Is chemotherapy for cancer treatment going the way of 8-track tapes and rotary dial phones?

While that overstates the situation, the trend away from chemo is clear as cancer care is changing rapidly.

Chemotherapy has been the primary way to treat cancer for decades, and its use will continue into the foreseeable future. But chemo’s role as the centerpiece of most treatment regimens is expected to diminish over time as more innovative targeted therapy, immunotherapy, and radiation options continue to emerge. These new treatment methods attack specific cancer cells rather than a generic type of cancer and location. They also are producing better patient outcomes often with fewer side effects.

Targeted Therapy
Targeted therapies are advanced medicines that fight specific cancer with greater precision. Unlike chemotherapy, which focuses on all rapidly dividing cells, targeted therapies attack the specific genetic mutations that make cancer cells different from healthy cells.

Targeted therapies attack the genes, proteins, or tissue environment that contribute to cancer cells’ growth and survival.

Multiple targeted therapies are available today. Some attack a single trait of the cancerous cell, while others attack several mutations within the cancer cells. Targeted therapies are often used in conjunction with other treatments including chemotherapy, radiation, and surgery.

Immunotherapy
Immunotherapy is one of most promising new frontiers in cancer care. This treatment boosts the body’s immune system to fight cancer. Scientists design and create antibodies in a lab to target specific antigens in cancers. Once they’re injected into a patient, the antibodies are on a mission to stop the ‘bad’ behaviors of cancerous cells. Because many immunotherapies do not affect healthy, normal cells, patients often experience fewer side effects.

CAR-T, or Chimeric Antigen Receptor T cell therapy, is a personalized therapy in which a patient’s own blood cells are removed and reengineered in a lab to engage the immune system to attack cancer. The Food and Drug Administration first approved the CAR-T therapy in 2017 for specific types of lymphoma and leukemia after promising results during clinical trials. Earlier this year, Texas Oncology–Baylor Charles A. Sammons Cancer, in collaboration with Baylor University Medical Center, became the second facility in the state to provide groundbreaking FDA-approved CAR-T therapy for large B-cell lymphoma.

Vaccines are another form of immunotherapy. Physicians remove immune cells and create a vaccine specific to individual patients and their cancers. The vaccines may boost the immune response. They can also help prevent recurrence, because the immune system has a “memory” of how it previously fought diseases.

Radiation
With major technological advancements, radiation oncology is light years ahead of where it was 10 to 15 years ago. For example, highly targeted stereotactic body radiation therapy (SBRT) can now be used to treat stage IV metastatic breast cancer. Proton therapy – an ultra-precise form of radiation – is another treatment option for some patients with cancer in highly sensitive areas.

Patients should speak with their doctor about whether targeted therapy, immunotherapy, or radiation – or a combination of treatment methods – is the most effective, appropriate option for their cancer.

While chemotherapy remains the primary form of cancer treatment, it is increasingly taking a back seat to more precise, effective, and safer alternatives.

 

Billie J. Marek, M.D., is a medical oncologist at Texas Oncology—McAllen, 1901 S 2nd Street in McAllen, Texas. To learn more about exciting advancements in cancer treatment, visit www.TexasOncology.com or call 1-888-864-I CAN (4226).