Pharma 67: Targeted Cancer Therapies - Precision, Pathways, and Resistance

This episode explores pathway-targeted cancer therapies as the pharmacology of precision with consequences. Monoclonal antibodies, small-molecule kinase inhibitors, and pathway disruptors are designed to strike specific molecular drivers of malignancy-often with dramatic early responses. We unpack oncogenic signalling, addiction to pathways, and biomarker-guided selection to explain why these drugs can be transformative yet fragile. Resistance, escape signalling, and on-target toxicity remind us that precision does not mean permanence.Key takeaways to sharpen clinical reasoning:* Driver dependence: why some tumours collapse when a single pathway is blocked.* Target classes: monoclonal antibodies vs small molecules-reach, duration, and limits.* Biomarkers matter: matching drug to mutation, amplification, or expression.* Resistance inevitability: bypass tracks, secondary mutations, pathway redundancy.* Therapeutic strategy: sequencing, combinations, and managing chronic toxicity. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe