What is Targeted Chemotherapy?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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This is where the treatment of cancer is going—along with the future of medicine. Targeted cancer therapies, also known as personalized medicine or precision medicine, are drugs that target a cancer’s specific genes, proteins, or the tissue environment that lead to the growth and spread of that cancer.
Confused? Here are ten facts to help you sort it out.

  1. With targeted chemotherapy we use information about people’s genes and proteins to prevent, diagnose and treat disease.
  2. Targeted chemotherapy uses antibodies and small molecule inhibitors rather than synthetic or natural chemicals—aka traditional chemotherapy.
  3. The goal of traditional chemotherapy is to reduce the size of a tumor. Targeted chemotherapy goes after making a tumor stable over a long period.
  4. Side effects of targeted chemotherapy are much better tolerated than traditional chemotherapy. Traditional chemotherapy is limited by toxicity—by how sick it makes you. This can include low white or red cell counts, kidney toxicity, liver toxicity, and so on.
  5. Because it’s better tolerated, chronic dosing is possible with targeted chemo.
  6. Traditional chemo acts on all rapidly dividing cancer or normal cells (we see hair loss, diarrhea, sores in the mouth, because the rapidly growing “normal cells” are affected). Targeted chemo acts instead on the specific cells associated with cancer.
  7. Think of traditional chemotherapy as the bazooka rocket launcher, while targeted chemo is the sniper rifle.
  8. Some examples of traditional chemo you may know: Taxol and 5-FU. Targeted chemo players include Rituxan, Gleevec and Avastin, among others.
  9. Surprisingly, the evidence is not clear that matching treatments to the genomic profiles of patients truly leads to improved outcomes.
  10. Many huge trials are in the works but as of now, though targeted chemotherapy is better tolerated, outcomes appear to be no better than with traditional chemo.

No matter how it’s treated—cancer sucks.
Dr O.

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