Understanding anti-cancer therapies

Cancer treatment today involves a wide range of therapies, each designed to target cancer in a different way. The type of treatment recommended depends on the cancer’s biology, stage, genetic characteristics, and the individual needs of each patient. Below is an overview of the main treatment categories used in modern oncology.

Chemotherapy

Chemotherapy refers to medications that destroy rapidly dividing cancer cells. It may be given alone or in combination with other therapies. Treatments are typically administered intravenously in cycles, allowing the body time to recover between sessions. Chemotherapy remains an essential option for many cancers and is often used to shrink tumours, control disease progression, and improve symptoms.

Hormonal (Endocrine) Therapy

Some cancers grow in response to hormones in the body. Hormonal therapy aims to block, reduce, or alter the hormones that drive cancer growth.
This form of treatment is commonly used in:

• Breast cancer (e.g., tamoxifen, aromatase inhibitors)
• Prostate cancer (e.g., androgen deprivation therapy)

Hormonal therapy may be used alone or in combination with other treatments such as radiotherapy, chemotherapy, or targeted therapy.

Targeted Therapy

Targeted therapies act on specific genetic mutations or molecular pathways within cancer cells. Unlike chemotherapy, which affects all rapidly dividing cells, targeted agents are designed to block the exact mechanisms cancer cells use to grow and spread.

Examples include:

• BRAF inhibitors (e.g., dabrafenib, trametinib) for melanoma and other cancers with a BRAF mutation
• EGFR inhibitors (e.g., osimertinib) for non-small cell lung cancer with EGFR mutations

Before starting targeted therapy, specialised testing is performed to identify whether a patient’s tumour carries the relevant mutation.

Immunotherapy

Immunotherapy stimulates the body’s own immune system to recognise and attack cancer cells. These therapies have transformed outcomes for many cancers, often providing long- term disease control.

Examples include:

• Checkpoint inhibitors (e.g., pembrolizumab, nivolumab, atezolizumab)
  These therapies “release the brakes” on the immune system, allowing a stronger and more effective response against cancer cells.

Immunotherapy can be used as first-line treatment or after other therapies, depending on the cancer type and stage.

Personalised Cancer Vaccines

Personalised cancer vaccines represent a major advancement in precision medicine. These vaccines are created uniquely for each patient, using genetic information from their tumour to train the immune system to recognise tumour-specific neoantigens.

They aim to:

• Enhance immune recognition of cancer
• Prevent recurrence
• Work alongside other treatments such as immunotherapy

This emerging field is available within selected clinical trials and early access programs.

Tumour-Infiltrating Lymphocyte (TIL) Therapy

TIL therapy is a highly specialised form of cellular immunotherapy. It involves:

1. Removing part of patient’s tumour to harvest immune cells (lymphocytes) that have naturally infiltrated the tumour
2. Expanding these cells in large numbers in a laboratory
3. Infusing them back into the patient after preparing the immune system with supportive treatment

Once reintroduced, these powerful immune cells can aggressively attack cancer cells. TIL therapy is showing promising results in melanoma and is being explored in other solid tumours like lung cancer.

Working With Your Oncology Team

Every patient’s treatment plan is tailored using the latest evidence and multidisciplinary input. Your oncologist will discuss which therapies are appropriate for your cancer type, expected benefits, potential side effects, and what to expect during treatment.