Targeted Cancer Therapy Quotes

Specificity refers to the ability of any medicine to discriminate between its intended target and its host. Killing a cancer cell in a test tube is not a particularly difficult task: the chemical world is packed with malevolent poisons that, even in infinitesimal quantities, can dispatch a cancer cell within minutes. The trouble lies in finding a selective poison—a drug that will kill cancer without annihilating the patient. Systemic therapy without specificity is an indiscriminate bomb. For an anticancer poison to become a useful drug, Meyer knew, it needed to be a fantastically nimble knife: sharp enough to kill cancer yet selective enough to spare the patient.

Humans do not benefit but are harmed by misleading animal testing, especially when it comes to predicting the efficacy of targeted therapies.

Cancer is not the only brain disease being targeted for treatment with living cells. Cell therapy also has the potential to replace aging or injured tissue. In this hope for regenerative medicine, modified stem cells are being studied as a treatment for Alzheimer’s disease.

(IMRT) has an advantage. The newer, high-dose, conformally directed, external-beam techniques for radiation therapy such as IMRT have been in widespread use for less than ten years; IGRT has been around for an even shorter time. However, some reports of long-term success are now emerging. New studies suggest that at ten years, high radiation doses alone can produce PSA control or cure rates in 93 percent of men with low-risk prostate cancer. What about more aggressive prostate cancer? As we discussed in chapter 9, the best treatment regimen for men with intermediate- and high-risk prostate cancer is still a moving target, but it will likely turn out to be a combination of high-dose radiation and short- or long-term hormonal therapy.

The personal case histories were the most encouraging. A prominent Los Angeles public relations executive has been living with MM for fourteen years, rides horses, and has an altogether active life on drug maintenance. An Arizona man survived MM and with his wife set up a foundation and website for other families bewildered by the diagnosis. I learned, for the first time, that Frank McGee, host of the Today show from 1971 to 1974, suffered from MM and kept it from everyone despite his ever more gaunt appearance. When he died after putting in another full week on the air his producers and friends were stunned. Sam Walton, founder of Walmart, was another MM casualty, which led many to believe that he had established the high-profile multiple myeloma treatment center in Little Rock, Arkansas. This is a full-immersion process in which MM is the singular target under the commanding title of Myeloma Institute for Research and Therapy. There is a Walton auditorium on the institute’s University of Arkansas medical school campus, but the institute itself was founded by Bart Barlogie, a renowned MM specialist from the MD Anderson Cancer Center in Houston. The institute has an impressive record, running well ahead of the national average for survival for those who are dealing with MM. One number is especially notable. The institute has followed 1,070 patients for more than ten years, and 783 have never had a relapse of the disease. Sam Walton was treated by Dr. Barlogie at MD Anderson before the Little Rock institute was founded, but the connection ended there. Walton, who’d had an earlier struggle with leukemia, didn’t survive his encounter with multiple myeloma, dying in April 1992, a time when life expectancy for a man his age with this cancer was short. I was unaware of all of this when I was diagnosed. I took comfort in the repeated reassurances of specialists that great progress in treating MM with a new class of drugs, your own body’s reengineered immunology system, was rapidly improving chances of a longer survival than the published five to ten years. As I began to respond to treatment the favored and welcome line was, “You’re gonna die but from something else.

Even targeted therapy, then, was a cat-and-mouse game. One could direct endless arrows at the Achilles' heel of cancer, but the disease might simply shift its foot, switching one vulnerability for another. We were locked in a perpetual battle with a volatile combatant. ... the Red Queen tells Alice that the world keeps shifting so quickly under her feet that she has to keep running just to keep her position. This is our predicament with cancer: we are forced to keep running merely to keep still.

To get the most out of this chapter, first find where you are on this map of the cancer journey: Critical stress points. When you have just been diagnosed with cancer or learned that your cancer has recurred or is not responding to treatment. Treatment preparation. When you are anticipating surgery, radiation, chemotherapy, or molecular target therapies. Side effect management. When you are undergoing treatment and need ways (instead of or in addition to drugs) to manage its side effects. Post-treatment. When you are adjusting to the end of active treatment, usually after the final chemotherapy cycle. This situation can, perhaps surprisingly, prove quite stressful. Remission maintenance. Although definitely good news, remission introduces its own issues, most notably fear of recurrence. Remission is also when you will be most determined to take back your life from cancer.

Activation of the androgen receptor (AR) is crucial for tumor cell progression and survival of prostate cancer, and androgen deprivation therapy remains the main clinical approach in men with locally advanced tumors ■ Current therapies incompletely suppress the androgen–AR axis, but a multiple therapeutic approach, targeting androgens and their receptor, has potential to improve clinical outcomes ■ Treatment of prostate cancer cells with 5α-reductase inhibitors (5ARIs) inhibits cellular pathways regulating metabolism, cell growth and proliferation, triggering apoptosis and decreasing prostate size ■ Although 5ARI treatment reduces the risk of developing prostate cancer, patients treated with these drugs have tumors with higher Gleason scores than those who receive placebo ■ Use of 5ARIs to prevent and treat prostate cancer remains controversial, and further investigation is necessary to understand the presence of more-aggressive tumors in patients receiving these drugs

Every multicellular organism begins as one cell, which contains all of the intricate instructions to synthesize, organize, and regulate not only this cell but the development and maintenance of all cells that will inevitably comprise the organism. All of these instructions are encoded in the first cell's DNA. This underscores the complexity of the genome and how each cell's expression must be controlled in specific ways depending on its function. The cells hailing from each tissue in the human body (e.g., muscle, lung, heart, liver) harbor a unique epigen­etic signature, which enables the maintenance of tissue-specific func­tions through the control of gene regulation, as just discussed. "Our knowledge of the total number of unique cells, or cell types, is still growing. Previous estimates put the number of unique cell types in the human body at ~300, but new estimates from the Human Cell Atlas have shown that we may have thousands of cell types and subtypes, each harboring a unique function for a specific physiological state or response to stimuli. But even cells of the same cell type will not be identical. A cell's 'presentation' of molecules on their surface can radi­cally change depending on internal variables such as genetic mutations or altered states of their epigenome, transcriptome, and proteome, as well as external stimuli including drugs and interactions with other cells. This novel presentation is most pronounced with a neoantigen, when a cancer cell creates an entirely new molecule on the surface of a cell. Given its unique presentation, which wouldn't be found in nor­mal cells, this offers a unique target for safer cancer therapies. "The human body has about 30 trillion human cells plus another 30-40 trillion bacterial cells, for a total of about 70 trillion cells. If your body were a democracy, the human cells would often be the minority or equal party. You (as a human) would never win an election. Your loss of control would likely result in you rolling around in the soil or lying in a bathtub full of yogurt, which I do sometimes on Sundays. Regard­less of how you spend your Sundays, there are a lot of microbes in, on, and around your body. There are in fact so many microbes that they compose the bulk of the cells on Earth. This is a humbling and exciting statistic, and one which is vividly apparent for anyone who has ever had explosive diarrhea.

A metabolic, deep nutrition, and nontoxic approach is the answer to cancer prevention and management. This book is our call to arms—we must focus on the 90–95 percent of cancers that are caused by the standard American diet and exposure to environmental toxins. We simply cannot keep shrugging our shoulders when we, or our loved ones, are diagnosed. If a new virus began to kill one of every four people in the United States, you can bet your pink ribbon a cure would be found, and fast. While Western medicine continues to drive along the dusty, dead-end road seeking the genetic and targeted answer to cancer, it is time for us to start taking control of our own health and health care choices. We’ll say it again: Cancer is a metabolic, environmental, and emotional disease. It’s not just a tumor; it signifies correctable imbalances that occur inside and outside our body. Now is the time for lifelong remission. It is time for some real hope and to disarm the most deadly disease of modern times. How? With the metabolic approach to cancer.

no patients with solid tumors have been cured by targeted therapies over that time period. Zero [is] the number of targeted therapies that have prolonged survival by one year, when compared to a conventional treatment.

CAR-T therapy in a very small subset of cancer patients with lymphoid disease is fantastically successful, albeit causing severe short-term toxicities and many known and unknown lifelong side effects. It is clear that much work lies ahead before this strategy can be scaled up for general use. Yet the hype surrounding CAR-T is such that practically every patient questions me about why they are being deprived of the magic cure. The results are not always magical: Despite high-target, cell-specific killing in vitro and encouraging preclinical efficacies in murine tumor models, clinical responses of adoptively transferred T cells expressing α-folate receptor (FR) specific CAR in ovarian cancer were disappointing. No reduction of tumor burden was seen in the 14 patients studied. The absence of efficacy was ascribed to lack of specific trafficking of the T cells to tumor and short persistence of the transferred T cells.

today the idea of interrupting the dialogue between the tumor and its host environment underlies targeted therapy, immunotherapy, and nearly every active cancer research program. The company that developed Avastin was called Genentech. Between the day the company first announced the data and the day the FDA approved the drug, its market value increased by $38 billion, a rough measure of the value of the drug. (Folkman owned no stock in the company; he routinely donated any financial stakes and prize money he received to his hospital.) Later, Folkman would say, “You can tell a leader by counting the number of arrows in his ass.

Cannabinoids are compounds that can activate two types of receptors within the ECS: CB1 receptors, which are located within the nervous system, brain, and nerve endings; and CB2 receptors, located primarily within the immune system. Targeting the ECS has been found to have anti-inflammatory, anticachexia, metabolic, pain management, antiseizure, and sleep-promoting effects.

The incidence of CML remains unchanged from the past: only a few thousand patients are diagnosed with this form of leukemia every year. "But the prevalence of CML---the number of patients presently alive with the disease---has dramatically changed with the introduction of Gleevec.  As of 2009, CML patients treated with Gleevec survive an average of thirty years after their initial diagnosis.  Based on that survival figure, Hagop Kantarjian estimates that within the next decade, 250,000 people will be living with CML in America, all of them on targeted therapy.  Druker's drug will alter the national physiognomy of cancer, converting a once-rare disease into a relatively common one.  (Druker jokes that he has achieved the perfect inverstion of the golas of cancer medicine: his drug has increased the prevalence of cancer in the world.)

Valter Longo, Ph.D., a cellular biologist at the University of Southern California, found that starving a mouse receiving chemotherapy or other targeted therapies will protect normal cells and organs while making the therapy up to 40 percent more toxic to cancer cells. In human clinical trials, Longo found that periods of no food for two to four days at a time during a six-month period killed older and damaged immune cells and triggered the generation of new healthy ones.

Valter Longo, Ph.D., a cellular biologist at the University of Southern California, found that starving a mouse receiving chemotherapy or other targeted therapies will protect normal cells and organs while making the therapy up to 40 percent more toxic to cancer cells.

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