The aim of the largest health diagnostic hospital complex in eastern Bulgaria St. Marina University Hospital - Varna is to provide Bulgarian patients with state-of-the-art approaches in diagnosis and treatment of oncology diseases through implementation of innovative technologies, and personalized and precise medicine.
Over the last decade the scientific knowledge of tumor biology has increased immensely, which in turn has enabled the global development of new drugs and therapeutic approaches. Targeted therapies began to modify cancer treatment.
What is the essence of targeted therapy? This is a therapy, which is individually targeted at each patient. The mutated protein in the cell, which does not have normal regulation, and is always active and causing tumor cell division, is treated by means of a drug. This drug blocks only the mutated protein, explains Assoc. Prof. Dr. Ivan Shterev, Head of the Clinic of Medical Oncology at St. Marina University Hospital - Varna.
Prior to the implementation of targeted therapies, a pre-therapeutic genetic test is required, which indicates the presence or absence of a particular biomarker in the tumor tissue of the patient, and this in turn determines the effectiveness of the respective targeted drug. This is basically personalized, individualized and precise medicine. Molecular tests are now a mandatory part of the routine diagnostic process for oncology patients. Furthermore, tumor profiling for detecting all specific genetic changes plays a crucial role in the selection of an individual targeted therapy.
The achievements of molecular diagnostics have resulted in the creation of many genetic tests for detecting characteristic genetic changes, mutations or overproduction of a specific protein in the tumor tissue of each patient individually. These are biomarkers, for whose specific blocking targeted drugs for tumor treatment have been developed.
At St. Marina University Hospital modern cancer treatment is closely related to modern methods for diagnosing tumors aimed at personalizing the treatment approach. These are the methods of immunohistochemistry, polymerase chain reaction (PCR) and in situ hybridization. Moreover, innovative digital technology has been used at the Clinic of General and Clinical Pathology since 2015. The Laboratory of Molecular Pathology possesses last generation equipment for determination of protein and genetic prototype of each tumor.
Targeted therapies have proven effectiveness in patients with breast, lung, colon, kidney carcinomas, and melanoma. According to our experience, which is of 5 years' duration, molecular genetic tests have indicated that approximately 60% of patients with colon carcinoma are suitable for targeted therapy. In addition, 50% of patients with melanoma, 10% with lung carcinoma, and 20% with breast carcinoma are also suitable for targeted therapy, said Assoc. Prof. Shterev.
Targeted therapy may be used in combination with the well-known cytotoxic therapy or independently, and the decision is to be made by the doctor for each patient individually, according to the molecular diagnostic results. Targeted therapy is used most frequently in patients in the fourth metastatic stage of the oncology disease. The efficacy and tolerance of targeted therapy is regularly assessed through examinations, imaging and laboratory tests.
The outcome of the implementation of personalized medicine at St. Marina University Hospital - Varna through individual molecular genetic tests and biomarkers in the tumor tissue is the chance the right medicine to be given to the right patient at the right time by means of targeted therapy, which leads to more qualitative and successful treatment of oncology diseases in general.
The benefits for patients from personalized targeted therapies are indisputable. Their application increases the possibility of a favorable outcome of the disease, reduces the side effects of the treatment, and improves the quality of life of oncology patients.
For contacts with Assoc. Prof. Shterev and the Clinic of Medical Oncology at St. Marina University Hospital - Varna tel .: 052/97 88 80 052/97 88 76
Assoc. Prof. Dr. Ivan Shterev is the Head of the Clinic of Medical Oncology at St. Marina University Hospital - Varna and an Associate Professor at the Department of Propaedeutics of Internal Medicine at MU-Varna. From 2007 to 2011 he specialized in Kanazawa, Japan, where he successfully defended his doctorate. Assoc. Prof. Dr. Ivan Shterev has been a reviewer for several leading international scientific journals in the field of oncology.
