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A randomized phase III study has reported significant improvements in R0 resection rate and overall survival associated with perioperative cisplatin and 5-fluorouracil treatment compared with surgery alone in patients with gastroesophageal adenocarcinoma. These data support the results of the randomized phase III MAGIC study that reported a 13% 5-year survival benefit from perioperative chemotherapy.
Patients with metastatic disease are usually treated initially with systemic therapy alone. Morgan and Parker review clinical data suggesting that the local treatment of the primary tumor might retard progression of distant metastases, making the case for the conduct of more randomized clinical trials that investigate this hypothesis.
MicroRNAs (miRNAs) is an exciting and fast-moving field in cancer diagnosis and therapeutics. This Review highlights the use of circulating miRNAs in body fluids as a noninvasive diagnostic tool and as a treatment-response predictor. It also explores the concept that body-fluid-based miRNAs possibly originated as the first 'hormones'.
Despite the improved progression-free survival and overall survival demonstrated by cisplatin–gemcitabine chemoradiation in a phase III randomized trial in patients with stage IIB to IVA cervical cancer, the acute and chronic toxic effects urge caution before embracing this as a new treatment paradigm.
The survival rate for adolescents and young adults with acute lymphoblastic leukemia has improved over the past decades. However, it is still behind the overall survival of children with this disease. In this Review, Schafer and Hunger analyze recent studies that have shown improved outcomes for adolescents and adults treated with pediatric-based regimens offering a potential solution for the “adolescents and young adults gap”.
Antiangiogenic therapy is thought to starve tumors by cutting their nutrient and oxygen supply. The authors review evidence for a potential link between hypoxia signaling and an invasive switch that occurs in cancer cells, through which antiangiogenic drugs could increase the risk of tumor metastasis in certain conditions, and discuss approaches to reduce tumor dissemination.
The exclusive expression of well-defined antigens renders prostate cancer an attractive target for immunotherapy. Di Lorenzoet al. review clinical results of immunotherapy trials in patients with prostate cancer and discuss methodological issues related to the evaluation of treatment efficacy of immunotherapeutic agents.
Therapeutic advances in melanoma seem on the horizon, with the identification of BRAF as a principal therapeutic target. The authors describe the scientific basis for the targeting ofBRAFmutations in cancer, the early clinical data with BRAF inhibitors, and how combinatorial therapies may address the current limitations of their use in the clinic.
The existence of a state of limited metastasis or oligometastasis observed in selected patients is associated with favorable outcomes. This Review discusses the role of local therapy for oligometastases that arise in lung and liver, the challenge of identifying the patients who will benefit from the treatment of their oligometastatic disease and how to select the right local therapy for these patients.
A recent publication presented objective evidence that patients with and without brain metastases perform similarly in phase I clinical trials for advanced-stage cancer. This finding supports what neurosurgeons and neuro-oncologists have long suspected; namely, that the presence of brain metastases need not mandate exclusion of patients from early-phase clinical trials.
Autophagy is an important cellular recycling mechanism that can be either tumor-promoting or tumor-suppressive and represents a novel anti-cancer target. In this article, Janku and colleagues explain the rational behind targeting autophagy for the development of anticancer therapy and discuss drugs that either inhibit or activate autophagy.
Zoledronic acid is a potent bisphosphonate used as the standard therapy for the prevention of skeletal-related events in patients with solid tumors metastatic to bone. Three phase III studies have reported head-to-head comparisons of zoledronic acid with denosumab, an inhibitor of the RANK signaling pathway.
