Anakoinosis: Communicative Reprogramming of Tumor Systems - for Rescuing Chemorefractory Neoplasia

Disruptive technologies, such as communicative reprogramming (anakoinosis) with cellular therapies in situ for treating refractory metastatic cancer allow patient care to accelerate along a totally new trajectory and highlight what may well become the next sea change in the care of patients with many types of advanced neoplasia ( Reichle A et al, Cancer Microenvironment 2008, 2009). Cellular therapy in situ consisted of repurposed drugs, pioglitazone plus all-trans retinoic acid or dexamethasone or interferon-alpha (dual transcriptional modulation) combined with metronomic low-dose chemotherapy or low-dose 5-azacytidine, plus/minus classic targeted therapy. The novel therapeutic tools for specifically designing communication processes within tumor diseases focus on redirecting (1) rationalizations of cancer hallmarks (constitution of single cancer hallmarks), (2) modular events, (3) the ‘metabolism’ of evolutionary processes (the sum of therapeutically and intrinsically inducible evolutionary processes) and (4) the holistic communicative context, which determines validity and denotation of tumor promoting communication lines. Published data on cellular therapies in situ (6 histologic tumor types, 144 patients, age 0.9 to 83 years) in castration-resistant prostate cancer (Vogelhuber M et al, Cancer Microenvironment 2014), pretreated renal clear cell carcinoma (Biomark Insights 2007), chemorefractory acute myelocytic leukemia (Thomas S et al, Haematologica 2014), multiple myeloma > 2^nd-line (Reichle A et al, Blood 2012), chemorefractory Hodgkin lymphoma (Ugocsai U, Br. J. Haematol 2015) or multivisceral Langerhans cell histiocytosis (Reichle A et al, Br. J. Haematol 2005), outline the possibility for treating refractory metastatic cancer with the hope that this type of reprogrammed communication will be scalable with minimal toxicity. Accessibility to anakoinosis is a tumor inherent feature, and cellular therapy in situ addresses extrinsic and intrinsic drug resistance, by redirecting convergent organized communication tools, while been supported by quite different pattern of (molecular-)genetic aberrations.