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Targeted therapy is one of the most important advances in modern cancer treatment. Instead of attacking all fast-growing cells like conventional chemotherapy, it acts on specific molecules, proteins, or genetic changes that drive a cancer’s growth. For many patients, this means better tumour control with a different, and often more manageable, side-effect profile.

This guide from the medical oncology team at Onco-Life Cancer Centre explains what targeted therapy is, how it works, which cancers it treats, common drugs used in India, side effects, treatment duration, success rate, and how much it typically costs.

Table of Contents

What Is Targeted Therapy?

Targeted therapy is a form of cancer treatment that uses medicines designed to identify and block specific proteins, genes, or signals that help cancer cells grow, divide, or spread. Because it acts on features specific to cancer, it is one of the pillars of precision oncology, along with immunotherapy and modern chemotherapy. The core idea is to match the right drug to the right cancer. This is only possible after the tumour has been tested to identify the mutation, receptor, or pathway that can be targeted.

How Targeted Therapy Works

Cancer cells often have specific “drivers” that push them to grow abnormally. Targeted therapy interferes with these drivers in one or more ways:

  • Blocks signals that tell cancer cells to grow and divide
  • Cuts off blood supply to the tumour by blocking the formation of new blood vessels
  • Marks cancer cells so the immune system can find and destroy them
  • Delivers a chemotherapy payload directly into cancer cells
  • Blocks proteins that help cancer cells survive despite DNA damage

Unlike chemotherapy, which affects many rapidly dividing cells (including hair follicles and gut lining), targeted therapy tends to hit a narrower range of cells. This is why side effects are often different, though not always milder.

The Role of Biomarker and Genetic Testing

Targeted therapy only works if the cancer has the target the drug is designed to hit. Biomarker testing is therefore essential before starting treatment. Common tests include:

  • Tissue biomarker testing on a biopsy sample (immunohistochemistry, FISH, next-generation sequencing)
  • Liquid biopsy (a blood test) for circulating tumour DNA in selected cases
  • HER2 testing in breast and stomach cancer
  • EGFR, ALK, ROS1, KRAS, BRAF, MET, RET testing in lung cancer
  • BRCA1 and BRCA2 testing in ovarian, breast, prostate, and pancreatic cancers
  • PD-L1 and tumour mutational burden (also used to guide immunotherapy decisions)

Your oncologist decides which tests are needed based on the cancer type and stage, and integrates the results with imaging, blood tests, and clinical findings

Main Types of Targeted Therapy

Small-molecule drugs Usually taken as tablets or capsules, these drugs enter cancer cells and block signals inside them. Examples include tyrosine kinase inhibitors (TKIs) such as imatinib, erlotinib, and osimertinib.

Monoclonal antibodies Lab-made proteins given by intravenous infusion. They attach to specific targets on the surface of cancer cells, either blocking growth signals or marking the cells for immune attack. Examples include trastuzumab, cetuximab, and rituximab.

Antibody-drug conjugates (ADCs) Monoclonal antibodies attached to a chemotherapy payload. The antibody delivers the chemotherapy directly to the cancer cell. Examples include trastuzumab-deruxtecan and enfortumab vedotin.

Angiogenesis inhibitors Drugs that stop cancer from forming new blood vessels, cutting off its nutrient supply. Examples include bevacizumab and sunitinib.

PARP inhibitors Drugs that block DNA repair in cancer cells that already have BRCA or similar mutations. Examples include olaparib, niraparib, and talazoparib, used mainly in ovarian, breast, prostate, and pancreatic cancers.

Targeted radiation (radioligand therapy) A radioactive substance attached to a molecule that seeks out cancer cells. Examples include Lu-177 PSMA in prostate cancer and Lu-177 DOTATATE in neuroendocrine tumours. This is different from external radiation therapy delivered by a machine.

Common Targeted Therapy Drugs in India

Several targeted therapy drugs are approved and available in India. The right drug depends on the cancer type and the biomarker present.

  • Imatinib – chronic myeloid leukaemia, gastrointestinal stromal tumours (GIST)
  • Trastuzumab (Herceptin) – HER2-positive breast cancer and some HER2-positive stomach cancers
  • Rituximab – non-Hodgkin lymphoma and certain autoimmune conditions
  • Cetuximab – head and neck cancer, colorectal cancer with KRAS wild-type
  • Bevacizumab (Avastin) – colorectal, lung, cervical, ovarian, and some brain cancers
  • Erlotinib, gefitinib, osimertinib – EGFR-mutated non-small cell lung cancer
  • Sorafenib, lenvatinib – liver, thyroid, and kidney cancers
  • Sunitinib – kidney cancer and GIST
  • Palbociclib, ribociclib, abemaciclib – HR-positive HER2-negative breast cancer
  • Olaparib, niraparib – ovarian, breast, prostate, and pancreatic cancers with BRCA or homologous recombination deficiency
  • Enzalutamide, abiraterone – advanced prostate cancer

Biosimilars of several targeted drugs are now available in India, often at lower cost than the original branded product.

Cancers Treated with Targeted Therapy

Targeted therapy is used in a wide range of cancers when the right target is present:

  • Non-small cell lung cancer
  • Breast cancer, particularly HER2-positive and hormone receptor-positive types
  • Colorectal cancer
  • Chronic myeloid leukaemia, acute lymphoblastic leukaemia, and certain other blood cancers
  • Non-Hodgkin lymphoma
  • Melanoma
  • Ovarian cancer
  • Prostate cancer, particularly advanced or castration-resistant disease
  • Kidney cancer
  • Thyroid cancer
  • Liver cancer
  • Stomach and oesophageal cancer
  • Gastrointestinal stromal tumours (GIST)
  • Pituitary tumours and some neuroendocrine tumours

Targeted therapy may be used alone or in combination with chemotherapy, immunotherapy, hormone therapy, radiation therapy, or surgery, depending on the cancer stage and treatment goals.

Who Is Suitable for Targeted Therapy?

Not every patient benefits from targeted therapy. Eligibility depends on:

  • Cancer type and stage
  • Presence of the specific mutation, receptor, or biomarker in the tumour
  • Overall health, heart, kidney, and liver function
  • Previous cancer treatments and any residual side effects
  • Availability and affordability of the drug

A patient with the same cancer type but a different biomarker profile may need a completely different plan. This is why detailed biomarker testing is central to modern cancer care.

How Targeted Therapy Is Given

Depending on the drug, targeted therapy may be given as:

  • Oral tablets or capsules (often taken daily at home)
  • Intravenous infusion in a day-care setting
  • Subcutaneous injection
  • A combination of oral and intravenous drugs

Most patients receive treatment as outpatients or day-care patients and do not need overnight admission. Careful timing with chemotherapy, radiation, or other treatments is often required.

Duration of Treatment

The duration of targeted therapy varies widely. Some general patterns:

  • Blood cancers with well-controlled disease: oral targeted therapy may continue for years, sometimes indefinitely, as long as it is working and tolerated.
  • Advanced solid tumours: treatment often continues as long as the cancer is controlled and side effects remain manageable.
  • Adjuvant treatment (given after surgery): may be planned for a defined period, such as one year of trastuzumab in HER2-positive breast cancer.
  • Combination regimens: duration is guided by the specific protocol.

Your oncologist plans the duration based on the drug, cancer type, response on scans, and how you feel.

Side Effects and How They Are Managed

Targeted therapy usually has a different side-effect profile from chemotherapy, but it is not free of side effects. Common ones include:

  • Fatigue
  • Skin rash, dryness, or acne-like eruptions
  • Diarrhoea
  • Mouth ulcers
  • Nail changes, brittle hair
  • High blood pressure
  • Mild swelling of hands or face
  • Thyroid changes

Less common but important side effects include:

  • Liver enzyme changes
  • Heart rhythm problems or reduced heart pumping function
  • Inflammation of the lungs (pneumonitis)
  • Bleeding or clotting problems
  • Severe allergic reactions during infusion

When to contact your oncologist immediately:

  • Persistent high fever
  • Severe or worsening rash
  • New shortness of breath or chest pain
  • Severe or bloody diarrhoea
  • Unusual bleeding, bruising, or sudden weakness
  • Marked swelling of the face, lips, or throat

Regular blood tests, ECGs where needed, and clinical reviews are part of a safe targeted-therapy programme

Success Rate and Drug Resistance

  • Targeted therapy can produce excellent responses when the right drug is matched to the right tumour biology. However, cancer cells sometimes develop resistance, meaning the drug stops working as well as it did initially.

    Modern oncology now includes:

    • Second- and third-generation targeted drugs designed to overcome resistance
    • Repeat biomarker testing at progression, to guide the next line of treatment
    • Combination strategies with chemotherapy or immunotherapy to delay resistance

    The “success rate” of targeted therapy is not one number; it depends on cancer type, stage, biomarker, drug used, and how early the therapy is started. Your oncologist will discuss realistic expectations based on your specific situation.

Targeted Therapy vs Chemotherapy

Feature

Chemotherapy

Targeted Therapy

How it works

Destroys rapidly dividing cells

Blocks specific molecular targets

Selectivity

Affects many normal cells

More selective

Requires biomarker testing

Usually no

Yes, in most cases

Common side effects

Hair loss, nausea, low blood counts, mouth sores

Rash, diarrhoea, fatigue, blood pressure, organ-specific effects

Route

Mostly intravenous

Oral or intravenous

Duration

Fixed cycles

Often continuous, as long as it works

For many patients, chemotherapy and targeted therapy are used together for the best outcome.

Targeted Therapy vs Immunotherapy

Both are forms of precision oncology, but they work differently.

  • Targeted therapy attacks specific cancer proteins or pathways directly.
  • Immunotherapy helps the immune system recognise and destroy cancer cells.

Some patients receive both, especially in lung, kidney, and bladder cancers, based on biomarker testing.

Cost of Targeted Therapy in India

The cost of targeted therapy in India depends on:

  • The specific drug prescribed
  • Whether it is a branded or biosimilar version
  • Dose, which is often weight-based
  • Duration of treatment
  • Whether it is oral (self-administered) or intravenous (day-care infusion)
  • Combination with chemotherapy or other therapies
  • Biomarker testing costs

Monthly costs commonly range from approximately ₹20,000 to ₹3,00,000 or more, depending on the drug. Some newer targeted therapies cost significantly more, while several older ones and biosimilars are available at more affordable prices.

Support options that can reduce out-of-pocket cost:

  • Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) – Maharashtra state scheme
  • Ayushman Bharat (PM-JAY) – national scheme
  • CGHS – for central government employees
  • Pharmaceutical company patient-assistance programmes for specific drugs
  • Private health insurance, subject to policy terms

Onco-Life is empanelled under MJPJAY, PM-JAY, and CGHS. Eligibility criteria apply; please check government scheme eligibility before starting treatment.

Targeted Therapy Care at Onco-Life

At Onco-Life Cancer Centre, targeted therapy is planned and delivered by an experienced medical oncology team. Patients benefit from:

  • Coordinated biomarker testing in-house or via partner laboratories
  • Multidisciplinary review through the Virtual Tumour Board
  • Day-care infusion for intravenous targeted therapies
  • Monitoring of blood counts, liver, kidney, thyroid, and heart function during treatment
  • Support from palliative care and nutrition teams
  • Long-term follow-up and adjustment as needed

Targeted therapy is offered at all Onco-Life centres in Maharashtra:

To discuss whether targeted therapy is right for your cancer, Book a Doctor Appointment or request a Second Opinion.

Most Popular Questions

Targeted Therapy -faqs

How Is Targeted Therapy Different From Chemotherapy?

Chemotherapy attacks all rapidly dividing cells. Targeted therapy acts on specific cancer features identified through biomarker testing, often with a different side-effect profile.

Do I Need Genetic Testing Before Targeted Therapy?

Yes, in most cases. Biomarker testing identifies whether your cancer has the target the drug is designed to hit; without it, treatment may not work.

How Long Does Targeted Therapy Last?

Duration varies. Some patients continue for months, others for years, as long as the cancer stays controlled and side effects remain manageable.

Is Targeted Therapy Safer Than Chemotherapy?

Not universally. It usually has a different side-effect profile and can still cause serious effects on the skin, gut, liver, lungs, and heart, so monitoring is essential.

Can Targeted Therapy Cure Cancer?

It can control or shrink cancer significantly and, in some cases, produce long-term remission. Complete cure depends on cancer type, stage, and biomarker.

Can Cancer Become Resistant To Targeted Therapy?

Yes. Some cancers develop resistance over time. Repeat biomarker testing and switching to newer targeted drugs or combinations often help overcome this.

How Much Does Targeted Therapy Cost In India?

Costs commonly range from around ₹20,000 to ₹3,00,000 per month depending on the drug and duration. Biosimilars and government schemes can significantly reduce this.

Is Targeted Therapy Covered Under Ayushman Bharat Or Mipjay At Onco-Life?

Onco-Life is empanelled under MJPJAY, PM-JAY, and CGHS. Coverage depends on eligibility and the specific drug prescribed; please verify before starting.

Can I Take Targeted Therapy At Home?

Oral targeted therapies are usually self-administered at home under supervision. Intravenous drugs are given in a day-care infusion room at the hospital.