• Citer

Nouvelles molécules en oncologie : Les thérapies biologiques ciblées

par Lalami, Yassine
Référence Revue médicale de Bruxelles, 40, 4, page (355-362)
Publication Publié, 2019

Article révisé par les pairs

• Détails
• Contenu

Résumé :

Since the 1950s, major progresses have been achieved in the field of cancer chemotherapy, targeting tumor cell DNA. Currently, the clinical advances in chemotherapy become limited, having reached a plateau of effectiveness. Despite an initial favorable response, more than half of the patients will present with a relapse of their disease and or a resistance to medical treatment in metastatic setting. Further, in addition to resistance, chemotherapy is also accompanied of several side effects that can strongly affect the quality of life of the patients. Over the decades, we attended a better understanding of the molecular events considered as crucial for growth and proliferation of cancer cells, in different types of tumors. All these mechanisms of intracellular signaling, but also within the microenvironment, helped to identify therapeutic targets beyond the tumor DNA. The growing understanding of the molecular events underlying the etiology of different cancers as well as the signaling events that are critical for the continued growth and proliferation of cancer cells enhanced the opportunities for developing new agents. This allowed the development of biological targeted therapies. These innovative molecules block tumor growth by inhibiting proteins (via tyrosine kinase inhibitors) and/or transmembrane receptors (via monoclonal antibodies) having a fundamental role in tumor proliferation, as opposed to the less specific mechanism of action related to conventional chemotherapy and its direct action on cell division. This targeted therapeutic approach allowed the development for a more personalized cancer medicine, identifying patients, but especially types of tumors that will draw the most significant clinical benefit, based on the identification of specific predictive molecular markers. The objective of this article is to present an overview of this therapeutic progress while emphasizing the undeniable therapeutic advances, but also to highlight limitations, toxicities and caution in using this new type of anti-cancer therapeutic. The place and role of immunotherapy, another revolution in the medical treatment of cancer, will be addressed in another chapter of this review.