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HPV-associated second primary tumors may present as synchronous and/or metachronous lesions and can arise outside the oropharynx after prolonged intervals. Further work is necessary to identify patients at risk and to elucidate the mechanisms of HPV-associated head and neck second primary tumors.

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Background:Trastuzumab was approved in the United Kingdom for adjuvant treatment of human epidermal growth factor receptor 2 (HER2)+ breast cancer in 2006 at significant economic cost and with limited evidence in smaller T1N0 tumours. The South East Wales Cancer Network covers a population of 1 420 000 and maintains a database of treatments used. We examined this database to ensure the outcome of Trastuzumab use is as expected, especially in patients with T1N0 cancers.Ethods:M Case notes of patients with HER2+ disease eligible for adjuvant Trastuzumab over 2005–2008 were reviewed. Disease-free survival (DFS) and overall survival (OS) were calculated with the Kaplan–Meier method using SPSS (version 16.0.01 for Windows, SPSS, Chicago, IL, USA).Results:A total of 239 of 338 (70.7%) eligible HER2+ patients received treatment. At 3 years, the DFS of the treated group was 90.3% vs 73.3% and the OS was 98.5% vs 87.6%. In all, 47 of 92 stage I patients received Trastuzumab. Despite a trend towards worse prognostic factors in the treated group the DFS was 100% vs 84.1% and the OS was 100% vs 93.3%.Conclusion:Our results are comparable to those from landmark Trastuzumab trials. As evidence continues to emerge that smaller HER2+ cancers may behave aggressively our analysis of stage I tumours adds further support to the use of Trastuzumab in these patients.

Patients with de novo metastatic prostate cancer are primarily treated with androgen deprivation with very high (>95%) response rates, but all patients eventually develop castrate-refractory prostate cancer, which has a poor prognosis. Accumulating evidence suggests that continued androgen receptor signaling remains critical for survival and growth, with adrenal and intratumoral sources of androgens contributing to disease activation. Abiraterone acetate is a novel androgen biosynthesis inhibitor that has been shown to improve survival for patients with metastatic castrate-refractory prostate cancer who have progressed on docetaxel chemotherapy. It is a well-tolerated orally administered drug with a low incidence of serious side effects, taken with prednisone to reduce the secondary effects of mineralocorticoid excess. In the chemo-naive population, a recent trial has also shown improved outcomes, and ongoing studies are investigating its role even earlier in the disease course and in combination with other drugs.