{"id":2689,"date":"2020-03-04T11:08:40","date_gmt":"2020-03-04T11:08:40","guid":{"rendered":"https:\/\/tansan.com.tr\/?p=2689"},"modified":"2020-09-11T14:24:11","modified_gmt":"2020-09-11T14:24:11","slug":"kanser-tedavisinde-gelismeler","status":"publish","type":"post","link":"https:\/\/tansan.com.tr\/en\/kanser-tedavisinde-gelismeler\/","title":{"rendered":"Advances in Cancer Treatment"},"content":{"rendered":"<p>Cancer is a disease that has existed since the dawn of humanity. The first steps in modern cancer treatment were taken after World War II. The successful use of drugs in cancer treatment began in the 1970s.<\/p>\n<p>The treatment of cancer with drugs is called chemotherapy, and these drugs are called chemotherapy drugs. The most important reason for using drug therapy in cancer treatment is that cancer is generally a systemic disease (i.e., a disease affecting many organs of the body). Of the three treatment methods (surgery, radiotherapy, and chemotherapy) that play a role in cancer treatment, drug therapy, or chemotherapy, is the only treatment method that can affect the entire body systemically. The common characteristic of the drugs used in chemotherapy is that they damage cells with a high rate of division\/growth. Since cancerous cells are generally cells with a very high growth rate, they are damaged by these drugs. These drugs also affect the body&#039;s normal cells that have a high division rate. As a result, common side effects of chemotherapy drugs can occur: nausea, decreased blood counts, hair loss, etc. One of the most important differences between cancerous cells and normal cells is that normal cells can repair themselves, while cancerous cells cannot fully repair themselves. While normal cells can recover from the effects of chemotherapy within two to three weeks, cancerous cells cannot and can die after repeated chemotherapy treatments.<\/p>\n<p>While chemotherapy alone can be curative in some cancers (such as lymph node cancers, breast and ovarian cancers, etc.), in other cases the cancerous cells develop resistance to the chemotherapy drug, and the disease reappears either immediately or after a while. There are two important reasons for this:<\/p>\n<ol>\n<li>Cancer cells developing resistance to chemotherapy drugs<\/li>\n<li>Because drugs also affect normal cells, they cannot be given in high doses to destroy all cancerous cells.<\/li>\n<\/ol>\n<p>In recent years, there have been significant advances in chemotherapy drugs and applications. New, more effective drugs are being introduced into treatment (e.g., nab-paclitaxel, liposomal drugs), the side effects of chemotherapy are being reduced thanks to new supportive medications (e.g., serotonin antagonists for nausea; G-CSF for patients with low blood counts \u2013 low leukocytes), new treatments against drug resistance are being investigated (e.g., MDR modulators, drugs that increase DNA damage), and new drugs are being developed that target only cancerous cells and do not harm normal cells (antivascular drugs, humanized antibody therapies that block growth factors).<\/p>\n<p>To treat cancer more effectively, in addition to chemotherapy, we need drugs that target the cause or mechanism of cancer. In the coming years, these types of treatments will be the most effective forms of cancer therapy. While some of these treatments are still in the experimental phase, others are already being used on humans, and we will have the opportunity to use many of them routinely within the next five years.<\/p>\n<p>The main new treatments are as follows:<\/p>\n<ol>\n<li><b>Drugs that prevent blood vessel formation (Angiogenesis inhibitors):<\/b>\u00a0Cancer cells depend on receiving oxygen and nutrients from the bloodstream to grow and multiply. To this end, cancer cells secrete certain substances to form their own capillaries. After a while, these capillaries allow the cancer cells to enter the bloodstream, reach other organs, and metastasize. Experiments have shown that if the formation of capillaries by cancer cells can be prevented, the cancer cells can neither multiply nor metastasize. One of the most important discoveries of recent years is the discovery of a group of substances that prevent cancer cells from forming capillaries, and the creation of other substances that can perform the same function. Many of these substances (angiogenesis inhibitors), numbering over ten, are currently being used therapeutically on humans. In this way, even if cancer cells are not destroyed, they will neither be able to grow nor metastasize. Thus, even if cancer is present in the body, it will not harm us. With the help of these drugs, it may be possible to live healthily even with cancer.<\/li>\n<li><b>Biological medicines:<\/b> Kanser tedavisinde en \u00f6nemli geli\u015fmelerden biri kanserin biyolojisine y\u00f6nelik tedaviler. Baz\u0131 kanserlerde a\u015f\u0131r\u0131 bulunan ve kanserin tedavisini zorla\u015ft\u0131ran baz\u0131 biyolojik mekanizmalara kar\u015f\u0131 genetik teknoloji kullan\u0131larak antikor s\u0131n\u0131f\u0131nda bir\u00e7ok ila\u00e7 geli\u015ftirildi ve geli\u015ftirilmekte. Bu devrin ilk \u00fcr\u00fcnleri g\u00fcn\u00fcm\u00fczde baz\u0131 lenf bezi kanserlerinde ve meme, kolon, akci\u011fer kanserlerinde ba\u015far\u0131 ile uygulanmakta. Bunlar\u0131n aras\u0131ndaki en \u00f6nemli ila\u00e7lar immunoterapi ila\u00e7lar\u0131d\u0131r. Immunoterapi denen bu y\u00f6ntemde t\u00fcm\u00f6rle sava\u015fan v\u00fccut h\u00fccrelerinin \u00fcst\u00fcndeki PD-1 veya t\u00fcm\u00f6r h\u00fccrelerinin PD-1\u2019e ba\u011flanmak i\u00e7in kulland\u0131klar\u0131 PDL-1 molek\u00fclleri hedef al\u0131n\u0131yor. \u015e\u00f6yle ki, t\u00fcm\u00f6r h\u00fccrelerle zarlar\u0131ndaki PDL-1 ile ba\u011f\u0131\u015f\u0131kl\u0131k h\u00fccrelerinin PD-1 a\u011f\u0131zc\u0131\u011f\u0131na ba\u011flan\u0131yor ve ba\u011f\u0131\u015f\u0131kl\u0131k h\u00fccrelerini bir nevi uyutarak etkisiz hale getiriyor. E\u011fer ba\u011f\u0131\u015f\u0131kl\u0131k h\u00fccreleri \u00fcst\u00fcndeki PD-1 bir antikorla bloke edilirse bu h\u00fccreler kuvvetleniyor ve aktive olarak t\u00fcm\u00f6r h\u00fccrelerine sald\u0131rarak onlar\u0131 yok ediyorlar. \u0130lk olarak geli\u015ftirilen anti PD-1 antikorlar\u0131 Nivolumab (tic. \u0130smi Opdivo) ve Pembrolizumab (Tic. \u0130smi Keytruda), akci\u011fer kanserli hastalar\u0131n %15-50\u2019sinde yarar g\u00f6sterebiliyorlar. Hangi hastalarda daha yararl\u0131 olabildiklerine ili\u015fkin en \u00f6nemli g\u00f6sterge t\u00fcm\u00f6rdeki mutasyon y\u00fck\u00fc. Her megabase genetik materyelde 18\u2019den fazla mutasyon mevcutsa buna y\u00fcksek mutasyonal y\u00fck deniyor (yani t\u00fcm\u00f6rde \u00e7ok mutasyon var) ve bu \u015fimdiye kadar ki en iyi g\u00f6sterge. Bunu tayin etmek i\u00e7in t\u00fcm\u00f6r blo\u011funun genomik analizinin yap\u0131lmas\u0131 gerekiyor. \u0130kinci \u00f6nemli g\u00f6sterge t\u00fcm\u00f6r dokusunda PDL-1 ekspresyonunun immunohistokimya y\u00f6ntemiyle saptanmas\u0131. Bu ekspresyon ne kadar y\u00fcksekse immunoterapi ila\u00e7lar\u0131n\u0131n \u00e7al\u0131\u015fma olas\u0131l\u0131\u011f\u0131 o denli y\u00fcksek oluyor.<br \/>\nImmunoterapi ila\u00e7lar\u0131 halen akci\u011fer kanserlerinde Evre IV hastalar\u0131nda birinci ve ikinci kademede ve yeni yeni kemoterapi ila\u00e7lar\u0131 ile birlikte birinci kademede kullan\u0131l\u0131yorlar. Di\u011fer \u00e7e\u015fitli kanser t\u00fcrlerinde de (ba\u015f boyun, triple negatif Meme kanseri, yemek borusu ve mide kanserleri, b\u00f6brek kanser, karaci\u011fer kanseri, mesane kanserleri) art\u0131k standart tedavide kullan\u0131l\u0131yorlar. Bu ila\u00e7lar\u0131n avantajlar\u0131, e\u011fer hastal\u0131k bu ila\u00e7lara cevap verirse, cevap s\u00fcresi olduk\u00e7a uzun oluyor (ortalama bir bu\u00e7uk seneden uzun). \u0130la\u00e7lar\u0131n sa\u00e7 d\u00f6kme, bulant\u0131 ve kan say\u0131mlar\u0131n\u0131 d\u00fc\u015f\u00fcrme gibi yan etkileri yok. Tam tersine ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 kuvvetlendirebiliyorlar. En ciddi yan etkisi de ba\u011f\u0131\u015f\u0131kl\u0131k h\u00fccrelerinin \u00e7ok kuvvetlenip aktive olup normal dokulara sald\u0131rmas\u0131. Olduk\u00e7a nadir g\u00f6r\u00fclen bu yan etki hastlar\u0131n %2-5\u2019inde ortaya \u00e7\u0131k\u0131yor ve imm\u00fcn pn\u00f6moni, kolit, tiroidit, veya hepatit \u015feklinde en s\u0131k ortaya \u00e7\u0131k\u0131yor. Kortizon tedavisi ile iyile\u015fme oran\u0131 %100\u2019e yak\u0131n oluyor<\/li>\n<li><b>Small molecules:<\/b> The most important of these, tyrosine kinase inhibitors, can make significant contributions to treatment by affecting targets in cancer cells that differ from those in normal cells. In some types of lung cancer (such as adenocarcinoma lung cancer with EGF-R receptor mutations), the orally administered tyrosine kinase inhibitor erlotinib can be more effective than chemotherapy and exhibits a very positive profile in terms of side effects. Two new generation drugs (afatinib and osimertinib) have now been introduced to the market. These can show benefit in cases resistant to erlotinib. Osimertinib (trade name Tagrisso), in particular, is both more effective than erlotinib and effective in brain metastases. In renal cell carcinoma, which is kidney cancer, numerous tyrosine kinase inhibitors have shown much more beneficial results compared to oral chemotherapy.<\/li>\n<li><b>Cancer vaccines:<\/b>\u00a0While partly related to the immune system, cancer vaccines, aided by recent advances in research, represent a significant breakthrough in cancer treatment. The discovery of certain substances found in cancerous cells but not in normal cells was the first step in this direction. Experimental studies have shown that by selectively stimulating the immune system against these substances, cancerous tissue can be rejected by the body. Human trials are currently ongoing. We expect these vaccines to be used within the next five years, particularly in early stages, to prevent cancer from recurring (adjuvant therapy).<\/li>\n<li><b>Drugs that transform cancer cells into normal cells:<\/b>\u00a0It was first demonstrated some time ago that cancerous cells can be transformed into normal cells by medication, using all-trans retinoic acid in a type of blood cancer (acute promyelocytic leukemia). Studies with such drugs are being conducted on other types of cancer, and it is thought that by increasing the quality and quantity of these transforming agents, it may be possible to utilize them in more common cancers in the near future.<\/li>\n<li><b>Gene therapy:<\/b>\u00a0Cancer is essentially a disease caused by genes within a cell failing to perform their functions for some reason. Two groups of genes play a crucial role in the cell. One group tells the cell that it needs to grow and divide. Another group tells the cell that it has grown sufficiently and that it should stop growing and perform its function. Cancer largely results from an imbalance between these two groups of genes. If the genes that promote growth work excessively, or if the genes that inhibit growth work insufficiently, or if they malfunction for any reason, then the cell continues to divide and grow, becoming a cancerous cell. The aim of gene therapy in cancer is to restore this imbalance, meaning to stop the genes that cause cancer by working harder, or to reactivate the genes that are not working and thus preventing cancer development. The most important of the genes that stop cancer is the P53 gene. When this gene is not working, it plays a significant role in the formation of many cancers (one of the most important mechanisms by which smoking causes cancer is that the substances in smoke disable P53). Experimentally, it has been shown that when a new P53 gene is introduced into a cancerous cell, the cell&#039;s cancer development stops. Following this, researchers in the US injected healthy P53 into the cancerous tissue of nine lung cancer patients, and in eight of them, the cancers almost completely disappeared. Now, the biggest obstacle for researchers is getting the healthy P53 to reach all the tissues where the cancer has spread. Studies are ongoing in this area, and it is thought that this treatment could be successful using viruses similar to the influenza virus, which are harmless to humans.<\/li>\n<\/ol>\n<p>In conclusion, we hope to use new, effective, and low-side-effect treatments for cancer in the coming years. These treatments will most likely not be a cure for cancer on their own. Cancer is not a relatively simple event like a microbial disease. For a definitive cure, we will need to use all these treatments, including chemotherapy, in a specific order or in combination. Perhaps instead of completely eradicating cancer, we will learn to control it and live with it.<\/p>","protected":false},"excerpt":{"rendered":"<p>Cancer is a disease that has existed since the beginning of humanity. The first steps in modern cancer treatment were taken after the Second World War. The successful use of drugs in cancer treatment began in the 1970s. Treating cancer with drugs is called chemotherapy, and these drugs are called chemotherapy drugs. The most important reason for using drug therapy in cancer treatment is that cancer is generally a systemic disease (meaning it affects many parts of the body).<\/p>","protected":false},"author":3,"featured_media":2664,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[518],"tags":[],"class_list":["post-2689","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-kanser-teshis-ve-tedavisi"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Kanser Tedavisinde Geli\u015fmeler - \u00d6zel Tansan Poliklini\u011fi<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/tansan.com.tr\/en\/kanser-tedavisinde-gelismeler\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Kanser Tedavisinde Geli\u015fmeler - \u00d6zel Tansan Poliklini\u011fi\" \/>\n<meta property=\"og:description\" content=\"Kanser insanl\u0131\u011f\u0131n ba\u015flang\u0131c\u0131ndan beri varolan bir hastal\u0131k. Kanserin modern tedavisinde ilk ad\u0131mlar ikinci d\u00fcnya harbinden sonra at\u0131lm\u0131\u015f. Kanserin tedavisinde ila\u00e7lar\u0131n ba\u015far\u0131l\u0131 bir bi\u00e7imde kullan\u0131lmaya ba\u015flanmas\u0131 1970&#8217;leri buluyor. Kanserin ila\u00e7larla tedavi edilmesine kemoterapi, bu ila\u00e7lara da kemoterapi ila\u00e7lar\u0131 deniyor. Kanserin tedavisinde ila\u00e7 tedavisinin kullan\u0131lmas\u0131n\u0131n en \u00f6nemli nedeni kanser hastal\u0131\u011f\u0131n\u0131n genelde sistemik bir hastal\u0131k (yani v\u00fccudun bir\u00e7ok\" \/>\n<meta property=\"og:url\" content=\"https:\/\/tansan.com.tr\/en\/kanser-tedavisinde-gelismeler\/\" \/>\n<meta property=\"og:site_name\" content=\"\u00d6zel Tansan Poliklini\u011fi\" \/>\n<meta property=\"article:published_time\" content=\"2020-03-04T11:08:40+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-09-11T14:24:11+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/tansan.com.tr\/wp-content\/uploads\/2020\/03\/blog_post1.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"500\" \/>\n\t<meta property=\"og:image:height\" content=\"250\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"admin_A\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin_A\" \/>\n\t<meta name=\"twitter:label2\" content=\"Estimated reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"10 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/tansan.com.tr\/kanser-tedavisinde-gelismeler\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/tansan.com.tr\/kanser-tedavisinde-gelismeler\/\"},\"author\":{\"name\":\"admin_A\",\"@id\":\"https:\/\/tansan.com.tr\/#\/schema\/person\/b82493f5f7dd55b8243b478922f5177f\"},\"headline\":\"Kanser Tedavisinde Geli\u015fmeler\",\"datePublished\":\"2020-03-04T11:08:40+00:00\",\"dateModified\":\"2020-09-11T14:24:11+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/tansan.com.tr\/kanser-tedavisinde-gelismeler\/\"},\"wordCount\":2028,\"publisher\":{\"@id\":\"https:\/\/tansan.com.tr\/#organization\"},\"image\":{\"@id\":\"https:\/\/tansan.com.tr\/kanser-tedavisinde-gelismeler\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/tansan.com.tr\/wp-content\/uploads\/2020\/03\/blog_post1.jpg\",\"articleSection\":[\"Kanser Te\u015fhis ve Tedavisi\"],\"inLanguage\":\"en-GB\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/tansan.com.tr\/kanser-tedavisinde-gelismeler\/\",\"url\":\"https:\/\/tansan.com.tr\/kanser-tedavisinde-gelismeler\/\",\"name\":\"Kanser Tedavisinde Geli\u015fmeler - 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\u00d6zel Tansan Poliklini\u011fi","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/tansan.com.tr\/en\/kanser-tedavisinde-gelismeler\/","og_locale":"en_GB","og_type":"article","og_title":"Kanser Tedavisinde Geli\u015fmeler - \u00d6zel Tansan Poliklini\u011fi","og_description":"Kanser insanl\u0131\u011f\u0131n ba\u015flang\u0131c\u0131ndan beri varolan bir hastal\u0131k. Kanserin modern tedavisinde ilk ad\u0131mlar ikinci d\u00fcnya harbinden sonra at\u0131lm\u0131\u015f. Kanserin tedavisinde ila\u00e7lar\u0131n ba\u015far\u0131l\u0131 bir bi\u00e7imde kullan\u0131lmaya ba\u015flanmas\u0131 1970&#8217;leri buluyor. Kanserin ila\u00e7larla tedavi edilmesine kemoterapi, bu ila\u00e7lara da kemoterapi ila\u00e7lar\u0131 deniyor. 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