Every week I see patients who have been on standard chemotherapy when a targeted therapy would have been more effective and significantly less toxic for their specific cancer. The question that should always be asked before treatment begins is: has your tumour been tested for targetable mutations? If that test was not done, it should be done now.
ప్రతి వారం నేను standard chemotherapy పై ఉన్న patients ని చూస్తాను, వారి specific cancer కి targeted therapy ఎక్కువ effective మరియు తక్కువ toxic అయి ఉంటే. Treatment మొదలుపెట్టే ముందు ఎల్లప్పుడూ అడగాల్సిన ప్రశ్న: మీ tumour targetable mutations కోసం test చేయబడిందా?
ہر ہفتے میں ایسے مریض دیکھتا ہوں جو معیاری کیموتھیراپی پر ہیں جبکہ ٹارگٹڈ تھیراپی ان کے لیے زیادہ مؤثر ہوتی۔ علاج شروع ہونے سے پہلے ہمیشہ یہ سوال پوچھا جانا چاہیے: کیا آپ کے ٹیومر کی جانچ ہوئی ہے؟
My MRCP SCE qualification from the Royal College of Physicians covers the current evidence on targeted therapy and immunotherapy. These fields move quickly. Being examined on London-standard medical oncology means being current on the evidence that drives these treatment decisions. That is what I bring to every patient consultation.
Royal College of Physicians నుండి నా MRCP SCE qualification targeted therapy మరియు immunotherapy పై current evidence cover చేస్తుంది. ఈ fields వేగంగా move అవుతాయి. London-standard medical oncology పై examined అవడం అంటే ఈ treatment decisions drive చేసే evidence పై current గా ఉండడం.
"Has your tumour been tested for targetable mutations? If not, that test should happen before treatment begins."
Dr. Owais Mohammed, Medical Oncologist, MRCP SCE UKChemotherapy attacks all rapidly dividing cells. Targeted therapy attacks cancer cells that have a specific molecular target, a mutation or protein the drug is designed to block. The result is that cancer cells are affected while many normal cells are spared. Side effects are different from chemotherapy and often less severe, though they are not absent.
HER2 positive breast cancer: HER2 targeted therapy (trastuzumab, pertuzumab) has transformed outcomes. EGFR mutated lung cancer: EGFR inhibitors are significantly more effective than standard chemo. BRCA mutated cancers: PARP inhibitors. BCR-ABL in chronic myeloid leukaemia: imatinib changed this from a life-threatening to a manageable chronic condition. Testing determines eligibility.
Before targeted therapy can be recommended, the tumour must be tested. This involves either tissue biopsy testing or in some cases liquid biopsy from blood. The test looks for specific mutations the drug targets. If the mutation is not present, the targeted therapy will not work. Testing is not optional. It is the foundation of the treatment decision.
Immunotherapy works differently from both chemotherapy and targeted therapy. Instead of attacking cancer cells directly, it enables the immune system to recognise and attack them. PD-1, PD-L1 checkpoint inhibitors are the most common. Not every cancer responds and not every patient qualifies. Biomarker testing determines eligibility. When it works, responses can be dramatic and durable.
For cancers with a specific targetable mutation, yes, targeted therapy is typically more effective and less toxic than standard chemotherapy. But targeted therapy only works when the specific target is present. For cancers without targetable mutations, standard chemotherapy remains the appropriate treatment. The comparison is not one versus the other universally. It is which is right for this specific cancer in this specific patient.
Molecular testing of the tumour determines eligibility. If your tumour has been biopsied and sent to pathology, you can ask whether molecular testing was done alongside the standard pathology. If not, it can often be done on stored tissue. WhatsApp me your pathology report and I will tell you whether the right testing has been done.
Yes. Checkpoint inhibitors are available. The question is not availability but eligibility. PD-L1 testing is needed to determine whether your cancer is likely to respond. Not every cancer type responds to immunotherapy. I assess eligibility based on cancer type, biomarker status and clinical situation.
Targeted therapy costs vary enormously by drug. Some oral targeted therapies are available as generics at significantly lower cost than branded versions. Others remain expensive. Insurance coverage varies. I discuss cost realistically at every consultation because it affects treatment decisions. Some targeted therapies are covered under specific insurance policies and Aarogyasri.
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حیدرآباد سفر سے پہلے اپنی رپورٹس واٹس ایپ کریں۔ میں جانچ کر بتاؤں گا کہ سفر ضروری ہے یا نہیں اور کیا لانا ہے۔
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