Designing a broad-spectrum integrative approach for cancer prevention and treatment
- PMID: 26590477
- PMCID: PMC4819002
- DOI: 10.1016/j.semcancer.2015.09.007
Designing a broad-spectrum integrative approach for cancer prevention and treatment
Abstract
Targeted therapies and the consequent adoption of "personalized" oncology have achieved notable successes in some cancers; however, significant problems remain with this approach. Many targeted therapies are highly toxic, costs are extremely high, and most patients experience relapse after a few disease-free months. Relapses arise from genetic heterogeneity in tumors, which harbor therapy-resistant immortalized cells that have adopted alternate and compensatory pathways (i.e., pathways that are not reliant upon the same mechanisms as those which have been targeted). To address these limitations, an international task force of 180 scientists was assembled to explore the concept of a low-toxicity "broad-spectrum" therapeutic approach that could simultaneously target many key pathways and mechanisms. Using cancer hallmark phenotypes and the tumor microenvironment to account for the various aspects of relevant cancer biology, interdisciplinary teams reviewed each hallmark area and nominated a wide range of high-priority targets (74 in total) that could be modified to improve patient outcomes. For these targets, corresponding low-toxicity therapeutic approaches were then suggested, many of which were phytochemicals. Proposed actions on each target and all of the approaches were further reviewed for known effects on other hallmark areas and the tumor microenvironment. Potential contrary or procarcinogenic effects were found for 3.9% of the relationships between targets and hallmarks, and mixed evidence of complementary and contrary relationships was found for 7.1%. Approximately 67% of the relationships revealed potentially complementary effects, and the remainder had no known relationship. Among the approaches, 1.1% had contrary, 2.8% had mixed and 62.1% had complementary relationships. These results suggest that a broad-spectrum approach should be feasible from a safety standpoint. This novel approach has potential to be relatively inexpensive, it should help us address stages and types of cancer that lack conventional treatment, and it may reduce relapse risks. A proposed agenda for future research is offered.
Keywords: Cancer hallmarks; Integrative medicine; Multi-targeted; Phytochemicals; Targeted therapy.
Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Conflict of interest statement
Keith Block is an owner of the Block Center for Integrative Cancer Treatment and of North Shore Nutraceuticals; Charlotte Gyllenhaal is an employee of the Block Center for Integrative Cancer Treatment; Jack Arbiser is the inventor of US Patents involving derivatives of honokiol and NADPH oxidase inhibitors. He has also cofounded ABBY Therapeutics for the development of NADPH oxidase inhibitors; Penny Block is the Executive Director of the Block Center for Integrative Cancer Treatment and President of North Shore Nutraceuticals; Ralph J. DeBerardinis is a member of the scientific advisory boards for Peloton Therapeutics and Agios Pharmaceuticals; Anna Mae E. Diehl has grants from Shire-Research, Metabolon, and Gilead. She is also a consultant for Astrazeneca, Genentech, Japan Tobacco, and the NuSI Foundation; Byoung S. Kwon holds patents for methods regarding anti-CD 137 and adaptive CTL therapeutics; Valter D. Longo has an equity interest in L-Nutra, a company that develops medical food; Kapil Mehta is a scientific advisor to Lifecare Innovations, and holds India Patent 8.765.797, TG2 inhibitors and uses thereof; Michael P. Murphy holds intellectual property in mitochondrial therapies and has ownership shares in a company called Antipodean Pharmaceuticals Inc. which is trying to commercialize some of these compounds; Jeffrey C. Rathmell received indirect compensation from Novartis while working on this project; Luigi Ricciardiello received an unrestricted research grant from SLA Pharma AG, Switzerland.; John Stagg has a sponsored research agreement with Medimmune LLC and is on the scientific advisory board of Surface Oncology; Matthew G. Vander Heiden is a consultant, scientific advisory board member, and owns equity in Agios Pharmaceuticals
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