This Belarusian researches cancer — here's what he says about SPF for melanoma, scientific progress, and the most difficult cancer to treat

How cancer and immunity are related

Maksim Domnich is a research fellow at the LMU University Hospital in Munich. He works in the field of oncoimmunology, meaning he researches the interaction between cancer and the immune system. Among the types of cancer he works with are, for example, melanoma, as well as head and neck cancer.

When Maksim came to Germany, he started working in a laboratory that primarily deals with neutrophils — immune cells that fight external aggressors like bacteria and viruses. But these cells are also interesting to oncologists:

"Under certain conditions, neutrophils can help cancer develop. When it arises, a tumor needs space to grow, and neutrophils facilitate this because their profile is precisely to destroy other cells.

Павялічыць

Cancer wants to survive, so it reshapes part of the immune system to its needs. It forces immune cells, which should protect our body, to engage in subversive activities. Several mechanisms of how this happens have already been discovered, but this process is quite complex and is being studied in many laboratories worldwide."

Maksim explains that if these cells are reprogrammed back into the body's "defenders," the immune system will work more effectively, and consequently, cancer treatment will be more successful.

One of the cancer treatment methods is precisely related to immunity. This is immunotherapy, and Maksim explains its action using an example of one of its variants — immune checkpoint inhibition.

Normally, the immune system has control points — checkpoints. These molecules prevent immune cells, which destroy viruses and tumors, from damaging healthy tissues. Cancer cells display a "decoy" protein on their surface: when an immune cell approaches a cancer cell, this protein signals that an attack is not necessary.

Checkpoint therapy works by special blocker drugs attaching to these "decoy" proteins and neutralizing them, so immune cells remain active and destroy the tumor.

HPV vaccinations? Great!

Before moving to Germany, Maksim worked at the Center for Epidemiology in Minsk. His laboratory there focused on HIV infection and hepatitis B and C, as well as HPV infection, because all these viruses often occur "in a package" — for example, through unprotected sex.

There, he worked in a team that also genotyped viruses, meaning they obtained their genetic sequence and observed how the virus mutates when it enters a different organism and different conditions — and the virus changes because it encounters the host's immunity.

"It's interesting to follow this, because when you see how the genome changes, you can hypothesize how it will change next. And then you can create a therapy that will be effective against new variants of the virus, especially now with the help of AI," Maksim explains.

In Minsk, he and his colleagues developed personalized therapy for HIV-infected individuals:

"You take the virus, sequence it (decode the genetic code of the virus. — "NN") and upload the result to an international database of HIV genomes. There, you can see which mutations make a particular drug ineffective. If you see such a mutation, you understand which drug is better not to prescribe.

Then, the person comes back in six months, we do a screening and see if new mutations have appeared that affect the effectiveness of the drugs."

By the way, how did the scientist react to the news that girls in Belarus have started receiving free HPV vaccinations?

"This is great, it's one of the ways to stop the HPV pandemic. Many people, if they don't suffer from HPV-associated diseases, are carriers of the virus.

Павялічыць

The HPV virus enters our body and can live there for 10, 20, 30 years; it integrates into the cell genome and reproduces, but the immune system sees these viral particles and kills them. But if, for some reason, immunity weakens, an infection begins. Then it's difficult to stop, because the virus reproduces faster than the immune system can handle it."

Vaccination is the most effective, safe, and inexpensive way to stop these processes, says the scientist.

Why SPF products are not a marketing lie

One type of cancer strongly linked to immunity is skin cancer, melanoma. And this is a disease for whose prevention there are many questions. It seems everyone knows that suspicious moles should be shown to doctors, but what about SPF creams, which we are so insistently advised to use daily in recent years? Are they really necessary?

Maksim is confident that it is not groundless and explains the mechanism:

"Cancer appears when a certain level of exposure accumulates on a particular tissue, in the case of melanoma, it's the skin. Sunlight contains a lot of ultraviolet radiation, and it damages our DNA.

It regenerates; cells have many mechanisms to do this. And it needs to be regenerated, because without DNA, proteins would not be produced in our body, and almost everything in our body is made of proteins."

For example, if a cell's DNA is damaged, the cell cannot produce proteins that would initiate the destruction process of the diseased cell. There are many backup mechanisms, but in very rare cases, it might happen that the diseased cell does not die. Most often, in such a case, immune cells realize that something is wrong with that cell and destroy it, but in some cases, even this might not happen, and then the cell can turn cancerous.

"If people work in the sun, don't use SPF products, and yet don't get melanoma — that's more of an exception to the rule. At some point, it will definitely happen to them, and in general, a person almost always dies from cancer if they don't die from something else earlier.

In most cases, if you don't die from a heart attack or a stroke, you will die from cancer. Because at some point, the resources for DNA repair will be exhausted, and cells simply won't be able to regenerate themselves; they will start functioning poorly and at some point will turn cancerous," says the scientist.

Павялічыць

Most SPF products contain molecules of substances that have a benzene ring in their structure (organic UV filters). If the skin is unprotected, a ray of sunlight damages the cell. But these benzene-derived molecules help dissipate the ray's energy as heat and reduce the sun's impact on cells.

And are such products necessary for an ordinary Belarusian who works indoors and lives in a not-so-sunny climate? The scientist advises paying attention to the UV index, which can be checked in any online weather forecast — the higher the index, the more ultraviolet spectrum there is in sunlight, and therefore, the greater the need for protection.

"Each case is unique, but life expectancy with any cancer has significantly increased"

Now, Maksim says, researchers are working hard to improve immune checkpoint therapy — asserting that it is very effective for certain types of cancer. Scientists are also looking for ways to reconfigure the immune system to make it perform its functions and fight cancer.

Oncologists are also studying how to use the CRISPR-Cas9 mechanism in the fight against cancer — a technology that allows cutting or replacing genome fragments.

"DNA is like a detailed instruction for assembling furniture, because it records how to assemble this or that protein so that it works correctly. For example, you bought a new apartment and decided to buy furniture for it. One assembled piece of furniture is a protein, and its instruction is a gene," Maksim explains.

And here's how the CRISPR-Cas9 mechanism would work:

"Imagine that we found certain proteins or molecules in cancer cells that are not present in other cells, and they are important for the cell's survival. With the help of this mechanism, those genes could be cut out of the cancer cells, and then they would stop functioning."

There are many promising directions in oncology now. All thanks to AI, which helps analyze databases:

"A huge amount of information has accumulated, which is very difficult to analyze because people don't have time for it. You can't weigh everything, draw parallels, make conclusions, because you simply lack the analytical capabilities.

But with the help of AI, you can do all this, find some patterns that you yourself don't see. And these patterns are then usually verified. Or if some drugs are used, and previously you could check several parameters for the effect of those drugs, now you can check dozens or hundreds of parameters."

Павялічыць

Despite all these scientific achievements, are there still types of cancer that remain hopeless today? Over the past 10-20 years, Maksim says, scientists have found many ways to treat cancer, it's just that many of them are still in the testing and development phase.

"If we find a substance or mechanism in the laboratory that will help treat this or that cancer, decades will pass before the first commercial drugs appear.

This is not a pharmaceutical conspiracy. It's simply that if you block something related to a tumor, you don't know how that experiment will affect the entire organism. Or you conducted an experiment on mice, but a human is a different organism, and what works on mice won't necessarily work on them," explains the scientist.

Nevertheless, researchers definitely have something to be proud of:

"The survival rate for people with head and neck cancer 20 years ago was less than 50%; now it's about 70%. Adding 20% in 20 years is a great success! If in the 2000s, statistically, a person with such a diagnosis would live, for example, 5-7 years, now the same person can live 10-15 years.

Each case is unique. But if you look at the statistics, life expectancy with all types of cancer has significantly increased."

However, there are types of cancer that are more difficult for scientists to tackle — these are brain cancer and all related cancers. They are very difficult to treat because there is a blood-brain barrier between the brain and the body, which prevents many substances and immune cells from entering the brain. Nature specifically created that barrier because the brain is vulnerable, and any damage to it can significantly affect the body.

"Therefore, to treat brain cancer, we need to find molecules that will pass through that barrier and at the same time not harm healthy cells, but only target diseased ones. We can afford local damage to other organs, but local damage to the brain can cause major problems," says Maksim.

• 21
• 0
• 0
• 2
• 1
• 0
• 0
• 1