Özet:

In the last 20 years, when we started to understand cancer biology better, targeted therapies and immunotherapies have been developed in systemic treatments and they have started to take their place as monotherapy or combined therapies in routine practice. Treatments that affect specific molecules are called targeted therapies. Monoclonal antibodies (mAbs), tyrosine kinase inhibitors (TKIs) and those affecting the proliferation cascade constitute the majority of targeted therapies currently used. mAbs are targeted molecules produced from a single B-cell clone by antigen exposure. Most immunotherapeutics currently in use are in the form of mAbs. The targets of mAbs that we frequently use in cancer treatment today are human epidermal growth factor receptor-2 (HER-2), epidermal growth factor receptor (EGFR), vascular endothelial growth factor, nuclear factor kappa-B ligand receptor activator, programmed death-1 and programmed death ligand-1. Treatments for tyrosine kinases, which play an important role in growth signal modulation, are used in many types of cancer. TKIs are small molecules and are used orally. The most commonly used TKIs are anti-angiogenic multikinase inhibitors. However by the EGFR and anaplastic lymphoma kinase inhibitors, a great progress has been made especially in the treatment of non-small cell lung cancer. Again BRAF/MEK, smoothened/hedgehog pathway, poly (ADP-ribose) polymerase, phosphoinositide 3-kinase, HER-2 inhibitors are other TKIs in use. The mammalian target of rapamycin pathway is also used as a target in many cancers. Immunotherapies are therapies that regulate the immune microenvironment, strengthening the immune system and allowing immune cells to fight against tumor cells. The effect of immunotherapy on cancer cells has been demonstrated by the high dose interferon, which was the first immunotherapy used. It consists of cancer vaccine, oncolytic viruses, ex vivo activated T-cell and natural killer cell transfer and immune checkpoint inhibitors. All these treatments contribute significantly to the survival and quality of life of patients with more antitumor efficacy. A large number of new molecules are being researched going forward, and promising advances in cancer treatment will continue.

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