Analysis of FDA approved anticancer drugs reveals the future of cancer therapy.

This review discusses 26 new anticancer drugs approved by the FDA in the past decade. Based on their targets, these anticancer agents can be divided into three groups. First group contains cancer-selective or semi-selective drugs that are effective in rare kinase- addictive cancers. For other malignancies, semi-selective drugs have to be judiciously combined with nonselective agents. The second group includes analogs of classic cytotoxic agents such as DNA alkylating agents, nucleoside analogs, and anti-microtubule agents. As expected, they have a marginal advantage over the existing cytotoxic drugs, nevertheless are more effective (in common cancers) than semi-selective agents. The third is a diverse group of tissue-selective agents that essentially attack the normal tissues of tumor origin and thus exploit the tissue-specific similarities between normal and cancer cells. Our analysis predicts that monotherapy with semi-selective agents will be limited to rare cancers. In most cancers, however, two anticancer strategies may be most fruitful: (a) combinations of cytotoxic drugs with semi-selective agents aimed at matching targets and (b) tissue-selective therapy aimed at normal and tumor cells of the same tissues.