What are the options for cancer treatment?
Proposed Bill Seeks To Help Women Battling Cancer Receive Fertility Preservation Options
- Go to https://oksenate.gov/senators
- Enter OK Zip (use 73105 if you’re out of State)
- Call and email the senators that populate based on your zip
What are the different ways to treat cancer?
surgery - an operation to remove the cancer is the main treatment for many types of cancer. radiotherapy - high energy x-rays are used to destroy the cancer cells. chemotherapy - uses anti-cancer (cytotoxic) drugs to destroy cancer cells. hormonal therapy - reduces the level of hormones in the body or blocks hormones from reaching cancer cells.
What is the best treatment for cancer?
Which ones are included in your treatment plan depends mostly on:
- the type of cancer you have and how advanced it is
- whether you have had chemotherapy before
- whether you have other health problems, such as diabetes or heart disease
What is the most successful cancer treatment?
- increase political commitment for cancer prevention and control;
- coordinate and conduct research on the causes of human cancer and the mechanisms of carcinogenesis;
- monitor the cancer burden (as part of the work of the Global Initiative on Cancer Registries);
What are the cancer treatment modalities?
Surgery, radiation-based surgical knives, chemotherapy, and radiotherapy are some of the traditional and most widely used treatment methods. Some of the modern modalities include hormone-based therapy, anti-angiogenic modalities, stem cell therapies, immunotherapy, and dendritic cell-based immunotherapy.
What does it mean by treatment modality?
Treatment modalities, or methods of treatment, are the ways that a doctor or administrative health professional treat a patient with mental, emotional, personality disorders or dual diagnosis.
What are 5 types of cancer treatment?
Types of Cancer TreatmentSurgery.Chemotherapy.Radiation Therapy.Targeted Therapy.Immunotherapy.Stem Cell or Bone Marrow Transplant.Hormone Therapy.
What modality is used to check the stage of cancer?
Depending on where the cancer is located, a physical exam may give some idea as to how much cancer there is. Imaging tests like x-rays, CT scans, MRIs, ultrasound, and PET scans may also give information about how much and where cancer is in the body. Endoscopy exams are sometimes used to look for cancer.
What is an example of modality?
Modality is the type of behavior, expression or way of life that belongs to a particular person or group of people. An example of modality is the type of behavior a doctor uses to treat a very ill patient.
What are the four treatment modalities?
There are several different modalities of treatment (Figure): Individual therapy, family therapy, couples therapy, and group therapy are the most common.
How many types of cancer treatments are there?
If you have cancer, your doctor will recommend one or more ways to treat the disease. The most common treatments are surgery, chemotherapy, and radiation. Other options include targeted therapy, immunotherapy, laser, hormonal therapy, and others.
How many types of treatment are there?
Three principal types of medical treatment Curative – to cure a patient of an illness. Palliative – to relieve symptoms from an illness. Preventative – to avoid the onset of an illness.
Where is the best treatment for cancer?
The Top 5 Countries For Cancer TreatmentAustralia. Whilst Australia suffers high levels of certain types of cancers, such as skin, prostate, lung, bowel and breast, it has the lowest cancer mortality rate in the world3 – which is a huge achievement. ... The Netherlands. ... USA. ... Canada. ... Finland.
What are the 4 staging classifications of cancer?
In situ—Abnormal cells are present but have not spread to nearby tissue. Localized—Cancer is limited to the place where it started, with no sign that it has spread. Regional—Cancer has spread to nearby lymph nodes, tissues, or organs. Distant—Cancer has spread to distant parts of the body.
What are the 5 stages of cancer?
Stage I: Cancer is localized to a small area and hasn't spread to lymph nodes or other tissues. Stage II: Cancer has grown, but it hasn't spread. Stage III: Cancer has grown larger and has possibly spread to lymph nodes or other tissues. Stage IV: Cancer has spread to other organs or areas of your body.
What imaging techniques are used to diagnose cancers?
There are only six imaging modalities available to clinicians who diagnose, stage, and treat human cancer: x-ray (plain film and computed tomography [CT]), ultrasound (US), magnetic resonance imaging (MRI), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and optical imaging.
What is the best treatment for cancer?
The success of treatment depends upon the type of cancer, locality of tumor, and its stage of progression. Surgery, radiation-based surgical knives, chemotherapy, and radiotherapy are some of the traditional and most widely used treatment options.
Which is the most effective treatment for cancer?
Chemotherapy is considered the most effective and extensively used modality in most types of cancers. Chemotherapy drugs target the tumor cells and mainly produce reactive oxygen species which largely destroy tumor cells by the means of genotoxicity [ 5 ].
How many people die from cancer each year?
Cancer is a major global issue causing more than eight million deaths annually. Recently, the International Agency for Research on Cancer (IARC) reported that 7.6 million deaths worldwide were due to cancer. Likewise, 12.7 million new cases are estimated per year [ 1 ]. It has been reported that developing countries are at higher risk of cancer; according to a survey, 63% of cancer-related deaths were reported only from developing countries [ 1 ]. Cancer is a multifactorial disorder involving complex modifications in the genome affected by the interactions between host and environment. The hallmarks of cancer include independence from growth signals, irresponsiveness to signals which halt the cell division, uncontrolled replication, evasion of apoptosis, sustained angiogenesis, and finally the capacity to penetrate in other tissues, known as metastasis [ 2 ]. The microenvironment of benign tumor manifests dysregulation of various regulatory proteins and extracellular environment which plays a vital role in origination and development of cancers [ 3 ]. Before 1950, only surgery was considered as a preferred treatment option for the cure of cancer. After 1960, radiation therapy was initiated to control local disease. With the passage of time, it was realized that individual treatment of surgery and radiation is not effective as compared to their use in combination to control the cancer. Nowadays, drugs, biological molecules, and immune mediated therapies are being used for treatment. Till today, we have not reached the excepted therapy level that resists the mortality rate and decreases the prolonged survival time for metastatic cancer. Pathways and characteristics of different tumor entities were determined to create new revolution in neoplastic cancer or targeting drugs to tumor. Radiation therapy is based upon the use of physical entities like electrons, protons, and various ions to kill the cancerous cells. The mechanism behind radiation therapy is that high energy radiations halt the cell division and block their ability to proliferate by damaging their genetic material. If it is done before surgery, radiation therapy is given with the intention to shrink the tumor. If done after surgery, radiations will destruct the left behind tumor cells and reduce the cancer relapse [ 4 ]. As radiation therapy acts in a localized manner so to treat systemic cancers, chemotherapy is used alone or in combination with radiotherapy. Chemotherapy is considered the most effective and extensively used modality in most types of cancers. Chemotherapy drugs target the tumor cells and mainly produce reactive oxygen species which largely destroy tumor cells by the means of genotoxicity [ 5 ]. However, chemotherapy also harms ordinary cells that leads to diverse dose-dependent side consequences such as fatigue, nausea, hair loss, and vomiting or even death in extreme cases [ 6 ].
What are the hallmarks of cancer?
The hallmarks of cancer include independence from growth signals, irresponsiveness to signals which halt the cell division, uncontrolled replication, evasion of apoptosis, sustained angiogenesis, and finally the capacity to penetrate in other tissues, known as metastasis [ 2 ].
Why do 90% of cancer deaths occur?
In fact, 90% of deaths due to cancers are because of the spread of cancer cells to other tissues which is called metastasis. During mitosis normal cells grow in an interdependent manner, relying on the availability of external growth factors.
Why is cancer the most common cause of death in developed countries?
Cancer is the principal cause of death equally in developed and underdeveloped countries but more prevalent in middle-income countries, probably due to prevailing poor socioeconomic conditions. The geographic differences in the prevalence of cancer can be explained by many contributing factors, like early diagnosis, age factor, occurrence of risk factors, screening tests, and accessibility of quality treatment [ 9 ]. According to the report of IARC (International Agency for Research on Cancer), 14.1 million cases of cancers were reported in 2012 globally, of which 8 million were reported from underdeveloped countries that is about 82% of total population of the world [ 10 ].
Which type of cancer has the highest ratio?
Carcinomas, which result from altered epithelial cells. They constitute the highest ratio in all types of cancer. Sarcomas denote the cancer abnormalities in the bone, muscle, fats, and connective tissue. Leukemia, which originate from cancerous white blood cells.
What is the treatment for cancer?
Radiation Therapy . Radiation therapy is a type of cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. Learn about the types of radiation, why side effects happen, which ones you might have, and more.
What is immunotherapy for cancer?
Immunotherapy is a type of cancer treatment that helps your immune system fight cancer. This page covers the types of immunotherapy, how it is used against cancer, and what you can expect during treatment.
What is stem cell transplant?
Stem cell transplants are procedures that restore blood-forming stem cells in cancer patients who have had theirs destroyed by very high doses of chemotherapy or radiation therapy. Learn about the types of transplants, side effects that may occur, and how stem cell transplants are used in cancer treatment.
How many types of cancer treatments are there?
There are many types of cancer treatment. The types of treatment that you receive will depend on the type of cancer you have and how advanced it is. Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy.
What is targeted therapy?
Targeted therapy is a type of cancer treatment that targets the changes in cancer cells that help them grow, divide, and spread. Learn how targeted therapy works against cancer and about common side effects that may occur.
What is the procedure that removes cancer from the body?
Surgery. When used to treat cancer, surgery is a procedure in which a surgeon removes cancer from your body. Learn the different ways that surgery is used against cancer and what you can expect before, during, and after surgery.
What is precision medicine?
Precision Medicine. Precision medicine helps doctors select treatments that are most likely to help patients based on a genetic understanding of their disease. Learn about the role precision medicine plays in cancer treatment, including how genetic changes in a person's cancer are identified and used to select treatments.
How does multimodal therapy affect cancer?
At the same time, however, the use of intensified therapies has resulted in substantial acute, chronic, and late effects that can significantly affect the quality of life, function, and health of survivors of childhood cancer. Efforts are under way to develop less toxic but effective therapies, including reductions and modifications of doses and schedules for radiation therapy and chemotherapy agents, and the incorporation of novel treatment approaches, such as different types of targeted therapies, into initial treatment strategies.
What are the side effects of multimodal cancer treatment?
As detailed above, multimodal cancer therapy can reliably be expected to cause a constellation of side effects, including low blood counts, immunosuppression, fatigue, nausea, vomiting, mouth sores, diarrhea, wound issues, and functional limitations. Those side effects may in turn result in additional hospitalizations, clinic visits, or home care needs to address sometimes life-threatening infection, anemia, thrombocytopenia, dehydration, malnutrition, pain, physical disability, anxiety, and depression. Supportive care for these common complications should be optimized not only to improve the quality of life of patients receiving anticancer therapy but also to avoid treatment delays and interruptions that can adversely affect long-term outcomes, including the potential for cure. Parents/legal guardians and the patients themselves, to the extent feasible, are integral to the optimal delivery of supportive care. Teaching delivered by the multidisciplinary care team during each step of the treatment can ensure that supportive therapies are appropriately administered and that the patient is monitored and adverse events are expeditiously addressed. Parents and patients are part of the team ensuring optimal care not only for anticipated nausea and vomiting but also for emergent events, such as fever, that require immediate intervention. Palliative care, often inappropriately confounded with end-of-life care, is a holistic approach, often supplemented by dedicated specialized teams, focused on the prevention or early treatment of symptoms stemming from the cancer itself; adverse effects of therapy; and the psychological, social, and spiritual impacts of the disease on patients and their support systems. Described below are some of the more common aspects of supportive care as pertains to children with cancer.
What is a COG trial?
The COG is the primary cooperative group in the United States, with more than 200 member sites and disease committees addressing the majority of childhood tumors ( O’Leary et al., 2008 ). Trials are conducted not only for patients with newly diagnosed disease but also for those with relapsed and refractory disease. Other consortia, including the Pediatric Early Phase Clinical Trials Network, the Pediatric Brain Tumor Consortium, the Pacific Pediatric Neuro-Oncology Consortium, New Approaches to Neuroblastoma Therapy, and Therapeutic Advances in Childhood Leukemia & Lymphoma, are developing and conducting clinical trials for children and young adults, with a focus on early-phase trials for refractory solid tumors or tumors for which no standard effective treatment options exist. In addition, some clinical trials of novel therapies—for example, novel immunotherapies—are conducted at single or limited academic institutions and not widely available. Promising new therapies identified by these groups are incorporated into clinical trials for children with newly diagnosed or relapsed cancers and thus have the potential to become standard therapies. While clinical trials for newly diagnosed patients are available at most of the COG’s participating sites, clinical trials for patients with recurrent disease and trials requiring specific equipment or expertise (such as metaiodobenzylguanidine or chimeric antigen receptor [CAR] T cell therapies or hematopoietic stem cell transplantation) are limited to fewer institutions and require travel and sometimes extended stays away from home. The pediatric oncology research community also collaborates with, and is part of, such international consortia as the International Society of Pediatric Oncology and such meetings as the International Symposium on Pediatric Neuro-Oncology. This collaboration is particularly helpful for understanding rare pediatric cancers, exchanging treatment approaches, and conducting selected international trials.
What is molecular targeted therapy?
Molecular targeted therapy refers to the use of drugs or other substances to target specific molecules involved in the growth, survival, and spread of certain types of cancer cells ( NCI, 2020g ). The advantage of molecular targeted therapy over traditional cytotoxic chemotherapy is the dramatic dependence of cancer cells, as opposed to normal cells, on the drug’s target, leading to improved selectivity and efficacy and often limiting the toxicity of therapy. The differential dependence on the target between cancer cells and normal cells is commonly related to a specific genetic or protein alteration present only in the cancer cells, which can be detected by modern diagnostic sequencing techniques. The terms “personalized medicine” and “precision oncology” refer to the concept of matching individual patients to drugs that target a genetic change present in their own tumors ( Glade Bender et al., 2020 ).
What is stem cell transplant?
Hematopoietic stem cell transplantation refers to the replacement of a person’s blood-forming cells after they have been destroyed by very high doses of radiation and/or chemotherapy that are used to treat certain types of cancer ( NCI, 2020e ). Although stem cell transplantation typically is used in the treatment of leukemia and lymphoma, it may also be used to treat some types of solid tumors. The stem cells used for transplantation can come from one of two sources. First, they may have been harvested previously from the person undergoing treatment (autologous transplant) to provide a rescue after high-dose chemoradiotherapy has destroyed normal blood-making cells. Autologous transplants are used most commonly to treat relapsed or refractory solid tumors or lymphomas ( D’Souza et al., 2020 ). Second, stem cells from a compatible donor may be used (allogeneic transplant); sometimes, an identical twin serves as donor (syngeneic transplant). The stem cells may be harvested from the donor’s bone marrow or mobilized from peripheral blood, or may be retrieved from stored umbilical cord blood. Allogeneic transplant not only can provide a rescue with healthy marrow after high-dose chemoradiotherapy but also may create a graft-versus-malignancy effect by the transfer of a new immune system. Accordingly, allogeneic transplant is used most commonly to treat children with high-risk, relapsed, or refractory leukemias, as well as nonmalignant disorders.
What is the effect of chemotherapy on cancer cells?
Chemotherapy entails the use of chemical agents (cytotoxic drugs) to eliminate or slow the growth of cancer cells by interfering with cell division ( COG, 2020a; NCI, 2020b ). Cytotoxic drugs have the greatest effect on rapidly dividing cells such as cancer cells, but they do not distinguish between cancer cells and rapidly dividing normal cells, such as hair follicles or the lining of the intestinal tract. Many of the side effects of chemotherapy, such as hair loss and diarrhea, are caused by the toxic effect of the drugs on normal cells in the body.
What is radiation therapy for pediatric cancer?
Radiation therapy is used in the majority of pediatric cancers involving localized tumors. Most malignant brain tumors, head and neck cancers, and STS receive daily radiation during the course of treatment for a localized tumor. Radiation therapy is often used in conjunction with surgery and/or systemic treatments such as chemotherapy. It targets rapidly growing cells, such as cancer cells, killing them and/or preventing them from growing or reproducing ( COG, 2020c; NCI, 2020d ). Radiation therapy entails the delivery of ionizing radiation to a localized area, generally using external beam radiation administered by a linear accelerator. The key to modern radiation delivery is the ability to simulate the patient in order to design an optimal treatment plan. The simulator used for this purpose is a machine that mimics a radiation therapy treatment unit. After simulation, physicists and physicians can formulate a treatment plan and calculate the precise dose delivery. Young children, typically less than 6 years of age, may require daily anesthesia to ensure the proper setup and precise delivery of the radiation. High-precision conformal radiotherapy techniques are increasingly being used to deliver the radiation dose more precisely to the targeted area, which decreases the amount of normal tissue that is irradiated.
How to make a decision about cancer treatment?
Ask your doctor how much time you have to decide. Delaying your decision and spending time worrying about it can drain your energy, so don't draw out the process too long.
How to make a reasonable treatment decision?
To make a reasonable treatment decision, keep in mind the type of cancer you have, its stage, what treatment options are available and how likely these treatments are to work under these circumstances. Talk to your doctor about trustworthy websites, books and patient education materials to supplement your discussions.
Why is it important to have a close friend at your appointment?
It may help to think about how you've handled difficult decisions in the past. And it may help to have a close friend or family member at your appointments to help you decide .
Do you have to be involved in treatment decisions?
You don't have to be involved with treatment decisions. If you prefer, tell your doctor you'd rather not be involved in the decision-making process. You can always get involved later when you feel more comfortable with the situation. Let your doctor know who you want to make decisions about your care. Also make sure the designated person is aware of your decision.
Do you have to have cancer treatment?
You don't have to have treatment. People with very advanced cancers sometimes find they'd rather treat the pain and other side effects of their cancer so that they can make the best of the time they have remaining. If you choose not to be treated, you can always change your mind. Forgoing treatment doesn't mean you'll be left on your own — many ways of controlling side effects exist.
Can you change your mind about a drug?
You can always change your mind. Making a treatment decision now doesn't bind you to that option. Tell your doctor if you're having second thoughts. Significant side effects may make you want to change your treatment plan and that's OK.
Can you endure the side effects of harsher treatments?
If this is your goal, you might not be willing to endure the side effects of harsher treatments. Comfort. If you have an advanced stage of cancer or a cancer that hasn't responded to treatments, you might decide that comfort is most important to you.
How does multimodal therapy affect cancer?
At the same time, however, the use of intensified therapies has resulted in substantial acute, chronic, and late effects that can significantly affect the quality of life, function, and health of survivors of childhood cancer. Efforts are under way to develop less toxic but effective therapies, including reductions and modifications of doses and schedules for radiation therapy and chemotherapy agents, and the incorporation of novel treatment approaches, such as different types of targeted therapies, into initial treatment strategies.
What are the best treatments for childhood cancer?
For decades, the pillars of effective therapies for childhood cancer have been surgery; chemotherapy; radiation therapy; and, for specific tumors, hematopoietic stem cell transplantation . The combined use of these therapies has enabled substantial improvements in the long-term survival rates
What is a COG trial?
The COG is the primary cooperative group in the United States, with more than 200 member sites and disease committees addressing the majority of childhood tumors ( O’Leary et al., 2008 ). Trials are conducted not only for patients with newly diagnosed disease but also for those with relapsed and refractory disease. Other consortia, including the Pediatric Early Phase Clinical Trials Network, the Pediatric Brain Tumor Consortium, the Pacific Pediatric Neuro-Oncology Consortium, New Approaches to Neuroblastoma Therapy, and Therapeutic Advances in Childhood Leukemia & Lymphoma, are developing and conducting clinical trials for children and young adults, with a focus on early-phase trials for refractory solid tumors or tumors for which no standard effective treatment options exist. In addition, some clinical trials of novel therapies—for example, novel immunotherapies—are conducted at single or limited academic institutions and not widely available. Promising new therapies identified by these groups are incorporated into clinical trials for children with newly diagnosed or relapsed cancers and thus have the potential to become standard therapies. While clinical trials for newly diagnosed patients are available at most of the COG’s participating sites, clinical trials for patients with recurrent disease and trials requiring specific equipment or expertise (such as metaiodobenzylguanidine or chimeric antigen receptor [CAR] T cell therapies or hematopoietic stem cell transplantation) are limited to fewer institutions and require travel and sometimes extended stays away from home. The pediatric oncology research community also collaborates with, and is part of, such international consortia as the International Society of Pediatric Oncology and such meetings as the International Symposium on Pediatric Neuro-Oncology. This collaboration is particularly helpful for understanding rare pediatric cancers, exchanging treatment approaches, and conducting selected international trials.
What is supportive care for cancer?
Supportive care includes tending to the psychological, social, and spiritual needs of children and families. The recently released Psychosocial Standards of Care (Standards), the result of a comprehensive evidence-based consensus project, suggest that all children with cancer on active treatment (and their families) need ongoing assessment of their psychosocial needs and continual access to evidence-based psychosocial care and treatment ( Wiener et al., 2015 ). In addition, the Standards specifically state that all youth with cancer and their families should be introduced to palliative care early in the diagnosis and should receive supportive care throughout the trajectory of illness, including attention to the psychological distress of both child and family ( Weaver et al., 2015 ). While the evidence base for psychosocial interventions is less well developed than that for medical interventions, it is nonetheless critical to recognize that children with cancer face extreme distress, isolation, and potentially negative psychological and social outcomes that can impact their ability to function along typical developmental trajectories. These outcomes can be as important as medical late effects and should be considered in a comprehensive assessment of functioning for children undergoing treatment. Moreover, pediatric oncology teams have an ethical duty to care for the family as well as the child, because the well-being of the family impacts the child’s physical and mental health in cancer care ( Jones et al., 2014 ). Additional information on psychosocial functional outcomes of cancer is provided in Chapters 4 and 8.
What is molecular targeted therapy?
Molecular targeted therapy refers to the use of drugs or other substances to target specific molecules involved in the growth, survival, and spread of certain types of cancer cells ( NCI, 2020g ). The advantage of molecular targeted therapy over traditional cytotoxic chemotherapy is the dramatic dependence of cancer cells, as opposed to normal cells, on the drug’s target, leading to improved selectivity and efficacy and often limiting the toxicity of therapy. The differential dependence on the target between cancer cells and normal cells is commonly related to a specific genetic or protein alteration present only in the cancer cells, which can be detected by modern diagnostic sequencing techniques. The terms “personalized medicine” and “precision oncology” refer to the concept of matching individual patients to drugs that target a genetic change present in their own tumors ( Glade Bender et al., 2020 ).
What is stem cell transplant?
Hematopoietic stem cell transplantation refers to the replacement of a person’s blood-forming cells after they have been destroyed by very high doses of radiation and/or chemotherapy that are used to treat certain types of cancer ( NCI, 2020e ). Although stem cell transplantation typically is used in the treatment of leukemia and lymphoma, it may also be used to treat some types of solid tumors. The stem cells used for transplantation can come from one of two sources. First, they may have been harvested previously from the person undergoing treatment (autologous transplant) to provide a rescue after high-dose chemoradiotherapy has destroyed normal blood-making cells. Autologous transplants are used most commonly to treat relapsed or refractory solid tumors or lymphomas ( D’Souza et al., 2020 ). Second, stem cells from a compatible donor may be used (allogeneic transplant); sometimes, an identical twin serves as donor (syngeneic transplant). The stem cells may be harvested from the donor’s bone marrow or mobilized from peripheral blood, or may be retrieved from stored umbilical cord blood. Allogeneic transplant not only can provide a rescue with healthy marrow after high-dose chemoradiotherapy but also may create a graft-versus-malignancy effect by the transfer of a new immune system. Accordingly, allogeneic transplant is used most commonly to treat children with high-risk, relapsed, or refractory leukemias, as well as nonmalignant disorders.
What is radiation therapy?
Radiation therapy is used in the majority of pediatric cancers involving localized tumors. Most malignant brain tumors, head and neck cancers, and STS receive daily radiation during the course of treatment for a localized tumor. Radiation therapy is often used in conjunction with surgery and/or systemic treatments such as chemotherapy. It targets rapidly growing cells, such as cancer cells, killing them and/or preventing them from growing or reproducing ( COG, 2020c; NCI, 2020d ). Radiation therapy entails the delivery of ionizing radiation to a localized area, generally using external beam radiation administered by a linear accelerator. The key to modern radiation delivery is the ability to simulate the patient in order to design an optimal treatment plan. The simulator used for this purpose is a
What is targeted cancer treatment?
Targeted therapy is another branch of cancer therapy aiming at targeting a specific site, such as tumour vasculature or intracellular organelles, leaving the surroundings unaffected. This enormously increases the specificity of the treatment, reducing its drawbacks [6].
What are the clinical trials of loaded exosomes?
Three clinical trials with loaded exosomes are currently ongoing for the treatment of different tumours [85–87]: a phase I trial is evaluating the ability of exosomes to deliver curcumin to normal and colon cancer tissues [85]; a phase II trial is investigating the in vivoperformance of autologous tumour cell-derived microparticles carrying methotrexate in lung cancer patients [86] and a clinical inquiry is focusing on autologous erythrocyte-derived microparticles loaded with methotrexate for gastric, colorectal and ovarian cancer treatment [87].
How are exosomes used in cancer?
Exosomes could also be exploited as natural, biocompatible and low immunogenic nanocarriers for drug delivery in cancer therapy. They can be passively loaded by mixing purified vesicles with small drugs [78–82], or actively loaded by means of laboratory techniques, such as electroporation and sonication [83, 84]. Superparamagnetic nanoparticles conjugated to transferrin have been tested for the isolation of exosomes expressing transferrin receptor from mice blood. After incubation with doxorubicin, they have been used to target liver cancer cells in response to external magnetic fields, inhibiting cell growth both in vitroand in vivo[80]. Kim et al.[83] engineered mouse macrophage-derived exosomes with aminoethyl anisamide-PEG to target sigma receptor, overexpressed in lung cancer cells and passively loaded them with paclitaxel. These systems acted as targeting agents able to suppress metastatic growth in vivo.
Is thermal ablation a precision medicine?
Thermal ablation of tumours and magnetic hyperthermia are opening new opportunities for precision medicine, making the treatment localised in very narrow and precise areas. These methods could be a potential substitute for more invasive practices, such as surgery [10, 11].
