Growth-Stimulating Pathways in Lung Cancer: Implications for Targets of Therapy

What are the reasons for negative phase III trials of molecular-target-based drugs?

The results of molecular-biological studies of cancer are changing the way we diagnose and treat cancer. Target-based drug discovery selects agents for development based on their mechanisms of action. The interaction between target-based drugs and their targets can be described by classical drug-receptor theory. Clinical trials have demonstrated that some effective target-based drugs induce apoptosis, even though they are considered to be cytostatic. Numerous phase III trials of target-based drugs have been conducted. Although some have yielded strongly positive results, the majority of the results have been negative. This article seeks to clarify the value of molecular-target-based therapy and to discuss the reasons for negative results in phase III trials. The importance of proof-of-principle studies is stressed throughout preclinical and clinical trials of molecular-target-based drugs.

Biology of lung cancer with implications for new therapies

PURPOSE/OBJECTIVES

To provide an overview of the biology of lung cancer with respect to genetic carcinogenesis and specific mutations and to discuss new therapies being developed to target lung cancer's biologic processes.

DATA SOURCES

Published articles, abstracts, book chapters, lectures, and personal experiences with experimental agents.

DATA SYNTHESIS

Lung cancer is the number one cause of cancer deaths for men and women in the United States, with minimal changes in the five-year survival rate during the past decade. New understanding of the biologic process of lung cancer is providing potential new therapies that many hope will lead to increased survival for patients with lung cancer.

CONCLUSIONS

Exciting new therapies for lung cancer are being developed that target specific biologic processes of lung cancer.

IMPLICATIONS FOR NURSING

When nurses are familiar with the rationale behind biologic therapies, they can understand the drugs, assess toxicities, and help patients make educated decisions about therapeutic alternatives.