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F. M. MUGGIA When faced with the inadequacies of current cancer
treatment, we prefer to look at what the future may hold. Quite
often, we take for granted the past, preferring research into
totally new areas. However, the persistent development of fertile
soil may yield surprising rewards for those who choose to build on
the knowledge of the past--hence, this symposium on anthracycline
antibiotics. Although the anthracycline antibiotics represent much
of the present and future of cancer treatment, their actual use c
stretches back barely two decades to the pioneering efforts of
Aurelio Di Marco, who characterized the antitumor properties of
daunomycin and adriamycin. * The clinical application of these two
compounds heralded a decade of excitement among oncologists dealing
with pediatric tumors, breast cancer, leukemias, and lymphomas, and
opened new hope for patients afflicted with sar comas and a variety
of other tumors that had been deemed - sistant to chemotherapy.
These successes were tempered with the realization that the
antitumor effect of anthracyclines could be achieved at times only
at the very high price of risking cardiac decompensation and,
almost invariably, with the occurrence of alopecia and other acute
toxicities. This record of past achievements and problems has
slowly given way to a present increasingly illuminated by our
ability to modify the distressing toxicities of these agents.
Detailed clinical studies supplemented by ingenious laboratory
models have gradually elucidated mechanisms and risk factors im
plicated in the cardiomyopathy."
The impressive advances in all branches of medical science during
the first half of this century with the discovery of many
chemotherapeutic or immunogenic agents gave rise to brilliant
achievements in the struggle against some infectious diseases and
aroused in many scientists the wishful thought that drugs for
cancer therapy would, soon lead to additional great success.
Notwithstanding ever-increasing worldwide endeavors, the major
problems in prevention or treatment of neoplastic diseases are
still unsolved. The approach to the resolution of these problems
follows many different pathways. Basic research tries to cast light
on the genetic and biochemical processes underly ing cell division
and differentiation as well as the interactions occurring between
the cell and the oncogenic stimulus, or between the neoplastic
cells and the different body systems endowed with immunological
reactivity. Another line of approach, coherent with the classic
basis of chemotherapy, relies upon the search for new compounds
selectively blocking the multiplication of the neoplastic cells.
The remarkable progress made in treating human cancer, as a result
of these efforts, has been until now ascribable chiefly to the
accomplishment of the chemo therapeutic approach. Studies on the
cytostatic activity of the anthracycline antibiotics carried out
over many years eventually led the investigators of Farmitalia
(Milan, Italy) to discover and characterize some new compounds
endowed with interesting chemotherapeutic properties against
malignant neoplastic diseases."
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