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Review article
peer-reviewed

The Concept of Hormesis in Cancer Therapy – Is Less More?



Abstract

There has, in recent years, been a paradigm shift in our understanding of the role of the immune system in the development of cancers. Immune dysregulation, manifesting as chronic inflammation, not only facilitates the growth and spread of tumors but prevents the host from mounting effective immune defenses against it. Many attempts are being made to develop novel immunotherapeutic strategies, but there is growing evidence that a radical reevaluation of the mode of action of chemotherapeutic agents and ionizing radiation is required in the light of advances in immunology.

Based on the concept of hormesis – defined as the presence of different modes of action of therapeutic modalities at different doses – a ‘repositioning’ of chemotherapy and radiotherapy may be required in all aspects of cancer management. In the case of chemotherapy, this may involve a change from the maximum tolerated dose concept to low dose intermittent (‘metronomic’) therapy, whilst in radiation therapy, highly accurate stereotactic targeting enables ablative, antigen-releasing (immunogenic) doses of radiation to be delivered to the tumor with sparing of surrounding normal tissues. Coupled with emerging immunotherapeutic procedures, the future of cancer treatment may well lie in repositioned chemotherapy, radiotherapy, and more localized debulking surgery.



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Review article
peer-reviewed

The Concept of Hormesis in Cancer Therapy – Is Less More?


Author Information

Andy Gaya Corresponding Author

London Oncology Clinic, Guy's and St. Thomas' NHS Foundation Trust

Charles A. Akle

Immodulon Therapeutics, The London Clinic

Satvinder Mudan

Department of Academic Surgery, The Royal Marsden Hospital

John Grange

Immodulon Therapeutics, The London Clinic


Ethics Statement and Conflict of Interest Disclosures

Conflicts of interest: The authors have declared that no conflicts of interest exist.


Review article
peer-reviewed

The Concept of Hormesis in Cancer Therapy – Is Less More?


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Review article
peer-reviewed

The Concept of Hormesis in Cancer Therapy – Is Less More?

  • Author Information
    Andy Gaya Corresponding Author

    London Oncology Clinic, Guy's and St. Thomas' NHS Foundation Trust

    Charles A. Akle

    Immodulon Therapeutics, The London Clinic

    Satvinder Mudan

    Department of Academic Surgery, The Royal Marsden Hospital

    John Grange

    Immodulon Therapeutics, The London Clinic


    Ethics Statement and Conflict of Interest Disclosures

    Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: April 01, 2015

    DOI

    10.7759/cureus.261

    Cite this article as:

    Gaya A, Akle C A, Mudan S, et al. (April 01, 2015) The Concept of Hormesis in Cancer Therapy – Is Less More?. Cureus 7(4): e261. doi:10.7759/cureus.261

    Publication history

    Received by Cureus: February 13, 2015
    Peer review began: February 15, 2015
    Peer review concluded: March 22, 2015
    Published: April 01, 2015

    Copyright

    © Copyright 2015
    Gaya et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

There has, in recent years, been a paradigm shift in our understanding of the role of the immune system in the development of cancers. Immune dysregulation, manifesting as chronic inflammation, not only facilitates the growth and spread of tumors but prevents the host from mounting effective immune defenses against it. Many attempts are being made to develop novel immunotherapeutic strategies, but there is growing evidence that a radical reevaluation of the mode of action of chemotherapeutic agents and ionizing radiation is required in the light of advances in immunology.

Based on the concept of hormesis – defined as the presence of different modes of action of therapeutic modalities at different doses – a ‘repositioning’ of chemotherapy and radiotherapy may be required in all aspects of cancer management. In the case of chemotherapy, this may involve a change from the maximum tolerated dose concept to low dose intermittent (‘metronomic’) therapy, whilst in radiation therapy, highly accurate stereotactic targeting enables ablative, antigen-releasing (immunogenic) doses of radiation to be delivered to the tumor with sparing of surrounding normal tissues. Coupled with emerging immunotherapeutic procedures, the future of cancer treatment may well lie in repositioned chemotherapy, radiotherapy, and more localized debulking surgery.



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Create a free account to continue reading this article.

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Andy Gaya, M.D.

London Oncology Clinic, Guy's and St. Thomas' NHS Foundation Trust

For correspondence:
agaya@theloc.com

Charles A. Akle

Immodulon Therapeutics, The London Clinic

Satvinder Mudan

Department of Academic Surgery, The Royal Marsden Hospital

John Grange

Immodulon Therapeutics, The London Clinic

Andy Gaya, M.D.

London Oncology Clinic, Guy's and St. Thomas' NHS Foundation Trust

For correspondence:
agaya@theloc.com

Charles A. Akle

Immodulon Therapeutics, The London Clinic

Satvinder Mudan

Department of Academic Surgery, The Royal Marsden Hospital

John Grange

Immodulon Therapeutics, The London Clinic