This issue of The American Journal of Hematology/Oncology® features insightful reviews on metastatic colorectal cancer, Hodgkin lymphoma, lung cancer, and polycythemia vera (PV). A common challenge addressed throughout the papers is the problem of resistance, which develops over time. It is the hope that these reviews, while providing the latest rationale for therapeutic options, at the same time spurs the innovative clinician to consider new approaches to managing these cancer types.
In “Targeted Therapy and the Use of Molecular Profiling in Metastatic Colorectal Cancer,” Dr Gagandeep Brar and colleagues comment on the role of predictive biomarkers in identifying subpopulations of patients who would benefit from appropriately targeted therapy and the magnitude of benefit of those therapies.
The field of Hodgkin lymphoma is rapidly changing. For example, in the treatment-naïve setting, Lorie A. Leslie, MD, and coauthors suggest that radiation therapy will be used more selectively, as novel agents are incorporated into upfront treatment regimens with the goal of decreasing long-term toxicity. In “Reshaping the Field of Hodgkin Lymphoma,” they discuss how to best use a PET-adapted approach to escalate versus de-escalate treatment.
In 1 of 2 lung cancer manuscripts in this issue, Luis E. Raez, MD, and Christian Rolfo, MD, PhD, MBA, discuss an interesting case involving a patient who developed a T790M mutation after erlotinib therapy. The use of liquid biopsy demonstrated this evolutionary genomic change after a tumor biopsy failed to do so. Another resistance mutation, c797s, was discovered after osimertinib therapy. In the second manuscript, Drs Zweig and Wakelee review frontline trials of ceritinib and alectinib in ALK-positive non–small cell cancer, drawing comparisons with crizotinib, the only FDA-approved frontline choice until the recent approval of ceritinib. With several new promising options, they attempt to better answer the question of which ALK tyrosine kinase inhibitor should be favored upfront.
In “Polycythemia Vera: Contemporary Updates in Diagnosis, Prognosis, and Treatment,” Saba S. Shaikh, MD, and Brady L. Stein, MD, MHS, discuss recent developments in the epidemiology of PV. They note that the molecular pathogenesis of the condition continues to be characterized, and the diagnostic criteria allow for recognition of more subtle presentations of PV.
This month’s CME article features an interview with Angela DeMichele, MD, MSCE, the Jill and Alan Miller Endowed Chair in Breast Cancer Excellence at the Abramson Cancer Center at the University of Pennsylvania. She provides an overview of the current and emerging role of PARP inhibitors in breast cancer.Michael J. Hennessy, Sr
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