A warm welcome to this edition of the Oncology & Hematology Review (US). Cancer care costs are placing an escalating burden on global healthcare systems, partly owing to the high price points for biological therapies. However, with patents on many of these biological treatments expiring, biosimilars offer the potential to reduce healthcare expenditure while improving patient access. Yet despite their promise, a regulatory pathway for biosimilars remains a significant challenge. The European experience of biosimilars, which includes a framework for approval established by the European Medicines Agency in 2006, is reviewed by Zelenetz. Crucially, Zelenetz highlights the need for healthcare professional education.
The most aggressive subtype of breast cancer, triple negative breast cancer, represents an important clinical challenge with no targeted therapy available. In the first article on this topic, Saha and Nanda explore drugs targeting the programmed death 1/programmed death ligand 1 axis while other recent updates in triple negative breast cancer management are presented by Sanft and Moran.
Cancer stem cells (CSC) are thought to play an important role in tumor pathogenesis and the gastrointestinal (GI) system provides a good example for CSC study. GI stem cells have a long life span and, coupled with rapid turnover, they may be predisposed to forming CSCs. As covered by Hubbard and Grothey, therapies that specifically target this subpopulation of cancer cells are opening exciting opportunities for future treatment.
Esophageal cancer, a highly lethal malignancy with rising incidence worldwide, is typically associated with symptoms of dysphagia and odynophagia and, sometimes, with chest pain, hoarse voice and other subjective upper GI symptoms. We report in this edition a patient whose primary presentation was left hemiparesis due to metastatic esophageal cancer to his brain. This is an exceptional case due to the absence of esophageal disease symptoms and it is possible that this case represents a particular subtype of esophageal cancer or it may just be one of the rarest cases.
The journal staff would like to thank all the contributors to this edition, from organizations to individuals and, in particular, the Editorial Board for their continued support and guidance. We hope you find the selection of articles in this edition stimulating and, as ever, we welcome feedback on any of the papers or suggestions for topics or controversies that you would like to see covered.