Current Oncology Reports最新文献

Purpose of the review: As cancer survival rates are increasing, alternative treatments to improve quality of life, such as cannabinoids, are gaining attention. Although cannabinoids are widely used to manage cancer-related symptoms, clear guidelines are lacking. This systematic review and meta-analysis assessed the safety and efficacy of cannabinoids in the management of symptoms among cancer patients. The study protocol was registered on PROSPERO (CRD42023479375). A systematic search was conducted using three main databases (PubMed, Embase, and CENTRAL) on 4 November 2023. We included interventional and observational studies that evaluated cannabinoids for symptom management in cancer patients compared to standard care, placebo, or baseline values. Pooled mean differences (MD), proportions and odds ratios (OR), and the 95% confidence intervals (CI) were calculated with a random-effects model.

Recent findings: Overall, 98 articles were eligible. Cannabinoids reduced pain (MRAW: -1.22, CI: -1.92; -0.52) and anxiety (MRAW: -1.30, CI: -2.22; -0.39) as compared to baseline values. Appetite (MRAW: -1.88, CI: -6.23; 2.46), chemotherapy-induced nausea and vomiting (OR: 2.18, CI: 0.79; 6.00), as well as insomnia (MD: -1.08, CI: -2.48; 0.33) presented with a tendency toward improvement. Cannabinoids do not influence constipation, depression, fatigue, mobility or overall quality of life. In terms of safety issues, THC-predominant formulations increase the risks of psychiatric (OR: 10.62, CI: 1.35; 83.57), neurological (OR:2.24, CI: 1.15; 4.35), and gastrointestinal (OR:2.69, CI:0.73;9.90) side effects. The risk of bias of articles included varied from some concerns to high. Cannabinoids may be beneficial for the treatment of cancer-related pain and anxiety; however, their use carries a significant risk of adverse effects, particularly psychiatric complications. Careful patient selection is essential when considering cannabinoid-based treatments.

Purpose of the review: This review advocates for the integration of health coaching into oncology care to enhance outcomes for patients, caregivers, healthcare professionals, and oncology services. Health coaching is a person-centred, supportive process that facilitates navigation through trauma, loss, and change while promoting holistic health, physical, emotional, social, and spiritual. It also supports overcoming depression and anxiety by aiding patients in redefining life priorities for health and fulfilment post-treatment.

Recent findings: Systematic reviews indicate that health coaching can reduce anxiety and depression in cancer patients, conditions linked with increased cancer recurrence and mortality. Consequently, health coaching holds potential not only to improve quality of life but also to influence cancer morbidity and mortality. The authors' view is that health coaching fills an important gap in oncology services, offering a scalable, cost-effective solution to improve patient outcomes across the cancer continuum. With established global standards and clear competencies, health coaching should be integrated as an essential component of oncology care services.

Purpose of review: This review evaluates the scientific evidence for Ivermectin's potential anticancer properties, an antiparasitic drug garnering interest for oncology applications. It assesses the gap between preclinical and clinical evidence and explores implications for healthcare communication based on current evidence.

Recent findings: Preclinical studies (in vitro and animal studies) demonstrate Ivermectin's anticancer effects, including inhibition of cancer cell proliferation, induction of apoptosis, and modulation of signaling pathways (e.g., Wnt/β-catenin, Akt/mTOR) across various cancers. However, clinical evidence in humans is limited, with no large-scale randomized controlled trials (RCTs) confirming therapeutic benefits. Observational studies and case reports highlight the risks of self-medication driven by social media touting Ivermectin's unproven cancer benefits, which can lead to toxicity in oncology patients in some cases. The lack of clinical studies creates a critical translational gap between preclinical results and practical clinical application. Despite promising preclinical data, the absence of conclusive large-scale human clinical evidence limits Ivermectin's utility in cancer treatment. Its affordability appeals in resource-limited settings, but ethical challenges arise from misinformation, which may lead patients to forgo proven therapies. Healthcare providers must communicate responsibly to counter misinformation and guide patients toward evidence-based interventions, while supporting rigorous clinical trials to bridge the preclinical-clinical gap.

Purpose of review: Colorectal cancer accounts for approximately 10% of cancer-related mortality in Western countries. The plant-derived terpenoids represent the largest and most diverse class of natural products which possess potent anti-cancer properties in various tumor types. Combination therapy interacts with multiple targets in the molecular networks of colorectal cancer and may achieve synergistic or additive efficacy but reduce adverse side effects. The purpose of this review, mainly based on available preclinical data, is to summarize various plant terpenoids as potential sensitizers to conventional colorectal cancer therapies, along with the challenges and opportunities of these combinations in the clinical application for colorectal cancer treatment.

Recent findings: A total of 33 relevant articles were considered for review. This review provided a comprehensive overview of the current state of combining plant terpenoids with conventional therapeutics for colorectal cancer treatment, and discussed the associated therapeutic challenges and opportunities for successfully translating the preclinical findings into clinical settings. We concluded that plant terpenoids as potential adjuvants potentiate the antitumor efficacy of conventional colorectal cancer therapies by inducing apoptosis, reducing senescence, and inhibiting angiogenesis, metastasis, and inflammation through multiple pathways. Hopefully, the knowledge gained from this review will shape future research directions in this field.

Purpose of review: Younger patients with acute myeloblastic leukemia with FLT3 mutations (FLT3-mutated AML) benefit from the addition of FLT3 inhibitors to intensive chemotherapy. However, patients who are not eligible for intensive chemotherapy have poor outcomes with standard low-intensity treatments. In this review we assess the current state of treatment strategies for patients with FLT3-mutated AML who are not candidates for intensive chemotherapy.

Recent findings: The addition of FLT3 inhibitors to standard low-intensity AML treatments (doublet) has increased response rates, although in a randomized clinical trial this did not improve survival. The addition of venetoclax to these regimens (triplet) shows promising activity (overall response rate of approximately 90%). However, myelotoxicity is common, and dose adjustments are usually necessary. Combinations of low-intensity treatments with venetoclax and potent FLT3 inhibitors are feasible and have shown encouraging outcomes. Dose adjustments are essential to reduce treatment-related myelosuppression.

Purpose of review: This article explores the evolving role of artificial intelligence (AI) in neuro-oncology, highlighting its potential to enhance diagnostic accuracy, predict patient outcomes, optimize treatment planning, and streamline clinical workflows.

Recent findings: AI applications have led to significant advancements in automated tumor segmentation, molecular classification, risk stratification, treatment response evaluation, and computational pathology. AI-driven innovations have also accelerated drug discovery and leveraged natural language processing to generate structured clinical reports and extract actionable insights from unstructured data. AI has transformative potential in neuro-oncology; however, challenges like data quality, model generalizability, and clinical integration persist. Overcoming these barriers may involve new computational techniques and hardware efficiencies, as well as raising awareness, fostering interdisciplinary education, and expanding access to AI-driven tools.

Purpose of review: Postoperative radio-hormone therapy plays a significant role in management of prostate cancer after radical prostatectomy (RP), particularly in efforts to reduce biochemical recurrence (BCR), distant metastasis, and improve overall survival. BCR rates can be upwards of 50-70% at 5 years, highlighting the need for optimized risk stratification and consideration of multimodal treatment approaches. The purpose of this review is to highlight evidence-based treatment recommendations, and call attention to the importance of personalized therapeutic strategies after RP.

Recent findings: Both radiotherapy (RT) and ADT have been shown to optimize survival outcomes and to reduce disease progression in patients with persistent PSA, pathologic lymph-node positive disease, and adverse pathology. Early salvage RT (SRT) is typically a preferred treatment approach as it allows for treatment intensification only when clinically indicated, avoiding unnecessary radiation in men who may never recur. ADT is often added to external beam radiation therapy (EBRT) to enhance treatment efficacy, particularly in patients with high-risk features, though in selected lower-risk scenarios, radiation alone may be sufficient. Short-term ADT is appropriate for low-intermediate risk patients and long-term is appropriate for patients with advanced pathological features or nodal involvement. For certain high-risk pathologic findings, such as positive surgical margins and seminal vesicle invasion (T3b), adjuvant RT (aRT) may be indicated to optimize disease control. Overall, radio-hormone therapy plays a significant role in the postoperative setting by reducing the risk of recurrence and disease progression, and improving survival outcomes. There are several well-validated tools that may offer personalized risk assessments to identify which patients may most benefit from adjuvant or salvage therapies. Finally, the optimal use of such therapies continues to be investigated with ongoing trials.