Therefore, the importance of conducting comprehensive investigations on recently introduced potent peptides, proteins, oligonucleotides, and antibody fragments for PEGylation cannot be overemphasized.
For better therapeutic effectiveness combination anticancer treatment has long been adopted in clinics. The general rationale for employing combination therapy is twofold. First,

when multiple drugs with different molecular targets are applied, the cancer adaptation process such as cancer cell mutations can be delayed. Second, when multiple drugs Inhibitors,research,lifescience,medical target the same cellular pathway they could function synergistically for higher therapeutic efficacy and higher target selectivity. Currently available combination regimens for metastatic breast cancer in clinics are limited to administrating a physical mixture of two or more anticancer agents. The clinically used combination Inhibitors,research,lifescience,medical regimens in the US can be broadly classified based on their mechanisms of action (Figures 1(a) and 1(b)) including: (1) combination of nonspecific small molecule chemotherapeutic

agents, (2) combination of target-specific biologic agent and small molecule chemotherapeutic agents, and Inhibitors,research,lifescience,medical (3) combination of target-specific biologic agents. Figure 1 Schematic representation of various combination drug delivery approaches for treatment of cancer. (a) combination of small molecule chemotherapeutic agents, (b) combination of target specific biologic agents including monoclonal antibodies, and small … 2.1. Combination of Nonspecific Small Molecule Chemotherapeutic Agents Small molecule chemotherapeutic agents can be given singly or in combination (Figure 1(a)). Toxicity is typically less with single-agent therapy and quality of life appears Inhibitors,research,lifescience,medical better. However, combination therapy may be a more appropriate first-line choice for symptomatic patients or those with rapidly SCH 900776 datasheet progressive visceral metastases because of the greater likelihood of an objective response. Of the many active combination chemotherapy regimens in metastatic breast cancer (Table 1), none is established as the optimal

first-line regimen. For example prior exposure to anthracyclines and/or taxanes is a Inhibitors,research,lifescience,medical major limiting factor when selecting such a regimen since it often renders tumors resistant and is therefore related to reduced clinical benefits including response rate upon rechallenging to these chemotherapeutic classes and even to other classes of drugs [17, 18]. Table 1 Clinically used combination regimens of nonspecific (-)-p-Bromotetramisole Oxalate small molecule chemotherapeutic agents in metastatic breast cancer. 2.1.1. Anthracycline-Based Regimens With response rates of up to 60% in previously untreated patients with metastatic breast cancer anthracycline-based regimens are one of the most widely used first-line chemotherapies. Because of this advantage patients relapsing more than 12 months after anthracycline-based treatment may be reinduced with anthracycline-based combination chemotherapy [19].