Targeted drugs have no side effects, which means they are ineffective?

No side effects were felt after taking targeted drugs, indicating that the drugs had no effect.

Rumors:

In recent years, the incidence of malignant tumors in China has increased significantly, which has seriously threatened people's lives and health. Conventional treatment of tumors includes surgery, chemotherapy and radiotherapy. Traditional chemotherapy drugs not only kill cancer cells, but also have great lethality to normal cells. With the development of tumor biology and related disciplines, it is considered that one of the causes of cell canceration is the imbalance of cell signal transduction pathway, which leads to unlimited cell proliferation. Therefore, tumor-targeted drugs that play a role in the abnormal signal system in tumor cells are constantly emerging, and more and more targeted drugs enter the clinic.

What are targeted drugs?

At the cellular and molecular level, targeted drugs specifically select the target of tumor cells after entering the human body, and then act, resulting in the specific death of tumor cells without affecting the normal tissue cells around the tumor. This drug is a targeted drug. Molecular targeted drugs can not only play a stronger anti-tumor role, but also reduce the damage to normal cells by targeting the changes of tumor cells different from normal cells [2]. It is precisely because of the small adverse reactions and remarkable curative effects of targeted drugs that the market share of targeted drugs has increased rapidly, and many clinical trials of targeted drugs have been carried out in full swing around the world. Different from chemotherapy drugs, targeted drugs lead us into the era of precise anti-tumor treatment, which enables more and more cancer patients to prolong their survival time and improve their quality of life.

How to evaluate the efficacy of targeted drugs?

Targeted drugs belong to anti-tumor drugs. The purpose of anti-tumor drug therapy is to kill tumor cells, and the curative effect is judged mainly by observing tumor regression. For example, for the treatment of solid tumors, the baseline imaging (CT or MRI) data of tumors should be available before anti-tumor drug treatment. After two cycles of treatment (or 6-8 weeks), imaging examination should be compared with baseline data again to evaluate the curative effect [3].

Evaluation criteria for curative effect of solid tumor (RECIST criteria):

A. Complete remission (CR): all targets disappear completely;

B. Partial remission (PR): the sum of the length and diameter of the baseline lesion is reduced by more than 30%;

C. Steady state (SD): the sum of the length and diameter of linear lesions decreased but did not reach PR or the lesions increased but did not reach PD;

D disease progression (PD): the total length and diameter of baseline lesions increased by more than 20% or new lesions appeared.

If the disease is in remission (CR or PR) or stable (SD), continue the current drug treatment plan; If the condition is progressive (PD), it is necessary to re-evaluate the patient's condition and re-select the drug treatment plan.

The above content is only a simple curative effect evaluation of solid tumor, and the clinical curative effect evaluation is more complicated and detailed. But what is certain is that the judgment of the curative effect of targeted drugs has nothing to do with the size of side effects.

How to treat the side effects of targeted drugs correctly?

As the saying goes, "it is a three-point poison", so is targeted drugs. Although compared with chemotherapy drugs, its adverse reactions are much smaller, but it is still inevitable. Since the efficacy evaluation of targeted drugs has nothing to do with the size of side effects, it must be hoped that targeted drugs can be "efficient and low toxic". However, due to the disease state and individual differences of each patient, the size of side effects will be different for each person. If you don't feel obvious side effects, you should actively cooperate with the treatment and regularly monitor and evaluate the effect. If you feel obviously uncomfortable during taking the medicine, don't think it is a manifestation of letting the medicine take effect. Instead, you should see a doctor or consult a doctor in time, because at this time, you may need to adjust the dosage of the drug, or even stop taking the drug or treat it, so as not to cause more harm.

Rumor expert: Jia, a clinical pharmacist in charge of anti-tumor specialty in Hebei Children's Hospital.

Appraisal expert: Zhang, Director of Pharmacy Department of Hebei Children's Hospital and Chief Pharmacist.

References:

Ye, Yu,, et al. Classification and research progress of tumor-targeting drugs [J]. Pharmaceutical Progress, 20 18(5).

Zhang Lu, Liu Xiangliang, Chen Xiao. Advances in targeted therapy and immunotherapy for brain metastasis of EGFR mutant non-small cell lung cancer [J]. chinese journal of cancer biotherapy, 2019,26 (9):1035-1041.

Dong Jian. Present situation and prospect of evaluation criteria for the therapeutic effect of targeted drugs for solid tumors [J]. chinese journal of cancer biotherapy, 2015,022 (004): 413-419.