Molecular Targeted Drugs

On June 26, Time magazine ran a story about molecular targeted therapy for treating cancer, characterizing these drugs as the promising future of cancer treatment. These therapies target cancer cells bearing one or more specific mutations. While general medical opinion suggests these molecular drugs are less damaging to healthy cells than conventional chemotherapies, other views suggest that targeted therapies are more likely than standard chemotherapy drugs to cause certain types of severe side effects that are typically experienced by small numbers of patients. 

Whichever is correct, because these drugs work by interfering with the specific molecules involved in tumor growth and progression, they do represent an advance in treatment. At the Block Center, we employ certain ones with individual patients whenever they are indicated. We are finding, however, that they’re not entirely the “miracle drugs” that we’d like them to be. 

For one thing, while targeted therapies don't share the same side effects as chemotherapy drugs, they are not totally free of problematic side effects, and many can be quite significant. Another myth circulating among both clinicians and patients is that patients will not develop a resistance to these drugs as they do with chemotherapies. This is simply not accurate. Individual patients do develop drug resistance. In fact, this can occur even more quickly than with chemotherapy, often with a full return of disseminated disease. And once cancer cells develop resistance to a specific drug, treatment must be halted. 

For this reason, scientists are experimenting with ways to combine two drugs, or even remove resistant portions of tumors if there are other non-resistant sections, so that treatment can be continued. But often, and perhaps even more than with chemotherapy, it appears that using two molecular drugs at a time magnifies side effects considerably. Plus, additional work is needed to determine which combination of drugs will be feasible for patients.

And then there’s the concern about cost. The new drugs are extremely expensive. Will insurance companies pay for multiple drug regimens in these scenarios? Not without far better results than we’ve seen so far. As it is now, the impact of these targeted drugs on survival is often measured in just weeks to months. Not what most insurance companies are expecting from costly drugs and certainly not an exciting prospect for most patients looking for years, if not a “permanent remission.”

But the idea of using two drugs with different molecular targets at the same time does make sense. I’ve discussed this before; it’s a concept called “multi-targeting. The thinking behind the multi-targeting approach is one I began exploring in a clinical and research setting, and before the recent wave of molecular targeted drugs was actively implemented. Details of how to incorporate this approach into a patient's treatment can be better understood in my book, Life Over Cancer.

Because cancer is a complex, multi-faceted disease with many dysregulated genes, an innovative, multi-targeted approach to treatment is essential to effectively address the multiple growth pathways that drive malignant disease. As it turns out, there are several natural compounds that have the ability to address these numerous targets. Examples include curcumin from turmeric, EGCG from green tea, and a host of other natural products. When combined with drugs, these can target multiple cancer defects without adding to the toxicity from drugs, and when carefully selected they can even provide a beneficial synergistic impact. Furthermore, their toxicity is generally a non-issue.

In addition, certain dietary changes, such as cutting saturated and omega-6 fats from meals, or eating low-glycemic foods — avoiding refined flours and sugar -- can help disable mutated genetic and disrupted growth pathways. And, as I believe about complementary interventions in general, such a strategy offers the greatest benefit in the context of a comprehensive, individually-tailored integrative treatment plan.

How do you find out which mutated genes, defective proteins and disrupted pathways might be driving your cancer? Your oncologist may have already done one or more tests on your cancer tissue in order to determine if you have a specific mutation, mostly to determine whether you might be a candidate for a particular single drug. But there is an emerging set of tests that assess multiple mutated genes, and we have started using a set of these at the Block Center. We use a far more comprehensive disease-specific panel of tests that we have designed to assist both with individualizing drug choices and for addressing the multiple growth pathways that might be targeted with select natural products.

Once testing has been performed, our research team and I design a regimen to address the various defects unique to your tumor, rather than hitting just one or two targets tested in more conventional approaches. While this test isn’t necessary for all patients, it can add important information to a strategy for treating different cancers, and may be particularly valuable for patients with advanced cancers.

In summary, molecular targeted drugs and the understanding that has led to this advance bring a new perspective to cancer treatment and, in time, hold the potential to revolutionize cancer care. However, the continued fixation with a drugs-alone mindset hampers our ability to reach genuine solutions. With these emerging innovations, combined strategically with a full integrative approach to care — including individually tailored supplementation plans using specific natural compounds — larger steps can be taken to potentially improve tolerance, response to treatment and enhanced benefit of these newer therapies. This is what I hope will be the future of cancer treatment for every patient battling one of these cancers, and it is what every patient deserves.'

For more information on The Block Center for Integrative Cancer Treatment, call (847) 230-9107 or visit BlockMD.com.

Comments

[MrsJP]

I will never do chemo or radiation. Quality of life with out the poison is the way I'll go. Cancer research has had plenty of time. It's all a money game for both pharma and natural remedies that prey on peoples hopes.