How Immunotherapy Targets Cancer Cells
Immunotherapy is an advanced type of cancer treatment. Instead of surgical procedures or radiation therapy, it works alongside the body’s natural immune system to fight
Treatments such as surgery, chemotherapy, and radiation therapy have been used in cancer care for decades. But cancer research is always advancing, and a newer form of treatment is becoming more widespread: targeted therapy. This approach uses specially formulated drugs to directly target cancer cells.
With locations in New Jersey, Connecticut, Maryland, and the Washington, D.C., area, Regional Cancer Care Associates (RCCA) offers a wide range of treatment options for all types of cancer, as well as treatment for blood disorders. Learn more about targeted therapy, how it works, and the types of cancer it can treat.
Targeted therapy is a form of precision medicine used in cancer treatment. The drugs used in targeted therapy work by interfering with or interrupting cellular processes that allow cancer to grow or spread. Unlike chemotherapy, targeted therapy can attack cancer cells while sparing healthy cells.
Before the introduction of targeted therapy, most cancer drugs worked by killing rapidly dividing cells. This enabled them to inhibit the growth of fast-growing cancer cells but could cause side effects such as hair loss because the drugs also affected non-cancerous cells that tend to divide rapidly, such as the cells involved in hair formation. The science behind targeted therapy was understood as early as the 1960s, but it was not until the 1970s that the first form of targeted cancer therapy was approved for use in breast cancer treatment.
The human body is made up of trillions of cells that have widely varying functions and that serve as the building blocks of tissues. The genes inside these cells are like a set of instructions for the cell proteins. If healthy cells become abnormal – a process known as genetic mutation – the cells can start to divide too frequently or too quickly. They live longer than they normally would and can develop into malignant tumors. These tumors can grow and invade other tissues or organs in the body.
Some forms of cancer respond better to targeted therapy than others. Targeted therapy currently is used to treat several types of cancer, including:
Researchers care working to expand the role of targeted therapy in other types of cancer, including both solid tumors and cancers of the blood and blood-forming tissues.
Different cancer drugs have different mechanisms of action. Targeted therapy drugs are designed to bypass normal, healthy cells and pinpoint specific mutations present in or on the surface of cancer cells. These drugs work by the following mechanisms:
The advantage of targeted therapy is that it kills cancer cells without hurting healthy cells, and it can help stop cancer from growing and spreading. However, targeted therapy has some limitations. It is not a good fit for every type of cancer, and in some cases, cancer cells can develop resistance to targeted therapy drugs. And like other cancer treatments, targeted therapy can cause side effects.
Targeted therapy is a form of precision medicine, a personalized approach to cancer treatment that takes into account a person’s genetics, environment, overall health, and lifestyle. An important aspect of targeted therapy is molecular profiling, the process of identifying specific cancer biomarkers that might respond to or resist certain forms of treatment. A biopsy is used to obtain a sample of cancer cells, which could be from a tumor, a lymph node, blood, or bone marrow. The sample is then analyzed using molecular profiling tests.
Cancer biomarkers are specific proteins, genes, or other substances that can be tested and analyzed. These biomarkers give medical oncologists important information that can help them develop treatment plans likely to offer the best outcomes for a specific patient. Testing for biomarkers can help:
Two common approaches to targeted therapy are the use of monoclonal antibodies and small-molecule drugs.
Monoclonal antibodies, also known as mAbs, are man-made versions of the antibodies that naturally occur in the human body. These proteins monitor and target antigens, the foreign substances that indicate the presence of an infection, virus, or disease, such as cancer. Monoclonal antibodies can attack cancer cells in different ways. Some enhance the immune system’s ability to recognize and eliminate cancer cells. Others directly attack malignant cells by interrupting cell growth.
Monoclonal antibodies usually are made with molecules that are too big to enter cells. They work by blocking specific targets on the cell surface or in tissues around the cancer. In contrast, small-molecule drugs are minuscule enough to enter cancer cells. One type of small-molecule inhibitor, for example, stops tumors from making new blood vessels. Without the blood supply needed to thrive, the cancer is less likely to grow or spread.
A healthy immune system has a type of white blood cell called a T cell. A key role of these T cells is to recognize and attack harmful antigens, such as cancer cells. However, the body also has so-called immune checkpoints, which prevent T cells from mistakenly attacking cells that do not pose a threat. Cancer cells can sometimes use immune checkpoints to “hide” from T cells, and continue to develop and spread undetected. Checkpoint inhibitors essentially “unmask” cancer cells so that they can be recognized and attacked. Checkpoint inhibitor drugs often are monoclonal antibodies.
Immune checkpoint inhibitors can be used to treat several cancers, including:
Checkpoint inhibitor drugs can cause side effects such as nausea, fatigue, and joint pain. In rare cases, these drugs may induce an autoimmune reaction that can lead to organ failure.
As with other forms of cancer treatment, side effects may occur during or after targeted therapy. Common side effects of targeted therapy include:
The frequency and severity of these side effects can vary based on the specific cancer drug. A patient’s oncology team can offer strategies for managing side effects and related symptoms. Fortunately, most side effects will go away over time once treatment is completed.
Molecular profiling is used to test cancerous cells for specific biomarkers. Once an oncology team understands the genetic mutation that caused a certain type of cancer to develop, the team can identify potential drugs that will target proteins or other substances on the surface of or inside cancer cells.
The medical community is still learning about biomarkers and how they inform cancer treatment. Some of the challenges associated with targeted therapy arise when a particular treatment does not work as expected. Sometimes, tumor cells continue to grow and mutate.
There are now dozens of types of targeted therapies used to treat different kinds of cancer. In skin cancer treatment, about half of patients with melanoma have a specific biomarker known as a BRAF gene mutation. The BRAF protein can help melanoma grow and spread. The selective BRAF inhibitor vemurafenib targets this protein, so it can stop the tumor from growing and spreading.
Another example of targeted therapy is a monoclonal antibody known as trastuzumab, which targets HER2, a cell-signaling protein. HER2 is overactive in about 25 percent of breast cancer cases. The drug binds to the protein and triggers an immune reaction to kill cells with high HER2 levels.
Common side effects of targeted therapy include fever, fatigue, nausea, and high blood pressure. One of the more common side effects is skin problems, including redness, rashes, and increased sensitivity to ultraviolet (UV) rays. To manage skin irritation and sensitivity, providers may recommend strategies such as:
As the field of cancer care continues to advance, targeted therapies offer a promising option for more personalized treatment. The medical oncologists at RCCA have extensive experience developing cancer care plans that include targeted therapy as an injection, infusion, or oral medication. Nationally recognized for excellence in cancer care as well as for treatment of blood disorders, RCCA has more than 20 locations throughout New Jersey, Connecticut, Maryland, and the Washington, D.C., area. Contact us for more information or to request an appointment.
At Regional Cancer Care Associates (RCCA), our doctors deliver top-quality, state-of-the-art treatment close to your home. We are proud of our healthcare teams because they are respected by their peers and trusted by our patients. At RCCA, we will be with you and your loved ones every step of the way, with our nationally-recognized level of cancer care.
Call (844) 346-7222 for more information or to schedule an appointment. You can also schedule an appointment by calling the RCCA location nearest you.
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