Targeted therapy stops the action of molecules that are key to the growth of cancer cells and are thought to cause less damage to healthy cells There are two main types of targeted therapy; the first being small molecule drugs i.e. the kinase inhibitors such as erlotinib or imatinib and the second, monoclonal antibodies i.e cetuximab or rituximab. These may be given alone or in combination with other treatment such as chemotherapy.
Note that those monoclonal antibodies commonly referred to as checkpoint inhibitors (e.g. nivolumab and pembrolizumab) that act on targets within the immune system are covered within Information to assist GPs in supporting patients receiving anticancer immunotherapies .
These therapies act on molecules which are more often associated with cancer cells and are thought to cause less damage to healthy cells. They have unique adverse effects that require specific attention. The most common side effects seen with targeted therapies are diarrhoea, skin reactions (e.g. acneiform rash) or liver problems (e.g. elevated liver enzymes). Other side effects may include, heart and lung toxicity and problems with blood clotting and wound healing.
Mild adverse effects may initially be managed in the community. However, the cancer team should be alerted within 24 hours as the adverse events can worsen rapidly.
Oral targeted cancer therapy may have complex dosing schedules. Assessment of patient's cognition as well as support from their carer are vital to ensure that the patient clearly understands the schedule and any specific administration precautions. If in doubt, enlist the help of a pharmacist for a medication review and education.