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Research Advances

Research Advances is your one-stop shop for the latest information in cutting edge cancer research. The New England Journal of Medicine, Journal of Clinical Oncology, and Lancet Oncology are recognized both nationally and internationally as among the world’s authoritative resources for significant advances in clinical cancer research and editorial opinions on a wide variety of cancer-related topics. Audiences of these publications include medical professionals from all oncology disciplines and sub-specialties, researchers, students, and related health care professionals throughout the world.

The Lancet Oncology

[Editorial] UK National Health Service—beyond repair?
In a recent editorial, we highlighted the disconnect between the UK National Health Service (NHS) and its founding philosophy, and the existential crisis facing British health care. Recent weeks have seen the highest numbers of patients on record not being treated within prescribed waiting times, patients being queued on trolleys in hospital corridors, and urgent surgeries cancelled because of insufficient intensive-care beds. Moreover, dangerous, financially-motivated, clinical decisions are being proposed, patients are donating chemotherapy equipment to under-resourced hospitals, and more protest marches by junior doctors and the public alike are happening than ever before.

[Comment] Adjuvant therapy for women with high-risk endometrial carcinoma
Identification of optimal therapy for patients with high-risk endometrial carcinoma has been frustrated by near-dichotomous paradigms of surgical treatment in the international community and a scarcity of level 1 data to inform adjuvant treatment. For example, at a meeting of the European Society for Medical Oncology–European Society of Gynaecological Oncology–European Society for Radiotherapy and Oncology Endometrial Consensus Conference Working Group, 14 recommendations were supported by level 1 or 2 evidence out of 50 nonsurgical treatment topics.

[Comment] BMI and outcomes in melanoma: more evidence for the obesity paradox
The association between increased body-mass index (BMI) and the risk of developing and dying from cancer has been recognised across a broad range of tumour types.1,2 The magnitude of this association is so great that in the USA obesity is considered to be the major preventable cause of cancer.3 However, data regarding the effect of obesity on the outcomes of patients undergoing cancer treatment is less clear. Several observational studies in different tumour types have shown that a moderately increased BMI (compared with an optimal BMI of 22·5 kg/m2) is associated with improved outcomes both around the time of treatment and in later years of follow-up for several cancers.

[Comment] Clinical trials in older, less fit populations: an unmet need?
Hans Wildiers and colleagues1 are to be congratulated on their demonstration of a framework for clinical trials in older, more frail patients with HER-positive metastatic breast cancer. Clinical trials are a global prerequisite for establishing new treatment standards, but eligibility criteria generally restrict participation to fit populations with minimal comorbidities. These criteria contribute to underrepresentation of older populations with functional limitations in most clinical trials.

[Comment] Cancer in pregnancy: evidence, or still empiricism?
Taking responsibility for a pregnant woman diagnosed with cancer and her unborn child is challenging for every physician. Therefore, an expert interdisciplinary team involving gynaecologists, medical oncologists, neonatologists, obstetricians, pathologists, psychologists, and radiotherapists is necessary to achieve the best oncological result for the woman and avoid morbidity for the fetus.

[Comment] Immune checkpoint inhibitors: the next step for thymic carcinomas
Thymic carcinoma is a rare cancer with few available treatment options. Over the past few years, chemotherapy for thymic malignancies, comprising thymic carcinomas and thymomas, has achieved minimal success. Therefore, a more promising, targeted approach is required.1

[Comment] Next-generation nuclear morphology to grade solid tumours
A central task for surgical pathologists diagnosing tumours is to reliably assess tumour aggressiveness from morphologic features. This tumour grade guides clinical therapy planning, and specific grading systems exist for all major tumour types. Typical components of grading systems are tissue architecture, degree of resemblance to the respective benign tissue, mitotic activity, necrosis, and aberrances in nuclear morphology (ie, nuclear pleomorphism, variations in size, nucleolar prominence, and chromatin distribution).

[Comment] Denosumab for myeloma bone disease: ready for prime time?
Increased osteoclast activity is the hallmark of myeloma bone disease and RANKL is the most potent osteoclast activator. Bisphosphonates and monoclonal antibodies targeting RANKL (eg, denosumab) inhibit osteoclasts and are the mainstay of therapy of cancer-related bone disease. Bisphosphonates reduce skeletal-related events. Zoledronic acid, a potent bisphosphonate, improved survival compared with clodronate of patients with myeloma in a large study1 that used thalidomide-based or conventional chemotherapy.

Journal of Clinical Oncology

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New England Journal of Medicine