New approaches in cancer treatment

Major advances in cellular biology, genetics, pharmacology and immunology i n the past decade are beginning to be translated into progress in cancer tr eatment. This progress is manifested by new cytotoxic drugs which have rece ntly entered clinical practice (taxanes, topoisomerase I inhibitors, gemcit abine, vinorelbine, new purines), as well as the efficacy of monoclonal ant ibody therapies against the CD-20 antigen of B-cell lymphomas and the Her2/ neu oncogene in breast cancer. Several new drugs in development are targete d at reversal or prevention of the multidrug resistance mechanism caused by expression of the MDR1 gene (P-glycoprotein). Tumour angiogenesis as a tar get is being studied in several early clinical trials. As with many other b iological therapies, the evaluation of these compounds and their integratio n with standard therapies presents a major challenge to clinical investigat ors. The emerging field of genomics and gene expression microarrays will pr ovide enormous information about the biology of cancers. This technology of fers great opportunities for the discovery of new therapeutic targets, whic h should provide a basis for the design and evaluation of many new agents i n the coming decade.