Targeted Therapy in Israel — How Treatment Is Selected

Targeted Therapy in Israel

Targeted therapy in cancer is one of the key approaches in modern oncology, and it is built not around the mere presence of a tumor, but around its biology.

Unlike classical treatment methods, the goal here is not simply to “act on the tumor”, but to understand the mechanisms that drive its growth — and specifically target them.

What does this mean in practice

Any tumor does not develop randomly. It is based on certain changes — most often at the level of genes and proteins — which begin to function abnormally.

These changes create “weak points” in the tumor. Targeted therapy is aimed precisely at these points.

Simply put, this is a treatment that:

does not act blindly
but works against a specific “target”
characteristic of a particular type of tumor

How targeted drugs work

The mechanism of action may differ, but the overall logic remains the same: to stop the processes without which the tumor cannot exist.

In practice, this may include:

blocking growth signals
suppressing cell division
disrupting the transmission of information inside the cell
influencing mutations that drive tumor growth

As a result, tumor cells lose their ability to develop and gradually die.

What “targets” are used

In oncology, several key mechanisms have been well studied:

receptors on the cell surface (for example, EGFR)
intracellular signaling pathways
specific mutations (for example, BRAF)
mechanisms of blood vessel formation (angiogenesis)

The choice does not depend on the name of the drug, but on whether this target is present in a specific patient.

When targeted therapy is used

There is no single standard scenario. Its role in treatment depends not only on the type of tumor, but also on how the disease behaves in a particular case.

In practice, everything starts with the main question: is there a target in the tumor that can be influenced.

If such a target is identified, targeted therapy may be considered at different stages of treatment.

In some situations, it is used as part of first-line therapy — sometimes in combination with other methods, such as chemotherapy or immunotherapy.

In other cases, it is introduced later, when the disease no longer responds to previously administered treatment.

A separate scenario is its use after surgery. In such cases, the goal of treatment is to reduce the risk of recurrence, especially if clinical data suggests that the risk remains high.

Sometimes, in Israel, targeted therapy is used as a maintenance approach — when it is necessary to control the disease over a long period of time.

With disease progression, a change in therapy may also be considered, including switching to drugs targeting different molecular mechanisms.

It is important to understand that targeted therapy is not always the “main” method.

In many cases, it works best as part of an overall treatment strategy, complementing other approaches.

That is why its role is not defined in advance, but within the context of the entire clinical picture.

Types of targeted therapy

Targeted therapy includes a wide range of treatment approaches. The choice of treatment depends not only on the type of cancer, but also on the molecular characteristics of the tumor, the presence of specific genetic alterations, previous treatments, and the patient’s overall condition.

Unlike traditional chemotherapy, targeted therapy is designed to interfere with specific biological mechanisms that help cancer cells grow and survive.

Monoclonal Antibodies

Monoclonal antibodies work outside the cancer cell. They are designed to recognize specific targets on the surface of tumor cells and may:

block growth signals
interfere with cell division
help the immune system recognize cancer cells
disrupt mechanisms involved in tumor progression

This approach is used in a variety of cancers, including breast cancer, colorectal cancer, lung cancer, and several hematologic malignancies.

Small Molecule Inhibitors

Small molecule drugs enter the cancer cell and work from within. These therapies are designed to block signaling pathways that control:

cell growth
cell division
survival of cancer cells
the activity of specific genetic mutations

Many modern targeted therapies belong to this category and are widely used in cancers driven by EGFR, ALK, BRAF, HER2, RET, MET, KRAS, and other molecular alterations.

Personalized Targeted Therapy

One of the most important developments in modern oncology is the ability to tailor treatment to the individual biology of a patient’s tumor.

In these situations, molecular and genomic testing is performed to identify specific alterations that may serve as treatment targets.

The goal is not simply to select a drug, but to identify a treatment strategy based on the unique characteristics of the cancer.

In some cases, this approach may provide access to therapies that are effective only in a small subset of patients but can offer meaningful clinical benefit when the appropriate target is present.

Targeted Therapy Drugs

Modern oncology uses dozens of targeted therapy drugs that act on different molecular pathways and genetic alterations.

These include therapies directed against EGFR, ALK, HER2, BRAF, RET, MET, NTRK, PARP, VEGF, CDK4/6, KRAS, and other molecular targets.

Detailed information about commonly used targeted therapy drugs is available in our dedicated drug directory.

🔍 Visit: Targeted Therapy Drugs Directory

In which types of cancer it is used

Targeted therapy is used in many oncological diseases.

Most commonly:

However, it is important to understand: the diagnosis itself does not mean that targeted therapy will be suitable.
The key role is played by the biology of the tumor, and therefore the initial task of the physicians is to fully understand the mechanisms driving the tumor.

Advantages of targeted therapy

The main difference is not that it is “stronger” or “more modern”, but that it works differently.

In classical chemotherapy, the effect is on all rapidly dividing cells.

Targeted therapy works more selectively — it focuses on specific mechanisms that drive tumor growth.

In clinical practice, this may mean several important things.

First, when a suitable target is present, treatment may be more effective, since the impact is directed at a key process within the tumor rather than at cells in general.

Second, in some cases, a more manageable side effect profile is observed.

This does not mean there are no side effects, but they are often different in nature and not always as pronounced as with chemotherapy.

In addition, targeted drugs can be effectively combined with other methods — for example, with chemotherapy or immunotherapy. In some treatment regimens, this enhances the overall effect.

At the same time, it is important to understand that this approach does not work in all situations.

If the tumor does not have a corresponding molecular “target”, targeted therapy may not produce the expected result.

That is why diagnostics — including molecular-genetic testing — plays a key role before starting treatment.

Possible side effects

Despite the more “precise” mechanism of action, targeted therapy can cause side effects.

Most commonly:

skin reactions
increased sensitivity to sunlight
fatigue
changes in blood tests
increased blood pressure

In some cases, more significant reactions may occur, which is why treatment requires monitoring and medical supervision.

How treatment decisions are made

The decision to prescribe targeted therapy is not made automatically based solely on the diagnosis.

First of all, it is important to understand whether the tumor has a target that can be influenced.

In practice, this means that treatment does not begin with choosing a drug, but with analyzing the tumor itself — its biological and molecular characteristics.

We look not only at the type of cancer and stage of the disease.

A key role is played by the results of molecular-genetic testing — they determine whether targeted therapy is relevant in principle.

Additionally, the following are taken into account:

what treatments have already been used
how the tumor responded to them
the patient’s general condition and comorbidities

In some situations, there are indeed several possible approaches.

And then it is not about “right” or “wrong” treatment, but about choosing between options, each with its own advantages and limitations.

That is why the treatment plan is formed individually — taking into account the entire clinical picture, not just a single parameter.

Targeted therapy and clinical trials

The development of targeted therapy is closely linked to clinical research.

Many of the drugs used today in standard practice were only recently part of clinical trials.

And this process is still ongoing.

In real practice, participation in a clinical trial may be considered not as an “experiment”, but as one of the possible treatment options — especially when standard approaches have already been used or provide limited results.

At the same time, it is important to understand that this is not a random choice.

Each study has strict inclusion criteria, and the decision is made only after analyzing the patient’s medical data — including tumor type, molecular characteristics, and previous lines of treatment.

In some cases, participation in a trial may provide access to new drugs that are not yet widely available but are already showing promising results.

However, this option is not suitable for everyone and always requires a balanced decision with an understanding of both potential benefits and limitations.

Oncologist consultation

If targeted therapy is being considered or there are questions about treatment, the first step is usually a detailed review of the medical situation.

During the consultation:

medical documents are analyzed
possible treatment options are evaluated
next steps are discussed

📞 Phone: +972-73-374-6844
📧 Email: [email protected]
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Frequently Asked Questions — Answers by Dr. Irina Stefansky

1. If a mutation is found, does that mean targeted therapy will definitely work?

Not always, and this is important to understand from the beginning.

Yes, the presence of a mutation is what usually starts the conversation about targeted therapy. But beyond that, things are more complex. There are mutations we can actually act on with available drugs, and others where options are still limited.

Sometimes patients come with genetic results already expecting that “now we will find the right drug”.
Unfortunately, it does not always work that way. We always look at the broader clinical picture, not just a single result.

2. Can targeted therapy be started immediately, without chemotherapy?

Sometimes yes. But this is not a universal scenario.

There are situations, for example with certain mutations in lung cancer, where targeted therapy can indeed be used as first-line treatment.

But in other cases, we choose a different sequence.

And here it is not about better or worse — just different strategies.

3. Why does a drug work for one patient but not for another?

This is probably one of the most difficult questions, and there is no simple one-line answer.

Even with the same mutation, tumors can behave differently.

Sometimes there is a good initial response, which is later lost.
Sometimes the effect appears more slowly.

We still cannot always predict this precisely. And that is part of the reality of modern oncology.

4. Is there a point in doing molecular testing if the disease has already been treated?

Yes, and quite often it changes the strategy.

Tumors can evolve over time — new mutations appear, and sensitivity to treatment can change.

That is why repeat testing is not duplication, but sometimes a way to find new options that were not available before.

5. Is targeted therapy a “milder” type of treatment?

I would not put it that way.

It is often tolerated differently than chemotherapy, but that does not mean it is easier or without side effects.

They are simply different.

And sometimes patients underestimate them because they expect something “gentler”.

6. What happens if targeted therapy stops working?

This is a situation we see quite often.

In such cases, we reassess the strategy — sometimes switching drugs, sometimes moving to a different type of treatment.

Sometimes it makes sense to re-evaluate molecular changes, because the tumor may no longer be the same as at the beginning.

7. Is there a benefit in coming to Israel specifically for targeted therapy?

Often, patients come not just for a specific drug, but for a clearer understanding of their situation.

What exactly is happening, what options exist, and what else can be done.

In some cases, the approach may indeed differ — especially in complex or non-standard situations.

We often expand the diagnostic process, perform molecular tests that may not be available elsewhere, and get a more complete picture of the disease.
This allows us to tailor treatment in a more precise and sometimes non-standard way — in short, individually for each patient.

But in any case, it makes sense to start with a consultation and a thorough review of medical records.

Important Information

The information presented on this page is for general informational purposes only and does not constitute medical advice, diagnosis, or a substitute for a personal consultation with a physician.

Tel Aviv Medical Clinic is not a pharmacy and does not sell or provide medications. Information about drug-based treatments, including chemotherapy and immunotherapy, is provided for general awareness only.

All treatment decisions must be made by the treating physician based on the individual condition of the patient.

If you have medical questions or need help choosing treatment, it is recommended to consult a qualified physician.