During the past decade, scientific evidence has emerged that shows that radiotherapy can induce: A) immunogenic cell death, a form of cancer cell death that is effectively signaling to the immune system; and B) a series of “danger” and pro-immunogenic signals that are sensed by the host’s immune system, and can be harnessed to reject the tumor.
Advances in basic science and clinical medicine in the past few decades have increasingly elevated the profile of personalized medicine, ie, the identification of individual tumor or biologic features that offer targets for therapy.
The aggressive management of brain metastases with SRS has supplanted radiation therapy in an effort to maintain patient quality of life in an era of advancing systemic cancer options.
Until prospective randomized clinical data accrue and mature, this controversial issue will continue to suffer from overinterpretation of inadequate supporting data.
Men with high-risk nonmetastatic CRPC should if possible be enrolled in a clinical trial and that patients with low-risk disease can be safely observed.
Overall, the future of patients with MCL is promising, since therapeutic options have widened. The implementation of universal aggressive treatment is challenged by novel regimens, targeted agents, the use of MRD to guide treatment decisions, and new trials that will directly compare transplant vs non-transplant approaches.
We are ready to move beyond a “one-size-fits-all ” approach in AML and join our colleagues treating other malignancies, such as lung cancer, in moving towards a personalized medicine approach.