The Future of Immunotherapy: A Revolution in Cancer Medicine from Earth to?Space KellyOnTech

Cancer, often referred to as the "king of all diseases," affects millions of people worldwide each year. According to data released by the World Health Organization (WHO) in 2023, the three most common cancers by incidence are lung, breast, and thyroid cancer.

What is the New Global Drug King?

In 2023, Keytruda (pembrolizumab) became the world’s top-selling drug, generating $25 billion in sales. Keytruda was developed by Merck & Co., known as MSD (Merck Sharp & Dohme) outside the U.S. and Canada.

Keytruda is an immunotherapy drug that was first approved by the U.S. Food and Drug Administration (FDA) in 2014 for the treatment of advanced melanoma and has since been approved for the treatment of many other types of cancer.

This issue talks about the hottest research field in cancer treatment – immunotherapy.

Immunotherapy Treatment Ideas

Immunotherapy is an exciting new approach in the fight against cancer. Traditional treatments like chemotherapy and targeted therapies treat tumors as external threats. Immunotherapy, however, represents a new era. The human body produces a cancer cell every seven minutes, yet most people do not develop cancer because their immune system effectively eliminates these cells.

Immunotherapy works by harnessing the body’s own strength, enhancing the immune system’s ability to fight cancer. Rather than focusing on attacking the enemy, it aims to restore the body’s natural balance, creating a healthier internal environment to combat the disease.

CAR-T Cell?Therapy

One approach in immunotherapy is CAR-T cell therapy, which uses the patient’s own immune system to target and destroy cancer cells. The treatment process is as follows:

1. T Cell Collection: The process begins by extracting T cells, a type of white blood cell that normally fights infections, from the patient’s blood.
2. Modifying T Cells: In the lab, scientists genetically modify these T cells by adding a chimeric antigen receptor (CAR). This receptor enables the T cells to recognize and attack cancer cells more effectively.
3. Expanding T Cells: Once modified, the CAR-T cells are grown in large quantities to ensure there are enough to combat the cancer.
4. Re-infusing T Cells: The modified CAR-T cells are then infused back into the patient, where they seek out and destroy cancer cells.

The key advantage of CAR-T cell therapy is its ability to specifically target cancer cells. For instance, Keytruda works by blocking a protein called PD-1 (programmed death receptor-1) on the surface of T cells, helping the immune system better recognize and attack cancer cells.

However, CAR-T therapy can also cause side effects. As the CAR-T cells destroy large numbers of cancer cells, they release significant amounts of signaling molecules called cytokines, which can lead to symptoms such as fever, fatigue, and low blood pressure?—?sometimes severe. Additionally, some patients may experience neurological side effects, including headaches, confusion, memory loss, and in more severe cases, difficulty speaking or moving.

Natural Killer Cell?Therapy

Another approach to immunotherapy is to use natural killer cells in the human immune system to fight cancer.

Natural killer (NK) cells are a type of white blood cells that naturally exist in the human body. Their main function is to recognize and kill abnormal cells, such as virus-infected cells or cancer cells. They are called “natural killer” cells because they can directly attack these abnormal cells without any prior activation.

In NK cell immunotherapy, doctors can use not only the patient’s own NK cells but also isolate them from healthy donors. These NK cells are expanded and activated in the lab to enhance their strength and ability to destroy cancer cells. The boosted NK cells are then infused back into the patient’s body, where they seek out and directly attack cancer cells, helping to control or eliminate tumors.

The advantage of enhanced NK cell therapy is its ability to target and destroy various types of cancer cells with minimal damage to healthy cells and fewer side effects. This therapy is still undergoing research and development.

Why Develop and Manufacture Drugs in the?Space

Currently, immunotherapy drugs can only be injected through an intravenous drip, causing long hours of pain for patients. If the concentration of the drug is increased, it can be injected under the skin, alleviating the pain. The key to doing this is protein crystallization technology.

We use 2D cell cultures for drug development currently, but these models don’t accurately reflect how the body responds. 3D cell cultures provide a better understanding of the body’s reaction to drugs. However, on Earth, gravity limits this process, causing 3D cultures to settle and flatten as they align. In space, without the influence of gravity, these cells can form more natural and complex structures.

While drug production in space offers many potential advantages, it also presents several challenges, including:

1. High costs: Space pharmaceutical production must take place on the International Space Station or other space facilities, which incurs significant expenses for transporting raw materials, equipment, and personnel into space. The launch and maintenance costs are substantial, making large-scale drug production less feasible at this time.
2. Complex logistics and transportation: Transporting raw materials from Earth to space, and returning the finished drugs, presents significant logistical challenges. The process is fraught with risks, including potential damage or contamination during transit.
3. Technical challenges: The microgravity environment in space affects the operation of production equipment and the stability of the drug production process. This requires specially designed equipment and technology to adapt to special conditions of space.
4. Regulatory and supervisory challenges: The cross-border collaboration and unique environment of space pharmaceutical production present additional hurdles for drug regulation and approval. Regulatory standards vary between countries, making it complex to unify guidelines and ensure compliance in space-based drug manufacturing.

Despite these challenges, pharmaceutical production in space remains a promising field, particularly for the research and development of new drugs. As technology continues to advance and costs decrease, space-based pharmaceuticals are likely to become more feasible and widely utilized in the future.

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