In the realm of cancer treatment, the landscape has been rapidly evolving with the advent of targeted therapy. This personalized approach has shown promising results in many cancer types and has become a cornerstone in precision medicine. If your treatment plan calls for targeted therapy, understanding how it works and what to expect may frequently help you get ready for treatment and make informed decisions about your care.

Cancer “targeted therapy” focuses on specific proteins that regulate the development, proliferation, and dissemination of cancer cells. This idea serves as the foundation of precision medicine. Researchers are better able to develop cancer medicines that target these proteins as knowledge about the DNA changes and proteins that fuel cancer grows.

Types of Targeted Therapy

There are several variations on targeted therapy. Monoclonal antibodies and small-molecule inhibitors are the two most prevalent types.

Small molecule inhibitors are generally oral form of therapy which can be given as a tablet or capsule.
Monoclonal antibodies are given through venous or subcutaneous route.

Identifying Targetable Mutations

Before initiating targeted therapy, comprehensive molecular profiling of the tumor is essential. Through advanced diagnostic techniques like next-generation sequencing (NGS) and other molecular tests, oncologists can identify specific genetic alterations or biomarkers within the tumor. Some common targetable mutations include EGFR, ALK, HER2, BRAF, and ROS1, among others, depending on the cancer type.

How does Targeted Therapy Works

Targeted therapy works through several mechanisms, depending on the identified target. Some common approaches include:

Inhibition of Growth Signaling Pathways: Targeted drugs can block the signaling pathways that promote uncontrolled cell growth in cancer cells.
Angiogenesis Inhibition: Certain targeted therapies can prevent the formation of new blood vessels within tumors, thereby starving them of nutrients and oxygen.
Immune Checkpoint Inhibition: Immunotherapies, a subset of targeted therapy, can block the immune checkpoints that prevent immune cells from recognizing and attacking cancer cells.
Apoptosis Induction: Targeted drugs can trigger apoptosis (cell death) specifically in cancer cells with certain genetic mutations.

Some of the Cancers Treated with Targeted Therapy:

Targeted therapy is being used in almost all cancer types and in various stages of cancer treatment. A few current instances of targeted treatments are provided below.

Breast Cancer – Human epidermal growth factor receptor 2 is a protein that is overexpressed in 20% to 25% of breast tumours (HER2). Trastuzumab, Pertuzumab, TDM-1, Lapatinib etc are targeted therapies used in Her2 positive breast cancer.

Chronic myeloid leukaemia (CML) – A gene known as BCR-ABL, which forms in nearly all chronic myeloid leukaemia cases, is what causes the disease. Normal myeloid cells start acting like cancer cells as a result of this protein. Imatinib, Dasatinib, Nilotinib etc are targeted therapies used in CML.

Lung Cancer – The pace of scientific research is causing a rapid change in targeted therapy for lung cancer. Numerous targeted treatments are accepted to treat non-small cell lung cancer (NSCLC). More than 20 different types of targeted therapies are approved for lung cancer.

Many others like colorectal cancer, kidney cancer, hepatocellular cancer, uterine cancer, thyroid cancer, etc. also harbour protein alterations that can be treated with targeted therapy.

Benefits of Targeted Therapy

Targeted therapy has demonstrated several advantages over traditional chemotherapy, including:

Increased Efficacy: By directly targeting the genetic abnormalities driving tumor growth, targeted therapy can be more effective in controlling cancer progression.
Reduced Side Effects: Since targeted therapy is designed to act selectively on cancer cells, it often leads to fewer and less severe side effects compared to conventional chemotherapy.
Personalized Treatment: Molecular profiling allows for individualized treatment plans, ensuring patients receive the most appropriate therapy for their specific cancer type.
Potential for Combination Therapy: Targeted therapies can be used in combination with other treatments, such as chemotherapy or immunotherapy, to enhance treatment efficacy.
Treatment of Advanced Cancers: Targeted therapy has shown remarkable success in treating advanced or metastatic cancers that may not respond well to other treatments.

Do’s & Don’ts During Treatments

Do’s

Maintain your hydration
Observe good hygiene
While leaving the house, use sunscreen.

Don’ts

Skip meals
Avoid contact with people who are sick or infected in any way.
Avoid eating food that is raw or undercooked.
Avoid large gatherings

Targeted Therapy