Current Cancer Therapy Reviews - Volume 11, Issue 2, 2015

The cancer originated from large bowel represents a widespread cancer along the world and a considerable percentage of new cases are diagnosed with distant disease. Recently, the detection of “clever” medicaments such as focused therapy was the outcome of an improved comprehension of the procedures that transform physiological tissues to tumor. The family of focused medication includes medicaments that specifically affect specific molecular routes implicated in the production of the tumor and its development. The new natural substances aim at inhibiting the procedure of angiogenesis which is fundamental for cancer development and distant metastasis. This process of angiogenesis and tumor development is inhibited by Bevacizumab a humanized recombinant antibody that prevents vascular endothelial growth factor (VEGF) receptor binding. The usage of bevacizumab as primary therapy for patients with metastatic colorectal cancer was approved by FDA (Food and Drug Administration) on February 26, 2004. Incorporating the focused therapies in the management of metastatic colon cancer has led to considerable advance in efficiency results. In this review article, the effectiveness of bevacizumab given as primary therapy in patients with large bowel tumor and distant metastases is analysed.

Hepatocellular carcinoma (HCC) is one of the most malignant human cancers, with a high mortality rate worldwide despite its early diagnosis in patients and improvement in therapeutic technology. Most cases of liver cancer show a strong resistance to anticancer therapy. Moreover, liver cancer patients generally have poor tolerance to chemotherapy due to liver dysfunction. In these situations, liver-targeting drugs with fewer side effects and a high efficacy are urgently needed during drug discovery for liver cancer. Researchers have aimed to derive target genes and drug candidates for HCC; however, the development of targeted drugs has not yet improved the outcome significantly. Recently, the role of the tumor microenvironment (TME) in HCC has been probed to combat this deadly disease. A deeper knowledge of the crosstalk between tumor cells and their TME is needed to fully understand tumor development, progression and chemo-resistance in HCC because this cancer develops from chronically damaged tissue that contains large amounts of inflammation and fibrosis. In this review, we summarize how distinct stromal cells of TME are involved in tumorigenesis and chemoresistance in HCC and the significant challenge to recapitulate tumor complexity and heterogeneity enhancement.

Urinary bladder carcinoma is estimated to be the ninth most common cause of cancer worldwide. The treatment of bladder carcinoma is an area of active research owing to lack of evidence of any treatment modality. Traditionally surgery, cystectomy, was considered the cornerstone of therapy. However, the morbidity of such approach has paved for bladder preservation approach with radiation in combination with chemotherapy. The use of transurethral resection of bladder tumor along with radiation and chemotherapy helps patients to have a functional bladder without compromising survival. Adjuvant radiation is an underutilized treatment modality. In the present era availability of sophisticated radiation technique allows delivery of radiation without increasing toxicity. Hence, adjuvant radiation may be used for patients with R1 resection and lymph node positive disease alone or in combination with chemotherapy. Radiation also appears a valuable treatment option for palliation in bladder tumor. We herein intend to review the present place of radiation in the management of transitional cell carcinoma of urinary bladder.

Although new passive and active immunotherapy methods are emerging, unconjugated monoclonal antibodies remain the only kind of biological preparations approved for high-grade glioma therapy in clinical practice. In this review, we combine clinical and experimental data discussion. As antiangiogenic therapy is the standard of care for recurrent glioblastoma multiforme (GBM), we analyze major clinical trials and possible therapeutic combinations of bevacizumab, the most common monoclonal antibody to vascular endothelial growth factor (VEGF). Another humanized antibody to gain recognition in GBM is epidermal growth factor (EGFR) antagonist nimotuzumab. Other antigens (VEGF receptor, platelet-derived growth factor receptor, hepatocyte growth factor and c-Met system) showed significance in gliomas and were used to create monoclonal antibodies applied in different malignant tumors. We assess the role of genetic markers (isocitrate dehydrogenase, O6-methylguanine-DNA methyltransnsferase) in GBM treatment outcome prediction. Besides antibodies studied in clinical trials, we focus on perspective targets and briefly list other means of passive immunotherapy.

Actinic keratoses (AKs) are common premalignant skin lesions. These are epidermal neoplasms of altered keratinocytes. Development of Actinic keratosis is correlated with chronic exposure of UVB sun radiation resulting in formation of cyclobutane pyrimidine dimmers (CPDs). During UV exposure, expression of tumor suppressor gene p53 is enhanced, which protects and repairs damaged DNA, failing which, cell leads to apoptosis. An irreversible damage to p53 gene results in failure of apoptosis and DNA repair resulting in expansion of cells into neoplasm. Risk of progression of these actinic keratosis lesions to squamous cell carcinoma makes it necessary to treat them aggressively. Various modalities like, lesion directed therapy (cryosurgery, curettage and electrodessication) and field directed therapy (5-fluorouracil, diclofenac, imiquimod, photodynamic therapy etc) exists for its treatment. US Food and Drug Administration has approved 5 medications for AK treatment which are topical 5-Fluorouracil, imiquimod cream, diclofenac gel, ingenol mebutate gel and photodynamic therapy. To enhance the outcome of available treatment strategies, their combination are gaining popularity and interests of dermatologists because of their efficacy and tolerability. Fluorouracil and salicylic acid Actikerall® combination is such an example which has received marketing approval from Medicines and Healthcare Products Regulatory Agency in UK for AK treatment. This combination therapy approach is supposed to be another step towards the ultimate goal of enhancing the effectiveness of skin cancer treatments and reducing the number of surgical excisions performed on the millions of people with these precancerous skin lesions.