Volume 13 Issue 12, December 2016

The SHIVA trial compared the efficacy of targeted agents selected on the basis of tumour molecular profiling (using an algorithmic approach) with that of physician's choice across multiple solid tumours; the trial was negative for the primary end point. We now discuss the challenges associated with precision medicine trial design and propose solutions learned from this trial.

The UK Joint Committee on Vaccination and Immunization recently announced a further delay before considering the subject of widespread human papillomavirus (HPV) vaccination in teenage boys, thereby excluding an estimated 2.9 million boys from receiving an effective treatment in this interim period. Vaccination of boys can offer significant clinical, economic and ethical advantages.

Most patients with cancer who develop brain metastases have a very poor prognosis, especially those with brain metastases from non-small-cell lung cancer. The short life-expectancy of these patients, which is typically measured in weeks or a few months, raises an important question: do they benefit from whole-brain radiotherapy, or are they appropriately treated with best supportive care alone? A recent randomized trial sought to answer this question.

Many of the molecular pathways that are aberrant in brain tumours result in reprogramming of metabolism, which creates opportunities forin vivometabolic imaging to improve diagnosis, patient stratification, and disease monitoring. Herein, the molecular basis and strategies for non-invasive metabolic imaging of brain tumours are reviewed.

Expediting the diagnosis of cancer is generally considered to result in improved patient outcomes, and much effort is applied to achieving this goal. Herein, the authors describe the various aspects of early diagnosis of cancer including the potential benefits, methods, most suitable patients and likely costs, in the context of the UK National Health Service.

Intrinsic pathophysiological barriers limit the delivery of drugs to pancreatic cancers, contributing to the limited effectiveness of treatment. Nanomedicine approaches have the potential to overcome many of these drug-delivery challenges, and two nanoparticle therapies are now approved for the treatment of this disease. The authors discuss the key pathobiological barriers that must be overcome, the approaches to nanomedicine that have been pursued to date, and those that are the focus of ongoing research.

The Internet is a valuable tool that continues to revolutionize many aspects of our lives. Herein, the current trends in the use of online resources in oncology are described, using the findings from the National Cancer Institute's Health Information National Trends Survey (HINTS) as a foundation. Future opportunities and challenges relating to the use of the Internet to improve cancer prevention and care are discussed.