Table 1.
List of drugs and targeted molecules.
| Targeted molecule | Drugs | Currently approved indications | Prophylaxis and treatment suggestions |
|---|---|---|---|
| ALK | Crizotinib, ceritinib, alectinib, brigatinib, lorlatinib | ALK+, ROS1+ non-small cell lung cancer | No known increased risk of infection |
| BCL-2 | Venetoclax | Chronic lymphocytic leukemia, acute myeloid leukemia | Prophylaxis for Pneumocystis jirovecii in patients receiving corticosteroids8 |
| BRAF | Vemurafenib, dabrafenib, encorafenib | BRAF-mutated melanoma Dabrafenib, trametinib: BRAF-mutated thyroid cancer and non-small cell lung cancer | Associated with drug-induced pyrexia. No known increased risk of infection |
| Bruton tyrosine kinase | Ibrutinib, acalabrutinib, zanubrutinib | Mantle cell lymphoma, chronic lymphocytic leukemia, Waldenström macroglobulinemia, marginal zone lymphoma | Assess antifungal prophylaxis or screening for fungal infections if other risk factors. Prophylaxis for Pneumocystis jirovecii in patients receiving corticosteroids8 |
| CCR4 | Mogalizumab | Mycosis fungoides, Sézary syndrome | Hepatitis B virus reactivation screening and prophylaxis. Prophylaxis for Pneumocystis jirovecii in patients receiving corticosteroids8 |
| CDK family | Palbociclib, ribociclib, abemaciclib | Estrogen receptor-positive breast cancer | Associated with higher risk of neutropenia. No known increased risk of infection |
| CD19 | Blinatumomab | Acute lymphocytic leukemia | Hepatitis B virus reactivation screening and prophylaxis. Prophylaxis for Pneumocystis jirovecii8 |
| CD20 | Rituximab, obinotuzumab, ofatumumab | B-cell lymphoproliferative diseases | Hepatitis B virus reactivation screening and prophylaxis. Prophylaxis for Pneumocystis jirovecii in patients receiving R-CHOP every 14 days (optional) or with additional risk factors such as corticosteroids8 |
| CD22 | Inotozumab ozogamicin, moxetumomab pasudotox | B-cell acute lymphocytic leukemia, hairy cell leukemia | Hepatitis B virus reactivation screening and prophylaxis. Prophylaxis for Pneumocystis jirovecii in patients receiving corticosteroids8 |
| CD30 | Brentuximab vedotin | Hodgkin’s lymphoma | Prophylaxis for Pneumocystis jirovecii in patients receiving corticosteroids8 |
| CD33 | Gentuzumab ozogamicin | CD33-positive acute myeloid leukemia | Hepatitis B virus reactivation screening and prophylaxis. Prophylaxis for Pneumocystis jirovecii in patients receiving corticosteroids8 |
| CD38 | Daratumumab | Multiple myeloma | Hepatitis B virus reactivation screening and prophylaxis. Prophylaxis for Pneumocystis jirovecii and varicella zoster infections in patients receiving corticosteroids or bortezomib8 |
| CD52 | Alemtuzumab | Anaplastic lymphoma, chronic lymphatic leukemia | Cytomegalovirus monitoring. Acyclovir prophylaxis for herpesvirus. Prophylaxis for Pneumocystis jirovecii.8 Hepatitis B virus reactivation screening and prophylaxis |
| c-Kit, PDGF-R, BCR-ABL | Imatinib, dasatinib, nilotinib, bosutinib, ponatinib | Gastrointestinal stromal tumors, Philadephia positive chronic myeloid leukemia and acute lymphoblastic leukemia, dermatofibrosarcoma protuberans | Hepatitis B virus reactivation screening and prophylaxis |
| c-Met | Crizotinib, cabozantinib | Crizotinib: ALK-positive, ROS1-positive non-small cell lung cancer Cabozantinib: medullary thyroid cancer, hepatocellular carcinoma, renal cell carcinoma | No known increased risk of infection |
| EGFR/HER1, ErbB2/HER2 and other ErbB family members | Erlotinib, gefitinib, afatinib, neratinib, lapatinib, osimertinib, dacomitinib Cetuximab, panitumumab, trastuzumab, trastuzumab emtansine, pertuzumab | Neratinib, lapatinib: HER2-positive breast cancer Trastuzumab: HER2-positive breast cancer, HER2-positive gastroesophageal cancer Trastuzumab emtansine, pertuzumab: HER2-positive breast cancer Cetuximab, panitumumab: Head and neck cancer, colorectal cancer Remaining agents: EGFR-positive lung cancer | Small increase in the risk of infection with some agents (cetuximab, panitumumab). No expected benefit from universal use of antiviral, antifungal or anti-Pneumocystis prophylaxis |
| HDAC | Panobinostat, vorinostat, belinostat, romidepsin | Multiple myeloma, T-cell lymphomas | Hepatitis B virus reactivation screening and prophylaxis |
| JAK/STAT | Ruxolitinib | Polycythemia vera, myelofibrosis | Hepatitis B virus reactivation screening and prophylaxis. Prophylaxis for Pneumocystis jirovecii in patients receiving corticosteroids |
| mTOR | Temsirolimus, everolimus | Temsirolimus: kidney cancer, mantle cell lymphoma Everolimus: kidney cancer, neuroendocrine tumors, breast cancer | Hepatitis B virus reactivation screening and prophylaxis. Prophylaxis for Pneumocystis jirovecii in patients receiving corticosteroids and/or with lymphopenia.8 Increased risk of herpes zoster infections: increased awareness and evaluate prophylaxis or vaccine in cases of recurrent zoster infections |
| FGFR | Erdafitinib | Urothelial carcinoma | No known increased risk of infection |
| MEK1/2 | Trametinib, cobimetinib, binimetinib | BRAF-mutated melanoma | Associated with drug-induced pyrexia. No known increased risk of infection |
| PD-1, PD-L1, CTLA-4 | Ipilimumab, tremelimumab, nivolumab, pembrolizumab, atezolizumab, avelumab, cemiplimab, durvalumab | Ipilimumab, tremelimumab: melanoma Remaining agents: Melanoma, non-small cell lung carcinoma, urothelial carcinoma, renal cell carcinoma, tumors with microsatellite instability, head and neck cancer, hepatocellular carcinoma, breast cancer | In case of immune related adverse event: Hepatitis B virus reactivation screening and prophylaxis. Prophylaxis for Pneumocystis jirovecii in patients receiving corticosteroids8,9 |
| PI3K | Idelalisib, rigosertib, duvelisib | Chronic lymphocytic leukemia, follicular lymphoma, myelodysplastic syndrome | Cytomegalovirus monitoring |
| RET | Vandetanib | Medullary thyroid cancer | No known increased risk of infection |
| TRK, ALK, ROS-1 | Entrectinib, larotrectinib | NTRK-positive tumors Entrectinib: ROS1-positive non-small cell lung cancer | No known increased risk of infection |
| VEGFR/VEGF | Axitinib, cabozantinib, lenvatinib, pazopanib, regorafenib, sorafenib, sunitinib, vandetanib Bevacizumab, aflibercept | Bevacizumab: colorectal cancer, gastric cancer, non-small cell lung cancer, renal cell carcinoma, breast cancer, ovarian cancer, cervical cancer Aflibercept: colorectal cancer Remaining agents: renal cell carcinoma, hepatocellular carcinoma, soft tissue sarcoma, gastrointestinal stromal tumors, colorectal cancer, neuroendocrine pancreatic cancer, differentiated thyroid cancer | Small increase in the risk of infections and increased risk of gastrointestinal perforation and fistulization with some agents (bevacizumab, aflibercept). No expected benefit from universal use of antiviral, antifungal or anti-Pneumocystis prophylaxis |
R-CHOP: rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone.