Understanding, recognizing, and managing toxicities of targeted anticancer therapies

CA Cancer J Clin. 2013 Jul-Aug;63(4):249-79. doi: 10.3322/caac.21184. Epub 2013 May 28.

Abstract

Answer questions and earn CME/CNE Advances in genomics and molecular biology have identified aberrant proteins in cancer cells that are attractive targets for cancer therapy. Because these proteins are overexpressed or dysregulated in cancer cells compared with normal cells, it was assumed that their inhibitors will be narrowly targeted and relatively nontoxic. However, this hope has not been achieved. Current targeted agents exhibit the same frequency and severity of toxicities as traditional cytotoxic agents, with the main difference being the nature of the toxic effects. Thus, the classical chemotherapy toxicities of alopecia, myelosuppression, mucositis, nausea, and vomiting have been generally replaced by vascular, dermatologic, endocrine, coagulation, immunologic, ocular, and pulmonary toxicities. These toxicities need to be recognized, prevented, and optimally managed.

Keywords: immunotherapeutic agents; kinase inhibitors; mechanism-based toxicity; off-target toxicity; targeted agents; therapeutic index; toxicity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Bone Marrow Diseases / chemically induced
  • Cachexia / chemically induced
  • Diarrhea / chemically induced
  • Drug Eruptions / etiology
  • Drug Eruptions / therapy
  • Endocrine System Diseases / chemically induced
  • Exanthema / chemically induced
  • Heart Diseases / chemically induced
  • Hemorrhage / chemically induced
  • Humans
  • Hyperbilirubinemia / chemically induced
  • Hyperlipidemias / chemically induced
  • Immune System Diseases / chemically induced
  • Lung Diseases, Interstitial / chemically induced
  • Magnesium / blood
  • Mood Disorders / chemically induced
  • Neoplasms / drug therapy*
  • Peripheral Nervous System Diseases / chemically induced
  • Pleural Effusion / chemically induced
  • Thrombocytopenia / chemically induced
  • Venous Thromboembolism / chemically induced
  • Vision Disorders / chemically induced

Substances

  • Antineoplastic Agents
  • Magnesium