Apoptosis: Future directions in cancer therapy

Cancer as a multifactorial disease results in gain of immortality due to de fective apoptosis, The primary mode of cell death by apoptosis induced by v arious modes of treatment often failin vivo. The in vitro environment is le ss complex while the in vivo environment is influenced by various external regulatory signals besides the existence of multiple, parallel and independ ent apoptotic pathways. Further, specific preference for an apoptotic pathw ay in a certain cell type would significantly alter the apoptotic responses . Identification of defects in preferred pathways and choosing alternative and potentially inducible pathways would help in deciding on apoptosis-base d treatment protocols. Mechanisms involved in the execution of apoptosis ma y also not be unique to apoptotic pathways since similar events, possibly w ith strict control, do occur during mitosis. Further evaluation may yield n ew dimensions to apoptosis and apoptosis-based therapy.