title: Are predictions of cancer response to targeted drugs, based on effects in unrelated tissues, the 'Black Swan' events?
abstract: Adverse effects of targeted drugs on normal tissues can predict the cancer response. Rash correlates with efficacy of erlotinib, cetuximab and gefitinib and onset of arterial hypertension with response to bevacizumab, sunitinib, axitinib and sorafenib, possible examples of 'Black Swan' events, unexpected scientific observations, as described by Karl Popper in 1935. The proposition is that our patients have individual intrinsic variants of cell growth control, important for tumor response and adverse effects on tumor-unrelated tissue. This means that the lack of predictive side effects in healthy tissue is linked with poor results of tumor therapy when tumor resistance is caused by mechanisms that protect all cells of that patient from the targeted drug effects.
authors.affiliation: Department of Anaesthesiology, Reanimatology & Intensive Care, University Hospital Centre, Zagreb, Croatia.
authors.forename: Beatrica
authors.initials: B
authors.lastname: Kurbel
authors.affiliation: Division of Abdominal Surgery, Department of Surgery, University Hospital Centre, Zagreb, Croatia.
authors.forename: Ante Zvonimir
authors.initials: AZ
authors.lastname: Golem
authors.affiliation: Department of Internal Medicine, Osijek University Hospital Centre, Osijek, Croatia.
authors.forename: Sven
authors.initials: S
authors.lastname: Kurbel
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D019317:Evidence-Based Medicine; D006801:Humans; D058990:Molecular Targeted Therapy / Q000009:adverse effects; D009369:Neoplasms / Q000188:drug therapy*; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: adverse effects; antineoplastic drugs; prediction markers; targeted drugs