2018 April

Molecular tumor profiling is rapidly driving personalized medicine within oncology. The value of identifying a targetable mutation using next-generation sequencing for available therapies or clinical trials cannot be underestimated. Herein, we review essential considerations in the initial assessment, specialty referral, and sequencing of treatment for advanced prostate cancer with an identified actionable mutation.

The physician editor-in-chief of The Journal of Targeted Therapies in Cancer™, found 2 articles particularly interesting in this issue on therapeutic possibilities for patients with recurrent and metastatic epithelial cancers.. These articles show that combinatorial strategies harnessing conventional modalities such as radiation therapy (RT) and immune stimulatory approaches may have additional value for this population of patients.

Emerging data indicate that patients with metastasis to a limited number of sites may have improved outcomes with the use of locally ablative therapy. The availability of minimally invasive LAT has led to the widespread adoption of this practice for patients with oligometastatic disease. There are currently no clear predictors of improved survival after LAT across tumor subtypes. New data suggest the use of molecular biomarkers and combination therapies improve patient outcomes.

This article provides a short historical overview of major lung cancer vaccination studies performed in the last decade to set the perspective on the development of current clinical trials of therapeutic cancer vaccines for patients with non–small cell lung cancer. 

The treatment combination of the tyrosine kinase inhibitor axitinib plus pembrolizumab was tolerable in 52 patients with treatment-naïve advanced renal cell carcinoma, and the combination demonstrated promising antitumor activity, according to the lead researcher from Georgetown Lombardi Comprehensive Cancer Center in Washington, DC.

Patients who have intermediate or poor-risk advanced renal cell carcinoma may see extended progression-free survival and overall survival in a phase II trial comparing pazopanib with temsirolimus, according to a presentation by Nizar M. Tannir, MD, FACP, at the 2018 Genitourinary Cancers Symposium.

Reviewers Commentary: This article adds to the growing body of literature on the role of PARP inhibitors in tumors with DNA repair defects.

Cisplatin-based neoadjuvant chemotherapy followed by radical cystectomy has been the standard of care in muscle-invasive bladder cancer for almost 2 decades. However, the rates of NAC utilization remain low and many patients are ineligible to receive cisplatin due to diminished renal function or other factors. Additionally, there are no reliable biomarkers routinely used in clinical practice that identify patients most likely to benefit from NAC, and limited prospective comparisons of the NAC regimens.

<strong>IN THIS ISSUE OF </strong><em>The Journal of Targeted Therapies in Cancer</em>&trade;, 2 articles in particular impressed me as reflective of the evolution and development of therapeutic possibilities for patients with recurrent and metastatic epithelial cancers. Although the 2 may initially seem to have distinct focuses, it is now becoming apparent that combinatorial strategies harnessing conventional modalities such as radiation therapy and immune stimulatory approaches may have additional value for this population of patients.