By Glendon Mellow
Just like the original moonshot, the future of battling cancer may rely on precision targeting. And that’s going to require new ways of looking at each patient’s data.
While there are over 100 diseases labeled as human cancers, future treatments may be as individual as the people themselves – right down to individual microbiomes. Here are a couple of advancements that may guide oncological patient care in the near future.
Calibrating care with VR
Virtual reality (VR) is finding its way into a couple of important roles in cancer treatment: in diagnosis, and potentially in education for palliative care.
Soon, mapping mutations and reviewing related MRIs, pathology reports, patient history and a microbiome profile could be managed through VR platforms, such as one being developed at Weill Cornell Medicine. On their news page, they detail how in using VR, “seeing a protein or mutation lets researchers see how to design a drug to fit and treat the cancer.” In addition, they note the boon for collaboration, since other specialists who may have an insight on treatment can review the data and model. The potential is there to have a number of different reports, images and treatment options presented visually in a VR space, instead of switching between browser tabs.
High-fidelity simulations (HFS) have gained a recent footing in being used to help educate students and professionals in understanding the various roles HCPs play during palliative care, and new studies involving mannequins, prop, and simulated patient rooms are likely to reveal interesting insights, such as this one described at Virtual Hospice. The decreasing cost of virtual reality technology could create a new standard for this type of simulation, with multiple parameters being available for training sessions. Being able to set different cancer stages, treatments and conditions, as well as different patient personality profiles, may give students and HCPs a greater variety of experiences to learn from.
Palliative care for patients with cancer has shifted from being solely about caring for people at their end-of-life to, in some cases, managing symptoms. At ASCO earlier this year, Dr. Richard T. Lee and Neal J. Meropol suggested more research and standardization on palliative chemotherapy is needed. People are not always the same in how they react to caregivers, or in how their bodies respond to treatment. The ability to interact with different VR simulations, encompassing the variety of challenges found in long-term care could provide valuable insights.
Nanotechnology delivery capsules
While identifying vectors in VR may improve due to diagnosis and training, a variety of targeted approaches to kill tumours are being developed using nanotechnology, or nano-scale–sized particles.
Nanoparticles are typically used as a Trojan Horse against tumours, carrying chemotherapeutic drugs wrapped in a PEG (polyethylene glycol)-coated, liposome shell that allows the nanoparticle to slip by the bodies’ systems. Cancerous blood vessel walls have larger spaces between their cells than healthy blood vessels, which allows the tiny particle to slip between them to the targeted site. New research, by researchers at the Institute for Biomedical Sciences at Georgia State University, the Atlanta Veterans Affairs Medical Center and Wenzhou Medical University and Southwest University in China, reported on by Phys.org, shows promise in developing vegetable-based nanoparticles by using liposomes derived from ginger. As reported, “Folic acid shows high-affinity binding to the folate receptors that are highly expressed on many tumors and almost undetectable on non-tumor cells.” The Trojan Horse nanoparticle should only release its chemical payload into cancerous tissue, and not bind to healthy tissue. It’s quite a remarkable molecular hack, and can potentially save patients some of the terrible side effects of chemotherapy.
Taking the precision targeting even further, MIT reports they may be able to deliver up to three drugs within the same nanoparticle, presumably to weaken the cancerous cells in different ways. These nanoparticles differ in that they’re not encapsulating the drugs; instead they are nanoparticles built, “from building blocks that already contain drug molecules.” In Phys.org, researcher Jeremiah Johnson notes, “We can take any drug… and we can load it into our particles in exactly the ratio that we want, and have it release under exactly the conditions that we want it to… It’s very modular.”
Keeping the target in sight
It’s heartening to see that amidst the most advanced disease fighting technology being explored, there’s awareness among researchers to remember care for the people they are treating, and not just the disease they are fighting. From getting the full picture of the patients’ data in VR, to targeting aimed squarely at cancerous tissue, the cancer moonshot isn’t only about doing something big: it’s about doing something with inspiring precision.
onto Project Virtual Tumor Cancer in silico and Alternative Cancer Therapies
By Glendon Mellow