What is and how does cytoreductive therapy used to fight against tumors work?

Cytoreductive therapy: what it is, what it is for and how the therapy used to combat tumors and leukemia works.

Among the therapies used for the pharmacological treatment of tumors and leukemias there is also cytoreductive therapy. Silvio Berlusconi's illness made this type of treatment known at a national-popular level. The former Italian prime minister, during his fight against chronic myelomonocytic leukemia , the rare form of leukemia that struck him, was also subjected to this type of treatment usually used to combat myeloproliferative neoplasms and related pathologies, i.e. tumors of bone marrow and blood. Let's find out together what it is and how it works.

Cytoreductive therapy: what it is and how it works

Cytoreductive therapy, also known as tumor shrinkage therapy, is a treatment used to shrink the size of a tumor in cancer patients. This type of treatment can be used in various situations, for example, to reduce the mass of a tumor before surgery, to relieve the symptoms of cancer or to improve the effectiveness of other types of therapies such as radiotherapy or chemotherapy.

Cytoreductive therapy can be done in several ways. It is usually implemented through the use of specific drugs. The method chosen depends on the size and location of the tumor, the patient's medical history , and the severity of the disease. In any case, the main goal of cytoreductive therapy is to shrink the tumor mass to improve the effectiveness of other treatments or to relieve the symptoms of the cancer. This therapy, which is not conclusive , is in fact used to "keep the disease at bay", limiting the abnormal proliferation of immature cells.

What drugs are used

According to a study presented at the European Congress of Hematology in 2022, hydroxyurea is the drug of choice for this type of therapy, even if there are other drugs capable of performing the same task. In the context of polycythemia vera, another disease in which cytoreductive therapy is used, ropeginterferon alfa-2b, for example, has been shown to have better tolerability and a reduced dosing frequency compared to other interferons.

However, as far as leukemia is concerned, hydroxyurea is the drug usually used. It is a chemotherapy available in capsules that can reduce the cells produced by the bone marrow, thanks to the fact that it is a DNA synthesis inhibitor that interferes with certain enzymes. The action of this therapy, by blocking the number of abnormal white blood cells, allows to achieve two benefits for the patient: it creates space for healthy blood cells and frees up space for red blood cells and platelets. For this reason it is often used in cases of this type.

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