Current Oncology Reports最新文献

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.

Purpose of review: The objective of this scoping review was to characterize published literature on unmet social needs and financial hardship among cancer caregivers. We sought to describe study attributes; assess the associations of needs with physical and psychosocial outcomes; identify tools to measure caregiver social needs and financial hardship; and examine needs-related interventions for caregivers.

Recent findings: Thirty-five articles were included in the review, most of which (60%) were published in the past three years (2022-2024). Financial hardship was addressed in nearly all of the included studies. There was a range of measurement tools used across the studies, and 37% of studies assessed social needs/financial hardship as part of a measure of caregiver burden. Most studies (92%) were cross-sectional and did not include a theoretical framework (59%), with only one study describing a caregiver-focused intervention. Most qualitative studies (n = 4/5) captured the interconnection among social needs. There is limited exploration of unmet social needs and financial hardship among cancer caregivers. Review findings demonstrate the need for increased research, both descriptive and interventional, on the social needs and financial hardship of cancer caregivers.

Background: Colorectal cancer (CRC) is the third most common cancer globally, with 25-30% of patients eventually developing liver metastases (CRLM). These metastases worsen prognosis, emphasizing the need for multidisciplinary management. Within multidisciplinary teams (MDTs), radiologists do more than interpret images, facilitating accurate staging, resectability assessment, and therapy guidance. This systematic review assesses radiologists' impact and advanced imaging's role in CRLM.

Methods: We searched Ovid MEDLINE, Ovid Epub, Cochrane Central, Embase, and Scopus (inception-August 31, 2023). Eligible studies involved adult CRC patients with CRLM, MDTs including radiologists, and reported on treatment decisions, survival, or imaging's influence.

Results: From 13,043 references, 9 studies (8 retrospective, 1 prospective) met inclusion, with 2342 patients across six countries. PET/CT altered management in up to 10.6% of cases by detecting additional lesions or changing staging. In one study, virtual MDTs prevented unnecessary referrals in 43.9% of patients. Several studies suggested improved survival outcomes associated with MDT-based care. Radiologists contributed to staging, resectability evaluations, and decisions on liver-directed therapies. However incomplete data, variability in imaging protocols, and inconsistent reporting remained obstacles.

Conclusion: Radiologists' expanding MDT role enhances CRLM management through improved disease characterization and treatment planning. However, definitive survival benefits remain uncertain due to retrospective designs, small sample sizes, and methodological heterogeneity. Prospective studies with standardized imaging protocols and consistent data integration are needed to better quantify radiologists' contributions. Virtual MDTs have promise in broadening access to specialist input, potentially improving outcomes and resource utilization in CRC with liver metastases.

Purpose of review: Radiation therapy (RT) remains a cornerstone of multidisciplinary cancer treatment but is frequently associated with acute and chronic toxicities that negatively impact patient quality of life and treatment adherence. This review examines evidence-based integrative oncology interventions-encompassing nutrition, phytochemicals, mind-body therapies, acupuncture, and homeopathy-and their role in mitigating RT-related side effects and supporting patient-centered care.

Recent findings: Emerging clinical trials and meta-analyses have demonstrated that specific integrative strategies can significantly reduce common toxicities associated with RT. Probiotic supplementation lowers the incidence of radiation-induced diarrhea, while high-fiber diets and omega-3 fatty acids may enhance gastrointestinal tolerance and limit therapy resistance. Acupuncture has shown efficacy in managing chronic xerostomia, and calendula-based topical treatments have been effective for radiation dermatitis. Mind-body interventions-including cognitive behavioral therapy, hypnosis, yoga, and mindfulness-based stress reduction-have consistently improved fatigue, anxiety, and overall well-being. Importantly, many of these interventions are low risk, feasible to implement, and increasingly incorporated into supportive oncology care. Integrative oncology offers a valuable complement to modern RT by reducing treatment-related toxicity and enhancing quality of life. As precision medicine advances the ability to tailor RT based on clinical and genomic risk, the integration of evidence-based supportive therapies aligns treatment with patient goals and promotes resilience. Ongoing research will further clarify best practices for incorporating these interventions into routine care, ensuring radiation oncology evolves to meet the dual goals of disease control and holistic patient well-being.

Purpose of review: Financial toxicity from cancer treatment is a significant barrier to equitable care and an important clinical and public health concern. This scoping review examines global patterns in the assessment of financial toxicity in cancer care and compiles an inventory of domains and subdomains used in existing assessment tools.

Recent findings: From 3,343 records screened, 454 studies were included. Most were conducted in high-income countries (81.7%, n = 371), with 93.8% focused on adult populations. Across 438 quantitative studies, 164 distinct financial toxicity questionnaires comprising 1,104 questions were identified. The COmprehensive Score for financial Toxicity (COST) was the most frequently used tool (40.4%). Only 48.2% of questionnaires had undergone validation in cancer populations. The majority of questions addressed material domains (51.3%), followed by behavioral (29.9%) and psychosocial (18.8%) aspects. The most common subdomains identified were health expenditure within the material domain (9.6%), delaying or forgoing healthcare services within the behavioral domain (12.6%), and perceived financial burden of healthcare costs within the psychosocial domain (12.8%). Findings from 32 qualitative studies aligned with these patterns, highlighting healthcare costs and employment loss as key concerns. Most studies of financial toxicity in cancer care are conducted among adults in high-income countries and measure material domains. Greater attention is needed to expand financial toxicity research in low- and middle-income countries and among pediatric, adolescent, and caregiver populations.

Purpose of review: This review highlights the evolving management of desmoid tumors, including the importance of an accurate diagnosis, the potential role for surgery and radiation therapy in select cases, growing data supporting the use of radiology-guided techniques, as well as the emerging role of systemic therapy for disease not amenable to active surveillance.

Recent findings: The initial management for desmoid tumors has shifted towards watchful waiting for a majority of patients. The recent FDA approval of nirogacestat, a gamma-secretase inhibitor, as well as prospective clinical trials examining multitargeted tyrosine kinase inhibitors, have increased systemic therapy options for patients. Local therapies, such as surgery, radiation and radiology-guided techniques, remain potential options in appropriate situations. An improved understanding of the underlying biology and inherent behavior of desmoid tumors has resulted in a rapidly evolving and shifting treating paradigm. A multi-disciplinary approach is critically important to provide the best outcomes for patients.

Purpose of review: Radiotherapy (RT) is a mainstay treatment strategy for patients with radically treatable head and neck cancer (HNC). Efforts to personalize RT have spanned decades, yielding variable results across different treatment stages. The purpose of this review was to assess the potential of AI-driven models to bridge personalized radiotherapy strategies.

Recent findings: Radiomics, an emerging imaging analytics approach, provides significant quantitative features that can predict survival outcomes, treatment responses, and radiation-induced toxicity. Radiomics-based models in the studies demonstrate promising predictive efficacy with a high C-index or area under the curve (AUC) exceeding 0.70. AI-driven multimodal and multitemporal imaging models can stratify patients and guide risk-adapted radiotherapy. A four-step AI-driven RT framework may provide a template for future randomized controlled trials, supporting more trustworthy evidence.