Drug therapy

Phernand Donis

March 12, 2014


Drug Therapy

      Cancer is a major health care challenge for the aging

population of the Western world. About 2.4 million new cases

were diagnosed within a population of about 470 million in the

European Union in 2006 and about 1.2 million cancer deaths

occurred [1]. In men, prostate cancer was the most common

with 301,500 new cases followed by lung cancer with

194,400 and colorectal cancer with 163,100. In women,

breast cancer was by far the most common with 319,900 new

cases followed by colorectal cancer with 134,100 cases. The

overall cancer survival rate in the Western world has slowly

increased over recent decades. For patients diagnosed from

1995 to 1999 in 23 European countries, the 5-year survival

was 44.8% for men and 54.6% for women with large

variations across diagnoses and countries [2]. The improved

survival is not only due to improved treatment but also to the

introduction of screening programs for early detection such as

cervical smears and mammography in women and also by

intensified cancer prevention, e.g., anti-smoking programs.

Conventional cytotoxic drugs

      From the introduction of nitrogen mustard during World War

II, which evolved from research in military laboratories on war

gases, about 60 cytotoxic drugs have been approved for

clinical use. Most of them are now off-patent, and interest has

shifted dramatically to more target-specific drugs, especially

monoclonal antibodies and orally delivered small-molecule

tyrosine kinase inhibitors. Many of the old cytotoxic drugs

were the result of serendipitous discoveries.

      The anthracyclines, being natural

products, are effective against more cancer types than any

other class of chemotherapy agents [8]. Daunorubicin,

produced naturally by Streptomyces peucetius was the first

anthracycline in clinical use and after 40 years is still widely

used in the treatment of acute myelogenous leukemia.

Drugs Examples 

Tyrosine kinase inhibitors and the indication for which they

were first approved

Axitinib- In clinical development (Pfizer)

Crizotinib - In clinical development (Pfizer)

Dasatinib- Philadelphia chromosome positive chronic

myelocytic -leukemia

Erlotinib - Lung cancer

Gefitinib - Lung cancer

Lapatinib- Breast cancer

Neratinib -In clinical development (Pfizer)

Nilotinib -Philadelphia chromosome positive chronic

Pazopani-  Renal cancer

Sorafenib - Renal cancer

Sunitinib - Renal cancer

Adjuvant Chemotherapy 

      The concept of  adjuvant chemotherapy is  after  initial surgery eliminating all detectable tumors. In cancer chemotherapy, it is important to select the best treatment from the very beginning since tumor progression and development of resistance makes it harder to achieve a good results.

References: 

        Curt Peterson

        Curt,P. (13 October 2010). 

Introduction. Drug therapy of cance, 1 (1), 437