Smart drug therapies are treatments that selectively target cancer cells for the defected structures or to eliminate their effects, after the identification of the defects in cancerous cells.
In order for the drug to be evaluated in the category of smart drug or targeted drug, the biology of cancer must be revealed. Targeted therapies with smart drugs were initially performed by evaluating a small number of cancer-related molecules. Today, however, it has been demonstrated that cancer cells may have different mutations and impaired pathways.
For this reason, in the case of planning smart drugs or targeted therapies or immunotherapy in cancer, the treatment should be planned as a result of revealing the biology of the cancer and analyzing this changing biology.
As Medicana, a high rate of smart drug treatments are planned in our personalized cancer treatment center. Sometimes, while using a single smart drug, it is also possible to use several smart drugs or immunotherapy drugs in combination. More successful results can be obtained with combination treatments. In addition, it may be necessary to add integrative treatments to the treatment.
Comprehensive genomic mapping is almost indispensable for any patient who will use smart drugs. Sometimes it is very important to know which treatment to do as well as which treatment not to do. It is necessary to see the resistance pathways of your treatment and take precautions accordingly.
Molecules defined as smart drugs usually do not have a single target. They can interact with more than one molecule. However, there are drugs that bind to certain molecules. Knowing the changing biology of the patient is especially important in the use of smart drugs that bind to multiple molecules.
For about 10 years, only targeted smart molecules and immunotherapy drugs have been developed by pharmaceutical companies. For this reason, many new smart molecules are offered to humanity every year. Due to the increasing number of molecules and targets, it is even more important to personalize the treatment by revealing the biology of cancer.
Recently, drugs such as Sotorasib and belzutifan have been offered to humanity for more specific targets.
Sotorasib is effective in KRAS G12C mutations. As in the figure below, Sotorasib can neutralize this constantly active mutation by binding to the protein region caused by the KRAS G12C mutation.
Belzutifan is in mutations that cause loss of function of the VHL gene.
Belzutifan, on the other hand, targets the HIF-2alpha molecule, which increases after VHL loss of function. As can be seen, there are differences in the target between the two drugs. Sometimes the changes caused by the degraded protein are targeted, sometimes the directly degraded proteins can be targeted.
One of the most important cancer pathways is the MAPK pathway.
Alterations in this pathway have been reported in many cancers and may cause the cancer to spread rapidly and grow.
In the yellow boxes, you see the list of developed and in-progress drugs that are effective at that level of MAPK pathways. There can be many mutations in this pathway. It is also important what the mutation is and which pathways it is associated with.
As can be seen, there is no single drug and it would not be appropriate to make a decision without analyzing the biology of cancer.
I have put the figure above so that you can see the mechanisms and pathways inside the cell and their relationships with each other. I think it is more clear why comprehensive genomic mapping should be done and why the changing biology of cancer should be analyzed.
It is often not possible to cure cancer with a single molecule. Combination therapies must be created.
As MEDICANA PERSONALIZED CANCER TREATMENT CENTER, we lead the way in both our country and in our region with our high experience when combination treatments are concerned.
Smart drug treatment can only be possible with a smart design and for a smart design the altered cancer biology needs to be deeply analized.
Successful treatments are possible with better information and analysis.
If you use smart molecules wisely, you can see their effects.
Conclusion;
Personalized cancer treatment.
