Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
Observations that CTLA4 has a key role in regulating immune responses mediated via T cells have led to therapeutic approaches targeting this inhibitory pathway for tumor immunotherapy. It is possible that combining anti-CTLA4 antibodies with a vaccine may help to direct immune responses toward target antigens, enhancing clinical efficacy and perhaps reducing treatment-related adverse effects. These theories have been tested in clinical trials in patients with advanced prostate cancer, as discussed in this Viewpoint.
Legal barriers, restricted resources, lack of physician training, and physician and patient worries about potential opioid addiction can be barriers to effective and rational pain management in patients with cancer pain. Sebastiano Mercadante discusses these issues, as well as suggesting interventions for improving care.
In the first review of this two-part series, Seiwert and co-authors described the rationale for the use of concurrent chemoradiotherapy for treating malignancies. Here the chemoradiotherapy platforms used for the treatment of head and neck cancer are described and the integration of novel agents such as EGFR inhibitors and antiangiogenic drugs into treatment platforms alongside multiagent-based regimens are reviewed. The authors provide guidance for clinicians based on current clinical trial evidence and suggestions for choosing the most appropriate treatment platform.
Combining cytotoxic drugs with radiation is aimed at improving survival without compromising quality of life. While the current trend in treating epithelial tumors favors concurrent chemoradiation, future regimens should exploit spatial cooperation and temporal modulation mechanisms to optimize the balance between treatment risks and benefits. The authors of this review propose that effective exploration of novel strategies will require a rigorous scientific and mechanistic framework to best identify and test exploitable mechanisms of drug-radiation interaction.
Schneider and Sledge discuss the mechanisms of resistance associated with anti-angiogenic agents and the problems associated with defining which groups of patients might benefit from this class of therapy. This review highlights the rationale for targeting VEGF and how the combination of anti-angiogenic drugs with other biologic agents is also being explored in clinical trials, in an attempt to improve efficacy and to overcome resistance seen with the initially studied anti-angiogenic drugs.
The MammoSite®breast brachytherapy applicator was designed to simplify the brachytherapy procedure and make it more accessible to patients who are suitable candidates for partial-breast irradiation (PBI). Dickler highlights the advantages of this technique such as low rates of serious complications and favorable cosmetic outcome and also summarizes ongoing trials that should provide a definitive answer regarding the benefits of PBI.
Carney's triad is a syndrome consisting of three rare neoplasms: gastric leiomyosarcoma, extra-adrenal paraganglioma and pulmonary chondroma. The article by Kächele et al. describes the case of a young woman who presented with a gastrointestinal stromal tumor and metastatic epicardial paraganglioma. The patient underwent an extended hemigastrectomy and cardiac surgery and remained free of recurrent disease during the follow-up period. This is the first report of an epicardial paraganglioma within a Carney's triad and the authors discuss the diagnostic workup and management of patients with Carney's syndrome.
