Expert opinion on biological therapy
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Expert Opin Biol Ther · Apr 2007
ReviewAdjuvant treatment of breast cancer: impact of monoclonal antibody therapy directed against the HER2 receptor.
The use of chemotherapy and endocrine therapies as adjuncts to the treatment of early-stage breast cancer has yielded small but significant improvements in disease-free and overall survival. Increased understanding of the role of growth factor receptors enabled the rational development of agents that are capable of modulating their function. ⋯ As a consequence, trastuzumab has been tested in the adjuvant setting the results of which have been presented recently. This review briefly summarises the use of trastuzumab in advanced breast cancer and describes recent studies of its use in the adjuvant setting.
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Cetuximab is a chimeric monoclonal antibody that binds to the epidermal growth factor receptor and thereby inhibits cell proliferation, metastasis and angiogenesis. Preclinical studies indicate that cetuximab induces synergistic antitumor activity when combined with chemotherapy or radiation. This observation is supported by clinical trials demonstrating that cetuximab improves tumor response when used in conjunction with modern chemotherapy in patients with metastatic colorectal cancer. ⋯ In pretreated patients, cetuximab may restore the sensitivity to irinotecan and, therefore, has been registered in this setting. Ongoing studies are investigating the integration of anti-epidermal growth factor receptor and anti-vascular endothelial growth factor strategies into new treatment regimens. Promising results have already been obtained in a trial combining irinotecan, bevacizumab and cetuximab.
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Mutations in the p53 gene are the most frequent genetic alterations in human tumours, occurring in approximately 50% of all cancers. The p53 protein is pivotal in maintaining genetic integrity after DNA damage, and alterations in the p53 pathway, including mutations in the p53 gene, greatly increase the probability of tumour formation. ⋯ Results show that Advexin is a well-tolerated and efficacious treatment for numerous cancers, both as monotherapy and in combination with radiation and/or chemotherapy agents. In addition, there is now data to support the use of Advexin in cancer immunotherapy.
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Expert Opin Biol Ther · Jan 2006
ReviewThe emerging role of recombinant activated Factor VII (rFVIIa) in the treatment of blunt traumatic haemorrhage.
Recombinant activated Factor VII (rFVIIa; eptacog alpha [activated], NovoSeven) is currently used for the management of a subgroup of haemophilia patients with inhibitors to Factors VIII or IX, and is under investigation as an adjuvant therapy for critical bleeding from other causes, including trauma. rFVIIa has a mode of action founded on physiological coagulation processes, and causes localised haemostasis at injury sites, both spontaneous and traumatic, with the capacity to correct the systemic coagulopathy associated with massive blood loss and its management. This review charts the development of rFVIIa as a new and potent adjuvant therapy for severe bleeding and coagulopathy caused by blunt trauma, where it is reported to produce rapid and significant haemostasis, reducing transfusion requirements and improving clinical outcome.
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Expert Opin Biol Ther · Dec 2005
ReviewTowards an improved serogroup B Neisseria meningitidis vaccine.
Meningococcal disease, presenting primarily as septicaemia and meningitis, continues to be a devastating problem around the world. Over the last century, vaccine development has been undertaken in earnest for the prevention of this disease. Polysaccharide vaccines have been available for almost 40 years, yet they are poorly immunogenic in young children who are at the highest risk. ⋯ This review details the many conventional vaccine strategies and the more recent genome-derived technological approaches being used in serogroup B vaccine development. The future prevention of serogroup B disease will rely on both outer membrane vesicle vaccines being used for serosubtype-specific outbreaks and new vaccines containing multiple other antigens. Investment by the pharmaceutical industry in preclinical research and development provides hope that an efficacious serogroup B meningococcal vaccine can be developed.