Targeted therapy works at the cellular level, acting in the environmental area of the cell. It targets a specific receptor or protein located in the plasma membrane. The effect is either on tyrosine protein or on intracellular serine-threonine kinases (a protein that can phosphorylate the protein and regulate intercellular signals, such as proliferation, differentiation, programmed death (apoptosis)).
This type of treatment is classified in accordance with their purpose and mechanism of action. Targeted therapy can be used alone or in conjunction with chemotherapy.
There are multichannel antibodies that are directed against extracellular domains on the plasma membrane of cells. The monoclonal antibody inhibits the ability of EGFR (Epidermal Growth Factor Receptor) to stimulate tyrosine kinase activation. This blocking prevents tumor growth, inhibiting the effects of activation of the EGFR receptor, thus the drugs cetuximab or trastuzumab act. Trastuzumab is indicated for the adjuvant treatment of breast cancer with excessive expression of HER2, and cetuximab is indicated in combination with chemotherapy for colon cancer of KRAS and NRAS or for metastatic cancer of the ENT organs.
There are small chemical molecules that are active when taken orally. Tyrosine kinase inhibitors act inside the cell, namely in the intracellular signaling pathway of the EGF receptors (epithelial growth factor). This is how such drugs as Osimertinib, Erlotinib, Gefitinib, Afatinib and Lapatinib act. Some of these drugs are indicated for non-small cell EGF mutated lung cancer. Trastuzumab monotherapy has relatively few side effects. Treatment with cetuximab can cause a rash, for example, acne-like folliculitis.
PARP inhibitors (poly-ADP-ribose polymerase-1) are used to treat cancer of the breast, pancreas and ovaries. They act on the DNA repair system in synergy with loss of BRCA function by tumor cells, causing significant DNA instability, which leads to cell death. The clinical benefits of PARP inhibitors have been demonstrated in breast cancer, in particular - triple negative breast cancer and ovarian cancer for patients with a BRCA gene germline mutation.
Olaparib is a PARP inhibitor prescribed for highly sensitive platinum-sensitive epithelial ovarian cancer as a supportive monotherapy after a complete or partial response to platinum-based chemotherapy.
The drug is taken in oral form. It is also used for locally advanced or metastatic (HER2-negative) BRCA mutated breast cancer as monotherapy, or for pancreatic cancer of a mutated BRCA 1 or BRCA 2. There are also other PARP inhibitors, such as Niraparib, Rucaparib, and Talazoparib.
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