Articles in 2011

One year of adjuvant trastuzumab, preferentially given upfront with a taxane as part of an anthracycline–taxane containing chemotherapy, is currently considered standard therapy for treating early-stage breast cancer. The long-awaited full publication of the BCIRG-006 trial now establishes the TCH (docetaxel, carboplatin, trastuzumab) regimen as an additional option with a distinct safety profile.boxed-text

Bone-targeting treatments have transformed the quality of life of patients with metastatic bone disease. 2011 saw the emergence of denosumab—a RANK ligand-specific antibody—as a more-effective alternative treatment to bisphosphonates and of data on the use of bone-targeting treatments to prevent metastasis from breast and prostate cancers.

Highly clinically relevant ovarian cancer clinical research in 2011 focused on an increased understanding of the biology of the malignancy, limitations of strategies for early detection and screening, and the provocative reports of alternative primary and second-line management strategies.

This Review article approaches the area of targeted therapies from two angles: efficacy and side effects. The authors outline the successes that have been achieved in treating cancer with targeted therapies and also discuss the pitfalls and quality of life issues that still need to be addressed.

A recent study of 843 patients from three hospitals that compared the assessment of HER2 status using FDA-approved immunohistochemistry and fluorescence in situ hybridization assays versus a quantitative reverse transcription PCR (qRT-PCR) assay by Oncotype DX^®, showed a high false negative rate for the qRT-PCR assay.

A new phase III study shows superior efficacy of fludarabine plus alemtuzumab combination therapy over fludarabine alone in the treatment of relapsed or refractory chronic lymphocytic leukemia (CLL). However, the study has limitations and the findings can not be generalized to the majority of patients with CLL.

Gene-expression profiling has led to the development of signatures designed to predict survival and treatment response in patients with breast cancer. In this Review, Prat et al. discuss the clinical utility of gene-expression-based assays and compare them with the performance of breast cancer biomarkers that are currently used as standard of care.

If a targeted therapy demonstrates convincing efficacy in early clinical testing, can randomized phase III trials be avoided? Sharma and Schilsky discuss when it is reasonable to consider foregoing randomized phase III trials before drug approval and also highlight the caveats. They explore the consequences of such an approach and propose criteria that the drugs must meet to be approved without a phase III trial.

Although breast density is a powerful factor for predicting the risk of developing breast cancer, unfortunately current methods of measuring mammographic density are not entirely satisfactory. This Review analyzes the different factors affecting breast density and how to consider them so that the accuracy of individual risk assessments can be improved.

Rates of central nervous system (CNS) involvement in metastatic cancer are believed to be increasing. The neurosurgical treatment of patients with metastatic cancer is an integral component of multimodality therapy for brain and spinal metastases. This Review discusses data from current randomized clinical trials that examine the role of neurosurgical intervention in the treatment of patients with CNS metastases.