Apollo Cancer Conclave

‘Apollo Cancer Conclave’ throws light on new innovations that will immensely benefit the patients & aid physicians to effectively treat cancers

Hyderabad, February 8th, 2017 : The 3rd edition of APOLLO CANCER CONCLAVE & 7th edition of their biennial CANCER CI – 2017 conducted from 2nd to 5th February 2017, at HICC, Hyderabad, was a resounding success, with a record 2340 delegates attending it. Globally acclaimed faculty comprising of Basic research Scientists, site specific Cancer experts, presented their data, participated in patient specific case discussions, issue based discussions and highlighted several recent innovations.

The advent of these new innovations will immensely benefit the patients and aid treating physicians to effectively combat cancer.

Robotic Surgery

Newer techniques of Robotic Surgery which can be used for newer areas and with more ease, were presented.

TOMOTHERAPY & Proton therapy

Advanced Radiation techniques, Tomotherapy & Proton therapy will drastically bring down the treatment duration and will replace Surgery in several areas of Cancer treatment. Also the whole body Radiation, whole marrow Radiation, multiple site treatment can be done in one go, making treatment less traumatic.

Liquid Biopsy

The hallmark of modern era cancer care is ‘Tailored therapy’ as it has been identified that ‘every patient is different.’ This tailored therapy relies on the determination of molecular targets on the tumour.

Liquid biopsies are non-invasive blood tests that detect circulating tumour cells and cell free tumor DNA, that are shed from the tumour and thus compliment an invasive biopsy.

Liquid biopsy can be used to identify these targets and modify treatments, apart from their primary role in diagnosis. It also helps in identifying sensitivity of tumour to various chemotherapeutic agents. Liquid biopsy can also be used to predict the toxicity of a particular therapeutic agent by pharmacogenetic analysis.

Pharmacogenomic Profiling

Most cancer drugs are effective in only a fraction of patients who take them. Identification of this responsive subset of patients would spare useless cytotoxic treatment. This sensitivity is identified by pharmacogenomics profiling. This can be done on tumor tissue or on Liquid biopsy.

Genetic Tests in disease & screening

Gene mutations that lead to cancer may be inherited from a parent or may happen spontaneously during a person’s lifetime. Genetic testing is the process of using medical tests to look for these changes in a person’s genes lost chromosomes. Genetic testing is used to see if a person has certain gene mutates known to increase the rest for a certain cancer eg. BRCA mutation testing in Breast Cancer.

Immunotherapy, also called biologic therapy is a type of Cancer treatment designed to boost the body’s natural defenses to fight cancer. It uses substances either made by the body or in a laboratory to improve or restore immune system function.

Checkpoint Inhibitors (CPI) block normal proteins on cancer cells, or the proteins on the T-Cells that respond to them. CPI seek to overcome one of Cancer main defenses against an immune system attack.

Cancers which can be treated with Immunotherapy are

Melanoma – Nivolumab and Pembrolizumab.

Hodgkin’s Lymphoma – Nivolumab

Head & Neck Cancers – Nivolumab

Lung Cancers – Nivolumab & Pembrolizumab

Lung – New way of treating Cancer…

Immune checkpoints affect immune system functioning. Immune checkpoints can be stimulatory or inhibitory. Tumors can use these checkpoints to protect themselves from immune system attacks. Checkpoint therapy can block inhibitory checkpoints, restoring immune system function.

For example –

One such ligand-receptor interaction under investigation is the interaction between the transmembrane programmed cell depth 1 protein (PDCD1, PD-1; also known as CD279) and its ligand, PD-1 ligand 1 (PD-L1, CD274).

Many cancer cells express PD1-L1 protein on their surface so that the immune system recognizes this marker as our own cell that should not be killed. Our immune T cell have another protein that is called PD1 or check point protein that involved in the recognition of PD1-L1. When PD1 marker on the immune T cell interacts with PD1-L1 marker on cancer cell the T cell dies or gets inactivated. This way cancer kills our T cells of our immune system and gets stronger whereas our immune system gets weaker. The immunotherapy drugs block the PD1 check point on T cells so that they cannot interact with PD1-L1 on cancer cells and cannot get killed or inactivated. With the blocked check point (PD1) the T cells kill cancer cells without a problem. In summary PD1 is sitting on our T cells and PD1-L1 is sitting on cancer cells. And there is a battle between them. Either cancer cells kills T cell or T cell kills cancer cell.

Nivolumab, Pembrolizumab are the new approved drugs for usage in Lung cancer.

The immunotherapy drugs are known to be better than Chemotherapy in terms of response and survival.

Neuro Oncology

Hippocampal sparing while treating brain tumors will improve the QOL – Neurocognitive function and memory.

Immunotherapy in Brain Metastases

Treatment of brain metastases remains a challenge as most therapeutic agents do not cross the blood brain / barriers. Immunotherapy involves the activation of the immune system in T cells that cross the barrier. Recent studies have shown the efficiency of Pembrolizumab in treatment of Brain metastases in patients with melanoma and Lung Cancers.

Head & Neck Cancers

HPV virus induced Cancers are increasing in our country too. These tumors are mostly in the Oropharynx and throat and are highly curable with less intensive treatment. Immunotherapy in H&N cancers.