 Home > Active Ingredient News > Drugs Articles > How to deal with the most common cancers in the world? Please collect this list

How to deal with the most common cancers in the world? Please collect this list

 Last Update: 2023-01-05
 Source: Internet
 Author: User

Tags

nausea medication walgreens

modafinil weight loss

Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com

Editor's note: Worldwide, cancer poses a heavy burden on public health and the economy, with nearly 10 million deaths and more than 19 million new cancer diagnoses diagnosed worldwide in 2020 alone
.
At the same time, cancer is one of the most important areas of interest in the pharmaceutical industry, and innovative therapies have emerged in the past few years
.
In order to share the latest cancer therapies in the world in a timely manner, WuXi AppTec's content team will also conduct a series of inventory to introduce readers to the relevant information
of overseas authoritative cancer societies.
This article is for informational purposes only, and the views expressed in this article do not represent the position of WuXi AppTec, nor do they represent WuXi AppTec's support or disapproval of the views
expressed herein.
This article is also not a treatment recommendation
.
For guidance on treatment options, go to a regular hospital
.

Editor's note:

According to the World Health Organization, breast cancer is the most common cancer in the world, with an incidence even surpassing lung cancer! According to a recent 2020 statistic, there were about 2.
3 million new breast cancer patients worldwide that year, resulting in 685,000 deaths
.
And breast cancer is not limited to women, in rare cases, men can also develop breast cancer
.

Breast cancer is the most common cancer in the world, even surpassing lung cancer! According to a recent 2020 statistic, there were about 2.
3 million new breast cancer patients worldwide that year, resulting in 685,000 deaths
.

With the advancement of histotyping and molecular pathological detection methods for breast cancer in clinical practice, the treatment of breast cancer has gradually entered the stage
of individualized precision medicine.
In today's article, WuXi AppTec's content team will take stock of targeted drugs and immunotherapy drugs
currently available for the clinical treatment of breast cancer based on official information from the American Cancer Society.

Image source: 123RF

What are the commonly used targeted therapies in breast cancer treatment?

Targeted drugs act on breast cancer cells, inhibiting cancer-causing targets that help them grow, spread and survive, and exert efficacy
by destroying cancer cells or slowing down their growth.
According to different targets, targeted drugs commonly used in breast cancer treatment can be divided into four categories
.

01 What are the targeted drugs for HER2?

What are the targeted drugs for HER2?

About 15% to 20% of breast cancer cases are HER2-positive breast cancer, and the HER2 protein promotes the growth and spread of cancer cells, so patients with HER2-positive breast cancer tend to progress faster and are more likely to metastasize
than HER2-negative patients.
At present, researchers have successfully developed a variety of targeted drugs
against the HER2 protein.

Monoclonal antibody drugs

Monoclonal antibody drugs used clinically for the treatment of breast cancer include trastuzumab, pertuzumab and margetuximab, all of which target HER2
.

Trastuzumab may be used as monotherapy or in combination with chemotherapy drugs to treat early and advanced breast cancer
.
The US FDA approved trastuzumab and capecitabine in 2020 for the treatment of patients with unresectable locally advanced or metastatic HER2-positive breast cancer who had previously received one or more anti-HER2 regimens
.
At present, the drug has been approved by the China Food and Drug Administration for marketing and can be used to treat a variety of solid tumors
, including HER2-positive breast cancer.

Trastuzumab

Pertuzumab (trade name: Pajet) is widely used
in the clinical treatment of breast cancer.
The US FDA approved pertuzumab in 2012 for the treatment of breast cancer-related indications, such as HER2-positive metastatic breast cancer, neoadjuvant therapy (preoperative) for HER2-positive locally advanced, inflamed, or early-stage breast cancer, and in combination with trastuzumab and chemotherapy as adjuvant therapy (postoperative)
for HER2-positive early breast cancer with a high risk of recurrence.
The Chinese Food and Drug Administration has also approved the drug for the treatment
of HER2-positive breast cancer.

Pertuzumab

Compared with the above two drugs, Margetuximab (trade name: Margenza) was launched late, and the marketing application of the drug in China is still under
review.
It was approved by the US FDA in 2020 for the treatment of patients with metastatic HER2-positive breast cancer who had received 2 anti-HER2 regimens (at least one of which was for metastatic disease).

margetuximab

Antibody drug conjugates

An antibody drug conjugate (ADC) is a monoclonal antibody
linked to a chemotherapy drug.
Taking anti-HER2 ADC drugs as an example, antibodies targeting HER2 act as "homing signals" by attaching to the HER2 protein of cancer cells, delivering chemotherapy drugs directly to tumor cells
.
ADC drugs currently used in breast cancer treatment include emmetrituzumab (ado-trastuzumab emtansine, trade name: Kadcyla) and fam-trastuzumab deruxtecan (trade name: Enhertu).

The drug molecule design of emmetrastuzumab links antibodies against HER2 with the chemotherapy drug emtansine to fight HER2-positive cancers
.
Emtansine is a paclitaxel-like drug that can be used to treat patients with early-stage breast cancer after surgery or advanced breast cancer who have been treated with trastuzumab and chemotherapy
.
The U.
S.
FDA approved the drugs enmetrastuzumab and paclitaxel in 2013 or in combination for the treatment of patients with HER2-positive metastatic breast cancer, respectively, and further expanded their indication in 2019 for adjuvant (postoperative) therapy for HER2-positive early-stage breast cancer
.
At present, emmetrituzumab has been approved for marketing by the China Food and Drug Administration, and its indication is HER2-positive breast cancer
.

Emmetrituzumab

Fam-trastuzumab The molecular structure of Deruxtecan is also a combination of antibody + chemotherapy drugs, and the drug it is connected to is a similar drug
of irinotecan.
The US FDA approved it in 2019 for the treatment of patients with unresectable or metastatic HER2-positive breast cancer who have previously received more than 2 anti-HER2 therapies, and further expanded its indication in 2022 for the treatment of patients with unresectable or metastatic breast cancer with low HER2 expression and recurrence 6 months after previous chemotherapy or completion of adjuvant therapy
.
Fam-trastuzumab Deruxtecan's listing application in China is still under review
.

Fam-trastuzumab deruxtecan

Kinase inhibitors

HER2 is a protein
with kinase activity.
Kinases are protein molecules in cells involved in signaling, such as cell growth signals, and blocking the activity of kinases may inhibit the growth
of cancer cells.
Common HER2 kinase inhibitor drugs in breast cancer treatment are mainly lapatinib (trade name: Telisa), neratinib (trade name: Helian), tucatinib (trade name: Tukysa), at present, lapatinib and neratinib have been approved for marketing in China, and the marketing application of tucatinib is still under
review.

Lapatinib can be used to treat advanced or metastatic breast cancer, often along with
chemotherapy drugs.
As early as 2007, the US FDA approved the clinical use of lapatinib in combination with capecitabine for the treatment of HER2-positive advanced or metastatic breast cancer; In 2010, the FDA further expanded its indication by approving lapatinib in combination with letrozole as first-line therapy for the treatment of patients
with HER2-positive metastatic breast cancer.
At present, lapatinib has been approved for marketing in China for the treatment of HER2-positive breast cancer patients
.

Lapatinib

Nelatinib is commonly used to treat patients with early-stage breast cancer who have received trastuzumab for one year, and can also be used in combination with chemotherapy drugs for
advanced breast cancer.
The US FDA approved it as an extended adjuvant therapy for patients with HER2-positive early-stage breast cancer, and in 2020 further expanded its indication to combine the chemotherapy drug capecitabine for the treatment of adult patients
with advanced or metastatic HER2-positive breast cancer who have previously received at least 2 anti-HER2 regimens.
The Chinese Food and Drug Administration also approved the marketing application of neratinib in 2020 for the treatment of patients
with HER2-positive breast cancer.

Neratinib

Tucatinib is commonly used in combination with chemotherapy drugs and trastuzumab, and was approved by the US FDA in 2020 in combination with capecitabine and trastuzumab for the treatment of patients with unresectable locally advanced or metastatic HER2-positive breast cancer (including those with brain metastases) who have previously received one or more anti-HER2 regimens
.

Tucatinib

Potential side effects of HER2-targeted drugs

Side effects of HER2-targeted drugs are usually mild, but in rare cases serious adverse effects
may occur.
The use of HER2-targeted drugs is strictly prohibited during pregnancy, and pregnant women may cause harm to the fetus and even cause fetal death
after medication.

Monoclonal antibodies and antibody conjugates can sometimes cause heart damage during or after treatment, leading to congestive heart failure
.
For most, but not all, women, this adverse reaction lasts for a short time and improves after stopping the drug
.
When these drugs are taken with certain chemotherapy drugs that can also cause heart damage, such as doxorubicin and epirubicin, patients are at higher risk of heart problems
.
In addition, people who are older than 50, overweight or obese, have heart disease, and take high blood pressure medications
are also at increased risk.

Lapatinib, neratinib, tucatinib, and a combination of pertuzumab and trastuzumab may cause severe diarrhoea
.
In addition, lapatinib and tucatinib may also cause hand-foot syndrome, where common symptoms include pain and redness in the hands and feet, and further blistering and peeling
may occur.
In a few cases, fam-trastuzumab Deruxtecan can cause serious lung disease and can even be life-threatening
.

02 What are the targeted drugs for hormone receptor-positive breast cancer patients?

What are the targeted drugs for patients with hormone receptor-positive breast cancer?

About three-quarters of breast cancer cases are hormone (estrogen or progesterone) receptor-positive breast cancer, for which hormone therapy is usually effective, and some targeted therapy drugs can make hormone therapy more effective
.
According to different targets, targeted drugs commonly used to treat hormone receptor-positive breast cancer can be divided into three major categories - CDK4/6 inhibitors, mTOR inhibitors and PI3K inhibitors
.

Targeted drugs commonly used to treat hormone receptor-positive breast cancer can be divided into three main groups – CDK4/6 inhibitors, mTOR inhibitors, and PI3K inhibitors
.

CDK4/6 inhibitors

CDK4/6 inhibitor drugs commonly used in the clinical treatment of breast cancer are pipericide (brand name: Aiboxin), ribociclib (brand name: Kisqali) and abeciclib (brand name: Only), which can block cyclin-dependent kinases (CDKs) in cancer cells, especially against
CDK4 and CDK6.
Blocking these CDK proteins in hormone receptor-positive breast cancer cells helps stop cell division, which in turn slows tumor growth
.

Pipercillib ribociclib abecilide

All three drugs have received marketing approval
from the US FDA.
Piperoceptib and abecepticlib can be used in combination with letrozole, fulvestrant, or aromatase inhibitors for the treatment of patients with hormone receptor-positive, HER2-negative advanced or metastatic breast cancer, and ribociclib is primarily used as initial endocrine therapy with aromatase inhibitors to treat patients with advanced or metastatic breast cancer before, during or after menopause who are molecularly classified as hormone receptor-positive and HER2-negative
.
In addition, ribociclib can also be used in combination with fulvests as a first/second line endocrine therapy to treat postmenopausal breast cancer patients
.

At present, piperaciclib and abecept have been approved for marketing in China for the treatment of hormone receptor-positive, HER2-negative breast cancer patients, and the marketing application of ribociclib is still under
approval.

The most common side effects of CDK4/6 inhibitors are low blood counts and fatigue, and other relatively rare mild adverse effects include nausea and vomiting, mouth ulcers, alopecia, diarrhea, and headache
.
In addition, a rare, but potentially life-threatening serious side effect associated with these drugs is inflammation
of the lungs.

mTOR inhibitor drugs

mTOR inhibitors specifically block mTOR signaling, a protein that helps cells grow and divide, and blocking the activity of this protein can inhibit tumor progression
.
The mTOR inhibitor drug commonly used in the treatment of breast cancer is everolimus (trade name: finito), which can slow tumor growth
by blocking the production of new blood vessels in tumors.
In the clinical treatment of breast cancer, everolimus can help hormone drugs work
better.
The U.
S.
FDA approved the combination of everolimus and exemestane in 2012 for the treatment of hormone receptor-positive, HER2-negative patients with advanced breast cancer who are postmenopausal women and have been treated
with letrozole or anastrozole.
The NMPA also approved the marketing application of everolimus in February 2022 for the treatment of hormone receptor-positive, HER2-negative breast cancer
.

Everolimus

Common side effects of everolimus include aphthous sores, rash, diarrhea, nausea, feeling weak or tired, low blood counts, shortness of breath, and cough
.
In addition, everolimus may also cause elevated blood lipids (cholesterol and triglycerides) and blood sugar
.

PI3K inhibitor drugs

The PI3K protein drives the growth of cancer cells, and blocking the activity of this protein can inhibit tumor progression
.
A commonly used PI3K inhibitor drug in breast cancer treatment is alpelisib (trade name: Piqray), which can be used with fulvestrant to treat hormone receptor-positive, HER2-negative advanced breast cancer in postmenopausal women who develop PIK3CA gene mutations
during or after treatment with aromatase inhibitors 。 Alpelisib received marketing approval from the US FDA in 2019 for the treatment of hormone receptor-positive, HER2-negative, postmenopausal advanced or metastatic breast cancer women and men
with PIK3CA gene mutations in combination with fulvestrant.
Alpelisib's listing application in China is still under review
.

alpelisib

Side effects associated with Alpelisib treatment include skin rash, high blood sugar levels, abnormal conditions of the kidneys, liver or pancreas, diarrhea, rash, low blood count, nausea and vomiting, fatigue, decreased appetite, mouth sores, weight loss, low calcium levels, blood clotting problems, and hair
loss.
Other more symptomatic adverse effects include severe skin reactions (e.
g.
, rash with peeling and blisters).

03 Targeted therapy for BRCA gene mutations

Targeted therapy targeting BRCA gene mutations

Commonly targeted drugs in clinical practice for breast cancer patients with BRCA gene mutations include olaparib (Lipzore) and talazoparib (trade name: Talzenna), both PARP inhibitors
.
The PARP protein can help repair damaged DNA in cells, and the BRCA genes (BRCA1 and BRCA2) can also help repair DNA, but mutations in either gene will cause DNA repair to fail
.
PARP inhibitors work by blocking the PARP protein, because the DNA damage repair function in tumor cells with BRCA gene mutation has been disrupted, and blocking the PARP protein often leads to a large accumulation of DNA damage and subsequent cell death
.

Olapali talazoparib

Olaparib was approved by the US FDA in 2018 for the treatment of metastatic breast cancer with BRCA germline mutations and in 2022 for a new indication as an adjuvant therapy for the treatment of patients with or suspected HER2-negative early-stage breast cancer with BRCA germline mutations who had received chemotherapy
before/after surgery.
At present, the indication of olaparib for breast cancer has been submitted to the China Food and Drug Administration
.

Olapalib

The U.
S.
FDA approved talazoparib in 2018 for the treatment of germline BRCA gene mutations, HER2-negative locally advanced or metastatic breast cancer
.
The indication of the drug for breast cancer has not yet submitted a marketing application
to the Chinese regulatory authorities.

talazoparib

Side effects associated with PARP inhibitor therapy may include nausea, vomiting, diarrhea, tiredness, loss of appetite, taste changes, low red blood cell count (anemia), low platelet count, and low white blood cell count
.
In a few cases, some people treated with PARP inhibitors develop blood cancers such as myelodysplastic syndrome or acute myeloid leukemia
.

04 Targeted therapy for triple-negative breast cancer

Targeted therapy for triple-negative breast cancer

In triple-negative breast cancer (TNBC), cancer cells do not have estrogen or progesterone receptors, and levels of HER2 protein are very low or absent, so these patients are not sensitive
to endocrine therapy or targeted drugs for hormone receptors and HER2.
At present, the main targeted drugs that can be used clinically for TNBC treatment are gorsatuzumab (trade name: Tuodavier), which is an antibody-conjugated drug composed of
chemotherapy drugs and monoclonal antibodies bound to them.
When the drug enters the body, its monoclonal antibody component can attach to a protein called Trop-2 on breast cancer cells and bring the chemotherapy drug to the cancer cells to take effect
.
Because cancer cells have much higher levels of the Trop-2 protein than normal cells, this approach can reduce the damage
to healthy cells from chemotherapy drugs to some extent.

Gorsatuzumab

The US FDA approved gosatuzumab as monotherapy in 2020 for the treatment of patients with advanced or metastatic TNBC who had previously received at least 2 or more systemic therapies
.
In June this year, gosartuzumab was approved by the China Food and Drug Administration for the treatment of triple-negative breast cancer
.

Some common side effects of this medication include nausea, vomiting, diarrhea, constipation, feeling tired, rash, loss of appetite, hair loss, low red blood cell count, and abdominal pain
.
In addition, relatively rare side effects include extremely low white blood cell counts and severe abdominal and infusion adverse effects
.

What are the immunotherapies for breast cancer?

Immunotherapy uses drugs to boost the immunity of the body's own immune system to more effectively recognize and destroy cancer cells
.
Immunotherapy usually works on specific proteins involved in immune system function, and the immunotherapy currently used in the clinical treatment of breast cancer is mainly the inhibitor drug pembrolizumab (trade name: KEYTRUDA), which targets the immune checkpoint PD-1, and the side effects of this drug are different
from the side effects of chemotherapy.

Pembrolizumab is a drug that targets PD-1, a protein on T cells, an important component of immune cells that helps T cells not attack healthy tissues
in the body.
By blocking PD-1, these drugs boost the immune system's immune response to breast cancer cells, causing tumors to shrink.

Pembrolizumab

The U.
S.
FDA approved pembrolizumab in 2020 as a combination with chemotherapy for the treatment of unresectable locally recurrent or metastatic triple-negative breast cancer
.
In 2021, a new indication was approved for pembrolizumab: the US FDA approved its combination chemotherapy as neoadjuvant therapy for patients with high-risk early-stage triple-negative breast cancer, and continued as a monotherapy adjuvant therapy after surgery
.
At present, the indication of pembrolizumab for breast cancer has been submitted to the Chinese regulatory authorities
.

Possible side effects of immune checkpoint inhibitors include fatigue, cough, nausea, rash, poor appetite, constipation, and diarrhea
.
Other serious but relatively rare side effects include infusion reactions and autoimmune reactions, specifically, some people may experience infusion reactions and experience a range of symptoms when injecting drugs, which may include fever, chills, facial flushing, rash, itchy skin, dizziness, wheezing, and difficulty
breathing.
In addition, because the mechanism of action of these drugs is a safeguard mechanism for eliminating the body's immune system, in a few cases the immune system may begin to attack other normal tissues of the body after medication, which can lead to serious and even life-threatening adverse conditions
in a variety of organs.

epilogue

With the increasing application of innovative treatment models represented by targeted therapy, immunotherapy and combination therapy in breast cancer patients, we have made some progress
in curbing tumor growth and improving breast cancer survival rate.
How to use precise and individualized treatment plans to improve efficacy, and how to find better biomarkers to make personalized treatment more clinically feasible still needs more research, which will also be the future
development direction of breast cancer.
Due to space limitations, this article only introduces some breast cancer therapies, not all of them, and we will pay close attention to the progress of cancer research to introduce readers to the latest treatments
.

This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.