More than 2,600 therapies are in clinical trials to treat cancer, including new targeted drugs and immunological therapies. Advances in genetics and stem cell research are unlocking mysteries of cancer that promise dramatic new approaches to conquer this devastating disease.
A number of promising breast cancer therapies are in late-stage development. One is Neratinib, in Phase III trials for HER2 type early-stage and metastatic breast cancer. PARP inhibitors (poly ADP-ribose polymerase) are also on the horizon. PARP is a protein involved in DNA repair and has shown early promise in treating metastatic breast cancer in women who are not candidates for estrogen or HER2 targeted therapies. Fenretinide is being studied as a way to reduce the risk of developing breast cancer in women at risk.
As researchers learn more about the underlying genetics of cancer, more targeted drugs can be developed to improve treatment. For example, Crizotinib, approved in 2011, is a targeted drug used to treat a special type of non-small cell lung cancer that affects only about 5% of patients identified using a special diagnostic test. In this small group, Crizotinib is highly effective.
Clinical trials are underway to develop a number of targeted lung cancer drugs, including Afatinib and Dacomitinib for non-small cell lung cancer. A vaccine, called Stimuvax also shows promise in patients with a certain subtype of non-small cell disease.
The introduction of the first immunotherapy for cancer, Provenge, was an important milestone. Harnessing the body's immune system to identify and destroy cancer cells has long been a focus of cancer research. There is now hope that immunotherapy for a wide range of cancers will advance in the coming years. Another prostate cancer vaccine, PROSTVAC-VF, is now in clinical trials. Other promising agents in development include Cabozantinib, approved in 2012 for thyroid cancer, and radium-223 Alpharadin, now undergoing FDA review for prostate cancer that has spread to the bone.
Research into the underlying genetics of lymphoma is increasing knowledge about how lymphocytes are transformed into cancer cells. These studies point to ways to improve diagnosis and block disease processes with new therapies. Clinical research is focusing on monoclonal antibodies and other targeted therapies for various types of lymphoma, including a promising immunotherapy called CAT-8015. Early results from studies of a lymphoma vaccine, called BiovaxID, show promise against mantle cell lymphoma. Progress is also being made in stem cell therapies. Stem cell transplants can now be used in some cases to restore bone marrow following high doses of chemotherapy or radiation that destroy blood-forming cells.
Genetic studies are revealing more about the underlying causes of leukemia are this knowledge is driving the development of new treatments. Physicians are learning how to use genetic information to guide treatment. Clinical studies are testing combinations of existing therapies in various types of leukemia, and evaluating new strategies including cancer vaccines and gene therapies.
Promising agents include the lymphoma drug Revlimid and the arthritis drug Auranofin, both in clinical trials to treat CLL. The childhood ALL drug Clolar is in trials to treat AML in adults and children. Several new drugs are in studies for AML, including farnesyl transferase inhibitors and FLT3 inhibitors. In a new approach to immunotherapy, researchers removed T-cells from patients before chemotherapy and genetically modified them so that the immune system could target and destroy CLL cancer cells. Positive results in this and similar studies offer hope that the immune system can be reprogrammed to fight leukemia and other cancers.