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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] Access to opioids: a balance of harms
Opioid overdose killed 64 070 Americans between 2016–17 to become the leading cause of mortality in the USA for people younger than 50 years. On March 29, 2017, US President Trump gave an executive order to investigate the crisis. The interim report called upon the US Administration to immediately increase capacity for addiction treatment through the removal of the Institutes for Mental Diseases exclusion from Medicaid funding. This recommendation is in stark contrast to this Administration's aim of cutting the government health budget, and Trump has refused to declare the current situation a national emergency, an action that would increase national impetus to act.

[Comment] BRAFV600E and BRAF-inactivating mutations in NSCLC
BRAF mutations, both V600E (ie, Val600Glu) and non V600E, are found in 6–8% of non-small-cell lung cancer (NSCLC)1 and cause downstream activation of the MAPK signalling pathway. Selective BRAF inhibitors, such as dabrafenib, led to 33% (95% CI 23–45) of patients achieving a response, and a median progression-free survival of 5·5 months (3·4–7·3) in patients with previously treated BRAFV600E-mutant NSCLC.2 The inhibition of RAF, together with its downstream kinase, MEK, has shown responses in BRAFV600E-mutant melanomas and NSCLCs.

[Comment] Guadecitabine: a new therapeutic option for acute myeloid leukaemia?
The median age at presentation of patients with acute myeloid leukaemia is 67 years, which means that more than half the cases are in older individuals.1 For elderly patients who are not enrolled in experimental trials—the preferred option—treatments aimed at changing the natural course of the disease include conventional aggressive chemotherapy and the hypomethylating drugs azacitidine and decitabine. These drugs offer the possibility of achieving a clinical benefit even in the absence of a conventional complete remission, and for some patients, they might also serve as a bridge to allogeneic stem cell transplantation.

[Comment] Carfilzomib versus bortezomib: no longer an ENDEAVOR
Carfilzomib is an irreversible, epoxyketone proteasome inhibitor, whereas bortezomib is a reversible, boronic acid-based proteasome inhibitor. The randomised phase 3 ENDEAVOR study directly compared carfilzomib (56 mg/m2) plus dexamethasone with bortezomib (1·3 mg/m2) plus dexamethasone in patients with relapsed or refractory multiple myeloma who had received between one and three previous therapies. The first pre-specified interim analysis showed that patients in the carfilzomib group had higher rates of deeper responses, which translated into significantly longer progression-free survival than those who received bortezomib (median progression-free survival 18·7 months [95% CI 15·6–not estimable] vs 9·4 months [8·4–10·4], hazard ratio [HR] 0·53 [95% CI 0·44–0·65]; p<0·0001).

[Comment] Defeating anaemia in myelodysplastic syndromes: another step forward
Myelodysplastic syndromes remain a group of neoplasias of difficult characterisation and even more difficult and frustrating clinical management, despite the increasing availability of treatment options. In The Lancet Oncology, Uwe Platzbecker and collegues1 have led a clinical study that has not only potentially opened new avenues for treatment of lower risk anaemic patients with myelodysplastic syndrome, but also has implications for the understanding of the biology of myelodysplastic syndrome.

[Comment] Nodal status and survival in anal cancer
In The Lancet Oncology, Hema Sekhar and colleagues1 describe a well designed, large-scale systematic review and meta-regression in anal cancer and their observation of an interesting phenomenon in stage migration and its effect on overall survival. After reviewing 62 studies that included more than 10 000 patients with anal cancer, the investigators noted a progressive increase in the proportion of patients with more advanced disease over time, particularly with the detection of more lymph-node positive disease.

[Comment] Targeting PI3K/AKT pathway in triple-negative breast cancer
Metastatic triple-negative breast cancer has one of the worst prognoses of all cancers. Its associated median overall survival of only 13 months has not changed for almost two decades despite many efforts to develop alternative approaches to chemotherapy, including targeting angiogenesis, DNA repair, and EGFR.1 Potential explanations are the very heterogeneous and unstable nature of this disease, together with the absence of known leading oncogenic drivers.1,2

[Comment] ACT IV: the final act for rindopepimut?
Glioblastoma remains an almost universally fatal cancer with few recent therapeutic advances. The gene encoding EGFR is the most frequently amplified gene in glioblastoma, with roughly 40% of primary glioblastomas showing EGFR amplification.1 Of these EGFR-amplified glioblastomas, 20–50% are characterised by a truncated gene resulting in the expression of mutated EGFRvIII, which is constitutively active. Activation of the EGFR pathway promotes several downstream pathways with oncogenic potential such as cellular proliferation and invasiveness.

Journal of Clinical Oncology

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New England Journal of Medicine