Abstract
The impressive advances in the knowledge of biomarkers and molecular targets has enabled significant progress in drug therapy for crucial diseases such as cancer. Specific areas of pharmacology have contributed to these therapeutic outcomes—mainly targeted therapy, immunomodulatory therapy, and gene therapy. This review focuses on the pharmacological profiles of these therapeutic classes and intends, on the one hand, to provide a systematic definition and, on the other, to highlight some aspects related to pharmacovigilance, namely the monitoring of safety and the identification of potential toxicities and adverse drug reactions. Although clinicians often consider pharmacovigilance a non-priority area, it highlights the risk/benefit ratio, an essential factor, especially for these advanced therapies, which represent the most innovative and promising horizon in oncology.
Highlights
In the last 20 years, pharmacology has attained incredible progress
To quickly understand the potential benefits expected of gene therapy through this category of agents, we must bear in mind that the goal of any therapeutic cancer vaccine is to increase and reactivate the body’s latent immune response, that of non-active T cells in the tumor microenvironment, by stimulating dendritic cells (DCs), conferring the T cells with the property of being tumor-specific antigens (TAAs)
Studies have shown that approximately 32% of patients treated with targeted therapy had to discontinue due to severe Adverse Drug Reactions (ADRs), which led to poor prognoses, such as cancer recurrence or progression [67]
Summary
In the last 20 years, pharmacology has attained incredible progress. The recent, unexpected, and fast implementation of a vaccination strategy against the SARS-CoV-2 virus in less than a year clearly confirms this. Evolution has been remarkable in cancer treatment, improving 5-year overall survival (OS) from diagnosis by an average of more than 11% over a decade (for both male and female patients). Italian data shows, in the period 1990–1994, a 5-year survival rate for male patients of 39%, whereas, in 2005–2009, the same rate reached 54%; for female patients, in 1990–1994, the 5-year survival rate was 55% and, in 2005–2009, it increased to 63% [1]. Several areas of application in pharmacology have contributed to these therapeutic results—mainly targeted therapy and immunomodulatory therapy; other disciplines, such as gene therapy, pharmacogenomics, and vaccine therapy in oncology, are in constant development but need further confirmation by clinical research. The increased availability of oral preparations has made patient treatment possible in hospital oncology wards and at home, promoting patient compliance. The studies selected to be included in this review used a multiplicity of terms to indicate the same pharmacological class; for the sake of clarity and consistency, preliminary definitions of the terms used in this review to group the pharmacological classes in the same clinical–therapeutic area are outlined
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