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Continuing Education in Anaesthesia, Critical Care & Pain 2008 8(1):36-38; doi:10.1093/bjaceaccp/mkm053
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© The Board of Management and Trustees of the British Journal of Anaesthesia [2008]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

What's new in oncology: targeted therapy

Elena E. Takeuchi, MB ChB MRCP
Specialist Registrar in Medical Oncology
Cancer Research UK Clinical Centre in Leeds
St James's Institute of Oncology
Beckett Street
Leeds
West Yorkshire LS9 7TF
UK

Dawn L. Alison, MD FRCP
Consultant in Medical Oncology and Palliative Medicine same unit as SPR
St James's University Hospital
Beckett Street
Leeds
West Yorkshire LS9 7TF
UK
Tel: +44 113 206 7500 Fax: +44 113 206 4863 Email: E.Takeuchi@leeds.ac.uk

Key Words: Recent advances in molecular biology and scientific technology have allowed better understanding of some of the critical pathways involved in carcinogenesis and have led to the development of new targeted systemic cancer treatments. • Adjuvant trastuzumab has shown efficacy in the treatment of HER2 positive early breast cancer • Imatinib mesylate has changed the natural course of disease in chronic myeloid leukaemia and gastrointestinal stromal tumours. • Multikinase inhibitors are achieving promising results in some chemo-resistant tumours.

The first 150 words of the full text of this article appear below.


   Monoclonal antibodies
 

This is the first of a series of invited articles describing recent advances in the treatment of a wide range of conditions. Although anaesthetic management is not covered, patients undergoing these new treatments may present for anaesthesia, intensive care, or pain management.

 

The ‘magic bullet’ concept of Paul Ehrlich that ‘toxins’ could be targeted to cancer took a leap forward when the hybridoma technique was described by Kohler and Milstein1 in 1975 allowing unlimited production of monoclonal antibodies (MAbs). However, the therapeutic promise of MAbs has taken some time to be realized requiring humanization of mouse antibodies, recombinant production protocols, and discovery of ideal targets.

Most of the approved MAbs are IgG1 molecules that can initiate complement-mediated cytotoxicity and antibody-dependent cellular cytotoxicity, leading to cell lysis. MAbs can also act directly when the binding of antibody activates or inhibits a signalling pathway in turn causing inhibition of proliferation and/or apoptosis.

Monoclonal antibodies in haematological malignancies

. . . [Full Text of this Article]

Monoclonal antibodies for solid tumours

Epidermal growth factor receptors

Antiangiogenesis

Side-effects of MAb therapy


   Small molecules
 

   Conclusion
 

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