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Targeted therapy means drugs that go after one specific fault inside the tumour instead of every dividing cell in the body. A cancer cell carries proteins and receptors that keep ordering it to grow and divide; a targeted drug finds exactly those molecules and switches the signal off. Healthy tissue is spared far more than it is under ordinary chemotherapy. The condition is that the driving mutation has to be known in advance — which is why oncology centres in Germany begin not with a prescription but with the genetics of your tumour.
Cancer is still one of the leading causes of death worldwide: according to the WHO, it took close to 10 million lives in 2024. Molecular drugs have not changed the picture for every diagnosis, but where a target is found they can hold the disease in check for months or years. If you are considering cancer treatment in Germany, the conversation almost always starts with a second reading of your slides and paraffin blocks and with a face-to-face consultation — for example with Professor Fuat Oduncu, who treats patients with advanced disease.
How targeted drugs work and how they differ from chemotherapy
Classic chemotherapy hits every fast-dividing cell in the body, which is where hair loss, mouth sores and low white cell counts come from. Targeted therapy in Germany rests on a different idea: the drug recognises a structure that a healthy cell either does not have at all or barely has. Some agents dock onto a receptor on the cell surface, others slip inside and silence the enzyme that passes on the order to divide, and a third group cuts off the new blood vessels the tumour feeds on.
It is usually easier to tolerate than chemotherapy, but easier does not mean without consequences. The German Cancer Information Service (Krebsinformationsdienst) at the DKFZ says it plainly: the structures these drugs attack also occur on healthy cells, so side effects do happen. The common ones are rash and dry skin, diarrhoea, raised blood pressure, thyroid trouble and shifts in liver values. Blood work is monitored throughout the course, and the dose is lowered or paused when it has to be.
Targeted drugs rarely work alone. They are often given together with chemotherapy: the cytotoxic drug shrinks the bulk of the tumour quickly, while the molecular agent holds back what is left. Sometimes the order is reversed and targeted treatment follows surgery or chemotherapy to delay a return of the disease. Which route to take is not one doctor’s decision: a tumour board (Tumorboard) of oncologist, pathologist, radiation oncologist, surgeon and geneticist goes through the case together.
Molecular genetic cancer testing before treatment is chosen
Without a target, a targeted drug is useless — that is the one thing worth understanding before you travel. Cancer diagnostics at German centres therefore starts with the tumour tissue itself: a pathologist reviews it, and the material then goes for next-generation sequencing (NGS), a method that reads hundreds of genes at once and looks for the faults that already have a drug against them. The US National Cancer Institute states the same rule: test the tumour first, then treat.
Paraffin blocks from an earlier biopsy or operation are usually enough, and you can either bring them with you or send them ahead. Laboratories check EGFR, ALK, ROS1, BRAF, KRAS, HER2 and dozens of other genes. If there is too little material, if it is old, or if the tumour has changed in the meantime, the doctor will suggest a repeat biopsy or a liquid biopsy — a blood test that looks for fragments of tumour DNA in the bloodstream.
The result decides the class of drug: kinase inhibitors in tablet form, which mute the signal inside the cell, or monoclonal antibodies given by infusion, which bind to the receptor on the outside. Chromosomal rearrangements are looked at separately; if the word Zytogenetik appears in a German report, that is the German term for the cytogenetic analysis of tumour cell chromosomes. The findings are then discussed by a molecular tumour board — these run at the university hospitals in Heidelberg, Cologne, Dresden, Essen and other cities.
Targeted therapy in Germany for different types of cancer
Targeted therapy for kidney cancer in Germany has long been the backbone of treatment for advanced disease: renal cell carcinoma hardly responds to chemotherapy, yet it is sensitive to drugs that cut off the vessels feeding the tumour and to their combinations with immunotherapy. What the work-up involves and which procedures are on the table is set out on the kidney cancer treatment page.
In the digestive tract, targets are looked for in almost every case. In gastrointestinal stromal tumours (GIST) the drug is chosen by the mutation in the KIT and PDGFRA genes; in colorectal cancer by RAS and BRAF status, which decides whether an antibody against the EGFR receptor will help at all. Targeted therapy for small bowel cancer in Germany follows the same rule — molecular profile first, drug second — because tumours in this location are rare and have no protocol that fits everyone.
Tumours in the chest are a story of their own. In lung cancer an EGFR mutation or an ALK or ROS1 rearrangement changes the entire plan, and an inhibitor often controls the disease for longer than chemotherapy does. Targeted therapy for thymus cancer in Germany is used less often and frequently within study protocols: thymoma and thymic carcinoma affect only a handful of people, so these patients are looked after at centres experienced with rare tumours — in Hamburg, Tübingen, Berlin.
With breast cancer, therapy in Germany depends above all on what the receptor test shows. HER2 overexpression calls for antibodies against that receptor; a hormone-driven tumour for endocrine treatment together with CDK4/6 inhibitors; an inherited BRCA mutation for PARP inhibitors. Rare diagnoses and tumours with no known target are discussed separately, and sometimes a clinical trial is the option on the table — German centres raise that with the patient openly.
Combining targeted drugs with radiotherapy and hormone therapy
A tumour board rarely settles on a single method. Radiotherapy in Germany often runs alongside molecular drugs: radiation deals with one specific site — a bone or brain metastasis, say — while the targeted drug acts throughout the body. The sequence and the gaps between them are planned in advance, because some agents make skin and lung reactions to radiation worse and are paused for that period.
In uro-oncology, molecular and hormonal drugs are combined all the time. Hormone therapy for prostate metastases in Germany remains the foundation, and the genetics decide what is added to it: with BRCA1/2 mutations and other faults in DNA repair, a PARP inhibitor is brought in. The decision rests on PSA, a bone scan or PSMA-PET and the molecular profile of the tumour together, not on a single number.
Arranging targeted therapy in Germany with AlenMed
The AlenMed office is in Munich, while the partner clinics are spread across Germany: 86 centres in 38 cities. We start with the paperwork — collecting your reports, arranging a second reading of the histology slides and blocks, including at the oncology practice in Munich, and sending the material to the laboratory for molecular analysis. The clinic then issues an official cost estimate (Kostenvoranschlag), so you can see what the sum is made of.
After that come the invitation letter for the visa, the appointment date, the airport pick-up, a medical interpreter at the consultations, and help buying original German medication so the course can continue at home. The estimate is always calculated by the clinic, never by us. Send us the discharge summary and the histology report: an AlenMed doctor will read through the documents and tell you whether molecular testing is needed and which centre makes sense in your case.
The information on this page is for general guidance only, is not a public offer, and does not replace a consultation with a doctor. Costs are set by the clinic in an official estimate (Kostenvoranschlag) after it has reviewed the medical records. The treatment plan and the specific drugs are prescribed only by a qualified physician at an in-person appointment.
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