- •Scope
- •What Genes are Mutated in Cancers?
- •Principles of Systemic Therapy
- •Cancer Chemotherapy
- •Cancer Chemotherapy
- •Clinical Application of Chemotherapy
- •Primary Induction Chemotherapy
- •Primary Induction Chemotherapy
- •Primary Induction Chemotherapy
- •Palliative Chemotherapy
- •Neoadjuvant Chemotherapy
- •Neoadjuvant Chemotherapy
- •Neoadjuvant Chemotherapy
- •Adjuvant Chemotherapy
- •Adjuvant Chemotherapy
- •Adjuvant Chemotherapy
- •Molecular Targets in Oncology
- •Approved EGFR-Targeted Therapies
- •Conclusion
Charuwan Akewanlop, MD
Division of Medical Oncology
Department of Medicine
Faculty of Medicine Siriraj Hospital
Scope
Overview of Molecular Genetics of Cancer
Principles of Systemic Therapy
“Cancer is, in essence, A Genetic Disease”
Gene mutations lead to cancer Predisposing mutations
Somatic mutations
Cancer
Cancer Arises From Gene Mutations
Germline mutations |
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Somatic mutations |
Parent Child
Mutation |
All cells |
Somatic |
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affected in |
mutation (eg, |
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in egg or |
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offspring |
breast) |
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sperm |
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l l l
Present in egg or sperm
Are heritable Cause cancer family syndromes
l
l
Occur in nongermlinermline tissues
Are nonheritablele
Multi-Step Carcinogenesis (e.g. Colon Cancer)
Loss of |
Activation |
Loss of |
Loss of |
Other |
APC |
of K-ras |
18q |
TP53 |
alterations |
Normal |
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Hyper- |
Early |
Inter- |
Late |
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MetastasisMetastasis |
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proliferative |
mediate |
Carcinomainoma |
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epithelium |
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adenoma |
adenoma |
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epithelium |
adenoma |
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Adapted from Fearon ER. Cell 61:759, 1990
Tumors Are Clonal Expansions
Normal
Tumor