Volume 10 Issue 12, December 2013

Concerns still exist regarding the best use of low-dose CT screening for lung cancer and how to select high-risk individuals who will benefit most from participation in screening programmes. Two studies now indicate factors that may reduce the false-positive rate of lung cancer screening with low-dose CT.

Controversy surrounds the use of mammography for breast cancer screening. This commentary explains why retrospective analyses of women who die from breast cancer do not add to the body of knowledge about the value of screening in young women. Mammographic screening alone cannot be expected to overcome aggressive biology.

Establishing breast cancer chemoprevention in standard clinical practice requires advances in many different fields, including biomarker research, the development of more powerful tools to predict and communicate the risks and benefits of treatments and establishing innovative trial designs. In this Review, the authors examine the efforts in breast cancer chemoprevention and explain why the field is progressing slowly than hoped.

Iniparib showed promising results in randomized phase II trials in patients with triple-negative breast cancer; however, negative results from a phase III study in this disease setting, tempered enthusiasm for this agent. The authors of this Review scrutinize the development of iniparib from preclinical studies to registration trials, and identify and discuss the pitfalls in the development of anticancer drugs to prevent future late-stage trial failures.

In this Review, the authors describe the pathophysiological effects of chemotherapy and radiotherapy that affect the heart and treatment-related cardiovascular effects in children with cancer. They argue that 5-year event-free oncological survival is no longer the paradigm of successful treatment of childhood cancer; instead overall quality of life is and maximizing oncological efficacy while minimizing toxicity and late-effects should be the ultimate goal.

Biopsy of suspected metastatic lesions is recommended, but not always performed in the clinic. Niikura and colleagues outline the rationale and techniques for performing biopsies on suspected breast metastases. The authors describe the issues surrounding biomarker discordance between primary and metastatic tumours and outline the optimal treatment approach to limit such problems.

There is much concern in the literature over the lack of reproducibility of many scientific reports. In this Perspective, the authors discuss how cognitive biases in research and flaws in the academic incentive system also contribute to the publication of immature results. The authors suggest some changes to the grant submission and funding system that could further improve the reproducibility of research findings.