In this article, we present a 53 year old patient who had an acute tinnitus that led to the diagnostic of chronic myeloid leukemia(CML). This symptom allowed an early diagnostic of the disease and a more favorable pronosis. This case demonstrates the inportance of blood tests for every patient who presents a tinnitus of unknown origin.

For drug development and pharmaceutical research, targeting the molecular abnormalities is considered as a new challenge. A number of diseases including cancer are linked to perturbation of tyrosine kinase (TK). Imatinib (Glivec or Gleevec, Novartis), the most potent inhibitor of c-abl TK, was recently developed. This molecule has been approved in the treatment of chronic myeloid leukemia (CML). However, emergence of clinical resistance regarding a low rate of CML patients leads to intensive research. In the current article, we discuss the data and the mechanism of the resistance phenomenon. This review illustrates the important requirement to transfer back the information from patient to laboratory in order to improve future drug design.

Advances in the biology of Hodgkin's lymphoma have lead to the distinction between two entities, "classical" Hodgkin's lymphoma and nodular lymphocyte predominance Hodgkin's lymphoma, previously called nodular paragranuloma, which share distinct clinical aspects. The definition of diagnostic criteria has also been helpful to separate Hodgkin's lymphoma from other lymphomas which can mimick Hodgkin's disease such as anaplastic large cell lymphomas, T-cell/histiocyte rich diffuse large B-cell lymphoma, and some peripheral T-cell lymphomas, mainly angioimmunoblastic-type. Reed-Sternberg cell, the neoplastic cell of "classical" Hodgkin's lymphoma, still retains some secrets. Despite some controversies, there is more and more evidence for a lymphoid B cell origin. The involvement of Epstein-Barr virus, cytokines and/or oncogenes expression in the pathogeny can be suggested, although the precise mechanisms leading to transformation and/or accounting for tumour progression are still elusive. Recently, the roles of the pathway implicating the activation of NFkappaB as well as the autocrine secretion of interleukin-13 have been demonstrated.

Hepatocellular carcinoma (HCC) is among the fifth most common cancers worldwide. Its incidence is still rising in part because of the high level of hepatitis C virus infection. Tumor markers currently used such as serum alpha-foetoprotein are not sufficient for diagnosis of the tumor and satisfying follow-up of the patients. Mechanisms of hepatocarcinogenesis ar not completely understood although several altered genes have been described in HCC. The genetic changes involved can be divided in at least 4 different pathways, each pathway contributing to a limited number of tumors. These are: 1) the p53 pathway involved in response to DNA damage, 2) the retinoblastoma pathway involved in the control of the cell cycle, 3) the transforming growth factor-beta (TGF-beta) pathway involved in growth inhibition, and 4) the Wnt pathway involved in cell-cell adhesion and signal transduction. Alterations of the epigenetic regulation of gene expression have also been described. Evolution of molecular biology methods tends to the development of more global genomic approaches; microsatellite instability analysis, chromosomal instability analysis or gene expression profile analysis have been used to investigate HCC. Finally, attempts to develop molecular biomarkers based on peripheral blood analysis more easily accessible in clinical routine patients have also been developed.

Uveal melanoma is the most frequent intraocular cancer. The recent development of new technologies such as microsatellite analysis and comparative genomic hybridization have elucidated both the cytogenetics and the natural history of this disease. Fifty to 60% of uveal melanomas are linked to monosomy 3, which appears as an early and determinant event in tumor progression. Tumors with this anomaly have a very poor prognosis. Recent work suggests that this category of uveal melanomas represents a distinct pathological entity from that associated with normal disomy 3. Chromosome 6 aberrations probably make up a second entry point into the process of carcinogenesis, while gains in 8q seem to appear later in the natural history of uveal melanoma because of their higher frequency in larger tumors. Progress in genome analysis has identified regions in chromosomes 3, 6, and 8 as those most probably involved in tumorigenesis. It is to be hoped that this will soon lead to the discovery of the genes responsible.

Prostate cancer has an androgen-dependent growth mediated by the androgen receptor (AR). Androgen pathway blockage is the standard therapy for the treatment of prostate cancers at an advanced stage. In spite of an initial sensitivity, prostate cancers become more or less quickly towards androgen-independent. Hormone refractory can be due to amplification of AR gene, AR mutations and the increase in co-activator protein expression or in the 5alpha-reductase activity. These induce an agonist activity with the anti-androgens or others steroid hormones like estrogens on AR and allow AR activation with weak concentrations of androgens. Growth factors and cytokines can induce AR phosphorylation independently of the ligand fixation. In condition of androgenic deprivation, AR remains actively involved in the growth of the cancerous cells prostate. Nevertheless, there are others partial AR-independent pathways as neuroendocrine differentiation. The comprehension of these various mechanisms is the key of the development of more effective therapies on hormono-refractory prostate cancers.

Over 60 years old, acute lymphoblastic leukemia (ALL) represents between 16 and 31% of all adult cases. Pre-B and common ALL are frequent, while T-cell lineage ALL is under-represented in elderly populations as compared with younger adults. The frequency of Philadelphia chromosome seems also to increase with age and adversely influences complete remission (CR) and survival rates. Poor performance status, co-morbidity factors and early mortality during intensive induction chemotherapy are the main reasons for poor outcome. Few reports on effectiveness and toxicity of therapeutic regimens involving exclusively elderly patients with ALL have been published and only some of them were prospective studies. Age-adapted approaches with less aggressive chemotherapy have been applied. The overall response ranged from 12 to 85%. Toxic death during induction chemotherapy was observed in 7 to 42% of the patients. Among the patients who received a curative approach, the median overall survival duration ranged from 3 to 14 months, while it ranged from 1 to 14 months for those treated palliatively. New therapeutic approaches are warranted to improve the outcome in this age group of ALL patients.

Necropsy on a 9-month-old ARK/J mouse, presenting with a large thymic mass as well as generalized hypertrophic lymphadenopathy, revealed a generalized thymic lymphoma on histopathological examination. This strain of mouse is genetically predisposed to developing this type of neoplasm.

The early diagnosis of cutaneous melanoma alone is capable of significantly reducing the morbidity and mortality associated with this tumour. It is pertinent to all physicians who normally observe skin during the clinical examination; who must have a degree of suspicion for all recent or modified pigmented lesions, and should offer a cutaneous follow-up and advise decreased sun exposure in all patients with multiple naevi. The modification of a lesion, intensely black in colour, are the key elements which arouse suspicion of a melanoma and incite either its removal or a specialist opinion. The follow-up of the patient treated surgically for a melanoma is mainly clinical (skin, subcutaneous tissues, lymph node examination) but has to be consistent (more often on a trimesterly basis), systematic, and annual after 5 to 8 years, during the whole life of the patient with a high risk of a second melanoma. Equally, family members of a patient with a melanoma should also be systematically examined.

Hematodermic CD4/CD56 neoplasm is a recently described entity. This name has been initially proposed by the French Study Group on Cutaneous Lymphomas which established the primary anatomoclinical and pathogenic and cytogenic bases of the disease in 1999. This descriptive and provisional name allowed conceptualizing the entity by its main clinical and phenotypical characteristics. The first case in the literature goes back to 1994. Since that time, several other cases have been published. The expression of CD56 led most of the authors to propose an NK-cell lineage origin. In the last WHO classification of lymphomas, the entity was indexed under the name of "blastic NK-cell lymphoma". However, the authors underlined that there were currently no clues to the etiology of blastic NK-cell lymphoma and that the precise lineage of this disease was still unresolved. At the clinical level the main characteristics of the disease are the skin tropism and the occurrence of a leukemic phase at any time during the course of the disease. The median age is 59 but pediatric cases do exist. At the morphological level skin biopsy shows a monomorphous cell proliferation simulating a pleomorphic T cell cutaneous lymphoma. The diagnosis is based on phenotypic criteria which require frozen tissue. Currently, the main characteristics are the expression of CD4 and CD56 antigens while the main defined lineage specific markers are negative (B-cell, T-cell, NK-cell and myeloid-cell lineages). The origin of the tumor cells still remains uncertain but the plasmacytoid dendritic cell is presently a very serious candidate. The tumor cells share a great phenotypical homology and particularly the expression of the CD123 antigen. Functional homologies have also been demonstrated with tumor cells in vitro. Outcome of CD4/CD56 hematodermic neoplasms is very bad. The median time of survival is 14 months irrespective of the treatment given. Conventional chemotherapies used for the treatment of aggressive lymphomas or acute myeloid leukemias are quickly inefficient.

DNA chip is a recently developed technique allowing analysis of thousands of genes at the same time in multiple biological samples. In few years it has become an obligatory step in massive gene expression study. The enormous quantity of results generated and the new way of thinking allowed make this kind of study a true revolution.

The recent discovery of the role of the Patched Sonic Hedgehog pathway in the physiopathogeny of BCC (basocellular carcinoma) and Gorlin's syndrome has greatly improved our knowledge on the mechanism of development of these tumors. For the first time, murine models have been developed allowing to further understand other molecular events implicated in such tumors as well as providing in vivo models to search for new curative or preventive therapeutical strategies which would be helpful to control CBC multiple forms, that are often disabling.

The poor prognosis of pancreatic cancer has remained unchanged for many years, with a 5-year survival of less than 5 %. Current methods for diagnosing pancreatic cancer are inadequate at identifying small tumors that can be resected by surgery. Characterization of gene expression patterns in pancreatic cancer provided a list of genes that are specifically overexpressed in cancer cells. These genes are putative novel markers for the diagnosis and the prognosis of pancreatic cancer and for the development of targeted therapies. Gene expression analysis should lead to the discovery of molecular markers for early detection of pancreatic cancer that could benefit patients at high risk of developing pancreatic cancer.

There is emerging evidence from clinical and experimental data that familial breast cancers, including BRCA1 and BRCA2 related forms, could be in fact estrogen-sensitive. Interactions between BRCA1 gene expression and estrogens have been reported. On one hand, BRCA1 expression could be induced by estradiol in experimental models. On the other hand, recent studies indicate that BRCA 1 interacts with and regulates the activity of estrogen receptor ERalpha. Endogenous or exogenous estrogens, such as oral contraceptive, may also increase the risk of breast cancer in BRCA1 mutation carriers in clinical studies. Conversely, prophylactic oophorectomy and anti-estrogens may decrease the risk of familial breast cancer. Prospective studies are thus required to estimate the potential benefits of estrogen suppression therapies for prevention or adjuvant treatment of familial breast cancer. Oral contraception and hormonal replacement therapy after menopause should be used with caution in BRCA1 or BRCA2 mutation carriers.

The post-genomic era offers a huge challenge for scientists used to hand-made tailored approaches that can deal with deep insight into a small number of objects. Reciprocally, industry is used to undergo massively parallel approaches, dealing with large numbers but rather shallow insight. The complementation is obviously tantalizing, and Institut Curie and Hybrigenics (HGX) have signed an alliance in the field of cancer and signal transduction. A comparative proteomic approach was undertaken, where ortholog baits from Homo sapiens and flies were used to screen extremely complex two-hybrid cDNA libraries. New partners of "old" proteins have been identified, new networks have emerged, and unexpected connectors have been shown to link biological niches supposed to be independent.

More than 50% of the hereditary forms are associated with germ line mutation in either BRCA1 or BRCA2 genes (BReast CAncer 1/2). The BRCA1 protein is expressed ubiquitously and is likely to play a role in several fundamental processes, including the maintenance of genomic integrity. Paradoxically, BRCA1 appears as a gene essential for proliferation of embryonic cells that simultaneously carries tumor suppressor activity. The nature of the role of BRCA1 in DNA repair and maintenance of genome integrity remains enigmatic. BRCA1 may indeed be a sensor of "abnormal" DNA structures that undergo heterochromatinisation. This model finds some support in the recent report that BRCA1 participates in the maintenance of X-chromosome inactivation, a paradigm for facultative heterochromatinisation. Why are epithelial cells from mammary glands and ovaries the privileged targets for tumorigenesis in women carrying germline mutations in BRCA1? The inheritance of a single defective copy of BRCA1 by women confers a status of susceptibility for developing breast and/or ovarian cancer. The loss of the wild-type allele inherited from the unaffected parent (LOH), commonly observed in the primary breast and ovarian tumors in these susceptible women, represents the event that initiates the tumorigenesis process. This classical two hit model, which assumes that heterozygote cells are "normal" until the LOH occurs stochastically, remains enigmatic.