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title: The End of Chemo?
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* [Health](/section/health/)

# The End of Chemo?

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by 

[Alice Park](https://time.com/author/alice-park/)

Jul 29, 2013 4:00 AM UTC

by 

[Alice Park](https://time.com/author/alice-park/)

Jul 29, 2013 4:00 AM UTC

Chemotherapy has long been one of medicine’s potent weapons against cancer, helping cut cancer deaths by about 20% in the U.S. over the past two decades. But cytotoxins, which target fast-growing cancer cells while killing normal cells too, can be just as brutal on the patient, with side effects ranging from nausea to infection to death.

So researchers are making progress with kinder, gentler ways of targeting cancer that could require nothing more than popping pills, and with fewer side effects. Could the end of chemotherapy be near?

“It’s a question we are all asking,” says Dr. Martin Tallman, chief of the leukemia service at Memorial Sloan-Kettering Cancer Center.

A pair of recent studies hint that for some leukemias, the answer may soon be yes. Patients who had failed to respond to existing treatments tallied a survival rate of up to 83% after two years on a drug called ibrutinib that blocked activity of a signaling molecule responsible for the cancer.

The field of such targeted therapies has been growing since the first precision anticancer drug, imatinib (Gleevec), was approved in 2001 to treat chronic myeloid leukemia and gastrointestinal stromal tumor (GIST). Now, rather than carpet bombing cancer, more than three dozen new “smart bomb” medications thwart specific pathways that tumor cells need to thrive. Some prevent cancer cells from signaling other cells for nutrients, while others inhibit angiogenesis–the ability to develop blood vessels that feed the growths.

Already, patients with GIST can avoid chemotherapy altogether thanks to Gleevec. Some with lung cancer and melanoma are starting to rely exclusively on targeted anticancer therapies as well, and more will likely follow.

While these patients may suffer fewer side effects from their cancer treatment, experts say they should expect to cycle through a combination of the drugs throughout the course of their disease. Cancer cells, like bacteria and viruses, can mutate to resist the targeted drugs, so it may take a cocktail of drugs to address this defense, as happened with HIV/AIDS.

“Many, many fundamental concepts in cancer are being challenged now,” says Tallman. Surgery and chemotherapy won’t disappear anytime soon, but the revolution to usurp their role has begun.

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