Molecular and Clinical Approach to Intra-abdominal Adverse Effects of Targeted Cancer Therapies

Area of Science:

• Radiology
• Oncology
• Molecular Biology

Background:

• Targeted cancer therapies are rapidly evolving, involving complex molecular pathways.
• Traditional organ system-based adverse effect cataloging is insufficient for modern oncology.
• Radiologists require a new framework integrating molecular mechanisms and clinical outcomes.

Purpose of the Study:

• To present a conceptual framework for understanding adverse effects of targeted cancer therapies.
• To classify these adverse effects based on molecular mechanisms.
• To aid radiologists in differentiating treatment toxicities from tumor progression.

Main Methods:

• Review of established and hypothesized molecular mechanisms of targeted therapy adverse effects.
• Classification of adverse effects into four categories based on molecular targets and treatment response.
• Illustration of key imaging findings for abdominal and pelvic toxicities.

Main Results:

• Adverse effects can be categorized as on-target with or without response, off-target, or tumor necrosis-related.
• Understanding molecular underpinnings aids in recognizing and managing toxicities.
• Imaging manifestations of adverse effects are linked to specific molecular pathways.

Conclusions:

• A molecular-based approach is essential for radiologists in the era of targeted cancer therapies.
• This framework enhances the ability to differentiate adverse effects from tumor progression.
• Radiologists can better guide oncologic treatment decisions by understanding these mechanisms.