Targeted Therapy

What is targeted therapy?

Targeted therapy is a cancer treatment that destroys cancer cells without harming healthy ones. In targeted therapy, oncologists identify specific genetic changes or mutations in your body that turn normal cells into cancer cells. Then, they select treatments that target the specific parts of the cancer cells that the genetic abnormalities activate. Oncologists may call targeted therapy a type of precision medicine.

How does targeted therapy work?

Cancer starts when something rewrites healthy cells’ genetic instruction book. Following the new genetic instructions is how healthy cells become cancer cells. To use targeted therapy, oncologists typically perform these steps:

• They’ll research the genetic mutation that changes a healthy cell into a cancer cell.
• Your oncologist will decide which parts of the cancer cell to target. They may focus on the cell’s surface or substances inside the cell.
• They’ll use what they learn to develop a drug to hit the targeted areas of cancer cells. The drug may kill the cells or block the genetic instructions that make the cells multiply.

There are many different types of targeted therapy. Oncologists classify types by the way they work. Targeted therapies include:

• Small-molecule drugs that focus on targets inside cancer cells and disrupt growth
• Immunotherapies like monoclonal antibodies, bispecific antibodies and CAR T cell therapy
• Antibody-drug conjugates

What kind of cancer does targeted therapy treat?

Oncologists commonly use targeted therapy to treat breast cancer, lung cancer and prostate cancer. It may be a treatment option for:

• Blood cancers, including multiple myeloma, acute leukemia and non-Hodgkin lymphoma
• Bone and soft tissue cancers, including some soft tissue sarcomas
• Common digestive system cancers, including colorectal (colon) cancer and esophageal cancer.
• Female reproductive system cancer, including cervical cancer and endometrial cancer
• Head and neck cancers, including laryngeal cancer and nasopharyngeal cancer
• Skin cancers, like melanoma and squamous cell carcinoma
• Thyroid cancers, like anaplastic thyroid cancer and medullary thyroid cancer
• Urinary system cancers, like bladder cancer and kidney cancer

Who’s a candidate for targeted therapy?

This treatment works by hitting specific targets in cancer cells. You may be a candidate if there’s a drug available that works against the type of cancer that you have.

What happens during targeted therapy?

There are more than 100 kinds of targeted therapy drugs. You may receive targeted therapy:

• In a pill that you swallow
• In a shot
• Through an IV

Your treatment schedule will vary depending on the targeted therapy drugs you receive. For example, you may have treatment every day, weekly or monthly. Sometimes, treatment may be indefinite; other times, it may have a pre-determined duration.

Your cancer care team will schedule regular visits. These allow your provider to see how you’re feeling and check how well your treatment is working. You may have blood tests, X-rays, computed tomography (CT) scans and other tests. The test results show your care team how well the targeted therapy is working. They’ll also ask how you’re doing with any treatment side effects.

Potential side effects

Targeted therapy side effects vary, but some common ones include:

• Bleeding in your stomach or intestines, which may cause changes in your poop like bright red blood or black tarry poop
• Blood clots
• Diarrhea
• Dry skin or rash
• Elevated liver enzymes
• Heart conditions, like arrhythmia and cardiotoxicity
• High blood pressure (hypertension)
• Loss of hair color
• Pulmonary fibrosis
• Wounds (cuts) that heal slowly

Your oncologist considers potential side effects when they recommend treatment. They’ll explain the different ways treatment may affect you. They’ll also discuss medication or other steps that can prevent or relieve side effects. For example, they may recommend palliative care.

What’s the success rate of targeted therapy?

The success rate of targeted therapy varies significantly. Factors like the type of cancer you have, the cancer stage and your health can affect treatment success rates. Ask your oncologist for information about success rates for the type of cancer that you have.

When should I call my oncologist?

You’ll have regular check-ups with your oncologist and other cancer care team members. Those check-ups will be an opportunity to discuss any issues or concerns. But don’t hesitate to contact them right away if you have side effects that are more serious than you expect.

Is targeted therapy better than chemotherapy?

In a sense, targeted therapy can be better than chemotherapy because it’s much more selective when destroying cancer cells. But not everyone is a candidate for targeted therapy. In that case, chemotherapy is an effective cancer treatment. Also, in some cases, the combination of targeted therapy and chemotherapy works better than either treatment alone.