Not that long ago, cancer treatments were synonymous with losing your hair and suffering from nausea and vomiting. Now with the advancements in cancer research, it’s not uncommon for patients to go complete a treatment regimen without either of these issues. One of these advancements is targeted therapy, also called targeted treatments. Targeted treatments “target” specific genes or proteins found in cancer cells These genes and proteins are related to cancer growth.
Many different types of cells make up the tissues in your body, from your bones to your skin. Cancer cells are created when specific genes in healthy cells mutate or change. To learn more about how cancer cells are made, check out my post on cancer cells.
When Dan’s oncologist first diagnosed him, she sent his biopsy sample to a special lab in California where they checked it for the most likely mutation, EGFR (epidermal growth factor receptor). The results said he was positive for this mutation. He was on an EGFR inhibitor called Tarceva for 18 months before it stopped working. After a time, the mutated cells that the Tarceva was fighting would mutate again in order to avoid getting eradicated. Think of them as the zombies in the video games that keep coming back with new strengths. While it had its own side effects, it greatly improved his quality of life and extended it.
He tried various more traditional treatments with different degrees of success. Each time we learned a treatment wasn’t working, we would try another one. Then he was put on Nivolumab. That treatment wasn’t right for Dan at all.
He was ready for hospice when a drug called Tagrisso was released by the FDA early. Tagrisso was a new generation of targeted treatment that went after the Tarceva resistant mutation. It was amazing how well it worked with very little side effects.
Initially, Dan was given a prognosis of 6 months to live. Thankfully, with both traditional and targeted treatments, and a lot of answered prayers, he reached his 6-year survival in October 1018. That’s a miracle for a stage IV lung cancer patient.
What is a Targeted Treatment?
Your genes tell your cells how to make the proteins that keep your cells working. What happens if your genes change, or mutate? The proteins will change, too. This is when you get cancer cells growing and spreading out of control. Like zombies, they don’t know when to die.
Targeted treatments “target” the mutations like a zombie killer. They try to normalize the cell growth by turning off signals that tell the cancer cell to grow or divide. This keeps the cells from living longer than normal and soon, they die the death they were meant to.
Traditional Chemotherapy Vs. Targeted Treatments
Traditional chemotherapy takes the carpet bomber approach. It blasts all the rapidly dividing cells in a patient. While it’s effective at killing cancer cells (since they are rapid dividers), it also kills healthy, rapidly dividing cells like hair, nails, skin, and mucous membranes. This leads to the classic chemotherapy side effects like nausea and hair loss. Targeted treatments attempt to treat cancer while sparing healthy cells.
One type of targeted treatment is small-molecule drugs. These treatments are typically taken orally in the form of a pill. One example of a small molecule drug is angiogenesis inhibitors. This type of treatment prevents the formation of blood vessels around a tumor. This cuts off the supply line of nutrients to the cancer cells, essentially starving them.
Finding a Match
Different types of tumors have their own unique genetic mutations. It’s important to have the biopsy tissue sent to a lab for molecular testing to find out if you are a match for one of the known mutations. Not all cancers have a known match, suitable for targeted treatments. This is still cutting-edge medicine. Researchers continue to isolate new mutations and develop drugs to treat them.
Cancer.Net has a comprehensive guide that you can use to see some of the latest information about specific cancers and known targeted treatments. Look up the type of specific cancer, and then click on the link for “treatment options.”
Another type of targeted therapy, called monoclonal antibody therapy, is a form of immunotherapy. It binds to certain cells or proteins outside of the cancer cell. Often the idea is to get the immune system to see the cancer cells that so often elude it. These drugs are usually given intravenously as an infusion. They are also often used in conjunction with traditional chemotherapy or radiation. It has been used in a variety of diseases including rheumatoid arthritis. You can spot this kind of therapy by the “mab” at the end of its name. For example, nivolumab, also known by the brand name, Opdivo. Researchers are still learning why these therapies work well for some diseases and not for others and why they work well in some patients while having no effect on others.
Some people assume that immunotherapy is natural or that targeted treatments don’t have side effects. These treatments are still drugs and they do still have side effects, sometimes even serious ones. If you are a good match for one of these treatments, they can be a valuable weapon in your arsenal against cancer.
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In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace. My books are available at Amazon.com:
I also blog at Heather Erickson Author/Writer/Speaker