Targeted cancer therapy – present and future
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Hebrew University of Jerusalem, Jerusalem, Israel
Background: Targeted therapy is slowly replacing cytotoxic therapy of Cancer and is also implemented in non-malignant diseases. In Cancer the success of targeted therapy is mixed. In some cases like the utilization of Tamoxifen daily for 5 years, in women with breast cancer, the risk of dying from the disease drops by one third, compared to their chances without the drug. Woman who are Her2+ and treated with Herceptin are 36 % less likely to have the cancer come back and are 40 % less likely to die from cancer. Gleevec induces 89 % 5-year survival as compared to 30 % in the pre-Gleevec era. Improvement is expected with Dasatinib a dual Src/Bcr-Abl inhibitor. Gleevec reduces the 2-year recurrence of high risk GIST from 77 % to 41 %. The performance of other targeted drug is less impressive but still benefits patients: Avastin, Tarceva, Sorafenib and Erbitux for example benefits patients for weeks to a few months and Plexxicon 4032 for a few months.
Thus, although targeted therapy has improved overall survival no long-term remission has been achieved except for cases in which the immune system has been harnessed in a targeted manner by using adoptive T cell therapy, which is very costly.
In the lecture I will discuss these issues and some novel strategies to upgrade targeted therapy.