Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. Other drugs help the immune system to attack cancer. These are called immunotherapy.
Some drugs work in more than one way. So they are targeted as well as working with the immune system.
You might have these drugs as part of your treatment for advanced stomach cancer. Advanced stomach cancer is cancer that started in the stomach and has spread to another part of the body.
When do you have targeted or immunotherapy drugs for stomach cancer?
If you have advanced cancer, your doctor will test a sample (biopsy) of your cancer for certain proteins. They usually test a sample of your stomach cancer tissue from when you were first diagnosed. The results of the tests show whether a targeted or immunotherapy cancer drug is suitable for you.
Types of targeted and immunotherapy cancer drugs for stomach cancer
Trastuzumab has the brand name Herceptin. It’s a type of targeted treatment called a monoclonal antibody. Monoclonal antibodies work by attaching to proteins on or in cancer cells.
Human epidermal growth factor receptor 2 (HER2) is a protein that makes cells grow and divide. Some cancers have large amounts of HER2 protein and are called HER2 positive cancers.
Trastuzumab works by locking onto HER2 in the cancer cells. It both stops them from growing and kills them. Trastuzumab only works if your cancer is HER2 positive.
You might have it with chemotherapy for advanced stomach cancer if:
- if you have not had any other treatment for advanced cancer
- your cancer is HER2 positive
Ramucirumab is another type of monoclonal antibody. It targets a different protein – vascular endothelial growth factor receptor 2 (VEGFR2). This drug works by blocking the protein so that the cancer can’t develop the blood vessels it needs to grow.
Some studies have shown that ramucirumab is beneficial for people with advanced stomach cancer, when other treatments haven’t worked. At the moment it’s not routinely available in the UK.
Nivolumab is a type of immunotherapy called a checkpoint inhibitor. It works by blocking the PD-L1 protein. This protein stops the immune system from working properly and attacking cancer cells. Nivolumab helps to make your immune system find and kill cancer cells.
Each of the UK nations have independent organisations that look at new cancer drugs. They decide whether a drug or treatment can be available on the NHS.
In Scotland, the Scottish Medicines Consortium (SMC) has approved nivolumab for advanced stomach cancer if:
- you have not had any other treatment for advanced cancer
- your cancer has a large amount of PD-L1 protein
- your cancer is HER2 negative
You have this drug with chemotherapy.
England, Wales and Northern Ireland
This drug has not been approved elsewhere in the UK. So it may not be available for people with stomach cancer outside of a clinical trial.
How you have targeted and immunotherapy cancer drugs
You can have targeted and immunotherapy cancer drugs as:
- a drip in your arm
- an injection under the skin
- a tablet
You have these drugs with chemotherapy every 2 to 3 weeks.
Side effects of targeted and immunotherapy cancer drugs
The side effects of targeted and immunotherapy cancer drugs are different depending on the drug you’re having. Not everyone gets all side effects.
The side effects you have depend on:
- which drug you have
- whether you have it alone or with other drugs
- the amount of drug you have (the dose)
- your general health
A side effect may get better or worse during your course of treatment. Or more side effects may develop as the treatment goes on. For more information about the side effects of your treatment, go to the individual drug pages.
Researchers are looking at many types of targeted drugs and immunotherapies for stomach cancer. Some of these drugs are already used to treat other cancers, and some are new.
Researchers are looking at giving these drugs on their own or with chemotherapy.
When you go home
Treatment for stomach cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects you have. Your nurse will give you numbers to call if you have any problems at home.