Chemotherapy articles within Nature Reviews Clinical Oncology

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  • News & Views |

    Eaton et al. report a very strong association between institutional clinical trial accrual volume and the survival of patients with stage III NSCLC. The observed volume effect might have been exaggerated by artefact. More work is required to quantify the volume effect and understand its causes, before rushing to centralize care.

    • William J. Mackillop
    •  & Christopher M. Booth

  • Review Article |

    Distant metastasis remains a common cause of death in patients with solid tumours, even after treatment with surgery, radiotherapy and/or chemotherapy. Treatment itself can sometimes cause or promote metastasis by increasing the number of circulating tumour cells. The authors of this article discuss preclinical and clinical data concerning cancer treatments, circulating tumour cell mobilization and other factors that might promote metastasis.

    • Olga A. Martin
    • , Robin L. Anderson
    •  & Michael P. MacManus

  • News & Views |

    To improve the survival rates globally for paediatric patients with cancer, looking beyond level A evidence to treat children in low and middle-income countries is imperative. Herein, we discuss why metronomic chemotherapy, which is less toxic and more affordable, offers a pragmatic approach to provide new standards for patients with relapsed disease who have no alternatives.

    • Nicolas André
    • , Shripad Banavali
    •  & Eddy Pasquier

  • News & Views |

    The results of a number of studies have demonstrated the promise of adding intrahepatic arterial selective internal radiotherapy (SIRT) to chemotherapy for patients with liver metastases from colorectal cancer; however, the frequent progression of extrahepatic metastases observed in patients treated with SIRT in the SIRFLOX trial call the potential overall benefit of this approach into question.

    • Josep Tabernero
    •  & Ramon Salazar

  • News & Views |

    The 21-gene recurrence score is a genetic assay developed to estimate the likelihood of distant recurrence in patients with oestrogen-receptor-positive, lymph-node-negative breast cancer treated with adjuvant endocrine therapy. Now, two studies explore how the 21-gene recurrence score has been used to inform treatment decisions in this setting and beyond.

    • Shannon L. Puhalla
    •  & Nancy E. Davidson

  • Review Article |

    Metronomic chemotherapy regimens were developed to optimize the antitumour efficacy of antiangiogenic agents and to reduce toxicity of antineoplastic drugs, but the effectiveness of this approach also relies on other mechanisms, such as the stimulation of the immune system. Investigating the pharmacokinetic and pharmacodynamic properties of agents administered in metronomic regimens will enable a more-personalized therapeutic approach. Herein, Bocci and Kerbel discuss results from early phase and pilot clinical studies that support the important link between pharmacokinetics and metronomic chemotherapy.

    • Guido Bocci
    •  & Robert S. Kerbel

  • Review Article |

    Triple-negative breast cancer has a poor outcome compared with other breast cancer subgroups, and chemotherapy is the primary treatment for this disease. 'Omics' technologies have revealed high levels of heterogeneity and helped to identify potentially actionable molecular features in some triple-negative breast cancer subtypes. Proof-of-principle studies suggest a potential benefit from immunotherapy in patients with this disease. Herein, Bianchini et al. discuss the most promising therapeutic opportunities for triple-negative breast cancer.

    • Giampaolo Bianchini
    • , Justin M. Balko
    •  & Luca Gianni

  • Review Article |

    Local and systemic treatments for advanced or metastatic cancer are rarely curative. Innate and/or acquired resistance can reduce therapy responsiveness, with studies highlighting the contribution of therapy-induced physiological changes in host tissues and cells that reduce the antitumour effects of therapy. These unwanted host effects can promote tumour-cell repopulation and malignant aggressiveness. In this Review, the author discusses ways to suppress these host-response effects as a possible new approach to improving local and systemic cancer therapies.

    • Yuval Shaked

  • News & Views |

    The recent FDA approval of MM-398 as a second-line treatment of metastatic pancreatic cancer, based on a 1.9-month overall survival benefit observed in the NAPOLI-1 trial, adds a new therapeutic option for this notoriously difficult-to-treat disease; however, by discouraging clinical trial enrolment, this approval might have negative consequences for the development of novel agents, which remain an essential unmet need.

    • Susan E. Bates
    •  & Tito Fojo

  • Opinion |

    Patients with advanced-stage ovarian cancer are widely believed to have a dismal prognosis; however, around 20% of women with this disease survive beyond 12 years after treatment and are effectively cured. In this Perspectives, Steven Narod presents the case that this proportion could be substantially increased through the combination of maximal debulking surgery and intraperitoneal chemotherapy.

    • Steven Narod

  • Year in Review |

    In 2015, published trials highlighted the remarkable efficacy of docetaxel combined with androgen-deprivation therapy in patients with newly diagnosed metastatic prostate cancer. Also in 2015, a large study revealing potential molecular targets for metastatic castration-resistant prostate cancer therapies was published, along with a study showing activity of PARP inhibition in patients harbouring mutations in genes governing DNA repair.

    • Julie N. Graff
    •  & Tomasz M. Beer

  • Review Article |

    Use of radiotherapy or chemotherapy generally increases the survival of women with breast cancer; however, the use of radiotherapy, chemotherapy agents, such as the anthracycline doxorubicin, or anti-HER2 agents, such as trastuzumab, confer an increased risk of adverse cardiovascular events in these patients. In this Review, the authors describe the incidence and management of treatment-induced cardiac disease in women with breast cancer, and highlight strategies that might be used to minimize this risk.

    • Timothy M. Zagar
    • , Daniela M. Cardinale
    •  & Lawrence B. Marks

  • Review Article |

    Haematopoetic stem-cell transplantation (HSCT), has been the standard-of-care for eligible patients with chronic myeloid leukaemia (CML) for several decades. The development of tyrosine kinase inhibitors (TKIs) 15 years ago revolutionized the treatment of CML. For some patients, however, allogeneic HSCT remains the best treatment option. The authors of this Review discuss the current status of HSCT as a therapeutic option for CML management.

    • Andrew J. Innes
    • , Dragana Milojkovic
    •  & Jane F. Apperley

  • News & Views |

    A study assessing the impact of the 21-gene recurrence score assay in routine clinical practice on the use of adjuvant chemotherapy in women with early stage ER-positive breast cancers showed that adjuvant chemotherapy use decreased in high-risk patients, but increased in low-risk patients. I discuss these results and highlight how this reflects more-selective administration of chemotherapy.

    • Lajos Pusztai

  • News & Views |

    In the RADIANT study, no difference in disease-free survival was observed for patients with non-small-cell lung cancer (NSCLC) treated with erlotinib versus placebo in the adjuvant setting. Further biomarker studies are awaited to determine whether patients with NSCLC can benefit from adjuvant therapy with tyrosine kinase inhibitors.

    • Fred R. Hirsch
    •  & Paul A. Bunn Jr

  • News & Views |

    In two recent phase III trials, investigators evaluated the addition of docetaxel to androgen-deprivation therapy for non-castrate prostate cancer. On the basis of the CHAARTED-trial findings, we can firmly conclude that this combination can be used in the metastatic setting. The results of the GETUG 12 trial are less informative, although some benefit for patients with high-risk localized prostate cancer was demonstrated.

    • Min Yuen Teo
    •  & Howard I. Scher

  • News & Views |

    A recent objective study has demonstrated that the use of adjuvant platinum-based intraperitoneal chemotherapy in patients with small-volume residual advanced-stage ovarian cancer remains limited, despite the publication of several phase III trials demonstrating superior overall survival associated with this approach. Several factors might explain this far less than satisfactory state of affairs.

    • Maurie Markman

  • Review Article |

    Cardiotoxic effects of chemotherapy can occur in various different ways depending upon the type of chemotherapy used and various patient characteristics. In this Review, the authors describe the established cardiotoxic effects of anthracyclines and HER2 inhibitors, and describe a systems medicine approach that might enable the optimal management of acute and chronic cardiotoxcities in patients who are receiving, or have received, these therapies.

    • Sherry-Ann Brown
    • , Nicole Sandhu
    •  & Joerg Herrmann

  • News & Views |

    Treatment with pembrolizumab, an anti-PD-1 antibody, improved progression-free survival compared with investigator-choice chemotherapy in a phase II trial in patients with advanced-stage melanoma previously treated with ipilimumab. Two subsequent independent trials have confirmed that anti-PD-1 therapy is a better option than either chemotherapy or ipilimumab in the frontline setting.

    • Ryan J. Sullivan
    •  & Keith T. Flaherty

  • Review Article |

    Neurotoxicity caused by treatment is widely recognized in patients with cancer. This Review addresses the main neurotoxicities of cancer treatment with a focus on the newer therapeutics. Recognition of these patterns of toxicity is important because drug discontinuation or dose adjustment might prevent further neurological injury. Familiarity with the neurological syndromes associated with cancer treatments enables clinicians to use the appropriate treatment for the underlying malignancy while minimizing the risk of neurological damage, which might preserve patient quality of life.

    • Jacqueline B. Stone
    •  & Lisa M. DeAngelis

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