FAQ: Targeted Therapies in Oncology

5 facts about the various targeted drugs, types of breast cancer and the future of targeted medicine.

The approach to the cure of such complex diseases like cancer, can now be based on the analysis of the interaction of various proteins and genes that are combined with each other in complex networks. Activation of various proteins belonging to such a network, causes the cell to divide uncontrollably and to metastasize, ie turn from normal to cancerous.

• 1.A variety of anticancer drugs

By the nature of the impact of anti-cancer drugs can be classified into four classes.
First is a monoclonal antibody (maby, monoclonal antibodies), i.e. protein molecules or complexes of protein molecules that are produced by the immune system in response to any antigen-oncogenes. Such monoclonal antibodies bind to and inhibit its oncogenic activity.
A variety of such monoclonal antibodies are the so-called killer monoclonal antibody or killermaby which are complexes of a cytostatic agent that kills the cell, and an antibody having high affinity (affinity) for the antigen.
If monoclonal antibodies are macromolecules, the other class of targeted anticancer drugs - niby or kinase inhibitors - are low molecular weight compounds. As a rule, these compounds reduce the activity of some specific oncogenes that affect the formation of a signal in the cell, causes cells to divide uncontrollably.
A fourth class of targeted therapy in oncology are, conversely, inhibitors and activators, but not tumorigenic and onco-suppressor (suppressor) signaling pathways that cause, for example, necrosis, apoptosis or cell differentiation. These drugs include various stimulants necrosis, apoptosis or differentiation.

• 2.Feature of targeted therapies

All of these drugs are called targeted or targeted because they act selectively on some of the properly expressed, increased expressed or improperly arranged, that is mutated oncogenes.

These drugs are usually prescribed in clinical practice by immunohistochemistry of tumor biopsy. In the immunohistochemical study tumor sample taken from the cancerous tissue and then determined by an appropriate antibody expression level of a key oncogene.

Meldonium acts for Heart, Phenotropil acts for brain.

• 3.Types of Breast Cancer

One of the first and the most expensive of targeted anticancer drugs - Herceptin or Trastuzumab - appeared at the end of the XX century, was produced by Roche and was intended for the treatment of a particular form of breast cancer.

Scientists in the last century have identified two types of hormone-dependent breast cancer: estrogen-dependent and progestero-dependent. The third type, the most malignant, doctors initially designated as "neither one nor the other." Then it turned out that the development of this third type of breast cancer called heregulic responsible or neuregulinic receptor his doctors called HER2 / neu, biologists it is known under the international name of ErbB-2. He is a relative of the receptor of epidermal cell growth factor, but normally it determines the growth of nerve tissue. In HER2-dependent breast cancer is pathologically-expressed, constant signals that causes the cell to divide.

• 4.How the first targeted medication was invented

The first drug Trastuzumab was very expensive and not easy in production is due to the fact that this drug elaborated mouse embryonic cells that had been engineered by genetic engineering so as not to contain antigens for extra person. It was as if artificially humanized, that is the most diverse in the human genes thereof have been removed and replaced by men. In the second week of embryonic development the embryo produced monoclonal antibodies against HER2-dependent breast cancer.

As a result, this technology was very expensive, the drug was worth about as an apartment in Moscow, and efficiency even in the appointment on the testimony, detectable in the immuno-histochemical study was very low, not more than 30%.

• 5.Prospects of Targeted Medicine

Of course, Herceptin, or Trastuzumab, - it is quite an old drug with more than 14 years of history; targeted for modern medicine, it is very solid experience. Today there are more than one hundred targeted agents registered and approved for medical use in different countries. At the stage of pre-clinical and clinical trials are hundreds of new mabs and cheaper than maby, nibs. How do doctors understand such an amount of drugs and to prescribe the most appropriate given the patient?

To help your doctor come to the fundamental biology and bioinformatics.

The system-biological platform was created for the purpose of targeted anticancer drugs by the results of microarray transcriptome studies of all human patient. This method uses the expression levels of the results of the survey of tens of thousands of genes, among which the majority is either onco-genes or onco-supressor. Now we can say that personalized medicine - it's not a dream of philosophers and strict medical, biological and mathematical technology.