1 261 161 ADVANCES IN TARGET THERAPY FOR LUNG CANCER. RECENT PROGRESS IN MOLECULAR BIOLOGY HAS SHOWN THAT CANCER CELLS ACQUIRE COMMON PHENOTYPES SUCH AS SELF-SUFFICIENCY OF GROWTH SIGNALS, RESISTANCE TO ANTI-PROLIFERATIVE AND APOPTOTIC SIGNALS THROUGH THE ACCUMULATION OF GENETIC AND EPIGENETIC CHANGES. RECENTLY DEVELOPED ANTICANCER DRUGS TARGET THESE MOLECULAR MECHANISMS AND GOOD RESULTS HAVE BEEN REPORTED FOR VARIOUS CANCER TYPES. IN LUNG CANCER, TYROSINE KINASE INHIBITORS SPECIFIC FOR THE EPIDERMAL GROWTH FACTOR RECEPTOR SUCH AS GEFITINIB AND ERLOTINIB HAVE CHANGED CLINICAL PRACTICE DRAMATICALLY. ABOUT HALF OF THE JAPANESE PATIENTS WITH LUNG CANCERS HARBOR AN ACTIVATING MUTATION OF THE EPIDERMAL GROWTH FACTOR RECEPTOR GENE AND THEY ARE VERY SENSITIVE TO EPIDERMAL GROWTH FACTOR RECEPTOR TYROSINE KINASE INHIBITORS. PROGRESSION-FREE SURVIVAL OF SUCH PATIENTS IS APPROXIMATELY 10 MONTHS WHEN TREATED WITH GEFITINIB, WHEREAS THE SURVIVAL FOR THOSE TREATED WITH PLATINUM DOUBLET THERAPY IS APPROXIMATELY 6 MONTHS. TARGET THERAPIES AGAINST ECHINODERM MICROTUBULE-ASSOCIATED PROTEIN-LIKE 4-ANAPLASTIC LYMPHOMA KINASE FUSION PROTEIN OR A MUTATED ERBB2 (V-ERB-B AVIAN ERYTHROBLASTIC LEUKEMIA VIRAL ONCOGENE HOMOLOGUE 2) PRESENT IN APPROXIMATELY 5% AND APPROXIMATELY 3% OF THE JAPANESE PATIENTS WITH ADENOCARCINOMAS, RESPECTIVELY, ARE CURRENTLY UNDER DEVELOPMENT. ADDITION OF AN ANTI-EPIDERMAL GROWTH FACTOR RECEPTOR ANTIBODY, CETUXIMAB, OR ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR ANTIBODY, BEVACIZUMAB, TO PLATINUM DOUBLET THERAPY SIGNIFICANTLY BUT MODESTLY PROLONGED THE SURVIVAL IN RECENT CLINICAL TRIALS. HOWEVER, CLINICAL DEVELOPMENT OF SMALL MOLECULE MULTI-KINASE INHIBITORS INCLUDING THOSE TARGETING VASCULAR ENDOTHELIAL GROWTH FACTOR RECEPTORS, SUCH AS VANDETANIB, SUNITINIB AND SORAFENIB, HAS NOT BEEN VERY SUCCESSFUL. THROUGH THESE COLLABORATIONS AMONG CLINICIANS, BASIC RESEARCHERS AND PHARMACEUTICAL COMPANIES, IT SHOULD BE POSSIBLE TO INDIVIDUALIZE LUNG CANCER TREATMENT TO TURN THIS FATAL DISEASE INTO A CHRONIC DISORDER AND, EVENTUALLY, TO CURE IT. 2010 2 4660 52 NEW APPROACHES TO THE TREATMENT OF MYELODYSPLASIA. THE THERAPEUTIC DILEMMA THAT CONFRONTS THE MANAGEMENT OF PATIENTS WITH MYELODYSPLASTIC SYNDROMES (MDS) IS ILLUSTRATED BY THE ABSENCE OF A FOOD AND DRUG ADMINISTRATION-APPROVED AGENT WITH AN INDICATION FOR THIS DISEASE. CLINICAL HETEROGENEITY AND INADEQUATE UNDERSTANDING OF THE DISEASE PATHOBIOLOGY HAVE LIMITED PROGRESS IN THE DEVELOPMENT OF NOVEL THERAPEUTICS. PRECLINICAL INVESTIGATIONS INDICATE THAT RECIPROCAL INTERACTION BETWEEN THE MALIGNANT CLONE AND THE MICROENVIRONMENT SERVE TO CREATE A HOSTILE MILIEU THAT REINFORCES INEFFECTIVE BLOOD CELL PRODUCTION. INEFFECTIVE HEMATOPOIESIS, THE HALLMARK OF MDS, ARISES FROM IMPAIRED PROGENITOR RESPONSIVENESS TO NORMAL TROPHIC SIGNALS AND EXCESS LOCAL GENERATION OF INHIBITORY CYTOKINES, WHICH PROMOTE ACCELERATED APOPTOTIC LOSS OF PROGENITORS AND THEIR PROGENY. EVIDENCE TO SUPPORT THIS MODEL DERIVES FROM CYTOKINE NEUTRALIZATION STUDIES AND THE DIRECT RELATIONSHIP BETWEEN PLASMA TUMOR NECROSIS FACTOR-ALPHA CONCENTRATION AND DNA OXIDATION AND GLUTATHIONE DEPLETION IN MALIGNANT CD34+ PROGENITORS. RECENT INVESTIGATIONS INDICATE THAT ANGIOGENIC MOLECULES GENERATED BY MALIGNANT MYELOMONOCYTIC PRECURSORS REPRESENT INTEGRAL DIFFUSABLE SIGNALS THAT REINFORCE LEUKEMIA PROGENITOR SELF-RENEWAL WHILE PROMOTING THE GENERATION OF PROAPOPTOTIC CYTOKINES AND MEDULLARY ANGIOGENIC RESPONSE. THE POTENTIAL FOR LEUKEMIA EVOLUTION IS COMPOUNDED BY EPIGENETIC EVENTS INCLUDING METHYLATION SILENCING OF THE P15 PROTO-ONCOGENE OR ACTIVATING RAS POINT MUTATIONS. DELINEATION OF SUCH BIOLOGIC FEATURES THAT ARE CENTRAL TO THE PATHOBIOLOGY OF MDS PROVIDES A RELIABLE FRAMEWORK FOR THE DEVELOPMENT OF NOVEL THERAPEUTICS. ANTIANGIOGENIC AGENTS IN CLINICAL TESTING INCLUDE VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF) RECEPTOR TYROSINE KINASE INHIBITORS, THALIDOMIDE AND RELATED ANALOGUES, AND THE RECOMBINANT VEGF NEUTRALIZING ANTIBODY, BEVACIZUMAB. AGENTS WHOSE ACTIONS MAY RESTORE DIFFERENTIATION PROGRAMS, SUCH AS THE DNA METHYLTRANSFERASE INHIBITORS OR HISTONE DEACETYLASE INHIBITORS, OFFER THE PROSPECT TO PROMOTE EFFECTIVE HEMATOPOIESIS WHILE IMPACTING THE POTENTIAL FOR LEUKEMIA EVOLUTION. RAS FARNESYL TRANSFERASE INHIBITORS HAVE SHOWN ENCOURAGING PRELIMINARY RESULTS IN ACUTE MYELOID LEUKEMIA AND ARE CURRENTLY UNDER INVESTIGATION IN ADVANCED MDS AND CHRONIC MYELOMONOCYTIC LEUKEMIA. ARSENIC TRIOXIDE (ATO) INTERACTS WITH A SPECTRUM OF BIOLOGIC TARGETS THAT MAY BE UNIQUELY SUITED TO MDS. ATO IS A POTENT INDUCER OF APOPTOSIS IN THIOL-DEPLETED MALIGNANT PROGENITORS AND NEOVASCULAR ENDOTHELIUM, WHILE PROMOTING DIFFERENTIATION THROUGH HISTONE ACETYLATION AND INACTIVATION OF TRANSCRIPTIONAL COREPRESSORS. THE IDENTIFICATION OF RELEVANT BIOLOGIC TARGETS IN MDS HAS RAISED EXPECTATIONS FOR THE DEVELOPMENT OF DISEASE-SPECIFIC THERAPIES FOR MDS IN THE YEARS THAT FOLLOW. 2002 3 358 47 ALTERNATIVE SPLICING IN CHRONIC MYELOID LEUKEMIA (CML): A NOVEL THERAPEUTIC TARGET? ALTHOUGH THE IMATINIB BASED THERAPY OF CHRONIC MYELOID LEUKEMIA (CML) REPRESENTS A TRIUMPH OF MEDICINE, NOT ALL PATIENTS WITH CML BENEFIT FROM THIS DRUG DUE TO THE DEVELOPMENT OF RESISTANCE AND INTOLERANCE. THE INTERRUPTION OF IMATINIB TREATMENT IS OFTEN FOLLOWED BY CLINICAL RELAPSE, SUGGESTING A FAILURE IN THE KILLING OF RESIDUAL LEUKAEMIC STEM CELLS. THERE IS NEED TO IDENTIFY ALTERNATIVE SELECTIVE MOLECULAR TARGETS FOR THIS DISEASE AND DEVELOP MORE EFFECTIVE THERAPEUTIC APPROACHES. ALTERNATIVE PRE-MRNA SPLICING (AS) IS AN EPIGENETIC PROCESS THAT GREATLY DIVERSIFIES THE REPERTOIRE OF THE TRANSCRIPTOME. AS ORCHESTRATES INTERACTIONS BETWEEN VARIOUS TYPES OF PROTEINS AND BETWEEN PROTEINS AND NUCLEIC ACIDS. CHANGES CAUSED BY INDIVIDUAL SPLICING EVENTS IN THE CELLS ARE SMALL, HOWEVER, "SPLICING PROGRAMS" TYPICALLY REACT TO THESE INDIVIDUAL CHANGES WITH CONSIDERABLE EFFECTS IN CELL PROLIFERATION, CELL SURVIVAL, AND APOPTOSIS. CURRENT EVIDENCE SUGGESTS A PIVOTAL ROLE OF AS IN LEUKEMIAS, PARTICULARLY IN MYELODISPLASTIC SYNDROME (MDS) AND CHRONIC LYMPHOCYTE LEUKEMIA (CLL). FROM THESE STUDIES AND STUDIES IN OTHER MALIGNANCES, IT IS CLEAR THAT SPLICING ABNORMALITIES PLAY A SIGNIFICANT ROLE IN MALIGNANT TRANSFORMATION. EVALUATION OF AS EVENTS IN CML CAN BE USED TO IDENTIFY NOVEL DISEASE MARKERS AND DRUGSENSITIVE TARGETS TO OVERCOME THE LIMITS OF THE SMALL MOLECULE INHIBITORS CURRENTLY USED FOR TREATING PATIENTS WITH CML. THE USE OF ABERRANT SPLICE VARIANTS AS DISEASE MARKERS HAS BEEN REPORTED, HOWEVER, LITTLE IS KNOWN ABOUT THE USE OF SPLICING ABNORMALITIES AS DRUG TARGETS IN CML. HEREIN WE DISCUSS POTENTIAL THERAPEUTIC APPROACHES THAT CAN BE USED TO TARGET SPLICING ABNORMALITIES IN CML. 2013 4 5944 48 TARGETING SMALL MOLECULE TYROSINE KINASES BY POLYPHENOLS: NEW MOVE TOWARDS ANTI-TUMOR DRUG DISCOVERY. BACKGROUND: CANCER IS A COMPLEX DISEASE INVOLVING GENETIC AND EPIGENETIC ALTERATION THAT ALLOWS CELLS TO ESCAPE NORMAL HOMEOSTASIS. KINASES PLAY A CRUCIAL ROLE IN SIGNALING PATHWAYS THAT REGULATE CELL FUNCTIONS. DEREGULATION OF KINASES LEADS TO A VARIETY OF PATHOLOGICAL CHANGES, ACTIVATING CANCER CELL PROLIFERATION AND METASTASES. THE MOLECULAR MECHANISM OF CANCER IS COMPLEX AND THE DYSREGULATION OF TYROSINE KINASES LIKE ANAPLASTIC LYMPHOMA KINASE (ALK), BCR-ABL (FUSION GENE FOUND IN PATIENT WITH CHRONIC MYELOGENOUS LEUKEMIA (CML), JAK (JANUS ACTIVATED KINASE), SRC FAMILY KINASES (SFKS), ALK (ANAPLASTIC LYMPHOMA KINASE), C-MET (MESENCHYMAL- EPITHELIAL TRANSITION), EGFR (EPIDERMAL GROWTH FACTOR RECEPTOR), PDGFR (PLATELET-DERIVED GROWTH FACTOR RECEPTOR), RET (REARRANGED DURING TRANSFECTION) AND VEGFR (VASCULAR ENDOTHELIAL GROWTH FACTOR RECEPTOR) PLAYS MAJOR ROLE IN THE PROCESS OF CARCINOGENESIS. RECENTLY, KINASE INHIBITORS HAVE OVERCOME MANY PROBLEMS OF TRADITIONAL CANCER CHEMOTHERAPY AS THEY EFFECTIVELY SEPARATE OUT NORMAL, NON-CANCER CELLS AS WELL AS RAPIDLY MULTIPLYING CANCER CELLS. METHODS: ELECTRONIC DATABASES WERE SEARCHED TO EXPLORE THE SMALL MOLECULE TYROSINE KINASES BY POLYPHENOLS WITH THE HELP OF DOCKING STUDY (GLIDE-7.6 PROGRAM INTERFACED WITH MAESTRO-V11.3 OF SCHRODINGER 2017) TO SHOW THE BINDING ENERGIES OF POLYPHENOLS INHIBITOR WITH DIFFERENT TYROSINE KINASES IN ORDER TO DIFFERENTIATE BETWEEN THE TARGETS. RESULTS: FROM THE LITERATURE SURVEY, IT WAS OBSERVED THAT THE NUMBER OF POLYPHENOLS DERIVED FROM NATURAL SOURCES ALTERS THE EXPRESSION AND SIGNALING CASCADE OF TYROSINE KINASE IN VARIOUS TUMOR MODELS. THEREFORE, THE DEVELOPMENT OF POLYPHENOLS AS A TYROSINE KINASE INHIBITOR AGAINST TARGETED PROTEINS IS REGARDED AS AN UPCOMING TREND FOR CHEMOPREVENTION. CONCLUSION: IN THIS REVIEW, WE HAVE DISCUSSED THE ROLE OF POLYPHENOLS AS CHEMORECEPTIVE WHICH WILL HELP IN FUTURE FOR THE DEVELOPMENT AND DISCOVERY OF NOVEL SEMISYNTHETIC ANTICANCER AGENTS COUPLED WITH POLYPHENOLS. 2020 5 732 40 CANCER DRUG RESISTANCE: THE CENTRAL ROLE OF THE KARYOTYPE. CURRENT GENETIC AND EPIGENETIC THEORIES OF CANCER-SPECIFIC DRUG RESISTANCE DO NOT ADEQUATELY EXPLAIN: (I) THE KARYOTYPIC CHANGES THAT COINCIDE WITH RESISTANCE, (II) THE HIGH RATES AT WHICH CANCER CELLS ACQUIRE AND ENHANCE RESISTANCE COMPARED TO THE RATES OF CONVENTIONAL MUTATION, (III) THE WIDE RANGES OF RESISTANCE SUCH AS MULTIDRUG RESISTANCE, (IV) THE FREQUENT OCCURRENCE OF INTRINSIC DRUG RESISTANCE. WE HAVE RECENTLY PROPOSED, THAT SPECIFIC KARYOTYPIC ALTERATIONS ARE SUFFICIENT FOR DRUG RESISTANCE VIA NEW TRANSCRIPTOMES OF COOPERATIVE GENES, INDEPENDENT OF GENE MUTATION. THIS MECHANISM GENERATES NEW PHENOTYPES JUST LIKE TRISOMY 21 GENERATES DOWN SYNDROME. THESE KARYOTYPIC CHANGES ARE GENERATED BY CANCER-SPECIFIC ANEUPLOIDY AUTOCATALYTICALLY, BECAUSE ANEUPLOIDY DESTABILIZES THE KARYOTYPE BY MISBALANCING TEAMS OF PROTEINS THAT SYNTHESIZE, REPAIR AND SEGREGATE CHROMOSOMES. EVIDENCE FOR THIS CHROMOSOMAL MECHANISM IS AS FOLLOWS: (I) RESISTANCE IS PROPORTIONAL TO THE NUMBER OF CLONAL CHROMOSOMAL ALTERATIONS COMPARED TO DRUG-SENSITIVE PRECURSORS. (II) THE HIGH RATES AT WHICH CANCER CELLS ACQUIRE DRUG RESISTANCE ARE COMPARABLE WITH THE RATES, AS HIGH AS 10(-2) PER CELL GENERATION, AT WHICH THEIR KARYOTYPES CHANGE-DIMMING HOPES FOR GENE-SPECIFIC THERAPIES. (III) MULTIDRUG RESISTANCE PROBABLY REFLECTS UN-SELECTED TRANSCRIPTOMES OF KARYOTYPES SELECTED FOR RESISTANCE AGAINST SPECIFIC DRUGS. (IV) INTRINSIC DRUG RESISTANCE PROBABLY REFLECTS UNSELECTED TRANSCRIPTOMES OF KARYOTYPES SELECTED FOR ONCOGENICITY. WE ALSO ADDUCE EVIDENCE THAT RESISTANCE OF CHRONIC MYELOID LEUKEMIA AGAINST THE DRUG IMATINIB IS CHROMOSOMAL, ALTHOUGH IT IS WIDELY BELIEVED TO BE DUE TO MUTATION OF A KINASE. 2007 6 3599 41 IMPORTANCE OF EPIGENETIC CHANGES IN CANCER ETIOLOGY, PATHOGENESIS, CLINICAL PROFILING, AND TREATMENT: WHAT CAN BE LEARNED FROM HEMATOLOGIC MALIGNANCIES? EPIGENETIC ALTERATIONS REPRESENT A KEY CANCER HALLMARK, EVEN IN HEMATOLOGIC MALIGNANCIES (HMS) OR BLOOD CANCERS, WHOSE CLINICAL FEATURES DISPLAY A HIGH INTER-INDIVIDUAL VARIABILITY. EVIDENCE ACCUMULATED IN RECENT YEARS INDICATES THAT INACTIVATING DNA HYPERMETHYLATION PREFERENTIALLY TARGETS THE SUBSET OF POLYCOMB GROUP (PCG) GENES THAT ARE REGULATORS OF DEVELOPMENTAL PROCESSES. CONVERSELY, ACTIVATING DNA HYPOMETHYLATION TARGETS ONCOGENIC SIGNALING PATHWAY GENES, BUT OUTCOMES OF BOTH EVENTS LEAD IN THE OVEREXPRESSION OF ONCOGENIC SIGNALING PATHWAYS THAT CONTRIBUTE TO THE STEM-LIKE STATE OF CANCER CELLS. ON THE BASIS OF RECENT EVIDENCE FROM POPULATION-BASED, CLINICAL AND EXPERIMENTAL STUDIES, WE HYPOTHESIZE THAT FACTORS ASSOCIATED WITH RISK FOR DEVELOPING A HM, SUCH AS METABOLIC SYNDROME AND CHRONIC INFLAMMATION, TRIGGER EPIGENETIC MECHANISMS TO INCREASE THE TRANSCRIPTIONAL EXPRESSION OF ONCOGENES AND ACTIVATE ONCOGENIC SIGNALING PATHWAYS. AMONG OTHERS, SIGNALING PATHWAYS ASSOCIATED WITH SUCH RISK FACTORS INCLUDE PRO-INFLAMMATORY NUCLEAR FACTOR KAPPAB (NF-KAPPAB), AND MITOGENIC, GROWTH, AND SURVIVAL JANUS KINASE (JAK) INTRACELLULAR NON-RECEPTOR TYROSINE KINASE-TRIGGERED PATHWAYS, WHICH INCLUDE SIGNALING PATHWAYS SUCH AS TRANSDUCER AND ACTIVATOR OF TRANSCRIPTION (STAT), RAS GTPASES/MITOGEN-ACTIVATED PROTEIN KINASES (MAPKS)/EXTRACELLULAR SIGNAL-RELATED KINASES (ERKS), PHOSPHATIDYLINOSITOL 3-KINASE (PI3K)/AKT/MAMMALIAN TARGET OF RAPAMYCIN (MTOR), AND BETA-CATENIN PATHWAYS. RECENT FINDINGS ON EPIGENETIC MECHANISMS AT WORK IN HMS AND THEIR IMPORTANCE IN THE ETIOLOGY AND PATHOGENESIS OF THESE DISEASES ARE HEREIN SUMMARIZED AND DISCUSSED. FURTHERMORE, THE ROLE OF EPIGENETIC PROCESSES IN THE DETERMINATION OF BIOLOGICAL IDENTITY, THE CONSEQUENCES FOR INTERINDIVIDUAL VARIABILITY IN DISEASE CLINICAL PROFILE, AND THE POTENTIAL OF EPIGENETIC DRUGS IN HMS ARE ALSO CONSIDERED. 2013 7 306 36 AKT TARGETING AS A STRATEGY TO BOOST CHEMOTHERAPY EFFICACY IN NON-SMALL CELL LUNG CANCER THROUGH METABOLISM SUPPRESSION. METABOLIC REPROGRAMMING IS A HALLMARK OF CANCER DEVELOPMENT, MEDIATED BY GENETIC AND EPIGENETIC ALTERATIONS THAT MAY BE PHARMACOLOGICALLY TARGETED. AMONG ONCOGENES, THE KINASE AKT IS COMMONLY OVEREXPRESSED IN TUMORS AND FAVORS GLYCOLYSIS, PROVIDING A RATIONALE FOR USING AKT INHIBITORS. HERE, WE ADDRESSED THE QUESTION OF WHETHER AND HOW INHIBITING AKT ACTIVITY COULD IMPROVE THERAPY OF NON-SMALL CELL LUNG CANCER (NSCLC) THAT REPRESENTS MORE THAN 80% OF ALL LUNG CANCER CASES. FIRST, WE DEMONSTRATED THAT AKT INHIBITORS INTERACTED SYNERGISTICALLY WITH MICROTUBULE-TARGETING AGENTS (MTAS) AND SPECIFICALLY IN CANCER CELL LINES, INCLUDING THOSE RESISTANT TO CHEMOTHERAPY AGENTS AND ANTI-EGFR TARGETED THERAPIES. IN VIVO, WE FURTHER REVEALED THAT THE CHRONIC ADMINISTRATION OF LOW-DOSES OF PACLITAXEL - I.E. METRONOMIC SCHEDULING - AND THE ANTI-AKT PERIFOSINE WAS THE MOST EFFICIENT AND THE BEST TOLERATED TREATMENT AGAINST NSCLC. REGARDING DRUG MECHANISM OF ACTION, PERIFOSINE POTENTIATED THE PRO-APOPTOTIC EFFECTS OF PACLITAXEL, INDEPENDENTLY OF CELL CYCLE ARREST, AND COMBINING PACLITAXEL/PERIFOSINE RESULTED IN A SUSTAINED SUPPRESSION OF GLYCOLYTIC AND MITOCHONDRIAL METABOLISM. THIS STUDY POINTS OUT THAT TARGETING CANCER CELL BIOENERGETICS MAY REPRESENT A NOVEL THERAPEUTIC AVENUE IN NSCLC, AND PROVIDES A STRONG FOUNDATION FOR FUTURE CLINICAL TRIALS OF METRONOMIC MTAS COMBINED WITH AKT INHIBITORS. 2017 8 3565 43 IMPACT OF GENETIC POLYMORPHISMS AND BIOMARKERS ON THE EFFECTIVENESS AND TOXICITY OF TREATMENT OF CHRONIC MYELOID LEUKEMIA AND ACUTE MYELOID LEUKEMIA. MOST MALIGNANT HEMATOLOGICAL DISEASES ARE GENERALLY A CONSEQUENCE OF ACQUIRED MUTATIONS OR REARRANGEMENTS IN CELL REPLICATION PROCESSES. ACUTE MYELOID LEUKEMIA (AML) IS A CLINICALLY AND MOLECULARLY HETEROGENEOUS DISEASE THAT RESULTS FROM ACQUIRED GENETIC AND EPIGENETIC ALTERATIONS IN HEMATOPOIETIC PROGENITOR CELLS. DESPITE THE ADVANCES MADE IN UNDERSTANDING THE PATHOGENESIS OF THIS DISEASE, THE OVERALL SURVIVAL OF PATIENTS REMAINS VERY LOW DUE TO THE HIGH RELAPSE RATE. PHARMACOGENETICS AND MASSIVE SEQUENCING STUDIES HAVE ALLOWED THE IDENTIFICATION OF NEW RECURRENT MUTATIONS WITH SIGNIFICANT PROGNOSTIC IMPACT IN AML; FURTHERMORE, IT SEEMS LIKELY THAT WHOLE GENOME SEQUENCING WILL SOON BECOME A STANDARD DIAGNOSTIC TEST, WHICH WILL ALLOW THE MOLECULAR DIAGNOSIS OF PATIENTS. THEREFORE, IT IS NECESSARY TO DEVELOP MOLECULAR TARGETS THAT OPEN NEW THERAPEUTIC PERSPECTIVES AND ALLOW INDIVIDUALIZED TREATMENT OF PATIENTS WITH THIS AGGRESSIVE DISEASE. CHRONIC MYELOID LEUKEMIA (CML) IS THE FIRST NEOPLASTIC DISEASE FOR WHICH A CHARACTERISTIC GENETIC ALTERATION WAS DESCRIBED. IT HAS, BY DEFINITION, A GENETIC MARKER, THE BCR::ABL1 REARRANGEMENT, AS A CONSEQUENCE OF THE T9;22(Q34;Q11) TRANSLOCATION. ITS STUDY IS ESSENTIAL FOR THE DIAGNOSIS OF THIS ENTITY AND ALSO FOR MONITORING THE RESPONSE TO TREATMENT. DRUGS KNOWN AS TYROSINE KINASE INHIBITORS (TKIS) THAT TARGET THE BCR::ABL1 PROTEIN (ORAL TARGETED THERAPY) ARE THE CONVENTIONAL TREATMENT OF CML, REPRESENTING A CHANGE OF PARADIGM IN THE MANAGEMENT OF ONCOHEMATOLOGICAL PATIENTS. 2022 9 2659 46 EPITHELIAL-TO-MESENCHYMAL TRANSITION IN THE CONTEXT OF EPIDERMAL GROWTH FACTOR RECEPTOR INHIBITION IN NON-SMALL-CELL LUNG CANCER. THE IDENTIFICATION OF ONCOGENIC DRIVER MUTATIONS IN NON-SMALL-CELL LUNG CANCER (NSCLC) HAS LED TO THE DEVELOPMENT OF TARGETED DRUGS. TYROSINE KINASE INHIBITORS (TKIS) DIRECTED AGAINST THE EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) TARGET LUNG TUMOURS BEARING EGFR-ACTIVATING MUTATIONS. THIS NEW THERAPEUTIC STRATEGY HAS GREATLY IMPROVED TUMOUR RESPONSE RATES. HOWEVER, DRUG RESISTANCE INVARIABLY OCCURS DURING TKI-BASED TREATMENT. EPITHELIAL-TO-MESENCHYMAL TRANSITION (EMT) IS ONE OF THE RESISTANCE MECHANISMS IDENTIFIED IN EGFR-MUTATED NSCLC TREATED WITH TKIS. IN THIS REVIEW WE GATHER TOGETHER THE MOST IMPORTANT FINDINGS ON THIS PHENOMENON IN RELATION TO CANCER STEM CELLS AND CANCER EPIGENETICS. WE ALSO OUTLINE THE CORRELATION BETWEEN THE EFFECTS OF STROMAL FACTORS FROM THE MICROENVIRONMENT, THE TRANSCRIPTION FACTORS ACTIVATED, THE EPIGENETIC CHANGES IN CHROMATIN, AND THE EVOLUTION OF CELLULAR BEHAVIOUR. NOTABLY, EMT HAS ALREADY BEEN SHOWN TO BE THE LINK BETWEEN BENIGN LUNG DISEASES SUCH AS CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND LUNG CARCINOGENESIS. THE VARIOUS MECHANISMS OF ACQUIRED RESISTANCE TO EGFR-TKIS ARE ALSO BRIEFLY DESCRIBED TO PROVIDE BACKGROUND INFORMATION ON EMT. OUR EXTENSIVE REVIEW OF THE SCIENTIFIC LITERATURE SERVES TO HIGHLIGHT THE CELLULAR AND MOLECULAR EVENTS THAT LEAD TO THE ONSET OF EMT IN NSCLC CELLS TREATED WITH EGFR-TKIS. FINALLY, WE PUT FORWARD A HYPOTHESIS TO EXPLAIN WHY, IN SOME CASES, EMT RATHER THAN OTHER KNOWN MECHANISMS IS INVOLVED IN RESISTANCE TO TKIS. 2018 10 4918 40 PANCREATIC CANCER: FROM BENCH TO 5-YEAR SURVIVAL. PANCREATIC DUCTAL ADENOCARCINOMA IS ONE OF THE MOST AGGRESSIVE HUMAN MALIGNANCIES, WITH AN OVERALL 5-YEAR SURVIVAL RATE OF LESS THAN 4%. ON THE MOLECULAR LEVEL, AN INCREASING NUMBER OF GENETIC AND EPIGENETIC ALTERATIONS HAVE BEEN DISCOVERED, WITH A PARTICULAR FOCUS ON GROWTH FACTORS AND RELATED PATHWAYS. SMALL-MOLECULE TYROSINE KINASE INHIBITORS, ANTIBODIES, AND OTHER APPROACHES HAVE BEEN DEVELOPED IN RECENT YEARS TO TARGET THESE SIGNAL TRANSDUCTION PATHWAYS, AND FIRST CLINICAL TRIALS SHOW ENCOURAGING RESULTS. IN ADDITION, MOLECULAR ALTERATIONS HAVE BEEN IDENTIFIED THAT ENABLE THE CANCER CELLS TO INVADE THE PERINEURIUM AND THE RETROPERITONEAL SPACE, THUS EXPLAINING AT LEAST IN PART THE HIGH RATE OF LOCAL RECURRENCE AND THE SEVERE PAIN SYNDROME. TECHNICALLY, PANCREATIC SURGERY HAS ADVANCED, WITH ACCEPTABLE MORBIDITY AND MORTALITY RATES IN HIGH-VOLUME CENTERS. RANDOMIZED CONTROLLED TRIALS ARE INCREASINGLY CARRIED OUT TO DEFINE THE BEST PALLIATIVE AND ADJUVANT THERAPY FOR THIS DISEASE. TRANSLATIONAL RESEARCH COMBINED WITH CLINICAL TRIALS WILL HOPEFULLY LEAD TO IMPROVED SURVIVAL AND BETTER QUALITY OF LIFE FOR PANCREATIC CANCER PATIENTS IN THE FUTURE. 2006 11 6896 31 [TARGETED EPIGENETIC THERAPY OF CANCER. ACHIEVEMENTS AND PERSPECTIVES]. IN THIS REVIEW, WE PROVIDE AN OVERVIEW OF THE PHYSIOLOGICAL AND PATHOPHYSIOLOGICAL EPIGENETIC CHANGES OF NORMAL CELLS AND CANCER CELLS, AND EMPHASIZE THE ACHIEVEMENTS AND THE PERSPECTIVES OF CANCER EPIGENETIC THERAPY. CANCER EPIGENETIC ALTERATIONS CORRESPOND FOREMOST TO HYPERMETHYLATION OF TUMOR SUPPRESSOR GENES PROMOTORS, GLOBAL DNA HYPOMETHYLATION, AND OVEREXPRESSION AND ACTIVITY OF HISTONE DEACETYLASES. THE PURPOSE OF EPIGENETIC THERAPY IS TO REVERT THE EPIGENETIC ALTERATIONS IN CANCER CELLS AND OBTAIN THE "NORMAL EPIGENOME" RESTORATION. EPIGENETIC TARGETS IN CANCER THERAPY HAVE FOCUSED ON HDACS AND DNMTS INHIBITION. THE AZACITIDINE AND THE DECITABINE, THE VORINOSTAT AND THE ROMIDEPSIN WERE APPROVED BY US-FDA FOR TREATMENT OF MYELODYSPLASTIC SYNDROME, AND CUTANEOUS T-CELL LYMPHOMA, RESPECTIVELY. EPIGENETIC AND EPIGENOMIC CHANGES IN SINGLE OR MULTIPLE GENES HAVE SHOWED POTENTIAL IMPACT IN CANCER AS EARLY DETECTION, PROGNOSIS AND PREDICTIVE MARKS. THE EPIGENETIC REVOLUTION HAS ARRIVED FOR BIOLOGY. THE SIGNIFICANT PROGRESS IN EPIGENETIC STUDIES HAVE ALLOWED US, TO UNDERSTAND NEW LOOKS IN THE PHYSIOLOGY AND PATHOPHYSIOLOGY OF EMBRYONIC DEVELOPMENT, CANCER AND OTHER CHRONIC DISEASES. SPECIFIC MOLECULAR EPIGENETIC ALTERATIONS IN DIFFERENT CANCER TYPES, GIVE US NEW STRATEGIES TO DESIGN IMPROVED CANCER THERAPY. THE CHALLENGE FOR EPIGENETIC INVESTIGATORS IS DESIGN MORE SPECIFIC EPIDRUGS WITH LESSER SIDE EFFECTS. 2012 12 943 33 CHRONIC LYMPHOCYTIC LEUKEMIA. PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA CAN BE DIVIDED INTO THREE CATEGORIES: THOSE WHO ARE MINIMALLY AFFECTED BY THE PROBLEM, OFTEN NEVER REQUIRING THERAPY; THOSE THAT INITIALLY FOLLOW AN INDOLENT COURSE BUT SUBSEQUENTLY PROGRESS AND REQUIRE THERAPY; AND THOSE THAT FROM THE POINT OF DIAGNOSIS EXHIBIT AN AGGRESSIVE DISEASE NECESSITATING TREATMENT. LIKEWISE, SUCH PATIENTS PASS THROUGH THREE PHASES: DEVELOPMENT OF THE DISEASE, DIAGNOSIS, AND NEED FOR THERAPY. FINALLY, THE LEUKEMIC CLONES OF ALL PATIENTS APPEAR TO REQUIRE CONTINUOUS INPUT FROM THE EXTERIOR, MOST OFTEN THROUGH MEMBRANE RECEPTORS, TO ALLOW THEM TO SURVIVE AND GROW. THIS REVIEW IS PRESENTED ACCORDING TO THE TEMPORAL COURSE THAT THE DISEASE FOLLOWS, FOCUSING ON THOSE EXTERNAL INFLUENCES FROM THE TISSUE MICROENVIRONMENT (TME) THAT SUPPORT THE TIME LINES AS WELL AS THOSE INTERNAL INFLUENCES THAT ARE INHERITED OR DEVELOP AS GENETIC AND EPIGENETIC CHANGES OCCURRING OVER THE TIME LINE. REGARDING THE FORMER, SPECIAL EMPHASIS IS PLACED ON THE INPUT PROVIDED VIA THE B-CELL RECEPTOR FOR ANTIGEN AND THE C-X-C-MOTIF CHEMOKINE RECEPTOR-4 AND THE THERAPEUTIC AGENTS THAT BLOCK THESE INPUTS. REGARDING THE LATTER, PROMINENCE IS LAID UPON INHERITED SUSCEPTIBILITY GENES AND THE GENETIC AND EPIGENETIC ABNORMALITIES THAT LEAD TO THE DEVELOPMENTAL AND PROGRESSION OF THE DISEASE. 2021 13 4671 40 NEW INSIGHTS INTO THE MECHANISM OF ACTION OF ASPIRIN IN THE PREVENTION OF COLORECTAL NEOPLASIA. THE RESULTS OF CLINICAL STUDIES HAVE SHOWN THAT THE CHRONIC ADMINISTRATION OF ASPIRIN, EVEN AT THE LOWDOSES (75-100 MG DAILY) RECOMMENDED FOR THE PREVENTION OF CARDIOVASCULAR DISEASE, IS ASSOCIATED WITH A REDUCTION OF CANCER INCIDENCE AND MORTALITY, IN PARTICULAR COLORECTAL CANCER (CRC). THE MECHANISM OF ACTION OF ASPIRIN AS AN ANTINEOPLASTIC AGENT REMAINS CONTROVERSIAL. HOWEVER, DATA OF CLINICAL PHARMACOLOGY AND SEVERAL FEATURES OF THE CHEMOPREVENTIVE EFFECT OF ASPIRIN, EMERGED FROM CLINICAL TRIALS, SUGGEST THAT THE ANTIPLATELET EFFECT OF ASPIRIN PLAYS A CENTRAL ROLE IN ITS ANTICANCER EFFECTS. IN ADDITION TO THEIR CONTRIBUTION TO TUMOR METASTASIS, PLATELETS MAY PLAY A ROLE IN THE EARLY PHASES OF TUMORIGENESIS. IN RESPONSE TO LIFESTYLE AND ENVIRONMENT FACTORS, INTESTINAL EPITHELIAL DAMAGE/ DYSFUNCTION MAY BE ASSOCIATED WITH PLATELET ACTIVATION, INITIALLY AS A MECHANISM TO REPAIR THE DAMAGE. HOWEVER, IF THE PLATELET RESPONSE IS UNCONSTRAINED, IT MAY CONTRIBUTE TO THE DEVELOPMENT OF CHRONIC INFLAMMATION. ALTOGETHER THESE EVENTS LEAD TO ALTER THE NORMAL FUNCTIONS OF INTESTINAL EPITHELIAL CELLS AND MAY TRANSLATE INTO CELLULAR TRANSFORMATION THROUGH SEVERAL MECHANISMS, INCLUDING THE OVEREXPRESSION OF CYCLOOXYGENASE(COX)-2 AND EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR), WHICH ARE CONSIDERED EARLY EVENTS IN COLORECTAL TUMORIGENESIS. THUS, ANTIPLATELET AGENTS MAY PLAY A ROLE IN THE PREVENTION OF CRC BY MODIFYING EPIGENETIC EVENTS INVOLVED IN EARLY PHASES OF COLORECTAL TUMORIGENESIS. FINALLY, WE CARRIED OUT A CRITICAL REVIEW OF THE LITERATURE ON OFF-TARGET MECHANISMS OF ASPIRIN ACTION AS ANTICANCER DRUG. 2015 14 736 40 CANCER STEM CELLS--NEW APPROACH TO CANCEROGENENSIS AND TREATMENT. RECENTLY, THERE IS AN INCREASING EVIDENCE SUPPORTING THE THEORY OF CANCER STEM CELLS NOT ONLY IN LEUKEMIA BUT ALSO IN SOLID CANCER. TO DATE, THE EXISTENCE OF CANCER STEM CELLS HAS BEEN PROVEN IN ACUTE AND CHRONIC MYELOID LEUKEMIA, IN BREAST CANCER, IN BRAIN TUMORS, IN LUNG CANCER AND GASTROINTESTINAL TUMORS. THIS REVIEW IS FOCUSING ON THE RECENT DISCOVERY OF STEM CELLS IN LEUKEMIA, HUMAN BRAIN TUMORS AND BREAST CANCER. A SMALL POPULATION OF CELLS IN THE TUMOR (LESS THAN 1%) SHOWS THE POTENTIAL TO GIVE RISE TO THE TUMOR AND ITS GROWTH. THESE CELLS HAVE A SUBSTANTIAL CHARACTERISTIC OF STEM CELLS--ABILITY FOR SELF-RENEWAL WITHOUT LOSS OF PROLIFERATION CAPACITY WITH EACH CELL DIVISION. FURTHERMORE THEY ARE IMMORTAL, RATHER RESISTANT TO TREATMENT AND EXPRESS TYPICAL MARKERS OF STEM CELLS. THE ORIGIN OF THESE RESIDENT CANCER STEM CELLS IS NOT CLEAR. WHETHER THE CANCER STEM CELLS ORIGINATE FROM NORMAL STEM CELLS IN CONSEQUENCE OF GENETIC AND EPIGENETIC CHANGES AND/OR REDIFFERENTIATION FROM SOMATIC TUMOR CELLS TO THE STEM-LIKE CELLS REMAINS TO BE INVESTIGATED. WE PROPOSE THE IDEA OF THE RELATION BETWEEN NORMAL TISSUE STEM CELLS AND CANCER STEM CELLS AND THEIR POPULATIONS--PROGENITOR CELLS. BASED ON THIS WE HIGHLIGHT ONE OF THE MAJOR CHARACTERISTIC OF STEM CELL--PLASTICITY, WHICH IS EQUALLY IMPORTANT IN THE PHYSIOLOGICAL REGENERATION PROCESS AS WELL AS CARCINOGENESIS. FURTHERMORE, WE CONSIDER THE MICROENVIRONMENT AS A LIMITING FACTOR FOR TUMOR GENESIS IN AML, BREAST CANCER AND BRAIN TUMORS. THUS THE BIOLOGICAL PROPERTIES OF CANCER STEM CELLS ARE JUST BEGINNING TO BE REVEALED, THE CONTINUATION OF THESE STUDIES SHOULD LEAD TO THE DEVELOPMENT OF CANCER STEM CELLS TARGET THERAPIES FOR CANCER TREATMENT. 2008 15 1621 51 DNA METHYLTRANSFERASES AS TARGETS FOR CANCER THERAPY. METHYLATION OF DNA AT 5-POSITION OF CYTOSINE, CATALYZED BY DNA METHYLTRANSFERASES, IS THE PREDOMINANT EPIGENETIC MODIFICATION IN MAMMALS. ABERRATIONS IN METHYLATION PLAY A CAUSAL ROLE IN A VARIETY OF DISEASES, INCLUDING CANCER. RECENT STUDIES HAVE ESTABLISHED THAT LIKE MUTATION, METHYLATION-MEDIATED GENE SILENCING OFTEN LEADS TO TUMORIGENESIS. PARADOXICALLY, GENOME-WIDE DNA HYPOMETHYLATION MAY ALSO PLAY A CAUSAL ROLE IN CARCINOGENESIS BY INDUCING CHROMOSOMAL INSTABILITY AND SPURIOUS GENE EXPRESSION. SINCE METHYLATION DOES NOT ALTER DNA BASE SEQUENCE, MUCH ATTENTION HAS BEEN FOCUSED RECENTLY ON DEVELOPING SMALL MOLECULE INHIBITORS OF DNA METHYLTRANSFERASES THAT CAN POTENTIALLY BE USED AS ANTICANCER AGENTS. VIDAZA (5-AZACYTIDINE), MARKETED BY PHARMION (BOULDER, CO, USA), WAS THE FIRST DNA METHYLTRANSFERASE INHIBITOR APPROVED BY THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) FOR CHEMOTHERAPY AGAINST MYELODYSPLASTIC SYNDROME (MDS), A HETEROGENEOUS BONE MARROW DISORDER. RECENTLY MGI PHARMA INC. (BLOOMINGTON, MN, USA) GOT FDA APPROVAL TO MARKET DACOGEN (5-AZA-2'-DEOXYCYTIDINE, OR DECITABINE) FOR TREATING MDS PATIENTS. THESE DRUGS WERE USED EARLIER AGAINST CERTAIN ANEMIAS TO INDUCE EXPRESSION OF FETAL GLOBIN GENES. INTEREST IN CLINICAL TRIALS OF THESE DRUGS AS ANTICANCER AGENTS HAS BEEN RENEWED ONLY RECENTLY BECAUSE OF REVERSAL OF METHYLATION-MEDIATED SILENCING OF CRITICAL GENES IN CANCER. CLINICAL TRIALS HAVE SHOWN THAT BOTH DRUGS HAVE THERAPEUTIC POTENTIAL AGAINST LEUKEMIA SUCH AS MDS, ACUTE MYELOID LEUKEMIA, CHRONIC MYELOGENOUS LEUKEMIA AND CHRONIC MYELOMONOCYTIC LEUKEMIA. IN CONTRAST, THEIR EFFECTIVENESS WITH SOLID TUMORS APPEARS TO BE LESS PROMISING, WHICH CHALLENGES RESEARCHERS TO DEVELOP INHIBITORS WITH MORE EFFICACY AND LESS TOXICITY. THE MAJOR HINDRANCE OF THEIR USAGE AS ANTICANCER AGENTS IS THEIR INSTABILITY IN VIVO AS WELL AS THE TOXICITY SECONDARY TO THEIR EXCESSIVE INCORPORATION INTO DNA, WHICH CAUSES CELL CYCLE ARREST. GENE EXPRESSION PROFILING IN CANCER CELLS REVEALED THAT ANTINEOPLASTIC PROPERTY OF THESE DRUGS IS MEDIATED THROUGH BOTH METHYLATION-DEPENDENT AND -INDEPENDENT PATHWAYS. RECENTLY, WE HAVE SHOWN THAT TREATMENT OF CANCER CELLS WITH THESE CYTIDINE ANALOGUES ALSO INDUCES PROTEASOMAL DEGRADATION OF DNA METHYLTRANSFERASE 1, THE UBIQUITOUSLY EXPRESSED ENZYME UPREGULATED IN ALMOST ALL CANCER CELLS. DEVELOPMENT OF RELATED STABLE DRUGS THAT CAN FACILITATE GENE ACTIVATION IN CANCER CELLS BY ENHANCING DEGRADATION OF DNA METHYLTRANSFERASES WITHOUT BEING INCORPORATED INTO DNA WOULD BE IDEAL FOR CHEMOTHERAPY. IN THIS MONOGRAPH WE REVIEW HISTORICAL PERSPECTIVE AND RECENT ADVANCES ON THE MOLECULAR MECHANISMS OF ACTION AND CLINICAL APPLICATIONS OF THESE DNA HYPOMETHYLATING AGENTS. 2007 16 2752 35 EXPRESSION OF ANGIOGENIC FACTORS IN CHRONIC MYELOID LEUKAEMIA: ROLE OF THE BCR/ABL ONCOGENE, BIOCHEMICAL MECHANISMS, AND POTENTIAL CLINICAL IMPLICATIONS. CHRONIC MYELOID LEUKAEMIA (CML) IS A STEM CELL DISEASE CHARACTERIZED BY AN INCREASED PRODUCTION AND ACCUMULATION OF CLONAL BCR/ABL-POSITIVE CELLS IN HAEMATOPOIETIC TISSUES. THE CHRONIC PHASE OF CML IS INEVITABLY FOLLOWED BY AN ACCELERATED PHASE OF THE DISEASE, WITH CONSECUTIVE BLAST CRISIS. HOWEVER, DEPENDING ON GENETIC STABILITY, EPIGENETIC EVENTS, AND SEVERAL OTHER FACTORS, THE CLINICAL COURSE AND SURVIVAL APPEAR TO VARY AMONG PATIENTS. RECENT DATA SUGGEST THAT ANGIOGENIC CYTOKINES SUCH AS VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF), ARE UP-REGULATED IN CML, AND PLAY A ROLE IN THE PATHOGENESIS OF THE DISEASE. THESE FACTORS APPEAR TO BE PRODUCED AND RELEASED IN LEUKAEMIC CELLS IN PATIENTS WITH CML. IN LINE WITH THIS NOTION, INCREASED SERUM-LEVELS OF ANGIOGENIC GROWTH FACTORS ARE MEASURABLE IN CML PATIENTS. IN THIS STUDY WE PROVIDE AN OVERVIEW OF ANGIOGENIC GROWTH FACTORS EXPRESSED IN CML CELLS, DISCUSS THE POSSIBLE PATHOGENETIC ROLE OF THESE CYTOKINES, THE BIOCHEMICAL BASIS OF THEIR PRODUCTION IN LEUKAEMIC CELLS, AND THEIR POTENTIAL CLINICAL IMPLICATIONS. 2004 17 4429 38 MOLECULAR BIOLOGY AS A TOOL FOR THE TREATMENT OF CANCER. CANCER IS A GENETIC DISEASE CHARACTERIZED BY UNCONTROLLED CELL GROWTH AND METASTASIS. CANCER CAN HAVE A NUMBER OF CAUSES, SUCH THE ACTIVATION OF ONCOGENES, THE INACTIVATION OF TUMOR-SUPPRESSING GENES, MUTAGENESIS PROVOKED BY EXTERNAL FACTORS, AND EPIGENETIC MODIFICATIONS. THE DEVELOPMENT OF DIAGNOSTIC TOOLS AND TREATMENTS USING A MOLECULAR BIOLOGICAL APPROACH PERMITS THE USE OF SENSITIVE, LOW-COST, NONINVASIVE TESTS FOR CANCER PATIENTS. BIOMARKERS CAN BE USED TO PROVIDE RAPID, PERSONALIZED ONCOLOGY, IN PARTICULAR THE MOLECULAR DIAGNOSIS OF CHRONIC MYELOID LEUKEMIA, AND GASTRIC, COLON, AND BREAST CANCERS. MOLECULAR TESTS BASED ON DNA METHYLATION CAN ALSO BE USED TO DIRECT TREATMENTS OR EVALUATE THE TOXIC EFFECTS OF CHEMOTHERAPY. THE ADEQUATE DIAGNOSIS, PROGNOSIS, AND PREDICTION OF THE RESPONSE OF CANCER PATIENTS TO TREATMENT ARE ESSENTIAL TO ENSURE THE MOST EFFECTIVE THERAPY, REDUCE THE DAMAGING EFFECTS OF TREATMENT, AND DIRECT THE THERAPY TO SPECIFIC TARGETS, AND IN THIS CONTEXT, MOLECULAR BIOLOGY HAS BECOME INCREASINGLY IMPORTANT IN ONCOLOGY. IN THIS BRIEF REVIEW, WE WILL DEMONSTRATE THE FUNDAMENTAL IMPORTANCE OF MOLECULAR BIOLOGY FOR THE TREATMENT OF THREE TYPES OF CANCER-CHRONIC MYELOID LEUKEMIA, HEREDITARY DIFFUSE GASTRIC CANCER, AND ASTROCYTOMAS (SPORADIC TUMORS OF THE CENTRAL NERVOUS SYSTEM). IN EACH OF THESE THREE MODELS, DISTINCT BIOLOGICAL MECHANISMS ARE INVOLVED IN THE TRANSFORMATION OF THE CELLS, BUT IN ALL CASES, MOLECULAR BIOLOGY IS FUNDAMENTAL TO THE DEVELOPMENT OF PERSONALIZED ANALYSES FOR EACH PATIENT AND EACH TYPE OF NEOPLASIA, AND TO GUARANTEE THE SUCCESS OF THE TREATMENT. 2018 18 1882 39 EMERGING TREATMENTS IN ACUTE MYELOID LEUKAEMIA. ACUTE MYELOID LEUKAEMIA (AML) IS THE MOST COMMON FORM OF LEUKAEMIA IN YOUNG ADULTS. ALTHOUGH 75-85% OF PATIENTS WILL ACHIEVE COMPLETE REMISSION AFTER INDUCTION CHEMOTHERAPY, THE LONG-TERM SURVIVAL IS STILL < 50% AT 5 YEARS. CHEMOTHERAPY HAS INCREASED IN INTENSITY IN RECENT YEARS AND IS PERCEIVED TO HAVE REACHED THE LIMIT OF TOXICITY. ALLOGENEIC BONE MARROW TRANSPLANTATION, WHICH IS UNDOUBTEDLY THE MOST EFFECTIVE WAY TO PREVENT RELAPSE, MAY NOT ADD SUBSTANTIAL SURVIVAL BENEFITS. SEVERAL NEW PHARMACOLOGICAL APPROACHES TO THE TREATMENT OF AML ARE NOW BECOMING AVAILABLE, WITH VARIOUS MOLECULAR TARGETS IDENTIFIED, INCLUDING THE FARNESYLATION OF RAS FAMILY PROTEINS AND TYROSINE KINASES INVOLVED IN SIGNAL TRANSDUCTION AND EPIGENETIC METHYLATION. MORE SELECTIVE DELIVERY OF CHEMOTHERAPEUTIC AGENTS IS ALSO FEASIBLE USING HUMANISED MONOCLONAL ANTIBODIES, WITH THE INTRIGUING POSSIBILITY OF INCREASING TREATMENT DELIVERY WITHOUT INCREASING THE TOXICITY. HOWEVER, DESPITE THE PROGRESS IN THE RATIONAL DESIGN OF DRUGS IN DISORDERS SUCH AS CHRONIC MYELOID LEUKAEMIA, AML LACKS A SINGLE SPECIFIC PATHOGNOMIC GENETIC EVENT TO ACT AS A DRUG TARGET. THIS REVIEW DISCUSSES THE DRUGS PRESENTLY UNDER INVESTIGATION IN PHASE II OR PHASE III TRIALS IN AML. 2004 19 6906 33 [THE ROLE OF GLYCANS IN CANCER DEVELOPMENT AND PROGRESSION. CLINICAL APPLICATIONS]. CHANGES IN GLYCOSYLATION PATTERN OF CELL SURFACE, BODY FLUIDS AND EXTRACELLULAR MATRIX GLYCOCONJUGATES IS A CHARACTERISTIC FEATURE OF TUMOR CELL MALIGNANCY. THESE CHANGES ARE THE RESULT OF MUTATIONS OF TUMOR-ASSOCIATED GENES AS WELL AS EPIGENETIC CHANGES IN THE TUMOR ENVIRONMENT, INCLUDING NUTRIENT INFLUX, HYPOXIA, CYTOKINE EXPRESSION AND STIMULATION OF CHRONIC INFLAMMATION. THE UNIQUE SET OF CELL SURFACE GLYCOANTIGENS ON NEOPLASTIC CELLS IS RECOGNIZED BY ENDOGENOUS LECTINS LOCATED IN THE EXTRACELLULAR MATRIX, VASCULAR ENDOTHELIUM, ON LEUKOCYTES OR PLATELETS, AND HAS AN IMPACT ON DISRUPTING BASIC CELLULAR PROCESSES, SUCH AS INTERCELLULAR RECOGNITION, CELL-CELL ADHESION OR CELL-ECM INTERACTION. THESE CHANGES HAVE A CRITICAL IMPACT ON THE MIGRATION, INVASIVE AND METASTATIC POTENTIAL OF NEOPLASTIC CELLS AND MODULATE THE IMMUNE RESPONSE. THIS UNIQUE PATTERN OF SUGAR ANTIGENS ON THE CANCER CELLS CAN BE A VAULABLE MARKER TO IDENTIFY THEM, DETERMINE THE STAGE OF THE DISEASE AS WELL AS BE A TARGET OF ANTI-CANCER THERAPY. 2021 20 5447 41 REPOSITIONING LIDOCAINE AS AN ANTICANCER DRUG: THE ROLE BEYOND ANESTHESIA. WHILE CANCER TREATMENT HAS IMPROVED DRAMATICALLY, IT HAS ALSO ENCOUNTERED MANY CRITICAL CHALLENGES, SUCH AS DISEASE RECURRENCE, METASTASIS, AND DRUG RESISTANCE, MAKING NEW DRUGS WITH NOVEL MECHANISMS AN URGENT CLINICAL NEED. THE TERM "DRUG REPOSITIONING," ALSO KNOWN AS OLD DRUGS FOR NEW USES, HAS EMERGED AS ONE PRACTICAL STRATEGY TO DEVELOP NEW ANTICANCER DRUGS. ANESTHETICS HAVE BEEN WIDELY USED IN SURGICAL PROCEDURES TO REDUCE THE EXCRUCIATING PAIN. LIDOCAINE, ONE OF THE MOST-USED LOCAL ANESTHETICS IN CLINICAL SETTINGS, HAS BEEN FOUND TO SHOW MULTI-ACTIVITIES, INCLUDING POTENTIAL IN CANCER TREATMENT. GROWING EVIDENCE SHOWS THAT LIDOCAINE MAY NOT ONLY WORK AS A CHEMOSENSITIZER THAT SENSITIZES OTHER CONVENTIONAL CHEMOTHERAPEUTICS TO CERTAIN RESISTANT CANCER CELLS, BUT ALSO COULD SUPPRESS CANCER CELLS GROWTH BY SINGLE USE AT DIFFERENT DOSES OR CONCENTRATIONS. LIDOCAINE COULD SUPPRESS CANCER CELL GROWTH IN VITRO AND IN VIVO VIA MULTIPLE MECHANISMS, SUCH AS REGULATING EPIGENETIC CHANGES AND PROMOTING PRO-APOPTOSIS PATHWAYS, AS WELL AS REGULATING ABC TRANSPORTERS, METASTASIS, AND ANGIOGENESIS, ETC., PROVIDING VALUABLE INFORMATION FOR ITS FURTHER APPLICATION IN CANCER TREATMENT AND FOR NEW DRUG DISCOVERY. IN ADDITION, LIDOCAINE IS NOW UNDER CLINICAL TRIALS TO TREAT CERTAIN TYPES OF CANCER. IN THE CURRENT REVIEW, WE SUMMARIZE THE RESEARCH AND ANALYZE THE UNDERLYING MECHANISMS, AND ADDRESS KEY ISSUES IN THIS AREA. 2020