Information about Targeted Therapy
Targeted therapy is a type of medication which blocks the growth of cancer cells by interfering with specific targeted molecules needed for carcinogenesis and tumor growth, rather than by simply interfering with rapidly dividing cells. Targeted cancer therapies may be more effective than current treatments and less harmful to normal cells.
The main categories of targeted therapy are small molecules and monoclonal antibodies.
Several are in development and a few have been licenced by the FDA. Examples of licenced monoclonal antibodies include:
In the U.S., the National Cancer Institute's Molecular Targets Development Program (MTDP) to identify and evaluate molecular targets that may be candidates for drug development.
The next stage of targeted therapies will focus on finding which patients will respond to which targeted therapies. This is called the identification of "sub-populations". The route to identify these sub-populations is through biomarkers and surrogate endpoints.
Tumor or tumour (via Old French tumour from Latin tumor "swelling") is an abnormal growth or mass of tissue. A tumor can be either malignant or benign.
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The main categories of targeted therapy are small molecules and monoclonal antibodies.
Small molecules
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- Imatinib mesylate (Gleevec®, also known as STI–571) is approved for chronic myelogenous leukemia, gastrointestinal stromal tumor and some other types of cancer. Early clinical trials indicate that imatinib may be effective in treatment of dermatofibrosarcoma protuberans.
- Gefitinib (Iressa®, also known as ZD1839), targets the epidermal growth factor receptor (EGFR) tyrosine kinase and is approved in the U.S. for non small cell lung cancer. EGFR is also overexpressed in the cells of other solid tumors, such as lung and breast cancers. This leads to inappropriate activation of the apoptotic Ras signal transduction cascade, eventually leading to uncontrolled cell proliferation.Gefitinib inhibits EGFR tyrosine kinase by binding to the adenosine triphosphate (ATP)-binding site of the enzyme. Thus the function of the EGFR tyrosine kinase in activating the Ras signal transduction cascade is inhibited; and malignant cells are inhibited.
- Erlotinib (marketed as Tarceva). Erlotinib works through a similar mechanism as gefitinib. Erlotinib has been shown to increase survival in metastatic non small cell lung cancer when used as second line therapy. Because of this finding, erlotinib has replaced gefitinib in this setting.
- Bortezomib (Velcade®) is an apoptosis-inducing drug that causes cancer cells to undergo cell death by interfering with proteins. It is approved in the U.S. to treat multiple myeloma that has not responded to other treatments.
Monoclonal antibodies
Main article: Monoclonal antibody therapySeveral are in development and a few have been licenced by the FDA. Examples of licenced monoclonal antibodies include:
- Rituximab targets CD20 found on B cells. It is used in non Hodgkin lymphoma
- Trastuzumab (Herceptin®) targets the Her2/neu (also known as ErbB2) receptor expressed in some types of breast cancer
- Cetuximab (marketed as Erbitux) targets the epidermal growth factor receptor. It is used in the treatment of colon cancer.
- Bevacizumab (marketed as Avastin) targets circulating VEGF ligand. It is approved for use in the treatment of colon cancer and is investigational in the treatment of breast cancer and sarcoma
Progress and future
Many oncologists believe that targeted therapies are the chemotherapy of the future. As solid tumor cancer continues to be viewed as a chronic condition, methods for long-term treatment, with less side-effects, continue to be investigated.In the U.S., the National Cancer Institute's Molecular Targets Development Program (MTDP) to identify and evaluate molecular targets that may be candidates for drug development.
The next stage of targeted therapies will focus on finding which patients will respond to which targeted therapies. This is called the identification of "sub-populations". The route to identify these sub-populations is through biomarkers and surrogate endpoints.
References
- Green, Mark Targeting Targeted Therapy New England Journal of Medicine (May 20, 2004)
- Molecular Oncology: Receptor-Based Therapy Journal of Clinical Oncology (April 10, 2005)
- Lynch, Thomas Activating Mutations in the Epidermal Growth Factor Receptor Underlying Responsiveness of Non–Small-Cell Lung Cancer to Gefitinib New England Journal of Medicine (May 20, 2004)
See also
A medication, medicine or drug is any substance or combination of substances administered to human beings or animals to treat or prevent disease; alternatively to assist in medical diagnosis.
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Cancer Cell is a scientific journal, concerning mainly cancer and its research. Published from 2002. It is a journal of the Cell (journal) group of journals.
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External links
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molecule is defined as a sufficiently stable electrically neutral group of at least two atoms in a definite arrangement held together by strong chemical bonds.[1][2] In organic chemistry and biochemistry, the term molecule
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Carcinogenesis (meaning literally, the creation of cancer) is the process by which normal cells are transformed into cancer cells.
Cell division is a physiological process that occurs in almost all tissues and under many circumstances.
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Cell division is a physiological process that occurs in almost all tissues and under many circumstances.
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For malignant tumors specifically, see .
Tumor or tumour (via Old French tumour from Latin tumor "swelling") is an abnormal growth or mass of tissue. A tumor can be either malignant or benign.
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Monoclonal antibodies (mAb or moAb) are antibodies that are identical because they are produced by one type of immune cell that are all clones of a single parent cell.
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Imatinib is a drug used to treat certain types of cancer. It is currently marketed by Novartis as Gleevec (USA) or Glivec (Europe/Australia) as its mesylate salt, imatinib mesilate (INN).
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Chronic myelogenous leukemia
Classification & external resources
The Philadelphia chromosome as seen by metaphase FISH.
ICD-10 C 92.1
ICD-9 205.1
ICD-O: M 9863/3
DiseasesDB 2659
MedlinePlus 000570
eMedicine med/371
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Classification & external resources
The Philadelphia chromosome as seen by metaphase FISH.
ICD-10 C 92.1
ICD-9 205.1
ICD-O: M 9863/3
DiseasesDB 2659
MedlinePlus 000570
eMedicine med/371
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MeSH D046152
In medical oncology, gastrointestinal stromal tumors (GIST) are a rare tumor of the gastrointestinal tract (1-3% of all gastrointestinal malignancies).
GIST is a form of connective tissue cancer, or sarcoma.
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In medical oncology, gastrointestinal stromal tumors (GIST) are a rare tumor of the gastrointestinal tract (1-3% of all gastrointestinal malignancies).
GIST is a form of connective tissue cancer, or sarcoma.
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Dermatofibrosarcoma protuberans (DFSP) is a rare neoplasm of the dermis layer of the skin, and is classified as a sarcoma. In many respects, the disease behaves as a benign tumor, but in 2-5% of cases it can metastasize, so it should be considered to have malignant potential.
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Gefitinib (INN) (IPA: [gɛˈfɪtənɪb]) (originally coded ZD1839) is a drug used in the treatment of certain types of cancer.
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epidermal growth factor receptor (EGFR; ErbB-1; HER1 in humans) is the cell-surface receptor for members of the epidermal growth factor family (EGF-family) of extracellular protein ligands.
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tyrosine kinase is an enzyme that can transfer a phosphate group from ATP to a tyrosine residue in a protein. Tyrosine kinases are a subgroup of the larger class of protein kinases.
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Motto
"In God We Trust" (since 1956)
"E Pluribus Unum" ("From Many, One"; Latin, traditional)
Anthem
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"In God We Trust" (since 1956)
"E Pluribus Unum" ("From Many, One"; Latin, traditional)
Anthem
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Lung cancer
Classification & external resources
Cross section of a human lung. The white area in the upper lobe is cancer; the black areas indicate the patient was a smoker.
ICD-10 C 33. -C 34.
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Classification & external resources
Cross section of a human lung. The white area in the upper lobe is cancer; the black areas indicate the patient was a smoker.
ICD-10 C 33. -C 34.
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RAS may refer to:
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- Royal Asiatic Society of Great Britain and Ireland, a society to further study into topics relating to science, literature, and the arts in relation to Asia
- RAS Records, a reggae record label
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In biology, signal transduction refers to any process by which a cell converts one kind of signal or stimulus into another, most often involving ordered sequences of biochemical reactions inside the cell, that are carried out by enzymes, activated by second messengers resulting in
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Adenosine 5'-triphosphate (ATP) is a multifunctional nucleotide that is most important as a "molecular currency" of intracellular energy transfer. In this role, ATP transports chemical energy within cells for metabolism.
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Erlotinib hydrochloride (trade name Tarceva, Genentech/OSIP, originally coded as OSI-774) is a drug used to treat non-small cell lung cancer, pancreatic cancer and several other types of cancer.
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Lung cancer
Classification & external resources
Cross section of a human lung. The white area in the upper lobe is cancer; the black areas indicate the patient was a smoker.
ICD-10 C 33. -C 34.
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Classification & external resources
Cross section of a human lung. The white area in the upper lobe is cancer; the black areas indicate the patient was a smoker.
ICD-10 C 33. -C 34.
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Bortezomib (originally PS-341 and marketed as Velcade by Millennium Pharmaceuticals) is the first therapeutic proteasome inhibitor to be tested in humans. It is approved in the U.S. for treating relapsed multiple myeloma and mantle cell lymphoma.
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Apoptosis (pronounced ă-pŏp-tŏ’sĭs, apo tō' sis) is a form of programmed cell death in multicellular organisms. It is one of the main types of programmed cell death (PCD), and involves an orchestrated series of biochemical events leading to a
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Motto
"In God We Trust" (since 1956)
"E Pluribus Unum" ("From Many, One"; Latin, traditional)
Anthem
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"In God We Trust" (since 1956)
"E Pluribus Unum" ("From Many, One"; Latin, traditional)
Anthem
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Multiple myeloma
Classification & external resources
ICD-10 C 90.0
ICD-9 203.0
ICD-O: M 9732/3
OMIM 254500
DiseasesDB 8628
MedlinePlus 000583
eMedicine med/1521
MeSH D009101
Multiple myeloma (also known as MM
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Classification & external resources
ICD-10 C 90.0
ICD-9 203.0
ICD-O: M 9732/3
OMIM 254500
DiseasesDB 8628
MedlinePlus 000583
eMedicine med/1521
MeSH D009101
Multiple myeloma (also known as MM
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Monoclonal antibody therapy is the use of monoclonal antibodies (or Mab) to specifically target cells. The main objective is stimulating the patient's immune system to attack the malignant tumor cells and the prevention of tumor growth by blocking specific cell receptors.
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Rituximab, sold under the trade names Rituxan® and MabThera®, is a chimeric monoclonal antibody used in the treatment of B cell non-Hodgkin's lymphoma, B cell leukemia, and some autoimmune disorders.
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MeSH D008223
Lymphoma
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This article is about lymphoma in humans. For the disease in dogs, cats, and ferrets, see lymphoma in animals.
Lymphoma
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Trastuzumab (more commonly known under the trade name Herceptin) is a humanized monoclonal antibody that acts on the HER2/neu (erbB2) receptor. Trastuzumab's principal use is as an anti-cancer therapy in breast cancer in patients whose tumors over express (produce more than
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V-erb-b2 erythroblastic leukemia viral oncogene homolog 2, neuro/glioblastoma derived oncogene homolog (avian), also known as ERBB2, is a human gene. This gene encodes a member of the epidermal growth factor (EGF) receptor family of receptor tyrosine kinases.
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Breast cancer
Classification & external resources
Histopathologic image from ductal cell carcinoma in situ (DCIS) of breast. Hematoxylin-eosin stain.
ICD-10 C 50.
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Breast cancer
Classification & external resources
Histopathologic image from ductal cell carcinoma in situ (DCIS) of breast. Hematoxylin-eosin stain.
ICD-10 C 50.
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