Kanser Tedavisinde Kullanılan İlaçların Moleküler Etki Mekanizmaları
Özet
Bir hastalık olarak kanser, her geçen gün daha büyük bir sağlık problemi haline gelmektedir. Son 20 yılda, insan kanserlerinin moleküler mekanizmaları ve patofizyolojisi hakkındaki bilgimizde muazzam bir artış olmuştur. Bu mekanizmaların birçoğu, halihazırda kullanılan ilaçlar ile karşılaştırıldığında hastaya daha az toksisite ile daha fazla antitümör aktiviteye sahip olacakları umuduyla ilaç geliştirme için yeni hedefler olarak geliştirilmiştir. Moleküler hedefli ajanların hızlı gelişimi ve klinik uygulamaları sayesinde kanserin sistemik tedavisinde de önemli bir ilerleme olmuştur. Çoklu genetik, epigenetik ve kromozomal anormallikler içeren bazı kanser tiplerinin hem kötü fenotip hem de hücre sağkalımı açısından bir veya birkaç gene “bağımlı” olduğunu açıklamak için “onkojen bağımlılığı” kavramı ortaya koyulmuştur. Bu anormalliklerin sadece bir veya birkaçının tersine çevrilmesi, kanser hücresi büyümesini inhibe edebilir ve bazı durumlarda gelişmiş sağkalım oranlarını düşürebilir. Bu derleme, kanserin hücresel mekanizmalarındaki farklılıkları, tedavi için güncel deneysel ve klinik kanıtları özetlemekte ve moleküler mekanizmaları tanımlamaktadır. Ayrıca, bu derlemede tedavi tiplerini optimize edebilmek ve hastalık tekrarını önleyecek bakış açılarını belirlemek için bir strateji olarak antikanser ajanların moleküler hedefli ajanlar ile ortak kullanımı da tartışılmaktadır.
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