Volume 3 Issue 10, October 2006

The dilemma for those managing patients with cancer and neutropenia is whether the potential benefit of fluoroquinolones outweigh their disadvantages—drug resistance, toxicity and cost. The authors of this Viewpoint re-examine the question of who (if anyone) should receive fluoroquinolone prophylaxis.

The development of the 70-gene prognosis signature for breast cancer was evaluated in the MINDACT (Microarray In Node negative Disease may Avoid ChemoTherapy) trial to assess the clinical relevance of the 70-gene prognosis signature, and how this compares with traditional prognostic factors for assigning adjuvant chemotherapy for patients with node-negative breast cancer. This review outlines the background work and rationale behind the final design of the MINDACT trial and how these considerations can help to optimize future trials and aim to improve individualization of cancer therapy.

Owing to cardiovascular and thromboembolic toxicities, oral estrogens were abandoned as treatments for prostate carcinoma; however, it is now recognized much of this toxicity can be avoided by parenteral (intramuscular or transdermal) estrogen administration. Ockrim and coauthors highlight the cost and protective andropause advantages of estrogen therapy, advocating a re-evaluation of this promising, but forgotten therapy.

The established role of theRETproto-oncogene in the development of medullary thyroid carcinoma makes this gene an attractive target for selective cancer therapy. The current evidence of RET involvement in the etiology of medullary thyroid carcinoma, and the therapeutic targeting of this process in preclinical and clinical studies are discussed, and the authors propose why targeting the RET proto-oncogene with small-molecule drugs is very likely to be successful in clinical applications.