Pub Date : 2025-01-28DOI: 10.1097/CCO.0000000000001117
Ariane Laparra
Purpose of review: Immune checkpoint inhibitors (ICI) have become an integral part of oncology treatment. ICI currently has approval for more than thirty tumor types with proven efficacy. However, ICI can expose patients to inflammatory side effects, such as immuno-related adverse events (irAE). The spectrum of irAE and the time to onset can be very broad, sometimes leading to the patient's death.Additionally, ICI could be associated with chronic or long-term adverse events that impact quality of life. The expansion of the indications for immunotherapy in the early adjuvant and neoadjuvant stages is altering the benefit-risk balance of these therapies.Furthermore, the combination of immunotherapies with other oncology treatments makes the interpretation of adverse events difficult.To date, no predictive factors have been identified in routine practice to identify patients at risk of developing serious toxicity.
Recent findings: This has led us to develop a patient care pathway dedicated to the management of these toxicities, enabling early detection of irAE to improve outcomes.
Summary: We have presented a novel care pathway based on a clinical evaluation, encompassing a daily hospital devoted to the management of toxicities, an iTox multidisciplinary board, and a pharmacovigilance database. This pathway involves a translational research program.The toxicity day hospital allowed us to care for patients at an early stage of an adverse event and to establish whether anticancer treatment was responsible for the onset of symptoms and/or biological abnormalities.The objective of this pathway is to enhance the quality of life and compliance of oncology treatment, while minimizing the necessity for unscheduled care.
{"title":"Immuno-oncology in the daily practice.","authors":"Ariane Laparra","doi":"10.1097/CCO.0000000000001117","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001117","url":null,"abstract":"<p><strong>Purpose of review: </strong>Immune checkpoint inhibitors (ICI) have become an integral part of oncology treatment. ICI currently has approval for more than thirty tumor types with proven efficacy. However, ICI can expose patients to inflammatory side effects, such as immuno-related adverse events (irAE). The spectrum of irAE and the time to onset can be very broad, sometimes leading to the patient's death.Additionally, ICI could be associated with chronic or long-term adverse events that impact quality of life. The expansion of the indications for immunotherapy in the early adjuvant and neoadjuvant stages is altering the benefit-risk balance of these therapies.Furthermore, the combination of immunotherapies with other oncology treatments makes the interpretation of adverse events difficult.To date, no predictive factors have been identified in routine practice to identify patients at risk of developing serious toxicity.</p><p><strong>Recent findings: </strong>This has led us to develop a patient care pathway dedicated to the management of these toxicities, enabling early detection of irAE to improve outcomes.</p><p><strong>Summary: </strong>We have presented a novel care pathway based on a clinical evaluation, encompassing a daily hospital devoted to the management of toxicities, an iTox multidisciplinary board, and a pharmacovigilance database. This pathway involves a translational research program.The toxicity day hospital allowed us to care for patients at an early stage of an adverse event and to establish whether anticancer treatment was responsible for the onset of symptoms and/or biological abnormalities.The objective of this pathway is to enhance the quality of life and compliance of oncology treatment, while minimizing the necessity for unscheduled care.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-23DOI: 10.1097/CCO.0000000000001120
Anthony Martin Fuentes
Purpose of review: Recent research underscores the significant influence of the skin and gut microbiota on melanoma and nonmelanoma skin cancer (NMSC) development and treatment outcomes. This review aims to synthesize current findings on how microbiota modulates immune responses, particularly enhancing the efficacy of immunotherapies such as immune checkpoint inhibitors (ICIs).
Recent findings: The microbiota's impact on skin cancer is multifaceted, involving immune modulation, inflammation, and metabolic interactions. Beneficial strains like Bifidobacterium and Lactobacillus have shown potential in supporting anti-PD-1 and anti-CTLA-4 therapies by promoting T-cell activation and immune surveillance. Evidence from preclinical and clinical studies, including fecal microbiota transplantation (FMT), highlights improved response rates in patients with microbiota-rich profiles. Notably, certain bacterial metabolites, such as inosine, contribute to enhanced antitumor activity by stimulating IFN-γ in CD8+ T cells.
Summary: Understanding the interplay between microbiota and skin cancer treatment opens promising avenues for adjunctive therapies. Probiotic and prebiotic interventions, FMT, and microbiota modulation are emerging as complementary strategies to improve immunotherapy outcomes and address treatment resistance in melanoma and NMSC.
{"title":"The role of the microbiome in skin cancer development and treatment.","authors":"Anthony Martin Fuentes","doi":"10.1097/CCO.0000000000001120","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001120","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recent research underscores the significant influence of the skin and gut microbiota on melanoma and nonmelanoma skin cancer (NMSC) development and treatment outcomes. This review aims to synthesize current findings on how microbiota modulates immune responses, particularly enhancing the efficacy of immunotherapies such as immune checkpoint inhibitors (ICIs).</p><p><strong>Recent findings: </strong>The microbiota's impact on skin cancer is multifaceted, involving immune modulation, inflammation, and metabolic interactions. Beneficial strains like Bifidobacterium and Lactobacillus have shown potential in supporting anti-PD-1 and anti-CTLA-4 therapies by promoting T-cell activation and immune surveillance. Evidence from preclinical and clinical studies, including fecal microbiota transplantation (FMT), highlights improved response rates in patients with microbiota-rich profiles. Notably, certain bacterial metabolites, such as inosine, contribute to enhanced antitumor activity by stimulating IFN-γ in CD8+ T cells.</p><p><strong>Summary: </strong>Understanding the interplay between microbiota and skin cancer treatment opens promising avenues for adjunctive therapies. Probiotic and prebiotic interventions, FMT, and microbiota modulation are emerging as complementary strategies to improve immunotherapy outcomes and address treatment resistance in melanoma and NMSC.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-23DOI: 10.1097/CCO.0000000000001114
Florian Scotté
Purpose of review: Although the management of nausea and vomiting induced by cancer treatments has evolved, several questions remain unanswered.
Recent findings: New antiemetics have been developed these last decades with therapeutic indications to be defined according to the anticancer regimen and partly as a consequence of the assessment of individual patient risk factors. Guidelines still seem to have a low level of knowledge and compliance, with a role for scientific societies in term of dissemination and education. A number of persistent issues relating to emesis still need improvement in prevention and management. Nausea remains a subjective semantic whose evaluation should possibly benefit from educational programs. The risk classification of anticancer drugs must be regularly updated, requiring regular literature reviews and the integration of data from clinical trials relating to emerging anticancer drugs. Recent data, particularly in the context of emerging drugs, highlight the importance to consider emesis' impact beyond the 5-day period, with a potential adaptation of antiemetic prophylaxis, including the mode of administration of oral drugs.
Summary: Guidelines update is presented with literature answers to the current issues in order to improve quality of patient's management in the context of emesis related to anticancer therapies.
{"title":"Chemotherapy-induced nausea and vomiting: can we do better?","authors":"Florian Scotté","doi":"10.1097/CCO.0000000000001114","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001114","url":null,"abstract":"<p><strong>Purpose of review: </strong>Although the management of nausea and vomiting induced by cancer treatments has evolved, several questions remain unanswered.</p><p><strong>Recent findings: </strong>New antiemetics have been developed these last decades with therapeutic indications to be defined according to the anticancer regimen and partly as a consequence of the assessment of individual patient risk factors. Guidelines still seem to have a low level of knowledge and compliance, with a role for scientific societies in term of dissemination and education. A number of persistent issues relating to emesis still need improvement in prevention and management. Nausea remains a subjective semantic whose evaluation should possibly benefit from educational programs. The risk classification of anticancer drugs must be regularly updated, requiring regular literature reviews and the integration of data from clinical trials relating to emerging anticancer drugs. Recent data, particularly in the context of emerging drugs, highlight the importance to consider emesis' impact beyond the 5-day period, with a potential adaptation of antiemetic prophylaxis, including the mode of administration of oral drugs.</p><p><strong>Summary: </strong>Guidelines update is presented with literature answers to the current issues in order to improve quality of patient's management in the context of emesis related to anticancer therapies.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-17DOI: 10.1097/CCO.0000000000001125
Isabelle Mahé, Samuel Benarroch, Sadji Djennaoui, Rabiaa Hakem, Abdallah Ghorbel, Hélène Helfer, Jean Chidiac
Purpose of review: The life expectancy of patients suffering from thrombosis associated with cancer has improved significantly, making them a chronic disease. Patients with thrombosis and cancer are fragile. Treated with anticoagulants, they remain at risk of complications.
Recent findings: Consequently, news issues emerge for clinical practice: anticoagulation therapy personalization is required to optimize the benefit ratio, involving patient characteristics and cancer characteristics. During follow-up, prediction score are designed and investigated to help identify and discriminate patients at risk of venous thromboembolism recurrences and major bleedings. Considering the improved prognosis of patients with cancer and cancer-associated thrombosis, the question of extended treatment arises, representing a major unmet need to date. Finally, new strategies, in particular anti-XI agents that appear attractive options, are currently being evaluated in the treatment of thrombosis associated with cancer.
Summary: The improved prognosis of patients with cancer-associated thrombosis is accompanied by new therapeutic strategies to improve the benefit-risk ratio of anticoagulant treatment in these fragile patients, at risk of both venous thromboembolic recurrence and haemorrhagic complication.
{"title":"Cancer-associated thrombosis: what is new?","authors":"Isabelle Mahé, Samuel Benarroch, Sadji Djennaoui, Rabiaa Hakem, Abdallah Ghorbel, Hélène Helfer, Jean Chidiac","doi":"10.1097/CCO.0000000000001125","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001125","url":null,"abstract":"<p><strong>Purpose of review: </strong>The life expectancy of patients suffering from thrombosis associated with cancer has improved significantly, making them a chronic disease. Patients with thrombosis and cancer are fragile. Treated with anticoagulants, they remain at risk of complications.</p><p><strong>Recent findings: </strong>Consequently, news issues emerge for clinical practice: anticoagulation therapy personalization is required to optimize the benefit ratio, involving patient characteristics and cancer characteristics. During follow-up, prediction score are designed and investigated to help identify and discriminate patients at risk of venous thromboembolism recurrences and major bleedings. Considering the improved prognosis of patients with cancer and cancer-associated thrombosis, the question of extended treatment arises, representing a major unmet need to date. Finally, new strategies, in particular anti-XI agents that appear attractive options, are currently being evaluated in the treatment of thrombosis associated with cancer.</p><p><strong>Summary: </strong>The improved prognosis of patients with cancer-associated thrombosis is accompanied by new therapeutic strategies to improve the benefit-risk ratio of anticoagulant treatment in these fragile patients, at risk of both venous thromboembolic recurrence and haemorrhagic complication.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1097/CCO.0000000000001116
Aspasia Georgala, Jean Klastersky
Purpose of review: Febrile neutropenia as a complication of cytotoxic chemotherapies, remains a major event in the medical journey of hematology and oncology patients. In this review, we are trying to review the new elements and highlights that are shaping febrile neutropenia in nowadays.
Recent findings: Introduction of risk-stratification, expanded use of granulocyte-colony stimulating factor and oral treatment for selected patients and rapid administration of antibiotics revolutionized the treatment of febrile neutropenia. Oral treatment with moxifloxacine or amoxicillin-clavulanate + ciprofloxacin has already been widely tested and is actually a standard of care for a meticulously selected group of patients managed as ambulatory patients. Intravenous treatment of febrile neutropenia is a major challenge for clinicians and microbiologists since the blast of the "silent pandemic" of antimicrobial resistance.
Summary: In this setting, strategies that reduce the chances of febrile neutropenia, misuse of antibiotics and enhance the rigorous control of infections may offer a chance to improve the management of febrile neutropenia and offer to our patients the chance to continue their antineoplastic treatment without perturbations.
{"title":"Can febrile neutropenia re-invent its self?","authors":"Aspasia Georgala, Jean Klastersky","doi":"10.1097/CCO.0000000000001116","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001116","url":null,"abstract":"<p><strong>Purpose of review: </strong>Febrile neutropenia as a complication of cytotoxic chemotherapies, remains a major event in the medical journey of hematology and oncology patients. In this review, we are trying to review the new elements and highlights that are shaping febrile neutropenia in nowadays.</p><p><strong>Recent findings: </strong>Introduction of risk-stratification, expanded use of granulocyte-colony stimulating factor and oral treatment for selected patients and rapid administration of antibiotics revolutionized the treatment of febrile neutropenia. Oral treatment with moxifloxacine or amoxicillin-clavulanate + ciprofloxacin has already been widely tested and is actually a standard of care for a meticulously selected group of patients managed as ambulatory patients. Intravenous treatment of febrile neutropenia is a major challenge for clinicians and microbiologists since the blast of the \"silent pandemic\" of antimicrobial resistance.</p><p><strong>Summary: </strong>In this setting, strategies that reduce the chances of febrile neutropenia, misuse of antibiotics and enhance the rigorous control of infections may offer a chance to improve the management of febrile neutropenia and offer to our patients the chance to continue their antineoplastic treatment without perturbations.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1097/CCO.0000000000001118
Oumnia Mouna, Charlotte Hanssens, Michel Meyers, Mireille Langouo
Purpose of review: This review aims to explore the evolving management strategies for stage III melanoma, focusing on the comparative effectiveness of traditional surgical approaches like complete lymph node dissection (CLND) versus modern adjuvant therapies. It also examines the latest evidence on the efficacy, risks, and complications of these strategies, emphasizing the role of shared decision-making between patients and clinicians.
Recent findings: Recent clinical trials and meta-analyses, including the MSLT-II and DeCOG-SLT studies, have demonstrated that CLND may not significantly improve survival outcomes in melanoma patients with sentinel lymph node biopsy (SLNB)-positive status. Instead, a shift towards observation combined with adjuvant therapies such as immune checkpoint inhibitors and targeted therapies (for BRAF-mutant melanoma) has been observed. These approaches have been associated with similar or improved recurrence-free survival rates and reduced treatment-related complications. However, challenges remain in establishing standardized protocols for adjuvant therapy use.
Summary: The management of stage III melanoma is rapidly transitioning from routine CLND towards a more individualized approach that incorporates active surveillance and adjuvant therapies based on tumor biology and patient-specific factors. Multidisciplinary discussions are essential to guide treatment decisions, and further research is required to develop clear, evidence-based protocols.
{"title":"Is there still a place for lymph node dissection for stage III melanoma since the approval of adjuvant therapy.","authors":"Oumnia Mouna, Charlotte Hanssens, Michel Meyers, Mireille Langouo","doi":"10.1097/CCO.0000000000001118","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001118","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to explore the evolving management strategies for stage III melanoma, focusing on the comparative effectiveness of traditional surgical approaches like complete lymph node dissection (CLND) versus modern adjuvant therapies. It also examines the latest evidence on the efficacy, risks, and complications of these strategies, emphasizing the role of shared decision-making between patients and clinicians.</p><p><strong>Recent findings: </strong>Recent clinical trials and meta-analyses, including the MSLT-II and DeCOG-SLT studies, have demonstrated that CLND may not significantly improve survival outcomes in melanoma patients with sentinel lymph node biopsy (SLNB)-positive status. Instead, a shift towards observation combined with adjuvant therapies such as immune checkpoint inhibitors and targeted therapies (for BRAF-mutant melanoma) has been observed. These approaches have been associated with similar or improved recurrence-free survival rates and reduced treatment-related complications. However, challenges remain in establishing standardized protocols for adjuvant therapy use.</p><p><strong>Summary: </strong>The management of stage III melanoma is rapidly transitioning from routine CLND towards a more individualized approach that incorporates active surveillance and adjuvant therapies based on tumor biology and patient-specific factors. Multidisciplinary discussions are essential to guide treatment decisions, and further research is required to develop clear, evidence-based protocols.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1097/CCO.0000000000001112
Berit Jordan, Franziska Jahn, Karin Jordan
Purpose of review: Chemotherapy-induced peripheral neuropathy (CIPN) is a substantial adverse effect of anticancer therapy. No effective preventive strategies are established in clinical routine, although some forms of cryotherapy or compression therapy seem to be promising. CIPN is difficult to grade objectively and has mostly relied on a clinician- or patient-based rating that is subjective and not easily reproducible.
Recent findings: Recent preclinical and clinical studies showed an indicative hint of serum neurofilaments for axonal damage as a biomarker and might be introduced in clinical practice in the future. Axonal degeneration in toxic neuropathy is triggered by molecular pathways including SARM1. Presence of certain genotypes predispose for developing severe vincristine neuropathy. Still, treatment of CIPN is focused on treating neuropathic pain primarily based on physicians experience. A positive effect of membrane stabilizers such as gabapentinoids could not be shown in a systematic review mostly due to inconsistent study populations. In the treatment and prevention of functional disability, physical exercise including sensorimotor-training and whole-body vibration seems promising.
Summary: More research is needed on quantification of biomarkers indicative for axonal degeneration prior to CIPN symptom expression. All these recent findings should support the health-care team for a patient centred treatment approach.
{"title":"Peripheral neuropathy: from guidelines to clinical practise.","authors":"Berit Jordan, Franziska Jahn, Karin Jordan","doi":"10.1097/CCO.0000000000001112","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001112","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is a substantial adverse effect of anticancer therapy. No effective preventive strategies are established in clinical routine, although some forms of cryotherapy or compression therapy seem to be promising. CIPN is difficult to grade objectively and has mostly relied on a clinician- or patient-based rating that is subjective and not easily reproducible.</p><p><strong>Recent findings: </strong>Recent preclinical and clinical studies showed an indicative hint of serum neurofilaments for axonal damage as a biomarker and might be introduced in clinical practice in the future. Axonal degeneration in toxic neuropathy is triggered by molecular pathways including SARM1. Presence of certain genotypes predispose for developing severe vincristine neuropathy. Still, treatment of CIPN is focused on treating neuropathic pain primarily based on physicians experience. A positive effect of membrane stabilizers such as gabapentinoids could not be shown in a systematic review mostly due to inconsistent study populations. In the treatment and prevention of functional disability, physical exercise including sensorimotor-training and whole-body vibration seems promising.</p><p><strong>Summary: </strong>More research is needed on quantification of biomarkers indicative for axonal degeneration prior to CIPN symptom expression. All these recent findings should support the health-care team for a patient centred treatment approach.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1097/CCO.0000000000001122
Didier Mayeur
Purpose of review: New anticancer drugs often are associated with improved results, such as objective response and disease-free survival. But with these new drugs, patients, caregivers and medical oncologist have to face new toxicities, quite different from the side effects of conventional chemotherapy. The aim of this review is to share the actual knowledge about these new toxicities.
Recent findings: We review here some of these new toxicities, as ocular, cardio, lung and mucocutaneous toxicities, as well as specific side effects of CAR-T cells. We also discuss a specific problem, which is financial toxicity.
Summary: With this review, caregivers and medical oncologists will be aware of these new toxicities and able to develop their own network of specialized practitioners to provide the best possible supportive care.
{"title":"Emerging toxicities in oncology.","authors":"Didier Mayeur","doi":"10.1097/CCO.0000000000001122","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001122","url":null,"abstract":"<p><strong>Purpose of review: </strong>New anticancer drugs often are associated with improved results, such as objective response and disease-free survival. But with these new drugs, patients, caregivers and medical oncologist have to face new toxicities, quite different from the side effects of conventional chemotherapy. The aim of this review is to share the actual knowledge about these new toxicities.</p><p><strong>Recent findings: </strong>We review here some of these new toxicities, as ocular, cardio, lung and mucocutaneous toxicities, as well as specific side effects of CAR-T cells. We also discuss a specific problem, which is financial toxicity.</p><p><strong>Summary: </strong>With this review, caregivers and medical oncologists will be aware of these new toxicities and able to develop their own network of specialized practitioners to provide the best possible supportive care.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-06DOI: 10.1097/CCO.0000000000001123
Mario Di Palma
Purpose of review: Monitoring the side effects of treatments in cancer patients is a key challenge in clinical practice, especially with the development of oral therapies.The impact on patients is multifaceted: morbidity or even life-threatening risks in the case of severe side effects; deterioration in quality of life and functional abilities; lower adherence to treatments; reduced dose intensity, which can affect the efficacy of therapies.
Recent findings: The availability of digital tools for remote patient monitoring is transforming our ability to track these patients effectively. These tools enable monitoring of a large number of patients while identifying those experiencing difficulties; early detection of side effects.
Summary: The aim of this article is to provide an overview of the use of digital tools for patient follow-up, their relevance, benefits, and the impact on both patients and healthcare organization.
{"title":"How to monitor the side effects of treatments in cancer patients.","authors":"Mario Di Palma","doi":"10.1097/CCO.0000000000001123","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001123","url":null,"abstract":"<p><strong>Purpose of review: </strong>Monitoring the side effects of treatments in cancer patients is a key challenge in clinical practice, especially with the development of oral therapies.The impact on patients is multifaceted: morbidity or even life-threatening risks in the case of severe side effects; deterioration in quality of life and functional abilities; lower adherence to treatments; reduced dose intensity, which can affect the efficacy of therapies.</p><p><strong>Recent findings: </strong>The availability of digital tools for remote patient monitoring is transforming our ability to track these patients effectively. These tools enable monitoring of a large number of patients while identifying those experiencing difficulties; early detection of side effects.</p><p><strong>Summary: </strong>The aim of this article is to provide an overview of the use of digital tools for patient follow-up, their relevance, benefits, and the impact on both patients and healthcare organization.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-12-02DOI: 10.1097/CCO.0000000000001111
Veronika Pozonec, Maria Dorothea Pozonec, Clemens Aigner, Joachim Widder, Kristiina Boettiger, Zsolt Megyesfalvi, Balazs Dome
Purpose of review: Small cell lung cancer (SCLC) is an aggressive disease with a poor prognosis, whereas its metastatic capacity carries a predilection for the brain. Although prophylactic cranial irradiation (PCI) has been used to address this problem, upcoming alternatives might necessitate reflection of its application in SCLC treatment.
Recent findings: The addition of immunotherapy to treatment guidelines has provided a new strategy for the management of brain metastases. Complementation of immunotherapy with active MRI surveillance could potentially replace PCI and avoid irradiation-related cognitive side effects. SCLC's molecular profile is heterogeneous, with differential response to treatment modalities between subgroups. Investigation of these variances might be essential to improve therapeutic outcomes in SCLC patients.
Summary: The role of PCI in SCLC treatment must be examined in light of immunotherapy. We summarize recent results, bearing SCLC subtypes and therapeutic vulnerabilities in mind, to derive tailored treatment strategies for SCLC patients in future settings.
{"title":"Prophylactic cranial irradiation for small cell lung cancer in the era of immunotherapy and molecular subtypes.","authors":"Veronika Pozonec, Maria Dorothea Pozonec, Clemens Aigner, Joachim Widder, Kristiina Boettiger, Zsolt Megyesfalvi, Balazs Dome","doi":"10.1097/CCO.0000000000001111","DOIUrl":"10.1097/CCO.0000000000001111","url":null,"abstract":"<p><strong>Purpose of review: </strong>Small cell lung cancer (SCLC) is an aggressive disease with a poor prognosis, whereas its metastatic capacity carries a predilection for the brain. Although prophylactic cranial irradiation (PCI) has been used to address this problem, upcoming alternatives might necessitate reflection of its application in SCLC treatment.</p><p><strong>Recent findings: </strong>The addition of immunotherapy to treatment guidelines has provided a new strategy for the management of brain metastases. Complementation of immunotherapy with active MRI surveillance could potentially replace PCI and avoid irradiation-related cognitive side effects. SCLC's molecular profile is heterogeneous, with differential response to treatment modalities between subgroups. Investigation of these variances might be essential to improve therapeutic outcomes in SCLC patients.</p><p><strong>Summary: </strong>The role of PCI in SCLC treatment must be examined in light of immunotherapy. We summarize recent results, bearing SCLC subtypes and therapeutic vulnerabilities in mind, to derive tailored treatment strategies for SCLC patients in future settings.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":"37 1","pages":"27-34"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}