Volume 11 Issue 1, January 2014

Colorectal cancer (CRC) screening strongly reduces CRC-related mortality, with the effects of screening persisting for 20–30 years. These observations support current CRC screening and surveillance guidelines. At the population level, screening contributes to longer, healthier living. Thus, it is one small step for mankind, yet one giant leap for man.

A landmark study has delineated and identified the genetic pathways that drive the natural course of chronic lymphocytic leukaemia (CLL) B cells into Richter's transformation. CLL-related Richter's transformation is a distinct lymphoma, and poses various questions about B-cell ontogeny and relevance of B cell receptor signalling inhibitors.

The recently updated HER2 testing guidelines by ASCO and the College of American Pathologists (CAP) are a significant step towards personalized medicine. It is excellent news that such great effort has been put into standardizing biomarker assessment. Undoubtedly, these recommendations will improve the analytical validity of HER2 testing, its clinical utility and the communication among health-care providers.

The international phase III REGARD study demonstrated improved overall survival with ramucirumab as second-line therapy for patients with advanced-stage gastric and gastroesophageal junction adenocarcinoma. As a novel biological treatment, is ramucirumab also the harbinger of a new era of targeted therapies in this prevalent and highly morbid disease?

Diffuse large B-cell lymphoma (DLBCL) is curable in advanced stages, but up to one-third of patients will ultimately fail to respond to initial therapy. As we have now entered the molecular era of defining DLBCL, the goal is to pinpoint driver mutations and pathway addictions within distinct molecular subsets of DLBCL. This Review describes the current molecular understanding of DLBCL and discusses promising targeted approaches for each subtype.

Recent immunotherapy approaches have focused on antibodies that block immune checkpoints, and these approaches have produced significant clinical responses in melanoma, lung cancer and kidney cancer. The authors of this Review briefly review the basic immunology underlying an antitumour immune response, and discuss the most relevant clinical trial results in these three tumour types.

Primary care providers are pivotal in reducing diagnostic delay of cancer, particularly in health systems that have long waiting times for outpatient diagnostic services. In this Review, the authors discuss several aspects of primary care, from referrals to communication and follow-up care, focusing on the most common cancers managed at the GP office.

Chemoprevention has been increasingly explored to mitigate the global burden of prostate cancer and the overtreatment of indolent disease that has arisen in the prostate-specific antigen screening era. In this Review, the authors summarize the major findings of chemoprevention trials and discuss the future opportunities in this arena.