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can interact with their surroundings. Interfering with the normal cell recognition
phenomenon using a small or large sugar molecule has been shown to block the
progression of tumors by blocking angiogenesis, cell-to-cell matrix interactions and
tumor invasion.
Targeting Pathways in Cancer
The phosphatidilinositol 3-kinase/protein kinase B (PI3K-AKT) pathway presents
an exciting new target for molecular therapeutics. PI3K-AKT pathway regulates a
broad spectrum of cellular processes, some of which are necessary to maintain nor-
mal physiological functions and explain the toxicity of the drugs targeting the path-
way. Elucidation of the precise function of the PI3K-AKT isoforms, could promote
the development of isoform specifi c approaches to provide a selective action on
tumor cells. Inhibition of the PI3K-AKT pathway at multiple sites or a combination
with inhibitors of different signaling pathways may allow the development of an
acceptable therapeutic index for cancer management. Further, inhibition of the
PI3K-AKT pathway combined with conventional chemotherapy or radiation ther-
apy may provide a more effective strategy to improve patient outcome. As molecu-
lar therapy targets the underlying defects in tumors, molecular diagnostics are
required to identify patients with particular genetic aberrations in the pathway to
enable personalized cancer treatment.
Targeted Personalized Anticancer Medicines in Clinical Use
Several cancer therapies are targeted to specifi c mutations or receptors in tumors
and have companion diagnostics to personalize their use. Table 10.3 shows mar-
keted personalized anticancer drugs described later in this chapter under organs
involved.
Immunotherapy of Cancer
Cancer immunology deals with the study of natural interplay between oncogenesis,
infl ammation and immune surveillance of the body as well. Immune mechanisms
may contribute to the effi cacy of some currently used chemotherapeutic agents that
may involve recognition of tumor-associated antigens or controlling growth of can-
cer stem cells. Immunological biomarkers may be used to determine prognosis of
cancer and predict the effi cacy of anticancer action. Important methods of immuno-
therapy for cancer are cytokines, monoclonal antibodies (MAbs), vaccines, and
immunogene therapy.
10 Personalized Therapy of Cancer