DISCLOSURES: Dr. Adjei is supported in part by the Conquer Cancer Foundation Drug Development Research Professorship.
Understanding, recognizing, and managing toxicities of targeted anticancer therapies
Version of Record online: 28 MAY 2013
Copyright © 2013 American Cancer Society, Inc.
CA: A Cancer Journal for Clinicians
Volume 63, Issue 4, pages 249–279, July/August 2013
How to Cite
Dy, G. K. and Adjei, A. A. (2013), Understanding, recognizing, and managing toxicities of targeted anticancer therapies. CA: A Cancer Journal for Clinicians, 63: 249–279. doi: 10.3322/caac.21184
- Issue online: 1 JUL 2013
- Version of Record online: 28 MAY 2013
- Manuscript Accepted: 25 FEB 2013
- Manuscript Revised: 21 FEB 2013
- Manuscript Received: 28 NOV 2012
- targeted agents;
- mechanism-based toxicity;
- off-target toxicity;
- therapeutic index;
- kinase inhibitors;
- immunotherapeutic agents
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. CA Cancer J Clin 2013;63:249–279. ©2013 American Cancer Society, Inc.