https://www.epo.org/en/node/therapies

Therapies

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The ultimate goal of cancer therapy is to eliminate both the tumour and circulating cancerous cells without harming healthy tissue. Despite the numerous therapies available today, total remission cannot be achieved for all cancers. The complexity of the disease makes developing safe and efficient treatments particularly difficult. The search queries in this section illustrate the range of tools available to oncologists and the multimodal approaches that can be used to attack cancer cells, reduce their spread and induce a systemic anti-cancer immune response against the primary tumour and metastases.

Surgery

The following datasets relate to invasive interventions that aim to ablate the solid tumour or at least shrink it. They cover patent documents aiming at improving the resection of the tumour without harming the surrounding tissues and the patient.

Conventional surgery

High-precision surgery includes any type of computer-aided surgery (CAS) with image-based planning and manual or (semi-)automatic execution. It includes real-time matching of pre-surgical images with live images to guide the surgeon to the regions of interest. Markers may be used to support the planning or ease repeated access.

Computer-aided surgery and robotics

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Markers

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Image correlation

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Treatment by cooling

Cooling therapy can be used during surgery to protect healthy tissue and reduce the risk of side effects. Cooling therapy may also be used to destroy cancer cells by freezing the tumour and surrounding tissue to provide a safety margin. The frozen tissue may then be removed surgically.

Use of an open-end probe

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In combination with an ultrasonic implement

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In combination with conventional excision surgery

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Treatment by heating

Cancer surgery heating, also known as thermal ablation, is a treatment that uses heat to destroy tumour cells. It can be performed during surgery or as a minimally invasive procedure. The use of heat can also reduce bleeding associated with surgery.

Ablation

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Coagulation with conventional excision surgery

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Passing current through tissue

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Electromagnetic radiation

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Localised ultrasound hyperthermia

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Electromagnetic radiation

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Including irradiation

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Coagulation treatment with single instrument

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Cell poration

This cancer treatment can be performed during surgery and uses electrical pulses to create pores in the cell membrane. This allows therapeutic agents to enter the cell more easily and kill the cancer cells.

Electroporation

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Ultrasound cell poration

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Radiotherapy

Radiotherapy, or radiation therapy, uses ionising radiation to kill cancer cells by damaging their DNA. The process of cancer cell death and their removal by the body takes place sometime after exposure to ionising radiation, i.e. the death of cancer cells is not immediate. There are two main radiotherapy types depending on how the radiation is delivered: radiation sources are brought near to the cancer cells (brachytherapy) or radiation is targeted at the cancer cells from outside the body (external radiotherapy).

Brachytherapy

In brachytherapy, radiation sources are placed inside or next to the tumour. This allows a higher dose of radiation to be delivered to the cancer cells while minimising damage to healthy tissue.

General aspects of brachytherapy

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The following datasets distinguish different brachytherapy types based on the delivery location of the radiation source:

Delivered to body lumens, e.g. vessels

Intraluminal radiation therapy

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Delivered to natural body cavities or cavities generated by surgery

Intracavitary radiation therapy

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Delivered through the patient's skin, e.g. using needle-like devices

Interstitial radiation therapy

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External radiotherapy

In external radiotherapy, high-energy X-rays or particle beams are directed at the tumour from outside the body. The accuracy of the beam's location and the control of its intensity are essential to provide an effective treatment that reduces damage to the surrounding healthy tissues. The following datasets concern specific aspects of external radiotherapy:

Radiation is guided in real time using medical images

Image-guided radiotherapy

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Adaptation of treatment parameters to changes in a patient's anatomy or to previous treatments

Adaptive radiotherapy

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Modulation of the beam intensity using e.g. multi-leaf collimators

Intensity-modulated radiation therapy (IMRT)

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Modulation of the beam intensity during movement of a gantry

Intensity-modulated arc therapy (IMAT)

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Use of proton or ion beams

Radiotherapy using charged particles

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Particles are generated by target irradiation with laser light

Particle beam generation using lasers

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Ultra-high-dose-rate radiotherapy, i.e. higher than 40 grays per second

FLASH radiotherapy

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Use of an isotope such as boron-10 to emit highly localised alpha particles (NCT)

Neutron capture therapy

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Radiotherapy planning with AI

The following dataset relates to the use of artificial intelligence (AI) in radiotherapy planning to improve the accuracy, efficiency and consistency of radiotherapy planning, leading to better patient outcomes. AI algorithms can automate and enhance various aspects of the planning process, leading to a significant reduction in the time needed for planning.

AI in radiotherapy planning

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Photodynamic therapy

Photodynamic therapy is a minimally invasive treatment that uses light and a photosensitiser to kill cancer cells. The photosensitiser is delivered to the cancer cells, e.g. by injection into the bloodstream or application to the skin. After its exposure to light of a specific wavelength, it produces reactive oxygen species that kill cancer cells.

Apparatus for photodynamic therapy

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Hyperthermia

Hyperthermia is an adjuvant to cancer treatment and involves heating body tissues to temperatures above physiologically normal values in the range of 40-43°C that are not high enough to directly destroy the cells. Hyperthermia apparatus use energy sources such as radio waves or microwaves to heat cancer cells. Hyperthermia is normally used in combination with (as an adjuvant to) radiotherapy and/or chemotherapy.

Apparatus for hyperthermia therapy

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Classical chemotherapy

Because they have acquired genetic mutations, cancer cells are highly proliferative. A further consequence of the genetic mutations is a lack of control and repair of genome damage. Chemotherapy targets the fast-growing cells and induces their death by necrosis, apoptosis or autophagy, e.g. through induction and accumulation of DNA damage or through inhibition of cell division. The following datasets relate to classes of chemotherapeutic agents.

Alkylating and alkylating-like agents

Nitrogen mustards

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Nitrosoureas

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Platinum agents

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Further alkylating agents

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Non-alkylating agents

Non-alkylating DNA-damaging agents and topoisomerase inhibitors

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Anti-metabolites

Anti-folates

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Anti-purines

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Anti-pyrimidines and cytidine analogues

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Anti-microtubule agents

Vinca alkaloids

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Taxanes

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Epothilones, auristatin and others

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Targeted therapy

Research over the past decades has unravelled the signalling pathways activated by cancer cell mutations that promote cancer cell proliferation, change in differentiation (epithelial-mesenchymal transition), angiogenesis and dissemination. Treatments based on this research target a cancer's specific genes, proteins or tissue environment (including blood vessels) that contribute to its growth and survival. These treatments are more focused and often cause fewer side effects than chemotherapy. These datasets therefore cover patent documents relating to the targeting of specific pathways activated in cancer cells, which ultimately leads to tumour growth reduction or even tumour eradication.

Protein kinase inhibitors

Receptor protein kinase inhibitors

Receptor tyrosine kinases (RTKs) are essential in regulating cellular processes such as growth, differentiation, metabolism and motility. RTKs transduce extracellular signals to the cytoplasm. Receptor tyrosine kinase inhibitors (R-TKIs) reduce phosphorylation and hence activation of their substrates and inhibit the proliferation or survival of cancer cells.

ALK inhibitors

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c-MET inhibitors

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HER1-4 inhibitors

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FGFR inhibitors

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PDGFR inhibitors

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RET inhibitors

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TAM family inhibitors

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TRK inhibitors

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VEGFR inhibitors

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Non-receptor protein kinase inhibitors

Non-receptor tyrosine kinases (NRTKs) are intracellular proteins that relay signals essential in regulating cell adhesion or cell growth. Non-receptor tyrosine kinase inhibitors (NR-TKIs) reduce phosphorylation and hence activation of their substrates and accordingly block activation of downstream signalling pathways that favour the survival or proliferation of cancer cells.

BCR-ABL inhibitors