Abstract
This review compares cytotoxic drugs, targeted therapies, and immunotherapies with regard to mechanisms and side effects. Targeted therapies relate to small molecule inhibitors. Immunotherapies include checkpoint inhibitory antibodies, chimeric antigen receptor (CAR) T-cells, cancer vaccines, and oncolytic viruses. All these therapeutic approaches fight systemic disease, be it micro-metastatic or metastatic. The analysis includes only studies with a proven therapeutic effect. A clear-cut difference is observed with regard to major adverse events (WHO grades 3–4). Such severe side effects are not observed with cancer vaccines/oncolytic viruses while they are seen with all the other systemic therapies. Reasons for this difference are discussed.
Highlights
Standard therapy for solid tumors such as breast cancer includes surgery, radiotherapy, chemotherapy, and anti-hormone therapy
Such severe side effects are not observed with cancer vaccines/oncolytic viruses while they are seen with all the other systemic therapies
This has been exemplified with NDV. Two types of such vaccine were developed over many years: (i) ATV-NDV, an autologous tumor cell vaccine modified by infection with a lentogenic strain of NDV [81,82,83,84,85], and (ii) IO-VACR, a dendritic cell (DC) vaccine modified by loading with oncolysate from patient-derived tumor cells infected with a mesogenic oncolytic strain of NDV [58]
Summary
Standard therapy for solid tumors such as breast cancer includes surgery, radiotherapy, chemotherapy, and anti-hormone therapy. It attempts to interfere with signaling pathways [7] which play an important role in distinct types of cancer It took several decades of basic research until the first small molecule inhibitor (SMI), imatinib mesylate (Gleevec), was developed. The analysis is based on specific textbooks to chemotherapy [19], small molecule inhibitors (SMIs) [6], molecular vaccines [20], cancer vaccines [21], viral oncology [22], and viral therapy of cancer [23] It involved a search using Pubmed on the side effects of new therapeutics approved during the years 2000–2020
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