Combination Approach: the Future of the War Against Cancer

Abstract

Cancer remains one of the major health problems worldwide and is responsible for one in eight deaths. The worldwide research against cancer as well as genome wide association studies was successful in indentifying the loci associated with cancer but still a substantial amount of casualty remains unexplained. The reason being the cancer cell rapidly develops resistance against the chemotherapeutic or chemopreventive agent in use. Over the last decade, the thorough understanding of molecular and biochemical mechanisms of the carcinogenesis process lead to the rationale of combining anti-cancer agents (therapeutic as well as chemopreventive) to target multiple pathways. Scientists, the world over trying various combinations of chemotherapy, radiation therapy, chemopreventive agents, nanoparticles, etc., in order to specifically as well as efficiently target cancer cells. The present review article summarizes the recent advances in the combination approach against cancer in order to enhance efficacy of treatment with minimal side effects.

Cancer Chemoprevention and Piperine: Molecular Mechanisms and Therapeutic Opportunities

“…Usually, combination chemopreventive strategy is preferred over single-agent chemoprevention. Combination chemopreventive approach utilizes multiple chemopreventive agents at low doses to achieve maximum chemopreventive efficacy with minimum toxicity (Chen and Malhotra, 2015 ). For example, GLAD, a cocktail of gefitinib, licofelone, atorvastatin, and α-difluoromethylornithine, suppresses colon tumorigenesis in APC(Min/+) mice with no toxicity (Mohammed et al, 2013 ).…”

Molecular mechanism and pharmacokinetics of flavonoids in the treatment of resistant EGF receptor‐mutated non‐small‐cell lung cancer: A narrative review

“…Cancer patients who develop drug resistance are often treated with chemotherapy in conjunction with radiotherapy, to improve the therapeutic outcome. However, such combinations induce serious adverse effects including mucositis, diarrhoea, cell toxicity, immunosuppression, and the development of metastatic tumours (Chen & Malhotra, 2015; Dalgleish, 2015; Hamming et al, 2017). Since the first discovery of multidrug resistance in 1970 by Bielder and Riehm (1970), the related mechanisms, reversal mechanisms, reversal agents, and agents protecting against tumour multidrug resistance have been extensively studied.…”

Dosimetric study of photobiomodulation therapy in 5-FU-induced oral mucositis in hamsters

“…1 This condition directly affects the quality of life of these patients due to the pain and difficulties with eating, swallowing, chewing, and speaking, contributing to debilitation of patients with cancer. [1][2][3] Sonis 4 described the etiological process of OM in five phases: the first phase, called initiation, occurs when either radiation or chemotherapy induces a large production of oxygen reactive species, leading to oxidative stress that can cause cell death or leaves the cell to act as a signaling mediator. In the second and third phases, in response to the primary damage and amplification, in other cells, oxidative stress stimulates death or activation of NF-kB-a nuclear factor that stimulates the production of inflammatory cytokines such as TNF-α, which in turn stimulate more NF-kB in other cells, in a positive feedback process, promoting amplification of inflammation.…”