Expert review of anticancer therapy
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The recent clinical and commercial success of anticancer antibodies, such as rituximab (Rituxan) and trastuzumab (Herceptin) has created great interest in antibody-based therapeutics for hematopoietic malignancies and solid tumors. Given the likely lower toxicity for antibodies versus small molecules, the potential increase in efficacy by conjugation to radioisotopes and other cellular toxins and the ability to characterize the target with clinical laboratory diagnostics to improve the drug's clinical performance, it is anticipated that current and future antibody therapeutics will find substantial roles alone and in combination therapy strategies for the treatment of patients with cancer. ⋯ However, although there are a large number of agents in both early and later stages of clinical development, only a handful will make it through regulatory approval and become successful products. This review considers the structure of anticancer therapeutic antibodies, the techniques used to reduce their antigenicity, factors that influence efficacy and toxicity, conjugation with isotopes and toxins and antibody target validation.
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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.
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Cancer-related fatigue is now a recognized phenomenon with an established diagnosis. Fatigue is the most common symptom experienced by cancer patients and in many cases, the challenge of alleviating its severity is daunting for the clinician. ⋯ Research of cancer-related fatigue treatment is in its infancy and future clinical trials examining the effects of various pharmacologic and nonpharmacologic therapies for cancer-related fatigue are needed. The development of effective therapies for the treatment of cancer-related fatigue could profoundly affect the lives of many cancer patients.