The Molecular Biology of Cancer (eBook, ePUB)

A Bridge from Bench to Bedside

• Format: ePub

Produktbeschreibung

The Molecular Biology of Cancer, Stella Pelengaris & Michael Khan

This capturing, comprehensive text, extensively revised and updated for its second edition, provides a detailed overview of the molecular mechanisms underpinning the development of cancer and its treatment.

“Bench to Bedside”: A key strength of this book that sets it apart from general cancer biology references is the interweaving of all aspects of cancer biology from the causes, development and diagnosis through to the treatment and care of cancer patients – essential for providing a broader view of cancer and its impact.

The highly readable presentation of a complex field, written by an international panel of researchers, specialists and practitioners, would provide an excellent text for graduate and undergraduate courses in the biology of cancer, medical students and qualified practitioners in the field preparing for higher exams, and for researchers and teachers in the field.

For the teaching of cancer biology, special features have been included to facilitate this use: bullet points at the beginning of each chapter explaining key concepts and controversial areas; each chapter builds on concepts learned in previous chapters, with a list of key outstanding questions remaining in the field, suggestions for further reading, and questions for student review. All chapters contain text boxes that provide additional and relevant information.

Key highlights are listed below:

• An overview of the cancer cell and important new concepts.

• Selected human cancers: lung, breast, colorectal, prostate, renal, skin, cervix, and hematological malignancies.

• Key cellular processes in cancer biology including (a) traditionally important areas such as cell cycle control, growth regulation, oncogenes and tumour suppressors apoptosis, as well as (b) more highly topical areas of apoptosis, telomeres, DNA damage and repair, cell adhesion, angiogenesis, immunity, epigenetics, and the proteasome.

• Clinical oncology: In-depth coverage of important concepts such as screening, risk of cancer and prevention, diagnoses, managing cancer patients from start to palliative care and end-of-life pathways.
• Chapters highlighting the direct links between cancer research and clinical applications.

• New coverage on how cancer drugs are actually used in specific cancer patients, and how therapies are developed and tested.

• Systems Biology and cutting edge research areas covered such as RNA interference (RNAi).

• Each chapter includes key points, chapter summaries, text boxes, and topical references for added comprehension and review.

• Quotations have been used in each chapter to introduce basic concepts in an entertaining way.
• Supported by a dedicated website at www.blackwellpublishing.com/pelengaris

We should list the great reviews we got for first edition which are on the back of the 2^nd edition:

“A capturing, comprehensive, clearly written and absolutely accurate introduction into cancer biology…..This book deserves great praise for the readable presentation of this complex field….the true synthesis of bench and bedside approaches is marvelously achieved.” Christian Schmidt, Molecular Cell

“Chapters address the issues of cancer diagnosis, treatment, and patient care and set the book apart from general molecular biology references….This book is applicable to both graduate and undergraduate students, and in the context of a research laboratory, this book would be an excellent resource as a reference guide for scientists at all levels.” V.Emuss, Institute of Cancer Research, London.

Also, from the first edition:

“Pelengaris, Khan, and the contributing authors are to be applauded. The Molecular Biology of Cancer is a comprehensive and readable presentation of the many faces of cancer from molecular mechanisms to clinical therapies and diagnostics. This book will be welcomed by neophyte students, established scientists in other fields, and curious physicians.” -Dean Felsher, Stanford University

Produktdetails

• Verlag: John Wiley & Sons
• Erscheinungstermin: 13. März 2013
• Englisch
• ISBN-13: 9781118430859
• Artikelnr.: 37650408

Autorenporträt

Stella Pelengaris Ph.D is Director of Pharmalogos and previous Researcher at the Imperial Cancer Research Fund, and Senior Research Fellow at the University of Warwick and Warwick Medical School.

Mike Khan Ph.D FRCP is Associate Professor of Medicine at University Hospitals of Coventry and Warwickshire and previous Head of Molecular Medicine at the University of Warwick.

Inhaltsangabe

Contributors vii

Preface to the Second Edition ix

Reviews of the First Edition x

Acknowledgments and Dedication xi

About the Companion Website xii

Introduction 1

1 Overview of Cancer Biology 3
Michael Khan and Stella Pelengaris

Introduction 5

Cancer incidence and epidemiology 8

Towards a definition of cancer 8

Causes of cancer 16

Cancer is a genetic disease 21

Cancers (and Darwin’s finches) evolve by mutation and natural selection 21

Blame the parents – inherited single gene defects and susceptibility to cancer 21

The cancer “roadmap” – What kinds of genes are epimutated in cancer? 23

Viruses and the beginnings of cancer biology 25

Hens and teeth or bears and woods? The hens have it – cancer is rare 25

The barriers to cancer 25

What is the secret of cancer developme “timing” 28

Location location location – the cancer environment: nanny or spartan state 28

Cancer goes agricultural 29

Cancer superhighways – blood vessels and lymphatics 31

On your bike and turn the lights off before you go 31

Catching cancer 31

Hammering the hallmarks 32

Painting a portrait of cancer 33

The drugs don’t work 34

Mechanism of origin rather than cell of origin – towards a new functional taxonomy of cancer 35

Is it worth it? 36

Conclusions and future directions 36

Bibliography 37

Appendix 1.1 History of cancer 40

2 The Burden of Cancer 43
William P. Steward and Anne L. Thomas

Introduction 43

Lung cancer 45

Breast cancer 49

Colorectal cancer 53

Carcinoma of the prostate 56

Renal carcinoma 57

Skin cancer 58

Carcinoma of the cervix 60

Hematological malignancies 60

Conclusions and future directions 63

Outstanding questions 63

Bibliography 64

Questions for student review 66

3 Nature and Nurture in Oncogenesis 67
Michael Khan and Stella Pelengaris

Introduction 69

Risk factors 73

Preventing cancers 76

Cancer genetics – in depth 78

Cancer genomics 87

Gene–environment interactions 89

Mutations and treatment 89

Chemoprevention of cancer 90

Risk factors act in combination 90

Environmental causes of cancer 93

The clinical staging and histological examination of cancer 101

Screening and biomarkers 102

Somatic gene mutations epigenetic alterations and multistage tumorigenesis 105

Conclusions and future directions 107

Outstanding questions 107

Bibliography 107

Questions for student review 109

4 DNA Replication and the Cell Cycle 111
Stella Pelengaris and Michael Khan

Introduction 112

The cell cycle – overview 114

Phases of the cell cycle 120

The cell-cycle engine: cyclins and kinases 123

Regulation by degradation 126

Regulation by transcription 129

MicroRNAs and the cell cycle 131

Chromatin 131

DNA replication and mitosis 131

Checkpoints – putting breaks on the cell-cycle engine 135

The DNA damage response (DDR) 136

The checkpoints 136

Cell-cycle entry and its control by extracellular signals 138

Changes in global gene expression during the cell cycle 139

Cell cycle and cancer 139

Drugging the cell cycle in cancer therapies 141

Conclusions and future directions 142

Outstanding questions 143

Bibliography 143

Questions for student review 144

5 Growth Signaling Pathways and the New Era of Targeted Treatment of Cancer 146
Stella Pelengaris and Michael Khan

Introduction 147

Growth factor regulation of the cell cycle 150

Growth homeostasis and tissue repair and regeneration 151

Regulated and deregulated growth 155

Cellular differentiation 157

Tissue growth and the “angiogenic switch” 158

Cancers and nutrients 158

Growth factor signaling pathways 160

A detailed description of signal transduction pathways and their subversion in cancer 160

Translational control and growth 184

Conclusions and future directions 185

Outstanding questions 185

Bibliography 186

Questions for student review 187

6 Oncogenes 188
Stella Pelengaris and Michael Khan

Introduction 189

The oncogenes 189

The discovery of oncogenes ushers in the new era of the molecular biology of cancer 191

Overview of oncogenes 191

Types of oncogenes 193

Oncogene collaboration – from cell culture to animal models 199

The c-MYC oncogene 199

The RAS superfamily 213

SRC – the oldest oncogene 228

BCR–ABL and the Philadelphia chromosome 232

The BCL-2 family 235

Biologically targeted therapies in cancer and the concept of “oncogene addiction” 235

Conclusions and future directions 235

Outstanding questions 236

Bibliography 236

Questions for student review 238

7 Tumor Suppressors 239
Martine F. Roussel

Introduction 239

The “two-hits” hypothesis: loss of heterozygosity (loh) 240

Haploinsufficiency in cancer 240

Epigenetic events 242

Definition of a tumor suppressor 242

The retinoblastoma protein family 242

p53/TP53 250

INK4a/ARF 254

The p53 and RB pathways in cancer 257

Senescence and immortalization: Role of RB and p53 258

Tumor suppressors and the control of cell proliferation 258

Tumor suppressors and control of the DNA damage response and genomic stability 260

The microRNAs and tumor suppressors 260

Conclusions and future directions 263

Acknowledgments 263

Outstanding questions 264

Bibliography 264

Questions for student review 265

8 Cell Death 266
Stella Pelengaris and Michael Khan

Introduction 267

An historical perspective 267

Apoptosis in context 267

Apoptosis as a barrier to cancer formation 271

Apoptosis versus necrosis 271

Cell death by necrosis – not just inflammatory 272

The pathways to apoptosis 272

The apoptosome – “wheel of death” 274

Caspases – the initiators and executioners of apoptosis 274

The IAP family – inhibitors of apoptosis and much more 276

The central role of MOMP and its regulators in apoptosis – the BCL-2 family 279

Mitochondrial outer membrane permeabilization (momp) 281

Endoplasmic reticulum stress 282

Stress-inducible heat shock proteins 282

Tumor suppressor p53 282

Oncogenic stress: MYC-induced apoptosis 283

Autophagy – a different kind of cell death and survival 287

Cell death in response to cancer therapy 290

Exploiting cell death (and senescence) in cancer control 290

Conclusions and future directions 292

Outstanding questions 293

Bibliography 293

Questions for student review 294

9 Senescence Telomeres and Cancer Stem Cells 295
Maria A. Blasco and Michael Khan

Introduction 296

Senescence 298

Conclusions and future directions 310

Outstanding questions 310

Bibliography 311

Questions for student review 312

10 Genetic Instability Chromosomes and Repair 314
Michael Khan

Introduction 316

Telomere attrition and genomic instability 321

Sensing DNA damage 323

Repairing DNA damage 325

Checkpoints 336

Microsatellites and minisatellites 343

Chaperones and genomic instability 344

Cancer susceptibility syndromes involving genetic instability 345

Genomic instability and colon cancer 346

Conclusions and future directions 346

Outstanding questions 347

Bibliography 347

Questions for student review 349

11 There Is More to Cancer than Genetics: Regulation of Gene and Protein Expression by Epigenetic Factors Small Regulatory RNAs and Protein Stability 350
Stella Pelengaris and Michael Khan

Introduction 351

The language of epigenetics 353

Epigenetics 353

Methylation of DNA 359

Acetylation of histones and other posttranslational modifications 360

Epigenetics and cancer 362

CIMP and MIN and the “mutator phenotype” 365

Imprinting and loss of imprinting 366

Clinical use of epigenetics 367

Regulation of translation 368

Noncoding RNA and RNA interference 369

Therapeutic and research potential of RNAi 371

Treatments based on miRNA 373

Regulating the proteins 373

Therapeutic inhibition of the proteasome 376

Receptor degradation 377

Wrestling with protein transit – the role of SUMO and the promyelocytic leukemia (PML) body 377

Conclusions and future directions 380

Outstanding questions 380

Bibliography 381

Questions for student review 382

12 Cell Adhesion in Cancer 383
Charles H. Streuli

Introduction 383

Adhesive interactions with the extracellular matrix 384

Cell–cell interactions 393

Critical steps in the dissemination of metastases 395

E-cadherin downregulation in cancer leads to migration 399

Epithelial–mesenchymal transitions 401

Integrins metalloproteinases and cell invasion 402

Survival in an inappropriate environment 404

Conclusions 406

Outstanding questions 406

Bibliography 407

Questions for student review 409

13 Tumor Immunity and Immunotherapy 410
Cassian Yee

Introduction 410

Endogenous immune response 411

Effector cells in tumor immunity 413

Tumor antigens 417

Antigen-specific therapy of cancer 420

Clinical trials in vaccine therapy 422

Cytokine therapy of cancer 423

Tumor immune evasion 424

Clinical trials in immunomodulatory therapy 425

Conclusions 425

Bibliography 426

Questions for student review 427

14 Tumor Angiogenesis 429
Christiana Ruhrberg

Introduction 429

General principles of new vessel growth 430

Pathological neovascularization: tumor vessels 430

Basic concepts in tumor angiogenesis: the angiogenic switch 432

Vascular growth and differentiation factors: stimulators of the angiogenic switch 432

Role of inhibitors in angiogenesis 436

Clinical outcomes and future directions 436

Acknowledgments 437

Bibliography 437

Questions for student review 437

15 Cancer Chemistry: Designing New Drugs for Cancer Treatment 438
Ana M. Pizarro and Peter J. Sadler

Introduction 439

Historical perspective 439

The drug discovery process and preclinical development of a drug 442

Questions remaining 457

Conclusions and future directions 457

Bibliography 458

Questions for student review 459

16 Biologically Targeted Agents from Bench to Bedside 461
Michael Khan Peter Sadler Ana M. Pizarro and Stella Pelengaris

Introduction 463

Targeted therapies 465

Cancer cell heterogeneity 466

Finding the molecular targets 468

Tumor regression in mice by inactivating single oncogenes 468

Targeted cancer therapies 473

Targeting oncogenes to treat cancer? 473

The concept of synthetic lethality and collateral vulnerability 475

Clinical progress in biological and molecular targeted therapies 476

Molecular targeted drugs – an inventory 479

DNA damage responses 490

Transcription factors 491

Targeting epigenetic regulation of gene expression 492

Hitting the extrinsic support network and preventing spread 493

Gene therapy antisense and siRNA 495

Resistance to targeted therapies – intrinsic resistance and emergence of secondary pathways and tumor escape 497

Negative feedback loops and failure of targeted therapies 500

Biomarkers to identify optimal treatments and tailored therapies 501

Pharmacogenetics and pharmacogenomics 505

Clinical trials in cancer 506

Conclusions and future directions 506

Bibliography 507

Questions for student review 508

17 The Diagnosis of Cancer 509
Anne L. Thomas Bruno Morgan and William P. Steward

Introduction 509

Clinical manifestations 510

Investigations in oncological practice 511

Non-invasive imaging techniques 516

Future novel uses of imaging 521

Proteomics and microarrays 523

Circulating tumor cells 523

Disease staging 523

Conclusions and future directions 524

Bibliography 524

Questions for student review 525

18 Treatment of Cancer: Chemotherapy and Radiotherapy 526
Anne L. Thomas J.P. Sage and William P. Steward

Introduction 526

Radiotherapy physics 526

Radiobiology 527

Treatment planning 528

Recent advances 529

Chemoradiation 530

Conclusion 540

Bibliography 542

Questions for student review 543

19 Caring for the Cancer Patient 544
Nicky Rudd and Esther Waterhouse

Introduction 544

Key concepts 544

Communication with the cancer patient 544

When is palliative care appropriate for cancer patients? 545

Palliative care assessment 545

Symptom control 545

Respiratory symptoms 547

Nausea and vomiting 547

Bowel obstruction 548

Constipation 549

Fatigue 549

Cachexia and anorexia 549

Psychological problems 549

The dying patient 550

Supportive care 550

An example of the care of a cancer patient 551

Questions remaining 551

Conclusions and future directions 551

Underlying problems 551

Comment 551

Underlying problems 552

Bibliography 552

Questions for student review 553

20 Systems Biology of Cancer 554
Walter Schubert Norbert C.J. de Wit and Peter Walden

Introduction 556

Information flow in cells 556

Model organisms and cancer models 557

Array-based technologies: genomics epigenomics and transcriptomics 559

SNPs the HapMap and the identification of cancer genes 559

Cancer mRNA expression analysis 562

CGH arrays CpG island microarrays and ChIP-on-Chip 564

Next-generation sequencing 564

Proteomics 566

Posttranslational modifications 567

Protein complexes and cellular networks 569

Clinical applications of proteomics 570

Toponomics: investigating the protein network code of cells and tissues 571

Processing the images from the cyclical imaging procedures 571

Structure code and semantics of the toponome: a high-dimensional combinatorial problem 573

Detecting a cell surface protein network code: lessons from a tumor cell 575

The molecular face of cells in diseases 576

Individualized medicine and tailored therapies 576

Discussion and conclusion 579

Bibliography 579

Internet resources 581

Questions for student review 582

Appendix 20.1 Techniques for the generation of genetically altered mouse models of cancer 582

Glossary 585

Answers to Questions 597

Index 603

---

Contributors vii
Preface to the Second Edition ix
Reviews of the First Edition x
Acknowledgments and Dedication xi
About the Companion Website xii
Introduction 1
1 Overview of Cancer Biology 3
Michael Khan and Stella Pelengaris
Introduction 5
Cancer incidence and epidemiology 8
Towards a definition of cancer 8
Causes of cancer 16
Cancer is a genetic disease 21
Cancers (and Darwin's finches) evolve by mutation and natural selection 21
Blame the parents - inherited single gene defects and susceptibility to
cancer 21
The cancer "roadmap" - What kinds of genes are epimutated in cancer? 23
Viruses and the beginnings of cancer biology 25
Hens and teeth or bears and woods? The hens have it - cancer is rare 25
The barriers to cancer 25
What is the secret of cancer developme . . . "timing" 28
Location location location - the cancer environment: nanny or spartan state
28
Cancer goes agricultural 29
Cancer superhighways - blood vessels and lymphatics 31
On your bike and turn the lights off before you go 31
Catching cancer 31
Hammering the hallmarks 32
Painting a portrait of cancer 33
The drugs don't work 34
Mechanism of origin rather than cell of origin - towards a new functional
taxonomy of cancer 35
Is it worth it? 36
Conclusions and future directions 36
Bibliography 37
Appendix 1.1 History of cancer 40
2 The Burden of Cancer 43
William P. Steward and Anne L. Thomas
Introduction 43
Lung cancer 45
Breast cancer 49
Colorectal cancer 53
Carcinoma of the prostate 56
Renal carcinoma 57
Skin cancer 58
Carcinoma of the cervix 60
Hematological malignancies 60
Conclusions and future directions 63
Outstanding questions 63
Bibliography 64
Questions for student review 66
3 Nature and Nurture in Oncogenesis 67
Michael Khan and Stella Pelengaris
Introduction 69
Risk factors 73
Preventing cancers 76
Cancer genetics - in depth 78
Cancer genomics 87
Gene-environment interactions 89
Mutations and treatment 89
Chemoprevention of cancer 90
Risk factors act in combination 90
Environmental causes of cancer 93
The clinical staging and histological examination of cancer 101
Screening and biomarkers 102
Somatic gene mutations epigenetic alterations and multistage tumorigenesis
105
Conclusions and future directions 107
Outstanding questions 107
Bibliography 107
Questions for student review 109
4 DNA Replication and the Cell Cycle 111
Stella Pelengaris and Michael Khan
Introduction 112
The cell cycle - overview 114
Phases of the cell cycle 120
The cell-cycle engine: cyclins and kinases 123
Regulation by degradation 126
Regulation by transcription 129
MicroRNAs and the cell cycle 131
Chromatin 131
DNA replication and mitosis 131
Checkpoints - putting breaks on the cell-cycle The DNA damage response
(DDR) 136
The checkpoints 136
Cell-cycle entry and its control by extracellular signals 138
Changes in global gene expression during the cell cycle 139
Cell cycle and cancer 139
Drugging the cell cycle in cancer therapies 141
Conclusions and future directions 142
Outstanding questions 143
Bibliography 143
Questions for student review 144
5 Growth Signaling Pathways and the New Era of Targeted Treatment of Cancer
146
Stella Pelengaris and Michael Khan
Introduction 147
Growth factor regulation of the cell cycle 150
Growth homeostasis and tissue repair and regeneration 151
Regulated and deregulated growth 155
Cellular differentiation 157
Tissue growth and the "angiogenic switch" 158
Cancers and nutrients 158
Growth factor signaling pathways 160
A detailed description of signal transduction pathways and their subversion
in cancer 160
Translational control and growth 184
Conclusions and future directions 185
Outstanding questions 185
Bibliography 186
Questions for student review 187
6 Oncogenes 188
Stella Pelengaris and Michael Khan
Introduction 189
The oncogenes 189
The discovery of oncogenes ushers in the new era of the molecular biology
of cancer 191
Overview of oncogenes 191
Types of oncogenes 193
Oncogene collaboration - from cell culture to animal models 199
The c-MYC oncogene 199
The RAS superfamily 213
SRC - the oldest oncogene 228
BCR-ABL and the Philadelphia chromosome 232
The BCL-2 family 235
Biologically targeted therapies in cancer and the concept of "oncogene
addiction" 235
Conclusions and future directions 235
Outstanding questions 236
Bibliography 236
Questions for student review 238
7 Tumor Suppressors 239
Martine F. Roussel
Introduction 239
The "two-hits" hypothesis: loss of heterozygosity (LOH) 240
Haploinsuffi ciency in cancer 240
Epigenetic events 242
Definition of a tumor suppressor 242
The retinoblastoma protein family 242
p53/TP53 250
INK4a/ARF 254
The p53 and RB pathways in cancer 257
Senescence and immortalization: Role of RB and p53 258
Tumor suppressors and the control of cell proliferation 258
Tumor suppressors and control of the DNA damage response and genomic
stability 260
The microRNAs and tumor suppressors 260
Conclusions and future directions 263
Acknowledgments 263
Outstanding questions 264
Bibliography 264
Questions for student review 265
8 Cell Death 266
Stella Pelengaris and Michael Khan
Introduction 267
An historical perspective 267
Apoptosis in context 267
Apoptosis as a barrier to cancer formation 271
Apoptosis versus necrosis 271
Cell death by necrosis - not just infl ammatory 272
The pathways to apoptosis 272
The apoptosome - "wheel of death" 274
Caspases - the initiators and executioners of apoptosis 274
The IAP family - inhibitors of apoptosis and much more 276
The central role of MOMP and its regulators in apoptosis - the BCL-2 family
279
Mitochondrial outer membrane permeabilization (MOMP) 281
Endoplasmic reticulum stress 282
Stress-inducible heat shock proteins 282
Tumor suppressor p53 282
Oncogenic stress: MYC-induced apoptosis 283
Autophagy - a different kind of cell death and survival 287
Cell death in response to cancer therapy 290
Exploiting cell death (and senescence) in cancer control 290
Conclusions and future directions 292
Outstanding questions 293
Bibliography 293
Questions for student review 294
9 Senescence Telomeres and Cancer Stem Cells 295
Maria A. Blasco and Michael Khan
Introduction 296
Senescence 298
Conclusions and future directions 310
Outstanding questions 310
Bibliography 311
Questions for student review 312
10 Genetic Instability Chromosomes and Repair 314
Michael Khan
Introduction 316
Telomere attrition and genomic instability 321
Sensing DNA damage 323
Repairing DNA damage 325
Checkpoints 336
Microsatellites and minisatellites 343
Chaperones and genomic instability 344
Cancer susceptibility syndromes involving genetic instability 345
Genomic instability and colon cancer 346
Conclusions and future directions 346
Outstanding questions 347
Bibliography 347
Questions for student review 349
11 There Is More to Cancer than Genetics: Regulation of Gene and Protein
Expression by Epigenetic Factors Small Regulatory RNAs and Protein
Stability 350
Stella Pelengaris and Michael Khan
Introduction 351
The language of epigenetics 353
Epigenetics 353
Methylation of DNA 359
Acetylation of histones and other posttranslational modifications 360
Epigenetics and cancer 362
CIMP and MIN and the "mutator phenotype" 365
Imprinting and loss of imprinting 366
Clinical use of epigenetics 367
Regulation of translation 368
Noncoding RNA and RNA interference 369
Therapeutic and research potential of RNAi 371
Treatments based on miRNA 373
Regulating the proteins 373
Therapeutic inhibition of the proteasome 376
Receptor degradation 377
Wrestling with protein transit - the role of SUMO and the promyelocytic
leukemia (PML) body 377
Conclusions and future directions 380
Outstanding questions 380
Bibliography 381
Questions for student review 382
12 Cell Adhesion in Cancer 383
Charles H. Streuli
Introduction 383
Adhesive interactions with the extracellular matrix 384
Cell-cell interactions 393
Critical steps in the dissemination of metastases 395
E-cadherin downregulation in cancer leads to migration 399
Epithelial-mesenchymal transitions 401
Integrins metalloproteinases and cell invasion 402
Survival in an inappropriate environment 404
Conclusions 406
Outstanding questions 406
Bibliography 407
Questions for student review 409
13 Tumor Immunity and Immunotherapy 410
Cassian Yee
Introduction 410
Endogenous immune response 411
Effector cells in tumor immunity 413
Tumor antigens 417
Antigen-specific therapy of cancer 420
Clinical trials in vaccine therapy 422
Cytokine therapy of cancer 423
Tumor immune evasion 424
Clinical trials in immunomodulatory therapy 425
Conclusions 425
Bibliography 426
Questions for student review 427
14 Tumor Angiogenesis 429
Christiana Ruhrberg
Introduction 429
General principles of new vessel growth 430
Pathological neovascularization: tumor vessels 430
Basic concepts in tumor angiogenesis: the angiogenic switch 432
Vascular growth and differentiation factors: stimulators of the angiogenic
switch 432
Role of inhibitors in angiogenesis 436
Clinical outcomes and future directions 436
Acknowledgments 437
Bibliography 437
Questions for student review 437
15 Cancer Chemistry: Designing New Drugs for Cancer Treatment 438
Ana M. Pizarro and Peter J. Sadler
Introduction 439
Historical perspective 439
The drug discovery process and preclinical development of a drug 442
Questions remaining 457
Conclusions and future directions 457
Bibliography 458
Questions for student review 459
16 Biologically Targeted Agents from Bench to Bedside 461
Michael Khan Peter Sadler Ana M. Pizarro and Stella Pelengaris
Introduction 463
Targeted therapies 465
Cancer cell heterogeneity 466
Finding the molecular targets 468
Tumor regression in mice by inactivating single oncogenes 468
Targeted cancer therapies 473
Targeting oncogenes to treat cancer? 473
The concept of synthetic lethality and collateral vulnerability 475
Clinical progress in biological and molecular targeted therapies 476
Molecular targeted drugs - an inventory 479
DNA damage responses 490
Transcription factors 491
Targeting epigenetic regulation of gene expression 492
Hitting the extrinsic support network and preventing spread 493
Gene therapy antisense and siRNA 495
Resistance to targeted therapies - intrinsic resistance and emergence of
secondary pathways and tumor escape 497
Negative feedback loops and failure of targeted therapies 500
Biomarkers to identify optimal treatments and tailored therapies 501
Pharmacogenetics and pharmacogenomics 505
Clinical trials in cancer 506
Conclusions and future directions 506
Bibliography 507
Questions for student review 508
17 The Diagnosis of Cancer 509
Anne L. Thomas Bruno Morgan and William P. Steward
Introduction 509
Clinical manifestations 510
Investigations in oncological practice 511
Non-invasive imaging techniques 516
Future novel uses of imaging 521
Proteomics and microarrays 523
Circulating tumor cells 523
Disease staging 523
Conclusions and future directions 524
Bibliography 524
Questions for student review 525
18 Treatment of Cancer: Chemotherapy and Radiotherapy 526
Anne L. Thomas J.P. Sage and William P. Steward
Introduction 526
Radiotherapy physics 526
Radiobiology 527
Treatment planning 528
Recent advances 529
Chemoradiation 530
Conclusion 540
Bibliography 542
Questions for student review 543
19 Caring for the Cancer Patient 544
Nicky Rudd and Esther Waterhouse
Introduction 544
Key concepts 544
Communication with the cancer patient 544
When is palliative care appropriate for cancer patients? 545
Palliative care assessment 545
Symptom control 545
Respiratory symptoms 547
Nausea and vomiting 547
Bowel obstruction 548
Constipation 549
Fatigue 549
Cachexia and anorexia 549
Psychological problems 549
The dying patient 550
Supportive care 550
An example of the care of a cancer patient 551
Questions remaining 551
Conclusions and future directions 551
Underlying problems 551
Comment 551
Underlying problems 552
Bibliography 552
Questions for student review 553
20 Systems Biology of Cancer 554
Walter Schubert Norbert C.J. de Wit and Peter Walden
Introduction 556
Information flow in cells 556
Model organisms and cancer models 557
Array-based technologies: genomics epigenomics and transcriptomics 559
SNPs the HapMap and the identification of cancer genes 559
Cancer mRNA expression analysis 562
CGH arrays CpG island microarrays and ChIP-on-Chip 564
Next-generation sequencing 564
Proteomics 566
Posttranslational modifi cations 567
Protein complexes and cellular networks 569
Clinical applications of proteomics 570
Toponomics: investigating the protein network code of cells and tissues 571
Processing the images from the cyclical imaging procedures 571
Structure code and semantics of the toponome: a high-dimensional
combinatorial problem 573
Detecting a cell surface protein network code: lessons from a tumor cell
575
The molecular face of cells in diseases 576
Individualized medicine and tailored therapies 576
Discussion and conclusion 579
Bibliography 579
Internet resources 581
Questions for student review 582
Appendix 20.1 Techniques for the generation of genetically altered mouse
models of cancer 582
Glossary 585
Answers to Questions 597
Index 603