Articles in 2011

Current treatments for patients with locally advanced rectal cancer (LARC) consist of neoadjuvant chemoradiotherapy, followed by total mesorectal excision and adjuvant chemotherapy. Aklilu and Eng review the pivotal trials that have led to this treatment paradigm and discuss novel therapies that are being developed for patients with LARC.

Cancer immunology is an interactive field that requires the skills of oncologists and immunologists, in addition to other aspects, such as pathology. This Review uses colorectal cancer as a prototypical cancer and describes how molecular features and immune reactions are inter-related.

Treatment options for patients with castration-resistant prostate cancer are rapidly increasing, offering these patients hope of better quality of life and longer disease-free periods. This Review discusses the recent advances, the pitfalls and outlines a new treatment paradigm for the future.

Abiraterone plus prednisone prolongs overall survival relative to prednisone alone in patients with metastatic castration-resistant prostate cancer who have disease progression after treatment with docetaxel. The survival gain observed in this pivotal trial is accomplished with few adverse events and conclusively demonstrates that patients with castration levels of serum testosterone remain sensitive to additional hormonal manipulation.

Three recent population studies have translated laboratory investigations into a clinical setting and concur in presenting evidence that suggest a dramatic new role for β-blockers in reducing metastases, tumor recurrence and specific mortality in breast cancer. Should we be skeptical about these controversial findings?

Recent clinical trials aim to identify biomarkers of response and resistance to the agents under investigation. This can require tissue samples that will not necessarily provide a direct benefit to the patient. Given the risks associated with any procedure, not every patient is willing to undergo a research biopsy. In this article, Olson et al. present the rationale to establish when research biopsies should be mandatory and to ensure that clinical trials are designed with scientific and ethical rigor.

Phase I trials have evolved from simple dose-finding studies to studies that provide therapeutic opportunities for patients where no standard therapy is available; however, various factors have hampered patient recruitment on phase I trials. The authors discuss how matching patients with specific genetic aberrations to specific therapies will improve drug attrition rates and improve patient outcomes.

Hormone replacement therapy (HRT) has been linked by several reports to an increased risk of breast cancer. The precipitous decrease in breast cancer incidence shortly after the cessation of HRT is well established. In this Review, Steven Narod summarizes the evidence and asks the question, where do the breast cancers go?

The adoptive transfer of autologous tumor-infiltrating lymphocytes is one of the most promising developments of recent years for the treatment of patients with solid tumors. In this Review, a pioneer of this method, Steven Rosenberg, outlines the history and current situation for this therapy and explains what clinicians need to know.

Recently published phase III trials involving interleukin-2, ipilimumab and vemurafenib redefine 'standard-of-care' for metastatic melanoma and demonstrate improved survival compared with dacarbazine. All three therapies are potential first-line options for patients with metastatic melanoma, with optimal treatment strategies evolving based on tumor mutation status, disease burden, performance status and comorbidities.

Radiation therapy techniques have made great strides over the past decade, both in terms of efficacy and in the avoidance of the associated toxic effects. This Review highlights the particular areas of concern for patients with head and neck cancer and outlines how to avoid toxic effects, while maintaining the optimal treatment efficacy.

For many patients with invasive bladder cancer, regional or systemic metastases are present at the time of presentation. Owing to the risk of micrometastatic disease, preoperative neoadjuvant cisplatin-based chemotherapy before radical cystectomy or radiation has been assessed and shown to provide a survival advantage.