Drug-related toxicity in breast cancer patients: a new path towards tailored treatment?—a narrative review
Eleonora Lai, Mara Persano, Marco Dubois, Dario Spanu, Clelia Donisi, Marta Pozzari, Giulia Deias, Giorgio Saba, Marco Migliari, Nicole Liscia, Mariele Dessì, Mario Scartozzi, Francesco Atzori
Abstract
Background and Objective: Side effects of drugs administered for breast cancer (BC) according to cancer biology and patients’ clinical features can limit patient’s compliance and consequently the benefit. Precision medicine is a growing research field to improve the management of BC patient’s care and evaluating toxicities profile could be an interesting feature in the choice a personalised treatment. This review aims to explore the implications of a tailored anti-cancer therapy knowing the safety profile and predisposing factors for potential specific drug-related toxicities. More specifically, this review aims to focus on personalised medicine and patients’ selection according to clinical, laboratory and genetic features involved in adverse events (AEs) development. Methods: We performed an extensive literature research on PubMed and available Medical Oncology Congresses resources regarding tailored anti-cancer therapy for BC, toxicity profile and predisposing factors for potential specific drug-related toxicities, selecting publications in English in a timeframe from January 1, 1997 to December 31, 2021. Furthermore, we provide a focus on personalised medicine with potential implications on patients’ selection. Key Contents and Findings: Literature review focused on the role of anti-cancer agents toxicity profile and AEs predisposing factors in the personalisation of BC patients treatment. For most anti-cancer agents, potential safety-related biomarkers and the implications of clinical features of BC patients for a tailored treatment were investigated. Conclusions: A safety profile-tailored treatment combined with the clinical characteristics of BC patients and potential biomarkers predisposing to specific treatment-related toxicities might be particularly helpful in the therapeutic choice in the context of precision oncology. In this perspective, the knowledge and the application of these factors would be crucial for better choice and management of the best care for the right patient.