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Anand U, Dey A, Chandel AKS, Sanyal R, Mishra A, Pandey DK, De Falco V, Upadhyay A, Kandimalla R, Chaudhary A, Dhanjal JK, Dewanjee S, Vallamkondu J, Pérez de la Lastra JM. Cancer chemotherapy and beyond: Current status, drug candidates, associated risks and progress in targeted therapeutics. Genes Dis 2023; 10:1367-1401. [PMID: 37397557 PMCID: PMC10310991 DOI: 10.1016/j.gendis.2022.02.007] [Citation(s) in RCA: 174] [Impact Index Per Article: 174.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022] Open
Abstract
Cancer is an abnormal state of cells where they undergo uncontrolled proliferation and produce aggressive malignancies that causes millions of deaths every year. With the new understanding of the molecular mechanism(s) of disease progression, our knowledge about the disease is snowballing, leading to the evolution of many new therapeutic regimes and their successive trials. In the past few decades, various combinations of therapies have been proposed and are presently employed in the treatment of diverse cancers. Targeted drug therapy, immunotherapy, and personalized medicines are now largely being employed, which were not common a few years back. The field of cancer discoveries and therapeutics are evolving fast as cancer type-specific biomarkers are progressively being identified and several types of cancers are nowadays undergoing systematic therapies, extending patients' disease-free survival thereafter. Although growing evidence shows that a systematic and targeted approach could be the future of cancer medicine, chemotherapy remains a largely opted therapeutic option despite its known side effects on the patient's physical and psychological health. Chemotherapeutic agents/pharmaceuticals served a great purpose over the past few decades and have remained the frontline choice for advanced-stage malignancies where surgery and/or radiation therapy cannot be prescribed due to specific reasons. The present report succinctly reviews the existing and contemporary advancements in chemotherapy and assesses the status of the enrolled drugs/pharmaceuticals; it also comprehensively discusses the emerging role of specific/targeted therapeutic strategies that are presently being employed to achieve better clinical success/survival rate in cancer patients.
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Affiliation(s)
- Uttpal Anand
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, West Bengal 700073, India
| | - Arvind K. Singh Chandel
- Center for Disease Biology and Integrative Medicine, Faculty of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
| | - Rupa Sanyal
- Department of Botany, Bhairab Ganguly College (affiliated to West Bengal State University), Kolkata, West Bengal 700056, India
| | - Amarnath Mishra
- Faculty of Science and Technology, Amity Institute of Forensic Sciences, Amity University Uttar Pradesh, Noida 201313, India
| | - Devendra Kumar Pandey
- Department of Biotechnology, School of Bioengineering and Biosciences, Lovely Professional University, Phagwara, Punjab 144411, India
| | - Valentina De Falco
- Institute of Endocrinology and Experimental Oncology (IEOS), National Research Council (CNR), Department of Molecular Medicine and Medical Biotechnology (DMMBM), University of Naples Federico II, Naples 80131, Italy
| | - Arun Upadhyay
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Bandar Sindari, Kishangarh Ajmer, Rajasthan 305817, India
| | - Ramesh Kandimalla
- CSIR-Indian Institute of Chemical Technology, Hyderabad, Telangana 500007, India
- Department of Biochemistry, Kakatiya Medical College, Warangal, Telangana 506007, India
| | - Anupama Chaudhary
- Orinin-BioSystems, LE-52, Lotus Road 4, CHD City, Karnal, Haryana 132001, India
| | - Jaspreet Kaur Dhanjal
- Department of Computational Biology, Indraprastha Institute of Information Technology Delhi (IIIT-D), Okhla Industrial Estate, Phase III, New Delhi 110020, India
| | - Saikat Dewanjee
- Advanced Pharmacognosy Research Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, India
| | - Jayalakshmi Vallamkondu
- Department of Physics, National Institute of Technology-Warangal, Warangal, Telangana 506004, India
| | - José M. Pérez de la Lastra
- Biotechnology of Macromolecules Research Group, Instituto de Productos Naturales y Agrobiología, IPNA-CSIC, San Cristóbal de La Laguna 38206, Tenerife, Spain
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Sonbol MB, Siddiqi R, Uson PLS, Pathak S, Firwana B, Botrus G, Almader-Douglas D, Ahn DH, Borad MJ, Starr J, Jones J, Stucky CC, Smoot R, Riaz IB, Bekaii-Saab T. The Role of Systemic Therapy in Resectable Colorectal Liver Metastases: Systematic Review and Network Meta-Analysis. Oncologist 2022; 27:1034-1040. [PMID: 36239399 PMCID: PMC9732220 DOI: 10.1093/oncolo/oyac212] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/12/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Despite multiple randomized trials, the role of perioperative chemotherapy in colorectal cancer liver metastasis (CRLM) is still under debate. In this systematic review and network meta-analysis (NMA), we aim to evaluate the efficacy of perioperative systemic therapies for patients with CRLM. METHODS We searched various databases for abstracts and full-text articles published from database inception through May 2021.We included randomized controlled trials (RCTs) comparing the addition of perioperative (post, pre, or both) systemic therapies to surgery alone in patients with CRLM. The outcomes were compared according to the chemotherapy regimen using a random effects model. Outcomes of interest included disease-free survival (DFS) and overall survival (OS). RESULTS Seven RCTs with a total of 1504 patients with CRLM were included. Six studies included post-operative treatment and one evaluated perioperative (pre- and postoperative) therapy. Fluoropyrimidine-based chemotherapy was the most used systemic therapy. NMA showed benefit of adding perioperative therapy to surgery in terms of DFS (HR 0.73, 95% CI 0.63 to 0.84). However, these findings did not translate into a statistically significant OS benefit (HR 0.88, 95% CI 0.74 to 1.05). NMA did not show any advantage of one regimen over another including oxaliplatin or irinotecan. CONCLUSIONS This systematic review and NMA of 7 RCTs found that the addition of perioperative systemic treatment for resectable CRLM could improve disease-free survival but not overall survival. Based on the findings, addition of perioperative treatment in resectable CRLM should be individualized weighing the risks and benefits.
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Affiliation(s)
| | - Rabbia Siddiqi
- Department of Medicine, Dow University of Health Sciences, Karachi city, Sindh, Pakistan
| | - Pedro Luiz Serrano Uson
- Department of Oncology Mayo Clinic Cancer Center, Phoenix, AZ, USA,Department of Oncology, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Belal Firwana
- Heartland Cancer Research, Missouri Baptist Medical Center, St Louis, MO, USA
| | - Gehan Botrus
- Department of Medicine, Honorhealth Research Institute, Scottsdale, AZ, USA
| | | | - Daniel H Ahn
- Department of Oncology Mayo Clinic Cancer Center, Phoenix, AZ, USA
| | - Mitesh J Borad
- Department of Oncology Mayo Clinic Cancer Center, Phoenix, AZ, USA
| | - Jason Starr
- Mayo Clinic Cancer Center, Jacksonville, FL, USA
| | - Jeremy Jones
- Mayo Clinic Cancer Center, Jacksonville, FL, USA
| | - Chee-Chee Stucky
- Department of Oncology Mayo Clinic Cancer Center, Phoenix, AZ, USA
| | - Rory Smoot
- Mayo Clinic Cancer Center, Rochester, MN, USA
| | - Irbaz Bin Riaz
- Department of Oncology Mayo Clinic Cancer Center, Phoenix, AZ, USA,Mayo Clinic Cancer Center, Rochester, MN, USA
| | - Tanios Bekaii-Saab
- Corresponding author: Tanios Bekaii-Saab, MD, Mayo Clinic College of Medicine and Science, 5777 East Mayo Boulevard Phoenix, AZ 85054, USA. Tel: +1 480 342 4800; Email address:
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Mauri D, Zarkavelis G, Filis P, Tsali L, Zafeiri G, Papadaki A, Vassou A, Georgopoulos C, Pentheroudakis G. Postoperative chemotherapy with single-agent fluoropyrimidines after resection of colorectal cancer liver metastases: a meta-analysis of randomised trials. ESMO Open 2018; 3:e000343. [PMID: 30018809 PMCID: PMC6045754 DOI: 10.1136/esmoopen-2018-000343] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 03/21/2018] [Accepted: 03/22/2018] [Indexed: 12/21/2022] Open
Abstract
Surgical resection is the only option of cure for patients with metastatic colorectal cancer. Risk of recurrence after metastasectomy is around 75%. Use of adjuvant chemotherapy after metastasectomy is controversial.
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Affiliation(s)
- Davide Mauri
- Department of Medical Oncology, Medical School, University of Ioannina, Ioannina, Greece.,Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN)
| | - George Zarkavelis
- Department of Medical Oncology, Medical School, University of Ioannina, Ioannina, Greece.,Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN)
| | - Panagiotis Filis
- Department of Medical Oncology, Medical School, University of Ioannina, Ioannina, Greece.,Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN)
| | - Lampriani Tsali
- Department of Internal Medicine, General Hospital of Arta, Arta, Greece
| | - Georgia Zafeiri
- Department of Medical Oncology, Medical School, University of Ioannina, Ioannina, Greece.,Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN)
| | - Alexandra Papadaki
- Department of Medical Oncology, Medical School, University of Ioannina, Ioannina, Greece
| | - Amalia Vassou
- Department of Hematology, Ioannina University Hospital, Ioannina, Greece
| | - Christos Georgopoulos
- Department of Medical Oncology, Medical School, University of Ioannina, Ioannina, Greece
| | - George Pentheroudakis
- Department of Medical Oncology, Medical School, University of Ioannina, Ioannina, Greece
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Mauri D, Filis P, Tsali L, Zarkavelis G, Pentheroudakis G. Role of chemotherapy in resectable liver metastases from colorectal cancer: food for thought from pooled evidence. ESMO Open 2018; 3:e000367. [PMID: 29942665 PMCID: PMC6012563 DOI: 10.1136/esmoopen-2018-000367] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Davide Mauri
- Department of Medical Oncology, University Medical School of Ioannina, Ioannina, Greece
| | - Panagiotis Filis
- Department of Medical Oncology, University Medical School of Ioannina, Ioannina, Greece
| | - Lampriani Tsali
- Department of Internal Medicine, General Hospital of Arta, Arta, Greece
| | - George Zarkavelis
- Department of Medical Oncology, University Medical School of Ioannina, Ioannina, Greece
| | - George Pentheroudakis
- Department of Medical Oncology, University Medical School of Ioannina, Ioannina, Greece
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