title: [Paradigm Transformation of Cancer Research and Development, Treatment, and Clinical Trials toward Total Cure - The Role of ARO].
abstract: We are living in an era characterized by an unprecedented scientific and technological revolution, which is also affecting both the health and medical fields. The revolution surrounding the cancer field is drastically changing not only the research and development sector, but also the manner in which malignancies are diagnosed and treated. This is due to achievements in genome, molecular immunology, and stem cell research. Here are some examples of molecular targeted therapy drugs. The targeted drug crizotinib, developed after the discovery of driver genes and genotype identification, opened up a newera of genome clinical sequencing. Mogamulizumab not only targets the chemokine receptor CCR4 but also modifies host antitumor immunity by suppressing Tregs. Trametinib is a molecular targeted therapy drug that controls molecules associated with the control system responsible for tumor maintenance. The creation of an assay system resulted in a breakthrough in this field, which led to the development of trametinib and crizotinib. The checkpoint inhibitor nivolumab acts on the immune system of the host and promotes tumor targeting. As exemplified by these developments, the paradigm of cancer drug therapy is changing from a probabilistic approach(ie, administering a general anticancer drug), to a deterministic approach(ie, administering the most adequate drug after diagnosing the specific mechanisms responsible for tumor generation, sustenance, and progression). The latter requires a drastic change in the way clinical trials are performed. Thus, we are now entering a newphase: the era of precision medicine. Herewe discuss the present state of the cancer medical revolution and the academic progress in research and development and cancer therapy in our country.
authors.affiliation: Translational Research Informatics Center, Foundation for Biomedical Research and Innovation.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kojima
authors.forename: Masanori
authors.initials: M
authors.lastname: Fukushima
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D035843:Biomedical Research; D019496:Cancer Vaccines / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006801:Humans; D058990:Molecular Targeted Therapy; D009369:Neoplasms / Q000188:drug therapy*; D014411:Neoplastic Stem Cells
chemical_list: D000970:Antineoplastic Agents; D019496:Cancer Vaccines