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Sunitinib is a standard first-line therapy for patients with advanced or metastatic clear-cell renal cell carcinoma. In an expanded-access study, sunitinib has demonstrated clinical benefit with an acceptable safety profile in a population of patients that is representative of those seen in clinical practice.
Although imatinib mesylate therapy has dramatically improved the prognosis of patients in the advanced phases of chronic myeloid leukemia, room for improvement remains. Tyrosine kinase inhibitors are undergoing evaluation as second-line therapy for patients with imatinib-resistant disease. Kantarjian et al. recently demonstrated that once-daily dasatinib 140 mg is well tolerated and achieves a high response rate.
Jørgensen and Gøtzsche quantified the degree of overdiagnosis of breast cancer in five publicly organized mammography screening programs in different parts of the world. Overall, they estimated a total degree of breast cancer (including carcinoma in situ) overdiagnosis of 52%, while overdiagnosis for invasive breast cancer was 35%, a finding with potential implications for both clinical practice and public health.
Bortezomib-based regimens are beneficial in the treatment of patients with symptomatic, newly diagnosed and relapsed or refractory multiple myeloma. Researchers who investigated the efficacy and safety of single-agent bortezomib as first-line therapy in patients with myeloma have particularly emphasized the incidence and management of peripheral neuropathy, which is the most common adverse effect of bortezomib administration.
Most patients with advanced colorectal cancer die from hepatic metastases. Radioembolization is a technique for administering radiotherapy internally to unresectable primary or secondary hepatic malignancies in a single procedure to improve local control of disease. This technique enables significant downsizing of liver metastases after surgical resection, and the rationale for this approach combined with cytotoxic and molecularly targeted agents is outlined.
Six European randomized controlled trials that will compare human papillomavirus (HPV) testing with cytology testing for cervical screening are under way. The outcome of HPV testing versus cytology testing depends not only on the relative accuracy of the primary test but also on how radical the different triage procedures are. Two trials have shown a 50% reduction in grade 3 cervical intraepithelial neoplasia detection in subsequent screening rounds. The authors critically discuss the reasons for the different results observed in these trials and the implications for primary screening.
Gamma-delta lymphomas are rare and aggressive lymphomas with a poor prognosis. The authors of this Review discuss the clinical and biological features of the two types of such lymphomas and the diagnostic challenges associated with these still insufficiently known diseases.
Microarray studies have been used to unravel the molecular characteristics of breast cancer and a molecular taxonomy has been proposed. The authors of this Review discuss the origins of the diversity of breast cancer and, based on the study of histological special types of breast cancer, propose an approach for the identification of novel therapeutic targets.
Targeted agents directed at VEGF and EGFR have become part of the standard treatment of metastatic colorectal cancer; however, only some patients benefit from such treatment. The CAIRO2 and PACCE trials have shown a detrimental effect of adding an anti-EGFR antibody to standard chemotherapy plus bevacizumab. In this Perspective, the authors discuss issues that may explain these unexpected results.
