Targeted Therapy

There's a very interesting article on targeted therapies in the current issue of Cure, a magazine for cancer patients and their loved ones. (Cure is the kind of magazine that you find 100 free copies of in oncologists' waiting rooms. That's not a criticism -- it's a very good, general cancer magazine.)

The article is called "Targeted Therapies: Hope or Hype?", and it discusses some of the promise and frustrations that targeted therapies have had over the years. Targeted therapies are cancer treatments that are developed in response to research that has identified some biological mechanism in a type of cancer; the treatment is aimed at shutting down the tumor by shutting down that particular mechanism that makes the tumpr grow. (The article uses a nice analogy: it's like stopping a car not by using the breaks, but by disconnecting the spark plugs.) The idea is to hit the cancer cells without doing damage to the healthy cells (which is the big problem with standard chemotherapies).

Targeted therapies were initially greeted with much fanfare, and early treatments were hailed as miracles. But, as the article points out, researchers have realized that stopping cancer isn't as easy as they had hoped, for lots of reasons. For instance, tumors usually have more than one mechanism that keeps them growing, so you need multiple targeted therapies to do the job of shutting them down permanently, which means different strains of research to identify the different emchanisms, and then time and money to develop the individual therapies.

There are other reasons, too, but you get the point -- this isn't a quick fix, much as we'd all like one.

Still, I'm leaning WAY to the side of "hope," rather than "hype." in the question posed by the title of the article.

Consider, for example, that Rituxin is an early instance of a targeted therapy. It targets CD20 proteins on lymphoma cells, without damaging other cells. A perfect example.

And a perfect example of a success -- the use of Rituxin has about doubled the overall survival rate of Follicular NHL patients in the last 10 years.

I think I've been looking deeply enough into all of this over the last year and a half to know that a miracle treatment isn't coming really soon. Maybe some day, but not really soon. For something like fNHL, which is essentially a chronic illness (or should be looked at as one, anyway), the "hope" comes in knowing that more and more targeted therapies are being developed, and that each one has the potential to stretch a remission just a little bit longer, with a little less toxicity than the last.

What they provide is time. And that's really what hope is all about.