Jennifer R. Eads, MD; Neal J. Meropol, MD; Jerry L. Spivak, MD
This article was published at www.annals.org on 11 April 2013.
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0272.
Requests for Single Reprints: Jennifer R. Eads, MD, University Hospitals Case Medical
Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH 44106; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Eads: University Hospitals Case Medical Center, 11100
Euclid Avenue, Lakeside 1200, Cleveland, OH 44106.
Dr. Meropol: University Hospitals Case Medical Center, 11100 Euclid Avenue, Wearn 145, Cleveland, OH
Dr. Spivak: Johns Hopkins University School of Medicine, Traylor 924, 720 Rutland Avenue, Baltimore,
Author Contributions: Conception and design: J.R. Eads, N.J. Meropol, J.L. Spivak.
Analysis and interpretation of the data: J.R. Eads, N.J. Meropol, J.L. Spivak.
Drafting of the article: J.R. Eads, N.J. Meropol, J.L. Spivak.
Critical revision of the article for important intellectual content: J.R. Eads, N.J. Meropol, J.L.
Final approval of the article: J.R. Eads, N.J. Meropol, J.L. Spivak.
Collection and assembly of data: J.R. Eads, N.J. Meropol, J.L. Spivak.
Eads J., Meropol N., Spivak J.; Update in Hematology and Oncology: Evidence Published in 2012. Ann Intern Med. 2013;158:755-760. doi: 10.7326/0003-4819-158-10-201305210-00105
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Published: Ann Intern Med. 2013;158(10):755-760.
Cytotoxic chemotherapy remains the mainstay treatment of most cancers, but new agents with greater target
specificity are being developed to treat molecularly defined cancers. In 2012, this opportunity was
highlighted by publication of a comprehensive genetic characterization of breast, colorectal, and squamous
cell lung carcinomas by The Cancer Genome Atlas Network researchers. Treatment advances have paralleled
these findings with application of mechanism-driven, highly selective, targeted therapeutics for prostate,
breast, colon, skin, and thyroid cancers. Here, we highlight several key laboratory and clinical advances in
medical oncology that represent a new generation of opportunities for patients with cancer.
A focus on mechanism has also characterized important advances in hematology. Building on the success in
targeting the BCR-ABL kinase in patients with chronic myelogenous leukemia (CML), a new tyrosine kinase
inhibitor (TKI), ponatinib, has shown efficacy in patients with resistance to other available agents.
Similarly, a new Janus kinase (JAK) inhibitor, ruxolitinib, improved survival of patients with primary
myelofibrosis (PMF). Other recent clinical advances in hematology include testing of a therapeutic
phlebotomy goal of hematocrit less than 45% in patients with polycythemia vera and clarification of the role
of the 4Ts clinical prediction model for heparin-induced thrombocytopenia (HIT) in decisions about
discontinuation of heparin therapy.
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