Topoisomerase inhibitors in metastatic breast cancer: Overview of current practice and future development

摘要

Topoisomerases are enzymes involved in the replication of DNA and they are the target of the topoisomerase inhibitors 1 and 2. This class of anticancer agents forms the backbone of chemotherapeutic regimens in several solid tumors including breast cancer. This review focuses on their role in the treatment of metastatic breast cancer. While anthracyclines (topoisomerase 2 inhibitors) are commonly used in metastatic breast cancer, other agents such as the topoisomerase 1 inhibitors and etoposide have reached some level of clinical development. New formulations of doxorubicin are frequently used in the clinic and a new formulation of irinotecan, and etirinotecan pegol, has recently reached phase 3 development. An overview of their mechanism of action, toxicity, and clinical use (single agent or combination settings) is provided.