Current Oncology Reports最新文献

Purpose of review: Adamantinomatous craniopharyngioma (ACP) is a histologically benign but clinically aggressive tumor arising from Rathke's pouch remnants, which is molecularly distinct from the other subtype, papillary craniopharyngioma (PCP). Despite advancements in surgery and radiotherapy, treatment outcomes remain unsatisfactory due to the tumor's invasiveness and resistance to conventional therapies. This review systematically examines the molecular pathogenesis of ACP and evaluates current and emerging therapeutic strategies to improve clinical management.

Recent findings: ACP is driven by CTNNB1 mutations and dysregulated Wnt/β-catenin signaling, alongside inflammatory and senescence-associated pathways. Current pharmacological approaches, including interferon-α, IL-6 inhibitors (e.g., tocilizumab), and intracystic agents (e.g., bleomycin), exhibit limited efficacy. Promising emerging therapies target the angiogenesis (e.g., bevacizumab) and MAPK/ERK pathway, which is activated by somatic BRAF V600E mutations in PCP, has been successfully targeted with BRAF/MEK inhibitors, demonstrating significant efficacy in the majority of treated PCP patients. whereas immune checkpoint inhibitors and SHH pathway modulators face significant challenges. Additionally, ACP-related endocrine dysfunction and hypothalamic obesity require tailored interventions, such as GLP-1 receptor agonists and MC4R-targeted therapies. Precision medicine, informed by molecular subtyping and multi-omics data, holds transformative potential for ACP treatment. Future strategies should focus on combinatorial therapies to address tumor heterogeneity, microenvironment modulation, and senolytic approaches. Collaborative multidisciplinary efforts are crucial to translating these insights into clinical practice, ultimately enhancing patient outcomes and quality of life.

Purpose: Immunotherapy has transformed cancer treatment and outcomes. Patients receiving immunotherapy often encounter immune-related and treatment-related adverse events, leading to substantial supportive care needs. Currently, no recommendations exist to guide the use of non-pharmacological supportive care interventions for people with cancer undergoing immunotherapy treatments. This review aims to summarise the available evidence regarding non-pharmacological supportive care strategies to inform future clinical management and research directions.

Methods: Six electronic databases (PubMed, CINAHL, EMBASE, PsycInfo, Web of Science and Scopus) were systematically searched for studies on non-pharmacological supportive care interventions for adults undergoing immunotherapy, published from October 2014 to October 2024.

Results: A total of 5383 studies were screened, with 14 meeting the inclusion criteria. Five were interventional studies and ten were observational. The interventional studies included three physical activity and exercise interventions, two dietary interventions, and one multimodal intervention. Most interventions were found to be feasible, acceptable, and demonstrate preliminary efficacy at improving quality of life, symptom burden, and clinical outcomes. Observational evidence demonstrated associations between physical activity and dietary factors and improved quality of life, reduced symptom burden, and improved clinical outcomes.

Conclusion: Growing observational and preliminary interventional evidence suggests a multimodal supportive care intervention that includes regular symptom monitoring, dietary support and exercise to address the physical and psychosocial needs of cancer patients undergoing immunotherapy may be beneficial. However, further high-quality trials are needed to confirm their efficacy and inform clinical implementation.

Purpose of review: The treatment landscape for advanced non-small cell lung cancer (NSCLC) with common EGFR mutations has evolved significantly, with osimertinib established as the first-line standard. Two recent phase III trials, FLAURA2 and MARIPOSA, demonstrated that first-line intensification-through osimertinib plus chemotherapy or amivantamab-lazertinib-significantly prolongs overall survival compared to osimertinib alone. The aim of this review was to critically assess whether treatment intensification should be adopted as a new standard and, if so, in which patients.

Recent findings: We identified high-risk subgroups more likely to benefit from upfront combination strategies, such as those with brain or liver metastases, L858R mutations, TP53 co-mutations, or detectable ctDNA. However, the improved efficacy comes with increased rates of grade ≥ 3 adverse events and treatment discontinuation, raising concerns about tolerability and quality of life (QoL), particularly in real-world settings with frailer patients. Post-progression strategies are also evolving and may impact the long-term value of upfront intensification. Emerging approaches, including targeted and untargeted therapies, and novel antibody-drug conjugates (ADCs), offer promising alternatives that may change future treatment options. Careful patient selection, improved toxicity management, and integration of QoL measures will be critical to ensure that the survival advantage demonstrated in trials can translate into true benefit in routine clinical practice. Future research should focus on identifying robust clinical and molecular markers to guide personalized treatment decisions.

Purpose of review: Although current treatments have improved outcomes in B-cell malignancies, therapy resistance remains a major challenge and is often driven by the tumor microenvironment. The purpose of this review was to assess the roles of monocytes and monocyte-derived cells in leukemia and lymphoma and to evaluate the potential of therapies targeting these populations.

Recent findings: Recent studies indicate that monocytes and monocyte-derived cells are associated with poor prognosis, therapy resistance, and treatment-related side effects in B-cell malignancies. These cells can suppress anti-tumor immunity, support malignant cell survival, and impair therapeutic efficacy. Strategies to deplete or reprogram these populations have shown promise in restoring immune function and enhancing the effectiveness of current treatments. Targeting suppressive monocyte-derived populations offers a promising strategy to overcome therapy resistance and improve outcomes in B-cell malignancies. Modulating these cells may reduce relapses, enhance treatment responses, and provide a foundation for the development of next-generation immunotherapies. Nevertheless, further studies are needed to better define the immunosuppressive and therapy-relevant subpopulations in specific diseases, which will be critical to translating these strategies into effective clinical interventions.

Purpose of review: Non-small cell lung cancer (NSCLC) is a biologically and clinically heterogeneous disease. In addition to tumor-intrinsic characteristics, clinical outcomes from immune checkpoint inhibitors (ICIs) are influenced by a variety of host-related factors. This review aims to summarize current evidence on how body composition, metabolic comorbidities, sex, and systemic inflammation shape anti-tumor immunity and affect immunotherapy efficacy.

Recent findings: Emerging data suggest that altered body composition, including obesity and sarcopenia, may modulate ICI outcomes, giving rise to the so-called "obesity paradox", which appears inconsistent across tumor types and may reflect disease-specific nutritional and immunological profiles. Likewise, metabolic disorders such as type 2 diabetes and dyslipidemia can promote chronic inflammation and immune exhaustion, potentially dampening ICI activity. Advances in cross-sectional imaging and molecular profiling are refining the characterization of host-tumor-immune interactions and providing novel predictive insights. Host-related determinants play an integral role in shaping response to ICIs in NSCLC. A deeper understanding of the dynamic continuum linking metabolism, body composition, systemic inflammation, and immune regulation may enable more precise patient stratification and open opportunities for personalized immunotherapy strategies.

Purpose of review: Papillary thyroid carcinoma (PTC) is the most prevalent form of thyroid malignancy. While it is widely regarded as having a beneficial prognosis, effective therapies at the advanced stage or metastatic risk pose a significant clinical challenge.

Recent findings: Conventional therapeutic strategies, encompassing surgical interventions, radioiodine therapy, and thyroid hormone inhibition, have demonstrated notable efficacy in the management of early-stage disease. Notwithstanding, the rising prevalence of advanced PTC, including instances that exhibit resistance to traditional therapeutic interventions, has prompted the formulation and exploration of innovative pharmacological treatments. Here we delineate the contemporary paradigm of pharmacological interventions investigated for PTC, emphasizing targeted therapies. We summarize the progress of drug-targeted therapy for PTC, focusing on key molecular pathways, commonly used clinically targeted drugs and their efficacy, the resistance mechanism and response strategy of targeted therapy, as well as the perspective of drug-targeted therapy in the comprehensive treatment system of PTC.

Purpose of review: This review explores the use of perioperative immunotherapy for early-stage non-small cell lung cancers (NSCLCs), highlighting key recent developments in the field, questions that remain, and perspectives on their future use.

Recent findings: Immunotherapy has seen a recent expansion of its use to earlier-stage settings, previously limited to advanced/metastatic cancers, with widespread regulatory adoption of immune checkpoint inhibitors (ICIs) into the perioperative setting of resectable early-stage (IB-IIIA) NSCLC. However, questions remain regarding the efficacy of different drug regimens, their duration and scheduling, and, in particular, combinations with other therapies. The use of ICIs alongside molecularly targeted therapy has prompted well-evidenced concerns around toxicity and efficacy, with focus shifting to alternative strategies. Promising findings are seen with the revolutionary use of antibody drug conjugates (ADCs) in various cancer fields, prompting growing interest and a number of trials investigating their use, including combined with immunotherapy, within lung cancer. While promising as a therapy, the full potential of perioperative immunotherapy still remains to be realised, to be aided by further research into optimisation of treatment regimens and combinatorial strategies.

Purpose of review: Cancer is a leading cause of death worldwide. The process to develop new anti-cancer drugs is long and arduous. Therefore, additional strategies for drug development could involve drug repositioning, i.e., identifying new uses for already approved medications that have been deemed expendable in the oncologic treatment realm. Indeed, there are already drugs that have proven that they are extendable into oncology and are now Food and Drug Administration (FDA) approved for malignancies, though they were initially developed for other conditions.

Recent findings: These drugs include: all-trans retinoic acid, first approved as a topical agent for photo-aging, with dramatic activity in acute promyelocytic leukemia (APL); arsenic, a compound known for its use as a homicidal poison with remarkable activity in APL; thalidomide, a drug with a scandalous past as it was given to pregnant women and resulted in severe fetal limb deformities, which is now approved for multiple myeloma; and the antibiotics amoxicillin, clarithromycin, and metronidazole, which can result in total regression of MALT lymphomas (triggered by Helicobacter pylori infections). There is also a wealth of compounds that could be repositioned including, but not limited to anti-inflammatory drugs, anti-infectious compounds (anti-bacterial, anti-viral, anti-fungal, anti-parasitic agents), autonomic system regulators, and commonly used drugs such as statins or metformin, which have anti-cancer properties, demonstrated in both preclinical and clinical studies. With improvement in molecular technologies as well as in our understanding of cancer biology, drug repositioning may be exploitable for target-defined anti-neoplastic compounds that are already in use for non-malignant disease.

Purpose of review: Chest ports are essential for long-term venous access in patients requiring chemotherapy, nutrition, or transfusions. Despite their utility, placement and use carry risks. This review summarizes common and uncommon complications to enhance prevention and management.

Recent findings: Complications are grouped into incision-, catheter-, and reservoir-related categories. Incision complications include adhesive dermatitis, suture pseudoinfection, wound dehiscence, and erosion. Catheter issues include arrhythmias, central venous stenosis, fracture, fibrin sheath formation, thrombosis, and migration, each with distinct clinical implications. Reservoir complications such as port flipping and extravasation may interrupt therapy and cause tissue injury. Advances in imaging guidance, port design, and retrieval methods have improved safety, but vigilance is essential. Chest ports are critical in oncologic and supportive care, but complications can undermine patient safety and treatment continuity. Understanding mechanisms, recognizing risks, and implementing preventive strategies are key to optimizing outcomes. Ongoing refinement of procedural techniques and device innovation will further improve reliability and reduce risk.

Purpose of review: Sarcomas are a heterogeneous group of over 170 malignant tumours of mesenchymal origin. The poor prognosis highlights the need for novel therapeutic strategies. Preclinical modelling is essential, yet challenging, given that sarcomas differ substantially from carcinomas and resources are very limited.

Recent findings: GEMMs allow for the precise modelling of recurrent sarcoma genetics. The Cre-loxP system offer spatial and temporal control over the activation of oncogenes or the loss of tumour suppressors, while the CRISPR-Cas9 system enables the rapid, simultaneous editing of key drivers such as Trp53, Nf1, Kras and Pten. These models reproduce key features of human sarcomas, including their histopathology, the initiation of tumours in specific lineages and sites, and tumour-immune interactions within immune-competent hosts. GEMMs have been used to investigate hypotheses about the cells of origin, to test radiotherapy and immunotherapy, and to compare fusion-driven sarcomas with those with a complex karyotype. Despite variability, GEMMs remain essential tools for investigating the mechanisms of initiation, progression, and response to therapy. GEMMs offer mechanistic fidelity, but their use is limited by factors such as breeding burden, variability in recombination, off-target effects of CRISPR, underrepresentation of genomic complexity and inconsistent metastasis. These weaknesses reduce their predictive value, particularly with regard to advanced disease and immunotherapy. Progress will require the integration of Cre-loxP with CRISPR-Cas9, the standardisation of induction and reporting, and a closer alignment with distinct sarcoma subtypes, in order to enhance translational relevance.