How is targeted therapy different from conventional/classical chemotherapy?

How is targeted therapy different than classical chemotherapy?

So in classical chemotherapy, you're also, you're going to have a lot more off target effects because in classical chemotherapy, you're treating just more proliferative cells. While myeloma cells are more proliferative, there are also other cells in our body that are more proliferative at baseline. So by using conventional chemotherapy, those cells are going to be affected. The targeted therapies are a lot more specific to the myeloma cells, and that should have less off target effects, less side effects from the agents.

This is a really interesting subject and a little bit somewhat controversial as to what therapies are considered classical chemotherapy and what are targeted therapies. Some people use the term chemotherapy broadly to encompass any type of treatment that's used for cancer. And this can include drugs that we would call classical chemotherapy as well as our targeted therapies. Some people believe this term refers to all of them combined.

That being said, the term chemotherapy or classical chemotherapy really refers to agents that were mostly developed around and just after World War Two that were developed a generation ago to treat a variety of different cancers and they were really developed with the thought in mind of how do we attack cancer cells? And cancer cells are cells that often divide rapidly and without following the cues of our body to tell them to stop.

And this is why classical chemotherapy agents tend to make people, unfortunately throw up and have their hair fall out because the cells that line our GI tract and our hair tend to grow rapidly. So chemotherapy drugs from that generation interfere with those processes for all cells.

That being said, we now have a new generation of what we call novel therapies and novel or targeted therapies are agents that really focus more on the cancer cells themselves so they have better efficacy because they don't spend time on non-cancer cells as much and they have a better toxicity profile because they don't affect those other cells.

So nowadays we refer to the novel therapies such as drugs like monoclonal antibodies or proteasome inhibitors as drugs that are novel, as in a new generation, from what we call the classical chemotherapy agents.