Complex and late stage cancer patients
are in need of novel methods of selecting and administering chemotherapy
particularly for those patients who are refractory to current treatment
methods. The use of biomarkers to enhance decision making with regard to the
molecular profile of a person’s cancer is becoming more important in the
practice of oncology. The standard for the last several decades is to elect
chemotherapeutic agents based on staging and histological identification of the
primary cancer site alone versus utilizing the genetic and molecular profile
information along with histological primary cancer site and staging to select
chemotherapy regimens. Cancers are caused by mutations that occur within cells
and therefore selecting treatment based on mutations and not primary cancer
site alone can provide advantages that may have gone overlooked. As time
progresses, more biomarkers continue to be discovered which can lead to more
targets for drugs either currently on the market or clinical trials. In
addition to advancements made in the progression of cancer treatment with
utilizing molecular profiles effectively, there are other therapeutic strategies
that have been postulated as advanced effective ways to administer
chemotherapy. These strategies provide chemotherapy to patients while fasting,
giving insulin or other biological response modifiers adjunctively prior to
chemotherapy for enhanced targeting, and giving chemotherapy in micro-doses to
allow for increased frequency of administration and the utilization of multiple
targeted chemotherapeutic agents concurrently. In this paper we will discuss
these topics and explain their benefits in addition to the evidence that
supports these treatments. A review on biomarkers and cancer cell metabolism is
discussed as it relates to providing a framework for what constitutes a
biomarker in addition to what metabolic processes are related to fasting and administering
insulin with chemotherapy. The information provided in this document is
designed to illuminate and provide evidence for various methodologies that are
underserved in the treatment of cancer.
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