Small-molecule targeted drugs
Enter cells and inhibit proteins such as EGFR, ALK, BRAF, KRAS, PARP or kinases driving abnormal growth.
- Needs
- A validated target and a drug able to reach it
- Watch
- Resistance mutations, interactions, organ toxicity
The treatment frontier
A new drug is only useful when it meets the right cancer.
Follow the target, the evidence and the person, not the headline. Explore modern cancer medicines, why they work, why they stop working and what to ask next.
01Identify the cancerPathology, origin, stage and behaviour
02Find the vulnerabilityMutation, protein, hormone or immune signal
03Measure the benefitSurvival, symptoms and quality of life
04Plan the next moveToxicity, resistance and sequencing
What has changed
From treating an organ to treating its biology
Chemotherapy, surgery and radiotherapy remain essential. The newer landscape adds medicines aimed at molecular drivers, immune checkpoints, cell-surface targets and radioactive delivery routes.
Two people with the same cancer name may receive different drugs. One drug may work across several organs when they share a biomarker. Precision is improving, but most treatments still help only a proportion of eligible patients.
Six treatment systems
Different routes to the same objective
These categories overlap. Modern regimens often combine mechanisms to deepen response or delay resistance.
Monoclonal antibodies
Bind targets on cancer cells or in their environment. Some block growth signals; others recruit immune destruction.
- Examples
- HER2, CD20, EGFR and VEGF pathways
- Watch
- Infusion reactions and target-specific effects
Antibody-drug conjugates
An antibody carries a potent payload toward cells displaying a target. The promise is selective delivery, not zero collateral damage.
- Frontier
- HER2-low, TROP2, Nectin-4 and more
- Watch
- Lung, blood, eye, liver and nerve toxicities vary
Immunotherapy
Checkpoint inhibitors, bispecific antibodies and cellular therapies help immune cells recognize or attack cancer.
- Potential
- Durable control in a minority; dramatic in some settings
- Watch
- Inflammation can affect almost any organ
Radioligand therapy
A targeting molecule carries a therapeutic isotope to cancer cells, combining molecular recognition with local radiation.
- Examples
- PSMA-directed prostate and somatostatin-receptor therapy
- Watch
- Marrow, kidney, salivary and radiation precautions
Synthetic lethality and combinations
Block a backup pathway a cancer depends on, or attack several escape routes together.
- Example
- PARP inhibition in selected DNA-repair deficient cancers
- Question
- Does extra benefit justify added toxicity?
Interactive preparation tool
What should I ask about?
Select what is known. This produces discussion prompts, not a drug recommendation or eligibility decision.
Your discussion prompts will appear here.
Important: a reported mutation may not be driving the cancer; an approved drug may not apply to that tumour, stage or treatment line; and a negative blood test can miss alterations found in tissue.
Headline decoder
“Breakthrough” can mean almost anything
A molecule killing cancer cells in a dish is interesting science. It is not evidence that the molecule safely treats cancer in a person.
Pause at these phrases“Could cure cancer”, “eradicated tumours in mice”, “100% effective” in a tiny selected sample, “game changer” without comparative data, or a press release that does not link the paper or trial.
Where innovation is moving
The pipeline beyond the next approval
Promising mechanisms still need trials showing that patients live longer or better, not merely that tumours shrink.
Drugging the “undruggable”
New inhibitors and protein degraders are expanding the set of reachable cancer drivers, including specific KRAS states and transcriptional machinery.
Smarter payloads
Next-generation ADCs, conditionally active antibodies and nanoparticles aim to release treatment mainly inside or near tumour tissue.
Bispecific and cellular therapy
Engineered molecules bring immune cells to tumours; CAR-T, TCR and tumour-infiltrating lymphocyte approaches are moving beyond blood cancers.
Personalised immune training
Neoantigen vaccines are being tested with checkpoint blockade and other therapies to amplify tumour-specific immune responses.
New isotopes and targets
Alpha emitters and new ligands may deliver higher-energy treatment across more tumour types while limiting exposure elsewhere.
Treating evolution
Serial tissue, liquid biopsy and response monitoring may help change treatment as resistant cancer populations emerge.
Old drug, new use
A medicine with years of safety data may gain a new cancer indication, dose, formulation or combination. Thalidomide-related drugs in myeloma and arsenic trioxide in acute promyelocytic leukaemia show how unusual histories can lead to established oncology roles.
Promising is not enough
Cheap familiar medicines such as metformin, statins, aspirin or antiparasitic drugs often generate headlines. Routine cancer use still requires convincing human trials for a defined cancer and setting.
A known drug, better selected
Biomarkers may reveal that an existing drug works in another tumour type. Tumour-agnostic approvals formalise this when the molecular feature matters more than the organ of origin.
“Old” and “new” are not measures of quality. The useful question is whether the treatment improves a meaningful outcome for people like the patient considering it, at an acceptable burden and risk.
Why good drugs stop working
Cancer is an evolving population, not one fixed target
Treatment removes sensitive cells while resistant clones may survive. They can alter the target, activate a bypass pathway, hide from immunity or change cellular identity.
- 1Confirm progressionImaging patterns, symptoms and sometimes repeat pathology
- 2Re-sample when usefulTissue or liquid biopsy may reveal a new mechanism
- 3Change the pressureNext-generation drug, combination or different treatment class
- 4Consider a trialEspecially when a plausible target lacks an approved option
Reading an approval
Four numbers matter more than “breakthrough”
Accelerated approval and surrogate endpoints can bring earlier access, but confirmatory evidence still matters.
Overall survival
Do people live longer? Crossover and later treatment can complicate interpretation.
Progression-free survival
How long before imaging or clinical progression? A statistical gain may or may not feel meaningful.
Response rate
How many tumours shrink by a defined amount? Also examine response duration.
Quality of life
Symptoms, function and time without severe toxicity can matter as much as scan measurements.
Cost is a treatment effect
Access, affordability and the real burden of therapy
Prices, public reimbursement, insurance rules and compassionate-access programs differ sharply by country and indication. Hospital administration, testing, travel and time away from work add to the drug price.
NCI guide to cancer costsBefore treatment
Ask for the expected personal cost, required biomarker test, treatment duration and whether an equally effective lower-cost option exists.
Before paying privately
Ask for absolute expected benefit, evidence in your exact setting, likely toxicities and what happens if treatment is stopped early.
When access is denied
Ask about appeal, multidisciplinary review, another funded regimen, manufacturer support, expanded access and suitable trials.
For advanced or resistant cancer
Make the trial conversation happen early
For many people with stage III or IV, recurrent, rare or treatment-resistant cancer, a suitable clinical trial may be the most direct route to a new drug. Ask before another treatment makes you ineligible or too unwell to participate.
Ask the treating oncologistWhat standard options remain, and are there trials at this hospital or through a referral centre?
Collect the recordExact pathology, stage, biomarker report, scans, previous drugs, response, toxicities and current fitness.
Contact the trial siteThe study coordinator can screen basic criteria, confirm whether recruitment is truly open and explain required visits.
Compare with current careAsk about randomisation, placebo or control therapy, washout, biopsies, likely costs and alternatives if the trial fails.
Usually establishes dose, safety and biological activity. Potential benefit is possible but uncertain; newer is not necessarily better.
Looks for meaningful activity in a defined cancer or biomarker group and continues safety assessment.
Compares a new strategy with current care, often through randomisation, to test benefit and harms more reliably.
Basket trials group cancers by a shared molecular target; umbrella trials test several matched options within one cancer type.
ClinicalTrials.govRecruiting and active studies worldwideANZCTRAustralia and New Zealand registryNCI trial searchUS cancer trials and supportWHO ICTRPSearch across international registries
A trial is not guaranteed access or benefit. Eligibility can depend on exact tumour biology, previous treatment, organ function, blood counts, performance status, measurable disease and timing. Travel, scans and routine-care costs may not all be paid by the sponsor.
Regulatory sources
Check what was actually approved
What this site will not promote
Evidence first. No influencer oncology.
No herb, supplement, special diet or “natural” protocol has been shown to cure cancer. Laboratory mechanisms, testimonials and claims that conventional doctors are hiding a cure are not clinical evidence.
NCI: diets, supplements and cancerSome carefully evaluated approaches may help symptoms, stress, function or quality of life alongside oncology care. They must not replace treatment shown to improve outcomes.
Herbs, concentrated extracts and supplements can change drug absorption or metabolism. St John’s wort, grapefruit and green-tea extracts are among products that can interact with particular cancer medicines.
Paclitaxel, vincristine and other medicines have natural origins, but clinical use relies on purified compounds, controlled doses, manufacturing standards and human trials.
A therapy may help nausea, pain, sleep or anxiety without treating the cancer itself. The site will label that distinction plainly and link to the underlying evidence.
Connected cancer guides
Continue the investigation
A-Z medicine appendix
Generic name first. Brand name second.
These are representative medicines discussed on this site, not every cancer drug. Official US labeling is linked through DailyMed; indications and brands differ by country. Trial medicines have no approved product insert.
ImatinibGleevec / Glivec
BCR-ABL and other kinase inhibitorOfficial labelsLutetium Lu 177 dotatateLutathera
Radioligand therapyOfficial labelLutetium Lu 177 vipivotide tetraxetanPluvicto
PSMA radioligand therapyOfficial labelNivolumabOpdivo
PD-1 checkpoint inhibitorOfficial labelsOlaparibLynparza
PARP inhibitorOfficial labelOsimertinibTagrisso
EGFR inhibitorOfficial labelPembrolizumabKeytruda
PD-1 checkpoint inhibitorOfficial labelRituximabRituxan / MabThera
CD20 monoclonal antibodyOfficial labelsSacituzumab govitecanTrodelvy
Antibody-drug conjugateOfficial labelSotorasibLumakras
KRAS G12C inhibitorOfficial labelTrastuzumabHerceptin and biosimilars
HER2 monoclonal antibodyOfficial labelsTrastuzumab deruxtecanEnhertu
HER2 antibody-drug conjugateOfficial labelRead the exact product label you receive. Formulation, dose, indication and warnings can differ between brands, biosimilars and countries. The oncology team and pharmacist should check interactions, organ function, pregnancy risk and monitoring.
Evidence library