Recent findings from Pillay and colleagues recommend that inhibition of a dominant oncogene by targeted therapy can also alter the hierarchy of receptor tyrosine kinases, resulting in speedy therapeutic resistance.
Certainly, accessible data imply that c MET may possibly be a clinically pertinent therapeutic target for some patients with acquired resistance to gefitinib or erlotinib, particularly offered Cabozantinib that MET gene amplification occurs independently of EGFRT790M mutations. The presence of MET gene amplification in combination with gain of function drug sensitive EGFR mutations could together lead to cellular changes that confer enhanced fitness to cells bearing both alterations. However, other mechanisms could contribute to disease progression in such patients. As the mechanism of interaction between HGF/c MET and resistance remains unclear, further research into crosstalk and balance between these two signal pathways remains critical and necessary for the development of novel anticancer therapies.
For c MET, further consideration needs to be given to the fact that genetic alterations of the kinase can induce oncogene addiction and therefore possibly aid prediction of therapeutic responsiveness. Importantly, research from Comoglio and colleagues has highlighted that preclinical investigations of developmental c MET inhibitors appear to utilize NSCLC a vast array of differing cell lines, most of which tend not to be genetically characterized. Capecitabine Clearly, to enable identification and recruitment of potentially responsive patients in future studies, the rational selection of genetically defined cell lines will need to become mandatory, in order to lead to the development of reliable in vitro models for the testing of c MET inhibition. Future models will need to be able to clearly display signaling abnormalities of c MET and also to respond to c MET inactivation with a distinct and measurable phenotypic readout.
Several c MET inhibitors are now under evaluation in clinical trials, and the interest around these compounds has consistently Capecitabine increased since an interaction between EGFR and c MET was observed. Clinical trials with these agents will hopefully validate positive observations from preclinical studies. c MET inhibitor agents under development include compounds that directly inhibit HGF and/or its binding to c MET, antibodies targeted at c MET, and small molecule c MET TKIs.
Monday, March 4, 2013
12 Cabozantinib Capecitabine Truth And Lies Totally Exposed
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