Systematic anti-cancer therapies
Downsides to targeted therapy and potential problems
Despite the benefits of targeted therapy on cancer overall survival (OS) and the continuous research leading to new developments, there are still problems with targeted therapy approaches and the development of targeted therapy has several issues hindering its development. Despite there generally being reduced side effects with targeted therapy approaches there are still side effects which are often different to the ones caused by chemotherapy but still very uncomfortable. An example of this is with the HER2-positive breast cancer treatment. 18 The drugs used can cause heart damage which can lead to congestive heart failure, severe diarrhoea and some even cause hand-foot syndrome or serious lung disease. Many of these inhibitors and monoclonal antibodies are very difficult and expensive to develop and produce, meaning that currently these targeted therapy approaches are only available privately, so for many people their only option is to continue to use the more toxic and less effective chemotherapy drugs. Furthermore, many of these drugs developed are only useful in about 1% of cases within a specific cancer and the investment could potentially be better used to improve training or facilities within hospitals. 19 Extensive mapping of the genome of the cancer tissue can potentially have a negative effect as it leads to too much information to process as it’s impractical to examine every gene of the cancer looking for abnormalities for every patient who has cancer. This rising complexity could also potentially lead to more clinical errors being made and may result in further specialties being required due to the extreme complexity of the quantity of different drugs and monoclonal antibodies used for specific gene mutations within the cancer. Some cancerous tissue can quickly develop resistance to treatments such as SCLC which, despite originally responding well to platinum based chemotherapy, mutates to develop resistance to it, 20 meaning that other drugs need to be used creating a race against the cancer to find effective drugs to treat it.
Conclusion
In conclusion, there are challenges that face the development of targeted therapy, in particular, the funding required to research into the development of new drugs to target specific characteristics of cancers. Despite this, targeted therapy is here to stay as a more effective and individualized method of treating cancer with fewer side effects and toxicity than chemotherapy.
18 See note 11. 19 See note 5. 20 See Niu, X. Chen, L. (2022) ‘Ferroptosis, necroptosis, and pyroptosis in the tumor microenvironment: Perspectives for immunotherapy of SCLC’, Seminars in Cancer Biology 86(3): 273-285.
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