Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023473 (chronic myeloid leukemia)
 18,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Conventional cytotoxic therapy of hematologic malignancies is often associated with significant morbidity. This morbidity is often due to the lack of specificity for hematopoietic cells. Therefore, the concept of targeted therapy for patients with hematologic malignancies has received attention for many years. The goal of monoclonal antibody therapy is to target specific cell surface antigens on malignant hematopoietic cells, while sparing normal cells and tissues. Currently, monoclonal antibodies are being evaluated for their cytotoxic effects as well as their ability to deliver toxic agents or radiation. Rituximab, a chimeric anti-CD20 antibody, has shown response rates of approximately 50% with minimal toxicity in patients with refractory indolent lymphoma. Campath-1H (anti-CD52) has shown encouraging results in patients previously treated for chronic lymphocytic leukemia, with response rates up to 33%, although with significant toxicity. Anti-CD33 antibodies are being used to deliver cytotoxic agents, such as calicheamicin to patients with acute myeloid leukemia with response rates up to 30%. In addition, anti-CD33 and anti-CD45 antibodies have been used to deliver radiation directly to leukemic cells. (131)I-labeled anti-CD45 antibodies are being studied in combination with conventional preparative regimens in patients receiving bone marrow transplantation. Lastly, the therapeutic agent STI571 (signal transduction inhibitor 571) has demonstrated the capability of targeting specific molecular abnormalities seen in hematologic malignancies. STI571 targets the tyrosine kinase activity of the bcr-abl fusion protein seen in chronic myeloid leukemia. STI571 has induced complete hematologic responses in up to 98% of patients evaluated in clinical trials.
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PMID:Cell surface antigen and molecular targeting in the treatment of hematologic malignancies. 1200 80

The last few years have seen major advances in the management of cancers. Since it is not possible for the non-oncologist to keep abreast with the latest developments in the field of oncology, this review summarises the most significant advances in the area of treatment of various cancers over the past four years. In some areas, a paradigm shift has occurred setting new standards of care, for example, the use of targeted therapy (trastuzumab) in adjuvant treatment of breast cancer; the use of monoclonal antibodies (rituximab), with or without chemotherapy, in the treatment and maintenance of indolent lymphoma; the use of the tyrosine kinase inhibitor, imatinib, in the adjuvant setting in resected gastrointestinal stromal tumours. In other areas, new treatments have emerged, such as, the use of targeted therapies in hepatocellular carcinoma (sorafenib) and renal cell carcinoma (sunitinib, sorafenib, temsirolimus, bevacizumab). In some other cancers, the addition of targeted therapies has improved survival rates, for example, in colon cancer (bevacizumab, cetuximb, panitumumab), head and neck cancers (cetuximab), and pancreatic adenocarcinoma (erlotinib). In yet another group, new targeted therapies have emerged where resistance was previously observed with the existing targeted therapies, for example, breast cancer (lapatinib), chronic myeloid leukemia (dasatinib). Finally, the addition of chemotherapeutic agents has improved survival in some forms of cancer, for example, oxaliplatin in adjuvant treatment of colon cancer, temozolamide in glioblastoma multiforme, and adjuvant chemotherapy in non-small cell lung cancer. The information summarized here may provide useful for the busy physician needing an update in the field of oncology.
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PMID:Major Advances in the Treatment of Cancer: What does a Non-Oncologist need to know? 2174 51