Volume 4 Issue 2, February 2007

In this Viewpoint the potential implications of improved understanding of the metastatic cascade in cancer patients are discussed. The detection of disseminated tumor cells before the onset of overt metastasis could improve stratification of patients who are in need of early systemic anti-cancer therapy; monitor the efficacy of such therapy; help to identify therapeutic targets; and assist in selection of cancer patients who are candidates for targeted therapies.

The authors of this Viewpoint discuss the protective activity of fenretinide on second breast cancer as a surrogate marker of primary prevention and the possibility of using this agent in young women bearing germlineBRCA-1 and BRCA-2mutations.

Concurrent chemoradiotherapy is a highly efficacious locoregional treatment option for solid tumors. The rationale for the use of concurrent chemoradiotherapy for treating malignancies, and the molecular basis for combining classic cytotoxic agents and novel targeted therapies agents with radiotherapy are discussed. This article is part one of two articles. In the subsequent article, the general principles outlined here will be applied to head and neck cancer, where the impact of concurrent chemoradiotherapy is particularly evident.

Viruses have been used for cancer treatment for over a century. From the early clinical studies with various wild-type viruses, to the modern trials with engineered viruses, virotherapy has emerged as a promising therapeutic strategy. The authors discuss the progress and challenges associated with oncolytic virotherapeutic agents, summarizing the data from clinical reports, and the implications of this data for future virotherapy development.

Health care statistics demonstrate a striking disparity in treatment selection, access, and outcomes between the African-American community and the general population. The role of race and ethnicity in lung cancer etiology is unclear but genetic, cultural and socio-economic factors, in addition to differences in tobacco use and exposure contribute to this disparity. This review summarizes the existing body of knowledge regarding lung carcinoma in African Americans, and identifies promising areas for future investigation and intervention.

Individuals with recessive mutations in the mismatch repair geneMSH6 are at an increased risk of developing primary and secondary malignancies. In this article, Scott et al. describe the case of a young girl with constitutional biallelic MSH6 mutations who had developed colonic carcinomas, medulloblastoma and acute myeloid leukemia. The patient underwent allogeneic bone marrow transplantation and panproctocolectomy and was treated with chemotherapy. This report broadens the tumor spectrum associated with biallelic MSH6mutations and discusses the differential diagnosis and implications for treatment in individuals with such mutations.