Abstract
Biological therapies have changed the face of oncology by targeting cancerous cells while reducing the effect on normal tissue. This publication focuses mainly on new therapies that have contributed to the advances in treatment of certain malignancies. Immunotherapy, which has repeatedly proven to be a breakthrough therapy in melanoma, as well as B-ALL therapy with CAR T cells, are of great merit in this progress. These therapies are currently being developed by modifying bispecific antibodies and CAR T cells to improve their efficiency and bioavailability. Work on improving the therapy with oncolytic viruses is also progressing, and efforts are being made to improve the immunogenicity and stability of cancer vaccines. Combining various biological therapies, immunotherapy with oncolytic viruses or cancer vaccines is gaining importance in cancer therapy. New therapeutic targets are intensively sought among neoantigens, which are not immunocompromised, or antigens associated with tumor stroma cells. An example is fibroblast activation protein α (FAPα), the overexpression of which is observed in the case of tumor progression. Universal therapeutic targets are also sought, such as the neurotrophic receptor tyrosine kinase (NTRK) gene fusion, a key genetic driver present in many types of cancer. This review also raises the problem of the tumor microenvironment. Stromal cells can protect tumor cells from chemotherapy and contribute to relapse and progression. This publication also addresses the problem of cancer stem cells resistance to treatment and presents attempts to avoid this phenomenon. This review focuses on the most important strategies used to improve the selectivity of biological therapies.
Highlights
Cancer is one of the leading causes of death in the world, generates enormous costs and is a major burden on humanity
Reaching the limits of the effectiveness of chemotherapy and its toxicity to normal tissues prompts the search for new treatment regimens based on personalized and combination therapy, which are the future of medicine
The evolution of cancer therapies is ensured by modern methods of molecular biology, enabling a better understanding of the biology of cancer and finding an appropriate therapeutic target, such as the nextgeneration sequencing (NGS) method
Summary
Cancer is one of the leading causes of death in the world, generates enormous costs and is a major burden on humanity. In the biological therapy of cancer, molecules that target genetic aberrations in oncogenes and tumor suppressor genes leading to tumor development are essential Classic examples of such molecules are: imatinib, a BCR-ABL tyrosine kinase inhibitor used in chronic myeloid leukemia; vemurafenib, a BRAF seronine/threonine kinase inhibitor for the treatment of melanoma; or osimertinib, approved by the FDA and the EC in 2017 for the treatment of non-small cell lung cancer in the presence of the EGFR T790M mutation [4,5,6,7]. After the discovery of this mechanism and the production of antibodies neutralizing these receptors, the effector T lymphocytes in the tumor microenvironment were unblocked and allowed to cause the lysis of neoplastic cells [16] This method has become a real revolution in the treatment of certain types of cancer. Potential therapeutic targets are another component of immune synapse, e.g., T cell immunoglobulin and mucin-3 (TIM-3), band T-cell lymphocyte attenuator (BTLA), V-domain Ig suppressor of T-cell activation (VISTA) and TIGIT [20]
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