title: Changing the pathophysiology of solid tumours: the potential of TNF and other vasoactive agents.
abstract: Solid tumour therapy with chemotherapeutic drugs is hampered by a number of factors resulting in poor results and failure of initially promising drugs. From the application of Tumour Necrosis Factor alpha in the melphalan-based Isolated Limb perfusion some lessons could be learned. Most importantly, combination of treatment approaches, certainly when multiple targets are involved, increases the effectiveness of the therapy. Clinical outcome may improve dramatically when the tumour pathophysiology is changed in such a way that co-administered chemotherapeutics are more active or are capable of reaching the tumour cells better. Here some of the methodologies and drug combinations which improve solid tumour therapy through acting on the tumour pathophysiology are discussed.
authors.affiliation: Department of Surgical Oncology, Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands. t.l.m.tenhagen@erasmusmc.nl
authors.forename: Timo L M
authors.initials: TL
authors.lastname: ten Hagen
authors.forename: Alexander M M
authors.initials: AM
authors.lastname: Eggermont
mesh_terms: D000970:Antineoplastic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion; D006801:Humans; D008833:Microcirculation / Q000502:physiology; D009369:Neoplasms / Q000098:blood supply* / Q000378:metabolism / Q000628:therapy; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology / Q000627:therapeutic use*; D014662:Vasoconstrictor Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D014409:Tumor Necrosis Factor-alpha; D014662:Vasoconstrictor Agents