Abstract
At present, there are ten times more anticancer drugs being tested in clinical trials than there were 15 years ago. However, many of the new anticancer agents target unconventional aspects of cancer development, interact with other drugs in an unpredictable manner and are predicted to show clinical benefit in only small subpopulations of patients. How can clinical trials be re-designed to accommodate the new features of targeted anticancer drugs and/or approaches? Herein we will review these obstacles: i) limitations in our knowledge of molecular and systems biology of cancer, ii) application of new agents in inappropriate clinical settings, in unselected patients, and without a clear understanding of the role of the putative target in mediating the antitumour effect. Collection of tissues from models mimicking human cancer at time points that correspond with maximal clinical effect will provide the best opportunity to gain insight into the reasons why agents work or, more commonly, dont work before going into a clinical trial.
Keywords: cancer treatments, targeted therapy, cancer stem cells, mouse models, pharmacogenomics, molecular image
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