Volume 6 Issue 8, August 2009

The incidence of tonsillar cancer in the UK has doubled over the past decade and the discovery of the human papillomavirus in tonsillar cancer specimens has been hypothesized to be the cause. We discuss and propose an explanation of how a reduction in tonsillectomy rates may be responsible for this increase in tonsillar cancer.

Central nervous system prophylaxis is recommended with the administration of high-dose methotrexate and/or intrathecal injection of chemotherapy in patients with anaplastic large-cell lymphoma (ALCL). Researchers investigated whether methotrexate dose, infusion duration and intrathecal mode of administration had an impact on the risk of systemic and central nervous system relapses in children with ALCL.

Imatinib is known to be effective in the first-line treatment of metastatic gastrointestinal stromal tumors. A randomized, placebo-controlled trial has now shown that imatinib is safe and improves recurrence-free survival when used as adjuvant therapy after surgical resection of a primary gastrointestinal stromal tumor.

Patients with extensive small-cell lung cancer who are treated with prophylactic cranial irradiation experience fewer brain metastases and prolonged survival compared with their counterparts. Slotman and colleagues have presented a detailed analysis of the effects of prophylactic cranial irradiation on health-related quality of life in these patients.

Conventional structural imaging provides limited information on tumor characterization and prognosis. Advances in neurosurgical techniques, radiotherapy planning and novel drug treatments for brain tumors have generated increasing need for reproducible, non-invasive, quantitative, imaging biomarkers. This Review discusses the role of physiological MRI and PET molecular imaging in understanding metabolic processes associated with tumor growth, blood flow and ultrastructure.

Dynamics of cells reactions and behavior between cells can be integrated into models of cancer using systems pathology. Integrating multiple data from the clinic to make models sufficiently robust to be of practical use is a challenge. The difficulties in using mathematics to model cancer are highlighted, and some approaches in systems biology and experimental pathology that may be applied successfully in the clinic are discussed.

Antiangiogenic agents that target the VEGF pathway have become an important part of standard therapy in multiple cancer indications. Although most adverse effects of VEGF inhibitors are modest and manageable, some are associated with serious and life-threatening consequences. This Review examines the toxicity profiles of anti-VEGF monoclonal antibodies and small-molecule inhibitors and considers the potential mechanisms of the adverse effects, risk factors, and the implications for patient management.

The management of metastatic clear-cell renal-cell carcinoma has been revolutionized by the approval of targeted therapies. These targeted therapies have, however, been unable to provide robust complete responses in metastatic clear-cell renal-cell carcinoma. The authors of this Review discuss the role of immunotherapeutic approaches in the management of this disease.

Lasting complete remission from widespread bone metastases is rare. The case of a 41-year-old premenopausal woman diagnosed with right-sided infiltrating ductal breast carcinoma andBRCA2mutation is described. She received high-dose anthracycline-based induction chemotherapy followed by autologous bone marrow transplantation with high-dose alkylator and platin-based conditioning regimens. The authors comment on the reasons for this unusual and sustained complete remission from widely metastatic breast cancer and the patient-specific factors that may have contributed to this outcome.