Targeted therapy of breast cancer: a systematic review

Introduction: Breast cancer is the most common type of cancer and the second cause of death among women worldwide. Tumors in this cancer are divided into four categories based on the presence of hormone receptors, estrogen receptor (ER), progesterone receptor (PR), growth factor human epidermal ۲ (HER ۲), if these receptors are not present, it is triple negative (TNBC). Its primary treatments include surgery, chemotherapy, radiation therapy. Emerging treatments include hormone therapy and targeted therapy. Targeted therapy, targeting protein Those that control the growth, division and spread of cancer cells are used in the prevention and treatment of cancer. This study was conducted with the aim of reviewing targeted therapy of breast cancer. Method: The present study is a systematic review based on searching Google Scholar and Elmnet search engines and Science Direct, Elsevier, PubMed, Scientific information database with keywords breast cancer, targeted therapy, hormone receptor, trastuzumab, HER-۲ It was done in the time range of ۲۰۰۰ to ۲۰۲۴. From all found articles, ۳۵ articles were selected and analyzed for the purpose of research. Articles that were not available or were not relevant were excluded from the study and finally ۲۶ articles were evaluated for review. Results: Today, increasing information about cell function and identifying more molecular targets has led to the development of targeted therapy. Drugs in targeted therapy are of two types: micromolecules and macromolecules. Micromolecules target specific targets such as kinases, genetic regulatory proteins, DNA damage repair enzymes, and proteases. Macromolecules include monoclonal antibodies and polypeptides. Pharmaceutical antibody compounds and nucleic acids. During this period, progress in micromolecular drugs has been more than macromolecules. In the past, the treatment of HER۲ type breast cancer was one of the most difficult treatments, but in the last two decades, with the availability of Taking monoclonal antibodies such as trastuzumab has made great progress in the management and treatment of HER۲. In HER۲, the combination of MTOR۶ inhibitor with anti-HER۲ drugs such as trastuzumab (TMD-۱) is effective for the second-line treatment of advanced cancer. This treatment may suffer from acquired resistance that the spread of resistance and interference between different signaling pathways such as changing or combining different targeted agents EPZ-۶۴۳۸ and IGF-۱R inhibitor BMS-۷۵۴۸۰۷ dual inhibitor BEZ-۲۳۵ improves the efficacy of this treatment. In triple breast cancer Negative, which is the most aggressive type of breast cancer, due to the lack of hormonal receptors, hormone therapy as an emerging treatment is not a suitable treatment. The main treatment of this type is chemotherapy, which leads to many complications, but targeted treatment can be achieved by inhibiting PARP with Talazoparib is a new therapeutic approach in the management of this type. In patients with ER+, the approach used in targeted therapy includes the use of PAM inhibitors along with CDK inhibitors, which can be combined with other anti-estrogen therapies for better response. to prevent drug resistance. Discussion: It is recommended to conduct more research on combining targeted therapy with other therapies to overcome drug resistance and metastasis to vital organs.

کلیدواژه ها:

breast cancer ، targeted therapy ، hormone receptor ، trastuzumab ، HER۲