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Experimental chemotherapy continues to be at the forefront of cancer thera peutics. Topics covered in the preceding volume on cancer chemotherapy in this series such as study of drugs by alkaline elution, the development of the antimetabolite tiazofurin, and the treatment of germ cell tumors have become informative references to current experimentalists and practitioners. In even earlier volumes, reviews of the platinum compounds, anthracyclines, and osteosarcoma represent topics associated with such rapid progress requiring a look back to provide the appropriate perspective. Similarly, we venture to predict that the topics in this volume will become useful landmarks for future drug development and disease strategies. In the area of drug development, what is being learned about old, estab lished antineoplastics is raising renewed expectations that it will be translated into improved applications and patient benefit. For example, we now have the ability to modulate the action of alkylating agents and fluorinated pyri midines to achieve greater sensitivity. A new compound for an old target, trimetrexate, an antifolate that does not polyglutaminate, will have a role not only in treatment of neoplastic diseases, but also protozoal infection.
Where do you begin to look for a recent, authoritative article on the diagnosis or management of a particular malignancy? The few general oncology textbooks are generally out of date. Single papers in specialized journals are informative but seldom comprehensive; these are more often preliminary reports on a very limited number of patients. Certain general journals frequently publish good indepth reviews of cancer topics, and published symposium lectures are often the best overviews available. Unfor tunately, these reviews and supplements appear sporadically, and the reader can never be sure when a topic of special interest will be covered. Cancer Treatment and Research is a series of authoritative volumes which aim to meet this need. It is an attempt to establish a critical mass of oncology literature covering virtually all oncology topics, revised frequently to keep the coverage up to date, easily available on a single library shelf or by a single personal subscription. We have approached the problem in the following fashion. First, by dividing the oncology literature into specific subdivisions such as lung can cer, genitourinary cancer, pediatric oncology, etc. Second, by asking emi nent authorities in each of these areas to edit a volume on the specific topic on an annual or biannual basis. Each topic and tumor type is covered in a volume appearing frequently and predictably, discussing current diagnosis, staging, markers, all forms of treatment modalities, basic biology, and more.
As in CANCER CHEMOTHERAPY 1, this volume brings to the reader highlights in three different areas of cancer therapeutics: new concepts and models; drug classes; and clinical settings. Topics were chosen because of their timeliness or probable current impact in cancer treatment. Authors were selected on the basis of their ability to provide a critical overview of specific subjects and their involvement in original work. I shall review the aims of this second volume, and then elaborate on the scope of its con tents. The principal aim of the volumes on cancer chemotherapy in the' Cancer Treatment and Research' series, as stated in the preface to the first volume, is to assemble in a concentrated form selected ingredients of chemothera peutic progress. These ingredients are to include concepts in therapeutic strategy, pre-clinical studies, development of major classes of compounds, identificatlon of new directions and of landmarks of clinical progress. Thus we do not foresee overlap with series which provide an yearly update of chemotherapy in an encyclopedic manner, or reviews of cancer chemother apy. Unlike those publications, our volumes are not intended to seek a place in shelves as a reference manual. It is this Editor's hope that persons repre senting various biomedical disciplines will seek the' Cancer Treatment and Research' chemotherapy volumes to survey advances in the field at regular intervals.
The complexity of cancer demands an integrated approach from both a cancer biology standpoint and a pharmaceutical basis to understand the different anticancer modalities. Current research has been focused on conventional and newer anticancer modalities, recent discoveries in cancer research, and also the advancements in cancer treatment. There is a current need for more research on the advances in cancer therapeutics that bridge the gap between basic research (pharmaceutical drug development processes, regulatory issues, and translational experimentation) and clinical application. Recent promising discoveries such as immunotherapies, promising therapies undergoing clinical trials, synthetic lethality, carbon beam radiation, and other exciting targeted therapies are being studied to improve and advance the studies of modern cancer treatment. The Handbook of Research on Advancements in Cancer Therapeutics serves as a comprehensive guide in modern cancer treatment by combining and merging the knowledge from both cancer biology and the pharmacology of anticancer modalities. The chapters come from multi-disciplinary backgrounds, including scientists and clinicians from both academia and various industries, to discuss nascent personalized therapies and big data-driven cancer treatment. While highlighting topic areas that include cancer prevention, cancer therapeutics, and cancer treatments through the lenses of technology, medicine/drugs, and alternate therapies, this book is ideally intended for oncologists, radiation oncologists, surgical oncologists, and cancer biologists, along with practitioners, stakeholders, researchers, academicians, and students who are interested in understanding the most fundamental aspects of cancer and the available therapeutic opportunities.
Concepts, Mechanisms, and New Targets for Chemotherapy describes new interconnections between rationally designed and empirically discovered compounds. One route that has not been travelled previously is that of protein kinase C inhibition. This pathway may be exploited to give potent inhibitors, such as the bryostatins, now in clinical trial. A summary is given of the current status of topoisomerase, focusing on recent clinical advances with camptothecin analogs based on connecting empiricism with concepts of drug selectivity. Modification of existing therapies based on the pursuit of leads arising from mechanistic studies is also being applied clinically on a wide scale. Greater understanding should follow from the studies of reversal of the multidrug resistant phenotype, on the use of hydroxyurea to reverse resistance mediated by extrachromosomal DNA, and on various aspects of the fluoropyrimidine pathways. Successful applications of chemotherapy to the treatment of specific diseases include the growing applications of systemic therapy using various skin malignancies. In prostate cancer, estramustine phosphate will likely play an expanding role. Taxanes are restructuring treatment regimens in breast cancer, and high-dose strategies are described with peripheral blood progenitor autografting in the treatment of ovarian and breast cancers.
An ideal health care system relies on efficiently generating timely, accurate evidence to deliver on its promise of diminishing the divide between clinical practice and research. There are growing indications, however, that the current health care system and the clinical research that guides medical decisions in the United States falls far short of this vision. The process of generating medical evidence through clinical trials in the United States is expensive and lengthy, includes a number of regulatory hurdles, and is based on a limited infrastructure. The link between clinical research and medical progress is also frequently misunderstood or unsupported by both patients and providers. The focus of clinical research changes as diseases emerge and new treatments create cures for old conditions. As diseases evolve, the ultimate goal remains to speed new and improved medical treatments to patients throughout the world. To keep pace with rapidly changing health care demands, clinical research resources need to be organized and on hand to address the numerous health care questions that continually emerge. Improving the overall capacity of the clinical research enterprise will depend on ensuring that there is an adequate infrastructure in place to support the investigators who conduct research, the patients with real diseases who volunteer to participate in experimental research, and the institutions that organize and carry out the trials. To address these issues and better understand the current state of clinical research in the United States, the Institute of Medicine's (IOM) Forum on Drug Discovery, Development, and Translation held a 2-day workshop entitled Transforming Clinical Research in the United States. The workshop, summarized in this volume, laid the foundation for a broader initiative of the Forum addressing different aspects of clinical research. Future Forum plans include further examining regulatory, administrative, and structural barriers to the effective conduct of clinical research; developing a vision for a stable, continuously funded clinical research infrastructure in the United States; and considering strategies and collaborative activities to facilitate more robust public engagement in the clinical research enterprise.
Provides a clear and accessible summary of all stages and aspects of the discovery, design, development, validation and clinical use of anticancer drugs This new edition provides an update on the current state of the art of cancer chemotherapy and clinical practice and presents new pipeline anticancer agents and promising therapeutic strategies that are emerging alongside new breakthroughs in cancer biology. Its unique approach enables students to gain an understanding of the pathological, physiological, and molecular processes governing malignancy, while also introducing the role of health professionals and scientists in the research and treatment of cancer. Invaluable for its clarity and accessibility, Cancer Chemotherapy: Basic Science to the Clinic, 2nd Edition offers complete coverage of the scientific and clinical aspects of the creation, development, and administration of drugs or drug regimens used in the treatment of the disease. Chapters look at: cancer epidemiology and histopathology; carcinogenesis; current research; tumor hypoxia; antiangiogenic and antivascular agents; protein kinase and Ras blockers; new targets associated with development such as Hedgehog and Wnt signaling; stem cells; immunotherapy and oncolytic viruses; and more. Presents a clear, accessible, and comprehensive approach to cancer chemotherapy from basic science to clinical practice Offers a major update that reflects the latest developments in personalized chemotherapy Provides in-depth coverage of advances in biomarker diagnostics Includes new chapters/sections on bioinformatics and the ‘omic sciences’; pharmaceutical strategies used to achieve tumor-selective drug delivery; and cancer cell autophagy Combines descriptions of both clinical protocol and explanations of the drug design process in one self-contained book Features numerous diagrams and illustrations to enhance reader understanding Aimed at upper undergraduate, graduate, and medical students, Cancer Chemotherapy: Basic Science to the Clinic, 2nd Edition is also an excellent reference for health professional, especially clinicians specializing in Clinical Oncology, and their patients who want to gain an understanding of cancer and available treatment options.
This is the third volume of our series Progress in Anti-Cancer Chemo therapy. Following the strategy of the first two volumes, it covers selected aspects of progress in this fast moving field of Oncology, with contribu tions from some of the world's best known leaders in both basic and clin ical research. This year we focused on seven areas: Three prominent Clinical investigators reviewed conceptual advances in cancer research. Dr Buzdar presented a history and overview of the protection of human subjects who participate in clinical research, and the mechanisms developed to assure the ethical conduct of research on human beings. Frei reviewed an exciting and rapidly moving area of che motherapy of solid tumors, including a cogent discussion of the issues related to dose-intensification. Fisher summarized conceptual advances in our therapeutic approach to breast cancer and the paradigm shifts that lead us to our current management strategies. From this summary he pro jected breast cancer research into the future, a daunting task under any circumstance. Fundamental research in cancer biology has been responsible for our improved understanding of the development and progession of malignant disease. Such understanding will lead to improved diagnosis, therapy, and eventually, prevention. Isaacs reviews the area of hereditary breast cancer, a topic undergoing rapid transformation and with mUltiple impli cations in the daily practice of medicine. Fidler, an international expert in metastasis research reviews the potential utility of angiogenesis inhib itors in research and the therapeutic ramifications.
Americans praise medical technology for saving lives and improving health. Yet, new technology is often cited as a key factor in skyrocketing medical costs. This volume, second in the Medical Innovation at the Crossroads series, examines how economic incentives for innovation are changing and what that means for the future of health care. Up-to-date with a wide variety of examples and case studies, this book explores how payment, patent, and regulatory policiesâ€"as well as the involvement of numerous government agenciesâ€"affect the introduction and use of new pharmaceuticals, medical devices, and surgical procedures. The volume also includes detailed comparisons of policies and patterns of technological innovation in Western Europe and Japan. This fact-filled and practical book will be of interest to economists, policymakers, health administrators, health care practitioners, and the concerned public.
The National Cancer Institute's (NCI) Clinical Trials Cooperative Group Program has played a key role in developing new and improved cancer therapies. However, the program is falling short of its potential, and the IOM recommends changes that aim to transform the Cooperative Group Program into a dynamic system that efficiently responds to emerging scientific knowledge; involves broad cooperation of stakeholders; and leverages evolving technologies to provide high-quality, practice-changing research.