A common viewpoint is that new drugs for treating human malignancies will be characterised by the capacity of targetting crucial steps of tumour cell growth. Unlike actual agents which target tubulin of nucleic acids, these new drugs shall, for example, interact with selective signalling transduction pathways leading to silencing or activating genes to induce cell suicide or to maintain cancer cells at low malignancy. This research will change the current view on cancer treatment: no more obstinate search for drugs aimed at aggressive tumour reduction or eradication (direct cytotoxicity), but rather we should witness the appearance of agents able to change tumours into chronic diseases with greater care to overall patient’s health condition. This big change of route will made it possible for these new agents to significantly broaden the present gap between active and toxic dose, particularly by recoursing to compounds administrable per os. Treatment will be continued for very long periods, even life long, the way it is currently done for cardiovascular disease (hypertension) or mental disorders (depression).
The scientific story of metal-based drugs seem to exclude them from the above race. They are mainly the result of the successes of platinum drugs (i.e. cisplatin and carboplatin); they have been - and still are - researched and investigated with the aim of being more powerful than those reference compounds. In other words, metal-derived compounds are included among the substitutes for platinum drugs and they are looked at with suspicion because of their potential renal toxicity that, among all, is expected for a compound based on a heavy metal. Thus, there is no room in the future of cancer chemotherapy for metal-based drugs.

Prof. Gianni Sava
g.sava@callerio.org