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The Seattle Cancer Care Alliance has added physician-assisted suicide to its host of services for patients within the final 6 months of life. According to a recent report published in the New England Journal of Medicine, the programme has been well received by patients and clinicians alike. So, why lose sleep?
A recent clinical trial showed that a significant progression-free and overall survival benefit was associated with maintenance chemotherapy in patients with HER2-negative metastatic breast cancer who have disease control after six cycles of conventional chemotherapy. However, the choice of observation alone as the control arm limits the clinical application of these data.
Tivantinib is being tested in a variety of phase II and phase III clinical trials as a highly selective, non ATP-competitive MET tyrosine kinase inhibitor. Its mechanism of action has been under scrutiny by two independent studies, which reveal that tivantinib is a cytotoxic drug acting on microtubule dynamics independently of MET. This finding has important implications for the interpretation of clinical results, for the design of new trials and for the selection of patients receiving tivantinib treatment.
In patients with colorectal cancer, resection of liver-limited metastatic disease provides the only chance of cure. A recent study showed that the addition of cetuximab to conventional chemotherapy significantly increased the response rate and the rate of liver metastases resection in patients with colorectal cancer, providing another chance to cure patients with initially liver-limited unresectable disease.
Circulating blood biomarkers are promising non-invasive real-time surrogates for tumour tissue-based biomarkers, and in breast cancer they have been used as tools for diagnosis, prognostication, prediction, monitoring of therapeutic response, and resistance. This Review outlines the techniques, challenges and possibilities of this promising area.
Although patients with melanoma generally benefit from BRAF or MEK targeted therapies, adverse events can occur on treatment, including the emergence of second malignancies. Evidence suggests unintended or paradoxical activation of MAPK signalling might underlie the majority of these second malignancies. The authors discuss the basis for this paradoxical MAPK activation, and the rationale for novel therapeutic strategies for the management of BRAF-inhibitor-induced neoplasia.
Highly efficacious vaccines are available to protect against persistent human papillomavirus (HPV) infection and, therefore, the associated neoplasias (most notably cervical cancer). This Review article discusses the two approved vaccines in terms of their structure, mode of action, efficacy, cross-reactivity with non-vaccine HPV types, safety and use in vaccination programmes.
Charged particle therapy (CPT) offers advantages over conventional radiotherapy, such as higher local control of the tumour and the potential for less damage to healthy tissues. Despite the advantages of CPT, only a small number of controlled randomized clinical trials have compared it to conventional radiotherapy. The latest clinical data on the use of CPT, dose calculations and delivery, cost-effectiveness issues, current status, and future directions are discussed.
