Revolutions in Cancer Treament—Past, Present, and Future
Sep 29, 2020
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Explore the past and future of cancer treatment with guests Gary Reedy, CEO of the American Cancer Society, Jonathan Lim, CEO of Erasca, and Jorge Conde, a16z general partner. Topics include the history of cancer treatment, the importance of screening and early detection, future therapies, and preventing cancer.
The first revolution in cancer treatment involved surgery, radiation therapy, and chemotherapy, which were effective for localized tumors but required further advancements for metastasized cancers.
The second revolution in cancer therapy was genomically targeted therapy, which personalized treatment based on the genetic characteristics of the tumor and offered improved outcomes and high survival rates.
Deep dives
Revolutionizing Cancer Treatment: From Surgery to Radiation to Chemotherapy
In this podcast episode, the revolutions in cancer treatment are discussed. The conversation begins by examining the history of cancer treatment, which primarily involved radical surgeries and radiation therapy. The advent of anesthesia led to the renaissance of surgical approaches, while radiation therapy showed promising results in killing rapidly dividing cancer cells. It wasn't until the 1940s that chemotherapy was introduced, with the use of antifolate therapy for certain types of leukemia. This marked the first administration of systemic therapy and launched the era of chemotherapy. These three treatment approaches, surgery, radiation therapy, and chemotherapy, are considered the first revolution in cancer treatment. However, it is noted that they are largely effective for localized tumors, and further advancements were needed for metastasized cancers.
The Emergence of Genomically Targeted Therapy
The second revolution in cancer therapy, known as genomically targeted therapy, began in the 1990s with the introduction of Gleevec. This revolutionary drug identified and targeted the genetic drivers of specific tumors, leading to remarkable success rates in certain types of cancers, such as chronic myelogenous leukemia. With the ability to personalize treatment based on the genetic characteristics of the tumor, genomically targeted therapy has demonstrated significant advancements in precision medicine. By administering drugs that specifically target the tumor, patients experience fewer side effects compared to traditional chemotherapy. This approach has transformed the landscape of cancer treatment, offering hope for improved outcomes and high survival rates.
Cancer Immunotherapy: Harnessing the Power of the Immune System
The third revolution in cancer treatment focuses on immunotherapy, which involves boosting the patient's own immune system to fight cancer cells. Checkpoint inhibitors, CAR-T cell therapy, and cancer vaccines are among the effective immunotherapy approaches discussed. Checkpoint inhibitors release the brakes on immune cells, allowing the patient's own T cells to combat solid tumors. CAR-T cell therapy harnesses the patient's immune cells and engineers them to specifically target cancer cells, showing remarkable success in liquid tumors like leukemia. Additionally, cancer vaccines aim to boost the patient's immune system to specifically recognize and destroy tumor cells. Immunotherapy has witnessed significant advancements in the last decade and offers new avenues for treating cancer outside of traditional surgery, radiation, and chemotherapy.
Future Paradigms: Circular DNA and Metabolic Therapy
The fourth revolution in cancer therapy centers around a new understanding of cancer behavior, specifically focusing on circular DNA found in cancer cells. These circular DNA play a crucial role in driving the growth, recurrence, and resistance of cancer cells. Targeting these circular DNA could complement existing therapies and represent a fundamental paradigm shift in cancer treatment. Additionally, metabolic therapy, including approaches like whole-food plant-based diets and targeting glucose and glutamine dependency of cancer cells, holds promise as a low-tech yet impactful strategy. As advances continue, the integration of these revolutions, combined with personalized therapies and improved prevention and early detection strategies, offers a hopeful outlook toward managing and potentially erasing cancer.
with @JorgeCondeBio, @JLimMD, @AmerCancerCEO, and @omnivorousread
In this episode of Bio Eats World, we explore all the major revolutions in cancer treatment across the history of medicine—and what’s coming next. Hanne Winarsky delves into the past and future of the fight against cancer with Gary Reedy, CEO of the American Cancer Society; Jonathan Lim, CEO of Erasca, a biotech company with the mission of erasing cancer; and Jorge Conde, a16z general partner. The conversation spans not only the history of cancer treatment from the early days of surgery and the first radiology treatment (with an x-ray!), but also the fundamental nature of cancer—its origins, progressions, and how to stop it; the birth of precision genetic medicine and targeted therapies; our most powerful tools today (both low and high tech); and finally, the coming new tools and revolutions at the very cutting edge of cancer treatment.
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