Cancer is already the leading cause of death in Spain, in demographic context increasingly older in which the upward trend of deaths due to this is expected to continue to increase in the coming years.
However, these isolated data can be somewhat misleading, as in general terms cancer survival is actually increasing thanks to a number of important medical advancesamong which personalized medicine stands out.
“We design specific treatments”
As explained to 20 minutes Dr. José Luis González Larriba, director of the Atrys Medical Oncology area of the Viamed Santa Elena Hospital (Madrid), on personalized medicine It is a discipline that is based on the development of treatments taking into account the very specific characteristics of each patient’s disease.
“Personalized medicine”, develops the expert, “is based on the application of a specially designed treatment, generally in the form of pills or intravenous agents, depending on the type of cancer each patient has.
“Unlike traditional approaches – he adds – we are not trying to cure lung, stomach or colon cancer in a general way, but to understand the particular molecular characteristics of the tumor in each patient. Depending on these specific alterations, a therapy aimed at blocking, canceling or neutralizing the alterations that caused the tumor is administered, with the aim of destroying it, reducing its size or stabilizing the disease.”
“We increase the survival and recovery rate”
Personalized medicine treatments, that is, unlike what happens with more traditional techniques (such as chemotherapy, radiotherapy or immunotherapy) are not administered in a generalized way to all tumors, but “are individualized treatments, adapted to the needs unique characteristics of each tumor, which allows for greater effectiveness with fewer adverse effects. “This precision increases the likelihood of a positive response and minimizes the impact on the patient’s quality of life.”
This personalization of treatments takes into account factors such as the patient’s genetics and the tumor itself. “The possibility of identify altered genes that trigger the development of each specific tumor allows the application of treatments directed against these alterations, thus increasing survival and improving the cure rate”, comments the expert. The impact is very significant: ”In cases of metastatic lung cancer, for example For example, “survival has gone from an average of one year to more than ten years, in some cases, thanks to these personalized therapies.”
“The great strength of these treatments,” he continues, “lies in its specificity. Instead of relying on the general results of large studies, personalized therapy focuses on the unique triggers of each individual tumor, applying one that blocks these specific factors. “These, in addition to being more effective, are usually easier to administer and have much lower toxicity, which allows side effects to be quickly identified and managed when they appear.”
“Progress in molecular biology is rapid”
Logically, in order to use this type of treatment, it is necessary that in a given patient’s tumor it is possible to identify the specific molecular causes that determine its appearance or growth. “To do this,” says González, “the first step is to realize a genetic analysis of the tumorgenerally through advanced techniques such as massive genetic sequencing or searching for fusion genes. “If a treatable alteration is detected and a targeted agent exists for that mutation, a personalized treatment can be applied that directly attacks the intrinsic cause of the tumor.”
He continues: “There are numerous types of tumors in which we have effective therapeutic agents to address identifiable molecular alterations. A notable example is non-small cell lung cancerwhich represents 85% of all cases of lung cancer. We can currently identify treatable alterations in approximately 50% of these cases.”
In these patients, he explains, “the continuous search for new active agents directed at these molecular targets has significantly improved treatment and there are lung tumors with alterations of specific genes that can benefit from highly effective oral therapies and limited side effects.
“However, about half of lung cancer patients do not have targeted treatments for their molecular alterations, even when these can be identified,” he clarifies. “Advances in molecular biology are rapid, and the same is true for many tumors they were not treatable a year or two ago today they can be addressed effectively. “The percentage of patients who will benefit from targeted treatments is expected to increase in the coming years.”
“Many cancers that were untreatable a year or two ago can be effectively addressed today”
González clarifies that the study of tumor biomarkers is not only essential for the advancement of personalized medicine, but also has applications, for example, in the field of immunotherapy. “In patients without treatable“increased recovery and survival rates”.
“Patients’ prognosis will continue to improve”
Fortunately, explains González, techniques such as massive sequencing or the search for fusion genes are used they are becoming more economically accessible and it is expected that Molecular Studies units will become a reality in most centers in the coming years. The doctor recalls, in this regard, that “there is no clinical characteristic that allows us to predict or suspect the presence of these treatable alterations in a given patient, which makes it essential to carry out these tests in all cases”.
On the other hand, the study techniques at the genetic and molecular level raise important remains, but the expert underlines that they are being perfected to be increasingly simpler and less invasivepotentially useful to more and more patients as they become more widespread.
“We hope that the prognosis of our patients will continue to improve in the coming years, not only by increasing life expectancy,” he predicts, “but also reach the chronicity of the diseasewhich would allow patients to live with the disease under long-term control.”
He adds: “Additionally, we are beginning to use these targeted agents in the early stages of cancer, administering them after surgery to increase the chances of recovery. We are also studying their use before surgery, to make tumors more easily resectableespecially those who, due to their location or the condition of the patients who could not tolerate extensive surgery, require more limited resections.”
“There is enormous potential for future development”
“Oncology and personalized medicine are already a reality in the present, although they have enormous potential for future development,” says González. “Nowadays, we should not treat tumors in a generic waybut to address the specific tumor of each patient, considering the molecular characteristics that make it unique and which may coincide or differ from those of other patients.
“To be able to identify these alterations, it is essential to have advanced techniques such as massive genetic sequencing or genetic fusion studies. These tools allow us to detect specific changes in each patient’s tumor and they make it easier for us to choose more effective and less toxic therapies, in an à la carte treatment strategy, fully adapted to the profile of each case.”
And he concludes: “This approach is already generating notable results, especially in oncology and in particular in lung cancer, where significant improvements in patient response and survival are being achieved. The advances are so relevant that we are confident that clinical and translational research will continue to expand the number of identifiable molecular alterationsthus increasing the number of patients who will be able to benefit from personalized and targeted treatments.
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