Therapeutic Advances in Oncology

Abstract

Around 77 new oncology drugs were approved by the FDA in the past five years; however, most cancers remain untreated. Small molecules and antibodies are dominant therapeutic modalities in oncology. Antibody-drug conjugates, bispecific antibodies, peptides, cell, and gene-therapies are emerging to address the unmet patient need. Advancement in the discovery and development platforms, identification of novel targets, and emergence of new technologies have greatly expanded the treatment options for patients. Here, we provide an overview of various therapeutic modalities and the current treatment options in oncology, and an in-depth discussion of the therapeutics in the preclinical stage for the treatment of breast cancer, lung cancer, and multiple myeloma.

Keywords: breast cancer; innovation; lung cancer; multiple myeloma; oncology; therapeutic modalities.

Figure 1

Therapeutic modalities for breast cancer, lung cancer, and multiple myeloma discussed in this article. Approaches shown in black are drugs in the market. Approaches labeled in orange are drugs in clinical development. mTOR: Mammalian target of rapamycin; CDK: Cyclic-dependent kinase; ADC: Antibody-drug conjugate; AKT: Protein kinase B; HDAC: Histone deacetylase; AR: Androgen receptor; PARP: Poly ADP-ribose polymerase; PI3K: Phosphatidylinostitol 3-kinase; EGFR: Epidermal growth factor receptor; VEGF: vascular endothelial growth factor; mAb: Monoclonal antibody; ALK: Anaplastic lymphoma kinase; ROS1: proto-oncogene tyrosine-protein kinase; NTRK: Neutrophilic receptor tyrosine kinase; PD-1: Programmed cell death protein 1; CTLA-4: Cytotoxic T-lymphocyte-associated protein 4; IMiDs: Immunomodulatory drugs; SLAMF7: Signaling lymphocytic activation molecule F7; BCMA: B-cell maturation antigen; BCL-2: B-cell lymphoma 2; CAR T: Chimeric antigen receptor; BiTE: Bispecific T cell engager; CELMoDS: Cereblon E3 ligase modulators.

Figure 2

Timeline for the discovery of CDK4/6 inhibitors for HR-positive/HER2-negative breast cancer. aBC: Advanced breast cancer; mBC: Metastatic breast cancer; PM: Postmenopausal.

Figure 3

Approval timeline of tastuzumab in combination with different drugs for different stages of breast cancer. aBC: Advanced breast cancer; mBC: Metastatic breast cancer; Ebc: Early breast cancer; PM: Postmenopausal.

Figure 4

Approved Immunotherapies for Lung cancer. PD-1: Programmed death protein-1; PD-L1: Programmed death ligand-1; NSCLC: Non-small cell lung cancer; SCLC: Small cell lung cancer; TC: Tumor cells; IC: Immune cells. * Either second-line or third-line treatment. Highlighted in red are the clinical trial names.

Figure 5

Approval timeline of proteasome inhibitors for multiple myeloma. MM: Multiple myeloma; RRMM: Relapsed/refractory multiple myeloma; DEX: Dexamethasone.