Management of stage III non-small cell lung cancer.

Optimal management of patients with locally advanced non-small cell lung cancer remains challenging in the context of this heterogeneous disease. Despite aggressive therapeutic approaches, survival benefits are still unsatisfactory for what might be viewed as a localized malignancy. A combined modality approach offers patients superior outcomes, especially because technological advances and refined surgical procedures now provide better results with fewer complications. Nevertheless, several features of therapy remain controversial and lack formal prospective data. Traditional cytotoxic chemoradiation therapy may have reached a plateau and future perspectives opting to integrate molecularly targeted agents and immunotherapy might be the way to improve outcomes in this disease subset.

Anti-EGFR Therapy for Metastatic Colorectal Cancer in the Era of Extended RAS Gene Mutational Analysis.

Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality worldwide. In the past 2 decades, advances in cancer therapeutics allowed for a remarkable improvement in terms of survival for patients with metastatic CRC. The advent of targeted therapy, coupled with more efficient chemotherapy regimens, was the pillar achievement that contributed to the success of CRC therapy. Cetuximab and panitumumab, monoclonal antibodies targeting the epidermal growth factor receptor pathway, are the focus of this review since their mechanism of action and efficiency are closely related to the mutational status of a predictive biomarker, the Kristen rat Sarcoma viral oncogene (KRAS). More recently, another biomarker, the neuroblastoma rat sarcoma viral oncogene (NRAS), was found to be as valuable for the refinement of this targeted therapy. The arguments for the use of extended analysis of the RAS gene are thoroughly reviewed because they directly affect the choice of targeted agents and potentially the choice of backbone chemotherapy.

Maintenance therapies for non-small cell lung cancer.

Treatment of lung cancer had evolved during the last decade with the introduction of new chemotherapeutic regimens and targeted therapies. However, the maximum benefit reached after first-line therapy is limited by the cumulative toxicity of platinum drugs and the subsequent deterioration in performance status in a high percentage of patients who end up receiving not more than one line of treatment. Maintenance therapy had been introduced and evaluated in many large randomized trials showing a delay in tumor progression and an improvement in overall survival. This effective strategy should be taken into account when discussing the initial treatment plan and tailored according to the preferences of both patients and physicians.

Managing advanced penile cancer in 2014.

PURPOSE OF REVIEW: To highlight the recent treatment recommendations that are proposed to improve the outcomes of patients with advanced penile cancer. RECENT FINDINGS: Penile cancer is a rare disease that presents with many diagnostic and treatment specificities. Adequate treatment requires interdisciplinary discussions involving urologist oncologists, medical oncologists and radiation oncologists as well as many other health professionals. Localized disease can now be adequately treated with many different penile-sparing approaches associated with close surveillance. However, many patients present with high-risk features associated with an unfavorable outcome. Recent data and multiple interdisciplinary collaborative groups have fueled a more standardized approach to the treatment of these patients, leading to better survival outcomes and improved quality of life. This review will focus on the recognition of high-risk disease; the indications of lymph node dissections and minimally invasive surgical approaches; the role of neoadjuvant therapy in the setting of advanced lymph node involvement as well as the potential role of targeted therapy for the salvage treatment of metastatic disease. SUMMARY: Improved outcomes in advanced penile cancer requires an integrated approach, including better identification of high-risk disease, use of novel dynamic sentinel lymph node identification techniques and use of neo-adjuvant chemotherapy in selected patients with advanced lymph node involvement. Such cases should preferentially be managed by a dedicated interdisciplinary team.