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Recent advances of molecular targeted agents: opportunities for imaging
1Investigational Drug Branch, Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, Maryland 20892, USA. danceyj@ctep.nci.nih.gov
Abstract:
A number of agents targeting components of pathways and processes critical to neoplastic transformation and progression are ongoing clinical development. Notable successes include imatinib mesylate (STI571, Gleevec) in Chronic Myelogenous Leukemia (CML), and Gastrointestinal Stromal Tumors (GIST) and trastuzumab (Herceptin) in HER2 amplified breast carcinoma. More recently, gefitinib (ZD1839, Iressa) and bortezomib (PS-341, Velcade) have been approved for refractory nonsmall cell lung carcinoma (NSCLC) and multiple myeloma (MM), respectively. In addition, promising results from randomized studies of bevacizumab (Avastin) and cetuximab (IMC-225, Erbitux) have been reported and shortly may lead to their approval for the treatment of colorectal carcinoma (CRC). To what degree the success or failure of these agents has been due to target, the agent, the dose or the selection of patients is uncertain. Certainly, further evaluation of these factors is required to optimize the therapeutic impact of targeted agents and imaging modalities may play a vital role in this process. The purpose of this review is to summarize recent results from trials of selected targeted agents and to suggest roles imaging may play in the further development of these and other targeted agents.
Insights
Targeted cancer therapies show promise, with successes like imatinib mesylate and trastuzumab. Further research is needed to optimize these agents, potentially using imaging.
Area of Science:
- Oncology
- Pharmacology
- Medical Imaging
Background:
- Targeted therapies are revolutionizing cancer treatment by focusing on specific molecular pathways.
- Several targeted agents have achieved notable clinical success in various cancers, including Chronic Myelogenous Leukemia (CML), Gastrointestinal Stromal Tumors (GIST), and breast carcinoma.
- Recent approvals and promising trial results for agents like gefitinib, bortezomib, bevacizumab, and cetuximab highlight the growing impact of targeted therapy.
Purpose of the Study:
- To review recent clinical trial outcomes of selected targeted anticancer agents.
- To explore the potential role of medical imaging in optimizing the development and application of targeted therapies.
- To discuss factors influencing the success or failure of targeted agents, such as target specificity, drug properties, dosage, and patient selection.
Main Methods:
- Review of recent clinical trial data for targeted anticancer agents.
- Analysis of factors contributing to treatment efficacy and challenges.
- Exploration of the integration of imaging modalities in targeted therapy development.
Main Results:
- Significant clinical successes have been observed with targeted agents like imatinib mesylate, trastuzumab, gefitinib, and bortezomib.
- Emerging data for bevacizumab and cetuximab suggest potential for broader application in colorectal carcinoma.
- The precise contribution of target, agent, dose, and patient selection to treatment outcomes remains an area for further investigation.
Conclusions:
- Targeted therapies represent a significant advancement in cancer treatment, with several agents demonstrating substantial efficacy.
- Optimizing the use of targeted agents requires a deeper understanding of factors influencing their success, including patient selection.
- Medical imaging holds promise as a tool to guide the development and application of targeted therapies, potentially improving patient outcomes.
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