Treating breast cancer in the 21st century: Emerging biological therapies

Gabriel Tinoco, Sean Warsch, Stefan Glück, Kiran Avancha, Alberto J. Montero

Research output: Contribution to journalReview article

94 Scopus citations

Abstract

For many years, the medical treatment of breast cancer was reliant solely on cytotoxic chemotherapy. However, over the past twenty years, treatment has evolved to a more target-directed approach. We now employ tailored therapy based on the presence or absence of receptors for estrogen, progesterone, and human epidermal growth factor 2 (HER2). We expect this trend to continue, as agents that use novel approaches to target HER2, as well as targeting different portions of the HER signaling pathway, are in various stages of development. Notably, pertuzumab, a humanized monoclonal antibody that binds to a different domain of the extracellular portion of the HER2 receptor than trastuzumab, was recently approved for use, as was lapatinib, a small-molecule tyrosine kinase inhibitor. Patients with triple negative breast cancer, particularly those with the BRCA mutation, have more limited treatment options and carry a worse prognosis than those who are hormone receptor positive. However, recent data has shown that PARP inhibitors may have significant anti-tumor effect in those with this subtype of breast cancer. Novel agents that inhibit mTOR, PI3K, the insulin-like growth factor, heat shock protein 90, and histone deacetylase have shown promise in phase I-III trials and offer exciting new possibilities for the treatment of this often fatal disease. As we are presented with an ever increasing number of treatment options, the timing and combinations of therapeutic agents used becomes ever more complex in the age of personalized care, but we are hopeful that ultimately this will lead to improved patient outcomes.

Original languageEnglish (US)
Pages (from-to)117-132
Number of pages16
JournalJournal of Cancer
Volume4
Issue number2
DOIs
StatePublished - 2013

Keywords

  • Biologics
  • Breast cancer
  • Chemotherapy
  • HER2
  • Novel therapeutics
  • PARP inhibitors.

ASJC Scopus subject areas

  • Oncology

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  • Cite this

    Tinoco, G., Warsch, S., Glück, S., Avancha, K., & Montero, A. J. (2013). Treating breast cancer in the 21st century: Emerging biological therapies. Journal of Cancer, 4(2), 117-132. https://doi.org/10.7150/jca.4925