Abstract
Although over 100 chemotherapeutic agents are currently available for the treatment of cancer patients, the overall long term clinical benefit is disappointing due to the lack of effectiveness or severe side effects from these agents. In order to improve the therapeutic outcome, a new approach called precision medicine or personalized medicine has been proposed and initiated by the U.S. National Institutes of Health. However, the limited availability of effective medications and the high cost are still the major barriers for many cancer patients. Thus alternative approaches such as herbal medicines could be a feasible and less costly option. Unfortunately, scientific evidence for the efficacy of a majority of herbal medicines is still lacking and their development to meet FDA approval or other regulatory agencies is a big challenge. However, herbal medicines may be able to play an important role in precision medicine or personalized medicine. This review will focus on the existing and future technologies that could speed the development of herbal products for treatment of resistant cancer in individual patients. Specifically, it will concentrate on reviewing the phenotypic (activity based) rather than genotypic (mechanism based) approach to develop herbal medicine useful for personalized cancer chemotherapy.
Highlights
Current Limitations of Cancer Chemotherapy more than 100 chemotherapy drugs (National Cancer Institution, http://www.cancer.gov/about-cancer/treatment/drugs) including alkylating agents, antimetabolites, anti-tumor antibiotics, anthracyclines, topoisomerase inhibitors, mitotic inhibitors, corticosteroids, and other molecularly-targeted agents are available for cancer chemotherapy, the overall long term clinical benefit from these agents has been generally disappointing, and modern chemotherapy usually ends in failure due to either severe side effects or loss of effectiveness
Can herbal medicine meet the rigorously testing required and offer improved personalized cancer chemotherapy over conventional anticancer agents? If it is subjected to rigorous testing, can herbal medicine still be cost effective? We believe the answers to both questions can be an optimistic “yes”
In order to speed the development that could rapidly lead to application in individual patients, this paper will concentrate in reviewing the phenotypic approach rather than genotypic/proteomic/metabolomics approaches to personalized cancer chemotherapy
Summary
More than 100 chemotherapy drugs (National Cancer Institution, http://www. cancer.gov/about-cancer/treatment/drugs) including alkylating agents, antimetabolites, anti-tumor antibiotics, anthracyclines, topoisomerase inhibitors, mitotic inhibitors, corticosteroids, and other molecularly-targeted agents are available for cancer chemotherapy (either alone or in combination), the overall long term clinical benefit from these agents has been generally disappointing, and modern chemotherapy usually ends in failure due to either severe side effects or loss of effectiveness. One major reason for the loss of effectiveness is the development of chemoresistance [1,2,3,4,5] To overcome such problem, a new approach called precision medicine or personalized medicine has been proposed and initiated by the National Institutes of Health (Bethesda, MD, USA). While the precision medicine approach is likely to yield more effective cancer treatment options in the future, the drug development cost is not expected to be reduced and the new drug cost for the patients will likely remain. We will examine the existing and future technologies that could speed the development of herbal products for personalized cancer chemotherapy leading to enhanced efficacy and reduced cost for treatment of resistant cancer in individual patients.
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