Reviews & Analysis

Gastric cancer is a heterogeneous disease with almost one million new cases occurring annually worldwide. The year 2012 saw important successes and failures in gastric cancer treatment, and also novel insights into the molecular characterization of this disease, which may lead to the development of more-effective targeted therapies.

In 2012, we increased our knowledge of the molecular portrait of breast cancer. The BOLERO-2 and CLEOPATRA trials led to the approval of everolimus and pertuzumab; and the EMILIA trial will likely result in the approval of T-DM1. Some of these findings represent a paradigm shift in the way we think about the biology and management of breast cancer.

In 2012, advances in molecular profiling of primary brain tumours allowed identification of subgroups of glioma and medulloblastoma that were associated with distinct prognoses and predicted treatment response. Adjuvant chemotherapy is now established for 1p/19q co-deleted anaplastic oligodendrogliomas, and may be the preferred treatment in elderly patients with glioblastoma with a methylated MGMT promoter.

In the past year, long-term follow-up of trials have confirmed and disproved paradigms in the treatment of colorectal cancer, and identified a chemoprevention agent. In metastatic disease, chemotherapy in unresected primary tumours was studied, and randomized phase III trials introduced new therapy options. Molecular characterization of colon and rectal tumours offers new drug targets.

Progress was made in major aspects of acute myeloid leukaemia in 2012. Gemtuzumab ozogamicin and decitabine were shown to improve outcomes, relapse after stem-cell transplantation might be prevented by selecting donors according to their KIR genotypes, and next-generation sequencing has provided insights into mutational patterns and disease evolution.