (ISSSTE), Mexican Institute of Social Security (IMSS) or the Institute of Health for Wellbeing (Insabi).
The evolution of treatments
Although to date no cure has been found for the vast majority of cancers, having different lines of treatment enrich the options for patients and their survival; In this sense, Celaya highlights some of the treatments that make up the current tools.
“We have experienced an evolution”, we were used to talking only about chemotherapy, which are cytotoxic substances that attack cancer cells and normally affect cell growth, but as a consequence also affect other non-cancer cells that have accelerated growth in a normal way , such as blood, hair or skin, that is why some of the adverse effects are hair loss, nausea, vomiting, decreased blood cell counts, because it is not specific.
Then we have target therapies, where it is possible to identify a molecule, protein or substance that the tumor expresses on its membrane, for which an antibody directed specifically against this molecule can be developed. The problem is that it is so specific that it only works for one particular cancer.
Immunotherapy does not look for specificity, but neither does it attack through toxic substances. What you do is “wake up” the immune system so that it locates the tumor cell and attacks it. For this reason it can identify different types of tumor, “it is the ability of the immune system to recognize what should not be there and eliminates them”, it is what is called “immunoediting”.
Broadly speaking, immunotherapy seeks to block the ability of tumor cells to put the brakes on so that they cannot escape the lymphocyte response and mount a response against the tumor.
Today we can divide immunotherapy into three types: immune checkpoint inhibitors, use of certain substances that accelerate the immune system, and adoptive or transfer immunotherapy (cell therapy).
Celaya assures that the investigation is carried out in an accelerated manner and there is still much to discover; however, it is an option that came to play in favor of patients. “Ten years after immunotherapy we are still understanding the true scope, there are some more documented than others, for example, certain types of lung cancer, melanoma, kidney, lymphoma. Until now, the studies with the longest follow-up are at 6.5 years, so the effects are still being documented ”.
Until a few years ago, various types of cancer saw their treatment options limited, immunotherapy allowed, for example, lung cancer or melanoma, both very aggressive, to find longer survivors, concludes the doctor.
Reference-www.eleconomista.com.mx