The lancet oncology
-
Until 2010, docetaxel was the only agent with proven survival benefit for castration-resistant prostate cancer. The development of cabazitaxel, abiraterone acetate, enzalutamide, radium-223, and sipuleucel-T has increased the number of treatment options. ⋯ The challenge now is to reach a consensus on the best way to sequence effective treatments, ideally by the use of an approach specific to patient subgroups. However, the absence of robust surrogates of survival and the lack of predictive biomarkers makes data for the sequential use of these agents difficult to obtain and interpret.
-
The lancet oncology · Jun 2015
ReviewResponse assessment criteria for brain metastases: proposal from the RANO group.
CNS metastases are the most common cause of malignant brain tumours in adults. Historically, patients with brain metastases have been excluded from most clinical trials, but their inclusion is now becoming more common. The medical literature is difficult to interpret because of substantial variation in the response and progression criteria used across clinical trials. ⋯ Previous efforts have focused on aspects of trial design, such as patient population, variations in existing response and progression criteria, and challenges when incorporating neurological, neuro-cognitive, and quality-of-life endpoints into trials of patients with brain metastases. Here, we present our recommendations for standard response and progression criteria for the assessment of brain metastases in clinical trials. The proposed criteria will hopefully facilitate the development of novel approaches to this difficult problem by providing more uniformity in the assessment of CNS metastases across trials.
-
The lancet oncology · Jun 2015
ReviewNext-generation (epi)genetic drivers of childhood brain tumours and the outlook for targeted therapies.
Arguably, nowhere has there been a greater advance in our understanding of biological mechanisms and potential translational targets during the next-generation sequencing era than in paediatric brain tumours. The so-called omics revolution, enabled by high-throughput sequencing, has empowered large consortia and independent groups alike to make major genetic discoveries, from dominant-negative histone mutations and hijacking of distal enhancer elements, to new oncogenic gene fusions and aberrantly active gene expression. Epigenetic deregulation has also been revealed as a common theme across several tumour subtypes. This Review focuses on key findings that have been transforming the landscape of paediatric neuro-oncology research and how these results are opening new avenues towards potential therapeutic translation.