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The value of sentinel-node biopsy for the management of localized primary melanoma has been questioned. In this Viewpoint, the authors discuss the data that support the routine use of sentinel-node biopsy, and assert why this technique should be considered the standard approach for staging patients with clinically localized, intermediate-thickness melanoma.
There are few treatment options for patients with metastatic HER2-positive breast cancer who are unresponsive to trastuzumab. The combination of lapatinib and capecitabine significantly prolongs time to disease progression in women previously treated with chemotherapy and trastuzumab for HER2-positive advanced disease. The rationale for using this combination and the promising activity of lapatinib in early trials of inflammatory breast cancer is highlighted.
It is unlikely that tumors are entirely dependent on only one abnormally activated signaling pathway and, consequently, treatment with an agent interfering with a single target may be insufficient. This Review discusses the experimental and early-stage clinical evidence to support the relevance of EGFR-dependent and VEGF-dependent pathways, their functional links and the implications of acquired resistance to targeted therapies.
Estrogen-deprivation strategies with aromatase inhibitors are superior to tamoxifen in the adjuvant, neoadjuvant and advanced breast-cancer settings in postmenopausal patients. Short-term hormonal resistance especially in the HER2-positive patient population, however, is a significant issue with these endocrine agents. The authors discuss the progress made in our understanding of resistance to endocrine therapy, and provide insights regarding the management of patients with hormone receptor-positive/HER2-positive advanced breast cancer.
Our understanding of the biology of Hodgkin's lymphoma has improved, in particular the genetic and phenotypic characteristics of malignant cells and the signaling pathways involved in the pathogenesis of this disease. While newer regimens have improved the cure rates of patients with Hodgkin's lymphoma, some are associated with severe acute and long-term toxicities. This comprehensive Review discusses combined modality regimens for treating early-stage disease, approaches used for treating advanced disease and other novel regimens.
The prognosis for patients with advanced melanoma and CNS metastases is poor. Hodi et al. report the case of a 63-year-old female who was diagnosed with metastatic melanoma from an unknown primary tumor. The authors discuss the use of the human monoclonal antibody against CTLA-4, ipilimumab, in patients with metastatic melanoma.