Page 42 - ITPS-8-3

INNOSC Theranostics and
Pharmacological Sciences Precision medicine and beyond in oncology

the classical “signs-and-symptoms” approach. Targeted subsections corresponding to each topic (established
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therapy, as defined by the National Cancer Institute, therapies, targeted therapies, and AI). To maintain a
involves chemotherapy that blocks the action of specific focused scope, the selection of publications prioritized
molecules (enzymes, proteins, etc.) in pathways involved studies addressing the pharmacological implications,
in neoplasm proliferation. Cancer immunotherapy can treatment response, and adverse effects of targeted
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be classified as active or passive. Active immunotherapies therapies. Commonly used treatments were identified, and
aim to induce specific immune responses against tumors a targeted, retrospective literature search was conducted to
and generate durable antitumor immune memory, whereas gather relevant information. Notably, this review does not
passive approaches involve the administration of immune follow a formal systematic review protocol.
components, such as monoclonal antibodies, without This review also discusses the emerging targeted
necessarily inducing immune memory. The current therapies currently in the pre-clinical or clinical trial phases
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chemotherapies have improved remarkably, with improved for HCC, CRC, and pancreatic cancer. These cancers were
remission and cure rates. Traditional chemotherapy selected due to their high resistance to treatment, poor
has undeniably established its importance regarding its response rates, and significant global prevalence. Tables
precedence in treating cancer, its lower cost, and easier were included to present summarized data from the
accessibility compared with targeted therapy. However, while reviewed publications more clearly.
there are abundant treatment options for chemotherapy, its
cytotoxic nature limits the possibility of applying all potential 3. Targeted therapies in clinical practice
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options without inducing more comorbidities. In addition,
gaps remain in understanding the best approach to integrate Compared to traditional chemotherapy and radiation
novel targeted therapies and immunotherapies into routine that indiscriminately damage both cancerous and healthy
clinical practice. As a result, this review summarizes both cells, targeted therapies concentrate on specific molecular
established targeted therapies currently approved for clinical pathways driving tumor growth, limiting systemic toxicity
use and those undergoing trials. Moreover, this review and adverse effects. These advancements have significantly
discusses the potential of incorporating artificial intelligence improved clinical outcomes, with many targeted drugs
(AI) into discovering new targeted therapies and designing achieving superior response rates and prolonged survival
individualized treatment regimens, which can help tailor the in patients with specific genetic mutations. Table 1 shows
most suitable treatment to achieve optimal outcomes. representative clinical trials highlighting the therapeutic
application of targeted agents and immunotherapies across
This review explores current precision medicine multiple cancer types.
practices in chemotherapy, focusing on targeted therapies
and immunotherapy options, and potential AI applications. 3.1. Human epidermal growth factor receptor 2
The review commences with a discussion on all established (HER2)
targeted therapies in standard care, specifically monoclonal HER2, a protein involved in normal cell growth, may be
antibodies or antibody-drug conjugates (ADCs) that target produced in excess by certain types of cancer cells, including
specific genes. The following section discusses monoclonal those in breast, ovarian, bladder, pancreatic, stomach, and
antibodies, including established therapies and combination esophageal cancers. HER2 belongs to the epidermal growth
regimens currently in clinical trials. It also covers preclinical factor receptor (EGFR) family, which comprises four types:
trial models, exploring various strategies to enhance drug ErbB1 (EGFR/HER1), ErbB2 (HER2), ErbB3 (HER3),
delivery and modulate the tumor microenvironment and ErbB4 (HER4). Overexpression of HER2 proteins
(TME), primarily focusing on hepatocellular carcinoma leads to the formation of homodimers or heterodimers
(HCC), pancreatic cancer, and colorectal cancer (CRC). that promote cell growth and proliferation through the
Chimeric antigen receptor (CAR) T-cell therapy is phosphatidylinositol 3-kinase/protein kinase B and
featured in both sections due to its established success in rat sarcoma/mitogen-activated protein kinase (MEK)
hematological cancer and its expanding application to other pathways, which ultimately contribute to oncogenesis,
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advanced-stage solid tumors. This is followed by a section leading to cancer development. Targeted therapies
exploring the potential of incorporating AI algorithms into that bind to the extracellular domain of HER2 prevent
precision medicine in various aspects, including diagnosis, heterodimer formation and inhibit cancer growth.
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drug development, and clinical practice. Trastuzumab deruxtecan (T-DXd), an ADC consisting
2. Methodology of a monoclonal antibody linked through a cleavable
tetrapeptide to a membrane-permeable topoisomerase I
This review was first conceptualized by outlining the inhibitor, ensures high drug delivery and cytotoxic effects
key topics to be discussed. It was then organized into within HER2-expressing cells, particularly targeting

Volume 8 Issue 3 (2025) 36 doi: 10.36922/ITPS025140018