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28.03.2012 00:00
Each year, when new annual cancer incidence and mortality statistics are published, the media are quick and happy to report that cancer mortality is reducing, despite some increases in incidence. There is a lot for the oncology community to celebrate and be proud of in
13.03.2012 00:00
A great proportion (65–85%) of women receiving treatment for breast cancer suffer from hot flashes and night sweats (HFNS), which can severely affect their quality of life. Myra Hunter and colleagues have now shown an effective way to make these symptoms manageable.In the MENOS1
Venous thromboembolism is a common complication of treatment in patients with cancer owing to the aging population and use of prothrombotic agents. Chemotherapy is a recognized risk factor for venous thromboembolism, and this complication is associated with significant mobidity and mortality. This adverse effect can
Neoadjuvant bevacizumab, when added to standard chemotherapy for operable breast cancer, improved the rate of complete pathological response in two large, well-conducted trials. However, the modest incremental benefits, combined with uncertain long-term effects on disease recurrence, mean that this approach remains experimental until follow-up data are available.
Recent neoadjuvant studies have examined the effects of adding single or dual agents targeting HER2 to chemotherapy, finding unanimously that dual HER2 targeting markedly improves pathologic response. These findings have significant implications for future trial designs, particularly if the impact on pathologic response is accompanied by improved disease-free survival or overall survival.
Previous studies have shown an association between endometriosis and increased risk of invasive epithelial ovarian cancer; however, “the risk associated with endometriosis might vary according to the [histological] subtype,” according to a new study by Pearce et al. published in Lancet Oncology.
06.03.2012 00:00
Until recently, patients with non-small-cell lung cancer (NSCLC) had very few therapy options. For the three-quarters of patients who presented with locally advanced (stage IIIb) or metastatic (stage IV) disease, the treatment recommendation was platinum-based first-line therapy, with an alternative therapy offered as a second-line
28.02.2012 00:00
Advances in our understanding of cancer biology have led to the discovery of a spectrum of new therapeutic targets. However, despite remarkable progress in the identification and characterization of novel mechanisms of the oncogenic process, the success rate for approval of oncology drugs remains low
Demonstration of the clinically significant activity of bevacizumab in advanced-stage ovarian cancer has attracted a great deal of interest. Here, we summarize the two positive phase III trials that led to EMA approval of bevacizumab as first-line therapy and discuss the optimum use of the drug in this disease.
ASCO has released a provisional clinical opinion (PCO) recommending the use of palliative care alongside standard oncologic therapy for patients newly diagnosed with metastatic cancer. The PCO is based on data from seven randomized clinical trials (RCTs), but the strongest evidence came from a phase
In the CLASSIC study, capecitabine–oxaliplatin was an effective chemotherapy after D2 gastrectomy for stage II–IIIB gastric cancer. We compared these data with the ACTS-GC study, which was the only pivotal study proving the benefit of adjuvant chemotherapy in these patients. Long-term survival data from CLASSIC are awaited with interest.
Chemotherapy is used to treat malignancy during the second and third trimester of pregnancy; however, the neurocognitive effects in children are poorly documented, and the cardiotoxic effects of anthracyclines, which are used frequently during pregnancy, are a concern. Thus, many women are faced with the
The receptor tyrosine kinases ALK and ROS are expressed as oncogenic fusion proteins in a small proportion of non-small-cell lung carcinomas (NSCLC) and other tumor types. For patients who harbor these genetic rearrangements, targeting fusion proteins has proved to be a very successful treatment. So
Mature outcomes from adjuvant endocrine therapy trials in estrogen receptor-positive breast cancer have enabled comparisons with neoadjuvant clinical trials that have parallel randomizations of treatment in terms of the response of disseminated disease versus the local response within the breast. Imprecise end points, such as
21.02.2012 00:00
Effectively treating patients with multiple myeloma is challenging. The development of therapeutic regimens over the past decade that incorporate the proteasome inhibitor bortezomib and the immunomodulatory drugs thalidomide and lenalidomide has been the cornerstone of improving the outcome of patients with myeloma. Although these treatment
For patients diagnosed with peripheral T-cell lymphoma (PTCL) the outlook has looked grim. There are no agents currently approved to treat patients in the first-line setting, and until recently that was also the case for patients who relapsed. Now, there are two options for these
Between January 2001 and January 2012, 48 new medicinal products for cancer treatment were licensed within the EU, and 77 new indications were granted for products already licensed. In some cases, a major improvement to existing therapies was achieved, for example, trastuzumab in breast cancer.
Currently, clinical examination is the only validated technique for early detection of oral cancer. However, data from a study by David Elashoff and colleagues demonstrate that salivary biomarkers can be used to discriminate between patients with oral squamous-cell carcinoma and healthy individuals.The researchers analyzed
Several studies have suggested that acupuncture is a very effective method to mitigate xerostomia (dry mouth), a side effect from radiotherapy that can occur in up to 100% of patients with head and neck cancer.To confirm whether the effects observed in these studies were
The action and activity of proteins in cancerous cells is an area of study that has provided us with many therapeutic targets. However, the targeted activation of tumor-suppressor proteins has not been readily achieved in the clinic. Now, research into EphB3, a protein that is
14.02.2012 00:00
The tumor genome is commonly aberrant as a consequence of mutagenic insult and incomplete DNA repair. DNA repair as a therapeutic target has recently received considerable attention owing to the promise of drugs that target tumor-specific DNA-repair enzymes and potentiate conventional cytotoxic therapy through mechanism-based
The BOLERO-2 and CLEOPATRA trials evaluated everolimus for estrogen receptor-positive and pertuzumab for HER2-positive metastatic breast cancer. Both agents enhanced the efficacy of standard therapy, were relatively well tolerated and should be approved for therapeutic use. These data confirm that targeting both major driver and escape pathways improves treatment outcomes.
Although prostate cancer is a slow progressing disease for which life expectancy is much higher than in other types of cancer, 3% of men diagnosed with this malignancy still die from it, which translates into approximately 10,000 deaths from prostate cancer every year in the
Clinical trials have consistently demonstrated the superior sensitivity of human papillomavirus (HPV) testing compared with cytology (Pap) testing for identifying women at risk of cervical cancer. Rijkaart et al. have now shown that adding HPV testing to routine cervical cancer screening can further reduce the risk of cervical cancer compared to Pap testing alone.
About 100 early-phase clinical trials and investigator-led studies of targeted antivascular therapies—both anti-angiogenic and vascular-targeting agents—have reported data derived from T1-weighted dynamic contrast-enhanced (DCE)-MRI. However, the role of DCE-MRI for decision making during the drug-development process remains controversial. Despite well-documented guidelines on image acquisition and
07.02.2012 00:00
Aromatase inhibitors are an effective and well tolerated neoadjuvant treatment with improved efficacy for postmenopausal women with breast cancer compared with tamoxifen. Moreover, neoadjuvant endocrine therapy provides an important treatment option to downstage tumors so mastectomy can be avoided in preference of breast-conserving surgery in
Treatment of melanoma has changed drastically with the development of the first inhibitor of BRAF, vemurafenib. BRAF is mutated in 70% of patients with melanoma and treatment with vemurafenib has led to significant tumor responses in 80% of these patients. Although with not such
Survival outcomes for early stage non-small-cell lung cancer (NSCLC) after resection are dismal, with metastatic disease recurring in 30–50% of patients. Despite the high rate of occult metastasis, some patients with micrometastases are cured by chemotherapy. It is, therefore, of paramount importance to develop a
Ovarian cancer has been given the moniker of the 'silent killer' as it was thought to progress, symptom free, to a stage where effective treatment was no longer possible. The assumption that women do not have symptoms is, however, in many cases incorrect—the problem is
31.01.2012 00:00
Harbeck, N. Nat. Rev. Clin. Oncol.9, 10–12 (2012); doi:10.1038/nrclinonc.2011.193In the version of this article initially published online the author's name in the citation line was spelled incorrectly. The error has been corrected for the
The increase and diversity of clinical trial data has resulted in a greater reliance on statistical analyses to discern value. Assessing differences between two similar survival curves can pose a challenge for those without formal training in statistical interpretation; therefore, there has been an increased
Late toxicities from radiation therapy are frequent in patients with Hodgkin lymphoma and can hamper survival. These late toxicities should decrease with modern radiation therapy but results are not mature and so the importance of this decrease is still unknown. Hence, all studies in Hodgkin lymphoma must report long-term outcome.
24.01.2012 00:00
Before the advent of effective targeted therapies, the standard treatment for patients with metastatic renal-cell carcinoma (mRCC) was cytokine therapy with IFN-α and IL-2. Durable complete remissions beyond 3 years have been noted in a few patients with these agents but relapse is common. In
Although it has been known that prostate cancer has a strong hereditary element, this pattern has not been linked to a particular gene, until now that is. Researchers led by Kathleen Cooney have found that germline mutations in the HOXB13 gene are associated with
Infections with hepatitis B virus (HBV) or hepatitis C virus (HCV) are associated with significant morbidity and mortality among patients with cancer, especially in patients with hematologic malignancies and those who undergo hematopoietic stem-cell transplantation. Reported rates of HBV reactivation in HBV carriers who undergo
17.01.2012 00:00
Despite the fact that up to 10% of colorectal cancers (CRC) have mutations in the Val600 codon of BRAF, the clinical response to treatment with the V600E B-Raf targeted agent vemurafenib has not been encouraging. Researchers based at Roche (the developing company of vemurafenib)
Development of malignant ascites is common in patients with ovarian cancer, and few therapeutic options exist for women with ascites whose tumors become resistant to chemotherapy. Furthermore, in such patients symptom palliation options are limited, and the few available treatments are unpleasant and can result
B-cell chronic lymphocytic leukemia (CLL) is the most common type of leukemia and it is characterized by the accumulation of impaired mature B lymphocytes in the blood and bone marrow. Although it progresses slowly in many cases and these patients may have normal active lives
10.01.2012 00:00
Androgen-deprivation therapy (ADT) is widely used for the treatment of patients with prostate cancer, but has been suggested to increase a patient's risk of dying from cardiovascular complications. However, in a meta-analysis of eight prospective, randomized trials with over 4,000 patients, a team of researchers
To determine tumor-related factors that influence the response of metastatic melanoma tumors to treatment with the anti-CTLA-4 antibody ipilimumab, researchers have performed gene-profiling assays on biopsies collected from 45 patients before and after treatment with ipilimumab. In patients who responded to treatment, expression of immune-related
Elucidation of the molecular pathways underlying bone turnover has revealed potential therapeutic targets, including receptor activator of nuclear factor-κB ligand (RANKL), which is a mediator of osteoclast formation, function and survival. Denosumab is a fully human monoclonal antibody that binds to and inhibits RANKL. This
A recent phase II trial has shown that bevacizumab is tolerated by patients with nasopharyngeal carcinoma. The trial assessed patients with grade IIB–IVB disease and combined treatment with bevacizumab and cisplatin with intensity-modulated radiation therapy. There were no grade 5 adverse events, which was one
Glioblastoma multiforme (GBM) is the most common and aggressive brain tumor in adults, and it is very difficult to treat as it is resistant to most conventional therapies, probably due to its heterogeneous nature. Tumorigenesis of GBM is commonly driven by gene amplification of tyrosine
2011 saw improvements in our understanding of B-cell malignancies: insights into the genomic basis of chronic lymphocytic leukemia were achieved; reduced treatment intensity caused fewer toxic effects in early-stage Hodgkin lymphoma; first-line rituximab maintenance therapy improved outcome in follicular lymphoma; and selected patients with diffuse large-cell lymphoma benefited from the addition of bortezomib.
Before the advent of HER2-targeted therapies, the 20–25% of patients with breast tumors that overexpressed HER2 had a poor prognosis. The approval and use of the HER2-targeted monoclonal antibody trastuzumab has gone some way to ameliorating this problem; however, more treatment options are still needed.
Options to treat late-stage castration-resistant prostate cancer continued to increase in 2011, as three agents with different mechanisms of action prolonged life and a fourth reduced the morbidity of skeletal metastases. These outcomes contrasted with the heightened controversy generated by the recommendation against PSA screening and other early detection strategies.
Peritoneal carcinomatosis resulting from metastatic colorectal cancer (pcCRC) is a relatively common and under recognized condition with a very poor prognosis. The presentation of pcCRC is distinct from hepatic or pulmonary metastases yet most studies do not differentiate CRC subtypes. The lack of a widely
An interesting therapy combination has been uncovered in preclinical studies. In an ovarian cancer cell line, the proteasome inhibitor bortezomib acted synergistically with indole-3-carbinol, a natural compound found in cruciferous vegetables. Treatment with the combination induced cell-cycle arrest and apoptosis and sensitized the cells to
Melanoma has emerged as the paradigm tumor for drug development through mutation-targeted therapies (inhibitors targeting BRAF, MEK, and c-KIT) and immunotherapy. Exploring the combinations of both approaches is a challenge that will require scientific rationale and the cooperation of the pharmaceutical industry. But, with these challenges comes another opportunity to change the paradigms in drug development.
A large population study has been completed in Sweden that aimed to identify whether there is a familial link for acute myeloid leukemia (AKL) and myelodysplastic syndromes (MDS). Interestingly, having a first-degree relative with AML or MDS did not increase the risk of developing either
Randomized controlled trials (RCTs) are central to evidence-based clinical and health-policy decisions. However, RCTs highlight the tension between the therapeutic obligations of the physician and the scientific obligations of the investigator. Clinical equipoise, defined as honest professional disagreement among expert clinicians about the preferred treatment,
21.12.2011 00:00
One year of adjuvant trastuzumab, preferentially given upfront with a taxane as part of an anthracycline–taxane containing chemotherapy, is currently considered standard therapy for treating early-stage breast cancer. The long-awaited full publication of the BCIRG-006 trial now establishes the TCH (docetaxel, carboplatin, trastuzumab) regimen as an additional option with a distinct safety profile.
The idea that it is acceptable to diagnose a patient with 'breast cancer' is outdated. It has long been recognized that breast cancer is not a single disease entity but constitutes different subtypes that are based on varying clinicopathological features and can also be defined
20.12.2011 00:00
Bone-targeting treatments have transformed the quality of life of patients with metastatic bone disease. 2011 saw the emergence of denosumab—a RANK ligand-specific antibody—as a more-effective alternative treatment to bisphosphonates and of data on the use of bone-targeting treatments to prevent metastasis from breast and prostate cancers.
Highly clinically relevant ovarian cancer clinical research in 2011 focused on an increased understanding of the biology of the malignancy, limitations of strategies for early detection and screening, and the provocative reports of alternative primary and second-line management strategies.
The advent of targeted anticancer therapies over the past few decades has reinvigorated the field of cancer therapeutics, with the promise of increased cancer cure rates accompanied by decreased toxicity. But, has that promise been fulfilled? The short answer is definitely 'no', both because of
13.12.2011 00:00
We thank Grannis for his comments and interest in our article—The ethical use of mandatory research biopsies.
The October 2011 issue of Nature Reviews Clinical Oncology included a Perspectives article by Olson et al. (The ethical use of mandatory research biopsies.
06.12.2011 00:00
A recent study of 843 patients from three hospitals that compared the assessment of HER2 status using FDA-approved immunohistochemistry and fluorescence in situ hybridization assays versus a quantitative reverse transcription PCR (qRT-PCR) assay by Oncotype DX®, showed a high false negative rate for the qRT-PCR assay.
A new phase III study shows superior efficacy of fludarabine plus alemtuzumab combination therapy over fludarabine alone in the treatment of relapsed or refractory chronic lymphocytic leukemia (CLL). However, the study has limitations and the findings can not be generalized to the majority of patients with CLL.
High mammographic density is associated with an increased risk of breast cancer, and of all known breast cancer risk factors has the greatest attributable fraction. Mammographic density is estimated to account for 16% of all breast cancers, but can be altered by endogenous and exogenous
There is wide variation in the survival of patients whose prognosis is determined using the American Joint Committee on Cancer (AJCC) staging system. A study in 3,728 patients who underwent surgery as first-line treatment has shown that the inclusion of pathologic stage, grade and estrogen
Patients with metastatic melanoma have a dismal prognosis but major advances have been made as a result of the FDA approval of vemurafenib—the first kinase inhibitor to prolong survival in patients with melanoma who have the V600E BRAF mutant protein. Unfortunately, despite showing dramatic initial
A single measurement of BCR-ABL1 transcripts 3 months after imatinib treatment is the best way to identify the patients who will not respond well, according to a study of 282 patients with chronic-phase chronic myeloid leukemia. Patients with elevated transcript levels at 3 months
It has long been believed that pregnancy after a breast cancer diagnosis adversely affects prognosis. A study of 115 women with breast cancer who were followed for a mean period of 6 years revealed no significant difference in prognosis between those that became pregnant and
Gene-expression profiling has had a considerable impact on our understanding of breast cancer biology, and more recently on clinical care. Two statistical approaches underlie these advancements. Supervised analyses have led to the development of gene-expression signatures designed to predict survival and/or treatment response, which has
Home is where the fat is, or at least that is what some cancer cells seem to think. Such is the case for ovarian cancer cells, which tend to metastasize in the omentum, a large fatty structure that covers the abdomen and is rich in
Scientists have developed a 38-gene classifier that can accurately predict patients who are at risk of developing leukemia. Gene expression was assessed in CD34+ cells from patients who developed therapy-related myelodysplasia or acute myeloid leukemia (t-MDS/AML) after transplantation and compared the results with
Personalized cancer treatment is just around the corner, suggests a new study. Using SNaPshot, a “multiplexed, robust, highly sensitive and quick clinical test,” Lecia Sequist, Dora Dias-Santagata and colleagues at Massachusetts General Hospital have screened patients with non-small-cell lung cancer (NSCLC) for multiple cancer-causing gene
Metastases in the central nervous system (CNS) are identified in up to 30% of patients at autopsy. Rates of CNS involvement in metastatic cancer are believed to be increasing, possibly owing to better control of systemic disease with novel chemotherapies or improved metastasis detection. The
In the era of cytotoxic therapies, tumor regression has rarely been observed in phase I trials and randomized controlled trials have usually been required to demonstrate modest improvements over prevailing standards of care. In the era of effective targeted therapies, drugs such as vemurafenib and
29.11.2011 00:00
VEGF is a key target in renal cell carcinoma (RCC) and several inhibitors of this protein (including sorafenib) have been approved as therapeutic options for this disease. Following in the steps of its relatives, axitinib, a second-generation inhibitor of VEGF, had already shown efficacy in
The advent of HER2-directed therapies has significantly improved the outlook for patients with HER2-positive early stage breast cancer. However, a significant proportion of these patients still relapse and die of breast cancer. Trials to define, refine and optimize the use of the two approved HER2-targeted
Screening for prostate cancer using PSA is a careful balance of benefits and harms. But current US practice involves testing older men who have little to gain and aggressively treating low-risk cancers. Debates about whether to test need to be replaced by debates on how to test better.
The ECOG E4201 study adds another piece of information to a growing body of evidence pointing strongly to the importance of local control and the role of radiotherapy in unresectable pancreatic cancer. Based on this evidence, we believe radiotherapy should be used routinely in this setting.
It is well established that screening for colorectal cancer is of paramount importance in the race to detect a malignancy while there is time for effective treatment. What is less clear is whether novel techniques can be used to supplement or replace colonoscopy. Investigators have
22.11.2011 00:00
Patients with advanced-stage medullary thyroid cancer (MTC) have a poor prognosis, and treatment options are limited because neither radiotherapy nor chemotherapy are effective at producing durable responses. Around 40% of patients have sporadic mutations in the oncogene RET, with most of these patients harboring
15.11.2011 00:00
Lung cancer is the leading cause of cancer-related death in the world. Many of the symptoms of lung cancer are non-specific and, by the time the patient seeks medical attention, the disease has frequently already progressed to advanced stages. It is, therefore, of critical importance
Genetic factors for increased risk of colorectal cancer have long been established, but cancer prevention options for carriers of these mutations have been limited. Aspirin has consistently been implicated in reduced incidence of colorectal cancer in observational and retrospective studies, and now a prospective trial
Despite the development of drugs inhibiting the oncogenic proteins that cancer cells are dependent on, attempts to match targeted therapies to the genetic makeup of individual tumors is proving more difficult than expected. Until now, the paradigm has been a binary correlation between a mutated
08.11.2011 00:00
Chemotherapy is the standard of care for patients with advanced-stage non-small-cell lung cancer (NSCLC), and it is widely agreed that therapy efficacy needs to be improved. A study led by Elisabeth Quoix has now shown that it is feasible to add immunotherapy to first-line chemotherapy
The AZURE trial data add to the uncertainty of whether adjuvant bisphophonates are a valuable addition to the armamentarium in the treatment of early stage breast cancer. Although the overall trial results were negative, a prespecified subgroup analysis demonstrated a 25% reduction in the risk of relapse and death in postmenopausal patients.
Conventional external-beam radiation therapy is dedicated to the treatment of localized disease, whereas radioimmunotherapy represents an innovative tool for the treatment of local or diffuse tumors. Radioimmunotherapy involves the administration of radiolabeled monoclonal antibodies that are directed specifically against tumor-associated antigens or against the tumor
Modern oncology drug development faces challenges very different from those of the past and it must adapt accordingly. The size and expense of phase III clinical trials continue to increase, but the success rate remains unacceptably low. Adaptive trial designs can make development more informative,
01.11.2011 00:00
Carcinomas of an unknown primary origin (CUP) account for 3–5% of all malignancies and are thus among the ten most-frequent cancers worldwide. Having a specific and unique phenotype of early and usually aggressive metastatic dissemination with no identifiable primary tumor, CUP are a challenge for
Taking a common dose and formulation of vitamin E as a dietary supplement increases the risk of prostate cancer. This “observation of important public health concern,” as described by the authors, was made after extended follow-up of the Selenium and Vitamin E Cancer Prevention Trial
The Cancer Act that was signed by President Nixon in December 1971 had a mandate “to support research and the application of the results of research, to reduce the incidence, morbidity and mortality from cancer.” It has succeeded in many of these aims, as this personal account testifies.
Gastric cancer is a leading cause of cancer-related death and approximately 60% of cases are diagnosed in Asia. The standard treatment is surgery and, particularly, in East Asia, gastrectomy with D2 nodal dissection (D2 gastrectomy). However, a considerable proportion of the patients relapse, and although
Patients receiving chemotherapy frequently experience anemia, which has a deleterious effect on patient outcome and quality of life. Interventions for treating chemotherapy-induced anemia include either oral or parenteral iron supplementation together with an erythropoiesis-stimulating agent (ESA). Data regarding the true advantages of oral versus parenteral
In a trial in patients with metastatic breast cancer, the prognostic value of the number of circulating tumor cells (CTCs) at baseline was independent of tumor subtype, except in patients with HER2-positive disease treated with anti-HER2 targeted therapy. These data support the use of CTC detection as a tool contributing to personalized medicine.
Over the years, the investigators conducting trials in patients with early stage breast cancer have been sharing their data, aiming to ensure that incremental changes in survival are not missed. A recent study by this group of researchers (the Early Breast Cancer Trialists' Collaborative Group)
28.10.2011 00:00
Although most oncologists would agree that defining the stage of a cancer is useful in decision making and the establishment of prognosis, a team have recently formally shown this to be the case for patients with colon cancer. They prospectively assessed 536 patients who underwent
Patients who have undergone hepatectomy as treatment for hepatocellular carcinoma frequently experience disease recurrence within the first year after surgery. It has been speculated that this could be caused by circulating cancer stem cells (CSCs) that have escaped from the tumor prior to resection. Therefore,
A group of investigators in Italy have developed what they have termed 'xenopatients' to help identify novel biomarkers for patients. They used genetically characterized samples taken from 85 patients with metastatic colorectal cancer. These in vitro 'xenopatients' responded in a similar way to the
25.10.2011 00:00
Nipple-sparing mastectomy (NSM) is a surgical protocol designed to reduce the disabling psychological effects of radical or skin-sparing mastectomy. The preservation of the nipple–areola complex produces a more-natural result of the breast reconstruction, but this preservation is suspected of increasing tumor local recurrence. To reduce
Women with BRCA1 or BRCA2 mutations have an increased risk of developing ovarian cancer. Therefore, as part of The Cancer Genome Atlas (TCGA) project, Wei Zhang and colleagues undertook a “comprehensive analysis of genomic, epigenetic, and clinical data in the TCGA database to
Targeted therapies can produce dramatic responses in some patients, but in many cases it is difficult to tell who will respond and who will not. A mathematical model of survival and death signals has predicted which lung cancer tumors will respond to the EGFR tyrosine
18.10.2011 00:00
Progression-free survival (PFS) is frequently used as a primary end point in oncology clinical trials. Employing PFS instead of overall survival as the primary outcome has the advantage that trial completion can be quicker with fewer patients required, and it is cheaper. PFS is sensitive
In 2009, the Union for International Cancer Control issued the seventh edition of the well-used T (tumor), N (node), and M (metastasis) classification guidelines. There has been a continual refinement of the staging for colorectal cancer since this system for assessing tumor stage was initially
11.10.2011 00:00
The field of prostate cancer therapy has been one of the most fast moving over the past year or so, with new treatment options against novel drug targets being developed and approved. This has led to an aura of optimism for this disease.Despite all
In 2011, more than 155,000 deaths in the USA were attributed to lung cancer making this malignancy the number one cancer killer. The standard of care for non-small-cell lung cancer (NSCLC) is platinum-based doublet chemotherapy. DNA repair capacity has an important role in resistance to
It was Hippocrates, the father of Western medicine, who first emphasized the patient as the most important determinant of therapeutic efficacy. Although the principle of adjusting treatment to specific patient characteristics has since been the strategy of physicians, this is undermined by a population-biased approach
04.10.2011 00:00
The optimal treatment for patients with advanced-stage Hodgkin lymphoma is an ongoing controversy. A recent trial seemed to answer some of the important open questions in the field; however, closer examination of the data indicates that the answers are not as clear as they might initially seem.
From 1989 to 2003, 709 phase III trials evaluating systemic cancer treatment were presented at ASCO meetings. Tam and collaborators have now reported that 9% of these trials were never published, and 13% were published after a 5-year delay. More than half of these studies would have had clinical impact if published promptly.
30.09.2011 00:00
Nat. Rev. Clin. Oncol.8, 25–37 (2011); doi:10.1038/nrclinonc.2010.174A software error resulted in several incorrect citations and two missing references: National Cancer Institute http://seer.cancer.gov/ (2010) and
Nat. Rev. Clin. Oncol.8, 357–368 (2011); doi:10.1038/nrclinonc.2011.67In the version of this article initially published online the title of Table 1 should have read “Completed and ongoing trials with bisphosphonates” and it should have stated that trial
27.09.2011 00:00
Although some of the mechanisms that confer de novo resistance to the monoclonal anti-EGFR antibody cetuximab have been identified (such as mutations in KRAS in colorectal cancer; CRC), less is known about mechanisms of acquired resistance to this drug. Pasi Jänne and his
Ovarian cancer is the most lethal of all the gynecologic malignancies. The lack of signs and symptoms contribute to the poor prognosis of this cancer as by the time is detected, it has often reached late stages. Even when the tumor is detected and patients
The incidence of melanoma is increasing worldwide, and the treatment options for patients have been rapidly expanding. However, 5–8% of patients develop metastases between the primary tumor and the draining lymph nodes—known as in-transit metastases, or IT-mets. A long-established protocol for treating patients that develop
Cell-based therapies, such as adoptive immunotherapy and stem-cell therapy, have received considerable attention as novel therapeutics in oncological research and clinical practice. The development of effective therapeutic strategies using tumor-targeted cells requires the ability to determine in vivo the location, distribution, and long-term viability
Elderly patients have often been excluded from, or under represented in, clinical trials. Now, a phase III trial has demonstrated that a platinum-based doublet regimen provides superior outcomes in elderly patients with advanced-stage non-small-cell lung cancer, and should be considered for palliative chemotherapy in this group of patients.
20.09.2011 00:00
Systemic cancer viriotherapy might have come one step closer. A team of scientists from USA and Canada proved the efficacy and safety of an intravenously infused virus that selectively infected metastatic lesions in a phase I trial. “We demonstrated for the first time in medical
Cutaneous T-cell lymphomas (CTCL) are the most frequently occurring primary skin lymphoma. These skin lesions contain a high number of inflammatory cells but early diagnosis of CTCL is challenging because of its clinical, pathological and histological similarity to benign inflammatory skin lesions such as psoriasis
13.09.2011 00:00
For many cancer types, the response rates to antiangiogenic agents have not been as successful as anticipated according to the results in preclinical models, and most patients develop resistance to this type of treatment. Ovarian cancer, however, seems to respond well to antiangiogenic therapy and
A retrospective study of Medicare patients over 65 years of age with stage II colon cancer, showed that adjuvant chemotherapy did not improve overall survival, even in patients with poor prognostic factors. But, does this mean that these patients should not be offered this treatment option?
In a recent randomized trial, electromotive intravesical administration of mitomycin before transurethral resection was shown to be effective in the prevention of bladder cancer recurrence. Although this treatment seems to be promising, one question remains: can these results be reproduced by other research groups? If this is the case, it could become a new standard.
06.09.2011 00:00
The use of antiangiogenic therapy as a treatment for solid malignancies has had a rocky road to travel in terms of approvals in the past year. After the recent recommendation for the withdrawal of FDA approval for the use of the VEGF-targeting antibody bevacizumab for
Tumorigenesisin situ
Cervical cancer is one of the most common gynecologic malignancies. If caught early, patients have a favorable prognosis with over 80% living beyond 5 years; however, for those diagnosed with advanced-stage disease the prognosis is very poor. For nonresectable tumors, the standard therapy is cisplatin-based
Cancer medicine frequently balances probability of cure against morbidity of treatment. A recent trial in patients with Hodgkin lymphoma compared two regimens of different intensity and toxicity and examined not only the immediate results, but also the broader algorithm of care, factoring in the effects of salvage treatment and high-dose therapy.
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