2016-12-06Resistance to endocrine therapy, the standard of care for patients with hormone-receptor-positive (HR+) breast cancer, is common. The cyclin-D–cyclin-dependent kinase 4/6 (CDK4/6)–Rb pathway is a promising therapeutic target in HR+ cancer, which account for 60–65% of all malignant breast neoplasms. Indeed, gene alterations affecting cell-cycle
2016-12-06Small-cell lung cancer (SCLC) is arguably the most-aggressive form of lung cancer. Most patients with SCLC present with metastatic disease and have limited treatment options; although novel therapies are now on the horizon, platinum-based chemotherapy remains the current mainstay therapy. Frustratingly, most SCLCs are initially
2016-11-22Intratumoural heterogeneity is a major cause of acquired anticancer drug resistance. The regulation of development and differentiation is a driver of tumour heterogeneity, as supported by evidence from studies of several malignancies (but mainly leukaemias). Among solid tumours, glioblastoma provides one of the best-established example,
2016-11-29The incidence of neuroendocrine tumours (NETs) is increasing, and treatment options are limited. Mouse model of NETs are responsive to the antiangiogenic agent sunitinib. In 2006, results from the first phase I trial investigating this agent in patients with various types of NETs were published.
2016-11-02An analysis of phase III trial results published between 2011–2015 using the European Society of Medical Oncology (ESMO)–magnitude of clinical benefit scale (MCBS) indicates that only 31% of treatments that resulted in statistically significant improvements in outcomes met the thresholds for clinical benefit. Investigators also
2016-11-02Newly published data indicate the sensitivity of 18F-fluorodeoxyglucose (18F-FDG)–PET for the detection of recurrent disease. A total of 88 patients with no, or equivocal signs of recurrence on clinical examination, but who had raised carcinoembryonic antigen (CEA) levels were examined using 18
2016-11-02Data from a retrospective study in a cohort of 23 men with breast cancer indicate that eribulin is a safe and effective treatment for men with this disease. All patients had at least a stable disease response, with two complete responses, after a median of
2016-11-02Biochemical tests for the presence of free light chains (FLCs) are used to indicate a possible diagnosis of multiple myeloma (MM). Most guidelines recommend measurement of urinary FLCs; however, recent research indicates that the presence of FLCs in blood might be a better indicator. In
2016-11-08Glioblastoma is an extremely aggressive cancer associated with an average survival of 12–18 months, and is incurable with current treatment options. Paediatric glioblastoma is highly heterogeneous and genetically distinct from its adult counterpart and, although some genetic causes have been identified, a substantial fraction of
2016-11-08Surgery is curative for 90% of patients with early stage gastric tumours (T1), but those with advanced-stage tumours (T2–4) or regional lymph-node involvement have a poor prognosis. Perioperative chemotherapy regimens containing epirubicin, cisplatin and fluorouracil (ECF) or epirubicin, cisplatin and capecitabine (ECX) can improve the
2016-11-15Retrospective data indicate that failure of first-line chemotherapy in patients with non-small-cell lung cancer and ≤3 metastases occurs mostly at lesions known to exist prior to treatment, and that advances in local and maintenance therapies can be leveraged to improve survival. This possibility has now
2016-11-29Molecular cancer-classifier assays enable the diagnosis of a single cancer type for most patients with cancer of unknown primary (CUP), thus opening the door to the administration of site-specific therapies. Herein, I discuss how such therapies can improve the survival of patients with CUP, and the resulting paradigm shift towards tissue-of-origin diagnostics and treatments that is now becoming the standard of care for this patient population.
2016-11-22Active surveillance has been proposed as a management option that reduces the risk of overtreatment in patients diagnosed with early stage prostate cancer. However, up until now, this approach has not been tested in a prospective, randomized fashion. The PROTECT study confirms that patients diagnosed with prostate cancer through prostate-specific antigen (PSA)-based screening are at a very low risk of cancer-related mortality, but patients undergoing active surveillance do have an increased risk of disease progression and metastases compared with those managed with upfront therapy.
2016-11-29The VOICE study addressed the oncologist–patient dyad by adding a two-sided intervention. The results of this ostensibly positive study are, at best, limited and, at worst, cosmetic because clinically relevant long-term outcomes were unaffected. VOICE is the first attempt at addressing complexity in this genre of studies and, even with its shortcomings, teaches us some important lessons.
2016-05-04Awareness that the metabolic phenotype of cells within tumours is heterogeneous — and distinct from that of their normal counterparts — is growing. In general, tumour cells metabolize glucose, lactate, pyruvate, hydroxybutyrate, acetate, glutamine, and fatty acids at much higher rates than their nontumour equivalents;
2016-08-23Despite progressive improvements in the management of patients with locoregionally confined, advanced-stage solid tumours, distant metastasis remains a very common — and usually fatal — mode of failure after attempted curative treatment. Surgery and radiotherapy are the primary curative modalities for these patients, often combined
2016-10-11Many patients with cancer are diagnosed through an emergency presentation, which is associated with inferior clinical and patient-reported outcomes compared with those of patients who are diagnosed electively or through screening. Reducing the proportion of patients with cancer who are diagnosed as emergencies is, therefore,
2016-07-05Our increasing understanding of cancer biology has led to the development of molecularly targeted anticancer drugs. The full potential of these agents has not, however, been realised, owing to the presence of de novo (intrinsic) resistance, often resulting from compensatory signalling pathways, or the