Targeted therapy or molecular targeted therapy is one of the main modalities of medical treatment (pharmacotherapy) for cancer, others are hormonal therapy and cytotoxic chemotherapy. As a form of molecular treatment, targeted therapy inhibits the growth of cancer cells by disrupting targeted specific molecules necessary for carcinogenesis and tumor growth, not by simply interrupting all the cells that divide rapidly (eg with traditional chemotherapy). Since most agents for targeted therapy are biopharmaceuticals, the term biological therapy is sometimes identical to targeted therapy when used in the context of cancer therapy (and thus differentiated from chemotherapy, ie , cytotoxic therapy). However, modalities can be combined; conjugate antibodies combine biological and cytotoxic mechanisms into one targeted therapy.
Another form of targeted therapy involves the use of nanoengineered enzymes to bind to tumor cells so that the body's natural cell degradation processes can digest cells, effectively removing them from the body. The basic biological mechanisms behind the research technique are being investigated in limited form with drugs derived from cannabis drugs (drugs) today in the United States. One example includes the reduction and elimination of brain tumors with a small intake of oil derived from marijuana strains of engineered drugs.
Targeted cancer therapy is expected to be more effective than older forms of treatment and less harmful to normal cells. Many targeted therapies are examples of immunotherapy (using immune mechanisms for therapeutic purposes) developed by the field of cancer immunology. Thus, as immunomodulators, they are one type of biological response modifier.
The most successful target therapy is a chemical entity that targets or specifically targets proteins or enzymes that carry mutations or other genetic changes specific to cancer cells and are not found in normal host tissues. One of the most successful molecular terrains therapy is Gleevec, which is an inhibitor of kinase with a remarkable affinity for the BCR-Abl oncofusion protein which is a powerful tumorigenesis drive in chronic myelogenous leukemia. Although used in other indications, Gleevec most effectively targets BCR-Abl. Another example of molecular targeted therapy targeting mutated oncogenes, including PLX27892 targeting the B-raf mutants in melanoma.
There are targeted therapies for colorectal cancer, head and neck cancer, breast cancer, multiple myeloma, lymphoma, prostate cancer, melanoma and other cancers.
Biomarkers are usually needed to help the selection of patients who are likely to respond to specific targeted therapies.
The definitive experiment shows that targeted therapy will reverse the malignant phenotype of tumor cells involved in treating the altered Her2/neu cells with monoclonal antibodies in vitro and in vivo by laboratory marker Mark Greene and reported since 1985.
Some people challenge the use of the term, stating that the drugs normally associated with the term are not selective enough. The sentence sometimes appears in a scary quote: "targeted therapy". Targeted therapy may also be described as "chemotherapy" or "non-cytotoxic chemotherapy", because "chemotherapy" strictly means only "chemical treatment". But in medical and general use "chemotherapy" is generally now widely used specifically for "traditional" cytotoxic chemotherapy.
Video Targeted therapy
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The major categories of currently targeted therapies are the small molecule and monoclonal antibodies.
Small molecule
Many are tyrosine-kinase inhibitors.
- Imatinib (Gleevec, also known as STI-571) is approved for chronic myelogenous leukemia, gastrointestinal stromal tumors and several other cancers. Preliminary clinical trials show that imatinib may be effective in the treatment of dermatofibrosarcoma protuberans.
- Gefitinib (Iressa, also known as ZD1839), targets the epithermal growth factor receptor (EGFR) tyrosine kinase and is approved in the US for non-small cell lung cancer.
- Erlotinib (marketed as Tarceva). Erlotinib inhibits epidermal growth factor receptors, and works through the same mechanisms as gefitinib. Erlotinib has been shown to improve survival in non-metastatic small cell lung cancer when used as second-line therapy. Because of these findings, erlotinib has replaced gefitinib in this setting.
- Sorafenib (Nexavar)
- Sunitinib (Sutent)
- Dasatinib (Sprycel)
- Lapatinib (Tykerb)
- Nilotinib (Tasigna)
- Bortezomib (Velcade) is a proteasome inhibitor that stimulates apoptosis that causes cancer cells to die of cells because they interfere with proteins. It is approved in the US to treat multiple myeloma that has not responded to other treatments.
- The selective estrogen receptor tamoxifen modulator has been described as the basis of targeted therapy.
- Janus kinase inhibitor, eg. FDA approves tofacitinib
- ALK inhibitors, e.g. crizotinib
- Bcl-2 inhibitors (eg drugoclax in clinical trials, navitoclax, and gossypol.
- PARP inhibitors (eg Iniparib, Olaparib in clinical trials)
- PI3K inhibitors (eg periphosin in phase III trials)
- Apatinib is a selective VEGF Receptor 2 inhibitor that has shown encouraging anti-tumor activity in various malignancies in clinical trials. Apatinib is currently in clinical development for metastatic gastric carcinoma, metastatic breast cancer and advanced hepatocellular carcinoma.
- AN-152, (AEZS-108) doxorubicin is associated with [D-Lys (6)] - LHRH, the result of phase II for ovarian cancer.
- Braf inhibitors (vemurafenib, dabrafenib, LGX818) are used to treat metastatic melanoma that traps the BRAF V600E mutation
- MEK inhibitors (trametinib, MEK162) were used in trials, often combined with BRAF inhibitors to treat melanoma
- CDK blockers, e.g. PD-0332991, LEE011 in clinical trials
- Hsp90 inhibitor, some in clinical trials
- salinomycin has demonstrated the potential for killing cancer stem cells in breast tumors made both laboratoryally and naturally in mice.
- VAL-083 (dianhydrogalactitol), the first "in-class" DNA targeting agent with a unique dual-binding DNA binding mechanism. Clinical NCI-sponsored trials have demonstrated clinical activity against a number of different cancers including glioblastoma, ovarian cancer, and lung cancer. VAL-083 is currently undergoing Phase 2 and Phase 3 clinical trials as a potential treatment for glioblastoma (GBM) and ovarian cancer. Starting July 2017, four VAL-083 trials are listed.
Small molecule conjugation
- Vintafolide is a small molecule molecule conjugate composed of small molecules that target the folate receptors. Currently in clinical trials for platinum-resistant ovarian cancer (PROCEED trial) and Phase 2b study (TARGET test) in non-small cell lung carcinoma (NSCLC). Serine/threonine_kinase_inhibitors_ (small_molecules) "> Serine/threonine kinase inhibitors
- Temsirolimus (Torisel)
- Everolimus (Afinitor)
- Vemurafenib (Zelboraf)
- Trametinib (Mekinist)
- Dabrafenib (Tafinlar)
- Rituximab targets CD20 found in cell B. It is used in non-Hodgkin's lymphoma
- Trastuzumab targets the Her2/neu receptor (also known as ErbB2) expressed in some types of breast cancer
- Alemtuzumab
- Cetuximab targets the epidermal growth factor receptor (EGFR). It is approved for use in the treatment of metastatic colorectal cancer, and squamous cell carcinoma of the head and neck.,
- Panitumumab also targets EGFR. It is approved for use in the treatment of metastatic colorectal cancer.
- Bevacizumab targets VEGF ligand circulation. It is approved for use in the treatment of colon cancer, breast cancer, non-small cell lung cancer, and is investigated in the treatment of sarcoma. Its use for the treatment of brain tumors has been recommended.
- Ipilimumab (Yervoy)
- CancerDriver: free and open database to find targeted therapies according to patient features.
- Targeted Therapy Database (TTD) [2] from the Melanoma Molecular Map Project [3]
- Fact sheets Targeted therapy from the U.S. National Cancer Institute
- Molecular Oncology: Recipe-Based Therapy Special Edition Clinical Oncology Journal (10 April 2005) is dedicated to targeted therapies in the treatment of cancer
- Targeting Targeted Therapy The New England Journal of Medicine (2004)
- Targeting a tumor with drug marijuana oil - a list of publications from Spain
Monoclonal antibody
Some are under development and some have been licensed by the FDA and the European Commission. Examples of licensed monoclonal antibodies include:
Many antibody-drug conjugates (ADCs) are being developed. See also ADEPT (antibody-directed enzyme prodrug therapy).
Maps Targeted therapy
Progress and future
In the US, the National Cancer Institute Molecular Target Development Program (MTDP) aims to identify and evaluate molecular targets that may be candidates for drug development.
See also
References
External links
Source of the article : Wikipedia
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