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Molecular Targeting of Colorectal Cancer

An Idea Whose Time Has Come

  • Chapter
Molecular Targeting in Oncology

Part of the book series: Cancer Drug Discovery and Development ((CDD&D))

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Summary

Colorectal cancer is the fourth most common cancer worldwide and the fourth most common cause of cancer mortality, with approximately 529,000 deaths annually (1). The concept of molecular targeting in colorectal cancer is not new. After all, 5-fluorouracil (5-FU), the standard bearer of “old school” treatment and continued mainstay of colon cancer systemic therapy, was developed as a “targeted” agent. In this case, the primary target is thymidylate synthase, a key enzyme in DNA synthesis, and the mechanism of action is competitive inhibition by a false substrate. Whereas 5-FU is clearly targeted, it lacks specificity, and the therapeutic window is therefore narrow. In the past decade, advances in understanding of the biology of colorectal cancer as well as the technology of drug development have permitted the identification of new targets and inhibitory pharmaceuticals with high specificity and favorable toxicity profiles. It is this specificity with regard to both target and tissue that characterizes the current generation of targeted therapeutics.

In contrast to other tumors that are driven by a single transforming molecular event, colorectal cancers are characterized by their genetic diversity. This diversity presents challenges for treatment and suggests that molecular profiling of individual patients and tumors will ultimately be required if we are to optimize the matching of patients and treatments. In this chapter, we will review the landscape of colorectal cancer treatment, with a focus on the most promising molecular targets in development. The cancer cell as well as surrounding stroma will be considered. In addition, we will review mechanisms of colorectal cancer pathogenesis and their implications for therapeutic intervention.

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Authors
  1. Mark L. Sundermeyer MD
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  2. Alfonso Bellacosa MD, PhD
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  3. Neal J. Meropol MD
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Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, Columbia University, New York, NY

    Howard L. Kaufman

  2. Division of Hematology and Medical Oncology, Department of Medicine, Weill Medical College Cornell University, New York, NY

    Scott Wadler

  3. Boston University Medical Campus Boston University School of Medicine, Boston, MA

    Karen Antman

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© 2008 Humana Press

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Sundermeyer, M.L., Bellacosa, A., Meropol, N.J. (2008). Molecular Targeting of Colorectal Cancer. In: Kaufman, H.L., Wadler, S., Antman, K. (eds) Molecular Targeting in Oncology. Cancer Drug Discovery and Development. Humana Press. https://doi.org/10.1007/978-1-59745-337-0_7

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  • DOI: https://doi.org/10.1007/978-1-59745-337-0_7

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-577-4

  • Online ISBN: 978-1-59745-337-0

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