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.