Drug Information Q&A Q47. There seems to be a test that can predict the effects and side effects of cancer drugs.
Answer
It is now possible to test whether or not a particular cancer drug will be effective by testing for genes. By testing an individual patient's response to a drug prior to treatment, it is possible to confirm not only whether the drug is effective, but also the possibility of side effects.
Explanation
By testing for cancer-related genes in the body of a particular cancer patient, the test determines which drugs are effective in treating that cancer.
Conventional cancer drugs attack not only cancer cells but also normal cells, causing various side effects such as nausea, vomiting, and hair loss. As a result, there have been many cases where the use of therapeutic drugs has been discontinued.
Today, research into cancer-related genes has led to the development of therapeutic agents that target and attack only specific molecules (see Q48).
These molecularly targeted drugs are expected to solve the problem of systemic side effects, which has been a problem with conventional cancer drugs.
Examples include trastuzumab, which targets the human epidermal growth factor receptor (HER-2), a cause of breast cancer; cetuximab, which targets K-ras gene mutations in colorectal cancer; and gefitinib and erlotinib, which target EGFR gene mutations in non-small cell lung cancer. Erlotinib" and others. Both of these drugs can be used when the presence of the target gene is confirmed. They can attack only cancer cells without attacking normal cells, and their side effects can be predicted to some extent and their symptoms reduced.
In addition, diagnostic agents called "companion diagnostics," which predict the effects and side effects of drugs, have been developed. Using these diagnostics, it is possible to select patients who are more likely to respond to a particular cancer drug, which can lead to higher treatment efficacy and avoid unnecessary treatment. Companion diagnostics are developed at the same time as cancer drugs. The aforementioned gefitinib, the blood cancer drug mogamulizumab, and the lung cancer drug crizotinib each have companion diagnostics. Research and development of these treatments and diagnostics is expected to lead to "tailor-made medicine," which realizes optimal treatment for individuals.
In addition, genetic testing is increasingly being performed to confirm whether a person has a gene that predisposes him or her to cancer. In cases where many blood relatives are cancer patients, genetic testing is intended to prepare them for cancer, such as what type of cancer they may develop and what kind of lifestyle they should lead in order to avoid cancer.
Chart/Column
47｜Genes to be tested and cancer drugs to be used
What to test and drugs
Horizontal scrolling is available
| Disease | Drug | To be tested | Predicted Effectiveness |
|---|---|---|---|
| Breast cancer | Trastuzumab | HER-2 protein | Higher protein levels are more effective in treatment |
| Lapatinib | |||
| Non-small cell lung cancer | Gefitinib | EGFR gene | More effective in patients with gene mutation |
| Erlotinib | |||
| Colorectal cancer | Cetuximab | K-ras | Highly effective if there is no mutation in K-ras gene. *Effective treatment is ineffective if there is a mutation in BRAF even if there is no mutation in K-ras gene. |
| Panitumumab |
Other than EGFR family
Horizontal scrolling is available
| Disease | Drug | To be tested | Predicted Effectiveness |
|---|---|---|---|
| Chronic myelogenous leukemia | Imatinib | Bcr-Abl | Effective when fusion protein is detected |
| Colorectal cancer | Irinotecan | UGT1A1 gene | UGT1A1 gene polymorphism is more likely to cause side effects |
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