Systems Biology In The Etiology Of Cancer: Implications For Treatment | 12955
Epidemiology: Open Access
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he current approach to treatment in oncology is to replace the generally cytotoxic chemotherapies with pharmaceutical
treatment that inactivates specific molecular targets associated with cancer development and progression. The goal is
to limit cellular damage to pathways perceived to be directly responsible for the malignancy. However, despite careful study
of tumor biology and initial positive responses to therapy, cancers appear to have a virtually limitless ability to respond to
treatments by reprogramming cells and developing resistance to specific therapeutics. Accumulating evidence suggests that
systemic dysfunction precedes the disruption of specific genetic/molecular pathways in most adult cancers and that targeted
treatments such as kinase inhibitors may successfully treat one pathway while generating unintended changes to other, non-
targeted pathways. Because there are many biological pathways and multiple epigenetic influences workingsimultaneously in the
expression of cancer phenotypes, studying individual components in isolation limits our ability to understand the complexity of
phenotypic expression. This paper will address the advantages of a systems biology approach for identifying early biomarkers of
cancer; the first goal being to intervene with lifestyle modifications at an early stage to revert epigenetic changes that are leading
to malignancy. The second goal is to use complex modeling to guide therapies at subsequent stages of tumor development.
Sarah Knox received her PhD from the University of Stockholm and began her career there and at the KarolinskaInsitute as PI of her own research
group. She subsequently moved back to the United States to do epidemiologic research at NIH and is currently a professor at the University of West
Virginia School of Public Health. She is an editorial board member of several oncology journals, has published and lectured extensively and won
national honors and awards.
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