Volume 11 Issue 8, August 2014

The decision of patients with breast cancer to have contralateral mastectomies is often related to their genetic risk. However, the increasing frequency of this surgical approach is also associated with social and psychological issues such as celebrity experiences and fear of contralateral breast cancer. Appropriate counselling may better inform patients' surgical choices.

Healthy individuals carrying the t(14;18) translocation might never develop follicular lymphoma (FL). However, individuals with more than 1 in 10,000 cells carrying this translocation are at high-risk of developing FL. The identification of this high-risk population will help define the pathways driving FL and designing targeted therapies to use before its development.

Around 20% of patients with colorectal cancer (CRC) have synchronous hepatic metastases at the time of presentation, highlighting the need for appropriate diagnostic and staging assessments. Furthermore, various approaches to the therapeutic management of such patients are available, and the treatment strategy used is influenced by clinical presentation. Herein, these aspects of the management of patients with CRC and synchronous liver metastases are comprehensively reviewed, focusing on the integration of surgical approaches within a multidisciplinary framework.

The sinonasal cavities are affected by a range of tumour types, the most common of which are sinonasal squamous-cell carcinoma (SNSCC) and intestinal-type adenocarcinoma (ITAC). Compared with the main types of head and neck cancer, these sinonasal cancers have distinct epidemiological, clinical, aetiological, pathological and genetic characteristics, and require specialized treatment, bearing in mind their important anatomical location. All these aspects of ITAC and SNSCC are reviewed in this article.

This Review explores breakthroughs in our understanding and treatment of acquired resistance to tyrosine kinase inhibitors in key molecular subtypes of non-small-cell lung cancer, which may be relevant across multiple different solid malignancies with oncogene-addicted subtypes. The potential of a number of clinical approaches to treat acquired resistance, from new drugs or drug combinations through to the use of more traditional therapies such as radiation or cytotoxic chemotherapy, are highlighted, and the implications for major changes in conducting clinical research in this setting are discussed.

Tissue-preserving focal therapies that target individual cancer lesions rather than the whole prostate have emerged as potential interventions for localized prostate cancer. In this article, the Prostate Cancer RCT Consensus Group recommends the development of a cohort-embedded randomized controlled trial methodology to evaluate focal therapy use in men with clinically significant localized disease. The importance for a randomized controlled trial design to provide cost-efficient practice-changing data is highlighted.

The current drug development procedures are far from optimal, owing to the continuous development of the health systems and the clinical research landscape. The European Organisation for Research and Treatment of Cancer proposes in this Perspective the use of collaborative molecular screening platforms (CMSPs) as a new approach for drug development. These CMSPs have the advantage of optimizing expertise of several partners and combining efforts alongside with cost-sharing models for efficient patient selection.