Commentary (Knoop): Understanding Novel Molecular Therapies

In the past decade numerous advances have been made in the arena of cancer treatment. Evolving scientific discoveries related to molecular targets and cellular signaling have led to an increased understanding of how to develop novel therapeutic cancer agents. As molecularly targeted therapies become commonly used in the armamentarium of treatment for solid tumors, it is imperative for nurses to stay abreast of these advances. This supplement to the ONCOLOGY Nurse Edition will be devoted to evolving novel therapies, particularly those that are directed toward certain molecular targets such as human epidermal growth factor (HER) and vascular endothelial growth factor (VEGF) pathways.

In "Understanding Novel Molecular Therapies," Pamela Carney and colleagues present the biology of the HER family of receptors, as well as the VEGF family of receptors. Molecular targeting of HER and VEGF through single- and multi-targeting strategies is reviewed, as well as the mechanisms of actions. A discussion of agents currently approved by the US Food and Drug Administration or those being studied in clinical trials for the treatment of solid tumors highlights the indications and potential uses of each drug.

Using the discussion of biology, mechanisms of action, and indications/uses of targeted agents as background information, Jeanne Riddle and colleagues present "Recognizing and Managing Side Effects Associated with Novel Targeted Therapies: Implications for the Oncology Nurse." This article discusses common, unique, and uncommon side effects that are particular to molecular agents, focusing on those that target HER and VEGF. Practical information and tools for nurses are provided that will improve patient care and monitoring and will enhance patient education.

Finally, in their article "Toxicity of Targeted Therapy: Focus on Rash and Other Dermatologic Side Effects," Patricia O'Keeffe and colleagues discuss the side effects of rash and dermatologic toxicities. These unique side effects are particularly common with drugs that target EGFR. Oncology nurses play an important role in helping patients detect and manage the sequelae of dermatologic side effects.

A key point for nurses to focus on regarding novel targeted therapies is that we are all learning together. Molecular science is constantly evolving. It is imperative to develop evidence-based practice and continue to learn and share knowledge to ensure our patients receive the utmost in quality care.

-Teresa Knoop, MSN, RN, AOCN