A movement is under way by researchers, doctors and entrepreneurs to find new ways to ease the dreaded side effects of chemotherapy for cancer patients. It is a much-needed effort, considering the statistics. According to the American Cancer Society, there will be 1.7 million new cancer diagnoses in the United States this year. In 2013, the most current year for which the society offers figures, the direct medical cost for cancer in the United States was $75 billion.
Common side effects for chemotherapy include hair loss, nausea and vomiting. Yet there are other side effects, such as nerve and bladder problems as well as extreme fatigue, that are much harder to tolerate. Worse yet, a recent global study, by Public Health England, an executive agency of the U.K.'s Department of Health, found that some patients receiving chemotherapy in 2014 died within 30 days of beginning treatment.
"Chemotherapy is a vital part of cancer treatment," said Dr. Jem Rashbass, cancer lead for Public Health England. "However, it is a powerful medication ... and often, getting the balance right on which patients to treat aggressively can be hard."
Thankfully, experimental technologies may give patients long-overdue relief. The following companies are working on new methods to make chemotherapy safer, and more tolerable, for patients.
Pictured here: Today, computer programs can create a "traffic map" of the proteins inside a cancer cell to pinpoint better treatment options.
From 2001 to 2005, former Wisconsin Gov. Tommy Thompson was Secretary of Health and Human Services in the administration of former President George W. Bush. Today he sits on the board of directors of Tyme Technologies, which is currently testing a combination therapy that includes melanin, melanotan and tyrosine isomers. The therapy, known as SM-88, has the potential to compromise a cancer's outer mucin layer by delivering an amino acid to the cancer cells. This would make it more vulnerable to chemotherapy and improve its effectiveness.
"By introducing this 'Trojan Horse' mechanism, SM-88 tricks the cancer into accepting it and then breaks down the cancer cell's defenses, thus allowing the body's immune system to eradicate the cells," Thompson told CNBC. "With metabolic therapy, there are no toxins or pathogens, just a path to starve the cancer and weaken it dramatically while bolstering the immune system."
Thompson said that Tyme's goal is to provide a compound for physicians to use in patients with breast, lung, prostate, gastric, esophageal and pancreatic cancers, which are altogether responsible for 62 percent of the annual cancer deaths in the United States.
"I personally look forward to the day, which I believe will come in my lifetime, when cancer is a treatable disease," Thompson said.
One of the more unpleasant parts of receiving chemotherapy is when the doctor accesses a patient's port to administer treatment. Relieving this pain would be a small but important part of making chemotherapy more tolerable for patients.
MMJ Labs, established in 2006 by CEO and pediatrician Dr. Amy Baxter, created Buzzy, a bumblebee-shaped device that combines cold with vibration to inhibit pain in patients, including those receiving chemotherapy.
"Any pain causes fight-or-flight reflexes, which get exhausting over time,'" Baxter said. "When a port is accessed, that hurts. Pain over time gets old, and Buzzy helps."
Baxter said that Buzzy has been adopted by more than 5,000 hospitals worldwide, including Sanford Health, Tucson Medical Center, Emory Healthcare and Kansas Mercy Children's, along with more than 20 studies that have evaluated it found that it reduced pain between 50 percent and 88 percent.
Bioquark is currently developing protein mixtures with the potential to change tumors back into normal tissue, as opposed to killing them with chemotherapy. If this sounds like a radical new approach, it's not. Such lower organisms, like jellyfish and worms, are able to naturally reverse tissue damage, and Bioquark is working to bring such regenerative biology to the human race.
"Our platform focuses on utilizing these novel biologics to 'reprogram' cancer cells in tumors to an earlier state when they were still normal," said CEO Ira S. Pastor. "Many lower organisms can replace lost or damaged organs and tissues that are identical in structure and function to the original, regenerating a wide variety of tissues, including spinal cords, limbs, hearts, eyes and even parts of their brains."
For all the side effects that chemotherapy patients endure, only 1 percent to 2 percent of the chemicals used in treatments actually reach the tumor. José M. Mejía Oneto, founder and CEO of Shasqi, said that his company has created a new drug-delivery method, which increases the amount that reaches the tumor by 10 times. It also decreases the side effects by remaining inactive until it reaches the tumor.
"Physicians often have access to tumors, for instance, with a needle at the time of biopsy," said Dr. Oneto, who holds a Ph.D. in organic chemistry from Emory University. "Shasqi's local drug-activation approach takes advantage of that physical access by injecting a polymer near the tumor. The polymer contains activating agents that do not exist anywhere else in the body. The patient then receives a specially modified, FDA-approved drug called doxorubicin. The modified drug is inactivated until it comes in contact with the gel."
Pictured here: Green cancer cells surrounded by normal cells.
Roger Holzberg is a cancer survivor and co-founder of Reimagine Well, a company founded in 2014 that creates customized virtual-reality treatment environments called Infusionariums. He knows firsthand that many facilities miss the mark when it comes to providing comfort to patients, so the Infusionarium was designed to let patients receive treatment in the simulated setting of their choice. The result has been rave reviews from patients, and staff members have even said that children being treated there actually look forward to their next visit.
"Every quarter, we ask patients, 'If you could heal anywhere in the universe and there were no rules, what place would best promote your healing?'" he said. "Then we put them in those places virtually, while they are in treatment. ... Anxiety and isolation negatively impact cancer outcomes; we reduce both of them."
Holzberg said that by the end of 2016, there will be 10 Infusionarium installations, at such locations as Children's Hospital of Orange County, Baptist Hospital South Florida, Miami Cancer Institute and St. Joseph Children's Hospital in Tampa. Although he wouldn't cite a specific dollar value, Holzberg said the cost varies from location to location.
"It's minimal for a hospital that has a digital network and screens in its patient rooms and broadcasts our educational programs and 'immersive healing experiences' themselves," he said. "The Infusionarium at the Miami Cancer Institute is part of a brand-new cancer center, built with a wall of 60-inch HD monitors, lighting effects, star curtains and images from the experiences around the room, like a theme-park experience, and this is much more costly."
Pictured here: At Reimagine Well, cancer patients can receive treatment in the setting of their choice.
Julian Aleksov is founder and executive chairman of Oasmia Pharmaceutical AB, a Swedish company that has created the excipient XR17. This transforms insoluble molecules into water-soluble nanoparticle formations. Aleksov kindly explained what this means in simpler terms, for the benefit of those of us without medical backgrounds.
"XR17 is essentially a drug-delivery system that, when combined with chemotherapeutic treatments, is more easily released into the bloodstream without added solvent," he said. "We can increase the amount of active pharmaceutical ingredient and give the patient a more potent drug. ... A potent drug is important because, as with all oncology treatments, the goal is to stop cancer cells from dividing, and ultimately to kill the existing cancer cells."
XR17 is used as a drug-delivery method for such medicines as Paclical, Docecal, Doxophos and OAS-19. While XR17 hasn't yet been approved by the FDA for human oncology products, Oasmia's veterinary product Paccal Vet-CA1, has conditional U.S. approval and is based on XR17 technology. XR17 is approved for use in Russia, Africa and several countries in the post-Soviet Commonwealth of Independent States.
Gateway for Cancer Research is a nonprofit organization that funds studies searching for that elusive, innovative cancer treatment breakthrough. Christopher R. Cogle, a professor of medicine at the University of Florida, is funded by it, and he and his team created a cancer treatment program that they named the Gateway impact framework in its honor.
The program analyzes a patient's cancer map and personalizes his or her diagnosis and treatment. CancerPOP, the company that was created in June 2016 to administer the framework, bills itself as "a one-stop precision cancer service," due to its highly targeted and patient-centric approach.
"CancerPOP reads cancer DNA, identifies misspellings in genes, creates protein traffic maps of the inside of cancer cells, and finds drugs that target those abnormal protein roadways," Cogle said. "The patient's information is then entered into a computer program that creates a 'traffic map' of the proteins inside the cancer cell. The patient's cancer protein traffic map is then used to digitally screen for drugs that fix the traffic jams."
CancerPOP is available to the public through Brio Ventures, in Newberry, Florida.
VAL-083 is a chemotherapy being developed by DelMar Pharmaceuticals to help treat glioblastoma multiforme (GBM), the most common and aggressive form of brain cancer. The treatment works by binding itself to a tumor cell's DNA and interfering with its cellular processes, which kills it.
DelMar Pharmaceuticals chairman and CEO Jeffrey Bacha said that the current standard treatment for GBM is surgery, followed by a combination of radiation and chemotherapy for six weeks, then chemotherapy alone for six months. He described the long-term success rate for GBM treatment under these circumstances as "generally poor," with side effects that can include memory loss, poor brain function and strokelike symptoms.
"VAL-083 attacks the tumor's DNA at a different point compared to current therapy," Bacha said. "If you imagine DNA as a twisted ladder, the chemotherapy-induced damage to the tumor's DNA can occur on the 'rungs' of the ladder or along the 'legs' of the ladder. ... VAL-083 works by binding the legs of the DNA ladder together. When the DNA unwinds in preparation for replication and cell division, the legs of the DNA ladder are broken. This is called a double-strand break, and it is one of the most potent and lethal types of DNA damage."
Bacha said that by focusing on and exploiting tumor DNA differently from current therapy, VAL-083's sidesteps the body's resistance mechanisms, which make other treatments less effective.
Current chemotherapy options for gastrointestinal neuroendocrine tumors may have limited outcomes for patients, some of whom may become resistant to it. Oscar Segurado, director of Medic Affairs Consulting, said that the company's compound, telotristat etiprate, can control serotonin production in tumor cells, thereby controlling tumor growth. Telotristat etiprate is currently under FDA review and is expected to be approved in early 2017 for patients with neuroendocrine tumors.
"[Studying] the physiological and behavioral functions of almost 5,000 genes in mice led to the discovery of drug candidates," he said. "Additional drug discovery and development programs have advanced into various stages of clinical and preclinical development, including identification and validation in animal models with promising profiles for drug discovery."
Traditional chemotherapy kills cancer cells with high doses of toxic treatments. The Cancer Biology and Evolution Program at the Moffitt Cancer Center in Tampa, Florida, has created what it hopes will be an alternative. Their treatment strategy, known as adaptive therapy, doesn't kill all the cancer cells. Instead, it leaves the patient with a small amount of cells that will still respond to treatment, which keeps the tumor responsive to therapy.
How does adaptive therapy work? According to a press release from the Moffitt Cancer Center, it "scales back treatment to reduce but not eliminate cells that are sensitive to the treatment. After the initial response, the cancer treatment is paused. ... By withdrawing treatment, adaptive therapy explicitly allows the tumor cells to regrow. Through repeated cycles of treatment and withdrawal, adaptive therapy tries to maintain a population of cells that is responsive to therapy, allowing for a longer period of tumor control."
Adaptive therapy is currently being tested in a clinical trial at the Moffitt Cancer Center for men with metastatic castrate-resistant prostate cancer.
"Our goal is to use the cells that we can influence to suppress the growth of cancer cells that we cannot treat," said Robert Gatenby, chair of radiology and co-director of the Cancer Biology and Evolution Program. "Adaptive therapy can maintain indefinite control of even highly aggressive tumors."
Pictured here: A Moffitt technician removes a rack of cells and biospecimens from the Moffitt Tissue Core, where samples are stored at -180 degrees Celsius for research at a later date.