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Recent evolution of prostate cancer treatment reflects technological arms races driven by economic incentives rather than high-quality evidence—as exemplified by proton-beam radiation, recently found markedly inferior to far less-expensive alternatives. Another study found promise for focal treatment, but much research is required before this could become a standard option.
Of three randomized trials testing lenalidomide maintenance in myeloma, a survival benefit is apparent in one. An increased risk of second cancers is seen in all three trials. Maintenance must be considered after a review of risks and benefits, but it is premature to recommend lenalidomide maintenance for all patients.
Multimodal organ-sparing treatment strategies have shown similar survival rates when compared to radical surgery for muscle-invasive bladder cancer; however, up to 80% of surviving patients retained their own, well-functioning bladder. Within an interdisciplinary bladder-preserving treatment protocol, concurrent chemoradiotherapy was superior to radiotherapy alone—supporting its use as an alternative to radical cystectomy.
In a randomized phase III trial of induction therapy in adult acute myeloid leukaemia, the addition of cladribine, but not fludarabine, to daunorubicin and cytarabine seemed to improve complete response rates and overall survival. However, serious methodological problems make it difficult to estimate the actual clinical importance of the result.
Cancer cells rely on angiogenesis to fulfil their need for oxygen and nutrients; hence, agents targeting angiogenic pathways and mediators have been investigated as potential cancer drugs. However, a significant number of patients either do not respond to antiangiogenic agents or fairly rapidly develop resistance to them, which raises questions about how resistance develops and how it can be overcome. In this Review, the authors examine the evidence linking antiangiogenic agents and intratumour hypoxia by providing an overview of the preclinical and clinical data, focusing on the possibility of exploiting intratumour hypoxia as a means to improve the therapeutic response to antiangiogenic agents.
Neuroblastoma is a debilitating disease and a leading cause of childhood cancer deaths. The discovery of ALK as a mutated oncogenic receptor in neuroblastoma has provided an attractive target for innovative therapies. In this article, Mosse and Carpenter review the preclinical and clinical advances in ALK-targeted therapies for neuroblastoma and discuss the emerging challenges.
Gliomas in children differ from their adult counterparts by histological grade, site of presentation and rate of malignant transformation. Molecular profiling experiments on adult high-grade glioma have revealed key biological differences between the adult and paediatric disease. The authors summarize the current and historical data, compare and contrast the findings in these tumours across age groups, and discuss the implications for paediatric patients whose treatment options are modelled on clinical data from adult patients.
Cancer and its associated treatment cause debilitating symptom clusters including sickness, nausea, fatigue, pain, distractibility and poor memory. The authors of this Review describe what is known about the mechanisms of the behavioural comorbidities experienced by cancer patients, discuss how cancer-related symptoms develop, and what can be done at the clinical and preclinical levels to better understand their mechanisms and identify appropriate treatments.
