Could targeted therapy be the “new” trend in fighting degenerative cancer genes that are affect nearly 13,000,000 people in the world? Scientific and technological advances and in the health care system have, and will continue to change as long as there are researchers willing and able to create new innovations for the continuum of care. There is no general definition for molecular or targeted therapy. Targeted therapy can block the growth and spread of cancer, thus preventing cancer cells from dividing or destroying.
The idea behind this therapy is to create drugs that attack molecular pathways that cause disease, without upsetting the normal functions of other cells and tissues throughout the human body. The American Cancer Society list Breast cancer as the second cause of death in women, right behind brain and other nervous system cancers. Over, 2,000,000 women have been diagnosed with HER2 positive breast cancer, and this number will continue to rise and fall. Targeted therapy has already had a significant improvement for the outcomes for patients with HER2 positive breast cancer.
However, Chemotherapy continues to be the mainstream way for cancer treatments because of evaluations on safety and ability from the drug combinations of targeted therapy. The US Food and Drug Administration (FDA) has the role of assessing clinical trials during approval processes. Chemotherapy and the combination of targeted therapy drugs like Herceptin have shown increases in survival and response rates. For normal cells to become cancer cells is a process called carcinogenesis and targeted therapy find the molecules that create signals in pathways to keep this process from happening.
Drugs are introduced that block such pathways. Herceptin (Trastuzumab) is a humanized monoclonal antibody approved by the FDA in 1998. Rita Nahta and Francisco J. Esteva, from the University of Texas Department of Breast Medical Oncology (Nahta & Esteva, 2006) state that “Herceptin is the only HER-2-targeted therapy approved by the United States Food and Drug Administration for the treatment of metastatic breast cancer (MBC). ” Cancer disease progression begins within a year for most patients who respond to Herceptin.
The overall goal of targeted therapy is block the growth and spread of cancer and by concentrating on molecular changes that occur when tumors progress during therapy. By doing so, targeted therapy will pave the way that designs new approaches in targeted therapy with the combination of other therapies also. Other cancers that are being treated with Molecular Targeted Therapy drugs and with the combination of other therapies are Breast cancer, Brain cancer, Kidney cancer, Leukemia, Skin cancer, Lung cancer, and Thyroid cancer.
The cancers listed before are just a few that are being treated with this treatment of targeted therapy and there are clinical trials being performed regularly to approve more drugs. Health care spending will increase and decrease with advances in new innovations through targeted therapy, drugs, and technology. To control the cost of health care spending, targeted therapies need to be effective and generate a profit for the investors of new health care innovations. Questions must be asked when considering these changes. In an article from OncLive, Anna Azvolinsky interviews Dr. Thomas J.
Smith, director of Palliative Medicine at the Sidney Kimmel Comprehensive Cancer Center and professor of Oncology at Johns Hopkins Medical School, on the rising costs of cancer with targeted therapy. Dr. Thomas J. Smith asks some important questions on new high priced targeted therapy (Azvolinsky, 2012), “Does it work? Is there a clear-cut improvement in overall survival or disease-free survival, or quality of life that makes it better than other treatments? How much does it cost and to who? ” These questions are vital to ask, but when asking such questions remember to ask if the price outweighs the value.
According to The Value of Medical Innovation website (2013) “new targeted therapies developed and used since 2000 account for 1% of the total health care spending. ” Where is 99% of health care spending going? It goes towards doctors, surgery, and other procedures. Here is an example that is provided by the same website The Value of Medical Innovation (2013): “The cost of getting an infusion of chemotherapy for lung cancer and using a pill for lung cancer is about the same ($20,000). Insurers will cover 80% of the infusion costs, but 100% after out-of-pocket spending exceeds $1,500.
Meanwhile, the same health care plan will make someone pay up to 25% to 50% of the costs of the oral medicine with no out-of-pocket limit. ” The first human genome was discovered in 2003 after 10 years of research and over $1 billion in spending. Today, human genomes can be cataloged in half a day at roughly $500. Tomorrow and in the future, genomes could be cataloged within minutes costing a fraction of what it cost in the past. Molecular or Targeted Therapy is already becoming a trend in health care world, and will continue to do so with the advances in science and technology.
However, to fully implement targeted therapies through innovation obstacles must be met and challenged. The major obstacle is the cost of the therapy, and in many cases can cost a patient up to 40% of out-of-pocket expenses. These costs can be lowered depending on insurance providers, but most times insurance programs just offer prescription drug programs to lower the cost for out-of-pocket expenses. Side effects such as, allergic reactions, blood clots, heart failure, and immunity to therapy are also obstacles that need to be defined. Nevertheless, this trend will take off because of prolonging life expectancies.
Drugs that are developed for targeted therapy can be less toxic and possibly more effective than medicine and treatment plans that are currently in use. Targeted therapy often has fewer side effects, which is a common good for those who receive this form of therapy. Over 14 million have survived cancer in the last 30 years as a result of this form of personalized medicine know as molecular or targeted therapy. This number, too, will rise in the future. Medical and health innovation lead the way to life expectancy and population growths.
HIV and AIDS, for example, once crippled life expectancy but due to new innovations in medicine the advances have created a way to have a better control on the disease. HIV and AIDS is not a “global killer” anymore. With this in mind, targeted therapy and personalized medicine will eventually create a cure for degenerative cancer genes and that is a common goal from everyone in the medical and health care world! Costs will, as they always have been, be the misfortune of many advances, but the strides that will be overcome will be rewarding in the end.
The fight to end cancer will never end until a cure has been found. It would be nice to walk into a cancer center with cancer and walk out the same day without cancer. There are over 70,000 researchers that go to work to everyday with a goal of finding tomorrow’s medical miracles through advances in medicine and technology. Targeted therapy researchers learn better ways to understand diseases, to discover pathways to track cancer and its response to treatment, and collectively collaborate ways to design drugs that are safe and effective based on this personalized approach.
References: Azvolinsky, Anna M. D. (2012, May 30). The Rising Cost of Cancer in the Era of Individualized Therapy: Q&A with Thomas J. Smith, M. D. Retrieved from OncLive Bringing the Community Together: http://www. onclive. com/publications/targeted-therapy- news/2012/june-2012/The-Rising-Cost-of-Cancer-Care-in-the-Era-of-Individualized- Therapy-A-QandA-With-Thomas-J-Smith-MD The Value of Medical Innovation. (2013). Retrieved from http://valueofinnovation. org Nahta, R. , & Esteva, F. J. (2006). Herceptin: Mechanisms of Action and Resistance. Cancer Letters, 123-138.