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1. Highlights from Adis Journals
1.1 Cancer
Role of Genotyping in Non-Small Cell Lung Cancer Treatment: Current Status
Non-small cell lung cancer (NSCLC) is a common malignant disease with an extremely poor prognosis. Chemotherapeutic treatment for advanced disease is currently based on histologic subtyping, but recent discoveries of genetic alterations in subsets of NSCLC have already changed clinical practice with regard to EGFR mutations as predictive markers of response to gefitinib and erlotinib. This has also paved the way for the integration of molecular analyses into early-phase clinical trials, as demonstrated by the clinical development of crizotinib, which is effective in lung cancer harboring ALK rearrangements. Similarly, other subgroups of NSCLC carry potentially targetable molecular alterations, and their study has the potential to change the diagnostic and therapeutic approaches to lung cancer in the near future. In contrast to a wealth of knowledge surrounding genomic alterations in lung adenocarcinomas, fewer data are available concerning squamous cell lung cancer (SCC), although recent data demonstrate that genotyping can provide new therapeutic perspectives in SCC treatment. Moreover, the study of molecular predictive markers of response to chemotherapy aims to improve chemotherapeutic treatment, increasing efficacy and limiting toxicity.
Bonanno L, Favaretto A, Rugge M, et al. Role of genotyping in non-small cell lung cancer treatment: current status. Drugs 2011; 71 (17): 2231-46
Tailoring Therapy for Locally Advanced Breast Cancer, Using Molecular Profiles: Are We There Yet?
The term 'locally advanced breast cancer' covers a range of clinical scenarios and has the implications that surgical clearance and local control will be difficult or impossible, and long-term survival rates will be poor. Treatment selection is particularly important in this group of patients to try to obtain maximum control of disease and to potentially improve surgical options and cure rates.
Currently, assessment of estrogen receptor, progesterone receptor, and human epidermal receptor 2 status in tumor samples remains the gold standard for prediction of response to endocrine therapy, chemotherapy, or targeted agents such as trastuzumab. Progress has been made in identifying markers that can help select treatments likely to be associated with response, and avoid those associated with resistance. These potential markers include the Ki67 proliferation rate, cytochrome P450 (CYP) 2D6 expression, BRCA1/2 gene status, and others.
Fosker C, Adlard JW, Shaaban A....