Highlights of This Issue

Abstract

The impact of pretransplantation iron overload on patient outcome after allogeneic stem cell transplantation is controversially discussed, because recent studies were retrospective in nature and relied on interference prone surrogate markers. Wermke and colleagues report prospective data based on liver MRI to quantify the extent of body iron in this context. In their cohort, surrogate parameters failed to accurately identify iron overloaded patients. Moreover, only liver iron as determined by MRI but not serum ferritin or transfusion burden predicted for survival. It will be important to understand the mechanisms by which excessive iron contributes to a worse outcome after transplantation.Measurement of HER family signaling is critically important in the clinical management of a significant number of breast cancer patients. Using a highly sensitive protein array, Wulfkuhle and colleagues identified a new subgroup of breast cancer patients with HER2 pathway activation in an otherwise HER2- negative cohort. These patients are not identified by current clinically approved or genomic tests for HER2, and are thus excluded from anti-HER2 therapies. Protein pathway activation mapping of receptor tyrosine kinases and linked signaling pathways may identify new patient cohorts that could benefit from existing FDA cleared and/or experimental molecular targeted inhibitors, if these measurements prove clinically useful.The novel magnetic resonance imaging method of vessel size imaging (VSI) provides in vivo images of blood volume and mean vessel radius. Using an intravascular contrast agent of the ultrasmall paramagnetic iron oxide class, Nielsen and colleagues utilized VSI for investigating the effect of the vascular disrupting agent combretastatin in a murine tumor model. Treatment with combretastatin reduced blood volume and indicated a change in the distribution of vessel sizes. VSI may be valuable in assessing tumor angiogenesis, prediction of response to vascular disrupting agents, and treatment monitoring.Adjuvant setting represents the optimal set to test the tumor vaccines because of the more conserved immune conditions of early cancer patients. In this phase II randomized trial, Filipazzi and colleagues used modified tumor peptides to immunize stage II–III melanoma patients. However, in spite of a prompt and persisting immune response, no evident clinical benefit was detected in vaccinated versus control patients. The limited number of true antitumor T cells induced by vaccination, unraveled by an extensive immunologic monitoring, shows that the choice of the immunization strategy is a critical step and that the use of modified peptides should be reconsidered.