CRITICAL FACTS VI: Angiogenesis inhibitors, differentiating agents and combination chemotherapy
(if med school is a Minnesota forest with millions of trees,
these are the red pines)
-
Most angiogenesis inhibitors work by decreasing the actions of substances that promote angiogenesis, particularly VEGF and mTOR. mTOR inhibitors reduce cell growth and proliferation, prevent angiogenesis and increase the cytotoxicity of drugs that damage DNA.
-
THALIDOMIDE is a developmental toxin whose only approved use is in the treatment of Hansen’s disease, although it has significant off-label use in AIDS treatment and in multiple myeloma. THALIDOMIDE has significant teratogenic effects (especially phocomelia) in the children and grandchildren of women who take the drug while pregnant.
-
Antineoplastic agents are almost always given in combination. Correct selection of drugs in a regimen can result in decreased development of resistance, synergistic effects and decreased toxic effects. Other common chemotherapeutic strategies include pulse and rescue therapy, recruitment and synchrony.