Review of targeted cancer therapies for the palliative care provider PART 2: Antibodies and conjugated agents

The incorporation of 'targeted therapies' into standard cancer care has changed how clinicians treat cancer. Small molecule inhibitors, antibodies, and conjugated agents target cancer cells more specifically than traditional chemotherapy. These therapies can be used alone or in combination with chemotherapy in first-line, refractory, or relapsed settings. Although designed to spare normal tissue, these agents do have systemic toxicity. Notably, their toxicity profiles are distinct from those encountered with chemotherapy. These agents have demonstrated efficacy in terms of improved tumour response, survival, symptom control, and/or quality of life. Cancer treatment will continue to change as additional targeted agents are evaluated in clinical trials and are brought into standard medical care. The palliative care clinician is likely to encounter these agents with increasing frequency, making decisions to continue or discontinue therapy, adding targeted agents to improve symptoms, performance status, or quality of life, or advising patients to return to their oncologists for further advice as new agents become available. Presented previously, Part 1 of this review introduced small molecule inhibitors; presented here, Part 2 focuses on antibodies and conjugated agents. The antibodies and conjugated agents are infusional with potentially greater side effects than the small molecules. If used in palliative care, these antibodies and conjugated agents are likely to be administered in conjunction with an oncologist.

Duke Scholars

Author Daphne Ruth Friedman Medicine, Medical Oncology