Targeted Therapy: Is it right for me?
“Targeted therapy is a game-changer for many patients who have certain types of cancers,” says Dr. Nadia Rehman, an oncologist with Illinois CancerCare. “It enables us to identify and attack specific types of cancer cells while reducing the damage done to normal cells. Resulting from extensive research, this emerging treatment option is exciting news for the cancer community.”
Back to Biology
In order to understand how targeted therapy works, we’ll start at the cellular level. Our bodies are comprised of trillions of cells that are grouped together to form organs and tissue. Genes within the cells direct the growth, work, division and death of the cells. When our cells are healthy, this growth and division only occurs when our body needs them to replace aging or damaged cells, while needed cell death occurs at the proper time.
However, these cells don’t always do what they’re supposed to. Instead, genes can mutate causing confusion within our cells, resulting in damaged cells that divide and grow. Generally, the faster the cells grow, the faster your cancer progresses.
Cell mutations can be inherited, occur over time or be the result of harmful substances like UV radiation (from the sun), cigarettes or other damaging elements. These genetic mutations in the cells interfere with the cell’s normal growth and cause them to behave differently than they should.
Most often, people talk about cancer cells dividing and growing out of control, but other aspects of genetic changes can be harmful as well. Cancer cells can be immature cells that don’t “grow into” the jobs they were designed to handle, cells that the immune system is unable to act upon, cells that ignore normal signals to stop dividing or die at appropriate times or cells that don’t stick together properly, making it easy for them to spread through the blood or lymphatic system.
When your normal cells undergo these changes – or don’t make the changes they’re supposed to – they can become a tumor that feeds off your blood supply and certain proteins. As you probably know, these tumors can grow and spread, causing damage throughout your body.
Next Level Knowledge
So, how does this understanding of basic cellular function help in treating cancer? And what does it mean for you, the patient?
As the cancer community continues to learn more about how and why these changes occur, we are able to start pinpointing very specific genetic markers in your body. This enables us to develop a treatment plan designed to stop or slow the growth of cells that are contributing to your cancer’s spread.
Even if you’re not a super sports fan, watching a football game can give you a basic idea of how this works. The targeted therapy drugs are designed to interfere with those specific cells that are out of control, in a way similar to how the defensive line does everything it can to prevent the offensive team from taking the football to the end zone. Sometimes, a touchdown is prevented. Other times, the defense only reduces the speed of the offense. In terms of cancer, sometimes the tumor is killed and other times, its growth is simply slowed down.
Targeted therapy doesn’t use the same playbook every time. The strategy is based upon the type of cancer and what is causing those cells to mutate. A few of the approaches include:
- Delivering toxins to the cancerous cells to kill them (As opposed to chemotherapy and radiation therapy, which kills both damaged and healthy cells. That being said, chemo and radiation are still effective treatment options for many types of cancers.)
- Triggering your immune system to go after those malignant cells
- Blocking chemical signals in your body that contribute to cancerous cell growth
- Preventing the growth of new blood vessels that are feeding the tumor
- Altering proteins in the cells that contribute to the mutation
If your physician recommends targeted therapy, he or she will typically use one of the following medications and methods:
- Angiogenesis inhibitors
- Apoptosis inducers
- Gene expression modulators
- Hormone therapies
- Monoclonal antibodies
- Proteasome inhibitors
- Signal transduction inhibitors
- Toxin delivery molecules
Cancer vaccines (like the one for HPV to prevent cervical, penis and throat) and gene therapy are sometimes included within the list of targeted therapies.
Targeted Therapy and You
This treatment option is primarily being used with certain types of cancer, including breast, colorectal, lung, chronic myeloid leukemia (CML), lymphoma and melanoma. It’s important to note that even if targeted therapy is being used to treat a specific type of cancer, that doesn’t mean that it is the right approach for every person with that type of cancer. The decision to use (or not use) targeted therapies is based upon the genetic makeup of your individual cells and your overall health history.
For example, in about 20-25% of breast cancer patients, the cells have too much of a protein called human epidermal growth factor receptor 2 (HER2). You may have even heard about HER2-postive breast cancer on TV commercials or you might have noticed that Illinois CancerCare has been involved with clinical studies related to HER2 treatment.
In fact, Illinois CancerCare is currently the ONLY practice in Illinois participating in a new clinical trial for this called HER2CLIMB-02. Illinois CancerCare is committed to staying abreast of the latest scientific advancements and works hard to bring those groundbreaking therapies to the patients of central and western Illinois.
Just like any treatment – for cancer or any other disease – there are benefits and potential downsides. Results and side effects vary by patient, genetic makeup, overall health, and the type and stage of cancer. But overall, targeted therapy is an exciting treatment option that continues to evolve and demonstrate successful patient outcomes.