BETA - What is targeted therapy?

What is targeted therapy? What are examples of targeted myeloma therapy? So targeted therapies are therapies that target specifically cancer cells, specifically in our case myeloma cells. And a good example of a targeted therapy in myeloma would be the proteasome inhibitors, which take advantage of cells that are actively making lots of proteins. Unfortunately, can't recycle the byproducts of protein synthesis. And by inhibiting that, that allows us to target specifically those cells that are making lots of proteins, which myeloma cells do. And that selectively kills the myeloma cells and leaves most other cells relatively untouched. Now targeted therapy implies that that drug is going after a specific either protein on the cell surface or maybe a way that the cell survives. So you can argue, for example, a proteasome inhibitor like bortezomib or carfilzomib, they are targeted towards that proteasome, which is kind of a garbage can inside the cell to break down proteins. And the idea is if you sort of shut down the garbage can, these helpful proteins survive. It's targeted somewhat in that sense, but there are other mechanisms of how both bortezomib and carfilzomib work. Probably a true targeted therapy we like to think of as, you know, a CD38 antibody like isotuximab or daritumumab. But then it gets a little blurry about whether that's an immune therapy or not. How are we able to use targeted therapies when patients have so many different mutations? How do we, how are we able to use targeted therapies when patients have so many different mutations and every patient's a little bit different? And that is true, and that does make it more challenging. So that's why we look for some of these more ubiquitous mutations and ubiquitous changes that are specific to the myeloma cells. I love to get to an area, to a time when we can actually have such personalized therapies that we're able to actually target everyone's specific mutation load. One of the real exciting parts of immunotherapy is that the more different a cancer cell looks from a normal cell, its origin was. So a lung cancer cell that, a lung cell that has now transformed into a lung cancer cell, the more different that looks, the more likely those cells are to respond to classic immunotherapy because it's easier for the body to recognize that cell as being very abnormal. The cells that are only mildly abnormal are not as susceptible to immunotherapies. So but that's sort of looking at globally, just sort of supercharging our immune system to attack cells that are somewhat odd or abnormal. If we can get to a point where little mutations that every patient has are targetable, that would be ideal. We're still a ways away from that. Quite honestly, I think that the infrastructure to do something like that is pretty significant. And I don't know that that exists right now.