Current Cancer Therapy Reviews - Volume 13, Issue 1, 2017

Background: Over expression of epidermal growth factor receptor (EGFR) has been found to play a vital role in cancer of lung and pancreas. Therapies that target EGFR-mediated signalling are the latest keystone for treating these two types of cancer. Methodology: Erlotinib is an EGFR tyrosine kinase inhibitor, a promising anticancer agent either alone or as combination therapy for the treatment of both lung and pancreatic cancers especially in EGFR mutated patients. It acts by blocking the action of an EGFR, which helps the cancer cells to grow and divide. Erlotinib solubility is pH dependent; which decreases with the increasing pH. It is a quinazolinamine derivative and exists as hydrochloride in the market which on oral administration has absorption of ~ 60% in plasma and also found to achieve appropriate therapeutic concentrations in Cerebrospinal fluid (CSF) required for intracranial responses. With adverse reactions like diarrhea and skin rashes that occur most commonly, erlotinib is usually a welltolerated therapy. It is associated with several kinds of drug interactions, generally associated with smoking, the enzyme inhibiting drugs, enzyme inducing drugs, etc. leading to alteration in the pharmacokinetic profile of erlotinib. Conclusion: In nonclinical toxicology studies, the drug has not shown any results of fertility impairment, carcinogenesis or mutagenesis. Though the EGFR-TKIs have shown great clinical significance, the development of drug resistance has also been reported by the patients. The resistance for EGFR-TKIs can occur through any of the several mechanisms involved like secondary mutation (T790M), ATP binding cassette transporter effusion, alteration of the downstream pathways, etc. This article reviews the safety and efficacy of erlotinib along with chemistry, mechanism, pharmacokinetics, drug interactions and resistance to the drug.

Background: Cancer is one of the most dreadful diseases all over the world that can cause death. Cancer could be treated with different methods such as surgery, chemotherapy or radiotherapy. Methodology: In this review study, various techniques in cancer treatment especially radiotherapy modalities including three dimensional radiation therapy, intensity modulated radiation therapy, image guided radiation therapy, intra operative radiotherapy, stereotactic methods and brachytherapy are reviewed and discussed. Conclusion: Over recent years, radiotherapy techniques have been greatly developed which create various suitable conditions for the treatment of different cancers while sparing normal tissues. As the radiotherapy techniques developed, tumor covering and precision on dose delivery increased.

Background: Multi Drug Resistance (MDR) is one of the main hindrances in the successful treatment of cancer by natural agents. Most of the natural anticancer drugs are effluxed by the P-glycoprotein resulting in the failure of cancer chemotherapy. Phenothiazines and related drugs are one of the first drugs investigated for the reversal of MDR. Exhaustive studies have been done to develop potent phenothiazines analogues for MDR reversal activity. Materials and Methods: Quantitative Structural Activity Relationship (QSAR) and Structural Activity Relationship (SAR) studies of phenothiazines have provided some fruitful results in order to develop potent anti-MDR phenothiazine drugs but no success has been achieved yet. The main mechanism through which phenothiazines act on the Pglycoprotein includes the same binding site of vinblastine drug and it inhibits the efflux of such drugs. To develop a potent anti-MDR agent, it is indispensable to study the mechanism of efflux of anticancer drugs by P-gp, SAR and QSAR studies of phenothiazines as anti-MDR agents and mechanism of phenothiazines as anti-MDR agents simultaneously. Conclusion: This review will discuss the work done on the SAR and QSAR of phenothiazines as anti-MDR agents along with their putative mechanism of action as MDR reversal agents.

Background: Angiogenesis stands as a symbol for the development of tumor as well as its metastasis. In this review, we discuss the various components that induce and enhance angiogenesis along with its several inhibitors in neuroblastoma. Angiogenesis is vital for tumor development and migration and it is dependent on the creation of angiogenic elements by tumor cell lines. Methodology: Neuroblastoma (NB) is a general pediatric tumor which originates from neural crest that is biologically and physiologically diverse. As tumor vascular index increases, it leads to the unfavorable consequence of NB. Tumor vascularity is very much interrelated with an ill consequence of neuroblastoma. Hence, unique drugs which aim at the vascular endothelium are applicants for integration into clinical experimentation. As the quest for new anti-angiogenic compounds goes on, several angiogenic inhibitors get discovered whose progress needs to be scrutinized from time to time. Antiangiogenic activity of a drug gets elevated when used as combination therapy than monotherapy. Vascular targeting is yet another strategy to increase the efficacy of antiangiogenic therapy. In general for children having neuroblastoma, the anti-angiogenic therapy works as a boon when administered along with gene therapy. Results: As a resulting discovery of unique molecular objective, several inhibition mediators are gaining attention of exploration by neuroblastoma researchers. The further discussion proceeds with understanding the process of angiogenesis, its clinical inferences, and future perspectives. Novel and more efficient methodologies are required to diagnose and treat extremely antagonistic neuroblastoma.

Background: Significant shortcomings have been displayed in conventional chemotherapeutics delivery which possesses some genuine side effects including harm of the immunity and different organs with quickly multiplying cells because of nonparticular focus on the absence of dissolvability and powerlessness to enter the tumor core bringing about debilitated treatment with diminished dosage and with low survival rate. Rapid development has adapted nanocarriers as distinct therapeutics which can directly access the tumor cells specifically with expanded medication limitation and cell take-up for cancer treatment. Methodology: This review focuses on core objective of drug targeting to the cancerous cells by demonstrating the advantages of the young medical field, “nanocarriers” including liposomes, polymer based nanoparticles, metal based nanoparticles, dendrimers, protein linked systems, co-polymers and fullerenes, which have been proven remarkably promising in enhancing drug distribution and bioavailability, increasing half life and achieving targeted drug delivery, thus reducing toxicity. Conclusion: Here we provide an update on the recent clinical trials in nanocarrier based therapy of colon rectal cancer, food and drug administration (FDA) approved nanomedicines for cancer and those in nanoplatforms which have reached an advanced stage of clinical development.