Multilevel Targeted Therapy as a New Medical Strategy: from Cell-Centered Lysis to Pathology-Centered Therapeutic Ecosystems

Targeted therapy represents one of the major achievements of modern medicine, enabling selective action on pathological cells while reducing systemic toxicity. However, the dominant paradigm of “one target — one drug — cell lysis” suffers from a fundamental limitation: it inevitably leads to the rapid emergence of resistance due to single-point evolutionary pressure [1–4]. In this work, we propose a new medical strategy — single-level and multilevel pathology-centered targeted therapy, in which the primary object of intervention is not an individual cell but the pathological space as a structurally and dynamically organized system [5,14]. The key element of this strategy is the formation of a stable therapeutic placdarm within the pathological focus, which remains functional after cell lysis and enables prolonged, localized, and multifactorial activation of therapeutic modalities. The proposed concept transforms treatment from a transient molecular interaction into a spatially anchored therapeutic ecosystem, minimizing the probability of resistance and expanding the prospects of chemo-, immuno-, and cell-based therapies.