Volume 11 Issue 3, March 2014

Between 2005 and 2007, mutations in JAK2 and MPL were described in most patients with myeloproliferative neoplasms (MPN). These seminal discoveries have forever changed our diagnostic approach to MPN. In December 2013, mutations in CALR were reported in MPN wild-type for JAK2 and MPL. These mutations provide additional diagnostic and prognostic tools in MPN.

The recent IBIS-II clinical trial results demonstrate anastrozole reduces breast cancer incidence by 53% in postmenopausal women. While this is a major advance in prevention research, its impact on clinical practice will ultimately depend upon subject perception of risk, adverse effects and benefits of anastrozole versus other available cancer preventive therapies.

Advances in single-cell molecular analysis are enhancing our ability to explore the mechanisms of metastasis. In this Review, the authors describe how circulating tumour cells (CTCs), captured from a minimally invasive blood test—and readily amenable to serial sampling—have the potential to inform intratumour heterogeneity and tumour evolution.

The discovery of miRNAs in body fluids has opened up the possibility of using them as non-invasive biomarkers in cancer detection and as predictors of therapy response in cancer treatment. This Review article considers the latest developments in the use of circulating microRNAs as prognostic and predictive biomarkers and discusses their utility in personalized medicine.

Bilateral mastectomy is used to treat an increased percentage of women with unilateral breast cancer in order to prevent a second primary cancer in the unaffected breast. Although this surgical approach has been proposed to benefit women at high risk of contralateral cancer, the decision to remove the contralateral breast is controversial and requires a careful evaluation on an individual basis. This Review discusses the risk factors for contralateral breast cancer, and the evidence that bilateral mastectomy might in fact reduce breast-cancer associated mortality.

Systems biology approaches are beginning to provide information that will enable a more complete view of how the genomic and epigenetic aberrations in cancer cells can alter the homeostasis of signalling networks within the tumour and surrounding microenvironment, both at the organ and organism level. This Review describes the potential of these systems-based approaches and how they are becoming vital for the development and implementation of effective drug discovery and personalized cancer therapy.