Evidence map›Paper›PMID 20080862›Full record

ReviewThe oncologist2010

Combining targeted therapies: practical issues to consider at the bench and bedside.

Jordi Rodon, Jose Perez, Razelle Kurzrock

Abstract readReview
In one paragraph

Review in The oncologist, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed.

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  9. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Jordi RodonServei d'Oncologia Medica, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institute of Oncology (V.H.I.O), Passatge Vall d'Hebron 119, 08035 Barcelona, Spain. jrodon@vhio.net
Jose Perez
Razelle Kurzrock

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Numerous practical issues must be considered when combining targeted therapies in early clinical drug development. These include tumor resistance mechanisms, the existence of multiple, redundant signaling pathways, and the failure of single-agent therapies to achieve cures. The strategies adopted to examine combinatorial therapy include the goal of hitting more than one target by specifically inhibiting signal transduction cascades and suppressing specific mechanisms of action with the use of multitargeted kinase inhibitors made possible by high-throughput screening techniques, combinatorial chemistry, and chemoinformatics. Two complex considerations are: which agents to combine given the heterogeneity of tumors and their various underlying perturbations, including secondary mutations and feedback loops, and how to translate findings from the bench to the bedside or directly from the bedside. Another consideration is: When is there enough information to provide a rationale for instituting a phase I trial? Various strategies have been used in combining molecules, including targeting diverse pathways, inhibiting upstream and downstream signals, and adopting a synthetic lethality paradigm. Other issues are: determining appropriate target populations for treatment, how to combine therapeutics with diagnostics, and the frequency of targets in patients referred to clinical trials. Here, we review these issues and we propose various novel trial designs that are logical for determining the efficacy of a drug or drug combination for personalized treatment. A difficult issue that must be answered is how many and which drugs to combine. Recent technologies, such as multiplexed assay platforms and bioinformatics, will shape the future of clinical trials and help answer these questions surrounding combinatorial treatment.

Indexed as

Drug CombinationsAntibodies, MonoclonalAntineoplastic Combined Chemotherapy ProtocolsClinical Trials, Phase I as TopicDecision MakingDose-Response Relationship, DrugDrug InteractionsErb-b2 Receptor Tyrosine KinasesErbB ReceptorsGenetic TherapyHumansMaximum Tolerated DoseNeoplasmsOligonucleotides, AntisensePrecision MedicineProtein Kinase InhibitorsAntibodies, MonoclonalDrug CombinationsErb-b2 Receptor Tyrosine KinasesErbB ReceptorsOligonucleotides, AntisenseProtein Kinase InhibitorsReceptors, EstrogenReceptors, Vascular Endothelial Growth Factor

Identifiers

PMID20080862
PMCPMC3227881

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.