ONCOLOGY Vol 27 No 9

The Cancer Genome Atlas results have led to some encouraging advances in the clinical perspective on squamous cell lung cancer and spurred new initiatives targeting patients with squamous cell lung cancer, giving us hope for future improvements in clinical management and therapeutic outcomes for this subgroup of lung cancer patients.

The Cancer Genome Atlas provides us with our first thorough insight into the genetic heterogeneity of squamous cell carcinoma of the lung; whether these findings will translate into personalized squamous cell lung cancer therapy is yet to be determined.

We summarize here key findings from the comprehensive analysis of squamous cell lung cancer by The Cancer Genome Atlas group and discuss the clinical implications of these findings.

MZL comprises three different entities that require integration of clinical and pathologic features to make a diagnosis. Treatment is chosen and initiated on the basis of presentation, symptoms, and underlying subtype.

Clearly there is no single therapy for all patients with TNBC, given the molecular heterogeneity of this subtype. However, new insights from further genomic analysis of TNBC suggest approaches to rational clinical trial design, and patients will undoubtedly benefit as we define the most appropriate therapeutic targets in management of this aggressive disease.

The number of recently approved agents and those under investigation is promising. However, there are currently no recommendations regarding the optimal timing for use of these agents, a reflection of the lack of data in this area and the need for prospective studies.

This is an exciting time in the treatment of PTCL, but with this opportunity comes responsibility. The challenge of how to optimize a plethora of promising new therapies for a small number of patients will drive therapeutic decision making for the foreseeable future.

To define the differences between the subtypes of myeloma patients, not only prospective collection of clinical and laboratory data are needed, but also cytogenetics and molecular profiling.

Myelomas that “lack” a monoclonal protein can be divided further into those that produce some protein and yet do not secrete it or whose serum concentration is so low that it cannot be measured, and those that truly produce no monoclonal protein at all.

Triple-negative breast cancer (TNBC) remains a very challenging entity today, but with the identification of new targets and further optimization of therapy, the landscape for TNBC may not look so negative. In the future, “TNBC” may be considered an antiquated misnomer, as we will have identified various breast cancer subgroups based on what they “are” rather than what they “are not.”

We examine efforts to correct cost inequities of oral anti-cancer agents through legislation, and we look at further efforts to reduce the cost of oral chemotherapy via cycle management and waste reduction.

There will always be patients who are either not surgical candidates or who refuse radical cystectomy, but in all other cases radical extirpative surgery should be the preferred management for patients with HGT1 disease who fail to respond to intravesical bacillus Calmette-Guérin therapy.

Decades of experience now exist to support the use of chemoradiotherapy in the treatment of muscle-invasive bladder cancer. Chemoradiotherapy for T1 tumors that recur following bacillus Calmette-Guérin therapy is promising and provides an important curative alternative for those unable or unwilling to undergo radical cystectomy.

The patient is a 66-year-old male who presented to his primary care physician with a 3-week history of painless gross hematuria. He underwent a renal ultrasound that showed a left kidney mass.

In this article we briefly review the labeled indications for new agents for cutaneous and peripheral T-cell lymphoma, focus on data from the last 1 to 2 years, and on data from ongoing clinical trials, with the hope that in doing so we can help elucidate difficult treatment decisions.

With regard to potential research strategies relevant to the treatment of triple-negative breast cancer/basal-like breast cancer, potential targets include PTEN, INPP4B, PIK3CA, KRAS, BRAF, EGFR, FGFR1, FGFR2, IGFR1, KIT, MET, PDGFRA, and the HIF1-α/ARNT pathway. Many of these will be discussed further in this review article.

Sorting out the clinical implications of genomic data is going to require extensive or perhaps remarkably extensive clinical correlations; obtaining these clinical data will require the cooperation of our patients.

Numerous small series of patients suggest that the prognosis for non-secretory myeloma patients is likely no worse than the prognosis for patients with traditional secretory myeloma, and in some settings may be superior.