Medicine
Smoke without fire? Should cancer of unknown primary be treated as a separate disease?
Metastases, but no primary tumour – the diagnosis ‘cancer of unknown primary’ still presents great challenges, even in this age of precision oncology. Cancer of unknown primary (CUP) is an entity that encompasses a heterogenous group of metastatic cancers without…
Does it work for my patient? A pragmatic approach to building evidence on clinical effectiveness
Should patients be at the centre of attention in the development of new cancer drugs? It might seem extraordinary that this question is even asked – what else matters? But it is a question high on the agenda of the…
Are tumour-agnostic approaches the future for oncology?
According to Francesco Pignatti, Head of Oncology at the European Medicines Agency (EMA), the term ‘tumour agnostic’ is a misnomer. The definition of agnostic in ancient greek, he argues, is ‘lacking in knowledge’. But with these new approaches, it’s not…
Artificial intelligence for skin cancer diagnosis, from science-fiction to reality
Artificial intelligence (AI) is a hot topic in many sciences, including medicine. A machine capable of making a medical diagnosis in full autonomy is fascinating and highly attractive. “Many years ago, in the movie Star Trek, the spaceship’s doctor diagnosed…
Real world data: can we rely on it to shape cancer policies and practice?
In November 2018, the US Food and Drug Administration granted accelerated approval to larotrectinib (Vitrakvi), a drug that targets a neurotrophic receptor tyrosine kinase (NTRK) gene fusion in a range of adult and paediatric tumours. European approval followed last autumn.…
CCC-19 and TERAVOLT studies show strength and limits of research on cancer and COVID-19
The virtual scientific program of the 2020 American Society of Clinical Oncology (ASCO) Annual Meeting2020 hosted a special session on cancer and COVID-19 pandemic. Data from the Thoracic cancERs international coVid 19 cOLlaboraTion (TERAVOLT) registry and from the COVID-19 and…
Evidence-based medicine and precision medicine – irreconcilable or inseparable?
"Medicine cannot be learned quickly, because it is impossible for there to exist any established method in it, as for example when someone who has learned to write in one way that is taught then understands everything. Medicine from one…
Right drug, wrong patient: here’s how we improve our targeting
When it comes to precision and personalised medicine (PPM), clinical practice in oncology takes pride in developing and administering treatments that selectively target components of tumour cells. But, PPM is a model that also takes into account the inherent variability…
How to make precision drugs that work better
Six lessons from the development of the first targeted anti-cancer therapy Tamoxifen famously started life as a failed contraceptive, developed by ICI (now Astra Zeneca), but with the fatal flaw that it increased ovulation rather than suppressing it. It’s a…
AI will help Cinderella to see herself in the mirror
Many women who undergo breast reconstruction after mastectomy end up disappointed. It is estimated that as many as 30% of women have to live with aesthetic results they are not happy with. On the other hand, some of those who…