Traditional chemotherapy is a blunt instrument: blast the patient with cytotoxic drugs in the hope that the treatment will kill off cancer cells without causing too much collateral damage. The only discrimination, in the main, is that cells that are dividing rapidly are more likely to be susceptible. Of course, this means that non-cancerous cells that divide rapidly will also be killed off, which is why many chemotherapy patients lose their hair. But side-effects, such as nausea and thrombocytopoenia, are also common, and can lead to patients discontinuing treatment as they simply can’t cope with the negative effects of the drugs on the healthy parts of their bodies.
The new breed of personalised cancer medicines is somewhat different. Designed to take advantage of genetic differences between cancer cells and healthy cells rather than attacking everything in sight, they bind to specific receptor targets on tumour cells. The availability of rapid genetic sequencing tools has made tumour typing routine, and in future we may see cancers being reclassified according to their genetic makeup rather than the location in the body at which they occur. While this can mean that far fewer patients may benefit from a specific drug, those who receive one designed to hit a specific genetic target that is present on their tumour cells are much more likely to respond.
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