Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
Nanotechnology offers great promise for the detection, prevention and treatment of cancer. Current limitations of this technology include the heterogeneous distribution of nanoparticles to tumors, caused in part by the physiological barriers presented by the abnormal tumor vasculature and interstitial matrix. This Review discusses these barriers and summarizes strategies that have been developed to overcome them. It additionally examines design considerations for the optimization of delivery of nanoparticles to tumors.
A study by Atkin and coauthors has demonstrated reduced mortality by screening average-risk patients with a single use of flexible sigmoidoscopy for colorectal cancer. This large UK trial of 170,432 subjects aged 55–64 years (median 60.2 years) randomized patients 2:1 to control or single flexible sigmoidoscopy. Reduction in colorectal cancer incidence was 23% and cancer mortality was reduced by 31% in the intention-to-treat population. In this News & Views article we discuss the role of flexible sigmoidoscopy in population-based screening for colorectal cancer.
Palumbo and coauthors report on the results of a randomized trial comparing two doses of melphalan in patients with symptomatic multiple myeloma. Overall complete response rates, median progression-free survival and projected 5-year overall survival were significantly higher among patients receiving the higher melphalan dose. These results confirm that for this patient population melphalan 200 mg/m2 should remain the gold standard conditioning regimen.
The results from two large, prospective, randomized, controlled trials examining the role of 5-α reductase inhibitors in the prevention of prostate cancer have been published. Initial results from the Prostate Cancer Prevention Trial (PCPT) were met with both enthusiasm and skepticism. The recently published REDUCE trial seems to corroborate the findings of the PCPT and reinforce the chemopreventive potential of 5-α reductase inhibitors. This article will assess the REDUCE trial and place the results of the 5-α reductase inhibitor trials in the context of clinical practice.
Nanoparticles are a promising vector-based strategy for the therapeutic administration of small interfering (si)RNA because they protect siRNA from nuclease degradation. A recent phase I study employed transferrin–targeted nanovectors to demonstrate RNA interference mechanisms in a melanoma patient. Multifunctional nanoparticles are providing patient-specific biodistributions of systemically administered siRNA.
A 63-year-old woman with chronic myeloid leukemia who achieved a complete cytogenic response after 6 years of interferon-alpha went on to lose molecular response 2 years after treatment cessation. In this Case Study, Monica Bocchia and colleagues demonstrate the positive outcome in this patient following treatment with a therapeutic vaccine that consists of the p210 BCR–ABL1-derived peptide. The patient has maintained a complete molecular response for over 39 months.
Radiotherapy has an important role in the treatment of metastatic epidural spinal cord compression; when used alone, it is important to select the most suitable radiotherapy regimen. In this Review, Rades and Abrahm report that longer-course radiotherapy is associated with better local control than short-course radiotherapy. However, short-course radiotherapy is more suitable than longer-course treatment in patients with a poor prognosis.
Adjuvant treatment with anthracycline–taxane combination therapy in high-risk early-stage breast cancer has raised the important question of how to manage patients who relapse. In the metastatic setting, one option is rechallenging with the same agent, or class of agent, that has been used in the adjuvant setting. This Review comprehensively examines the evidence from clinical trials for rechallenging with both anthracyclines and taxanes, and highlights issues to be examined in the context of future clinical trials.
Bone is the most common site of breast cancer metastasis, resulting in substantial morbidity and mortality. A number of therapies are being developed, including bisphosphonates, which target factors that promote tumor growth in bone. The authors of this Review outline the underlying mechanisms that drive this pathological process, and highlight potential molecular targets that will improve therapeutic interventions for metastatic breast cancer. Tools that assess response in individual patients and guide appropriate treatment are also discussed.
