Exploiting Cancer's Tactics to Make Cancer a Manageable Chronic Disease

被引:8
作者
Afrasiabi, Kambiz [1 ]
Linskey, Mark E. [1 ]
Zhou, Yi-Hong [1 ]
机构
[1] Univ Calif Irvine, Dept Neurol Surg, Brain Tumor Res Lab, Irvine, CA 92617 USA
关键词
evolution of cancer therapy; surgical advances in gliomas; cancer stem cell; cancer metabolism; chromosomal instability; intra-tumoral heterogeneity; dominant cancer evolution strategies; future cancer therapeutics; CHROMOSOME MIS-SEGREGATION; STEM-CELLS; 5-AMINOLEVULINIC ACID; CLINICAL-IMPLICATIONS; VASCULOGENIC MIMICRY; SIGNALING PATHWAYS; TUMOR ANGIOGENESIS; CURRENT CHALLENGES; NITROGEN-MUSTARD; POOR-PROGNOSIS;
D O I
10.3390/cancers12061649
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The history of modern oncology started around eighty years ago with the introduction of cytotoxic agents such as nitrogen mustard into the clinic, followed by multi-agent chemotherapy protocols. Early success in radiation therapy in Hodgkin lymphoma gave birth to the introduction of radiation therapy into different cancer treatment protocols. Along with better understanding of cancer biology, we developed drugs targeting cancer-related cellular and genetic aberrancies. Discovery of the crucial role of vasculature in maintenance, survival, and growth of a tumor opened the way to the development of anti-angiogenic agents. A better understanding of T-cell regulatory pathways advanced immunotherapy. Awareness of stem-like cancer cells and their role in cancer metastasis and local recurrence led to the development of drugs targeting them. At the same time, sequential and rapidly accelerating advances in imaging and surgical technology have markedly increased our ability to safely remove >= 90% of tumor cells. While we have advanced our ability to kill cells from multiple directions, we have still failed to stop most types of cancer from recurring. Here we analyze the tactics employed in cancer evolution; namely, chromosomal instability (CIN), intra-tumoral heterogeneity (ITH), and cancer-specific metabolism. These tactics govern the resistance to current cancer therapeutics. It is time to focus on maximally delaying the time to recurrence, with drugs that target these fundamental tactics of cancer evolution. Understanding the control of CIN and the optimal state of ITH as the most important tactics in cancer evolution could facilitate the development of improved cancer therapeutic strategies designed to transform cancer into a manageable chronic disease.
引用
收藏
页码:1 / 18
页数:18
相关论文
共 167 条
[1]  
Afrasiabi K., 2018, FUNDAMENTALS LIVING
[2]   Immune checkpoint inhibitors of PD-L1 as cancer therapeutics [J].
Akinleye, Akintunde ;
Rasool, Zoaib .
JOURNAL OF HEMATOLOGY & ONCOLOGY, 2019, 12 (01)
[3]   AML with gain of chromosome 8 as the sole chromosomal abnormality (+8sole) is associated with a specific molecular mutation pattern including ASXL1 mutations in 46.8% of the patients [J].
Alpermann, Tamara ;
Haferlach, Claudia ;
Eder, Christiane ;
Nadarajah, Niroshan ;
Meggendorfer, Manja ;
Kern, Wolfgang ;
Haferlach, Torsten ;
Schnittger, Susanne .
LEUKEMIA RESEARCH, 2015, 39 (03) :265-272
[4]  
Arbab Ali S, 2015, Biochem Physiol, V4
[5]   Recent Progress in Gene Therapy for Ovarian Cancer [J].
Ayen, Angela ;
Jimenez Martinez, Yaiza ;
Marchal, Juan A. ;
Boulaiz, Houria .
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 2018, 19 (07)
[6]   The Multifaceted Role of Chromosomal Instability in Cancer and Its Microenvironment [J].
Bakhoum, Samuel F. ;
Cantley, Lewis C. .
CELL, 2018, 174 (06) :1347-1360
[7]   Numerical chromosomal instability mediates susceptibility to radiation treatment [J].
Bakhoum, Samuel F. ;
Kabeche, Lilian ;
Wood, Matthew D. ;
Laucius, Christopher D. ;
Qu, Dian ;
Laughney, Ashley M. ;
Reynolds, Gloria E. ;
Louie, Raymond J. ;
Phillips, Joanna ;
Chan, Denise A. ;
Zaki, Bassem I. ;
Murnane, John P. ;
Petritsch, Claudia ;
Compton, Duane A. .
NATURE COMMUNICATIONS, 2015, 6
[8]   Chromosomal Instability Substantiates Poor Prognosis in Patients with Diffuse Large B-cell Lymphoma [J].
Bakhoum, Samuel F. ;
Danilova, Olga V. ;
Kaur, Prabhjot ;
Levy, Norman B. ;
Compton, Duane A. .
CLINICAL CANCER RESEARCH, 2011, 17 (24) :7704-7711
[9]  
Baudino Troy A, 2015, Curr Drug Discov Technol, V12, P3
[10]   C2c: turning cancer into chronic disease [J].
Beck, Stephan ;
Ng, Tony .
GENOME MEDICINE, 2014, 6