Targeted therapies for gynecologic malignancies.

Despite the enormous promise that targeted therapies hold for patients with gynecologic malignancies, it is far too early to recommend any targeted therapy outside of a clinical trial. There remains considerable work to be done before targeted therapies will have a significant role in this patient population. We have learned that different tumor types express different targets, but that the mere expression of a target does not necessarily correlate with benefit from the use of the targeted agent. No less important is the challenge of determining how these agents should be studied in clinical trials, and what constitutes an active agent. To document efficacy, targeted agents would hopefully produce response (ie, shrinkage of measurable tumor), but as cytostatic agents, the ability to delay tumor growth or slow the development of symptoms would be clinically important. Combining targeted therapies with cytotoxic agents, radiation, or other targeted therapies may be important areas for study, but it is essential to demonstrate the additive or synergistic effect of the targeted therapy to an already established active one. This review covers strategies used to develop targeted agents, reviews available targeted therapies, and suggests potential roles in the treatment of gynecologic cancers.