Summary of targeted agents and licensed uses
| Agent | Cancer Hallmark | Mode of Action | Site/Context | Common side effects | NICE Guidance |
|---|---|---|---|---|---|
| Panitumumab | Growth signalling | Monoclonal Abs EGFR | Colorectal—metastatic | Dermatological reactions, pulmonary complications, electrolyte disturbances | Not recommended as monotherapy |
| Trastuzumab | Growth signalling | Monoclonal Abs HER2 | Breast—in early breast cancer or metastatic HER2 +++ | Cardiotoxicity, allergic reaction, hypertension, neutropenia, diarrhoea, nausea and vomiting | Given at 3-week intervals for 1 year or until disease recurrence treatment option for women with early-stage HER2-positive breast cancer neoadjuvant or adjuvant |
| Trastuzumab | Growth signalling | Monoclonal Abs HER2 | Gastric—in metastatic pts HER2 +++ | Cardiotoxicity, allergic reaction, hypertension, neutropenia, diarrhoea, nausea and vomiting | Not recommended |
| Lapatinib | Growth signalling | TKI | Breast—in metastatic setting | Anorexia, headache, cardiotoxicity, diarrhoea | Not recommended |
| Cetuximab | Growth signalling | Monoclonal Abs EGFR | Colorectal+head/neck—both in first-line+metastatic | Dermatological reactions, electrolyte disturbance, anaphylaxis | In combination first line (with 5FU/folinic acid and oxaliplatin) when surgery carried out, mets only in liver, neoadjuvantly to shrink. In metastatic setting with irinotecan |
| Erlotinib/Gefitinib | Growth signalling | TKI | Lung—first-line in EGFR+pts and in second-line NSCLC | Dermatological reaction, diarrhoea, nausea | Use in first line in presence of EGFR mutation, and in the context of progression |
| Everolimus | Growth signalling | mTOR inhibitor | RCC—second-line treatment | Dermatological reaction, diarrhoea, nausea, loss of appetite | Use in metastatic/second line setting in RCC |
| Temsirolimus | Growth signalling | mTOR inhibitor | RCC—second-line treatment | Dermatological reaction, diarrhoea, nausea, loss of appetite | Use in metastatic/second line setting in RCC |
| Bevacizumab | Angiogenesis | Monoclonal Abs VEGF | Breast, colorectal, RCC, lung, ovarian, Brain—in metastatic setting | Hypersensitivity reaction, nausea, vomiting, high blood pressure, VTE, bleeding | Available for breast, brain and ovarian cancer on cancer drugs fund. Licensed for second-line use in metastatic colorectal cancer |
| Sunitinib | Angiogenesis | TKI | RCC—In first-line metastatic setting | Thyroid dysfunction, hypertension, diarrhoea, dermatological reaction | In first line metastatic setting |
| Sorafenib | Angiogenesis | TKI | HCC—In first-line metastatic setting | Diarrhoea, hypertension, sore mouth, dermatological reaction | Use in HCC in first line setting |
| Imatinib | Cell Proliferation | TKI | CML—First-line | Nausea, diarrhoea, fluid retention, neutropenia, rash, bleeding | Use in first line in CML |
| Vemurafenib | Cell Proliferation | TKI | Melanoma—metastatic setting | Arthralgia, skin rash, photosensitivity | In metastatic setting—those who express BRAF V600E mutation |
| Abiraterone | Cell Proliferation | Hormonal agent against CYP17 | Prostate—metastatic setting | Hypokalaemia, hypertension, fluid retention | Recommended in refractory prostate cancer |
CML, chronic myeloid leukaemia; EGFR, epidermal growth factor receptor; mTOR, mammalian target of rapamycin; NSCLC, non-small cell lung cancer; TKI, tyrosine kinase inhibitor; VEGF, vascular endothelial growth factor; RCC, renal cell carcinoma; HCC, hepatocellular carcinoma; NICE, National Institute of Health and Clinical Excellence.