A new therapy to kill cancer cells using infrared light bursts into the horizon

Rakuten Medical, a global biotechnology company announced earlier this week that the first head and neck cancer patient in India received the company’s proprietary technology based photoimmunotherapy treatment, Alluminox, under its global phase-3 clinical trial.

PREMIUM

The ASP-1929-301study is ongoing in several countries and regions including the United States, India and Taiwan, and will enroll 275 patients globally. In India, six medical institutions, including the Amrita Institute of Medical Sciences and Research Centre, Kochi, Tata Medical Centre, Kolkata, and Tata Memorial Centre, Mumbai, are participating in the study.

Alluminox works by combining the power of light with drug, device, and other related components to develop new, innovative therapies. Illuminating the targeted cells with non-thermal (i.e low temperature light) light activates the cell-bound drug, which leads to rapid and selective killing of the cell. This therapy has the potential to be the fifth pillar of cancer treatment, experts working on the technology said.

According to a 2021 paper published in medical journal The Lancet, near-infrared photoimmunotherapy (NIR-PIT) is a newly-developed, highly-selective cancer treatment, which utilises a monoclonal antibody conjugated (loosely explained, mixed) to a photo absorbing dye. The antibody conjugate is injected into the patient and accumulates in the tumour. Within 24 hours of injection, the tumour is exposed to near infra-red light, which activates the conjugate and causes rapid, selective cancer cell death. A targeted therapy is designed to identify certain genes and proteins that aid cancer cell growth, and tackles them in particular.

According to the paper, Japan granted conditional clinical approval for NIR-PIT in recurrent head and neck squamous cell cancers in 2020. “Not only does NIR-PIT induce highly selective and immediate cancer cell killing, but it also stimulates highly active anti-tumour immunity,” it stated.

“The nature of the cell death associated with NIR-PIT is unique. Cells rapidly swell, bleb (bulge, like a blister) and rupture, emptying intracellular contents into the extracellular compartment thus stimulating a vigorous host immune response,” read the paper.

The jury, however, is still out on the use of such treatment modalities in a poor country like India even though the number of cancer cases is growing significantly each year.

According to government estimates, the total number of new cancer patients in India in 2020 was at least 1.3 million — the fourth largest population of cancer patients in the world. Particularly, there is a high occurrence of head and neck cancer, which accounts for 30% of all cancer types. India accounts for nearly 26% of all head and neck cancer cases globally.

“As it is being given under clinical trials currently, it is too early to say whether this is going to be a game changer in cancer treatment or not. Infrared has been tried before also in cancer treatment but we will have to wait for the clinical trial results to know the efficacy of this particular platform,” said Dr PK Julka, former head, radiation oncology department, All India Institute of Medical Sciences, Delhi.

But, he added, “for a country like ours one needs to think of the masses; for a poor patient this will be too expensive to afford making it of use largely for only a section of cancer patients. Among new cancer treatment modalities, immunotherapy is showing good results but that’s cost-prohibitive for poor patients. All these things need to be considered when thinking about the Indian population.”

Health Talk by Rhythma Kaul is a weekly dispatch on the most significant medical news of the week. Rhythma is the national deputy editor, health.