In the last five years, IDH1 mutations in human malignancies have significantly shaped the diagnosis and management of cancer patients. Ongoing intense research efforts continue to alter our understanding of the role of the IDH1 mutation in tumor formation. Currently, evidence suggests the IDH1 mutation to be an early event in tumorigenesis with multiple downstream oncogenic consequences including maintenance of a hypermethylator phenotype, alterations in HIF signalling, and disruption of collagen maturation contributing to a cancer-promoting extracellular matrix. The most recent reports elucidating these mechanisms is described in this review with an emphasis on the pathogenesis of the IDH1 mutation in glioma. Conflicting findings from various studies are discussed, in order to highlight areas warranting further research. Finally, the latest progress in developing novel therapies against the IDH1 mutation is presented, including recent findings from ongoing phase 1 clinical trials and the exciting prospect of vaccine immunotherapy targeting the IDH1 mutant protein.

Objective: Cancer has been reported to trigger symptoms of post-traumatic stress disorder (PTSD) in a substantial proportion of individuals. Despite the significant burden associated with these symptoms, there are as yet no therapeutic guidelines. This systematic review aims to evaluate the effectiveness of interventions for cancerrelated post-traumatic stress in order to provide an evidence base for developing appropriate clinical practice. Methods: Databases searched until April 2018 included Psych INFO, EMBASE, Medline, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). No restrictions to study design were applied. Participants aged 18 years or older who received their cancer diagnosis in adulthood and had symptoms of cancer-related PTSD were included. Because of significant clinical heterogeneity, a meta-analysis was not performed. Results: Of 508 unique titles, eight studies met study inclusion criteria: five randomised controlled trials (RCTs), one before-and-after study, one case series, and one case study. Interventions were predominately psychological and were administered to patients with a range of cancer types. Eye movement desensitisation and reprocessing and cognitive behavioural therapy-based interventions were associated with reduced symptomatology; however, overall the methodological quality of studies had limitations. Conclusions: At present, there is only weak evidence available for the effectiveness of psychological interventions in reducing symptoms of cancer-related PTSD. The majority of interventions were administered to all cancer patients regardless of whether they showed pretreatment levels of post-traumatic stress. Future studies would be better targeted towards patients with a diagnosis of cancer and who have significant levels of cancer-related post-traumatic symptoms. Higher quality trials are also needed before treatment recommendations can be made.

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BackgroundAdvances in immunohistochemistry have spearheaded major developments in our understanding and classification of sinonasal tumours. In the last decade, several new distinct histopathological entities of sinonasal cancer have been characterised.ObjectivesThis review aims to provide a clinical update of the major emerging subtypes for the ENT surgeon and an overview of the management strategies available for this heterogeneous group of pathologies.ConclusionAlthough rare, knowledge of sinonasal neoplasm subtypes has implications for prognosis, treatment strategies and the development of novel therapeutic targets.