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2014 ; 32
(26
): 2871-8
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Molecular radiobiology: the state of the art
#MMPMID25113768
Giaccia AJ
J Clin Oncol
2014[Sep]; 32
(26
): 2871-8
PMID25113768
show ga
Traditional cytotoxic agents used in cancer therapy were initially discovered
based on their ability to kill rapidly dividing cells. The targets of these
early-generation agents were typically one or more aspects of DNA synthesis or
mitosis. Thus, dose-limiting toxicities commonly associated with these agents
include GI dysfunction, immunosuppression, and other consequences of injury to
normal tissues in which cells are replicating under normal physiologic
conditions. Although many of these agents still play an important role in cancer
therapy when given concurrently with radiation therapy, the major thrust of
radiobiology research in the last two decades has focused on discovering
tumor-specific traits that might be exploited for more selective targeting that
would enhance the efficacy of radiotherapy with less normal tissue toxicity.
These newer generation molecular targeted therapies interfere with the growth of
tumor cells by inhibiting genes and their protein products that are needed
specifically by the tumor for survival and expansion. These agents can be
complementary to radiotherapy, a spatially targeted agent. Although there have
been extraordinary technical advances in radiotherapy in recent years, we are
reaching the limits of improvements that radiotherapy delivery technology can
bring and need different approaches. This review will highlight promising new
tumor biology-based targets and other novel strategies to reduce normal tissue
injury, increase tumor control, and expand the use of radiotherapy to treat
widespread metastatic disease.
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