New Agents – Manifold Consequences: The Management of Lung and Colorectal Cancer is Changing

Christine      Armbruster

doi:10.2174/157339409787314072

Abstract

1,444,920 new cases of cancer were projected in 2007 in the U.S., half of these patients are suffering from cancers of the prostate, the breast, the lung, and the colon/rectum. Colorectal and lung cancer are the most frequent solid tumors in both women and men. However, the US cancer statistics offer some hope. The incidence rates of colorectal and lung cancer rose till 1985 and 1991, respectively after which they fell. Global statistics is the one side of the coin but successful prevention and treatment of solid tumors requires the acceptance that these are not single diseases. This review focuses on the following topics: 1) Tumor biology: inflammation, growth factors (EGF, VEGF, IGF and its receptors), and epigenetic events. 2) Management strategies in diagnosis: Is early diagnosis feasible? a) Tumor-specific antigens. b) Radiological methods. c) Endoscopy. d) Contributions of pathology to diagnosis and treatment decisions. 3) Appropriate patient selection for treatment purposes. a) Evaluation of tumor tissue. b) Tumor staging. 4) Therapy sequencing: drugs, beams, surgery. 5) Clinical trials a) Phase I trials. b) What are the best inclusion criteria and endpoints? 6) The pipeline. 7) New drugs and manifold consequences. 8.) Prevention strategies. 9.) Future directions.

Keywords: NSCLC, colorectal cancer, tumor biology, targeted therapy, therapy sequencing, patient selection