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Prevention of Post-Mastectomy Pain Syndrome: A Review of Recent Literature on Perioperative Interventions. 预防乳房切除术后疼痛综合征:关于围手术期干预措施的最新文献综述。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-05-30 DOI: 10.1007/s11912-024-01553-2
Rachel R Wu, Simon Katz, Jing Wang, Lisa V Doan

Purpose of review: Up to 60% of breast cancer patients continue to experience pain three months or more after surgery, with 15 to 25% reporting moderate to severe pain. Post-mastectomy pain syndrome (PMPS) places a high burden on patients. We reviewed recent studies on perioperative interventions to prevent PMPS incidence and severity.

Recent findings: Recent studies on pharmacologic and regional anesthetic interventions were reviewed. Only nine of the twenty-three studies included reported a significant improvement in PMPS incidence and/or severity, sometimes with mixed results for similar interventions. Evidence for prevention of PMPS is mixed. Further investigation of impact of variations in dosing is warranted. In addition, promising newer interventions for prevention of PMPS such as cryoneurolysis of intercostal nerves and stellate ganglion block need confirmatory studies.

审查目的:多达 60% 的乳腺癌患者在术后三个月或更长时间内仍会感到疼痛,其中 15% 至 25% 的患者报告有中度至重度疼痛。乳房切除术后疼痛综合征(PMPS)给患者带来了沉重的负担。我们回顾了近期有关围手术期干预措施以预防 PMPS 发生率和严重程度的研究:我们回顾了近期关于药物和区域麻醉干预的研究。在纳入的 23 项研究中,仅有 9 项报告了 PMPS 发生率和/或严重程度的显著改善,有时类似干预措施的结果也不尽相同。预防 PMPS 的证据不一。有必要进一步研究剂量变化的影响。此外,用于预防 PMPS 的前景看好的新干预措施,如肋间神经冷冻神经溶解术和星状神经节阻滞术,也需要进行确证研究。
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引用次数: 0
An Annual Symposium on Disparities in Milwaukee, WI, with a 2023 Focus on Older Adults with Cancer. 威斯康星州密尔沃基市差异问题年度研讨会,2023 年重点关注患癌症的老年人。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-05-27 DOI: 10.1007/s11912-024-01525-6
Sailaja Kamaraju, June McKoy, Grant R Williams, Nikesha Gilmore, Christina Minami, Kathryn Bylow, Helena Rajalingam, Chandler S Cortina, Angela Beckert, Melinda Stolley, Dan Bullock, Razelle Kurzrock, Aminah Jatoi

Purpose of review: Cancer-related inequities are prevalent in Wisconsin, with lower survival rates for breast, colorectal, and lung cancer patients from marginalized communities. This manuscript describes the ongoing efforts at the Medical College of Wisconsin and potential pathways of community engagement to promote education and awareness in reducing inequities in cancer care.

Recent findings: While some cancer inequities are related to aggressive disease biology, health-related social risks may be addressed through community-academic partnerships via an open dialogue between the community members and academic faculty. To develop potential pathways of community-academic partnerships, an annual Cancer Disparities Symposium concept evolved as a pragmatic and sustainable model in an interactive learning environment. In this manuscript, we describe the programmatic development and execution of the annual Cancer Disparities Symposium, followed by highlights from this year's meeting focused on geriatric oncology as discussed by the speakers.

审查目的:在威斯康星州,与癌症相关的不公平现象十分普遍,来自边缘化社区的乳腺癌、结直肠癌和肺癌患者的存活率较低。本手稿介绍了威斯康星医学院正在开展的工作以及社区参与的潜在途径,以促进教育和提高认识,减少癌症治疗中的不公平现象:虽然一些癌症不平等与侵袭性疾病生物学有关,但与健康相关的社会风险可通过社区成员与学术教师之间的公开对话,通过社区-学术合作关系加以解决。为了开发社区-学术合作的潜在途径,一年一度的癌症差异研讨会概念逐渐发展成为互动学习环境中的一种务实、可持续的模式。在本手稿中,我们将介绍年度癌症差异研讨会的计划制定和执行情况,然后介绍今年会议的亮点,重点是老年肿瘤学,正如演讲者所讨论的那样。
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引用次数: 0
Management of Localized Melanoma in the Anti-PD-1 Era. 抗PD-1时代的局部黑色素瘤治疗。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-06 DOI: 10.1007/s11912-024-01556-z
Elan Novis, Alexander C J van Akkooi

Purpose of review: The management of cutaneous melanoma has rapidly progressed over the past decade following the introduction of effective systemic therapies. Given the large number of recent clinical trials which have dramatically altered the management of these patients, an updated review of the current evidence regarding the management of localized melanoma is needed.

Recent findings: The role of effective systemic therapies in earlier stages (I-III) melanoma, both in adjuvant and neoadjuvant settings is rapidly changing the role of surgery in the management cutaneous melanoma, particularly regarding surgical safety margins for wide local excision (WLE), the role of sentinel lymph node biopsy (SLNB) and the extent of lymph node dissections. The randomized phase 2 SWOG1801 trial has demonstrated superiority of neoadjuvant-adjuvant anti-PD1 therapy in improving event-free survival by 23% at 2-years over adjuvant anti-PD-1 therapy only. Furthermore, the PRADO trial has suggested a more tailored approach both the extent of surgery as well as adjuvant therapy can safely and effectively be done, depending on the response to initial neoadjuvant immunotherapy. These results await validation and it is expected that in 2024 the phase 3 Nadina trial (NCT04949113) will definitively establish neo-adjuvant combination immunotherapy as the novel standard. This will further redefine the management of localized melanoma. The use of effective systemic therapies will continue to evolve in the next decade and, together with new emerging diagnostic and surveillance techniques, will likely reduce the extent of routine surgery for stage I-III melanoma.

综述的目的:在过去十年中,随着有效的全身疗法的引入,皮肤黑色素瘤的治疗取得了快速进展。鉴于最近的大量临床试验极大地改变了这些患者的治疗方法,因此有必要对有关局部黑色素瘤治疗的现有证据进行最新回顾:在早期(I-III期)黑色素瘤的辅助治疗和新辅助治疗中,有效的全身疗法正在迅速改变外科手术在皮肤黑色素瘤治疗中的作用,尤其是在广泛局部切除术(WLE)的手术安全边缘、前哨淋巴结活检(SLNB)的作用以及淋巴结清扫的范围等方面。随机 2 期 SWOG1801 试验表明,与仅辅助抗 PD-1 治疗相比,新辅助-辅助抗 PD1 治疗可将 2 年无事件生存率提高 23%。此外,PRADO 试验还表明,可以根据患者对初始新辅助免疫疗法的反应,采取更有针对性的方法,安全有效地进行手术和辅助治疗。这些结果还有待验证,预计 2024 年进行的三期 Nadina 试验(NCT04949113)将最终确定新辅助联合免疫疗法为新标准。这将进一步重新定义局部黑色素瘤的治疗。在未来十年中,有效全身疗法的使用将继续发展,加上新出现的诊断和监测技术,将有可能减少 I-III 期黑色素瘤的常规手术范围。
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引用次数: 0
Radiation and Melanoma: Where Are We Now? 辐射与黑色素瘤:我们现在在哪里?
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-01 DOI: 10.1007/s11912-024-01557-y
Roy Bliley, Adam Avant, Theresa M Medina, Ryan M Lanning

Purpose of review: This review summarizes the current role of radiotherapy for the treatment of cutaneous melanoma in the definitive, adjuvant, and palliative settings, and combinations with immunotherapy and targeted therapies.

Recent findings: Definitive radiotherapy may be considered for lentigo maligna if surgery would be disfiguring. High risk, resected melanoma may be treated with adjuvant radiotherapy, but the role is poorly defined since the advent of effective systemic therapies. For patients with metastatic disease, immunotherapy and targeted therapies can be delivered safely in tandem with radiotherapy to improve outcomes. Radiotherapy and modern systemic therapies act in concert to improve outcomes, especially in the metastatic setting. Further prospective data is needed to guide the use of definitive radiotherapy for lentigo maligna and adjuvant radiotherapy for high-risk melanoma in the immunotherapy era. Current evidence does not support an abscopal response or at least identify the conditions necessary to reliably produce one with combinations of radiation and immunotherapy.

综述的目的:本综述总结了目前放射治疗在皮肤黑色素瘤的根治性、辅助性和姑息性治疗中的作用,以及与免疫疗法和靶向疗法的结合:最新研究结果:如果手术会造成毁容,则可考虑对恶性白斑病进行最终放疗。高风险、已切除的黑色素瘤可采用辅助放疗,但自有效的全身疗法出现以来,这种疗法的作用尚不明确。对于转移性疾病患者,免疫疗法和靶向疗法可与放疗同时安全进行,以改善疗效。放疗与现代全身疗法的协同作用可提高疗效,尤其是在转移性疾病中。在免疫疗法时代,需要进一步的前瞻性数据来指导对恶性白斑的最终放疗和对高危黑色素瘤的辅助放疗。目前的证据并不支持腹水反应,或者至少不能确定在放射治疗和免疫治疗联合应用的情况下产生腹水反应的必要条件。
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引用次数: 0
Use of Circulating Tumor DNA to Guide Decision-making in Adjuvant Colon Cancer. 利用循环肿瘤 DNA 指导结肠癌辅助治疗决策。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-06 DOI: 10.1007/s11912-024-01565-y
Zachary Gottschalk, Stacey A Cohen

Purpose of review: The use of circulating tumor DNA (ctDNA) assays to guide clinical decision-making in early-stage colon cancer is an area of rapidly advancing active research. With assays clinically available, clinicians must be informed how to best use this novel tool to treat patients.

Recent findings: Recent observational and prospective studies have suggested that ctDNA has potential to guide clinical decision-making in early-stage colon cancer by detecting minimal residual disease (MRD) and predicting recurrence risks. MRD-negative patients may be able to de-escalate or forgo adjuvant chemotherapy (ACT) without compromising disease-free survival or overall survival, while MRD-positive patients may benefit significantly from ACT. Recent and ongoing studies have given reason for optimism about the future of ctDNA as a useful biomarker for clinicians treating early-stage colon cancer. Data thus far are mostly limited to observational studies; inconsistent results highlight the need for caution. As more evidence emerges, ctDNA may become standard of care for colon cancer patients.

综述目的:使用循环肿瘤 DNA (ctDNA) 检测来指导早期结肠癌的临床决策是一个快速发展的活跃研究领域。随着检测方法在临床上的应用,临床医生必须了解如何更好地利用这一新型工具来治疗患者:最近的观察性和前瞻性研究表明,ctDNA 有可能通过检测最小残留病(MRD)和预测复发风险来指导早期结肠癌的临床决策。MRD阴性患者可以降低或放弃辅助化疗(ACT),而不会影响无病生存期或总生存期,而MRD阳性患者则可能从辅助化疗中获益匪浅。最近和正在进行的研究使人们有理由对ctDNA作为临床医生治疗早期结肠癌的有用生物标志物的前景持乐观态度。迄今为止的数据大多局限于观察性研究;不一致的结果凸显了谨慎的必要性。随着更多证据的出现,ctDNA 可能会成为结肠癌患者的标准治疗方法。
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引用次数: 0
Immunological Checkpoint Blockade in Anal Squamous Cell Carcinoma: Dramatic Responses Tempered By Frequent Resistance. 肛门鳞状细胞癌的免疫检查点阻断疗法:频繁的抗药性抑制了剧烈的反应
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-11 DOI: 10.1007/s11912-024-01564-z
Thejus Jayakrishnan, Devvrat Yadav, Brandon M Huffman, James M Cleary

Purpose of review: Squamous cell carcinoma of the anus (SCCA) is an HPV-associated malignancy that has limited treatment options. Immunotherapy has expanded these options and here we review current and emerging immunotherapeutic approaches.

Recent findings: Multiple studies of single-agent anti-PD1/PD-L1 immunotherapy have demonstrated a modest response rate of approximately 10% to 15%. While a minority of patients (~5%) with SCCA experience durable complete responses, most advanced SCCAs are resistant to anti-PD1/PD-L1 monotherapy. Given the need for more broadly effective immunotherapies, novel strategies, such as adaptive cell therapies and therapeutic vaccination, are being explored. To reduce the recurrence risk of localized high-risk SCCA, strategies combining immunotherapy with chemoradiation are also being investigated. While a small subset of patients with SCCA have prolonged responses to PD1-directed immunotherapy, the majority do not derive clinical benefit, and new immunotherapeutic strategies are needed. Better understanding of the immune microenvironment and predictive biomarkers could accelerate therapeutic advances.

综述目的:肛门鳞状细胞癌(SCCA)是一种与 HPV 相关的恶性肿瘤,其治疗方案有限。免疫疗法扩大了这些选择的范围,在此我们回顾了当前和新兴的免疫治疗方法:单药抗PD1/PD-L1免疫疗法的多项研究显示,反应率不高,约为10%至15%。虽然少数 SCCA 患者(约 5%)获得了持久的完全应答,但大多数晚期 SCCA 患者对抗 PD1/PD-L1 单药治疗产生了耐药性。鉴于需要更广泛有效的免疫疗法,目前正在探索适应性细胞疗法和治疗性疫苗接种等新策略。为了降低局部高危SCCA的复发风险,免疫疗法与化疗放疗相结合的策略也在研究之中。虽然一小部分 SCCA 患者对 PD1 引导的免疫疗法有长期反应,但大多数患者并没有获得临床获益,因此需要新的免疫治疗策略。更好地了解免疫微环境和预测性生物标志物可加快治疗进展。
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引用次数: 0
Toxicities from BRAF and MEK Inhibitors: Strategies to Maximize Therapeutic Success. BRAF 和 MEK 抑制剂的毒性:最大限度提高治疗成功率的策略。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-08 DOI: 10.1007/s11912-024-01544-3
Mike Wang, Ryan J Sullivan, Meghan J Mooradian

Purpose of review: This report highlights several of the recent therapeutic advancements in the treatment of BRAF-mutant tumors, discusses the most common adverse events observed with BRAF-targeted agents, and suggests strategies to manage and mitigate treatment-related toxicities.

Recent findings: BRAF and MEK inhibitors represent a significant advancement in the treatment of BRAF-mutated malignancies with data across tumor types demonstrating the anti-tumor efficacy of dual MAPK inhibition. Although these agents have a reasonable toxicity profile, variable side effects across organ systems can develop. The discovery of activating BRAF mutations and subsequent development of BRAF and MEK inhibitors has transformed the treatment algorithms of BRAF-mutant malignancies. With increased application of these targeted regimens, identification and prompt management of their unique adverse events are crucial.

综述目的:本报告重点介绍了治疗BRAF突变肿瘤的几项最新治疗进展,讨论了BRAF靶向药物最常见的不良反应,并提出了管理和减轻治疗相关毒性的策略:BRAF和MEK抑制剂是治疗BRAF突变恶性肿瘤的重大进展,各种肿瘤类型的数据都证明了MAPK双重抑制的抗肿瘤疗效。虽然这些药物具有合理的毒性,但在不同器官系统中会产生不同的副作用。活化 BRAF 突变的发现以及随后 BRAF 和 MEK 抑制剂的开发改变了 BRAF 突变恶性肿瘤的治疗算法。随着这些靶向治疗方案应用的增加,识别并及时处理其独特的不良反应至关重要。
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引用次数: 0
Exploring the Role of Target Expression in Treatment Efficacy of Antibody–Drug Conjugates (ADCs) in Solid Cancers: A Comprehensive Review 探索靶点表达在抗体药物结合物 (ADC) 治疗实体癌疗效中的作用:全面综述
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-27 DOI: 10.1007/s11912-024-01576-9
Laurent Mathiot, Capucine Baldini, Octave Letissier, Antoine Hollebecque, Rastislav Bahleda, Anas Gazzah, Cristina Smolenschi, Madona Sakkal, François-Xavier Danlos, Clémence Henon, Kristi Beshiri, Vincent Goldschmidt, Claudia Parisi, Anna Patrikidou, Jean-Marie Michot, Aurélien Marabelle, Sophie Postel-Vinay, Alice Bernard-Tessier, Yohann Loriot, Santiago Ponce, Stéphane Champiat, Kaïssa Ouali

Purpose of Review

Antibody–drug conjugates (ADCs) offer a promising path for cancer therapy, leveraging the specificity of monoclonal antibodies and the cytotoxicity of linked drugs. The success of ADCs hinges on precise targeting of cancer cells based on protein expression levels. This review explores the relationship between target protein expression and ADC efficacy in solid tumours, focusing on results of clinical trials conducted between January 2019 and May 2023.

Recent Findings

We hereby highlight approved ADCs, revealing their effectiveness even in low-expressing target populations. Assessing target expression poses challenges, owing to variations in scoring systems and biopsy types. Emerging methods, like digital image analysis, aim to standardize assessment. The complexity of ADC pharmacokinetics, tumour dynamics, and off-target effects emphasises the need for a balanced approach.

Summary

This review underscores the importance of understanding target protein dynamics and promoting standardized evaluation methods in shaping the future of ADC-based cancer therapies.

综述目的 抗体-药物共轭物(ADC)利用单克隆抗体的特异性和连接药物的细胞毒性,为癌症治疗提供了一条前景广阔的途径。ADC 的成功取决于根据蛋白质表达水平对癌细胞进行精确靶向。本综述探讨了实体瘤中靶蛋白表达与ADC疗效之间的关系,重点关注2019年1月至2023年5月期间开展的临床试验结果。近期发现我们在此重点介绍已获批准的ADCs,揭示它们即使在低表达靶细胞群中也能发挥疗效。由于评分系统和活检类型的不同,评估靶点表达是一项挑战。数字图像分析等新兴方法旨在使评估标准化。本综述强调了了解靶蛋白动态和推广标准化评估方法对塑造未来基于 ADC 的癌症疗法的重要性。
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引用次数: 0
For the Long Haul: Management of Long-Term Survivors after Melanoma Systemic Therapy. 为了长远:黑色素瘤系统治疗后长期存活者的管理。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-01 Epub Date: 2024-05-23 DOI: 10.1007/s11912-024-01541-6
Jordyn Silverstein, Neha Goyal, Katy K Tsai

Purpose of review: This review summarizes the latest advancements in survivorship care for patients with advanced melanoma who received systemic therapy and emphasizes the areas where more research is needed.

Recent findings: Over the last decade there have been remarkable advances in the treatment of advanced and metastatic melanoma. Due to these novel treatments, including several immune checkpoint inhibitors and tyrosine kinase inhibitors, there are and will continue to be increasing numbers of long-term melanoma survivors who have been treated with systemic therapy. These patients will navigate new challenges are they are essentially among the first long term survivors after these novel therapies. Survivorship care focuses on improving the health-related quality of life of patients including the physical, emotional, social and functional effects of cancer that begin at diagnosis and continue through the end of life. Survivorship also includes screening for cancer recurrence and second cancers. As the number of melanoma survivors who received systemic therapy continues to grow, the survivorship care plan will become increasingly important for optimal care of patients even after their cancer treatments. Understanding the many domains of survivorship care for this group of patients is imperative for their care now and to identify unmet needs for future research.

综述的目的:本综述总结了接受过系统治疗的晚期黑色素瘤患者生存期护理的最新进展,并强调了需要开展更多研究的领域:过去十年间,晚期和转移性黑色素瘤的治疗取得了显著进展。由于采用了这些新型治疗方法,包括几种免疫检查点抑制剂和酪氨酸激酶抑制剂,接受过全身治疗的黑色素瘤长期存活者的人数正在不断增加,而且还将继续增加。这些患者将面临新的挑战,因为他们基本上是接受这些新型疗法后的首批长期幸存者。生存期护理的重点是改善患者与健康相关的生活质量,包括从诊断开始一直持续到生命终结的癌症对身体、情感、社交和功能的影响。生存期护理还包括癌症复发和二次癌症筛查。随着接受系统治疗的黑色素瘤幸存者人数不断增加,幸存者护理计划对于患者在接受癌症治疗后的最佳护理将变得越来越重要。了解这部分患者的生存期护理的多个方面,对于他们现在的护理以及确定未来研究中尚未满足的需求都是非常必要的。
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引用次数: 0
Beyond Immune Checkpoint Inhibitors: Emerging Targets in Melanoma Therapy. 超越免疫检查点抑制剂:黑色素瘤治疗中的新靶点。
IF 4.7 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-01 Epub Date: 2024-05-25 DOI: 10.1007/s11912-024-01551-4
Andrew D Knight, Jason J Luke

Purpose of review: This review provides a comprehensive update on recent advancements in melanoma treatment by highlighting promising therapeutics with an aim to increase awareness of novel interventions currently in development.

Recent findings: Over the last decade there has been considerable expansion of the previously available treatment options for patients with melanoma. In particular, novel immunotherapeutics have been developed to expand on the clinical advancements brought by BRAF targeting and immune checkpoint inhibitors. Despite the success of checkpoint inhibitors there remains an unmet need for patients that do not respond to treatment. This review delves into the latest advancements in novel checkpoint inhibitors, cytokines, oncolytic viruses, vaccines, bispecific antibodies, and adoptive cell therapy. Preclinical experiments and early-stage clinical trials studies have demonstrated promising results for these therapies, many of which have moved into pivotal, phase 3 studies.

综述的目的:本综述全面介绍了黑色素瘤治疗的最新进展,重点介绍了前景看好的治疗方法,旨在提高人们对目前正在开发的新型干预措施的认识:在过去十年中,黑色素瘤患者的现有治疗方案有了很大的扩展。特别是,新型免疫疗法的开发扩大了BRAF靶向药物和免疫检查点抑制剂带来的临床进展。尽管检查点抑制剂取得了成功,但对治疗无反应的患者的需求仍未得到满足。本综述将深入探讨新型检查点抑制剂、细胞因子、溶瘤病毒、疫苗、双特异性抗体和收养细胞疗法的最新进展。这些疗法的临床前实验和早期临床试验研究已取得了令人鼓舞的成果,其中许多疗法已进入关键的第三阶段研究。
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引用次数: 0
期刊
Current Oncology Reports
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