Targeted Therapy and Immunotherapy
Precision cancer therapies targeting specific molecular drivers of tumour growth or activating the patient's own immune system to recognise and destroy cancer cells.
Overview
Overview
Targeted Therapy and Immunotherapy represent the precision oncology revolution, using the specific molecular characteristics of a patient's cancer to guide treatment far more precisely than conventional chemotherapy. Targeted therapies block specific proteins or genes that drive cancer cell growth and survival, while immunotherapy checkpoint inhibitors activate the patient's own immune system to recognise and destroy cancer cells. Both approaches require biomarker testing of the tumour to confirm eligibility. These treatments have transformed survival outcomes in melanoma, non-small cell lung cancer, breast cancer, renal cell carcinoma, and many other tumour types.
Types of Targeted Therapy and Immunotherapy
- EGFR tyrosine kinase inhibitors (gefitinib, osimertinib) — for EGFR-mutated non-small cell lung cancer
- HER2-targeted antibodies (trastuzumab, pertuzumab) — for HER2-positive breast and gastric cancer
- PD-1 and PD-L1 checkpoint inhibitors (pembrolizumab, nivolumab, atezolizumab) — immunotherapy for multiple biomarker-positive tumour types
- BRAF and MEK inhibitors (vemurafenib, dabrafenib, trametinib) — for BRAF V600E-mutated melanoma and other cancers
- CDK4/6 inhibitors (palbociclib, ribociclib, abemaciclib) — for hormone receptor-positive HER2-negative advanced breast cancer
Risk Factors of Targeted Therapy and Immunotherapy
- Confirmed biomarker-positive tumour (EGFR mutation, HER2 amplification, PD-L1 expression, MSI-H, BRCA mutation) on molecular testing
- Failed response to conventional first-line chemotherapy requiring escalation to targeted or immunotherapy agents
- High tumour mutational burden (TMB-H) predicting enhanced response to checkpoint inhibitor immunotherapy
- ALK or ROS1 gene rearrangement in non-small cell lung cancer indicating eligibility for ALK inhibitor therapy
- Metastatic or locally advanced disease where systemic precision therapy is the primary treatment modality
- PARP inhibitor eligibility in BRCA-mutated ovarian, breast, or prostate cancer after standard treatment failure
Symptoms of Targeted Therapy and Immunotherapy
- Skin rash and pruritus — the most common immune-related adverse event from checkpoint inhibitor immunotherapy
- Immune-related colitis causing diarrhoea with 3 or more loose stools daily and abdominal cramping
- Fatigue and general malaise related to immune activation and systemic inflammatory response
- Infusion-related reactions including fever, chills, and breathlessness during intravenous checkpoint inhibitor administration
- Hypothyroidism and other immune-related endocrine dysfunction causing fatigue, weight gain, and cold intolerance
- Pneumonitis — dry cough and progressive breathlessness from immune-related inflammation of the lung parenchyma
- Hepatitis and elevated liver enzymes from immune-related liver toxicity requiring steroid treatment
- Hand-foot skin reaction (palmar-plantar erythrodysaesthesia) — redness, blistering, and pain on palms and soles with certain targeted agents
Key Benefits
Discover the advantages of choosing our targeted therapy and immunotherapy services.
Targeted therapies achieve response rates of 60 to 80% in biomarker-selected patients
Checkpoint inhibitors produce durable long-term remissions in 20 to 30% of responding patients
Oral targeted therapies allow treatment at home without frequent hospital infusion visits
Immune-related adverse event management with corticosteroids resolves the majority of irAEs completely
Modern immunotherapy combinations have transformed long-term survival in melanoma lung and renal cancers
Clinical Features
The technology, techniques and clinical approach behind our targeted therapy and immunotherapy.
Biomarker confirmation mandatory before prescribing targeted therapy or immunotherapy
Baseline organ function tests established before first treatment for toxicity monitoring reference
Extended first-infusion monitoring with vital signs every 15 minutes
Structured irAE screening at every cycle appointment before treatment is administered
RECIST response assessment by CT every 2 to 3 cycles tracks treatment efficacy objectively
Preparation Instructions
Blood tests are checked before every cycle including thyroid function liver function and kidney function. Attend pre-treatment blood test 24 to 48 hours before each infusion. Report any new rash, diarrhoea, breathlessness, joint pains, or eye symptoms immediately -- these may indicate immune-related adverse events requiring prompt assessment.
The Procedure
Step-by-step guide to what you can expect during your targeted therapy and immunotherapy procedure.
Biomarker Testing and Eligibility Confirmation
Molecular testing of the tumour biopsy confirms the specific biomarker determining eligibility for the targeted therapy or immunotherapy agent before prescribing.
Pre-Treatment Baseline Assessment
Thyroid function liver function renal function blood pressure and relevant organ-specific assessments establish the baseline for monitoring treatment-related toxicity throughout the course of treatment.
Treatment Initiation and First Infusion Monitoring
The first infusion is administered under close observation with extended monitoring for infusion reactions. Pre-medications are administered before checkpoint inhibitor infusions to reduce reaction risk.
Toxicity Assessment and irAE Review
Before every cycle patients are systematically screened for immune-related adverse events. Grade 2 irAEs require treatment modification. Grade 3 to 4 irAEs require immediate treatment hold and high-dose corticosteroid therapy.
Radiological Response Assessment
CT scan is performed every 2 to 3 cycles. Response is classified by RECIST criteria as complete partial stable or progressive disease -- guiding continuation or treatment change.
Exceptional Responder and Treatment Duration
Patients achieving complete or exceptional responses are monitored for optimal treatment duration. Long-term survivors on targeted therapy continue until disease progression or unacceptable toxicity.
What to Expect
Treatment is administered in the oncology day unit through an IV infusion over 30 to 90 minutes. Your observations are monitored throughout. Blood tests are reviewed before each cycle to confirm it is safe to proceed. CT scan response assessment is performed every 2 to 3 cycles.
Recovery
Monitor for and report immediately: new skin rash, diarrhoea more than 3 times daily, breathlessness, cough, eye redness, joint swelling, or severe fatigue. These are signs of immune-related adverse events which are treatable when caught early. Attend all scheduled blood test and review appointments.
Frequently Asked Questions
Common questions about targeted therapy and immunotherapy.
Related Services
Explore other services in our Oncology department.
Chemotherapy Administration
Radiation Therapy
Cancer Staging and Tumour Marker Assessment
Ready to Get Started?
Schedule your consultation today and take the first step towards better health.