Having just returned from the10^Th国家癌症研究所（NCRI）会议– the UK’s biggest cancer meeting –BMC医学takes a look at some key themes and new research presented at the meeting.

NCRI 2014将利物浦的临床医生，科学家，患者，资助者和许多其他群体汇集在一起​​，以展示和讨论癌症研究中的最新发现。

癌症风险和预防

One of the key themes of the meeting was cancer prevention. As highlighted byPeter Sasieni，，，，smoking is the number one cause of cancer, and removing tobacco would substantially reduce the number of people developing cancer. However, Tim Lobstein from the世界肥胖联合会解释说，吸烟后，超重是第二重要的癌症可预防危险因素。

“Diet is the new tobacco透明– Tim Lobstein, World Obesity Federation

Lobstein强调，为了减少可预防癌症的发生，需要在戒烟工作中进行协调的努力，以改善饮食和减少肥胖症。

专注于预防药理癌症，Jack Cuzick解释说，预防性芳香酶抑制剂在预防患有这种疾病的高风险的女性乳腺癌的临床试验中显示出令人鼓舞的结果。Cuzick描述了IBIS-II预防试验，，，，which revealed thatanastrozoleis more effective than他莫昔芬in preventing the return of breast cancer in postmenopausal women. Increasing evidence also points towards taking regular aspirin as an effective way to prevent cancer; Peter Rothwell from Oxford University outlined the research, discussing how the risk:benefit ratio of taking daily aspirin should be carefully considered.

除了这些可修改的癌症危险因素外，基因在确定个人患癌症的机会方面起着关键作用。Sir Mike Stratton，他的早期工作确定了BRCA2breast cancer susceptibility gene，，，，explained that the next 5 years should see some infrequently mutated cancer genes unveiled, to provide further insights into genetic cancer susceptibility. Of course, genetic and environmental risk factors do not operate independently; in a评论published inBMC医学’sSpotlight on breast cancer本文收集、奥利维亚·弗莱彻和弗兰克Dudbridge discuss gene-environment interactions that could modify breast cancer risk, and explain that a number of these putative interactions require further validation in large cohort studies.

Caring for cancer patients: therapeutic strategies and palliative care

许多治疗策略 - 来自neoadjuvant chemotherapy在NCRI上探索了针对特定肿瘤蛋白的治疗。在临床试验展示中，科琳·菲弗尔·芬（Corinne Faivre-Finn）从REST phase III clinical trialshowing that thoracic radiotherapy improves survival in patients with small-cell lung cancer.海伦娜·伯爵提供了证据证明血管生成抑制剂贝伐单抗与新辅助化疗相结合的乳腺癌患者的益处。伯爵解释说，在调查新辅助环境中的疗法时（即手术前给予的治疗），可以将病理完全反应用作在没有整体生存信息的情况下用作治疗疗效的量度。

尽管许多临床试验在改善癌症患者的寿命方面表现出非常有希望的结果，但延长寿命可能并不是所有患者的主要优先事项。如概述罗杰·威尔逊，，，，founder ofSarcoma UK对于某些患有更晚期癌症的患者，姑息治疗的患者代表可能比强烈的治疗更可取，并且应与患者一起做出临床决策。艾琳·希金森（Irene Higginson）discussed the integration of oncology and palliative care, giving the example of how breathlessness support can be integrated into cancer care. In arandomized controlled trialpublished in BMC Medicine, Morag Farquhar and colleagues show that the呼吸干预服务（（BIS) is effective for relieving dyspnea in advanced cancer patients, and in an accompanying guest blog, Sara Booth describes the development of this intervention and how it can help patients cope with breathlessness.

展望未来：基因组学

许多演讲者专注于个性化的患者护理，探索了基因组医学的概念，以帮助指导治疗决策。Lewis Cantley在许多癌症类型的靶向磷酸肌醇3-激酶（PI3K）的全体会议上，开放了会议，突出了B细胞癌中通常使用PI3K靶向剂的方式，例如idelalisib，现在正在接受其他具有PI3K改变的癌症类型的试验。拉马萨米·戈文丹discussed recent progress in lung cancer genomic profiling and described that some genetic alterations can be targeted therapeutically, for examplecrizotinibTherapy can be given to lung cancer patients withALKrearrangements。

Looking to the future of genomic cancer medicine, a debate on转移性乳腺癌中的基因组医学：炒作还是现实？在会议上举行。认为这是一个realistic prospect,大卫·卡梅隆andIain Macphersonemphasized that genomic medicine is already here and cannot be ignored, explaining the results of theSafir-01试验，，，，where Fabrice André and colleagues carried out the first study of its kind to test genomically-driven treatment in metastatic breast cancer. Macpherson argued that:

“tumor heterogeneity is a fact; a patient-centric approach is required to deal with it透明

大卫·迈尔斯（David Miles）and安德烈亚斯·马克里斯（Andreas Makris）反对基因组医学已经在这里的情况。Miles解释说，在肿瘤中鉴定出的突变可能不会推动癌症的进展，并且癌症可以迅速适应靶向疗法，并指出：

“一个愚蠢的肿瘤比10位肿瘤学家更聪明透明

Kimberly Blackwell and Mark Robson debate the use of tumor mutation profiling and next-generation sequencing in aforum debate articleinBMC医学。While Blackwell supports Cameron and Macpherson’s view that genomic medicine is ready for the clinic, Robson argues that genomically-directed therapies are not yet appropriate for routine use.

These debates highlight that while genomic medicine holds a great deal of promise in breast cancer and other cancer types, it is still a very controversial topic. We look forward to the results of further genomic-driven clinical trials to further elucidate whether genome-directed therapies represent a viable future in cancer medicine. As concluded by Sir Stratton, the next 20 years should address whether genomic sequencing and molecular-guided therapy will become the new standard of care.

基因组医学论坛的辩论以及弗莱彻（Fletcher）以及达德布里奇（Dudbridge）关于基因环境互动的评论，以及来自FabricAndré和Sunil Verma的文章，可以作为我们的一部分免费访问Spotlight on breast cancer文章集合。本文现已开放用于研究提交，如果您有任何研究，您希望我们考虑将其纳入该系列，请通过电子邮件发送电子邮件。bmcmedicineeditorial@biomedcentral.com

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