ecancermedicalscience editor's choice for March 2015

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Published: 9 Apr 2015
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Prof Gordon McVie - ecancer and European Institute of Oncology, Milan, Italy

Managing editor, Prof Gordon McVie, discusses the top articles from March 2015, published in ecancermedicalscience.

Articles mentioned are:

Is IORT ready for roll-out?

Biology of colorectal cancer

Current management approach to hidradenocarcinoma: a comprehensive review of the literature

Hello, welcome to ecancer.

I’m Gordon McVie.

I’m just going to review last month, that’s February’s, activities at ecancer.

The big highlight for me personally was going to Lima in Peru for the first ecancer cancer congress in Latin America.

We’re organising our own cancer events now and this was the first in Latin America.

450 oncologists from every country in Latin America except Paraguay.

Just extraordinary, two days of very high quality papers, nearly all of them in Spanish.

Mine had to be translated inevitably.

Paolo Veronesi from IEO was there and Mattia Intra also talking about limited surgery for breast cancer and intraoperative radiotherapy; more of that in a second.

The meeting was implemented by a local team there called Crystal, together with Samantha Salas in Bristol who is our Latin America project manager.

There were 450 medical students appearing the day before and they also had a congress, a mini congress, of their own.

There was a superb workshop, two afternoons, run by Paola De Castro from the Istituto Superiore di Sanità in Rome about how to write scientific articles – extremely important for everybody but particularly for the Spanish scientists and clinicians who feel that they don’t necessarily always get best treated by the American and European journals.

So that was a big success and we’ll be doing more of these events in Latin America and in Europe.

Now to the articles.

I’d like to highlight a very nice paper from Emanuela Esposito and Michael Douek at Kings in London.

They looked very critically at the two big trials which have reported now on intraoperative radiotherapy for breast cancer.

The big TARGIT trial which was run predominantly in London and the trial from the European Institute of Oncology called ELIOT which was masterminded by Roberto Orecchia, the new Scientific Director.

Both these trials recruited well; the follow-up for the Milan trial is a couple of years longer.

The first matter of interest was that the planners of the two trials had overestimated the local regional recurrence from conventional radiotherapy post-surgery because in both these trials the conventional radiotherapy arm scored around 1-2% lower than had been expected.

The two trial arms in TARGIT were looking at a slight increase in local regional recurrence, about 3% and in the Milan trials a little higher than that.

The conclusion and the recommendations from Douek and Esposito are quite clear that this is a very attractive, attractive for patients particularly, mode of giving radiotherapy and it is very safe and it’s very effective.

Given a careful choice of patients, so we’re looking at the ASTRO and the ESTRO criteria for small volume disease, given those guidelines then there are a group of patients who absolutely definitely should be considered for intraoperative radiotherapy.

Then there are a couple of review articles which I commend to you.

One is from Venezuela, from Caracas, and it’s looking at the biology of colorectal cancer.

It’s very complete, it’s got a lot of references and it takes you step by step through the last ten years of the literature.

The other comes from the other side of the globe, from India.

I’ve not seen a lot of hidradenocarcinomas, that’s cancer of the sweat gland; I’ve seen, I think, three in my forty years as a consultant medical oncologist but in India they are much more common.

All head and neck cancers are common and the Indian doctors are really the masters of this whole field.

This is a review from Haryana Cancer Centre in India. The authors are Chauhan and Kaushal, the senior authors, and they both work in Haryana.

They have reviewed this thankfully quite rare cancer and they make the point that although it appears as a sweat gland tumour and one would think that would be fairly innocuous, actually these are aggressive tumours.

They have a terrible reputation for local recurrence and they metastasise quite vigorously.

The recommendation from the review is that there’s nothing yet better than wide excision surgery.

There’s no clear evidence that post-operative radiotherapy or pre-operative radiotherapy actually improves the outcome and a variety of the usual culprits in the cytotoxic field, the fluoropyrimidines, the anti-purines, the anti-DNA drugs, the platinums and so on, they really do not have much of an impact.

So the key to this cancer, hidradenocarcinoma, is early detection and wide excision surgery.

Another ecancer event in Milan, in the European Institute, where we’re reviewing angiogenesis as it applies to gastric cancer.

The first drug for gastric cancer based on an antiangiogenesis effect has just been approved by the FDA and perhaps is through the EMA by now and we’ll be looking at the procedures and the biology and the pathobiology and the results of clinical trials.

So that’s angiogenesis in gastric cancer and we’re making some educational modules from it.

That’s it for February and I’ll report in a month’s time.