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Isolated limb perfusion (ILP) combined with melphalan and TNF-α produces striking response rates for the treatment of bulky melanoma metastases, soft tissue sarcomas and various other tumors. TNF-α-based ILP is a well-established treatment that helps to avoid amputations, and this represents an important approach that is now widely practiced in Europe.
Women withBRCA1/2mutations have a higher risk of breast and ovarian cancer than the general population. The authors outline current evidence for strategies to reduce the risks of cancer development in these women, and discuss future research directions.
In low-resource regions of the world, women with breast cancer often do not present themselves for treatment until the disease has reached an advanced stage. This article offers some cost-effective and practical recommendations for early detection, diagnosis and treatment of breast cancer in low-resource countries.
Bevacizumab with standard chemotherapy improved overall survival in colorectal and lung cancer patients and progression-free survival in breast cancer patients, but this combination failed to increase survival in patients with previously treated and refractory metastatic breast cancer. Reasons for these contrasting results, the mechanisms behind normalization of tumor vasculature for improved drug and oxygen delivery, and the need for biomarkers and imaging techniques to guide patient selection and protocol design are discussed.
The processes of normal and pathological bone biology have been revolutionized since the discovery of the key regulators osteoprotegerin, receptor activator of nuclear factorkappa B (RANK) and RANK ligand (RANKL). Recent research suggests a pivotal role for these molecules in mediating cancer-induced bone destruction. This review provides a comprehensive update on the pathophysiology and mechanisms of skeletal metastasis, and the relevance of therapeutic targeting of these regulators for cancer treatment and pain management.
Development of therapies directed to specific molecular abnormalities within cancer cells, as exemplified by human epidermal growth factor receptor 2 (HER2), can be a very rewarding strategy in cancer treatment. The integration of genomic and proteomic approaches into the search for therapeutic targets will be more fruitful than either approach alone and allow further individualization of breast cancer therapy.
Substantial progress has been made using aromatase inhibitors in early-stage breast cancer. This article highlights results from recent and ongoing trials of aromatase inhibitors as adjuvant therapy and discusses options for integration of these agents with tamoxifen in various subsets of patients and clinical scenarios.
As our understanding of cancer evolves, the perceptions and prevailing paradigms that define this disease have also changed. The molecular basis of cancer has helped to influence oncology clinical practice; however, paradigms affect both the focus and design of research and also impact upon patient care. A clear recognition of how these varying perceptions of cancer affect and limit communication among the cancer-related disciplines as well as between these disciplines is needed. Both professionals and the general public should consider cancer as a group of diseases for which cure is related to tumor type, stage and available treatment.
Breast cancer is a multifactorial condition, and changes in cellular biology are affected by a large number of variables known to affect an individual's susceptibility to this malignancy. Current risk prediction models are based on combinations of risk factors and have good predictive but low discriminatory power. Risk estimation might be improved by incorporating additional factors into risk prediction models, which will allow better determination of breast cancer risk and provide new targets for preventive therapies.
Important changes in the field of epidemiology as a result of genotyping, identification of genetic and gene-environment causes of disease, and proteomics will ultimately influence all aspects of medical practice. The necessity for good study design, and the difference between observation and experiment, is paramount in this regard. This review discusses opportunities for molecular classification of disease that will help tailor treatment to the biologic profile of the patient and disease.
The evidence for prostate cancer screening using prostate-specific antigen with reference to UK criteria is presented. Such screening might result in considerable over-diagnosis and over-treatment of clinically insignificant prostate cancer. Morbidity associated with treatment of suspected prostate cancer is substantial, so the likelihood of harm may outweigh the prospect of benefit.
This Viewpoint assesses whether prostate cancer screening within the US is justifiable outside clinical trials. Prostate-specific antigen (PSA) values may fluctuate for physiologic reasons and the natural history of the disease varies between individuals. PSA testing increasingly identifies too many cases of indolent disease that would never have threatened patients' lives.