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A study of cervical cancer screening in 52 villages in India has shown that a single round of human papillomavirus testing was linked to a significant reduction in the number of deaths from cervical cancer, compared with other screening methods. This has implications for primary screening in low-resource settings.
The use of autologous stem-cell transplantation in the treatment of follicular lymphoma remains controversial. Results from the GOELAMS trial show a higher progression-free survival rate in patients treated with autologous stem-cell transplantation compared to those treated with chemotherapy.
The authors present a case of a 48-year-old man with a history of diarrhea, flushing and upper abdominal pain who was subsequently diagnosed with metastatic carcinoid tumor. The authors discuss the importance of a stepwise approach in a multi-disciplinary team setting to provide effective patient care.
Conventional structural imaging provides limited information on tumor characterization and prognosis. Advances in neurosurgical techniques, radiotherapy planning and novel drug treatments for brain tumors have generated increasing need for reproducible, non-invasive, quantitative, imaging biomarkers. This Review discusses the role of physiological MRI and PET molecular imaging in understanding metabolic processes associated with tumor growth, blood flow and ultrastructure.
The management of metastatic clear-cell renal-cell carcinoma has been revolutionized by the approval of targeted therapies. These targeted therapies have, however, been unable to provide robust complete responses in metastatic clear-cell renal-cell carcinoma. The authors of this Review discuss the role of immunotherapeutic approaches in the management of this disease.
Pancreatic endocrine tumors (PETs) represent an important subset of pancreatic neoplasms. Patients with completely resected tumors generally have a good prognosis, and an aggressive surgical approach in patients with advanced disease may also prolong survival. The authors of this Review discuss the current surgical management strategies for treating PETs, focusing on insulinomas, gastrinomas and nonfunctional PETs.
The mainstay of therapy of chronic lymphocytic leukemia (CLL) is cytotoxic chemotherapy; however, CLL is still an incurable disease with resistance to therapy developing in a majority of patients. This Review summarizes the progress made in understanding the biological basis of CLL pathogenesis and other aspects of CLL biology, and describes novel treatment strategies that have also been exploited in current clinical trials.
Targeted therapies offer new hope in overcoming the challenges encountered with conventional chemotherapy. However, little is known about the precise mechanisms that cause resistance. These issues are discussed in light of data from the BRiTE study, which indicate that the antiangiogenic effects of bevacizumab might persist despite the development of resistance to first-line chemotherapy.
A randomized phase III trial evaluated the effect of adding lapatinib to paclitaxel as first-line therapy for patients with metastatic breast cancer whose tumors were negative or untested for human epidermal growth factor receptor 2 (HER2) overexpression. Progression-free survival was prolonged significantly in patients with HER2-overexpressing tumors, which indicates that lapatinib exerts its main effects via the HER2 pathway.
Mathis et al. aimed to determine the effect of multimodality therapy on recurrence and survival in patients with locally advanced colorectal cancer. Use of multimodality treatment led to excellent local control with five year disease-free and overall survival rates comparable to that of stage-matched resectable colorectal cancers.
The association of a treatment-related adverse effect with treatment success has been reported in various clinical situations. The development of vasomotor or joint symptoms is an indication of therapeutic benefit in women receiving endocrine treatment for hormone-receptor-positive breast cancer.
Treatment interruptions during radiotherapy may have a negative effect on patient outcome. D'Ambrosio et al. demonstrated that prolonging treatment duration has an adverse effect in low-risk patients with prostate cancer. Thus, limiting or modifying the overall elapsed time between treatments is necessary.
On the basis of the results of KRAS analysis from the CO.17 randomized, controlled, phase III study by Karapetis et al., KRAS mutations have emerged as a valid predictive marker associated with resistance to cetuximab and lack of survival benefit from this anti-EGFR antibody in patients with chemoresistant colorectal cancer.
Breast cancer during pregnancy is increasingly being encountered, and establishing the safety of trastuzumab in this setting is important. The case of a 29-year-old woman diagnosed with node-positive, HER2-positive breast cancer is described. She underwent surgery followed by chemotherapy and radiotherapy and then received trastuzumab. The authors suggest that short-term trastuzumab exposure may be safe and they recommend careful monitoring of the amniotic fluid and cardiac assessment of the mother and fetus.
No validated biomarkers currently exist for appropriately selecting cancer patients for antiangiogenic therapy. A number of potential systemic, circulating, tissue and imaging biomarkers have emerged as suitable candidate biomarkers, but all require prospective validation. The authors discuss the current challenges in establishing biomarkers, the advantages and disadvantages of systemic, circulating, tissue and imaging biomarkers, and the future opportunities for validating biomarkers of antiangiogenic therapy.
The authors summarize the literature and present an overview of the fast-moving field of anti-EGFR therapeutics for the treatment of non-small-cell lung cancer. They focus on describing the effects of somaticEGFRmutations in selection of patients for treatment with tyrosine kinase inhibitors and the influence of EGFR pathway regulation.
Although VEGF-targeted anti-angiogenic agents have proved successful, resistance to these targeted therapies remains a challenge. Therefore, additional angiogenesis inhibitors are being developed to overcome resistance. Carmeliet et al. discuss the molecules implicated in conferring resistance to VEGF-targeted therapy, and describe how targeting non-endothelial mechanisms in the tumor stroma may offer opportunities to overcome resistance to VEGF-targeted therapy.
The long-term outcome for patients with inflammatory breast cancer is poor despite advances in combined-modality treatment. Treatments targeting the vasculolymphatic pathway have shown potential and therapies targeting cell proliferation pathways are also promising. The authors of this Review discuss the biology of inflammatory breast cancer and potential molecular targets.
Understanding the process of tumor angiogenesis and ways to modify this is a key point in the fight against cancer. This Review explores the current status of vascular-disrupting strategies, discusses how anti-VEGF-based anti-angiogenic therapies can be combined with conventional chemotherapy and radiotherapy, and highlights potential future targets for therapeutic intervention.
Haller et al. demonstrated that irinotecan plus oxaliplatin (IROX) is more efficacious than irinotecan alone after fluoropyrimidine failure in advanced colorectal cancer. IROX does not change, but enriches the treatment algorithm of advanced colorectal cancer at the second-line level.
