Sunday, 2 June 2019

precision medicine in cancer care



The  new paradigm in cancer management – precision medicine

A form of medicine that uses information about a person’s genes and proteins to prevent, diagnose, and treat disease.

Most standard chemo drugs work by killing cells in the body that grow and divide quickly. Cancer cells divide quickly, which is why these drugs often work against them. But chemo drugs can also affect other cells in the body that divide quickly, which can sometimes lead to serious adverse effects

With the advancement of scince a lot of information has been gathered regarding the genes and proteins that cause the formation, growth and spread of cancer cells.

This new information is now being utilized to specifically design drugs that target these genes and proteins

There are many different types of cancer, and not all cancer cells are the same. For example, colon cancer and breast cancer cells often have different gene changes that help them grow and/or spread. Even among people with colon cancer, the cancer cells can have different gene changes.

Therefore for each patient a portion of the tumor tissue is taken and subjected to molecular and genetic analysis and depending on the target identified specific drugs are administered to counter their effects – hence the name ‘precision medicine’

How it works –

  • Block or turn off chemical signals that tell the cancer cell to grow and divide
  • Change proteins within the cancer cells so the cells die
  • Stop making new blood vessels to feed the cancer cells
  • Trigger your immune system to kill the cancer cells
  • Carry toxins to the cancer cells to kill them, but not normal cells





More effective with better side effect profile. May be administered in outpatient setting. Better quality of life

Before 2001, fewer than 1 in 3 people with chronic myelogenous leukemia (CML) survived more than five years after diagnosis. Then, along came Gleevec. The U.S. Food and Drug Administration (FDA) approved the drug as a targeted treatment for CML in 2001. Treatment for CML hasn’t been the same since. A 10-year follow-up study showed that 83 percent of people using the drug survived 10 years, some well beyond the decade mark. They did so without unacceptable toxic effects.

Long-term results from a major international clinical trial reveal that a fifth of patients with advanced gastrointestinal stromal tumours (GIST) continue to survive a decade after first taking the targeted drug imatinib, also known as Glivec.

Some 10% of patients are still on the trial after 10 years, living free of any progression of their cancer – providing evidence that targeted cancer therapy can deliver dramatic, long-term responses even in patients with advanced cancer that has spread round the body.




Dr VIBHOR MAHENDRU

Sr Consultant – Cancer Surgery

Sahara hospital

SM Cancer Centre

A26, Faizabad road

Indiranagar

2 comments:

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