Analyzing Challenges and Solutions for Cancer Immunotherapy in UAE

This report examines the challenges of cancer immunotherapy in the UAE, highlighting issues such as early screening and the development of effective immunotherapies. The discussion analyzes the challenges associated with immunotherapy, including targeting the tumor microenvironment, and provides evidence of evolving challenges over the past five years. The report presents two solutions: the use of YC-1, an anti-angiogenic agent targeting the hypoxic tumor microenvironment, and the targeting of Vps34 protein involved in autophagy. The conclusion emphasizes the need for innovative approaches to combat cancer and improve patient outcomes, with references to scientific literature.

Running head: FIGHTING AGAINST CANCER
FIGHTING AGAINST CANCER
Name of the student:
Name of the university:
Author note:

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Introduction:
With the global burden of chronic diseases, combating the high prevalence of cancer has
been a long-standing challenge that impacted more than thousands of the lives every year. In
UAE, it is the third leading cause of the death, accounting for 16% of the death. In 2015,
approximately 427 deaths caused by the cancer, intensifying the need for developing therapeutic
interventions that can combat the disease (Www.haad.ae., 2020).. This paper aims to
demonstrate challenging issues experienced STEM advancement, two examples showing
evidence for change and two solutions to improve the challenge in the following paragraphs.
Discussion:
Two challenging issues experienced in UAE:
In the recent era, mitigating cancer has been a long-standing challenge in UAE. The
two most common challenge experienced by the United Arab Emirates is early screening and
immunotherapy. While early screening of cancer can prevent premature morbidity, early
screening of the cancer is a challenge due to lack of awareness amongst population and no
symptoms of the cancer in the early stages (So et al., 2019). Several early screening tests have
been proved to detect early symptoms of cancer and reduce the possibility of early deaths
(Albeshan et al., 2018). The second long-standing challenge experienced in STEM advancement
is developing appropriate immunotherapy. The immunotherapy has been a severe challenge
because majority of the immunotherapy are cannot be applicable for the general population and it
requires an individualized approach. Another factor that contributed to the challenge is target site
development. The UAE government decided to include cancer in the key performance indicator
in The UAE National Health Agenda 2021 for assessing the health care goal of the nation (So et
al., 2019).
Analysis of the challenge associated with immunotherapy:
Cancer immunotherapy has emerged as a critically significant approach for treating
cancer patients in the recent era. UAE has been conducted extensive research on cancer immune
therapies to mitigate certain cancers such as non-small cell lung cancer, melanoma, renal cancer,
breast cancer and bladder cancer. While vast research and clinical investments dedicated to

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advance this synthetic therapeutic approach, there is a range of challenges raised that hinder
appropriate development of cancer immunotherapy (Hegde & Chen, 2020). The key challenges
of developing immunotherapy include identification of the key driver of cancer immunity, full
characterization of the impact of steroid and immune suppression on the autoimmune disease,
development of regulatory endpoints for cancer immune therapy, targeting tumour
microenvironment and development of multi-agent cancer therapy regimen (Kaimala et al.,
2018). The monoclonal antibodies and cancers vaccinations are common examples of immune
therapy of cancers that subjected to extensive challenges.
Two examples showing evidence of the evolution of challenges:
In the recent 5 years, the challenges have been significantly evolved in the more specific
one that significantly hindered the clinical trials. The more specific challenge associated with
cancer immunotherapy is targeting tumour microenvironment as it is the essential component for
facilitating malignancies in certain cancers such as breast cancer, prostate cancer (So et al.,
2019). Noman et al. (2019), highlighted evidence that targeting hypoxic tumour environment is a
significant challenge that hindered the optimized result in the clinical trials. The tumour
microenvironment protects the tumour from the anti-tumour response where hypoxic stress
reduces the immunoplasticity and facilitate the tumour heterogeneity. On the other hand, Janji,
Berchem and Chouaib (2018), exhibited another evidence that over the years, targeting
autophagy in the tumour microenvironment has been another challenge due to heterogeneity.
Therefore, these evolutions of challenges further intensifying comprehensive need for
developing cancer immune therapy.

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Figure: tumour microenvironment
Source: (Francis et al., 2018),
Solutions for mitigating challenge:
Francis et al. (2018), highlighted that YC-1 is an anti-angiogenic anticancer agent that
targets hypoxic tumour microenvironment which proved to be effective in reducing hypoxia-
induced HIF-1α levels. Furthermore, an anti-angiogenic anticancer agent also reduces expression
of VEGF and erythropoietin ( HIF-1 downstream targeting genes) and HIF-1 trans activity. On
the other hand, Janji, Berchem and Chouaib (2018), suggested that Vps34 is a protein involving
in the early step of autophagy initiation that can serve as a potential target for protein
microenvironment. The inhibition of the protein can leads to lysosome dysfunction that can
result in vesicle trafficking between the late endosome and the lysosome. Additionally, raising

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awareness and empowering the population to seek the therapy are effective interventions that can
facilitate the immunotherapy.
Conclusion:
On a concluding note, it can be said that combating the high prevalence of cancer has
been long-standing challenges worldwide, UAE is no exception to it. The two most common
challenge experienced by the United Arab Emirates is early screening and immunotherapy. The
main challenge of developing immunotherapy in targeting the tumour microenvironment,
especially autophagy and hypoxic microenvironment. Two prominent solutions for this challenge
include YC-1 is an anti-angiogenic anticancer agent and targeting Vps34 protein involving in the
early initiation of autophagy.

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References:
Albeshan, S. M., Mackey, M. G., Hossain, S. Z., Alfuraih, A. A., & Brennan, P. C. (2018).
Breast cancer epidemiology in gulf cooperation council countries: a regional and
international comparison. Clinical breast cancer, 18(3), e381-e392.
Francis, A., Venkatesh, G. H., Zaarour, R. F., Zeinelabdin, N. A., Nawafleh, H. H., Prasad, P., ...
& Chouaib, S. (2018). Tumor Hypoxia: A Key Determinant of Microenvironment
Hostility and a Major Checkpoint during the Antitumor Response. Critical Reviews™ in
Immunology, 38(6).
Hegde, P. S., & Chen, D. S. (2020). Top 10 Challenges in Cancer
Immunotherapy. Immunity, 52(1), 17-35.
Janji, B., Berchem, G., & Chouaib, S. (2018). Targeting autophagy in the tumor
microenvironment: new challenges and opportunities for regulating tumor
immunity. Frontiers in immunology, 9, 887.
Kaimala, S., Al-Sbiei, A., Cabral-Marques, O., Fernandez-Cabezudo, M. J., & Al-Ramadi, B. K.
(2018). Attenuated bacteria as immunotherapeutic tools for cancer treatment. Frontiers in
oncology, 8, 136.
Noman, M. Z., Hasmim, M., Lequeux, A., Xiao, M., Duhem, C., Chouaib, S., ... & Janji, B.
(2019). Improving cancer immunotherapy by targeting the hypoxic tumor
microenvironment: new opportunities and challenges. Cells, 8(9), 1083.
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Www.haad.ae. (2020). Retrieved 4 April 2020, from
https://www.haad.ae/simplycheck/tabid/140/Default.aspx