SERVICES

1. What is IMMUNOTHERAPY
These drugs modulates the natural immune system of our body to attack cancer cells.
Immune system of our body protect us from infection and foreign bodies. If it recognizes cancer cells as foreign body and attacks the cells. But most often it does not as cancer cells are formed from normal cell. In cases where immunotherapies work. They live reasonably long life with minimal side effects. With advent of these drugs we have changed the way we cure cancer.

2. Immunotherapies helps our immune system to recognize cancer cells and strengthen its response.

3. How it works and different from chemotherapy
Chemotherapy directly kills cancer cells. Immunotherapy aids or boosts function of our immune system to destroy cancer cells.

4. Immunotherapy works on which cancer:
There are special tests done which can help us to know if Immunotherapy will work on that kind of cancer. Immunotherapy treatment is a tissue or tumor agnostic therapy. This therapy is based on cancer genetics and molecular features and not where cancer has originated from(primary). The first approved tumor agnostic Immunotherapy, is PEMBROLIZUMAB for treating tumors positive for biomolecular known as microsatellite instability. This was approved by FDA in 2017.

5. Types of Immunotherapy

a) Immune checkpoint inhibitors
b) T-cell transfer therapy/CART –T cell therapy
c) Monoclonal antibodies
d) Treatment vaccines
e) Immune system modulates

6. Side effects of immunotherapy:

7. Since they modulate immune system they can sometimes harm other organs. But early detection of side effects and years of use equip us well with side effects management.

TARGETED THERAPY

1. They are part of precision medicines. These drugs target cancer cells without harming normal cells. They inhibit molecular pathways which are essential for growth and maintenance of cancer cells.
2. How do they work
   a) By blocking chemical signals that tell cancer cells to grow or divide.
   b) Change proteins within cancer cells so that they die.
   c) Stop making new blood vessels supplying tumor.
   d) Modulates immune system to kill cancer cells.
3. Some examples of Targeted therapy
   1. TRASTUZUMAB: If tumor cells express HER 2 New receptor, these drugs attach to it and stops growth. Has role in breast cancer and sometimes in gastric cancer.
   2. BEVACIZUMAB: Here act as antiangiogenesis ie stop making new blood vessels supplying tumors. Works in Ovarian cancer and certain brain tumors.
   3. BORTEZOMIB: They block an enzyme called proteasomes. So that protein builds up inside the cell causing cell death.
   4. PARP: Inhibitors like OLAPARIB which kills BRCA mutated cancer cells in Ovarial or breast cancer.

There are many more targeted therapies available. Some of them are in oral form and it made life treatment easier and better for many types of cancer. Your doctor will advise you to do certain test on basis of which he will prescribe Targeted therapy.

Targeted therapy and Immunotherapy are part of precision medicine. We are in many ways moving away from chemotherapies and adopting more and more Targeted therapies with lesser side effects.