Expert review of anticancer therapy
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Expert Rev Anticancer Ther · Dec 2003
ReviewRole of imatinib mesylate (Gleevec/Glivec) in gastrointestinal stromal tumors.
Gastrointestinal stromal tumors are soft tissue sarcomas of the gastrointestinal tract that originate from mesenchymal cells. Advances in the systemic therapy of gastrointestinal stromal tumors are highlighted by the rapid development and approval of the molecularly targeted therapy imatinib mesylate (Gleevec/Glivec). ⋯ Inhibiting the downstream signaling of KIT switches the cell balance into apoptosis. Although complete responses have seldom been seen up until now, imatinib has proven to be extremely effective in the treatment of patients with unresectable and/or metastatic gastrointestinal stromal tumors.
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Expert Rev Anticancer Ther · Jun 2003
ReviewTargeting epidermal growth factor receptor: novel therapeutics in the management of cancer.
Overexpression of epidermal growth factor receptor (EGFR) in epithelial tumors, including head and neck, lung, breast, colon and other solid tumors, has frequently been correlated with poor prognosis, thus stimulating efforts to develop new cancer therapies that target EGFR. Monoclonal antibodies and tyrosine kinase inhibitors specifically targeting EGFR are the most well-studied and hold substantial promise of success. Several compounds of monoclonal antibodies and tyrosine kinase inhibitors targeting EGFR have been studied and clinical trials are now underway to test the safety and efficacy of these targeting strategies in several human tumors. ⋯ EGFR targeted treatment by monoclonal antibodies and tyrosine kinase inhibitors have been proven to sensitize tumor cells to the effects of chemotherapy and radiation therapy. The synergistic activities and nonoverlapping toxicities of these compounds allow concomitant administration with cytotoxic therapy. Challenges of evaluating EGFR targeted agents exist in selecting the optimal dosages and determining long-term toxicity.
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Expert Rev Anticancer Ther · Apr 2003
ReviewAromatase inhibitors for treatment of postmenopausal patients with breast cancer.
The third generation of aromatase inhibitors and inactivators, such as anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin), have become available for treatment of postmenopausal breast cancer patients. Several clinical trials have demonstrated that these new drugs can achieve better treatment results than megestrol acetate (Megace) and may replace tamoxifen for the first-line hormonal therapy for metastatic breast cancer patients. In fact, these drugs are now used in many hospitals and clinics for patients with metastatic breast cancer who were previously given tamoxifen as adjuvant treatment. ⋯ Additional data regarding survival resulting from comparative trials of letrozole and tamoxifen and of exemestane and tamoxifen are expected to be available in a few years. However, limited information is available regarding adverse events caused by long-term administration of aromatase inhibitors. Longer follow-up is needed to determine the efficacy and safety of these new aromatase inhibitors when used for adjuvant treatment of postmenopausal patients with breast cancer.
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The statistics on lung cancer survival remain disappointing and form a powerful argument to develop new methods to control this most deadly form of cancer in both men and women. Chemoprevention is one of these new approaches. While carcinogens from cigarette smoke form an essential link between nicotine addiction and lung cancer, several investigations confirm that dietary and genetically determined factors play an important role in modulating the individual susceptibility and are linked to the chemoprevention approach. ⋯ On the other hand, recent progress in molecular biology has led to the discovery of specific approaches to chemoprevention and there considerable optimism regarding the potential of molecules and antibodies that target specific receptors or mutations. Epidermal growth factor receptor blocking agents, farnesyltransferase and cyclooxygenase inhibitors and 9-cis retinoic acid have been identified as promising candidates for studies in high risk populations. After more than 20 years of worldwide research, the prospects for effective lung cancer treatment are better than ever.