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The Affordable Care Act—the Obama administration's signature legislation designed to insure over 30 million currently uninsured Americans—was recently declared constitutional by the US Supreme Court. Although not perfect, the law contains provisions that will benefit patients with cancer, those at risk of cancer and those in remission.
Suboptimal studies had established preoperative chemoradiation as the preferred strategy in the management of localized oesophageal cancer (LEC) and gastro-oesophageal cancer. The recent CROSS trial has now demonstrated considerable benefit from preoperative chemoradiation over surgery alone in patients with LEC. But, are these results only reinforcing advocates of the preoperative chemoradiation strategy?
The current definition of multiple myeloma is outdated. The diagnosis requires evidence of overt end-organ damage, preventing initiation of early therapy when the malignancy is at its most susceptible stage. We propose an evidence-based approach using more-sensitive and highly specific biomarkers to update the definition of this disease.
Dabrafenib is the second agent in the therapeutic class of selective BRAF inhibitors, and has proven efficacy in a phase III trial (BREAK-3) with impressive improvements in progression-free survival and response rates. Differences in the safety profile exist compared with vemurafenib, but the future lies in combinatorial strategies and improved patient selection.
The association between cancer and angiogenesis has been established for decades, but it is only in the past 10 years that the concept of cancer prevention using antiangiogenic agents has emerged. This Review outlines the mechanisms of action of these preventative agents and proposes that there should be four levels of angioprevention, depending on the cancer risk.
This Review describes current strategies and future approaches to improve T cell-based therapies to treat post-transplant lymphoproliferative disease, a serious and often life-threatening complication that is associated with Epstein-Barr virus and can occur after haematopoietic stem-cell or solid organ transplantation.
The identification ofBRCA1 and BRCA2 mutations has affected multiple aspects of breast cancer care, including screening and prevention. The authors discuss therapies that have quickly entered clinical practice and highlight some of the challenges in the development of targeted therapies in BRCA1 and BRCA2mutation carriers, as well as specific issues in the area of diagnostic testing related to these targeted therapies.
Most studies for identifying biomarkers for oestrogen receptor-α (ERα)-positive breast cancer have been performed using material from consecutive series of patients treated with tamoxifen. Consequently, the predictive value of any biomarker identified is confounded by its prognostic value. In this Review, the authors discuss how different biomarkers might enable the prediction of broad endocrine or agent-specific resistance.
The goal of personalized therapy is to target tumours with the right drug for the right person at the right time. This is not an easy task, and in this Perspectives article, Funda Meric-Bernstam and Gordon B. Mills tell us about the challenges that need to be overcome and how we should temper the current excitement about targeted therapies with realistic expectations.
