Volume 14 Issue 5, May 2017

Fraser and colleagues describe the whole-genome sequencing (WGS) profiles of over 200 localized intermediate-risk prostate cancers. WGS has been widely used in research but not, thus far, in clinical settings. Herein, we consider the possible use of WGS in the field of precision oncology.

Early diagnosis is a key component of melanoma prevention, but diagnostic accuracy varies considerably among clinicians managing patients with potentially suspicious skin lesions. Several tools have been developed to objectively enhance diagnostic assessment and accuracy. Herein, we discuss the potential diagnostic value and limitations of GoogleNet Inception, a new tool for image-based classification of skin lesions.

Emerging evidence suggests that the prolonged therapeutic use of androgen receptor (AR)-targeting agents in patients with prostate cancer induces histological dedifferentiation and lineage alterations. Roubaud and colleagues propose that AR suppression creates a checkpoint by which potent therapies exert a selective pressure on prostate cancer cells, favouring dedifferentiated and/or treatment-resistant cell lineages. The authors present a new clinical trial strategy in which rapid drug cycling is used to delay the onset of resistance and treatment-induced lineage crisis in patients with prostate cancer.

The PARP inhibitor olaparib has been approved for clinical use in patients with ovarian cancer withBRCA 1/2 mutations; however, this agent, which can confer substantial improvements in patient survival might also be effective in those without a BRCA mutation. Here, the authors describe the potential for expanding the use of BRCA-mutation testing and PARP inhibition beyond those who are likely to have a BRCAmutation.

After curative treatment, 30% of patients with stage I–III and up to 65% of patients with stage IV colorectal cancer (CRC) develop recurrent disease. Thus, surveillance for disease recurrence is clearly needed in these patients, but controversy surrounds the optimal follow-up approaches. Herein, the current evidence relating to surveillance strategies for patients with CRC is comprehensively reviewed, and the future development of patient-centred programmes is discussed.

Clinical trial design has dramatically evolved with the advent of precision medicine. As a result, expedited drug-approval decisions have been made on the basis of evidence obtained in uncontrolled clinical trials. Herein, Saad et al. discuss the need to conduct randomized controlled trials at all phases of drug development in oncology, and present strategies to facilitate a seamless transition between phases of drug and/or biomarker development.