HER2-Targeting Drugs
Some drugs for stomach cancer target the growth-promoting protein HER2, which is sometimes overproduced on the surface of cancer cells.
Trastuzumab (Herceptin, Ogivri, Herzuma, Ontruzant, Trazimera, Kanjinti) works by binding to the HER2 protein and blocking HER2-positive cells from sending chemical signals that tell them to grow, while also stimulating the immune system to kill cells with a lot of the HER2 protein. Side effects tend to be mild and include fever, chills, and nausea, though in rare cases it can cause heart damage.
Fam-trastuzumab deruxtecan (Enhertu) is a targeted drug linked to a chemotherapy drug. It works like a homing signal by attaching to the HER2 protein and bringing the chemotherapy drug directly to the cancer cell. It can cause mild side effects similar to trastuzumab, as well as an increased risk of infections and bleeding, hair loss, serious lung disease, and rare heart damage.
VEGF-Targeting Drugs
This class of drugs targets the vascular endothelial growth factor (VEGF) receptor, which is involved in the formation of new blood vessels (called angiogenesis) that tumors need to grow.
Ramucirumab (Cyramza) works by binding to VEGF receptors on cancer cells. This blocks VEGF from binding to these cells and prevents them from making more blood vessels, ultimately slowing or stopping the growth of the cancer.
Common side effects include high blood pressure, headache, and diarrhea. Less often, more serious side effects can develop, including:
- Blood clots
- Severe bleeding
- The formation of holes or perforations in the stomach or intestines
- Issues with wounds healing
TRK Inhibitors
Rarely, some stomach cancers may have mutations in one of the NTRK genes, which causes the production of abnormal TRK proteins, leading to abnormal cell growth and cancer. The TRK inhibitors larotrectinib (Vitrakvi) and entrectinib (Rozlytrek) work by targeting these abnormal proteins. Side effects are usually mild, and include:
- Dizziness
- Fatigue
- Nausea
- Vomiting
- Constipation
- Weight gain
- Diarrhea
Serious and uncommon side effects include abnormal liver tests, heart problems, and confusion.
Monoclonal Antibodies
Monoclonal antibodies are proteins created in a lab that can bind to certain targets on a cell’s surface.
Zolbetuximab-clzb (Vyloy) is currently the only monoclonal antibody approved for the treatment of stomach cancer. It’s used along with chemotherapy and administered intravenously.
Common side effects include vomiting, nausea, diarrhea, fever, and decreased appetite. Serious side effects include low white blood cells, intestinal obstruction, pneumonia, respiratory failure, pulmonary embolism, and sepsis.
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