BRUNO ZILBERSTEIN
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Imagine a world without cancer(2014) BRUECHER, Bjoern L. D. M.; LYMAN, Gary; HILLEGERSBERG, Richard van; POLLOCK, Raphael E.; LORDICK, Florian; YANG, Han-Kwang; USHIJIMA, Toshikazu; YEOH, Khay-Guan; SKRICKA, Tomas; POLKOWSKI, Wojciech; WALLNER, Grzegorz; VERWAAL, Vic; GAROFALO, Alfredo; D'UGO, Domenico; ROVIELLO, Franco; STEINAU, Hans-Ulrich; WALLACE, Timothy J.; DAUMER, Martin; MAIHLE, Nitah; III, Thomas J. Reid; DUCREUX, Michel; KITAGAWA, Yuko; KNUTH, Alexander; ZILBERSTEIN, Bruno; STEELE, Scott R.; JAMALL, Ijaz S.Background: Since the ""War on Cancer"" was declared in 1971, the United States alone has expended some $300 billion on research, with a heavy focus on the role of genomics in anticancer therapy. Voluminous data have been collected and analyzed. However, in hindsight, any achievements made have not been realized in clinical practice in terms of overall survival or quality of life extended. This might be justified because cancer is not one disease but a conglomeration of multiple diseases, with widespread heterogeneity even within a single tumor type. Discussion: Only a few types of cancer have been described that are associated with one major signaling pathway. This enabled the initial successful deployment of targeted therapy for such cancers. However, soon after this targeted approach was initiated, it was subverted as cancer cells learned and reacted to the initial treatments, oftentimes rendering the treatment less effective or even completely ineffective. During the past 30 plus years, the cancer classification used had, as its primary aim, the facilitation of communication and the exchange of information amongst those caring for cancer patients with the end goal of establishing a standardized approach for the diagnosis and treatment of cancers. This approach should be modified based on the recent research to affect a change from a service-based to an outcome-based approach. The vision of achieving long-term control and/or eradicating or curing cancer is far from being realized, but not impossible. In order to meet the challenges in getting there, any newly proposed anticancer strategy must integrate a personalized treatment outcome approach. This concept is predicated on tumor-and patient-associated variables, combined with an individualized response assessment strategy for therapy modification as suggested by the patient's own results. As combined strategies may be outcome-orientated and integrate tumor-, patient-as well as cancer-preventive variables, this approach is likely to result in an optimized anticancer strategy. Summary: Herein, we introduce such an anticancer strategy for all cancer patients, experts, and organizations: Imagine a World without Cancer.
- Genomics, microRNA, epigenetics, and proteomics for future diagnosis, treatment and monitoring response in upper GI cancers(2016) BRUECHER, Bjorn L. D. M.; LI, Yan; SCHNABEL, Philipp; DAUMER, Martin; WALLACE, Timothy J.; KUBE, Rainer; ZILBERSTEIN, Bruno; STEELE, Scott; VOSKUIL, Jan L. A.; JAMALL, Ijaz S.One major objective for our evolving understanding in the treatment of cancers will be to address how a combination of diagnosis and treatment strategies can be used to integrate patient and tumor variables with an outcome-oriented approach. Such an approach, in a multimodal therapy setting, could identify those patients (1) who should undergo a defined treatment (personalized therapy) (2) in whom modifications of the multimodal therapy due to observed responses might lead to an improvement of the response and/or prognosis (individualized therapy), (3) who might not benefit from a particular toxic treatment regimen, and (4) who could be identified early on and thereby be spared the morbidity associated with such treatments. These strategies could lead in the direction of precision medicine and there is hope of integrating translational molecular data to improve cancer classifications. In order to achieve these goals, it is necessary to understand the key issues in different aspects of biotechnology to anticipate future directions of personalized and individualized diagnosis and multimodal treatment strategies. Providing an overview of translational data in cancers proved to be a challenge as different methods and techniques used to obtain molecular data are used and studies are based on different tumor entities with different tumor biology and prognoses as well as vastly different therapeutic approaches. The pros and cons of the available methodologies and the potential response data in genomics, microRNA, epigenetics and proteomics with a focus on upper gastrointestinal cancers are considered herein to allow for an understanding of where these technologies stand with respect to cancer diagnosis, prognosis and treatment.