Annals of Oncology 

Abstract: Background: Monitoring the evolution of the cancer burden in Europe is of great value. Estimates of the cancer burden in Europe have been published for 2004 and estimates are now being presented for cancer incidence and mortality in Europe for 2006. Methods: The most recent sources of cancer incidence and mortality data have been collected and projections have been carried out using short-term prediction methods to produce estimated rates for 2006. Additional estimation was required where national incidence data were not available, and the method involved the projection of the aggregations of cancer incidence and mortality data from representative cancer registries. The estimated 2006 rates were applied to the corresponding estimated country population to obtain the best estimates of the cancer incidence and mortality in Europe in 2006. Results: In 2006 in Europe, there were an estimated 3 191 600 cancer cases diagnosed (excluding nonmelanoma skin cancers) and 1 703 000 deaths from cancer. The most common form of cancers was breast cancer (429 900 cases, 13.5% of all cancer cases), followed by colorectal cancers (412 900, 12.9%) and lung cancer (386 300, 12.1%). Lung cancer, with an estimated 334 800 deaths (19.7% of total), was the most common cause of death from cancer, followed by colorectal (207 400 deaths), breast (131 900) and stomach (118 200) cancers. Conclusions: The total number of new cases of cancer in Europe appears to have increased by 300 000 since 2004. With an estimated 3.2 million new cases (53% occurring in men, 47% in women) and 1.7 million deaths (56% in men, 44% in women) each year, cancer remains an important public health problem in Europe and the ageing of the European population will cause these numbers to continue to increase even if age-specific rates remain constant. Evidence-based public health measures exist to reduce the mortality of breast and colorectal cancer while the incidence of lung cancer, and several other forms of cancer, could be diminished by improved tobacco control.

Abstract: The 12th St Gallen International Breast Cancer Conference (2011) Expert Panel adopted a new approach to the classification of patients for therapeutic purposes based on the recognition of intrinsic biological subtypes within the breast cancer spectrum. For practical purposes, these subtypes may be approximated using clinicopathological rather than gene expression array criteria. In general, systemic therapy recommendations follow the subtype classification. Thus, 'Luminal A' disease generally requires only endocrine therapy, which also forms part of the treatment of the 'Luminal B' subtype. Chemotherapy is considered indicated for most patients with 'Luminal B', 'Human Epidermal growth factor Receptor 2 (HER2) positive', and 'Triple negative (ductal)' disease, with the addition of trastuzumab in 'HER2 positive' disease. Progress was also noted in defining better tolerated local therapies in selected cases without loss of efficacy, such as accelerated radiation therapy and the omission of axillary dissection under defined circumstances. Broad treatment recommendations are presented, recognizing that detailed treatment decisions need to consider disease extent, host factors, patient preferences, and social and economic constraints.

Abstract: The 13th St Gallen International Breast Cancer Conference (2013) Expert Panel reviewed and endorsed substantial new evidence on aspects of the local and regional therapies for early breast cancer, supporting less extensive surgery to the axilla and shorter durations of radiation therapy. It refined its earlier approach to the classification and management of luminal disease in the absence of amplification or overexpression of the Human Epidermal growth factor Receptor 2 (HER2) oncogene, while retaining essentially unchanged recommendations for the systemic adjuvant therapy of HER2-positive and 'triple-negative' disease. The Panel again accepted that conventional clinico-pathological factors provided a surrogate subtype classification, while noting that in those areas of the world where multi-gene molecular assays are readily available many clinicians prefer to base chemotherapy decisions for patients with luminal disease on these genomic results rather than the surrogate subtype definitions. Several multi-gene molecular assays were recognized as providing accurate and reproducible prognostic information, and in some cases prediction of response to chemotherapy. Cost and availability preclude their application in many environments at the present time. Broad treatment recommendations are presented. Such recommendations do not imply that each Panel member agrees: indeed, among more than 100 questions, only one (trastuzumab duration) commanded 100% agreement. The various recommendations in fact carried differing degrees of support, as reflected in the nuanced wording of the text below and in the votes recorded in supplementary Appendix S1, available at Annals of Oncology online. Detailed decisions on treatment will as always involve clinical consideration of disease extent, host factors, patient preferences and social and economic constraints.

Abstract: S. Novello1, F. Barlesi2, R. Califano3,4, T. Cufer5, S. Ekman6, M. Giaj Levra7, K. Kerr8, S. Popat9, M. Reck10, S. Senan11, G. V. Simo12, J. Vansteenkiste13 & S. Peters14 on behalf of the ESMO Guidelines Committee* Oncology Department, University of Turin, AOU San Luigi-Orbassano, Orbassano, Italy; Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, Marseille, France; Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester; Department of Medical Oncology, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK; Medical Faculty Ljubljana, University Clinic Golnik, Golnik, Slovenia; Department of Oncology, Karolinska University Hospital, Stockholm, Sweden; Thoracic Oncology Unit, Centre Hospitalier Universitaire Grenoble Alpes (CHUGA), Grenoble, France; Department of Pathology, Aberdeen University Medical School, Aberdeen Royal Infirmary, Aberdeen; Department of Medicine, Royal Marsden Hospital, London, UK; Department of Thoracic Oncology, LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Centre for Lung Research (DZL), Grosshansdorf, Germany; Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands; Thoracic Surgery Service, Salamanca University Hospital, Salamanca, Spain; Respiratory Oncology Unit (Pulmonology), University Hospital KU Leuven, Leuven, Belgium; Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland