It is perhaps one of the biggest health threats that developed countries will face. The International Agency for Research on Cancer (IARC), an agency of the World Health Organization (WHO), presented a catastrophic scenario at the start of the year: an increase of 77% in annual cases is expected between 2022 and 2050. In France, the number of cancers has already doubled in thirty years, affecting 433,136 individuals in 2023. Faced with this imminent wave of affected people, research is activating and launching into a frantic time trial. Today, all eyes are on immunotherapy, the latest breakthrough innovation that appeared in 2010 in the treatment of cancers and whose full benefits remain to be discovered.
Concretely, immunotherapy aims to activate the patient’s immune system so that it attacks the tumor on its own. And this is the difference with previous treatments, which consisted of targeting cancer cells using elements external to the individual. While there are several forms of immunotherapy, one of the main areas of research comes from vaccines. And more particularly messenger RNA, brought to light during the Covid-19 crisis. At the Esmo congress, the great European mass of oncology which took place in Barcelona from September 13 to 17, a very first study on humans of an experimental immunotherapy based on messenger RNA showed positive results on lung and skin cancers. But this technology has several limitations and makes some scientists skeptical.
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40% of “avoidable” cases
“In a patient population where there are less than 10% of tumor antigens in common, it is difficult to make a universal vaccine”says Professor Bruno Quesnel, director of the research and innovation center at the National Cancer Institute (Inca). In reality, research has made a huge leap in understanding tumors. “We have learned over the last ten years that we all have, in our tissues, cells carrying mutations which are characteristic of cancers, says Éric Solary, vice-president of the ARC foundation for cancer research. Some appear from childhood. And for a very long time, our body can control them. But inflammation can suddenly cause one of these cells to lose control and become cancer. »
A discovery highlighted by the arrival of new machines allowing the isolation, one by one, of cancer cells, as well as their individual sequencing. The whole question now remains to know the reason for the departures from cancer. Tissue inflammation seems to be the preferred avenue. Concretely, it would promote the transformation of a cell carrying genetic alterations into a cancer, whereas this same cell was until now controlled by the surrounding tissues. New tumor analysis technologies, now more precise, will perhaps be able to accelerate the discovery of this origin but also make it possible to understand the evolution of a tumor over time, particularly in very elderly people.
« If there is no foreseeable progression of cancer in the following decade, then we could choose to abstain from treatment in order to optimize the patient’s quality of life. », explains Bruno Quesnel. In addition to treatments, research is also and above all focused on prevention. It is estimated that 40% of so-called preventable cancers are present today. If risk factors such as alcohol, tobacco or even UV rays have already been widely proven, other studies are underway to identify new elements in our environment likely to increase the appearance of tumors. A long and complicated job that artificial intelligence could revolutionize.
Personalization of screenings
Recently, in a study carried out in Denmark as well as the United States, researchers applied an artificial intelligence algorithm to clinical data from 9 million patients. Result: AI could now predict the development of pancreatic cancer up to three years in advance. The long-term objective is also to better personalize screening according to individual risk. This is why the European Commission has set up a European Health Data Space (EEDS) since June. “It will take ten years for this space to be fully operational,” estimates Professor Éric Solary. Cancer research data will then be able to circulate throughout Europe so that researchers, subject to authorization by an ethics committee, can analyze them. »
And this thanks to an application on your phone where it will be possible to enter your personal data but also to block or not their sending to scientists. “The challenge is to put in place a system that does not target the citizen”underlines the researcher before concluding: “The hope now is that the processing of the massive data generated by the analysis of cancers will lead to a new breakthrough discovery to prevent, detect or treat cancer, for example by acting instead on the tissues around the tumor” , concludes the researcher
