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For patients with colorectal cancer and liver metastases, hepatic resection is the only potential curable treatment. The role of adjuvant chemotherapy in this setting is still under debate. The authors of this Viewpoint discuss the final results of the EORTC Intergroup randomized phase III study 40983 and whether FOLFOX4 should be the new standard in patients with resectable colorectal cancer and liver metastases.
Capecitabine is commonly substituted for conventional 5-fluorouracil chemotherapy based on evidence of the efficacy equivalence of these two drugs and the lack of an increase in overall toxic effects when capecitabine is used. This Review summarizes why there may not be a universally applicable dose for capecitabine because of interpatient differences in basic physiology, pharmacogenomics and diet. The authors also discuss which of these factors contribute to the inter-regional geographical variation in capecitabine toxicity, and the reasons for modifying the starting dose.
Brain metastases are an increasingly prominent problem in the management of women with metastatic breast cancer. Trastuzumab has provided excellent systemic disease control for many patients; however, many women are now living long enough to develop CNS disease. This Review considers the potential for targeted therapy to provide effective management for brain metastases in patients with ErbB2-positive breast cancer, reviewing in particular the data currently available in this setting for lapatinib.
In the era of personalized, systems-driven medicine, computational orin silicomodeling and the simulation of disease processes is becoming increasingly important for hypothesis generation and data integration in both experiments and clinics alike. The authors of this Review discuss selected studies on modeling malignant brain tumors and the implications for clinical practice, including trial design and outcome prediction.
Despite frequent responses to chemotherapy, curative treatment remains elusive for the majority of metastatic solid tumors. By contrast, chemotherapy routinely cures patients with testicular cancers, gestational choriocarcinoma, Hodgkin's disease and high-grade lymphomas. Savage et al. suggest that the chemo-curability of these malignancies results from an intrinsic 'locked-in' state of sensitivity to pro-apoptotic stresses in these particular cell types, and they discuss some of the characteristics shared by the curable cancers that might explain their curability.
The authors present the case of a 57-year-old male who was diagnosed with grade IV glioblastoma multiforme and enrolled in a clinical trial of adoptive cellular immunotherapy. The authors used PET imaging technology to image the T cells non-invasively and report the first case using a non-invasive imaging reporter gene/probe technology.
