Volume 12 Issue 7, July 2015

Randomized trial data support the use of laparoscopic surgery for colon cancer; however, such evidence was lacking for rectal cancer. Now, the COLOR II randomized trial gives minimally invasive resection of rectal cancer the 'green light', answering the question 'should laparoscopic surgery be used?' The new key question is 'who should be performing laparoscopic surgery for rectal cancer?'

In a recent international phase III trial, addition of bortezomib to a R-CHOP-like immunochemotherapy regimen for the first-line treatment of mantle-cell lymphoma resulted in a clinically meaningful extension of median progression-free survival. This finding emphasizes the role of targeted therapies in a relatively chemotherapy-refractory disease; however, therapeutic recommendations have to consider the observed haematotoxicity of this combination.

Despite the commercialization of HPV vaccines, cervical cancer remains a major cause of death, especially in developing countries. Recent data implicate a discrete population of cells within the cervical squamocolumnar junction in the pathogenesis of cervical precancerous lesions, indicating that ablation of these cells might reduce the rate of cervical cancer in high-risk populations.

Traditionally, intertumour heterogeneity in breast cancer has been documented in terms of different histological subtypes, treatment sensitivity profiles, and clinical outcomes among different patients. High-throughput molecular profiling studies have confirmed that spatial and temporal intratumour heterogeneity of breast cancers exist at a level beyond common expectations. In this Review, the authors describe the different levels of tumour heterogeneity, and discuss the strategies that can be adopted by clinicians to tackle treatment response and resistance issues associated with such heterogeneity for the optimal clinical management of breast malignancies.

PET has evolved from a purely diagnostic imaging technique to a multifunctional modality that can provide diverse information of relevance to oncological management. This modality might offer the potential to improve patient care and outcomes by enabling better disease characterization, treatment-response monitoring, and follow-up assessment. Herein, the authors discuss the data supporting the use of PET in personalizing the clinical management of patients with locally advanced and metastatic non-small-cell lung cancer.

Liver cancer mortality has increased in the past 20 years, and estimates indicate that the global health burden of this disease will continue to grow. Advances in our knowledge of the human genome have provided a comprehensive picture of commonly mutated genes in patients with hepatocellular carcinoma (HCC). In this Review, the authors summarize the molecular concepts of progression of HCC, discuss the potential reasons for clinical trial failure, and propose new concepts of drug development.

A lack of clinical investigation, which has arguably become more pronounced in the past decade, currently hinders progress in cancer surgery research, and ultimately the treatment of patients with cancer. This Perspectives describes the major barriers to progress in surgical oncology, and how improvements might be made in this important, but often overlooked, aspect of cancer treatment.