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ELIZABETH AU ONCOLOGY

Cancer Care and Treatment

Immunotherapy, Targetted Therapy, Is there a Difference?

Targetted therapy means precisely what it says: there is a target and we have a medicine that works against that target. The target may be receptors that are present on the cancer cell, such as the estrogen receptor and Her-2 receptor on breast cancer cells. Or the target may be a receptor present on blood vessels supplying the cancer, such as VEGF or VEGFR. Using a VEGF inhibitor would hypothetically lead to less blood supplying the cancer. Other targets include mutations on cancer cells, such as EGFR, ALK and ROS-1 mutations found on lung cancer cells which make the cancer cells more sensitive to EGFR and ALK inhibitors, respectively. But sometimes, the presence of a mutation makes certain medicines not as effective, such as kras or nras mutations present on colon cancer cells make them less sensitive to EGFR inhibitors. Then there are multi-targetted drugs that work against many targets at the same time. Targetted therapy is a rapidly expanding field as scientists find more and more targets.

immune checkpoint inhibition

Imuunotherapy can mean many things. The recent "hot" drugs are called immune checkpoint inhibitors. In the human body, T-cells are activated by the cancer cell. These activated T-cells circulate, locate the cancer cells and attack the cancer cells. However, when PD-1 on the activated T-cell binds with the PD-L1 on the cancer cell, the T-cell becomes inactivated. Immune checkpoint inhibitors block the PD-L1 on the cancer cell, so the T-cell remains activated.