Saint-Ghislain Mathilde, Levenbruck Chloé, Bellesoeur Audrey
Medical Oncology Department, Institut Curie, Paris, France.
Pharmacy Department, Institut Curie, Paris, France.
Int J Womens Dermatol. 2021 Oct 27;7(5Part A):552-559. doi: 10.1016/j.ijwd.2021.10.006. eCollection 2021 Dec.
Breast cancer and gynecologic cancers affect >3 million women worldwide each year. With advances in precision medicine, a growing number of targeted therapies have been approved recently, and new therapeutic classes have emerged, including cell cycle inhibitors for hormone receptor positive breast cancer, antibody drug conjugate for human epidermal growth factor receptor 2 positive and triple negative breast cancer, and poly-ADP-ribose polymerase inhibitors for ovarian cancer. This article focuses first on the challenges for health care systems to address the specificities of each emerging targeted therapy and new issues raised by oral antitumor treatments, including individualization of prescriptions, drug-drug interaction assessment, pharmaceutical counseling, patient education, and outpatient management. Then, we provide an overview of the main adverse effects of targeted therapies approved for breast and gynecologic cancers, such as hematologic toxicity of cyclin-dependent kinase 4/6 inhibitors and poly-ADP-ribose polymerase inhibitors, metabolic disorders of phosphatidylinositol-3-kinase/Akt/mammalian target of rapamycin inhibitors, and cardiovascular toxicity of agents targeting human epidermal growth factor receptor 2.
乳腺癌和妇科癌症每年影响全球超过300万女性。随着精准医学的发展,近年来越来越多的靶向治疗药物获批,新的治疗类别不断涌现,包括用于激素受体阳性乳腺癌的细胞周期抑制剂、用于人表皮生长因子受体2阳性和三阴性乳腺癌的抗体药物偶联物,以及用于卵巢癌的聚ADP核糖聚合酶抑制剂。本文首先关注医疗保健系统在应对每种新兴靶向治疗的特殊性以及口服抗肿瘤治疗引发的新问题方面所面临的挑战,包括处方个体化、药物相互作用评估、药学咨询、患者教育和门诊管理。然后,我们概述了获批用于乳腺癌和妇科癌症的靶向治疗的主要不良反应,如细胞周期蛋白依赖性激酶4/6抑制剂和聚ADP核糖聚合酶抑制剂的血液学毒性、磷脂酰肌醇-3-激酶/蛋白激酶B/雷帕霉素靶蛋白抑制剂的代谢紊乱,以及靶向人表皮生长因子受体2药物的心血管毒性。