9 Emerging Oncology Treatments That Could Replace Chemotherapy

While chemotherapy remains a cornerstone of early-stage cancer treatment, its well-documented side effects and financial burden continue to challenge both patients and healthcare systems. Beyond the familiar issues of nausea, fatigue, and immunosuppression, the logistical complexities of handling and maintaining the efficacy of hazardous chemo drugs persist as critical concerns for hospitals and biomedical waste managers.

In response, cutting-edge alternatives are gaining traction. Gene therapy and programmable nanomaterial antibodies represent two promising avenues under exploration. These innovations not only target cancer cells more precisely but also aim to reduce systemic toxicity, potentially revolutionizing the standard of care in oncology.

Finding these innovations is now much easier with tools like Slate. It’s like ChatGPT but for R&D innovations. Here’s how easily it found dozens of highly relevant results for a single search query.

Targeted therapies that inhibit specific proteins to suppress cancer

Contrary to traditional chemotherapy, targeted therapies are administered hyper-locally to target the specific molecules involved in cancer growth and spread.

Gleevec is a targeted therapy for several types of cancers and blood disorders. Novartis markets it as an oral tablet taken once or twice daily. Gleevec targets and inhibits the BCR-ABL tyrosine kinase, a protein produced by the Philadelphia chromosome responsible for the uncontrolled growth of cancer cells. Here are some of the critical conditions it treats:

Condition	Description
Chronic Myeloid Leukemia (CML)	Gleevec is highly effective in treating CML, particularly in patients with the Philadelphia chromosome-positive (Ph+) variant.
Acute Lymphoblastic Leukemia (ALL)	It treats Ph+ ALL.
Gastrointestinal Stromal Tumors (GIST)	Gleevec is used to treat GIST, a type of tumor in the digestive tract.
Myelodysplastic/Myeloproliferative Diseases (MDS/MPD)	These disorders are caused by poorly formed or dysfunctional blood cells.
Aggressive Systemic Mastocytosis (ASM)	It is a rare condition where mast cells accumulate in various tissues.
Hypereosinophilic Syndrome (HES) and Chronic Eosinophilic Leukemia (CEL)	They cause the overproduction of eosinophils, a type of white blood cell.
Dermatofibrosarcoma Protuberans (DFSP)	A rare type of skin cancer.

Here are the side effects of Gleevec to consider:

• Edema (fluid retention)
• Nausea and Vomiting
• Muscle Cramps and Pain
• Diarrhea
• Rash
• Blood Disorders
• Liver Problems
• Heart Issues
• Severe Skin Reactions

Similarly, Erlotinib, marketed under the brand name Tarceva, is a tyrosine kinase inhibitor (TKI) administered orally once a day. It targets and inhibits the epidermal growth factor receptor (EGFR), a protein found on the surface of both regular and cancerous cells. EGFR plays a crucial role in cell growth and division. In some cancers, EGFR is overactive, leading to uncontrolled cell proliferation. By blocking EGFR, erlotinib helps to slow down or stop the growth of cancer cells.

Erlotinib is used to treat Non-Small Cell Lung Cancer (NSCLC) and pancreatic cancer, among other types. Here are its side effects to consider:

• Rash or acne
• Diarrhea
• Loss of Appetite
• Nausea and Vomiting
• Fatigue
• Lung Problems
• Liver and Kidney Issues
• Gastrointestinal Perforation
• Severe Skin Reactions
• Eye Disorders
• Lung Problems
• Liver and Kidney Issues
• Gastrointestinal Perforation
• Severe Skin Reactions
• Eye Disorders

Checkpoint inhibitors that prevent cancer cells from hijacking and evading an immune attack

These drugs block the proteins cancer cells use to bypass an immune attack, thus invoking the natural immune system to target the cancerous cells. 

Pembrolizumab is one such medication that helps fight cancer by blocking a specific protein called PD-1. This PD-1 protein normally acts as a brake on immune cells, preventing the immune system from attacking healthy cells. However, some cancer cells exploit the PD-1 protein to hide from the immune system. By blocking PD-1, pembrolizumab releases this brake, allowing immune cells to recognize and attack cancer cells more effectively. This activity can slow down or stop tumor growth.

These antibodies are potent chemotherapy alternatives and can treat several types of cancer, including:

Condition	Description
Non-Small Cell Lung Cancer (NSCLC)	Particularly effective in patients with tumors expressing PD-L1.
Melanoma	Used for both advanced melanoma and as an adjuvant therapy.
Head and Neck Squamous Cell Carcinoma (HNSCC)	For patients with recurrent or metastatic HNSCC.
Hodgkin Lymphoma	Effective in treating refractory or relapsed Hodgkin lymphoma.
Bladder Cancer	Used for certain patients with advanced or metastatic bladder cancer.
Gastric Cancer	For patients with PD-L1 positive gastric or gastroesophageal junction adenocarcinoma.
It is particularly effective in patients with tumors expressing PD-L1.	For PD-L1 positive cervical cancer.

Here are the side effects observed with Pembrolizumab:

• Fatigue
• Rash
• Diarrhea
• Nausea
• Loss of Appetite
• Pneumonitis
• Hepatitis
• Colitis
• Nephritis
• Endocrinopathies
• Severe Skin Reactions, such as Stevens-Johnson syndrome

Another checkpoint inhibitor, Nivolumab (Opdivo), works similarly by blocking the PD-1 receptors. FDA has approved Pembrolizumab for certain types of cervical cancer and triple-negative breast cancer, whereas Nivolumab is approved for mesothelioma. Nivolumab is often combined with another immunotherapy drug, Ipilimumab (Yervoy). Both drugs share similar side effects.

Modifying a patient’s T-cells to attack cancerous B-cells

These early-market drugs contain genetically engineered T-cells that attack cancer cells and prevent their growth. Kymriah, a therapy developed by Novartis, works by genetically modifying the patient’s T-cells to express a chimeric antigen receptor (CAR). When infused back into the patient, these CAR-T cells target the CD19 protein found on the surface of cancerous B cells.

Kymriah has FDA approval and shows significant efficacy in treating certain blood cancers, with many patients achieving complete remission.

Yescarta is another among CAR-T cell chemotherapy alternatives developed by Gilead Sciences, specifically through its Kite Pharma division. It works the same way as Kymriah. They also share similar side effects:

• Difficulty Breathing
• Fever
• Chills/Shaking Chills
• Severe Nausea, Vomiting, Diarrhea
• Severe Muscle or Joint Pain
• Very Low Blood Pressure
• Serious Side Effects
• Cytokine Release Syndrome (CRS)
• Neurological Problems
• Hemophagocytic Lymphohistiocytosis (HLH)/Macrophage Activation Syndrome (MAS)
• Serious Infections
• Allergic Reactions

Adaptimmune, a clinical-stage biopharmaceutical company, uses a proprietary platform to engineer T-cell receptors that target cancer cells and infuse them back into the patient. Their therapies target specific antigens present in solid tumors. For example, their recently approved therapy, Tecelra (afami-cel), targets MAGE-A4+ synovial sarcoma.

Similarly, Kite Pharma, a subsidiary of Gilead Sciences, develops chimeric antigen receptor T-cell (CAR-T) therapies. These therapies treat various types of blood cancers.

Specialized antibodies that prevent cancer cells from getting nutrients to grow

These chemotherapy alternatives include lab-made antibodies that bind to specific targets on cancer cells and prevent them from multiplying. Trastuzumab (brand name Herceptin) is an antibody that treats HER2-positive breast cancer and HER2-positive metastatic gastric cancer. It binds to the HER2 receptors on the surface of cancer cells, blocking the signals that tell those cells to grow and divide. Trastuzumab also flags the cancer cells for destruction by the body’s immune system, a process known as antibody-dependent cellular cytotoxicity (ADCC). Furthermore, it prevents the shedding of the HER2 extracellular domain, which is associated with poor recovery.

Similarly, Bevacizumab (brand name Avastin) treats various types of cancer, including colorectal, lung, ovarian, glioblastoma, hepatocellular carcinoma, and renal cell carcinoma. It inhibits the growth of new blood vessels that tumors need to grow and spread by targeting a protein called vascular endothelial growth factor A (VEGF-A). VEGF-A plays a crucial role in forming new blood vessels (angiogenesis).

Both of these drugs exhibit similar side effects:

• Cardiac issues, which may not arise until months into the treatment
• Infusion reactions
• Gastrointestinal issues
• Fatigue
• Hypertension
• Respiratory problems

Modifying viruses to selectively infect and kill cancer cells

This approach uses viruses to target and infect cancer cells to kill them. Talimogene laherparepvec (T-VEC), sold as Imlygic, is a cancer treatment that uses a modified cold sore virus. This specially engineered virus is designed to infect and kill cancer cells while mostly leaving healthy cells alone.

When the virus enters cancer cells, it multiplies, causing the cells to burst open. This releases substances that alert the immune system to the presence of cancer. Additionally, the virus produces a protein that further boosts the immune system’s ability to recognize and attack cancer cells throughout the body.

The observed side effects of Imlygic are more common than most:

• Flu-Like symptoms
• Nausea
• Fatigue
• Fever
• Loss of appetite
• Muscle aches and pains
• Shivering
• Sweating

Recommended Report: Top 20 Patent Buyers Of Cancer Curing Technologies

Cancer-fighting vaccines are real.

These mRNA-based vaccines stimulate the immune system to attack cancer cells. However, the efficacy and safety of these chemotherapy alternatives are still being evaluated through clinical trials.

Moderna makes one such investigational personalized mRNA cancer vaccine known as mRNA-4157/V940. It’s designed to work with Merck’s immunotherapy drug, Keytruda, to treat certain types of cancer, particularly melanoma.

The vaccine uses mRNA sequences specifically designed based on the unique mutational signature of the patient’s tumor. The mRNA in the vaccine instructs the patient’s cells to produce neoantigens, proteins associated with the cancer cells. These neoantigens trigger the immune system to recognize and attack the cancer cells. Keytruda helps to enhance the immune response by blocking the PD-1 pathway, which cancer cells often use to evade the immune system. Common side effects of this vaccine include fatigue, injection site pain, and chills. Most side effects are mild to moderate (Grade 1-2), with fatigue being the most common severe side effect (Grade 3).

BioNTech is also developing several mRNA-based cancer vaccines, such as autogenous cerumen (BNT122), to treat various types of cancer, including pancreatic cancer and melanoma. This vaccine works similarly to Moderna’s vaccine. In early trials, the vaccine was generally well-tolerated. Common side effects included fatigue, fever, and injection site reactions. Serious side effects were rare, with only a small percentage of patients experiencing severe reactions like Grade 3 fever and hypertension.

Genetic therapy to enhance the patient’s immune system

These therapies involve inserting genes into a patient’s cells to treat cancer. Companies like Spark Therapeutics and Bluebird Bio are exploring gene therapies that can modify a patient’s immune cells to recognize and attack cancer cells. This includes investigational therapies combining gene addition and autologous hematopoietic stem cell transplants (HSCT). Using the patient’s own stem cells helps reduce the risk of immune rejection and improve treatment efficacy.

These antibodies bind immune cells to cancer cells to prompt an attack.

Bispecific T-cell Engagers (BiTEs) are specialized antibodies that bind to T-cells and cancer cells, bringing them together. Amgen’s Blinatumomab, marketed as Blincyto, is a pioneering therapy in Bispecific T-cell Engagers (BiTEs). Blincyto is designed to treat certain types of blood cancers, specifically B-cell precursor acute lymphoblastic leukemia (B-ALL).

Blincyto antibody simultaneously binds to CD19, a protein found on the surface of cancerous B cells, and CD3, a protein on T-cells (a type of immune cell). It brings T-cells close to the cancerous B-cells, prompting them to attack and kill the cancer cells. The FDA has approved this therapy for treating patients with minimal residual disease (MRD)-positive B-ALL, which is a strong predictor of relapse.

Some side effects of Blinatumomab are:

• Fever
• Headache
• Infections
• Muscle, joint, and bone pain
• Low white or red blood cell counts (neutropenia or anemia)
• Low platelet count (thrombocytopenia)
• Diarrhea
• Cytokine Release Syndrome (CRS)
• Neurological Toxicities

Programmable nanoparticles will carry cancer-killing drugs to tumors.

Programmable nanoparticles are being tested to deliver drugs directly to cancer cells. BIND Therapeutics, now part of Pfizer, developed a novel approach to cancer treatment using nanomaterials called Accurins. These nanoparticles are designed to deliver drugs directly to cancer cells, enhancing the effectiveness of the treatment while minimizing side effects.

Accurins can be programmed to recognize and bind to specific markers on the surface of cancer cells, ensuring that the drug is delivered precisely where needed. This delivery method increases the local drug concentration, improving treatment outcomes. Furthermore, Accurins minimize exposure to healthy tissues, reducing the side effects commonly associated with traditional chemotherapy, making them one of the most potent alternatives to consider.

The side effects of these nanoparticles are generally related to the payload they carry. For instance, with AZD2811, typical side effects might include those associated with kinase inhibitors, such as fatigue, nausea, and hematologic toxicities. Accurins can reduce the frequency and severity of side effects compared to traditional formulations by providing more targeted delivery and controlled release.

Another company, CytImmune Sciences, is developing nanomedicine-based cancer treatments for solid tumors. Their approach uses engineered gold nanoparticles to deliver therapeutic agents to the tumor site. One of their key innovations is the inclusion of TNF alpha on their nanoparticles. 

TNF alpha helps remodel the tumor microenvironment, making it easier for the nanoparticles and other co-delivered therapies to penetrate and accumulate inside the tumor. By disrupting the tumor’s blood vessel networks and reducing high fluid pressure inside tumors, their nanoparticles enable deeper and longer retention of therapeutic agents.

Conclusion

These advanced alternatives will be administered along with chemotherapy to increase its efficacy with reduced side effects. This is a win-win situation for existing drug and chemotherapy-infusion device manufacturers and players at other levels in the value chain.

However, market-ready approaches are not available for all cancer types. They are still in phase-4 trials. Studies on their pharmacological and toxicological aspects are ongoing to broaden the scope and applicability to more cancer types. 

Discovering companies developing revolutionary, viable treatments and ensuring the compatibility of new technologies with existing regulations and protocols requires extensive research. GreyB understands the value of finding solutions and how innovation works.