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Screening for prostate cancer using PSA is a careful balance of benefits and harms. But current US practice involves testing older men who have little to gain and aggressively treating low-risk cancers. Debates about whether to test need to be replaced by debates on how to test better.
The ECOG E4201 study adds another piece of information to a growing body of evidence pointing strongly to the importance of local control and the role of radiotherapy in unresectable pancreatic cancer. Based on this evidence, we believe radiotherapy should be used routinely in this setting.boxed-text
One year of adjuvant trastuzumab, preferentially given upfront with a taxane as part of an anthracycline–taxane containing chemotherapy, is currently considered standard therapy for treating early-stage breast cancer. The long-awaited full publication of the BCIRG-006 trial now establishes the TCH (docetaxel, carboplatin, trastuzumab) regimen as an additional option with a distinct safety profile.boxed-text
A recent study of 843 patients from three hospitals that compared the assessment of HER2 status using FDA-approved immunohistochemistry and fluorescence in situ hybridization assays versus a quantitative reverse transcription PCR (qRT-PCR) assay by Oncotype DX®, showed a high false negative rate for the qRT-PCR assay.
A new phase III study shows superior efficacy of fludarabine plus alemtuzumab combination therapy over fludarabine alone in the treatment of relapsed or refractory chronic lymphocytic leukemia (CLL). However, the study has limitations and the findings can not be generalized to the majority of patients with CLL.
Despite the advent of HER2-directed therapies, many patients with HER2-positive early stage breast cancer relapse and die of this disease. Trials to define, refine and optimize the use of the approved HER2-targeted agents are ongoing. New approaches are being developed and a series of large trials in the adjuvant and neoadjuvant settings are planned or in progress. In this Review, Arteaga et al. describe the current treatment for HER2-positive breast cancer and provide an update on ongoing clinical trials and translational research.
Although breast density is a powerful factor for predicting the risk of developing breast cancer, unfortunately current methods of measuring mammographic density are not entirely satisfactory. This Review analyzes the different factors affecting breast density and how to consider them so that the accuracy of individual risk assessments can be improved.
Many trials report progression-free survival rather than overall survival outcomes but few trials have good quality-of-life data collected via patient-reported outcome measures. The authors describe what is understood by progression-free survival, and discuss what this means for patients with advanced-stage cancer and what factors should be taken into account when clinicians try to help patients considering treatment options.
Gene-expression profiling has led to the development of signatures designed to predict survival and treatment response in patients with breast cancer. In this Review, Prat et al. discuss the clinical utility of gene-expression-based assays and compare them with the performance of breast cancer biomarkers that are currently used as standard of care.
Microarray-based gene-expression profiling has advanced the breast cancer field. However, definitive answers to many of the questions for the successful implementation of personalized medicine remain elusive. The authors discuss the hurdles in the development and validation of molecular classification systems, and the challenges ahead for development of the next generation of molecular predictors.
