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] Ovarian cancer: breaking the silence
The heterogeneous nature of cancer makes it a very difficult disease to manage. Although great progress has been made against many types of cancer (as highlighted by recent mortality data from the American Cancer Society), treatment of others has shown little change in the past few decades. Ovarian cancer, for example, has traditionally lagged behind: recent research, however, is starting to provide a better outlook for women with this cancer. Two phase 3 clinical trials published in December, 2011, in the New England Journal of Medicine ( GOG018 and ICON7) showed that women with newly diagnosed advanced ovarian cancer given concomitant bevacizumab with a paclitaxel and carboplatin chemotherapy regimen following surgery, and then maintenance bevacizumab, had significantly longer progression-free survival compared with those who received chemotherapy alone.

[Comment] Don't pick the loser: lessons from the GeparQuinto trial
In The Lancet Oncology, Michael Untch and colleagues report the first efficacy results from the GeparQuinto (GBG 44) study, a randomised phase 3 trial of lapatinib versus trastuzumab in combination with neoadjuvant anthracycline-based and taxane-based chemotherapy. 620 women with HER2-positive operable or locally advanced breast cancer were randomly assigned to receive lapatinib (a tyrosine-kinase inhibitor of HER1 and HER2) or trastuzumab (a monoclonal antibody to the HER2 receptor), concurrent with a planned regimen of four cycles of an anthracycline (epirubicin 90 mg/m2 plus cyclophosphamide 600 mg/m2) followed by four cycles of a taxane (docetaxel 100 mg/m2).

[Comment] Easing acceleration of head and neck chemoradiotherapy
In the past 20 years, management of locoregionally advanced head and neck cancer has evolved from often devastating surgical resection towards radiotherapy, intensified either by altered fractionation or by addition of concurrent chemotherapy, with the aim of cure with functional preservation of organs. A key expectation was that intensification of radiotherapy would result in improved outcomes for patients, which would justify any extra morbidity.

[Comment] VEGF Trap for the treatment of malignant ascites
About 10% of all cases of ascites are caused by a malignant disease. In developed countries the most common neoplasm associated with ascites is ovarian cancer. The pathophysiology of malignant ascites is multifactorial, and its molecular pathogenesis is only poorly understood. Ascites formation can result from obstruction of lymph vessels by tumour cells, resulting in incomplete absorption of intraperitoneal fluid and protein, especially in patients with lymphoma or breast cancer. Since malignant ascites is usually an exsudate with a high protein concentration, an increased vascular permeability has been implicated in its pathogenesis.

[Comment] Nasopharyngeal cancer: a promising future
The results of the Intergroup 00-99 trial represented a key turning point for the management of nasopharyngeal cancer and heralded a new era of concurrent chemoradiation regimens. These findings were built on by the addition of intensity-modulated radiotherapy to tackle local failure. As a result, 90% local control rates for nasopharyngeal cancer can be expected, leaving the battle for distant control as the most pressing research problem.

[Comment] Biliary-tract cancer: improving therapy by adding molecularly targeted agents
Until recently, for most patients, biliary-tract cancer could be managed only by supportive care, with resection possible in a few individuals. In parallel with improved surgical procedures and a multidisciplinary approach, oncological treatment has evolved and now offers options with survival benefit. The continued improvement of systemic treatment is an exciting research topic with great potential. Various chemotherapy treatments, including gemcitabine, result in better outcomes than supportive care, and combination chemotherapy with gemcitabine and a platinum-based agent is even more efficacious than gemcitabine alone.

[Comment] Prostate cancer therapy: finding the right balance
More than 30 years ago Willet Whitmore, one of the pioneers in urological oncology, asked the question: “If cure is necessary, is it possible, and if cure is possible, is it necessary?” Such questioning can be applied to the use of androgen suppression therapy. Androgen suppression is an extremely powerful treatment that can help control cancers that recur after primary therapy or are regarded as high risk at the time of presentation. Although clinicians can be proud of the successes obtained with such suppression, many patients who do extremely well might have been overtreated.

[Comment] PTLD treatment: a step forward, a long way to go
Post-transplant lymphoproliferative disorders (PTLD) are a heterogeneous group of diseases that develop as a consequence of immunosuppression in patients who have undergone solid-organ or haemopoietic-stem-cells transplantation. PTLDs include a series of disorders ranging from Epstein-Barr virus (EBV)-driven polyclonal proliferation to disorders indistinguishable from some B-cell lymphomas or, less often, T-cell lymphomas. Although the diagnosis can be suspected by clinical features (ie, lymphadenopathy), serum markers (ie, increasing concentrations of serum lactate dehydrogenase), imaging studies, and an increase in the EBV viral load, definitive diagnosis eventually relies on tissue biopsy.