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The authors present the case of a 57-year-old male who was diagnosed with grade IV glioblastoma multiforme and enrolled in a clinical trial of adoptive cellular immunotherapy. The authors used PET imaging technology to image the T cells non-invasively and report the first case using a non-invasive imaging reporter gene/probe technology.
For patients with colorectal cancer and liver metastases, hepatic resection is the only potential curable treatment. The role of adjuvant chemotherapy in this setting is still under debate. The authors of this Viewpoint discuss the final results of the EORTC Intergroup randomized phase III study 40983 and whether FOLFOX4 should be the new standard in patients with resectable colorectal cancer and liver metastases.
Despite frequent responses to chemotherapy, curative treatment remains elusive for the majority of metastatic solid tumors. By contrast, chemotherapy routinely cures patients with testicular cancers, gestational choriocarcinoma, Hodgkin's disease and high-grade lymphomas. Savage et al. suggest that the chemo-curability of these malignancies results from an intrinsic 'locked-in' state of sensitivity to pro-apoptotic stresses in these particular cell types, and they discuss some of the characteristics shared by the curable cancers that might explain their curability.
Venous thromboembolism (VTE) is a major cause of morbidity and mortality in patients with cancer. Treatment with low-molecular-weight heparin is the recommended first-line approach for treating cancer patients with newly diagnosed VTE. The authors of this Review discuss the optimal duration of anticoagulant therapy, treatment of recurrent VTE, the role of vena cava filters, the effects of VTE and its treatment on quality of life, and the impact of anticoagulants on survival.
Anal mucosal melanoma is a disorder with limited treatment options and is associated with a poor prognosis. The authors describe the case of a 79-year-old man who was diagnosed with stage IV anal mucosal melanoma expressing the KIT Val560Asp mutation, and was treated with surgery, radiotherapy, and a combination of sorafenib and temozolomide therapy. The authors discuss the potential therapeutic use of sorafenib in anal mucosal melanoma patients with specific mutations such as the KIT Val560Asp mutation.
Capecitabine is commonly substituted for conventional 5-fluorouracil chemotherapy based on evidence of the efficacy equivalence of these two drugs and the lack of an increase in overall toxic effects when capecitabine is used. This Review summarizes why there may not be a universally applicable dose for capecitabine because of interpatient differences in basic physiology, pharmacogenomics and diet. The authors also discuss which of these factors contribute to the inter-regional geographical variation in capecitabine toxicity, and the reasons for modifying the starting dose.
Brain metastases are an increasingly prominent problem in the management of women with metastatic breast cancer. Trastuzumab has provided excellent systemic disease control for many patients; however, many women are now living long enough to develop CNS disease. This Review considers the potential for targeted therapy to provide effective management for brain metastases in patients with ErbB2-positive breast cancer, reviewing in particular the data currently available in this setting for lapatinib.
Breast angiosarcoma following surgery and radiotherapy for breast cancer is a rare but important clinical entity. In this Review the authors discuss data collected from over 250 case reports and provide a comprehensive discussion of the incidence, etiology, histopathology, cytogenetics, presentation, diagnosis, prognosis and management of this tumor type.
Cytoreductive nephrectomy has been a standard treatment for patients with metastatic renal cell carcinoma. The introduction of targeted agents has generated interest in using these drugs pre-operatively. The authors discuss the use of molecular targeted therapy and the benefits of cytoreductive nephrectomy.