Is targeted drug therapy for cancer really that miraculous? The sooner you know these three truths, the better

Truth1: Are targeted drugs the cure for cancer?

The reality is that most targeted drugs currently only have the potential to prolong the survival of patientsand improve their quality of life, but they cannot cure cancer or directly lead to recovery.

Let's use the concept of "genetic mutation abundance" in targeted drugs as an example. This indicator reflects the relative quantity of mutated cells in tumor tissue, usually expressed as a percentage (%) or a decimal.

For example, if the abundance is 30%, it means that approximately 1/3 of the cells in the tumor can be killed (or inhibited from replicating) by the targeted drug. That is to say, after the targeted drug takes effect, it can shrink the tumor to a certain extent and control it, but it cannot completely eliminate the tumor.

Truth2: Do I need to keep taking the targeted drug?

Many patients with advanced cancer who aim to control their condition and prolong their survival usually need to take targeted drugs for a long time. However, after taking the drugs for three to five years and seeing their condition stabilize, they may think they have been cured and can stop taking the drugs? Under this misconception, abruptly discontinuing medication often carries significant risks, providing cancer cells with the opportunity to become active again. As we mentioned earlier, targeted drugs do not eradicate tumors or cure cancer; they only temporarily suppress tumor activity. Once medication is discontinued, the tumor is no longer restrained, and the condition may progress again. Therefore, for patients with advanced cancer, if targeted drugs effectively control tumor growth, alleviate symptoms, and are well tolerated by the patient, it is generally recommended to continue taking the medication to maintain efficacy. For patients who undergo adjuvant therapy with targeted drugs after surgery, such as those with lung or breast cancer who need to take targeted drugs for a period of time to reduce the risk of recurrence, medication can be discontinued according to the doctor's advice after the doctor assesses that the predetermined course of treatment has been completed and the condition is stable.

Truth3: The Inevitable Drug Resistance of Targeted Drugs

Although targeted drugs have become the "lifesaving drugs for cancer patients，“”almost all targeted drugs will eventually lead to drug resistance, with gradually weakening efficacy, symptoms reappearing or worsening, and indicators rising again...

How to maintain the efficacy of targeted drugs？? How can we delay the emergence of drug resistance? How can we strive for more time of “high-quality survival with tumor”? This has become an unavoidable challenge for patients on medication.

As an immunology researcher, today I would like to offer some suggestions from the perspective of "What can immunity do to resist drug resistance?" As we all know, targeted drugs can kill cancer cells carrying matching gene mutations and reduce the overall tumor burden. However, this killing cannot achieve 100% effectiveness, and a small number of cancer cells that are insensitive to targeted drugs or have new mutations can evade the "sanctions" of targeted drugs. After a period of growth, these cancer cells will eventually make targeted drugs resistant. In the past, scientists tried to combine targeted drugs with immune checkpoint inhibitors (such as PD-1/PD-L1 antibodies), but the combination was highly toxic and had poor efficacy, leading to the forced suspension of multiple clinical trials.

Over 20 years ago, Professor Zhang Minghui's research team turned their attention to “Adoptive immunotherapy”, which involves infusing in vitro cultured vNKT immune cells back into patients' bodies. This approach combines immune cell therapy with broad-spectrum tumoricidal effects and targeted drugs, providing an alternative potential treatment strategy for eliminating cancer cells, achieving long-term tumor control, and delaying the emergence of drug resistance.

The vNKT immune cells used in this adoptive immunotherapy can rapidly kill cancer cells, including those that are insensitive to targeted drugs and immune-suppressing cells (MDSCs) that create immune escape opportunities for newly mutated cancer cells. The complementary nature of the treatments allows targeted drugs to “last longer”.

Targeted drugs have indeed changed the history of cancer treatment, but they are not magic wands. Instead, they are a relay race against the "evolution speed" of tumors. Understanding the truth about targeted drug treatment earlier will give you more treatment options.

Written by: Chali Si

Audited by: Lehe New Medical Department
 

Edited/typeset by JOJO

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