|
The last decade we have witnessed a major change in the
development of new techniques and agents for the treatment of cancer in
general, and for soft tissue sarcomas in particular. The important
achievements of molecular biology research have changed the landscape
markedly. Increasingly subtypes of soft tissue sarcomas are shown to be
related to changes in cellular growth factors in the cell signaling
pathways. This in theory enabled to development of agents with specific
activity against these factors. The presence of the KIT receptor at the
surface of the gastrointestinal stroma tumor cell, and the constitutive
activation by mutations, has lead to the discovery of the specific KIT
tyrosine kinase inhibitor Imatinib, an agent with impressive activity in this
disease. Before the era of Imatinib, GIST was an untreatable disease once
metastasized. Imatinib clearly is a breakthrough in the approach of soft
tissue sarcomas, and will likely serve as a role model for the development
of other agents acting towards other receptors. Likewise, soft tissue
sarcomas with their specific molecular characteristics, will likely serve as
role model diseases for targeted treatment approaches. Whether the future
lies in drugs with selective inhibition of only one receptor and one
pathway, or multiple receptors and multiple pathways is currently a matter
of debate, and again soft tissue sarcomas serve as role model.
Fully in line with the more targeted approach in drug use, the
changes in the field of radiation therapy and surgery basically also focus
on a better targeting of the disease, albeit not based on the molecular
characteristics yet.
The present volume of this series reflects all of the above
mentioned changes. World wide renowned experts have been willing to
contribute to this book, and we would like to thank all of them for their
efforts. Hopefully this book will contribute to a better understanding of
the changes in the field, and will serve our patients in helping getting a
better future. |
