The reading about mechanisms of resistance of to Taxol calls for a new strategy for treatment of triple negative breast cancer; while it is true that PARP inhibitor should still be considered in BRCA positive cancers, adding AURORA inhibitors seems to offer logically the best opportunity to increase the activity of proposed first line drugs.
Indeed, triple negative breast cancer assumes that the receptors to conventional stimulants of the breast cancer cell are not functional or responsive. Therefore, increasing the role of a direct attack of either the nuclear material or the microfilament/microtubule. Taxol - Cisplatin combination achieves that! Adding Avastin and other receptor stimulators could be a riskier proposition if you assume a questionable sensitivity of receptor in general. Your best bet is an action on the Histones and further DNA destruction. The cell division is your focus here and this is re-emphasized by the importance of CDKs as described by MD Anderson researchers. As a matter of fact, the AURORA inhibitors by binding to Adenine and to the Histone appear to offer a potential and logical choice to recruit in first line to boost response rates! So, pending proof of concept, we support the idea of adding Aurora inhibitors to a Taxane-Cisplatin core combination. Some of the Aurora Kinase also target CDKs and JAK2. These will be my choice for new trials!
After the cancer has seen chemotherapy, endothelial cells have been altered, hypoxia has been triggered by closure of some of the blood vessel closure, the MTOR has been stimulated, we believe adding the MTOR makes more sense. This has been also suggested after failure of Avastin, These concepts have been publicized, It is time to move to clinical trial! (FOR THOSE WHO CAN, WE HAVE OUR HANDS TIED BY HUMAN HISTORY!)
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