INNOVAZIONI TERAPEUTICHE IN ONCOLOGIA MEDICA CAGLIARI 23-24 GIUGNO 2005

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INNOVAZIONI TERAPEUTICHE IN ONCOLOGIA MEDICA CAGLIARI 23-24 GIUGNO 2005. LE TERAPIE A TARGET MOLECOLARE: UNA EVOLUZIONE EPOCALE DELLA TERAPIA ANTINEOPLASTICA. GIOVANNI MANTOVANI CATTEDRA DI ONCOLOGIA MEDICA UNIVERSITA’ DEGLI STUDI DI CAGLIARI.
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INNOVAZIONI TERAPEUTICHE IN ONCOLOGIA MEDICA CAGLIARI 23-24 GIUGNO 2005 LE TERAPIE A TARGET MOLECOLARE: UNA EVOLUZIONE EPOCALE DELLA TERAPIA ANTINEOPLASTICA GIOVANNI MANTOVANI CATTEDRA DI ONCOLOGIA MEDICA UNIVERSITA’ DEGLI STUDI DI CAGLIARI THE MOLECULARLY TARGETED ANTICANCER TREATMENT
  • The so-called molecularly targeted anticancer treatment is based on compounds that interefere with cell targets directly connected with pathogenetic events. Such therapies are expected to target specifically tumor cells, thus allowing for strong anticancer effects and minimal toxicities
  • The possible targets are represented by:
  • the interaction between the ligand (growth factor) and its specific receptor with the consequent activation of a cascade of biochemical events leading to the transduction of the cell proliferating signal from the membrane surface to the nucleus;
  • the cell cycle checkpoint, acting by a negative counterregulation
  • the apoptosis, by using proapoptotic molecules
  • (neo)angiogenesisthrough angiogenesis inhibitors
  • the immune compartment of the host, by modulating his immune response
  • EGFR INHIBITION (Harari PM, Huang SM. Clin Can Res 10:428, 2004) * *HRPC: hormone-refractory prostate cancer (TK INHIB)
  • Erlotinib (Tarceva) EGGR (TK INHIB)
  • MAIN CURRENT CLINICAL APPLICATIONS 2005
  • GEFITINIB
  • MONOTHERAPY (3rd LINE IN NSCLC)
  • ISEL study in adjuvant setting: negative
  • Colorectal cancer, breast cancer, brain tumor
  • ERLOTINIB
  • MONOTHERAPY IN RECURRENT NSCLC after failure of at least one prior chemotherapy regimen (NCIC CTG study)
  • BR.21: a randomised phase III trial of Tarceva following chemotherapy in advanced NSCLC
  • MONOTHERAPY IN BAC (Yoshimura A, Gan To Kagaku Ryoho. 2004 Mar;31(3):318-21.)
  • IN COMBINATION WITH CHEMOTHERAPY IN ADVANCED PANCREATIC CANCER (Moore MJ, NCI-CTG – Study PA.3, ASCO 2005)
  • MAIN CURRENT CLINICAL APPLICATIONS 2005
  • ERLOTINIB + BEVACIZUMAB in advanced refractory NSCLC
  • ERLOTINIB + BEVACIZUMAB in metastatic breast cancer (phase II study)
  • ERLOTINIB + BEVACIZUMAB in metastatic RCC
  • ERLOTINIB combined with CISPLATIN and GEMCITABINE in advanced NSCLC (TALENT STUDY: negative)
  • ERLOTINIB combined with CARBOPLATINand PACLITAXEL in advanced NSCLC (TRIBUTE STUDY: negative)
  • MAIN CURRENT CLINICAL APPLICATIONS 2005 CETUXIMAB
  • CETUXIMAB + HIGH DOSE RADIATION IN ADVANCED HEAD AND NECK SCC
  • CETUXIMAB +/- IRINOTECAN IN METASTATIC REFRACTORY CRC (BOND I TRIAL)
  • FOLFOX/FOLFIRI +/- CETUXIMAB FIRST LINE IN METASTATIC CRC (CALGB TRIAL)
  • MAIN CURRENT CLINICAL APPLICATIONS 2005 BEVACIZUMAB PHASE III TRIALS
  • Bolus IFL +/- BEVACIZUMAB FIRST LINE IN METASTATIC CRC (Hurwitz, NEJM 2004)
  • BEVACIZUMAB +/- FOLFOX4 vs FOLFOX4 SECOND LINE IN METASTATIC CRC (E3200)
  • PACLITAXEL + CARBOPLATIN +/- BEVACIZUMAB IN ADVANCED NON SQUAMOUS NSCLC (E4599)
  • CAPEOX/FOLFOX +/- BEVACIZUMAB FIRST LINE IN METASTATIC CRC (SWOG 0303)
  • BEVACIZUMAB + CETUXIMAB +/- IRINOTECAN THIRD LINE IN METASTATIC CRC (BOND II TRIAL)
  • BEVACIZUMABIN RCC
  • * *HRPC: hormone-refractory prostate cancer Thank you for your attentionand interest!
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