Targeted therapy is a type of cancer treatment that uses drugs or other substances to precisely identify and attack cancer cells, usually by focusing on specific molecular targets associated with cancer. Unlike traditional chemotherapy, which can affect both cancerous and normal cells, targeted therapy aims to interfere with specific molecules involved in tumor growth and progression, thereby minimizing damage to normal cells.

How Targeted Therapy Works

Targeted therapies work by targeting specific proteins or genes involved in the growth, progression, and spread of cancer cells. These therapies can:

• Block Cancer Cell Growth Signals: Interfere with the proteins that signal cancer cells to grow and divide.
• Prevent Tumor Blood Vessel Formation: Inhibit angiogenesis, the process by which new blood vessels form to supply nutrients to tumors.
• Deliver Toxins to Cancer Cells: Attach toxic substances to targeted molecules, delivering them directly to cancer cells while sparing normal cells.

Targeted Therapy for Bladder Cancer

1. FGFR Inhibitors

• Erdafitinib (Balversa)
  • Description: Erdafitinib is an FGFR (fibroblast growth factor receptor) inhibitor used to treat bladder cancer with specific genetic mutations in the FGFR3 or FGFR2 genes.
  • Usage: Typically used for patients with locally advanced or metastatic urothelial carcinoma who have specific FGFR genetic alterations.
  • Sources: American Cancer Society, National Cancer Institute

2. Antibody-Drug Conjugates

• Enfortumab Vedotin (Padcev)
  • Description: Enfortumab vedotin is an antibody-drug conjugate that combines an anti-Nectin-4 antibody with a chemotherapy drug. The antibody targets the Nectin-4 protein on bladder cancer cells, delivering the chemotherapy directly to the cancer cells.
  • Usage: Used for patients with locally advanced or metastatic urothelial carcinoma who have previously received immunotherapy and chemotherapy.
  • Sources: American Cancer Society, National Cancer Institute

Benefits of Targeted Therapy

• Specificity: Targets specific molecules involved in cancer growth, potentially leading to fewer side effects compared to traditional chemotherapy.
• Effectiveness: Can be more effective for certain patients, especially those with specific genetic mutations.
• Personalized Treatment: Allows for more personalized treatment plans based on the genetic profile of the tumor.

Side Effects of Targeted Therapy

While targeted therapies are generally more specific and potentially less harmful to normal cells than traditional chemotherapy, they can still cause side effects. Common side effects include:

• Fatigue
• Nausea and vomiting
• Diarrhea
• Liver problems (elevated liver enzymes)
• Skin problems (rash, dry skin)
• Mouth sores

Monitoring and Follow-Up

Patients undergoing targeted therapy require regular monitoring to assess the effectiveness of the treatment and manage any side effects. This often involves routine imaging tests, blood tests, and clinical evaluations.

Sources and Further Reading

• American Cancer Society: Targeted Therapy for Bladder Cancer
• National Cancer Institute: Erdafitinib
• National Cancer Institute: Enfortumab Vedotin
• Mayo Clinic: Bladder Cancer

Targeted therapy represents a significant advancement in bladder cancer treatment, offering new hope for patients with advanced or refractory disease. Always consult with healthcare providers for the most personalized and up-to-date treatment options.