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Discovery Medicine / No 039


Pharmacotherapy for Prostate Cancer: The Role of Hormonal Treatment

Abstract: The role of hormonal therapy in the management of prostate cancer has been known for almost half a century. However, many controversies exist regarding the place and timing of androgen deprivation therapy. An increasing spectrum for the use of androgen deprivation therapy has been assessed, including multimodal treatment with radiation therapy. New approaches to androgen deprivation have been explored, including LHRH (luteinizing hormone-releasing hormone) antagonists and improved depot formulations. Recent evidence about the chemo-sensitivity of prostate cancer has opened avenues for treatment of hormone refractory disease and the combination of hormonal and chemotherapy is being studied at various stages of the disease. We explore the evidence, controversies and future of androgen deprivation therapy and critically reexamine the dogmas surrounding hormone therapy for prostate cancer. ... Read more

Therapeutic Targeting of the Alpha-Secretase Pathway to Treat Alzheimer's Disease

Abstract: Alzheimer's disease (AD) is a progressive and degenerative disorder pathophysiologically characterized by the accumulation of beta-amyloid peptides (Aβ) in the brain. Aβ is indicated to be the primary agent in the pathogenesis of AD. Aβ is generated from the amyloid precursor protein (APP) via two proteolytic enzymes, β- and γ- secretases. α-secretase conducts an alternative proteolytic cleavage that prevents Aβ production and accumulation. Elevating levels of α-secretase cleavage, therefore, is a potential therapeutic strategy to treat AD. ... Read more

In Search of Novel Treatments for Peripheral Neuropathies and Nerve Regeneration

Abstract: Currently, we do not have effective therapies aimed at preventing or reversing axonal degeneration seen in peripheral neuropathies. Drug development programs should be aimed at understanding mechanisms of distal axonal degeneration and take into account the critical role Schwann cells play in axonal maintenance and nerve regeneration. ... Read more

Universal Tumor Antigens for Cancer Vaccination: Targeting Telomerase for Immunoprevention

Abstract: Despite their much-heralded clinical potential, therapeutic cancer vaccines have thus far failed to achieve the necessary clinical benchmarks to allow their regulatory approval. In contrast, vaccination against infectious pathogens represents one of the biggest achievements of modern medicine, and in certain cases such as vaccines against the human papilloma virus or hepatitis B virus, vaccination may impact the development of cancer. To the extent that these two approaches differ as immunotherapy vs. immunoprevention, the challenge is to rethink the types of non-viral antigens that are currently being targeted in cancer vaccines. Immunological analysis suggests that the telomerase reverse transcriptase hTERT is a widely applicable target recognized by T lymphocytes and a prototype for a novel class of universal tumor antigens. Findings from initial clinical trials demonstrate that hTERT-specific immune responses can be safely induced in cancer patients. If the amplitude and duration of cellular immunity against hTERT can be optimized without toxicity in humans, then an opportunity exists to test hTERT vaccination as a way to reduce the risk of cancer recurrence in patients or even the risk of developing cancer in otherwise healthy individuals. ... Read more

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