Cytotoxic Drugs in the Modern Era of Personalized Medicine: Are They Still of Value?
A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pharmacology".
Deadline for manuscript submissions: closed (31 August 2021) | Viewed by 7469
Special Issue Editor
Interests: clinical pharmacokinetics; chemotherapeutic agents; therapeutic drug monitoring
Special Issues, Collections and Topics in MDPI journals
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Dear Colleagues,
For several years, cytotoxic drugs have been the cornerstone in oncology and haematology. The new class of antineoplastic drugs entered into the therapeutic armamentarium did not weaken the role of cytotoxic agents in the management of tumours. Indeed, the combination regimens revitalized their use through improved effectiveness. Furthermore, an ameliorated knowledge of their mechanisms of action and molecular pathways they targeted paved the way to the development of new drugs. These efforts were driven by the need for overcoming cancer cell resistance, and to reduce the risk of severe, and sometimes life-threatening, toxicities associated with their use. The paradigmatic example of 5-fluorouracil well describes how the landscape of this class of drugs has been changed. Indeed, the different infusion regimens, the development of oral prodrugs and the combination of an oral prodrug plus an enzymatic inhibitor improved the drug efficacy. Furthermore, the better knowledge of molecular mechanisms has fueled the search for predictive biomarkers of efficacy and tolerability based on the individual’s genotype and/or phenotype of patients. The analysis of either a single marker or a panel of pharmacokinetic and/or pharmacodynamic markers may enable the stratification of patients according to their expected therapeutic benefit or the probability of adverse reactions. More recently, the dissection of molecular mechanisms targeted or modulated by cytotoxic drugs has enabled the evaluation of their use in combination with immune checkpoint inhibitors, which represent one of the newest approaches in cancer therapy. Although some of them represent the dawning of cancer chemotherapy, cytotoxic drugs are still the underpinning of several combination regimens in oncology and haematology.
Prof. Dr. Antonello Di Paolo
Guest Editor
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Keywords
- cytotoxic drugs
- oncology
- hematology
- pharmacokinetics
- pharmacogenetics
- epigenetics
- combination therapies
- efficacy
- tolerability
- predictive markers
- cancer resistance
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