Oral mucositis in cancer therapy
Oral mucositis induced by radiation therapy and chemotherapy is a frequently occurring toxicity in patients with cancer. Severe mucositis has a major impact on patient daily functioning,well-being, and quality of life. It can also compromise a patient’s ability to tolerate planned therapy, resulting in missed doses or dose reductions. Mucositis negatively affects other health outcomes as well, increasing the risk of opportunistic infections and mortality due to sepsis. It also imposes a significant economic burden, since extended hospitalization and greater analgesic use can substantially increase treatment costs. A five-phase model of the pathobiology of mucositis has been proposed that facilitates our understanding of mucositis pathogenesis and the complex interactions that occur in response to tissue insult. Application of this evolving model has aided in the development of mechanistically based therapies for the prevention and treatment of mucositis. Continued research is needed to optimize when these treatments should be administered during the course of cancer therapy to maximize therapeutic benefit. [1]
The experimental development of bioreductive drugs and their role in cancer therapy
Bioreductive drugs undergo metabolic reduction to generate cytotoxic metabolites. This process is facilitated by bioreductive enzymes and the lower oxygen conditions present in solid tumours compared to normal tissues. Because of this specificity, bioreductive drugs have enormous potential to contribute to modern cancer therapy. Examples undergoing clinical trials includeN-oxides such as tirapazamine, aziridinylnitroimidazoles RSU 1069/RBU 6145 and quinones such as indoloquinone EO9. Other novel structures are also under study. Here we review the experimental development of bioreductive drugs and their role in cancer therapy. [2]
The potential of proteasome inhibitors in cancer therapy
Background: The ubiquitin-proteasome system has become a promising novel molecular target in cancer due to its critical role in cellular protein degradation, its interaction with cell cycle and apoptosis regulation and its unique mechanism of action. Objective: This review focuses both on preclinical results and on data from clinical trials with proteasome inhibitors in cancer. Methods: Results in hematological malignancies and solid tumors were included, and important data presented in abstract form were considered in this review. Results/conclusion: Bortezomib as first-in-class proteasome inhibitor has proven to be highly effective in some hematological malignancies, overcomes conventional chemoresistance, directly induces cell cycle arrest and apoptosis, and also targets the tumor microenvironment. It has been granted approval by the FDA for relapsed multiple myeloma, and recently for relapsed mantle cell lymphoma. Combination chemotherapy regimens have been developed providing high remission rates and remission quality in frontline treatment or in the relapsed setting in multiple myeloma. The combination of proteasome inhibition with novel targeted therapies is an emerging field in oncology. Moreover, novel proteasome inhibitors, such as NPI-0052 and carfilzomib, have been developed. This review summarizes our knowledge of the ubiquitin-proteasome system and recent data from cancer clinical trials. [3]
Cancer Therapy by Nutritional Restrictions: Current Knowledge and Future Guidelines
Cancer therapy has been a major scientific and medical focus for decades, treatment of which has proven to be a challenging task, especially in the light of its escalating incidence all over the globe. The material and moral costs of understanding the nature of the disease and finding successful ways of treatment have been extremely high. One major experimental addition to the methods of dealing with the various types of cancer has been the use of starvation protocols that may halt or delay the progression of malignant cells. In this review, a comprehensive and a pioneering account of the literature on starvation therapy is being demonstrated with an emphasis on the experimental and clinical evidence that exist, in addition to the molecular mechanisms and cellular alterations that accompany the starvation. The major objectives were to open ways for further research into understanding the topic and developing suitable and effective methods based on nutritional manipulations, for combating malignancies. The starvation includes precursors of growth such as energy precursors and others such as amino acids, nucleic acids, in addition to environmental manipulations such as abnormal oxygenation. Additional emphasis has highlighted the synergistic effects of combining conventional chemotherapy and radiotherapy with various modes of the artificial starvation. Methods of manipulating nutritional precursors have also been compiled. Additionally, negative effects of starvation were also briefly explained in an attempt to comprehend future guidelines for antagonizing such negative effects. [4]
Novel Therapy for Oral Cancer – Gene Therapy an Update
Gene therapy provides modern medicine with new perspectives and had great potential as a novel therapeutic modality. Progress in molecular biology, especially molecular medicine is now changing the basics of genetic disease. This technology takes advantage of our understanding of cancer at the molecular level. It has been exploited to develop new strategies for killing cells selectively or arresting their growth. This is new technique, being developed which offers incredible pledge for the upcoming therapeutic modality in oral cancer treatment. The aim of this paper is to review delivery routes, vector design, therapeutic applications and possible obstacles faced by gene therapist. [5]
Reference
[1] Sonis, S.T., 2004. Oral mucositis in cancer therapy. The journal of supportive oncology, 2(6 Suppl 3), pp.3-8.
[2] Workman, P. and Stratford, I.J., 1993. The experimental development of bioreductive drugs and their role in cancer therapy. Cancer and Metastasis Reviews, 12(2), pp.73-82.
[3] Sterz, J., Metzler, I.V., Hahne, J.C., Lamottke, B., Rademacher, J., Heider, U., Terpos, E. and Sezer, O., 2008. The potential of proteasome inhibitors in cancer therapy. Expert opinion on investigational drugs, 17(6), pp.879-895.
[4] Al Joudi, F. (2015) “Cancer Therapy by Nutritional Restrictions: Current Knowledge and Future Guidelines”, Journal of Advances in Medicine and Medical Research, 11(9), pp. 1-19. doi: 10.9734/BJMMR/2016/21795.
[5] Kumar, N. A., Agrawal, A. and Sreedevi, R. (2015) “Novel Therapy for Oral Cancer – Gene Therapy an Update”, Journal of Advances in Medicine and Medical Research, 9(3), pp. 1-8. doi: 10.9734/BJMMR/2015/15317.
