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Chemotherapy & targeted therapies

Constant innovation is transforming the treatment of cancer.

During World War II, scientists discovered that a group of people who were accidentally exposed to mustard gas had low white blood cell counts. Concluding that the gas hindered the growth of rapidly dividing cells, they speculated that this otherwise deadly compound might be a valuable weapon against cancer — and chemotherapy was born.

Since then, researchers have been seeking increasingly sophisticated drug therapies for cancer and its symptoms. Their innovations range from alternative dosing strategies and methods of delivering chemotherapy directly to a tumor to the creation of altogether new categories of life-extending anticancer drugs.

New treatment techniques

These alternative approaches to chemotherapy may help make treatments more powerful while limiting side effects.

Chemotherapy resistance testing. Before your treatment begins, your doctors can perform laboratory tests on tumor cells to determine which drugs are likely to be most effective against the cancer. Not only does testing limit unnecessary exposure to potentially toxic chemotherapy agents, but it can be especially valuable when there’s a choice between two or more possible treatments.

Metronomic chemotherapy. The chemotherapy is delivered in small, regular amounts over a prolonged period rather than all at once. While the individual doses used in metronomic chemotherapy are smaller than typical doses, giving them at frequent intervals can not only shrink the tumor by inhibiting the growth of the blood vessels that feed it, but may also destroy cancer cells.This approach is also less toxic and easier to tolerate than traditional chemotherapy, in which the maximum tolerated dose (MTD) is used.

Intra-arterial chemotherapy (IAC). This treatment is used most commonly in the treatment of liver cancer, but may also be used for head, face, neck, pancreatic, and pelvic cancers. The medication is delivered through the arteries that lead to the site of the tumor. The goal is to subject the cancer to a very high dose of chemotherapy while delivering less to the rest of your body.

Intraperitoneal chemotherapy. In this treatment for ovarian cancer, chemotherapy is administered directly to your peritoneal area, or abdominal cavity, to prevent tumor cells from forming.

Targeted drug therapies

While traditional chemotherapy agents aim to destroy rapidly dividing cells, new types of drugs interfere with the development of cancer at the molecular level. Because these drugs target specific molecules, they’re sometimes called molecular-targeted treatments.

Targeted therapies are more selective than traditional cancer therapies and spare more healthy cells. Ultimately researchers hope to develop targeted therapies tailored to the unique molecular characteristics of each individual’s tumor, resulting in truly personalized treatment.

Many targeted therapies are still in development, but others are in clinical trials or have already been approved by the FDA. They are being tested for use alone, in combination with other targeted therapies, and with conventional treatments, such as traditional chemotherapy.

  • Anti-angiogenesis drugs: Chemicals in the body control the process of angiogenesis, or the formation of new blood vessels. These drugs are designed to stop the spread of cancer by cutting off the blood supply that feeds tumors. Several anti-angiogenesis medications are already available and are used in coordination with standard chemotherapy to increase its effectiveness.

  • Apoptosis-inducing drugs: Also known as programmed cell death (PCD), apoptosis is the orderly process of cell death by which the body disposes of abnormal, diseased, or unnecessary cells. Unlike normal cells, however, cancer cells are unable to undergo apoptosis. These drugs stimulate cancer cell death by interfering with proteins and other substances in tumor cells that cause them to live longer than normal cells.

  • Differentiation drugs: These drugs cause immature cells to become more differentiated, making them function more like normal cells and limiting the uncontrolled growth associated with cancer. This approach has potential for cancer prevention, and the FDA has already approved one such drug to protect people who have a high risk of developing colon cancer.

  • Signal transduction inhibitors: These drugs prohibit the spread of cancer cells by interfering with the communication signals they rely on to grow. Also present naturally in foods such as soy and citrus fruits, signal transduction inhibitors may help stop cancer from spreading to healthy tissue.