Volume 3 Issue 4, April 2006

Although the epidermal growth factor receptor tyrosine kinase inhibitors gefitinib and erlotinib can produce dramatic and durable tumor responses, not all patients with non-small-cell lung cancer (NSCLC) benefit from these drugs. This Viewpoint discusses the molecular correlates of response for these agents in patients with NSCLC.

For the treatment of advanced non-small-cell lung cancer, randomized controlled trials have shown that platinum-based chemotherapy and radiotherapy provide a measurable survival benefit compared with radiotherapy alone. Newer drugs that target growth factor receptors might further synergize with ionizing irradiation, although convincing data from multicenter phase III are currently lacking. The authors discuss why concurrent chemoradiation followed by consolidation platinum-based chemotherapy is an attractive approach for treating patients with inoperable tumors.

Recent advances in tumor cytogenetics and molecular biology have clarified that renal-cell carcinoma is not a single entity but comprises a variety of tumors with different histological features, genetic patterns and varying clinical course. Since many cancer molecular markers have been described, this information could help to discriminate aggressive tumors from indolent lesions. The authors describe the benefits of predictive nomograms for improving risk assessment, and discuss the prospects for individual customized follow-up protocols based on tumor molecular characteristics.

The use of central venous catheters (CVC) has improved the management of patients with cancer but this procedure is associated with complications such as infections and upper limb deep-vein thrombosis. This review describes the epidemiology of CVC-related thrombosis and the risk factors associated with this problem. The authors comment on the diagnosis and presentation of CVC-related thrombosis and consider how cancer patients with this complication can be appropriately managed with long-term anticoagulant therapy.