Inicio  /  Cancers  /  Vol: 16 Par: 1 (2024)  /  Artículo
ARTÍCULO
TITULO

Addressing Genetic Tumor Heterogeneity, Post-Therapy Metastatic Spread, Cancer Repopulation, and Development of Acquired Tumor Cell Resistance

Dennis Christoph Harrer    
Florian Lüke    
Tobias Pukrop    
Lina Ghibelli    
Albrecht Reichle and Daniel Heudobler    

Resumen

The present review summarizes and interprets uniform therapy schemes for rescuing relapsed or refractory (r/r) neoplasias of quite different histologic origins. Exploiting tumor tissues? plasticity by reprogramming hallmarks of cancer into biologic hallmarks controlling tumor regrowth with metronomic chemotherapy and simultaneous targeting of nuclear and/or cytokine receptors plus/minus targeted therapies, termed tumor tissue editing, may induce cCR or long-term tumor control, as indicated by data from clinical trials designed for the treatment of r/r neoplasias of quite different histologic origins. Tumor tissue editing may overcome unique post-therapy disease traits that arise following treatment of r/r tumor disease with standard therapy regimens using maximum tolerable doses, i.e., metastatic spread, cancer repopulation, and acquired tumor cell resistance (M-CRAC), by attenuating, or resolving M-CRAC. The introduction of M-CRAC control in future therapeutic considerations may help to overcome the multifold translational challenges of precision medicine in the large group of r/r neoplasias without driver mutations.

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