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A pattern of response we have observed with various targeted agents, e.g. VEGF pathway targeting antiangiogenic drugs or trastuzumab, is effective when treating primary tumors in contrast to a complete or severely reduced lack of such efficacy when treating advanced metastatic disease.
76 In addition, several clinical trials are currently evaluating the activity of mTOR, PI3K, Akt, and dual PI3K/mTOR inhibitors in combination with various targeted agents.
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Recent studies indicate that paracrine stimuli from stromal fibroblasts may confer resistance to various molecular targeted agents including lapatinib [ 49- 51].
Colorectal cancer (CRC) shows high mortality and morbidity worldwide 1. Various molecular targeted agents such as anti-vascular endothelial growth factor (VEGF) monoclonal antibody (bevacizumab) and anti-epidermal growth factor receptor (EGFR) monoclonal antibody (cetuximab) have been developed for CRC therapy 2, 3.
The development of novel models of drug development that allow the assessment of the expression of these genes, particularly within the presurgical setting, offers major opportunities to assess the potential of the various new targeted agents to be combined with endocrine therapy.
Several prospective studies have evaluated various cytotoxic and/or targeted agents in the setting of refractory mCRC, and potent new anti-cancer agents have been developed in recent years.
Finally, possible sequence-dependent synergy or additive effects of pralatrexate with various cytotoxic and targeted agents were also investigated.
Dulanermin exhibits single-agent anti-tumour activity as well as cooperativity with various conventional and targeted agents in tumour xenograft models (Ashkenazi et al, 2008).
Changes in glucose and choline metabolism have been described in patients after treatment with various therapies including targeted agents (e.g., imatinib) using PET technology (Heymach et al, 2004; Pantaleo et al, 2008).
An ongoing trial is evaluating the penetrability of various chemotherapeutic and targeted agents, comparing intratumoral and blood drug concentrations in patients with ≥1 resectable breast cancer BM who receive 1 dose of chemotherapy or targeted therapy (trastuzumab or lapatinib) prior to surgery (NCT00795678).
38 Ixabepilone has been evaluated in patients with locally advanced and metastatic breast cancer in a series of phase II trials 23– 27, 39, 40 (as a single agent [ Table 2] 23– 27 and in combination with various cytotoxic and targeted agents) and phase III trials (in combination with capecitabine).
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