Future outlook for growth factors

In the future improvements in the efficacy and safety profiles of the various growth factors in clinical use should be achievable through optimization of dosage schedules. The use of combinations of growth factors to provide hemopoietic support should enable considerable advances to be made in the treatment of hematological and non-hematological malignancies. Growth factors, such as granulocyte-macrophage colony stimulating factor may be used not only to maximize neutrophil recovery after myeloablative therapy, but also to mobilize peripheral blood stem cells prior to harvesting by leukapheresis. Growth inhibitory cytokines such as transforming growth factor-beta and macrophage inflammatory protein-1 alpha may be used to protect normal cells in the bone marrow and other sites where dose-limiting toxicities occur. Therefore, in the next few years, the whole approach to chemoradiotherapy will need to be reconsidered in the light of the dose intensification made possible by improved bone marrow support techniques and advances in other areas of supportive care.