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Table 1 Systemic treatment in breast cancer

From: Systemic treatment in breast cancer: a primer for radiologists

Drugs Mechanism of action Side effects
Anthracycline (doxorubicin and epirubicin) Inhibits DNA and RNA synthesis Cardiotoxicity, typhlitis, bone marrow suppression
Taxanes (paclitaxel and docetaxel) Inhibits mitosis by stabilization of microtubule polymer Fluid retention, neutropenic enterocolitis and typhlitis, drug-associated pneumonitis
Cyclophosphamide Interferes with DNA replication by forming intrastrand and interstrand DNA cross-links Hemorrhagic cystitis, Drug associated pneumonitis, diarrhoea
Capecitabine Irreversibly inhibits thymidylate synthase Neurotoxicity, mucositis, hand-foot syndrome
Eribulin Inhibits mitosis by interfering with growth of microtubule Neutropenia, diarrhoea, anaemia, peripheral nHER2athy
Hormonal therapy  
Tamoxifen Selectively blocks estrogen receptor blockage Hepatic steatosis and hepatotoxicity, hypercoagulability, endometrial proliferative changes
Aromatase inhibitors
(anastrozole, letrozole, and exemestane)
Blocks estrogen production Osteoporosis, arthralgia
Fulvestrant Estrogen receptor antagonist Elevation of liver enzymes, oedema
Molecular-targeted therapy   
Trastuzumab, pertuzumab Interferes with the HER2/neu receptor Cardiotoxicity, pulmonary toxicity
Lapatinib Interrupts the HER2/neu and epidermal growth factor receptor (EGFR) pathways Rash, diarrhoea, liver dysfunction,
Bevacizumab Inhibits vascular endothelial growth factor (VEGF) Hepatic steatosis, pancreatitis, cholecystitis, infection
Trastuzumab emtansine Antibody-drug conjugate binds to HER2 receptors and enters the cell and releases the cytotoxic agent emtansine Hepatotoxicity, thrombocytopenia