Targeted therapy in the treatment of oncology

A tumor is an array of cells that are actively dividing. Normal cells also renew themselves from time to time, but most of them do so at a very different rate. Chemotherapy drugs inhibit the division of all cells in the human body, including tumor cells. Hence such consequences as a drop in blood counts, ulceration of the mucous membranes of the gastrointestinal tract, hair loss and impaired nail growth.

At the heart of the development of cancer is a whole cascade of genetic mutations, as a result of which the metabolic processes in the cell radically restructured. Begins the synthesis of substances not peculiar to the human body. It is on the determination of these substances in the blood is based on the analysis of oncomarkers. Unlike chemotherapy, targeting drugs recognize the altered cells and selectively affect only them.

Currently, two groups of drugs are used for targeting therapy:

• Monoclonal antibodies. These are substances that recognize cancer cells, block the supply of oxygen to them and thereby disrupt the growth of the malignant tumor.
• Tyrosine, serine and threonine kinase enzyme inhibitors. These are so-called “small molecules.” They freely penetrate into the cell and change a number of important for cancer cell metabolic processes, thereby reducing their viability and rate of division.

The method is relatively new, but the list of cancers that can be cured with the help of targeted therapy is expanding every year.

There are no universal targeting drugs. In the clinical practice of oncologists, several dozens of drug names are already in use. Their prescription is appropriate in the following cases:

• Brain cancer.
• Metastatic lung cancer.
• Breast cancer.
• Melanoma.
• Pancreatic cancer.
• Gastric cancer.
• Colon cancer.
• Kidney cancer.

Molecular targeted therapy is often used as the only treatment option. It can also be successfully combined with radiation, immunotherapy and chemotherapy. The gentle effect of targeted drugs on the body allows them to be administered in cases where classical chemotherapy is contraindicated, for example, in the elderly or in the general serious condition of the patient. Monoclonal antibodies and “small molecules” can be used for prophylactic purposes if there is a risk of cancer recurrence, as well as to control the growth of metastases detected in the patient.

A simplified scheme of development of pathological changes in cancer is as follows: spontaneous genetic mutation – change of metabolic processes in the cell – transition of the cell to tumor growth. Target drug affects the intermediate link (metabolic processes). However, an effective drug can be selected only if the cause of this intermediate link (a specific mutant gene) is established beforehand.

The full range of necessary tests can be performed in Germany. A fragment of cancerous tissue obtained during a biopsy must be sent to the laboratory. The sent samples are searched for 742 genes involved in the cancerous transformation of normal cells. Comparison of gene sequences in tumor tissue and blood allows you to identify mutations that are characteristic of cancer and are absent in healthy cells.

The results can be obtained 10-14 days after delivery of samples to the laboratory. It is possible to additionally determine the MSI tumor mutation load index and TMB microsatellite instability index, which allow to judge the effectiveness of immunotherapy.

Treatment prescription

Based on the data obtained from the laboratory, the oncologist determines the most optimal regimen of targeted therapy. The first 4 weeks will need to be spent in the clinic, where the medication will be administered under the supervision of the attending physician. Thereafter, you can take the recommended drugs at home, periodically performing the necessary examinations (CT, MRI, etc.) and sending their results electronically to your oncologist.

The use of this method allows our patients to stop the aggressive growth of the tumor, makes it possible to reduce the radiation exposure to the body, reduce the doses of chemotherapy drugs used, and, consequently, their overall toxic effect. At the same time, the price of targeted therapy is high due to the high cost of the prescribed drugs. Experts Medical actively cooperates with a number of charitable foundations that can help pay for treatment.