Exploring the contrasts among chemotherapy, immunotherapy, and targeted therapy is key to fully grasping the workings of cancer drugs

Drugs were not considered to be a "cure" for cancer until the 1960s; the cornerstones of cancer treatment were surgery and radiation. In the late 1930s, pharmacological therapies for prostate cancer in males produced, at best, a short-lived, incomplete remission. Hormone therapy was an exception. After the National Cancer Act of 1937 established the National Cancer Institute (NCI) and provided funding for cancer research, medical professionals and researchers started to focus more on employing chemical agents and pharmaceuticals to treat cancer. When chemotherapies were used to successfully treat children with leukaemia and adults with Hodgkin's lymphoma in the 1960s and early 1970s, these treatments represented the first major advances. More than 600 medications are currently approved in the US to treat cancer. The majority of them fight cancer in various ways and can be divided into three primary categories: chemotherapy, immunotherapy, and targeted therapy.

Chemotherapy attacks cancer cells

Chemotherapy medications kill cancer cells by preventing their growth and reproduction. Some chemotherapy medications only function during a particular cell cycle stage. Chemotherapy is administered in treatment cycles in part to deliver medications at their peak potency. To give your body time to strengthen before the following round or "cycle" of chemotherapy, treatment sessions are frequently separated by rest periods.

Chemotherapy medications efficiently target cancer cells that multiply and develop quickly, but they also target some healthy, normal cells that do the same, including blood cells, cells in hair follicles, and cells that line the digestive tract. Unfortunately, this is the root of a lot of the adverse effects of chemotherapy that are frequently experienced, including hair loss, nausea, vomiting, diarrhoea, and low blood-cell counts. An elevated risk of infection, exhaustion, and bleeding results from these adverse effects. Thankfully, these quickly proliferating healthy cells may frequently mend themselves once chemotherapy is over.

Examples of chemotherapy

• Alkylating agents include cyclophosphamide, carmustine, and temozolomide.
• plant alkaloids: Vincristine, Paclitaxel, and Vinblastine.
• Antitumor antibodies include rituximab, trastuzumab, and pembrolizumab.
• Antimetabolites: methotrexate, cytarabine Fluorouracil Etoposide, irinotecan, and topotecan are topoisomerase inhibitors.

The type of cancer you have, the medications' type and dosage, and your pre-treatment condition will all have an impact on side effects. Chemotherapy's side effects include diarrhoea, fatigue, a higher risk of bleeding and infection, hair thinning or loss, mouth sores, constipation, changes in taste, lack of appetite, and concerns with the nerves and skin.

Immunotherapy strengthens your defences

Biotherapy, also known as immunotherapy, employs medications that target cancer cells' capacity to evade your immune system. Some immunotherapy medications identify cancer cells and mark them so that the immune system can detect and eliminate them.

Types of immunotherapies

Instead, then directly attacking the tumour, checkpoint inhibitors interfere with how cancer cells escape an immune system onslaught. Checkpoint inhibitors include, for example the drugs Keytruda® (pembrolizumab) and Opdivo® (nivolumab).

• Adoptive cell therapy seeks to enhance your T cells' inherent capacity to combat malignancy. T-cells from your tumour will be tested by your cancer treatment team. It takes two to eight weeks to produce and multiply in big numbers the T-cells that are most effective against your malignancy. To decrease the quantity of immune cells in your body at this time, you might receive chemotherapy and/or radiation treatment. Following these therapies, you are given back a large number of laboratory-grown T-cells that are particularly effective against your cancer through an intravenous (IV) line to assault the cancer cells. Both Kymriah® (tisagenlecleucel) and YescartaTM (axicabtagene ciloleucel) are examples of adaptive cell therapy.
• Monoclonal antibodies are immune system proteins created in a lab with a specific target location on cancer cells in mind. Certain monoclonal antibodies identify cancer cells, allowing the immune system to recognise and combat them. Monoclonal antibodies include, for instance, the drugs Herceptin® (trastuzumab) and Erbitux® (cetuximab).
• Treatment vaccines combat cancer by enhancing your immune system's reaction to cancer cells. Vaccines used for treatment are distinct from those that aid in disease prevention. Provenge® (sipuleucel-T), a type of therapeutic vaccination, is one example.

Targeted therapy prevents the spread of cancer

This sort of medications works by obstructing specific chemicals, or "targets," that are essential for the growth and spread of cancer cells. Targeted therapies cause less harm to healthy cells than chemotherapy medications because they concentrate on stopping the growth of cancer cells rather than immediately killing them.

Types of targeted therapies

• Hormone therapies inhibit or stop the growth of malignancies that require certain hormones to proliferate. Examples include Lupron® (leuprolide) and Arimidex® (anastrozole).
• Angiogenesis inhibitors prevent the tumour from producing the additional blood vessels required for further growth. Examples are Zaltrap® (ziv-aflibercept) and Avastin® (bevacizumab).
• A signal for the cell to expand and divide, for example, is blocked by signal transduction inhibitors from one molecule to another inside a cell.
• Apoptosis inducers make cancer cells susceptible to apoptosis, a normal cell process that causes aged cells to die. Examples include LynparzaTM (olaparib) and Velcade® (bortezomib).

Certain restrictions apply to targeted therapy. The malignancy may develop a resistance to the treatments, rendering them ineffective. Targeted therapies are frequently administered in conjunction with other cancer medication therapy to prevent this. Diarrhoea, high blood pressure, skin rashes, issues with liver function, slow wound healing, and blood clotting are some of the side effects of targeted therapy. Many patients' treatment plans include drug therapy to treat cancer, control disease, relieve symptoms, and enhance the quality of life.

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