Evolving Molecular Therapeutics and Their Applications to Surgical Oncology

Despite major advances in the diagnosis and treatment of cancer, chemotherapy, the mainstay of therapy for systemic disease, is rarely curative and toxicity is common. Research efforts are focusing on the development of agents that target molecules that are specific to tumor cells with few effects on normal healthy cells. The ultimate goal of molecular therapeutics is to develop agents that are lethal only to tumor cells, that maintain efficacy without developing resistance, and that possess acceptable toxicities that make them well tolerated by patients. This review covers tyrosine kinase inhibitors, angiogenesis inhibitors, cell cycle inhibitors, inducers of apoptosis, phosphatidylinositol 3-kinase/Akt/mammalian target of rapamycin inhibitors, and focal adhesion kinase inhibitors. Figures show activation of a receptor tyrosine kinase, the interaction of cyclin-dependent kinases and cyclins during regulation of the cell cycle, cyclin-cyclin-dependent kinase-regulated progression through each phase of the cell cycle, and the role of focal adhesion kinase in a signaling cascade that can lead to the tumorigenic properties of cancer cells. Tables list tyrosine kinase inhibitors, cell