Genetically Targeted Fractionated Chemotherapy

Abstract

Complex and late stage cancer patients are in need of novel methods of selecting and administering chemotherapy particularly for those patients who are refractory to current treatment methods. The use of biomarkers to enhance decision making with regard to the molecular profile of a person’s cancer is becoming more important in the practice of oncology. The standard for the last several decades is to elect chemotherapeutic agents based on staging and histological identification of the primary cancer site alone versus utilizing the genetic and molecular profile information along with histological primary cancer site and staging to select chemotherapy regimens. Cancers are caused by mutations that occur within cells and therefore selecting treatment based on mutations and not primary cancer site alone can provide advantages that may have gone overlooked. As time progresses, more biomarkers continue to be discovered which can lead to more targets for drugs either currently on the market or clinical trials. In addition to advancements made in the progression of cancer treatment with utilizing molecular profiles effectively, there are other therapeutic strategies that have been postulated as advanced effective ways to administer chemotherapy. These strategies provide chemotherapy to patients while fasting, giving insulin or other biological response modifiers adjunctively prior to chemotherapy for enhanced targeting, and giving chemotherapy in micro-doses to allow for increased frequency of administration and the utilization of multiple targeted chemotherapeutic agents concurrently. In this paper we will discuss these topics and explain their benefits in addition to the evidence that supports these treatments. A review on biomarkers and cancer cell metabolism is discussed as it relates to providing a framework for what constitutes a biomarker in addition to what metabolic processes are related to fasting and administering insulin with chemotherapy.