Highly Commended in the category of Oncology at the British Medical Association Awards 2019
The accessible guide to the principles behind new, more targeted drug treatments for cancer
Written for anyone who encounters cancer patients, cancer data or cancer terminology, but have no more than a passing knowledge of cell biology. A Beginner’s Guide to Targeted Cancer Treatments provides an understanding of how cancer works and the many new treatments available.
Using over 100 original illustrations, this accessible handbook covers the biology and mechanisms behind a huge range of targeted drug treatments, including many new immunotherapies. Dr Vickers translates a complex and often overwhelming topic into something digestible and easily understood. She also explains what cancer is, how it behaves and how our understanding of cancer has changed in recent years.
Each chapter takes the reader through how new cancer drugs work and their benefits and limitations. With the help of this book, readers will be able to better understand more complex, in-depth articles in journals and books and develop their knowledge. This vital resource:
* Offers the latest insights into cancer biology
* Provides a broad understanding of how targeted cancer treatments work
* Describes many of the new immunotherapy approaches to cancer treatment, such as checkpoint inhibitors and CAR-modified T cells
* Helps readers feel confident discussing treatment options with colleagues and patients
* Provides an overview of which treatments are relevant to each of the most common solid tumours and haematological cancers, and the rationale behind them
* Demystifies the jargon – terms such as the EMT, cancer stem cells, monoclonal antibodies, kinase inhibitors, angiogenesis inhibitors etc.
* Explains the resistance mechanisms to many new treatments, including issues such as the way cancer cells diversify and evolve and the complex environment in which they live
Table of Content
Acknowledgments vii
About the Author ix
How to Use This Book xi
Chapter 1 An Introduction to Cancer Cell Biology and Genetics 1
1.1 Introduction 1
1.2 DNA Damage is the Cause of Every Cancer 2
1.3 The Defining Features (Hallmarks) of Cancer Cells 15
1.4 Genetic Variation among Cancer Cells in a Single Tumor 16
1.5 The Cancer Microenvironment 17
1.6 Cancer Spread/Metastasis 19
1.7 Cancer Stem Cells 23
1.8 Obstacles That Prevent us from Curing Cancer 24
1.9 Final Thoughts 28
Chapter 2 Introducing Targeted Cancer Treatments 33
2.1 Introduction 34
2.2 Monoclonal Antibodies 36
2.3 Kinase Inhibitors 48
2.4 Final Thoughts 60
Chapter 3 Treatments That Block Proteins Involved in Cell Communication 65
3.1 Introduction 65
3.2 Introducing Growth Factor Receptors 67
3.3 Drugs That Target EGFR 75
3.4 Drugs That Target HER2 81
3.5 Drugs That Block Other Growth Factor Receptors 85
3.6 Introduction to Signaling Pathways as a Target for Cancer Therapy 86
3.7 Targeting the MAPK Signaling Pathway 87
3.8 Targeting the PI3K/AKT/m TOR Signaling Pathway 94
3.9 Targeting the JAK-STAT Pathway 100
3.10 Final Thoughts 103
Chapter 4 Drugs That Target: Angiogenesis, Fusion Proteins, PARP, Hedgehog Signaling, and CDKs 111
4.1 Angiogenesis Inhibitors: Introduction 112
4.2 Drugs That Block Fusion Proteins: Bcr-Abl, ALK, RET, and ROS1 122
4.3 PARP Inhibitors 127
4.4 Hedgehog Pathway Inhibitors 134
4.5 Cyclin-Dependent Kinase (CDK) Inhibitors 139
4.6 Final Thoughts 145
Chapter 5 Immunotherapies for Cancer 151
5.1 Introduction 152
5.2 A Bit About Cancer and the Immune System 154
5.3 Checkpoint Inhibitors 160
5.4 Adoptive Cell Transfer 168
5.5 Modified Bi-specific Antibodies 175
5.6 Therapeutic Cancer Vaccines 176
5.7 The Future of Immunotherapy 181
Chapter 6 Targeted Treatments for Common Solid Tumors 187
6.1 Introduction 188
6.2 Targeted Treatments for Breast Cancer 188
6.3 Targeted Treatments for Prostate Cancer 200
6.4 Targeted Treatments for Lung Cancer 204
6.5 Targeted Treatments for Bowel Cancer 214
6.6 Targeted Treatments for Malignant Melanoma Skin Cancer 220
6.7 Targeted Treatments for Kidney Cancer 225
6.8 Targeted Treatments for Head and Neck Cancer 231
6.9 Targeted Treatments for Brain Tumors 235
6.10 Targeted Treatments for Bladder Cancer 236
6.11 Targeted Treatments for Pancreatic Cancer 240
6.12 Final Thoughts 244
Chapter 7 Targeted Treatments for Hematological Cancers 259
7.1 Introduction 259
7.2 A Bit About Hematological Cancers 260
7.3 Antibody-Based Treatments That Target CD Antigens 274
7.4 Drugs That Block B Cell Receptor Signaling 287
7.5 Bcr-Abl Inhibitors 292
7.6 Drugs That Block the Proteasome 294
7.7 Thalidomide and its Derivatives 297
7.8 JAK2 Inhibitors 298
7.9 Bcl-2 Inhibitors 299
7.10 FLT3 and KIT Inhibitors 301
7.11 IDH2 Inhibitors 304
7.12 CAR-Modified T Cell Therapy 304
7.13 Final Thoughts 304
Appendix 313
Glossary of Terms 315
Index 329
About the author
DR. ELAINE VICKERS is the Founder of Science Communicated Ltd, an independent company creating courses and educational materials that explain cancer biology and the science behind targeted cancer treatments. In partnership with numerous hospitals, institutes, charities, companies and clinical trials units, her teaching reaches many hundreds of nurses, doctors, pharmacists and clinical trials coordinators each year. Dr. Vickers has a degree in Medical Science from the University of Birmingham and a Ph D in Molecular Biology from the University of Manchester. She has been working as a science educator and writer for over fifteen years.