NCCN Guidelines for Patients
: Caring for Adolescents and Young Adults
Part 5: Understanding your treatment options
Chemotherapy is usually given in cycles of treatment
days followed by days of rest. These cycles vary in length
depending on which drugs are used. Often, the cycles
are 14, 21, or 28 days long. These cycles give the body a
chance to recover before the next treatment.
The immune system usually does a pretty good job of
defending your body against germs, viruses, and parasites
(as well as the occasional grain of pollen). In theory, it
should recognize cancer cells as abnormal and attack
them in the same way. But cancer cells have ways of
getting around the immune system’s defenses.
Immune therapies are designed to boost immune activity
and help the immune system recognize and attack cancer
cells. Currently available immune therapies include:
Nonspecific immune therapies
interferons) that produce an overall boost in immune
function that can increase immune activity against
ipilimumab, rituximab), man-made versions of
proteins that recognize and attach to special
molecules on the surface of cancer cells. (Kind of
like a key fitting into a lock.) Once MABs link up
with the cancer cell, other immune cells are able to
recognize and attack the cancer, and
(eg, Sipuleucel-T) that act in
much the same way as vaccines against the flu
or chicken pox: they teach the immune system to
recognize cancer cells so the immune system can
start defending itself against the cancer.
Unlike chemotherapies, which go after just about any
fast-dividing cell, targeted therapies seek out specific
molecules on cancer cells that play a role in tumor
growth and development. Targeted therapies are usually
grouped on the basis of what they do or the part of the
cell they target.
(eg, tamoxifen, anastrozole)
block the production or the activity of estrogen, a
hormone that some cancers of the breast and uterus
need to survive.
growth factor inhibitors
(eg, trastuzumab, erlotinib) block specific enzymes
and growth factors that cancer cells need to grow
and spread. These drugs may also be called small-
molecule drugs or signal transduction inhibitors.
pralatrexate) alter parts of the cancer cell that control
survival and death, essentially causing the cell to