Targeted therapies: a new generation of cancer treatments

Am Fam Physician. 2008 Feb 1;77(3):311-9.

Abstract

Targeted therapies, which include monoclonal antibodies and small molecule inhibitors, have significantly changed the treatment of cancer over the past 10 years. These drugs are now a component of therapy for many common malignancies, including breast, colorectal, lung, and pancreatic cancers, as well as lymphoma, leukemia, and multiple myeloma. The mechanisms of action and toxicities of targeted therapies differ from those of traditional cytotoxic chemotherapy. Targeted therapies are generally better tolerated than traditional chemotherapy, but they are associated with several adverse effects, such as acneiform rash, cardiac dysfunction, thrombosis, hypertension, and proteinuria. Small molecule inhibitors are metabolized by cytochrome P450 enzymes and are subject to multiple drug interactions. Targeted therapy has raised new questions about the tailoring of cancer treatment to an individual patient's tumor, the assessment of drug effectiveness and toxicity, and the economics of cancer care. As more persons are diagnosed with cancer and as these patients live longer, primary care physicians will increasingly provide care for patients who have received targeted cancer therapy.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / pharmacology*
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / economics
  • Antineoplastic Agents / pharmacology*
  • Drug Eruptions / etiology
  • Heart / drug effects
  • Heart / physiopathology
  • Humans
  • Hypertension / chemically induced
  • Neoplasms / drug therapy*
  • Neoplasms / metabolism
  • Protein Kinase Inhibitors / adverse effects*
  • Protein Kinase Inhibitors / pharmacology*
  • Proteinuria / chemically induced
  • Receptor, ErbB-2 / drug effects
  • Signal Transduction / drug effects
  • Thrombosis / chemically induced
  • Vascular Endothelial Growth Factor A / drug effects
  • Ventricular Dysfunction / chemically induced

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Vascular Endothelial Growth Factor A
  • ERBB2 protein, human
  • Receptor, ErbB-2