Targeted Therapy in Cancer Treatment: Comprehensive Guide for Patients in India

What is Targeted Therapy?

Targeted therapy is a type of cancer treatment that uses drugs or other substances to precisely identify and attack cancer cells, usually by focusing on specific molecular targets that are associated with cancer. Unlike traditional chemotherapy, which attacks rapidly dividing cells indiscriminately, targeted therapy aims to interfere with specific molecules involved in the growth, progression, and spread of cancer.

Types of Targeted Therapy

• Monoclonal Antibodies: These are laboratory-made molecules designed to serve as substitute antibodies that can restore, enhance, or mimic the immune system's attack on cancer cells. Examples include Rituximab (Rituxan) for certain types of lymphomas and Trastuzumab (Herceptin) for HER2-positive breast cancer.
• Small-Molecule Drugs: These drugs are small enough to enter cells easily and target the proteins inside. Examples include Imatinib (Gleevec) for chronic myeloid leukemia (CML) and Erlotinib (Tarceva) for non-small cell lung cancer (NSCLC).
• Hormone Therapies: These treatments block the body’s ability to produce hormones or interfere with hormone action. They are often used in cancers that rely on hormones to grow, such as breast and prostate cancer. Examples include Tamoxifen for breast cancer and Enzalutamide for prostate cancer.
• Signal Transduction Inhibitors: These drugs block the activities of molecules that participate in signal transduction, the process by which a cell responds to signals from its environment. Examples include Sorafenib (Nexavar) and Sunitinib (Sutent).
• Gene Expression Modulators: These therapies modify the function of proteins that play a role in controlling gene expression. Examples include Histone deacetylase (HDAC) inhibitors.
• Apoptosis Inducers: These drugs cause cancer cells to undergo programmed cell death, or apoptosis. An example is Venetoclax (Venclexta).
• Angiogenesis Inhibitors: These block the growth of new blood vessels that tumors need to grow. Examples include Bevacizumab (Avastin).
• Proteasome Inhibitors: These block the action of proteasomes, which help destroy proteins that cells no longer need. Examples include Bortezomib (Velcade).
• PARP Inhibitors: These block an enzyme used by cells to repair damaged DNA, leading to cancer cell death. Examples include Olaparib (Lynparza).

Who is Treated with Targeted Therapy in India?

Targeted therapy is used to treat many types of cancer, often when:

• The cancer has specific genetic mutations that can be targeted.
• Other treatments, such as chemotherapy and radiation, are not effective or have stopped working.
• The cancer has spread (metastasized) and is no longer localized.

Cancers commonly treated with targeted therapy include breast cancer, lung cancer, colorectal cancer, melanoma, and various types of leukemia and lymphoma.

How Does Targeted Therapy Work Against Cancer?

Targeted therapies work in several ways:

• Blocking Growth Signals: Some targeted therapies block the signals that tell cancer cells to grow and divide. For instance, EGFR inhibitors block signals from the epidermal growth factor receptor, which is often overactive in cancer cells.
• Inducing Apoptosis: Some targeted therapies can cause cancer cells to undergo programmed cell death. For example, Venetoclax (Venclexta) mimics a protein that cancer cells rely on to stay alive, causing them to self-destruct.
• Inhibiting Angiogenesis: By blocking the development of new blood vessels, angiogenesis inhibitors starve the tumor of nutrients and oxygen needed for growth.
• Delivering Toxins to Cancer Cells: Some targeted therapies deliver toxic substances directly to cancer cells, reducing harm to normal cells. An example is antibody-drug conjugates.
• Blocking the Repair of DNA: PARP inhibitors prevent cancer cells from repairing their DNA, leading to cell death, especially in cancers with specific genetic mutations.

Are There Drawbacks to Targeted Therapy?

While targeted therapies offer many benefits, there are some drawbacks:

• Resistance: Cancer cells can develop resistance to targeted therapies, similar to antibiotic resistance in bacteria. This may occur due to mutations in the target or activation of alternative pathways.
• Limited Targets: Not all cancers have identifiable targets suitable for therapy, limiting the use of targeted treatments.
• Cost: Targeted therapies are often very expensive, which can limit accessibility for some patients in India.
• Side Effects: Although generally less severe than those of chemotherapy, targeted therapies can still cause significant side effects.

What are the Side Effects of Targeted Therapy?

Side effects of targeted therapy can vary depending on the specific drug and target but may include:

• Fatigue
• Diarrhea
• Liver problems (elevated liver enzymes)
• Skin problems (rash, dry skin)
• High blood pressure
• Blood clotting issues and wound healing complications
• Mouth sores
• Heart problems (in some cases)

What Can I Expect When Having Targeted Therapy?

When undergoing targeted therapy in India, you can expect the following:

• Testing for Targets: Your doctor will perform tests to identify specific targets, such as genetic mutations or proteins in your cancer cells.
• Treatment Plan: Based on test results, your doctor will develop a treatment plan that may involve oral medications, injections, or intravenous infusions.
• Monitoring: Regular monitoring through blood tests, imaging tests, and physical exams to assess the effectiveness of the therapy and manage any side effects.
• Adjustments: Your treatment plan may be adjusted based on how well your cancer responds to the therapy and any side effects you experience.

Where Can I Find Out About Clinical Trials of Targeted Therapy in India?

To learn about clinical trials for targeted therapy in India, you can:

• Visit ClinicalTrials.gov: This is a comprehensive database of privately and publicly funded clinical studies conducted around the world, including India.
• Consult with Your Oncologist: Your doctor may be aware of ongoing clinical trials and can help determine if you are eligible to participate.
• Cancer Research Centers: Many leading cancer centers in India, such as Tata Memorial Centre (Mumbai), All India Institute of Medical Sciences (AIIMS, New Delhi), and National Cancer Institute (NCI, Jhajjar), have information about clinical trials and can provide resources and support for enrollment.
• Patient Advocacy Groups: Organizations such as the Indian Cancer Society, Cancer Patients Aid Association (CPAA), and others often have information about clinical trials and can offer guidance.

Conclusion

Targeted therapy has revolutionized cancer treatment by offering more precise and personalized approaches. While there are challenges and side effects associated with these treatments, ongoing research and clinical trials continue to advance the field, providing new hope for patients with various types of cancer in India.

Discover the Best Oncologists and Cancer Hospitals in India

When it comes to cancer treatment, finding the right specialist and hospital can make a significant difference in the outcome. In this blog, we have compiled a list of the top oncologists and cancer hospitals across major cities in India, ensuring that you have access to the best care available.

Top Oncologists in Major Cities

For those seeking expert oncologists, we have identified the best specialists in key cities:

• Best Oncologist in Delhi
• Best Oncologist in Mumbai
• Best Oncologist In India

Leading Cancer Hospitals

In addition to finding the right specialist, choosing the right hospital is crucial for comprehensive cancer care. Here are the top hospitals in major cities:

• Top 5 Cancer Hospitals in Mumbai
• Top 5 Cancer Hospitals in Delhi
• Top 10 Cancer Hospitals in India

Conclusion

Finding the right oncologist and hospital is the first step in your cancer treatment journey. Explore the links above to learn more about the top specialists and hospitals in your area.