The days of science fiction meeting reality are here.
Individualized therapy for cancer and chronic disease based on an individual’s genomics, lifestyle, and environmental factors are now part of clinical medicine. The Human Genome Project, completed in 2003, decoded the entire human genome composed of 3 billion DNA base pairs and identified the exome that contains approximately 23,000 genes. The exome is only 2% of the entire DNA content of the entire genome but is where proteins are encoded. The majority of disease causing mutations occur in the exome.1
In 2015, the US Precision Medicine Initiative placed cancer research and treatment at the forefront of medical priorities in the country. Precision medicine incorporates the use of genomic information to guide medical decision making.2 Targeted therapy is a type of cancer treatment that blocks cancer cell growth by interfering with targeted molecules involved with development of cancer.3
One targeted therapy that has been used in early and late stage breast cancer treatment is Herceptin. Herceptin acts on the receptor site for human epidermal growth factor receptor 2 (Her-2). The Her-2 pathway promotes growth and cell division when it is functioning normally but when the Her-2 protein is overexpressed on cell membranes there is unregulated cell growth and tumor formation. Herceptin blocks the Her-2 receptor function and in turn prevents cancer cell proliferation. Targeted breast cancer drugs may work when conventional chemotherapy does not work and may work in concert with other treatments.4 Her-2 chemotherapy medications are similar to other adjuvant chemotherapy agents used for advanced breast cancer. They may cause cardiotoxicity especially if used with anthracycline chemotherapy agents.5
Immunotherapy - Check Point Inhibitors
Immunotherapy is actually not a new therapeutic modality but has not been particularly beneficial in cancer treatment in the past. However, expanded knowledge about immunology and better understanding about the molecular behavior of cancer cells have led to the creation of new forms of cancer treatment like immunotherapy that can potentially extend and improve the lives of patients living with cancer.
Immunotherapy uses the body’s immune system to fight cancer. The immune system is efficient at identifying and destroying tumors even after early malignant transformation. However, the malignant clones are able to evade the immune system’s surveillance through a complex process called immunoediting.