Short Review on Recent Approaches of Cancer Therapy

Anuradha College Of Pharmacy Chikhli,Buldana(M.S) India

Corresponding Authors: Anis shah Akram shah*, Saurabh S. Joshi,

Akash G. Ambhore, Saloni S.Khandelwal, Rasika P.Babhulkar

Email ID: sjoshi18799@gmail.com , anisakmal750@gmail.com

____________________________________________________

Abstract

According to the newest cancer statistics presented worldwide, there has been a dramatic increase within the rates of occurrence of some cancers, particularly within the more developed countries. Many therapeutic strategies to prevent and cure this disease have been proposed and evaluated by clinicians and researchers, there need to find more effective approaches. During Chemotherapy, the two side effects are frequently faced such as toxicity and drug resistance. As new anticancer therapeutics, small - molecule drugs are being intensively pursued , Oncology drug discovery has benefited significantly from progress in understanding how to target kinases with small molecules that were found to be correlated with the disease. One reason for this is that many kinases have been found to be intimately involved in the processes leading to tumor cell proliferation and survival. Monoclonal antibodies produced in vitro and can be used in cancer treatment in a number of ways. They may enhance the immune system by reacting with certain types of cancer cells. They can be

programmed to act against specific cell growth factors to interfere with the multiply of cancer cells. Furthermore, they may be linked to anticancer drugs, radioactive substances, other biologic therapies, or other toxins (antibody – drug conjugates). During the process of bone marrow transplantation, the usage of cytotoxic monoclonal antibodies may be a key to improve the efficacy of the method. The objective of this review was to present some of the new cancer treatment modalities that have been developed. The advantages of each method including its safety and efficacy have been highlighted. The present study may support the improvement and future development of new therapeutic approaches.

Introduction

Cancer was first described by Hippocrates using the Greek word karkinos . The name is came from the appearance of cut surface if solid malignant tumour, with the veins stretched on all sides as the crab has it’s feet whence it derive it’s name. According to World Health organisation (WHO) it is estimated that word wide there will be almost 22.2 million Cancer cases diagnosed annually by 2030. The overall survival times of patients with many types of malignancies remain low.The above finding underline the urgent need for the development of new therapeutic model and the improvement of the existing ones,to inhibit cancer progression and deliver improved therapeutic outcome. Recently the International Agency for Research on

cancer (IARC) reported that 7.6 millions deaths world wide due to cancer. Likewise 12.7 million new cases are estimated per year. It has been reported that developing countries are at higher risk of cancer , according to survey 63% of cancer related deaths were reported only from developing countries. Cancer is a multifactorial disorder which concerning complex modifications in the genome signals, irresponsiveness to signal which stop the cell division, uncontrolled replication, evasion of apoptosis, sustained angiogenesis and finally the capacity to penetrate in other tissues, referred as metastasis. The microenvironment of benign tumour manifest dysregulation of various regulatory protein and extracellar environment which play a vital role in origination and development of cancer . Before 1950 only surgery was considered as a preferred treatment for the approches of cancer. After 1960 radiotherapy was initiated to regulate local disease. With the passage of your time it had been realised that individual treatment of surgery and radiation isn’t effective as compared to their use together to regulate the cancer. Nowadays drugs ,the Biological molecules and immune medicated therapies are getting used for treatment .Till today, we’ve not reach to expected therapy level that resist the death rate and decrease the prolonged survival times for metastatic cancer. Pathways and characteristics of different tumour entities were determined to create new revolution in neoplastic cancer or targeting drugs or tumour. Radiation therapy is based upon the use of physical entities like electron, proton and various ions to

kill the cancerous cells. The mechanism of the radiation therapy is that High energy radiation stop 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 tumour. If done after surgery, radiations will destruct the left behind tumour cells and reduce the cancer relapse.

Cell division and cancer

The cancer cells are sales gone wrong in other words the cancer cells are no longer respond to many of the signals that control cellular growth and death. Cancer cells originate within tissue and as they grow and divide they diverge ever further from normalcy. This sales become increasingly immune to the controls that are maintain in normal tissue and as a result they divide sooner than their progenitors and subsided dependent on signals from other cells. Cancer sales even odd program cell death despite the fact that there are multiple abnormality would normally make them prime targets for of apoptosis stop in the late stages of Cancer cells break through normal tissue boundaries and metastasize to new site in the body.

Figure. Development of cancer cell

Types of tumour :

1.On the basis of type of cell initially altered

Tumours are named depending upon the type of cell from which they originate. These include.

Carcinomas, which result from altered epithelial cells. They constitute the highest ratio in all type of cancer.

Sarcomas denote the cancer abnormality in the bone for muscle of fat and connective tissue

Leukaemia, which originate from cancerous cells lymphoma which is malignancy of lymphatic system or

cells which are derived from the bone marrowMyelomas depict the Cancers of dost particular white

blood cells that synthesise antibodies

2. Classification by Grades

This is abnormality with inthe cell with regard to their surrounding the normal tissue increase within the abnormality the great from 1-4 well differentiated cell closely resemble normal sales and they belong to low grade tumours. Improperly differentiated cells are highly abnormal with respect to surrounding tissues. These are highly grade tumours

Grade 1st: This includes well differentiated cells having slight abnormality.

Grade 2nd : These are moderately differentiated and bit more abnormal.

Grade 3rd: These are improperly differentiated cells and very abnormal in the contacts of having mutated chromosomes and produce some harmful chemicals which affect nearly cells and may enter in the blood.

Grade 4th: Cells are immature, primitive, and undifferentiated.

Causes of cancer :

Causes of cancer origin and advancement of cancer depend on many factors include inside the cells (mutation, immune condition, and hormones,) as well as external factor from the environment like smoking chemicals in excess organism and radiation is our entire elements act together to cause abnormal cell behaviour and uncontrolled proliferation the resultant unusual cell mass in the body grows and affect normal tissue in the surrounding and sometime it also spread to the body other locality in the body. According to the most accepted model for cancer causation mutations in tumour suppressor and oncogene is the major factor leading to cancer development another model suggest mutation in master gene that control the division of sales and also shepherd normal

Figure. Causes of cancer

Cells towards abnormal chromosomal replication, which can result in in the application or deletion of the entire sections of chromosome. This change in genetic content in the cells produce abnormal amount of specific protein irrespective of the actual need. If any chromosomal aberration effects a protein that plays a crucial role in the cell cycle quantitatively or qualitatively it may result in cancer. There is also a strong

indication that the unnecessary addition or deletion of methyl group to genes involved in the regulation of cell cycle DNA repair and apoptosis is also associated with some cancer it is necessary to commemorate that cancer mas to be detectable. Thus there can be several mechanism which lead to development of cancer. This further obscure the difficult task of defining the actual cause of cancer.

Cancer treatment modalities :

Since the recognition of malignancy, the objective of extra ordinary research is to discover new method of quality treatment approaches for cancer therapy. Presently over 60% of all ongoing Medical College treatment trials worldwide are concentrating on cancer. The selection of treatment and its developemet depends on the type of cancer, its locality, and stage of progression. Surgery radiation based surgical knife, chemotherapy and radiotherapy are some of the traditional and most widely used treatment methods. Some of the modern modular 30 include hormone based therapy, anti-angiogenic modalities, stem cell therapies immunotherapy and dendritic cell-based immunotherapy. Side effects related with traditional methods of cancer treatment highlights the scope of novel cancer treatment methods. Different novel treatment system utilised for treatment of malignancy include treatment against angiogenic ability of cancer, oncolytic virotherapy heredity control of apoptotic and tumours attacking pathways antisense and RNAi techniques. These treatment are employed against

the cancer of the cerebrum, prostate, lungs, breast, colorectal, pancreatic ,liver,head,neck, bladder,skin, ovarian and rectal malignancy.

New anticancer drugs put cancer to sleep permanently :

In the world ,Meibourne was first scientists to discovered a novel type of anticancer drug. The drug can put cancer cells into a permanent sleep without the harmful effect caused by conventional cancer therapies. The Search associate professor of team Thomas and the associate professor Anne Voss from the Walter. Eliza hall institute professor Jonathan Baell Monash institute of pharmaceutical science. Dr.Brendon Monahan from cancer therapeutics crc investigated weather inhibiting KAT6A KAT6B could be a new approach to treating for cancer diseases.

“Intially on we discovered that genetically depleting KAT6A quadrupled the life expectancy in animal models of blood cancers called lymphoma. Armed with the knowledge that kat6a is important driver of Cancer. So, begin to look for purpose of inhibiting the protein to treat cancer” associate professor Thomas said

The compound had already shown great promise in preclinical testing he said. This class of anticancer drugs was effective in preventing cancer progression in our clinical models. We are extremely excited about the potential that the world has an entirely new weapon for fighting cancer. “The compound which we used ,it was well tolerated in our preclinical models and it is very potent against tumours cells while appearing not to

adversely affected healthy cells” associate professor Thomas said.

No more DNA damage

The research effort was almost shows in the making requiring strong teamwork between expert in Cancer Research medical chemistry and drug discovery. there is a critical difference between this new class of drug and standard cancer therapies. Chemotherapy and radiotherapy work by causing a reversible DNA damage. Cancer cells are unable to repair this damage and they become a die. Downside is a standard therapy can not be targeted only differences in the causes significant damage to the healthy cells as well as this causes short term side effects, such as nausea fatigue ,hair loss and susceptibility to infection as well as long term effects such as nausea, fatigue, hair loss and susceptibility to infection as well as long term effects auch as infertility and increased risk of other Cancer developing.

“Undruggable” no more

“Professor Baell set the project was particularly significant because the scientific community had coined the gene family Undruggable. There where many hurdles to overcome with this project this compound certainly didn't fall into our laps, requesting decided PhD students and NHMRC supported post-doctoral medicinal chemists to drive the chemistry forward” professor Baell said “but with preserved and commitment we are excited to have developed a potent, precise and clean compound that appear to be safe and effective in our

preclinical models. Our team are now working on developing this compound into a drug that is appropriate for human trials.

Other Recently used therapies

Surgical Removal of tumour

Surgery, resection or operation is assumed together of the forecast useful and traditional treatment of the many benign and malignant tumours. because it as yours least damage to the encompasing tissue as compared to chemotherapy and radiotherapy. One more reason of considering surgery as a preferred treatment option is that the tumours can be removed without unnecessary risk of tissue damage. Different quite of surgeries either open for minimally invasive are often performed

Depending upon various factors

The reason of surgeryThe a part of body wear surgery is to be performedThe mass of tumours to be removedPatients preferenceSurgery is also vary depending upon the stage of cancerRemoval of entire tumours from the certain partDebulk a Tumour just in case its removal may cause

damage to the certain organEase cancer symptoms in cases when an outsized tumours

is causing pain or intense pressure on any body part

In case of open surgery one Lajpat is formed and it always result in removal of the tumour along with some amount of healthy tissues related to some closely present lymph node. In contrast, for minimal invasive surgery, surgeon makes a few small cut instead of one large one and then with the aid of laparoscope which is a thin tube with a camera attached to it views the tumour in detail. the camera shows the image on the screen which helps the surgeon to monitor is activity will stop the tumour along with small amount of healthy tissue is then carefully removed with the assistant of specialised surgery tools.

Radiation based surgical knife :

Stereotactic radiosurgery :Stereotactic radiosurgery may be sort of therapeutic radiology during which include ionising reactions. These reaction are used for the damage and destruction of selected areas with in an organ or tissue. This technique exposes a small area of the body to a very high dose of reactions. How ever know cutting or blade is used in the entire process, but it is still called a surgery because the results of this treatment are similarly and ordinary surgery. As the beam of reactions administered is of very high dose it is very important that the beam of radiation is highly focus so that the peripheral tissue are left un affected.This primary utilised in case of brain tumour at location where the conventional surgical techniques are hard or unsafe to use or in other cases

when the health status of a patient does not support him to tolerate a surgical procedure.

Gamma knife system :

A Gamma knife technique does not include real surgery 9 is that gamma knife actually a blade. It utilizes light emission scented Gamma beam to treat little to medium size source and tumours. Many radiation beams combined to concentrate on the cell mass under treatment giving an exceptionally high dose of radiation without a surgical cut or opening.

Linear accelerator system :

Linear accelerator system utilise high energy x-ray to treat a tumour or other injuries. Some basic kinds of LINA framework include CyberKnife® ,X-Knife®, Novalis®, and Peacock®. LINAC frameworks can treat bigger tumours and bigger affected regions than the gamma knife police Stop zones other than the brain can be treated with a LINAC frameworks.

Proton beam therapy :

Proton beam therapy may be a quite of molecular radiation treatment. For example, Gamma beams or X-ray , molecular radiation treatment utilizes particles like proton or neutrons, Against to the utilising beams of radiation

Radiation therapy:

The discovery of X-Ray by German physicist Wilhelm Conrad Rontgen in 1895 also mark their clinical importance in the treatment of cancer. After that almost a hundred year ago Marie Curie's research in radium makes her a two-time Nobel prize winner and one to introduce the field of radiotherapy in medicine. The 2011 thus became the year of radiation therapy announced by the UK enclosing a country of developments in radiation therapy. Now , Radiation therapy distinguished in field of specialisation in medicine with branches such as that radiation oncology employs professionals from various sectors of health working on the field's advancement

(Figure. Radiation Therapy)

Principles of radiation therapy :

Radiation in Cancer therapy can be described as a physical entirety used to kill the cancer cells. The kind of radiation used in therapy is ionizing radiation. The radiation upon incidence causes particles in biological bodies to charge electrically,thus term is ionizing and energy is transferred in this way from the race to the cells of the body through which it passes. This energy can either directly kill cancer cells or generally alter them so that they accede to apoptosis and cell death.The mechanism underlying genetic alteration in cells treated with radiation lies in the fact that the damaged DNA is unable to replicate and does cell division is halted which in turn causes call to die on stop.The adverse effect of the therapy is that it also hits the normal cells lying in the peripheries of the main tumorous mass. How ever improved imaging techniques and attempts at accurate targeting of Cancer mass in addition to normal cells ability to regain normal function faster than cancer cells as cancer cells Lake efficient repair system minimising the net damage done by radiation

Chemotherapy :

Chemotherapy hearts tumours progression by killing of their ability to divide and enforcing apoptosis. Normal biological functioning of the body refresh cells of the body by removing excess sales or damaged cells and does signalling new cell formation. In contrast tumour cells have an increased capacity to divide and the quality of immortality as they are not control

by apoptosis. Therefore where is normal body is the cell proliferation is balance by cell death and is regulated cancerous mass cell proliferation to cell death ratio is high.

Common Risk Factor in Chemotherapy:

Illness and weakened immune system

Cancer on the treatment of it can we can the Indian system. Because chemotherapy kills healthy immune cells it can make a person more vulnerable in accident. Since a person's immune system will be less able to fight off germs infection may also last longer. Eating a healthful diet frequently washing hands avoiding people who are ill and seeking from medical care of signs of illness can reduce the risk of various infection.

Bruising and bleeding more easily

chemotherapy can cause a person to produce or bleed more easily. Many people having chemotherapy experience this side effect and it does not usually cause concern.

Hair loss

chemotherapy can damage hair follicles causing the year we can become brittle and fall out. Any hair that regrows maybe much thinner or different colour.

This pattern usually continue until chemotherapy and hair loss always regrows after chemo.

Nausea and Vomiting:

Nausea and vomiting can come on suddenly appear after is chemotherapy season for have one seemingly at random

Neuropathy

neuropathy is nerve pain caused by damage to the nerves

it often affects the hands and feet causing tingling numbness and unusual electrical sensation. Some people also experience weakness and ringing in the ears

Trouble breathing

sometime chemotherapy can damage a person’s lung reducing their capacity which makes it harder for them to get the oxygen they need.

Constipation and diarrhoea

chemotherapy may trigger digestion problems because it can damage cells that help digestion.

Rash

chemotherapy can cause changes in the immune system that triggered the rashes and other skin changes.

Mouth sore

some people notice painful soresin their mouth 1 to 2 weeks after having some forms of chemotherapy the soreness can vary in severity.

Pain

general eyes pain including chronic muscle pain headache and other aches and pain is common after chemotherapy

Conclusion

Cancer is a disease that affects about 82% of the world’s population. Cancer is a complex disorder involving alterations in the physiological conditions of the body. Some traditional methods for cancer treatment like radiotherapy, chemotherapy, and surgery are effective, but there are certain side effects. Treatments are generally depends upon the cancer’s type , its location and stages of progression. In current, we will work for some advancement in cancer treatment targeted therapies such as hormone-based therapies immunotherapies, anti-angiogenic modalities, gene therapy, stem cell therapy, and dendritic cell-based immunotherapy. Recent research is helping us to understand the stem cell,

tumor genomics and this will help to develop novel therapies to eliminate cancer. In this review we conclude that, new generation of cancer treatment is associated with several adverse effects .So, these targeted therapies proved better tolerated than traditional treatment. They have also improve the standards of living of cancer patients. The advancements of cancer immunotherapy ,it more focused to treat tumour cell. Cancer immunotherapy will need to discover the approaches to control the acquired resistance. The objective of this review was to present some of the new cancer treatment.

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