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Targeted Therapies in Breast Cancer: Implications for Advanced Oncology Practice
1The Sage Colleges, Troy, New York, and City of Hope National Medical Center, Duarte, California.
Abstract:
The systemic therapeutic management of breast cancer has undergone significant transformation in the past decade. Without targeted therapies, conventional treatment with cytotoxic agents has reached the limit of its potential in terms of patient survival for most types of cancer. Enhanced understanding of the pathogenesis of tumor cell growth and metastasis has led to the identification of signaling growth pathways as targets for these directed therapies. Novel therapies targeted to HER2/neu, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), poly(ADP ribose) polymerase (PARP), mammalian target of rapamycin (mTOR), histone deacetylase (HDAC), the heat shock protein, and cyclin-dependent kinase (CDK) inhibitors have been developed and have demonstrated some efficacy in breast cancer. Recognition and management of the toxicities associated with targeted therapies is imperative. This review will describe the clinical development and utilization of targeted therapies currently in use or in clinical trials, with a focus on considerations for the oncology advanced practitioner.
Insights
Targeted therapies represent a significant advancement in breast cancer treatment, offering improved patient survival beyond conventional cytotoxic agents. Understanding and managing their toxicities is crucial for oncology practitioners.
Area of Science:
- Oncology
- Pharmacology
- Molecular Biology
Background:
- Conventional cytotoxic chemotherapy for breast cancer has limitations in improving patient survival.
- Advances in understanding tumor growth and metastasis have identified key signaling pathways for targeted intervention.
Purpose of the Study:
- To review the clinical development and application of targeted therapies in breast cancer.
- To highlight considerations for oncology advanced practitioners in managing these novel treatments.
Main Methods:
- Literature review of targeted therapies in breast cancer.
- Analysis of clinical trial data and established treatments.
- Focus on specific molecular targets and their inhibitors.
Main Results:
- Novel targeted therapies show efficacy in breast cancer treatment.
- Key targets include HER2/neu, EGFR, VEGF, PARP, mTOR, HDAC, heat shock protein, and CDK.
- Management of treatment-related toxicities is essential.
Conclusions:
- Targeted therapies have transformed breast cancer management.
- Oncology practitioners require specialized knowledge for effective utilization and toxicity management.
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