Volume 4 Issue 8, August 2007

The evidence for use of spiral CT for lung cancer screening and the results and implications of the International Early Lung Cancer Action Program study are discussed in this Viewpoint.

There are a number of factors that make cancer screening more difficult in the lungs than in other organs. These factors include the characteristics of the patient group being screened, the heterogeneous nature of lung cancer and issues with the screening process itself, as discussed in this Viewpoint.

Surgery is the most frequently used approach in the treatment of nonmelanoma skin cancer, and Mohs micrographic surgery, conventional excision, cryosurgery, or electrodesiccation and curettage are usually performed. Newer noninvasive options include topical chemotherapeutics, biological immune-response modifiers, retinoids, and photodynamic therapy. Neville et al. propose that treatments should be tailored to the tumor type, location, size, and histological pattern, and suggest that, although surgical methods remain the most frequently used, newer noninvasive treatments can be used in select tumors and may reduce morbidity.

There have been considerable advances in our understanding of renal cell carcinoma, which have been translated into the development of several drugs with proven efficacy, with kinase inhibitors demonstrating significant activity. The authors of this review discuss the targeted agents that have proved efficacious in the difficult-to-treat metastatic setting, and highlight the issues of patient selection, scheduling, dose, duration of treatment, potential combinations and toxicity.

Confocal laser endomicroscopy is a new endoscopic tool that allowsin vivo histology at subcellular resolution during ongoing endoscopy, and permits subsurface imaging of normal and neoplastic human mucosa. The authors of this Review highlight why confocal laser endomicroscopy can no longer be regarded as just another endoscopic technique but emerges as a crucial novel imaging technique for in vivodiagnosis of colorectal cancer.

Isolated extramedullary relapse of acute myeloid leukemia after allogeneic transplantation is a rare phenomenon, which is not well understood. Owonikoko et al. describe the case of a patient with primary refractory acute myeloid leukemia who received chemotherapy treatment on protocol, salvage therapy, matched-unrelated-donor stem-cell transplants and donor-lymphocyte infusion. The patient received radiation therapy and gemtuzumab to treat numerous extramedullary sites of disease and remains disease free with no further cytotoxic therapy since gemtuzumab administration. The authors highlight the safety and efficacy of gemtuzumab in the treatment of patients with isolated extramedullary relapse.