Derek Raghavan, MD, PhD, FACP, FRACP, FASCO

In most cases, localized small-cell bladder cancer requires cystectomy for optimal cure rates.

The problem with large sets of data is the risk of the “GIGO” principle-viz. garbage in, garbage out-and it requires a very careful and thoughtful investigator to rule out the many errors of large-scale data capture.

Germ cell tumors (GCT) are an exemplar of the successful use of chemotherapy and of the successful interplay of phase II and phase III trials. The biggest contributor to cure in metastatic GCT is cisplatin-based chemotherapy, unchallenged after more than 30 years.

The “experts” should maintain a stringent standard regarding what merits further development and reconsider carefully and critically the available data before committing to PARP inhibition, attacks on the PI3K pathway, and vasoactive agents in prostate cancer.

This review summarizes recent findings in clinical prostate cancer research reported at the 2012 Annual Scientific Meeting of the American Society of Clinical Oncology (ASCO) and addresses their relevance to clinical practice.

I think it is a real shame that inside the Beltway, both sides of the political arena have had neither the wisdom nor the courage to recognize and address the fact that medicolegal drivers will continue to push costs upward until someone takes the lead in tackling this issue.

I am troubled by the approach we seem increasingly to be taking, as a profession, in advising the public on cancer screening.

For the September and October issues of ­ONCOLOGY, we have assembled a team of experts in the diagnosis and management of early-stage prostate cancer-ie, disease that has not clinically metastasized at first presentation, and which is theoretically curable-and have asked them to take a position on optimal patterns of care.

The treatment of metastatic renal cell carcinoma (RCC) has changed dramatically over the past few years. An improved understanding of the biology of RCC has resulted in the development of novel targeted therapeutic agents that have altered the natural history of this disease. In particular, the hypoxia-inducible factor (HIF)/vascular endothelial growth factor (VEGF) pathway and the mammalian target of rapamycin (mTOR) signal transduction pathway have been exploited. Sunitinib malate (Sutent), sorafenib tosylate (Nexavar), bevacizumab (Avastin)/interferon alfa, and temsirolimus (Torisel) have improved clinical outcomes in randomized trials by inhibiting these tumorigenic pathways. Combinations and sequences of these agents are being evaluated. Other novel multitargeted tyrosine kinase inhibitors (pazopanib and axitinib) and mTOR inhibitors (everolimus) are in clinical development. Recently reported and ongoing clinical trials will help further define the role of these agents as therapy for metastatic RCC.

There is an increased incidence of cancer in minority populations, accompanied by reduced survival. This review will address specific areas of disparity in cancer care, including prevention, diagnosis, treatment, and outcomes, and will consider steps toward resolving these issues.

The elegant and thoughtful review of current management of renal cell carcinoma, by Feldman and Motzer,[1] indicates that there has been clear and defined progress in the management of this frustrating disease. Our limited understanding of the biology of the immune response in renal carcinoma has led to the use of the interferons and varying doses of interleukin-2 (Proleukin), occasionally and inconsistently achieving spectacular, durable responses, but often at the cost of significant toxicity.

The management of germ cell tumors has advanced dramatically,with cure rates approaching 90% to 95%. Treatment of stage I/Aseminomas generally includes orchiectomy and adjuvant radiotherapy.Treatment of stage I/A nonseminomatous germ cell tumors involvesorchiectomy followed by retroperitoneal lymph node dissection oractive surveillance. One of the major advances has been the introductionof cisplatin-based chemotherapy for metastatic disease and thedevelopment of a system of risk attribution. The logical managementof any patient with curable disease is to provide curative therapy andthen follow the patient in a structured manner, to diagnose and treatany complications in a timely manner.

The second edition of the Textbook of Uncommon Cancer is a useful resource for practicing oncologists who encounter unusual presentations of common tumors or esoteric subtypes of more common cancers. The text is laid out according to