What is Smart Drug in Cancer? How Should Smart Drugs Be Used?

Smart drugs are a method that enables targeted results in cancer treatment.

Smart drugs are a method that allows for targeted outcomes in cancer treatment. As knowledge increases about genetic mutations and molecular changes that are effective in cancer formation, smart drugs are becoming more important in cancer therapy.

What is Smart Drug in Cancer?

Cancer occurs when normal body cells acquire uncontrolled proliferation due to changes (mutations) in their genetic structure. These mutations cause cancer cells to gain the ability to grow, develop, and spread. In each type of cancer, mutations can lead to changes specific to that cancer type. As scientists have started discovering these changes and as knowledge about cancer has increased, targeted therapy in cancer treatment has gained importance.

Smart drugs, which are one of the most important tools in targeted therapy, aim to prevent the uncontrolled proliferation and spreading of cancer cells. The use of smart drugs, which contain molecules that attempt to stop the features gained through mutations, is an increasingly important method in cancer treatment.

How Do Smart Drugs Work in Cancer Treatment?
Smart drugs can be beneficial in various ways by affecting different pathways in cancer treatment:

• Facilitate the immune system in destroying cancer cells: One of the reasons cancer cells proliferate and spread rapidly is their ability to hide from the immune system. These cells modify parts of their structure, which are responsible for recognition by the immune system, using mutations. As a result, they become unrecognizable and easily grow and spread in the body. Smart drugs mark cancer cells to facilitate their recognition by the immune system. This way, the immune system can identify these cells as harmful and destroy them.
• Stop the growth of cancer cells: Healthy cells only proliferate when they receive a division signal from outside. These signals bind to proteins on the cell membrane and send a signal to the cell to divide. Under normal conditions, this happens only when the body needs more cells. However, in cancer cells, the signal transmission is disturbed. Cancer cells continue to proliferate without receiving division signals. Smart drugs stop the pathways that involve this signaling, thus preventing cancer cells from proliferating as though there is constant stimulation. This helps in preventing uncontrolled tumor growth.
• Prevent blood vessel development inside tumors: Tumors need blood flow to grow. To meet the needs of oxygen and nutrients, new blood vessels start forming within the tumor. This process is called angiogenesis. Smart drugs can stop angiogenesis, preventing the tumor from growing in size. They can also shrink existing blood vessels, thus reducing tumor size.
• Deliver cancer-killing drugs to cancer cells: Combining chemotherapy, radiation, or toxins with smart drugs can be beneficial. Smart drugs ensure that these substances target only cancer cells, delivering their effect specifically to them.
• Induce cancer cell death: Normal cells die when they are damaged or no longer needed. Cancer cells lose this ability. Some types of smart drugs can cause the death of cancer cells, thus preventing tumor formation.
• Block the effect of hormones necessary for tumor growth: Some cancers, such as prostate and breast cancer, are hormone-dependent. These types of tumors need various hormones to grow. Smart drugs can stop the production or action of these hormones, thus preventing the tumor from growing.

What Are the Types of Smart Drugs?

There are different types of smart drugs used in cancer treatment:

• Hormone Therapies: Hormone therapy is used in the treatment of hormone-dependent cancers. This method can be applied to cancers such as breast and prostate cancer, where hormones play an essential role in their formation. It works by eliminating or blocking the production or action of hormones.
• Signal Transduction Inhibitors: Cancer cells can receive various signals from the external environment and respond to them abnormally. Tyrosine kinase is a type of protein that helps transmit signals into the cell. When inappropriate signaling occurs, as in the case of cancer cells continuously receiving division signals and continuing to proliferate, tyrosine kinase inhibitors like osimertinib, imatinib, gefitinib, and erlotinib are used.
• Gene Expression Regulators: These affect proteins involved in regulating gene expression within the cell.
• Apoptosis Inducers: Apoptosis is the normal process through which damaged cells or cells with mutated genetic material die. In cancer cells, this mechanism is disrupted. Some smart drugs that induce apoptosis can cause cancer cells to die, preventing tumor growth. Some examples of these drugs include bortezomib, oblimersen, and olaparib.
• Angiogenesis Inhibitors: This group of smart drugs prevents the formation of new blood vessels, which are necessary for tumor growth. By blocking the effects of VEGF (Vascular Endothelial Growth Factor), a molecule involved in angiogenesis, these drugs help prevent tumor growth. Some examples are bevacizumab, sunitinib, and thalidomide.
• Immunotherapy: This treatment helps the immune system recognize cancer cells. Monoclonal antibodies, which are produced specifically for certain cancer types, bind to these cancer cells, allowing the immune system to recognize and destroy them. Trastuzumab, bevacizumab, rituximab, and cetuximab are examples of smart drugs used in immunotherapy.

When naming smart drugs used in chemotherapy, those that are antibody-based usually end with the suffix -ab, and those that are inhibitors end with -ib.

In Which Stages of Cancer Are Smart Drugs Used?

The use of smart drugs in cancer treatment can vary depending on many factors. Smart drugs can be used in cancers of the bladder, brain, breast, cervix (cervical), colon, esophagus, head and neck, gastrointestinal (digestive) system, kidney, lung, pancreas, skin, thyroid, and many other tissues/organs. However, smart drugs may only be effective in the presence of specific mutations. Therefore, genetic tests are performed to determine whether the cancer patient is suitable for targeted therapy.

Smart drugs are typically used in advanced-stage diseases or those with distant metastasis, but some smart drugs are also used for postoperative protection, i.e., as adjuvant therapy.

In conclusion, whether smart drugs can be used in cancer depends on the type of cancer, the mutation present in cancer cells, and the patient's overall health. The price of smart drugs also varies depending on the specific drug and dosage. For a more detailed and personalized evaluation of smart drug therapy, it is beneficial to consult a healthcare facility with a well-equipped oncology department.

What Are the Side Effects of Smart Drugs?

The treatment method using smart drugs is generally less harmful than other methods used in cancer treatment, such as chemotherapy. However, as with any drug, some side effects may be observed with these medications.

Side effects of smart drugs in cancer treatment may include diarrhea, liver dysfunction, acne formation, changes in nails, dry skin, reduced hair pigmentation, blood clotting issues, delayed wound healing, high blood pressure, and, rarely, perforation of the stomach or intestines.

Differences Between Smart Drugs and Chemotherapy in Cancer Treatment

Compared to standard chemotherapy, smart drugs have the following differences: they target only cancer cells, whereas chemotherapy can affect both cancerous and healthy cells. Smart drugs work more by preventing cancer cells from dividing and proliferating rather than directly killing them. The difference between chemotherapy and smart drugs in cancer treatment indicates that while both methods are used, smart drugs are considered a step ahead in terms of their effects.

Smart drugs are specifically designed based on the type of cancer and the mutation that caused the cancer. This allows them to act more selectively and effectively within the body.

There are many smart drugs that have been proven effective and are available on the market. They have revolutionized cancer treatment and achieved successful results in patients who are suitable candidates. Cancer patients should consult an experienced oncologist at a well-equipped center to discuss potential treatment options and choose the most appropriate method together.