Perspective: Challenging Roadblocks to Cancer Cure (chronic vs cure...) Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

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Saturday, August 13, 2016

Perspective: Challenging Roadblocks to Cancer Cure (chronic vs cure...)




open access

The Pezcoller Symposium in Trento, Italy, June 2015, focused
entirely on the question of why advanced cancer cure is so
uncommon despite the extraordinarily rapid growth of invaluable
therapeutic information.
Participants were asked to define and to
critically evaluate real and potential obstacles to permanent
disease eradication. High-level concepts on potential road blocks
to cures as well as opportunities for intervention in diverse areas of
investigation ranging from genomic alterations to metabolism,
microenvironment, immunity, and mechanotransduction were
discussed. Provocative concepts and novel therapeutic avenues
were proposed. What follows is a critical analysis of the highlights
of this meeting.
Cancer Res; 76(17); 1–7. 2016 AACR.

 Introduction
Although cures or long-term, disease-free survival can be
achieved in certain cancers such as CML and testicular cancer,
others, particularly solid tumors, have eluded them altogether.On
the other hand, extended survival without definitive cure has been
achieved in many malignancies, either as a result of prevention or
chronic therapeutic approaches (e.g., prostate and breast cancer).
Therapies range from traditional chemotherapeutic agents to
targeted approaches with small molecules, to biological and,
most recently, powerful immunotherapeutic approaches.
Tumors also range in pathogenetic mechanisms, which, in turn,
may affect therapeutic responsiveness. Monogenic alterations,
such as certain genomic translocation-driving leukemias and
non–small cell lung cancers, are potentially treatable with targeted
agents. In contrast, most solid tumors with their complex genetic
alterations, their heterogeneity, clonal diversity, and intricate
microenvironments have proven to be a
much more arduous
therapeutic problem.

Because of the difficulty in addressing cancers that are so diverse
and resourceful, some have advocated a goal of turning lethal
cancers into chronic diseases rather than curing them. Others
would argue that this is a defeatist approach
that sets a "low bar"
and avoids decisive endpoints......

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