Volume 7 Issue 5, May 2010

The optimal age-specific treatment approach for adolescents with Hodgkin lymphoma (HL) is controversial. Here we discuss the results of a recent retrospective analysis that compared the outcomes for adolescents with those of young adults with HL treated with regimens normally recommended for adults. The investigators conclude that adult treatment protocols are a safe and effective treatment option for adolescents with HL, but the results do not consider late treatment toxicity that may impact quality of life and survival.

A recent trial concluded that preoperative biliary drainage (PBD) in patients with pancreatic head cancer increases complications but is unlikely to change clinical practice. The difference in the outcomes reported was because of excessive complications in the PBD group using plastic stents. We argue that these patients need treatment in regional pancreatic cancer centers using low-occlusion metal stents.

The role of preoperative biliary drainage (PBD) before surgery for tumors of the pancreatic head causing biliary obstruction has been controversial. A recent randomized trial revealed a higher complication rate with PBD in comparison to early surgery (within one week). Based on this trial, early surgery should be considered the preferred approach; however, the role of PBD when early surgery is not possible remains unclear.

A recent study analyzed the timing of non-platinum chemotherapy in combination with radiotherapy in patients with head-and-neck cancer and showed that only those who had not undergone surgery benefited from the chemoradiation therapy. However, inconsistencies between some results of this study and those of previous studies, along with the advent of novel, less toxic combinations of radiotherapy, are likely to limit the development of the chemotherapy regimens used in their study.

The 5-year follow up data from a study on localized prostate cancer has shown high rates of bladder, lung, and rectal cancers in men treated with external beam radiotherapy compared with radical prostatectomy. At 10 years of follow-up, only excess lung cancer risk was significant, and the authors conclude that increased secondary malignancy risk with radiation should be included in initial treatment decisions and counseling. In my opinion, younger men subjected to radiation might suffer more in the long-term than if they had undergone surgery.

Rapid advances in techniques such as DNA sequencing and genome-wide-association studies have made a great impact on oncology research. In this comprehensive Review, the authors describe some of the most important molecular changes in different cancers that have been gleaned from these technologies, and have allowed earlier diagnosis and more appropriate treatment. The authors also highlight why the molecular pathology revolution is profound for cancer patients and the health-care system.

The first generation of anti-cancer agents using novel nanomaterials has successfully entered widespread use and newer nanomaterials are gaining increasing interest as potential multifunctional therapeutic agents. The authors of this Review discuss how the new features of these agents could potentially allow increased cancer selectivity, changes in pharmacokinetics, amplification of cytotoxic effects, and simultaneous imaging capabilities.

Mutations inVHL cause von Hippel–Lindau (VHL) disease, and are common in sporadic clear-cell renal-cell carcinoma (ccRCC). Drugs that modulate the downstream targets of the pVHL/HIF pathway have proven benefit in treating ccRCC. This Review, therefore, discusses the potential role of VHLalterations as prognostic and predictive markers in ccRCC.

This Case Study describes a patient with multiple myeloma and renal impairment who developed acute renal failure after three cycles of bortezomib-based primary therapy. Second-line lenalidomide and dexamethasone, with lenalidomide dose adjustment according to the patient's renal function, was well tolerated. This therapy elicited a rapid, durable partial tumor response and prompt improvement in the patient's kidney function.