Clinical Application of New Anticancer Agents

Abstract

Recent advance in the development of several novel anticancer agents has led to

significant improvement of outcome of cancer treatment. Major achievements in the field of

target therapy have been focusing on identification of newer generation of anti-growth factor

receptor. Combinatorial therapy with specific monoclonal antibodies like trastuzumab and

pertuzumab to target parallel growth factor signaling pathways may lead to improvement of

outcome of breast cancer treatment. In addition, a novel toxin conjugated trastuzumab has

been shown to possibly break the resistant barrier of HER2 positive advanced breast cancer.

Second generation tyrosine kinase inhibitors (TKI) targeting EGFR mutation, for example

BIBW2992 and HKI272, have been studied to overcome the secondary resistance occurred

following previous exposure to TKI. Several of these agents have now entered into phase III

studies in lung cancer. Other non-TKI targeted agents are currently under intensive studies in

several indications. Key targeted non-growth factor receptor pathways involve mTOR

survival pathway, protein degradation apparatus, and DNA repair mechanism. Everolimus, a

mTOR inhibitor is now a proven second line agent following failure to first line multi-target

TKI like sunitinib or sorafenib in renal cell carcinoma. Moreover PARP inhibitors have

preliminary shown to be effective in the so called triple negative breast cancer which has no a

current specific agent of choice. All of these examples strongly illustrate a new era of

fighting against cancer.