Biomedical Engineering Reference
In-Depth Information
23
Anticancer Agents
Fredrik Björkling and Lars H. Jensen
CONTENTS
23.1 The Disease ......................................................................................................................... 375
23.1.1 The Hallmarks of Malignant Cancer..................................................................... 375
23.1.2 Acquired Capabilities of Cancer Cells .................................................................. 378
23.1.3 Enabling Characteristics of Cancer Cells .............................................................. 379
23.1.4 Anticancer Agents.................................................................................................. 380
23.2 Anticancer Agents Currently Used ..................................................................................... 380
23.2.1 Xeloda .................................................................................................................... 381
23.2.2 Alimta .................................................................................................................... 382
23.2.3 Taxol....................................................................................................................... 384
23.2.4 Zolinza ................................................................................................................... 385
23.2.5 Gleevec................................................................................................................... 388
23.2.6 Herceptin................................................................................................................ 390
23.3 Concluding Remarks........................................................................................................... 391
Abbreviations ................................................................................................................................. 391
Further Readings ............................................................................................................................ 392
23.1 THE DISEASE
Cancer is the second most common cause of death in the United States, and the rest of the western
world, exceeded only by heart diseases. Thirty years ago, 50% of the Americans diagnosed with
cancer died due to the disease within 5 years; today's 5-year survival rate is 65%. The FDA has
approved 43 new cancer drugs over the last 10 years, compared with 27 in the previous 10 years.
Table 23.1 gives an overview of some of the anticancer agents approved today indicating their pri-
mary target/mechanism of action and the indications they are used for. Despite this improvement in
anticancer therapy, more and more people are being diagnosed with cancer; the primary reason for
this being the prolongation of mean life span as a result of more effective treatments against deadly
infections and cardiovascular diseases. The need for effective anticancer treatments is therefore still
urgent. In this chapter, we will give an overview of the molecular and cellular alterations associated
with the development of cancer, and the challenges to be overcome for the effective treatment of this
disease. Finally, we will focus on the development and characterization of some anticancer agents
used in today's praxis.
23.1.1 T
HE
H
ALLMARKS
OF
M
ALIGNANT
C
ANCER
Metastatic cancer, responsible for 90% of all human cancer deaths, is characterized by a number of
molecular, cellular, and morphologic characteristics that has been described as the six hallmarks, or
acquired capabilities, of cancer. These hallmarks relate to different levels of dysregulation required
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