Targeted Cancer Therapy in India
Precision drugs that attack specific molecular targets in cancer cells. How they work, which cancers respond, biomarker testing, and costs.
Targeted therapy uses drugs designed to attack specific proteins or genetic changes that drive cancer growth. Unlike chemotherapy, which affects all rapidly dividing cells, targeted drugs are more precise. They block growth signals, cut off blood supply to tumours, or deliver toxic payloads directly to cancer cells.
Biomarker testing is essential before starting targeted therapy. Your tumour must be tested for specific mutations (EGFR, ALK, HER2, BRAF, BRCA, etc.) to determine if a targeted drug will work. In India, molecular testing costs INR 15,000-50,000 and is increasingly available at major cancer centres.
Many targeted drugs are now available as affordable generics in India. Imatinib (for CML) costs as little as INR 3,000/month; erlotinib for lung cancer is INR 8,000-12,000/month. However, newer agents like osimertinib or olaparib remain expensive at INR 1-2 lakh/month. HealOnco helps patients access the most cost-effective option.
How Targeted Therapy Works
Biomarker testing first: Tumour tissue (from biopsy) or blood (liquid biopsy) is tested for specific mutations. Results guide drug selection. Without testing, targeted therapy is a guess.
Oral or IV: Many targeted drugs are oral pills taken daily at home. Others (like trastuzumab, bevacizumab) are IV infusions given at the daycare centre every 2-3 weeks.
Duration: Usually continued as long as the cancer responds and side effects are manageable. Some patients take oral targeted drugs for years. IV drugs typically continue until progression.
Resistance: Most cancers eventually develop resistance to targeted therapy. When this happens, re-biopsy or liquid biopsy can identify new mutations and guide the next-line drug.
Common Targeted Therapy Regimens and Costs
| Regimen | Drugs | Duration | Approx. Cost |
|---|---|---|---|
| Trastuzumab (HER2+ breast, stomach) | Trastuzumab 6mg/kg IV q3w | 1 year (breast); until progression (stomach) | Biosimilar INR 20,000-25,000/dose; branded INR 60,000-80,000 |
| Imatinib (CML, GIST) | Imatinib 400mg oral daily | Indefinite | Generic INR 3,000-5,000/month |
| Erlotinib/Gefitinib (EGFR+ lung) | Erlotinib 150mg or Gefitinib 250mg daily | Until progression | INR 8,000-15,000/month |
| Osimertinib (EGFR T790M lung) | Osimertinib 80mg daily | Until progression | INR 1,50,000-2,00,000/month |
| Olaparib (BRCA+ breast, ovarian) | Olaparib 300mg BID oral | Until progression or 2 years maintenance | INR 1,20,000-1,80,000/month |
| Bevacizumab (colon, cervical, ovarian) | Bevacizumab 5-15mg/kg IV q2-3w | Until progression | Biosimilar INR 15,000-20,000/dose |
| Lenvatinib/Sorafenib (liver, thyroid) | Lenvatinib 12mg or Sorafenib 400mg BID daily | Until progression | INR 40,000-80,000/month |
Side Effects and Management
| Side Effect | How Common | How We Manage It |
|---|---|---|
| Skin rash / hand-foot syndrome | 20-50% with EGFR/kinase inhibitors | Moisturisers, topical steroids, dose modification; can be a sign the drug is working |
| Diarrhea | 20-40% | Loperamide; dietary modification; dose reduction if persistent grade 2+ |
| Hypertension (anti-VEGF drugs) | 20-30% | BP monitoring; antihypertensives (ACE inhibitor or ARB); hold drug if severe |
| Cardiac toxicity (HER2 agents) | 2-5% heart failure | Baseline and 3-monthly echocardiogram; hold if LVEF drops >10% from baseline |
| Liver enzyme elevation | 10-20% | Regular LFT monitoring; dose adjustment or hold if grade 3+ |
| Fatigue | 20-40% | Generally milder than chemo; thyroid function check; activity encouraged |
Cancers Treated with Targeted Therapy
Targeted Therapy Treatment by City
Questions About Targeted Therapy?
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