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In 2012, advances in molecular profiling of primary brain tumours allowed identification of subgroups of glioma and medulloblastoma that were associated with distinct prognoses and predicted treatment response. Adjuvant chemotherapy is now established for 1p/19q co-deleted anaplastic oligodendrogliomas, and may be the preferred treatment in elderly patients with glioblastoma with a methylated MGMT promoter.
In the past year, long-term follow-up of trials have confirmed and disproved paradigms in the treatment of colorectal cancer, and identified a chemoprevention agent. In metastatic disease, chemotherapy in unresected primary tumours was studied, and randomized phase III trials introduced new therapy options. Molecular characterization of colon and rectal tumours offers new drug targets.
Gastric cancer is a heterogeneous disease with almost one million new cases occurring annually worldwide. The year 2012 saw important successes and failures in gastric cancer treatment, and also novel insights into the molecular characterization of this disease, which may lead to the development of more-effective targeted therapies.
In 2012, we increased our knowledge of the molecular portrait of breast cancer. The BOLERO-2 and CLEOPATRA trials led to the approval of everolimus and pertuzumab; and the EMILIA trial will likely result in the approval of T-DM1. Some of these findings represent a paradigm shift in the way we think about the biology and management of breast cancer.
Progress was made in major aspects of acute myeloid leukaemia in 2012. Gemtuzumab ozogamicin and decitabine were shown to improve outcomes, relapse after stem-cell transplantation might be prevented by selecting donors according to their KIR genotypes, and next-generation sequencing has provided insights into mutational patterns and disease evolution.
Palliative care is a crucial part of the treatment spectrum for patients with cancer because these patients frequently undergo aggressive therapy, sometimes in discordance with their wishes. This Review article outlines the different elements of palliative care, including communication, quality of life, symptom control, patient satisfaction and resource utilization, and shows how it can benefit patients.
Cancer cachexia is a metabolic syndrome that is defined by loss of muscle mass. This syndrome can cause a great deal of distress to patients with cancer and their families. This Review article outlines the symptoms, mechanisms and treatment options for cachexia with the aim of improving the quality of life of patients.
There is a general belief that paediatric palliative care should be provided only when no hope for the cure exists. This Review discusses how paediatric palliative care should be applied consistently and concurrently with other therapies regardless of the prognosis or disease stage, to ensure that the best possible care for children and their families is provided.
Patients with cancer frequently experience pain, which is considered to be the most-common and feared symptom of the disease. In most patients, this pain can be successfully relieved with judicious use of opioids. Unfortunately, there are a number of barriers to patients receiving adequate pain relief, which are outlined in this Review. Guidelines and strategies to improve pain relief for patients with cancer are also outlined.
In this article, Ruth Rechis—a 20-year survivor of Hodgkin lymphoma—describes her personal account of surviving cancer and her experience as a researcher and advocate in the field of survivorship. She provides recommendations for engaging survivors as active participants in their post-treatment, long-term survivorship care and to ensure appropriate care is universally available as part of patient-centred comprehensive care.
Nature Reviews Clinical Oncologyis proud to feature a specially commissioned focus issue on palliative care. The February 2013 issue covers a wide range of issues within the field of palliative care, including cancer cachexia, access to pain relief, specific issues for paediatric patients, and survivorship.
