An increasing number of individuals are turning to targeted therapy as a preferred treatment option for cancer in India due to its remarkable effectiveness compared to traditional chemotherapy. While chemotherapy typically achieves success in around 30% of cases, targeted therapy boasts success rates of up to 80%. Unlike chemotherapy’s broad approach, targeted therapy operates more precisely, akin to a sniper, precisely targeting cancer cells without harming healthy ones.
However, not all cancer patients are suitable candidates for targeted therapy. Its effectiveness hinges on accurate diagnosis and tailored treatment plans crafted by skilled medical professionals. Each patient’s symptoms are unique, necessitating personalized care. This approach, often termed “Precision Medicine,” ensures treatments are finely tuned to the individual, resulting in enhanced efficacy and a greater likelihood of successful outcomes.
Let’s understand more about this in detail.
What is Targeted Therapy For Cancer?
Targeted therapy is a special kind of cancer treatment. Instead of just attacking all cells, it goes straight for cancer cells while leaving normal ones alone.
Here’s how it works: Cancer cells have messed-up genes that make them act differently from normal cells. These genes are like instructions for the cell. When they’re changed in cancer cells, the cells start doing weird stuff, like growing too fast. Not all cancer cells are the same. Even within the same type of cancer, like breast cancer, cells can be different from person to person.
Scientists have figured out that certain proteins or enzymes in cancer cells are like little messengers telling the cells to grow and spread. So, they made drugs that can stop these messengers in their tracks.
These drugs are like targeted missiles aimed specifically at the bad guys, leaving the good guys alone. They either block the signals telling the cancer cells to grow, or they tell the cancer cells to self-destruct. It’s a big deal because it means we can fight cancer more precisely, with fewer side effects than traditional treatments like chemotherapy.
But here’s the thing: Targeted therapy isn’t a one-size-fits-all solution. Most of the time, it’s used alongside other treatments like surgery, chemotherapy, or radiation therapy. Scientists are always working on new targeted drugs to help even more people beat cancer.
Benefits of Targeted Therapy
Targeted therapy offers several benefits as a treatment for cancer:
Precision Targeting: Unlike traditional treatments like chemotherapy, targeted therapy precisely identifies and attacks cancer cells while sparing healthy cells. This focused approach reduces side effects and enhances treatment effectiveness.
Higher Success Rates: Targeted therapy has shown higher success rates compared to conventional chemotherapy in many cases, offering improved outcomes and increased chances of remission.
Customized Treatment Plans: Targeted therapy allows for personalized treatment plans tailored to each patient’s specific cancer type, genetic makeup, and medical history. This individualized approach optimizes treatment effectiveness and patient response.
Reduced Side Effects: By selectively targeting cancer cells, targeted therapy minimizes damage to healthy tissues, leading to fewer and less severe side effects compared to traditional chemotherapy.
Combination Therapy Potential: Targeted therapy can be combined with other treatments such as chemotherapy, radiation therapy, or immunotherapy to create synergistic effects and enhance overall treatment outcomes.
Improved Quality of Life: With fewer side effects and a more targeted approach, targeted therapy can help improve patients’ quality of life during and after treatment, allowing them to better tolerate and manage their cancer care journey.
Potential for Long-Term Management: Targeted therapy may offer options for long-term management of certain types of cancer, helping to control disease progression and improve survival rates over time.
Overall, targeted therapy represents a significant advancement in cancer treatment, offering improved efficacy, reduced side effects, and enhanced quality of life for many patients.
Targeted Therapy Types
Targeted therapy encompasses various approaches to treating cancer by specifically targeting the abnormal processes that drive cancer growth and survival. Here are several types of targeted therapies along with examples of how they function in cancer treatment:
Angiogenesis inhibitors: These drugs hinder the formation of new blood vessels that supply nutrients to cancer cells, effectively starving the tumor.
Monoclonal antibodies: These specialized molecules can either deliver drugs directly to cancer cells or stimulate the immune system to attack cancer cells more effectively. Examples include alemtuzumab for certain types of chronic leukemias, trastuzumab for specific breast cancers, and cetuximab for colorectal, lung, and head and neck cancers. It’s important to note that while some monoclonal antibodies directly target cancer cells, others function as immunotherapy, bolstering the immune response against cancer.
Proteasome inhibitors: These medications disrupt essential cellular functions, leading to the death of cancer cells. Bortezomib, for example, is used to treat multiple myeloma by interfering with protein degradation processes within cancer cells.
Signal transduction inhibitors: These drugs interfere with the signaling pathways that regulate cell growth and division in cancer cells, essentially halting their aberrant activity. Imatinib is a notable example, utilized in treating certain types of chronic leukemias by blocking specific signaling pathways.
Each type of targeted therapy offers a distinct mechanism of action tailored to disrupt the specific vulnerabilities of cancer cells. By precisely targeting these vulnerabilities, targeted therapies can effectively inhibit cancer growth while minimizing harm to healthy tissues, offering a promising approach to cancer treatment.
How Target Therapy Works?
Targeted therapy against cancer is like precision medicine, aiming directly at the mechanisms that drive cancer growth. Unlike traditional chemotherapy, which can harm healthy cells along with cancerous ones, targeted therapy pinpoints specific proteins or processes crucial for tumor development.
Here’s how it works:
Boosting the Immune System: Cancer cells often evade detection by the immune system. Certain targeted therapies can flag these cells, making them visible to the immune system or enhancing its ability to recognize and attack them. It’s like giving the immune system a pair of glasses to better spot the enemy.
Halting Uncontrolled Growth: Normally, cells divide in a controlled manner in response to signals. But cancer cells can ignore these signals, multiplying uncontrollably. Targeted therapies intervene by blocking the signals that drive this unchecked growth, essentially putting a brake on the tumor’s expansion.
Blocking Blood Vessel Formation: Tumors need a blood supply to grow beyond a certain size. Angiogenesis inhibitors, a type of targeted therapy, disrupt the signals that prompt the formation of new blood vessels. Without a blood supply, tumors struggle to grow or even shrink because they’re starved of nutrients and oxygen.
Delivering Cell-Killing Substances: Some targeted therapies use antibodies tailored to latch onto specific proteins found on cancer cells. These antibodies can be armed with toxins, chemotherapy drugs, or radiation, which are then delivered directly to the cancer cells, sparing healthy ones.
Inducing Cancer Cell Death: Cancer cells often have tricks to evade programmed cell death, or apoptosis, which eliminates damaged or unnecessary cells. Certain targeted therapies can override these defenses, prompting cancer cells to undergo apoptosis, effectively killing them off.
Cutting Off Hormone Supply: Hormones like estrogen and testosterone can fuel the growth of certain cancers, such as breast and prostate cancers. Hormone therapies either reduce hormone production in the body or block hormones from interacting with cancer cells, depriving them of the fuel they need to thrive.
By targeting specific vulnerabilities in cancer cells, targeted therapy offers a more precise and potentially less toxic approach to treatment, with the aim of slowing down tumor growth or even eradicating cancer altogether.
Approved Targeted Therapy Drugs For Different Cancer Types
Understanding the Difference Between Targeted Therapy and Chemotherapy in Cancer Treatment
Targeted therapy and chemotherapy are both used to treat cancer, but they work in different ways. Think of targeted therapy as a precision tool, while chemotherapy is more like a blunt force.
Targeted therapy drugs are designed to attack specific features that make cancer cells different from normal cells. They’re like smart missiles that seek out and attack only the cancer cells, leaving healthy cells mostly unharmed. On the other hand, traditional chemotherapy drugs are more like a carpet bomb—they kill cancer cells, but they can also damage healthy cells along the way.
One big difference between the two is how they affect cell division. Targeted therapy drugs interfere with the process of cancer cells making copies of themselves. By doing this, they can slow down or even stop the cancer from growing and spreading. Chemotherapy, on the other hand, works by directly killing cancer cells that have already formed.
Imagine your body as a city, with cancer cells as troublemakers causing chaos. Targeted therapy is like deploying specialized units to take out those troublemakers with precision, without causing much collateral damage to the city. Chemotherapy, on the other hand, is more like sending in a massive army to wipe out everything in its path, including some innocent bystanders.
Because targeted therapy is more precise, it often comes with fewer side effects compared to chemotherapy. People undergoing targeted therapy might experience less nausea, hair loss, and other common side effects associated with traditional chemotherapy.
However, targeted therapy isn’t a one-size-fits-all solution. Just like different types of troublemakers require different strategies to deal with, different cancers may respond differently to targeted therapy. Doctors carefully choose the right treatment based on the specific characteristics of each person’s cancer.
In summary, targeted therapy is a more precise and targeted approach to treating cancer, aiming to stop cancer cells from growing and spreading by blocking their ability to divide. It’s like using a sniper rifle to take out specific targets. In contrast, chemotherapy is a more general attack that kills cancer cells directly, but it can also harm healthy cells in the process, like using a bomb to destroy a whole area.
Targeted Therapy Limitations in Cancer Treatment
Targeted therapy offers a promising avenue for cancer treatment, but its effectiveness can vary depending on individual factors. While it may seem straightforward to match a specific drug to a particular cancer, targeted therapy is a nuanced approach that may not always be suitable for every patient.
One of the key limitations of targeted therapy lies in its dependency on specific genetic changes or proteins present in the tumor. If the tumor lacks these specific targets, the treatment may prove ineffective. Even when the necessary targets are present, there’s no guarantee of a positive response. Tumors may exhibit resistance to the drug, rendering it ineffective over time. Additionally, the duration of response to targeted therapy can be limited, as the importance of the targeted molecules in cancer growth may diminish or cells may develop resistance.
Moreover, like many cancer treatments, targeted therapy can lead to significant side effects. While these side effects differ from those associated with chemotherapy, they can still impact quality of life. Common side effects of targeted therapy include skin, hair, nail, or eye problems. It’s crucial for patients to discuss potential side effects with their doctors and understand how they can be managed.
Despite its limitations, targeted therapy remains an essential tool in the arsenal against cancer. It is often used in conjunction with other treatments such as surgery, radiation therapy, chemotherapy, hormone therapy, or immunotherapy to maximize effectiveness. Researchers continue to explore and refine targeted therapy approaches, seeking to enhance its efficacy and broaden its applicability across different cancer types.
How To Find Cancer Targets For Target Therapy?
To pinpoint the target for targeted cancer therapy, doctors rely on specialized tests:
Advanced Genomic Testing: This involves scrutinizing the genetic makeup of a tumor to spot specific mutations that are driving its growth and behavior. If a particular mutation is identified, doctors can match it with a targeted drug designed to tackle that mutation directly.
Pathology Tests: These tests examine samples of tissue, blood, or stool. By looking for abnormal proteins or an excess of certain proteins in cancer cells, pathologists can identify potential targets for treatment. They may also examine the chromosomes within cancer cells for abnormalities.
Genetic Testing: These tests determine whether a patient has inherited gene mutations that are associated with their cancer. Identifying these mutations can help doctors tailor treatment plans more effectively.
Side Effects of Targeted Cancer Therapies
Side effects of targeted cancer therapies can be serious and varied. Some common ones include diarrhea, liver problems such as hepatitis, and changes to the skin, hair, and nails.
Skin issues are particularly challenging for many patients undergoing targeted therapy. These occur because the therapy affects the same growth factors and blood vessels needed for healthy skin. Watch out for:
Rash Resembling Acne: This can appear on the scalp, face, neck, chest, and back. It might itch, burn, sting, or be painful, sometimes leading to infection. It typically persists throughout treatment but tends to disappear once treatment ends.
Sunburn-Like Sensation: You might feel like you have a severe sunburn even before visible changes occur in your skin.
Increased Sensitivity to Sunlight: Extreme sensitivity to sunlight can occur, necessitating extra precautions when going outdoors.
Dry Skin: Nearly everyone undergoing targeted therapy experiences dry skin, which can lead to cracking, especially on the hands and feet, making tasks like using hands or walking difficult.
Swollen, Painful Sores on Nails: Painful sores can develop on fingernails and toenails, causing discomfort and difficulty in daily activities.
Scalp Sores and Hair Issues: Sores may develop on the scalp, accompanied by hair loss or bald patches. Hair may also change color or fail to regrow after treatment.
Eye Problems: Redness, swelling, and changes in eyelid position can occur, potentially affecting the cornea, the clear layer on the front of the eye.
In addition to skin-related side effects, targeted therapies can lead to other serious side effects, some of which may be life-threatening.
Before starting treatment, it’s advisable to switch to gentle, chemical-free and fragrance-free soaps and shampoos. Any changes in the skin should be reported to the doctor promptly to prevent infections. In severe cases, targeted medications may need to be discontinued.
Since many targeted therapies are combined with other treatments like chemotherapy and radiation, patients may also experience side effects associated with those treatments.
It’s crucial to discuss the potential side effects and treatment plan with your doctor to understand what to expect and how to manage them effectively.
Targeted Therapy Treatment Procedure and Monitoring
Before beginning targeted therapy, your healthcare provider will thoroughly assess whether it’s the most suitable treatment for your specific type of cancer. This typically involves conducting tests on samples of your blood or tissue obtained through biopsies. These samples are scrutinized to identify particular gene mutations or changes that indicate potential targets for the therapy.
During targeted therapy, the process varies depending on individual circumstances. Your healthcare provider will outline a treatment plan tailored to your needs, providing you with a clear understanding of what to expect. Here’s a detailed breakdown of what may occur during targeted therapy:
Administration Methods: Targeted therapy can be administered in several ways:
- Oral Medication: You may be prescribed pills that you swallow.
- Subcutaneous Injection: Some treatments are given as shots under the skin.
- Intravenous Infusion: For others, therapy is administered through an IV, typically requiring visits to your healthcare provider’s office or an outpatient treatment center.
Combination Treatments: Targeted therapy might be combined with other treatments such as chemotherapy or radiation therapy to enhance effectiveness.
Frequency of Treatment: The frequency of targeted therapy sessions can vary:
- You might receive treatment daily, weekly, multiple times a week, monthly, or less frequently, depending on your treatment plan.
- Periods of treatment interruption or breaks may be scheduled as part of the regimen.
Monitoring and Follow-Up:
- Regular visits with your healthcare provider are crucial to monitor your progress.
- Monitoring methods may include blood tests, X-rays, CT scans, and other diagnostic tests to evaluate the therapy’s effectiveness.
- Your healthcare provider will inquire about any treatment-related side effects to ensure they are managed effectively.
Overall, targeted therapy involves a personalized approach with close monitoring and adjustments as needed to optimize treatment outcomes while managing potential side effects.
Types of Cancer Treatable with Targeted Therapy
Here’s a list of cancers that can be treated with Targeted Therapy:
Blood Cancers
- Leukemia
- Multiple myeloma
- Lymphoma
Brain Cancers
- Glioblastoma
- Neuroblastoma (treated with monoclonal antibodies acting as immunotherapy)
Bone and Soft Tissue Cancers
- Certain soft tissue sarcomas
Breast Cancers
- BRCA gene mutation breast cancer
- HER2-positive breast cancer
- Hormone receptor-positive breast cancer
- Triple-negative breast cancer
Digestive System Cancers
- Colorectal (colon) cancer
- Esophageal cancer
- Gastrointestinal stromal tumor (GIST)
- Neuroendocrine tumors
- Non-Hodgkin’s lymphoma
- Pancreatic cancer
- Stomach cancer (intestinal stomach adenocarcinomas)
- Hepatocellular (liver) cancer
- Cholangiocarcinoma (gallbladder cancer)
Head and Neck Cancers
- Laryngeal cancer
- Nasal cavity and paranasal sinus cancer
- Nasopharyngeal cancer
- Oral cancer
- Oropharyngeal cancer
Lung Cancers
- Non-small cell lung cancer
- Small cell lung cancer
- Mesothelioma
Reproductive System Cancers
- Cervical cancer
- Endometrial cancer (high risk or cancer that’s come back)
- Prostate cancer
Skin Cancers
- Melanoma
- Cutaneous squamous cell skin cancer
Thyroid Cancers
- Anaplastic thyroid cancer
- Medullary thyroid cancer
- Papillary/follicular thyroid cancer
Urinary System Cancers
- Bladder cancer
- Kidney cancer
- Prostate cancer
A Brief Into Types of Cancer Treatable with Targeted Therapy
Targeted Therapy For Breast Cancer: Around 20% to 25% of breast cancers exhibit overexpression of the human epidermal growth factor receptor 2 (HER2) protein, stimulating tumor growth. HER2-positive breast cancer offers numerous targeted therapy options specifically designed to counteract this protein’s effects.
Targeted Therapy For Chronic Myeloid Leukemia (CML): Chronic myeloid leukemia is primarily driven by the BCR-ABL gene, leading to the production of the BCR-ABL protein, which transforms normal myeloid cells into cancerous ones. Targeted therapies for CML focus on inhibiting this aberrant protein.
Targeted Therapy For Colorectal Cancer: Colorectal cancer often involves overactivity of epidermal growth factor receptor (EGFR). Targeted therapies aim to block EGFR, slowing or halting cancer progression. Additionally, treatments may target vascular endothelial growth factor (VEGF) and NTRK fusions, or utilize anti-angiogenesis therapy to impede tumor growth.
Targeted Therapy For Lung Cancer: Rapid advancements in lung cancer targeted therapy include EGFR inhibitors, ALK inhibitors, ROS1 fusion inhibitors, and drugs targeting various mutations like KRAS G12C and BRAF V600E. These therapies aim to disrupt specific molecular pathways driving non-small cell lung cancer (NSCLC) growth.
Targeted Therapy For Lymphoma: Targeted drugs inhibiting enzymes responsible for B-cell overproduction have shown efficacy in treating lymphomas and some B-cell leukemias, offering a tailored approach to combat these blood cancers.
Targeted Therapy For Melanoma: Approximately half of melanomas feature mutations in the BRAF gene, making it a prime therapeutic target. BRAF inhibitors, along with MEK inhibitors, have been approved for melanoma treatment, often used in combination to effectively tackle tumors with BRAF mutations.
Understanding the Cost of Targeted Cancer Therapies
Targeted therapies, including immunotherapy such as CAR T, often come with substantial costs, sometimes reaching tens of thousands of dollars per month. CAR T therapy, in particular, can be close to half a million dollars. However, pricing varies based on factors like medication type, administration method, treatment duration, and healthcare facility. Generally, oral medications tend to incur higher out-of-pocket expenses compared to IV treatments administered in hospitals or clinics.
It’s essential to thoroughly understand your insurance coverage before initiating any cancer treatment to ascertain what costs will be covered. Being informed about potential financial implications can help you plan and navigate your treatment journey effectively.
Questions to Ask Your Healthcare Team about Targeted Therapy
- What kind of targeted therapy do you suggest for my treatment, and why?
- What are the goals of this treatment?
- Will targeted therapy be the only treatment, or will there be other treatments included in my cancer treatment plan?
- Are there any clinical trials available for targeted therapy that I might be eligible for?
- How will I receive this treatment and where will it take place?
- How often will I need this treatment, and how long will it last?
- What are the potential short-term side effects of this targeted therapy, and how will they be managed?
- Who should I contact if I experience any side effects, and how soon should I reach out?
- How will this treatment impact my daily life? Will I be able to work, exercise, and carry out my usual activities?
- What are the possible long-term side effects of this targeted therapy?
- Who can I contact with questions or concerns?
- How can I reach someone during regular office hours? What about after hours?
- If I’m feeling worried or anxious about undergoing this treatment, who can I talk to?
- If I’m concerned about the cost of this treatment, who can help me manage it?
- How will we know if the targeted therapy is effective?
- Will I need any tests or scans before, during, or after receiving targeted therapy?
Final Note
Navigating targeted therapy for cancer treatment can feel overwhelming, but understanding the basics and asking the right questions can empower you to make informed decisions about your care. Remember, targeted therapy offers a tailored approach, aiming to attack cancer cells while sparing healthy ones, potentially leading to fewer side effects and improved outcomes. However, it’s crucial to discuss with your healthcare team the specifics of your treatment plan, including potential side effects, frequency of treatment, and monitoring protocols. Additionally, consider exploring available resources for financial assistance and clinical trials that may offer alternative treatment options. By advocating for yourself and staying informed, you can embark on your cancer treatment journey with confidence and hope for a brighter future.
