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 language | English |
|---|---|
| Pages (from-to) | 117-132 |
| Number of pages | 16 |
| Journal | Journal of Cancer |
| Volume | 4 |
| Issue number | 2 |
| DOIs | |
| State | Published - Aug 30 2013 |
| Externally published | Yes |
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Keywords
- Biologics
- Breast cancer
- Chemotherapy
- HER2
- Novel therapeutics
- PARP inhibitors.
ASJC Scopus subject areas
- Oncology
Cite this
Treating breast cancer in the 21st century : Emerging biological therapies. / Tinoco, Gabriel; Warsch, Sean; Glück, Stefan; Avancha, Kiran; Montero, Alberto J.
In: Journal of Cancer, Vol. 4, No. 2, 30.08.2013, p. 117-132.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treating breast cancer in the 21st century
T2 - Emerging biological therapies
AU - Tinoco, Gabriel
AU - Warsch, Sean
AU - Glück, Stefan
AU - Avancha, Kiran
AU - Montero, Alberto J.
PY - 2013/8/30
Y1 - 2013/8/30
N2 - 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.
AB - 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.
KW - Biologics
KW - Breast cancer
KW - Chemotherapy
KW - HER2
KW - Novel therapeutics
KW - PARP inhibitors.
UR - http://www.scopus.com/inward/record.url?scp=84877814639&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877814639&partnerID=8YFLogxK
U2 - 10.7150/jca.4925
DO - 10.7150/jca.4925
M3 - Article
C2 - 23386910
AN - SCOPUS:84877814639
VL - 4
SP - 117
EP - 132
JO - Journal of Cancer
JF - Journal of Cancer
SN - 1837-9664
IS - 2
ER -