Pub Date : 2024-10-22DOI: 10.1016/j.critrevonc.2024.104533
Miriam Forte , Sabrina Chiara Cecere , Marilena Di Napoli , Jole Ventriglia , Rosa Tambaro , Sabrina Rossetti , Anna Passarelli , Chiara Casartelli , Martina Rauso , Gennaro Alberico , Chiara Mignogna , Francesco Fiore , Sergio Venanzio Setola , Teresa Troiani , Sandro Pignata , Carmela Pisano
Endometrial cancer incidence and related mortality are on the rise due to aging demographics. This population often presents with unfavorable features, such as myometrial invasion, non-endometrioid histology, high-grade tumors, worse prognosis, etc. The role of age as an independent prognostic factor is still debated, and screening tools addressing frailty emerge as pivotal in guiding treatment decisions; however, they are still underutilized. Treatment disparities are evident in the case of older patients with endometrial cancer, who frequently receive suboptimal care, hindering their survival. Radiotherapy and minimally invasive surgical approaches could be performed in older patients. Data on chemotherapy and immunotherapy are scarce, but their potential remains promising and data are being gathered by recent trials, contingent on optimal patient selection through geriatric assessments. Overall, we recommend personalized, screening tool-guided approaches, adherence to guideline-recommended treatments, and inclusion of older people in clinical trials to help identify the best course of treatment.
{"title":"Endometrial cancer in the elderly: Characteristics, prognostic and risk factors, and treatment options","authors":"Miriam Forte , Sabrina Chiara Cecere , Marilena Di Napoli , Jole Ventriglia , Rosa Tambaro , Sabrina Rossetti , Anna Passarelli , Chiara Casartelli , Martina Rauso , Gennaro Alberico , Chiara Mignogna , Francesco Fiore , Sergio Venanzio Setola , Teresa Troiani , Sandro Pignata , Carmela Pisano","doi":"10.1016/j.critrevonc.2024.104533","DOIUrl":"10.1016/j.critrevonc.2024.104533","url":null,"abstract":"<div><div>Endometrial cancer incidence and related mortality are on the rise due to aging demographics. This population often presents with unfavorable features, such as myometrial invasion, non-endometrioid histology, high-grade tumors, worse prognosis, etc. The role of age as an independent prognostic factor is still debated, and screening tools addressing frailty emerge as pivotal in guiding treatment decisions; however, they are still underutilized. Treatment disparities are evident in the case of older patients with endometrial cancer, who frequently receive suboptimal care, hindering their survival. Radiotherapy and minimally invasive surgical approaches could be performed in older patients. Data on chemotherapy and immunotherapy are scarce, but their potential remains promising and data are being gathered by recent trials, contingent on optimal patient selection through geriatric assessments. Overall, we recommend personalized, screening tool-guided approaches, adherence to guideline-recommended treatments, and inclusion of older people in clinical trials to help identify the best course of treatment.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"204 ","pages":"Article 104533"},"PeriodicalIF":5.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-20DOI: 10.1016/j.critrevonc.2024.104535
Serena Astore, Ester Oneda, Alberto Zaniboni
The first-line combination therapies utilizing cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) with endocrine therapy (ET) have significantly impacted the course of hormone receptor positive (HR+)/Human Epidermal Growth Factor Receptor 2 negative (HER2-) advanced breast cancer (ABC). However, resistance often emerges, leading to a molecularly different disease. Estrogen receptor one (ESR1) gene mutations, driving resistance to aromatase inhibitors (AIs), may guide the use of fulvestrant or emerging oral selective estrogen receptor degraders (SERDs) like elacestrant. The dynamic nature of ESR1 mutations suggests potential guidance for continuing CDK4/6i therapy beyond progression. Targeting mutations like breast cancer gene 1 and 2 (BRCA 1/2) with Poly (ADP-ribose) polymerase (PARP) inhibitors or the PI3K/AKT/mTOR pathway provides therapeutic options. The advent of antibody-drug conjugates (ADCs) like trastuzumab deruxtecan (T-DXd) and novel agents targeting Trophoblast cell surface antigen-2 (Trop-2) introduces further complexity, underscoring the need for early intervention targeting specific genomic alterations in metastatic BC.
{"title":"A therapeutic algorithm guiding subsequent therapy selection after CDK4/6 inhibitors’ failure: A review of current and investigational treatment for HR+/Her2- breast cancer","authors":"Serena Astore, Ester Oneda, Alberto Zaniboni","doi":"10.1016/j.critrevonc.2024.104535","DOIUrl":"10.1016/j.critrevonc.2024.104535","url":null,"abstract":"<div><div>The first-line combination therapies utilizing cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) with endocrine therapy (ET) have significantly impacted the course of hormone receptor positive (HR+)/Human Epidermal Growth Factor Receptor 2 negative (HER2-) advanced breast cancer (ABC). However, resistance often emerges, leading to a molecularly different disease. Estrogen receptor one (ESR1) gene mutations, driving resistance to aromatase inhibitors (AIs), may guide the use of fulvestrant or emerging oral selective estrogen receptor degraders (SERDs) like elacestrant. The dynamic nature of ESR1 mutations suggests potential guidance for continuing CDK4/6i therapy beyond progression. Targeting mutations like breast cancer gene 1 and 2 (BRCA 1/2) with Poly (ADP-ribose) polymerase (PARP) inhibitors or the PI3K/AKT/mTOR pathway provides therapeutic options. The advent of antibody-drug conjugates (ADCs) like trastuzumab deruxtecan (T-DXd) and novel agents targeting Trophoblast cell surface antigen-2 (Trop-2) introduces further complexity, underscoring the need for early intervention targeting specific genomic alterations in metastatic BC.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"204 ","pages":"Article 104535"},"PeriodicalIF":5.5,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-19DOI: 10.1016/j.critrevonc.2024.104538
Ioana-Claudia Costin , Corina Cinezan , Loredana G. Marcu
Cardio-oncology is lately gaining more attention due to radiation-induced cardiac events reported by a very large number of studies. In view of this, the current overview of the literature aimed to encompass all studies from the past 15 years to assess changes in cardiac dose due to treatment evolution, as well as the changes in treatment planning customs to incorporate not only the heart as a whole but also cardiac substructures. Modern treatment techniques, particularly proton therapy, offers superior cardiac sparing compared to more established radiotherapy, for all evaluated tumor sites. Intensity modulation, particularly coupled with respiratory gating shows significant improvement in dose-volume parameters pertaining to the heart. While past studies considered mean heart dose as the only reference for cardiac toxicities, recommendations for the other cardiac substructures to be dosimetrically assessed during planning are becoming more common.
{"title":"Cardio-oncology concerns in radiotherapy: Heart and cardiac substructure toxicities from modern delivery techniques","authors":"Ioana-Claudia Costin , Corina Cinezan , Loredana G. Marcu","doi":"10.1016/j.critrevonc.2024.104538","DOIUrl":"10.1016/j.critrevonc.2024.104538","url":null,"abstract":"<div><div>Cardio-oncology is lately gaining more attention due to radiation-induced cardiac events reported by a very large number of studies. In view of this, the current overview of the literature aimed to encompass all studies from the past 15 years to assess changes in cardiac dose due to treatment evolution, as well as the changes in treatment planning customs to incorporate not only the heart as a whole but also cardiac substructures. Modern treatment techniques, particularly proton therapy, offers superior cardiac sparing compared to more established radiotherapy, for all evaluated tumor sites. Intensity modulation, particularly coupled with respiratory gating shows significant improvement in dose-volume parameters pertaining to the heart. While past studies considered mean heart dose as the only reference for cardiac toxicities, recommendations for the other cardiac substructures to be dosimetrically assessed during planning are becoming more common.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"204 ","pages":"Article 104538"},"PeriodicalIF":5.5,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 10.1016/j.critrevonc.2024.104536
Zi-Zhan Li , Kan Zhou , Qiuji Wu , Bing Liu , Lin-Lin Bu
Lymph node metastasis (LNM) is often regarded as an indicator of poor prognosis in various cancers. Despite over three centuries of exploration since its discovery, the molecular mechanisms underlying LNM remain inconclusive. This review summarizes the molecular mechanisms of LNM, using the "PUMP+" principle for clarification. Pathological examination remains the gold standard for LNM diagnosis, yet there is a need to explore early diagnostic strategies that can effectively improve patient outcomes. With the advent of immunotherapy, discussions on the fate of lymph nodes (LN) have emerged, emphasizing the importance of preserving LN integrity prior to immunotherapy. This, in turn, poses higher demands for diagnostic accuracy and precision treatment of LNM. This review comprehensively discusses the molecular mechanisms, diagnostic methods, and treatment strategies for cancer lymph node metastasis, along with current bottlenecks and future directions in this field.
{"title":"Lymph node metastasis in cancer: Clearing the clouds to see the dawn","authors":"Zi-Zhan Li , Kan Zhou , Qiuji Wu , Bing Liu , Lin-Lin Bu","doi":"10.1016/j.critrevonc.2024.104536","DOIUrl":"10.1016/j.critrevonc.2024.104536","url":null,"abstract":"<div><div>Lymph node metastasis (LNM) is often regarded as an indicator of poor prognosis in various cancers. Despite over three centuries of exploration since its discovery, the molecular mechanisms underlying LNM remain inconclusive. This review summarizes the molecular mechanisms of LNM, using the \"PUMP+\" principle for clarification. Pathological examination remains the gold standard for LNM diagnosis, yet there is a need to explore early diagnostic strategies that can effectively improve patient outcomes. With the advent of immunotherapy, discussions on the fate of lymph nodes (LN) have emerged, emphasizing the importance of preserving LN integrity prior to immunotherapy. This, in turn, poses higher demands for diagnostic accuracy and precision treatment of LNM. This review comprehensively discusses the molecular mechanisms, diagnostic methods, and treatment strategies for cancer lymph node metastasis, along with current bottlenecks and future directions in this field.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"204 ","pages":"Article 104536"},"PeriodicalIF":5.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 10.1016/j.critrevonc.2024.104531
Antonio Galvano , Andrea Gottardo , Valerio Gristina , Daniele Fanale , Lidia Rita Corsini , Carlo Pavone , Tancredi Didier Bazan Russo , Emilia Di Giovanni , Giuliana Iannì , Ugo Randazzo , Federica Iacono , Alessandro Perez , Chiara Brando , Marco Bono , Viviana Bazan , Lorena Incorvaia , Giuseppe Badalamenti , Saverio Cinieri , Mauro Boldrini , Rossana Berardi , Antonio Russo
The communication of scientific knowledge to patients and society as a whole has never been more central than in modern times. Thanks to the recent pandemic, it has become evident how Scientific Communication (SC) has evolved over time, increasingly diverging from common language. However, it is also clear that it must be properly used by healthcare professionals to avoid comprehension issues that could be severe for the audience. Presently, science and technology are at the heart of progress and innovation; therefore, the proper dissemination of accurate yet accessible information to the population is vital to ensure that no one is left behind and to promote cohesive social advancement. This review aims to analyze the notions of SC and Scientific Method (SM), examining the relationships between them and providing suggestions on how to integrate them properly in both a broader context and the specific field of communication with oncology patients.
{"title":"Scientific Communication and oncology – \"The bridge between knowledge and patients\"","authors":"Antonio Galvano , Andrea Gottardo , Valerio Gristina , Daniele Fanale , Lidia Rita Corsini , Carlo Pavone , Tancredi Didier Bazan Russo , Emilia Di Giovanni , Giuliana Iannì , Ugo Randazzo , Federica Iacono , Alessandro Perez , Chiara Brando , Marco Bono , Viviana Bazan , Lorena Incorvaia , Giuseppe Badalamenti , Saverio Cinieri , Mauro Boldrini , Rossana Berardi , Antonio Russo","doi":"10.1016/j.critrevonc.2024.104531","DOIUrl":"10.1016/j.critrevonc.2024.104531","url":null,"abstract":"<div><div>The communication of scientific knowledge to patients and society as a whole has never been more central than in modern times. Thanks to the recent pandemic, it has become evident how Scientific Communication (SC) has evolved over time, increasingly diverging from common language. However, it is also clear that it must be properly used by healthcare professionals to avoid comprehension issues that could be severe for the audience. Presently, science and technology are at the heart of progress and innovation; therefore, the proper dissemination of accurate yet accessible information to the population is vital to ensure that no one is left behind and to promote cohesive social advancement. This review aims to analyze the notions of SC and Scientific Method (SM), examining the relationships between them and providing suggestions on how to integrate them properly in both a broader context and the specific field of communication with oncology patients.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"204 ","pages":"Article 104531"},"PeriodicalIF":5.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.1016/j.critrevonc.2024.104528
Istiak Ahmad , Fahad Alqurashi
Cancer, characterized by the uncontrolled division of abnormal cells that harm body tissues, necessitates early detection for effective treatment. Medical imaging is crucial for identifying various cancers, yet its manual interpretation by radiologists is often subjective, labour-intensive, and time-consuming. Consequently, there is a critical need for an automated decision-making process to enhance cancer detection and diagnosis. Previously, a lot of work was done on surveys of different cancer detection methods, and most of them were focused on specific cancers and limited techniques. This study presents a comprehensive survey of cancer detection methods. It entails a review of 99 research articles collected from the Web of Science, IEEE, and Scopus databases, published between 2020 and 2024. The scope of the study encompasses 12 types of cancer, including breast, cervical, ovarian, prostate, esophageal, liver, pancreatic, colon, lung, oral, brain, and skin cancers. This study discusses different cancer detection techniques, including medical imaging data, image preprocessing, segmentation, feature extraction, deep learning and transfer learning methods, and evaluation metrics. Eventually, we summarised the datasets and techniques with research challenges and limitations. Finally, we provide future directions for enhancing cancer detection techniques.
癌症的特点是异常细胞不受控制地分裂，对人体组织造成伤害，因此必须及早发现，才能有效治疗。医学成像对识别各种癌症至关重要，但放射科医生的人工判读往往主观、耗费大量人力和时间。因此，亟需一种自动决策程序来加强癌症检测和诊断。此前，针对不同癌症检测方法的调查做了大量工作，其中大部分都集中在特定癌症和有限的技术上。本研究对癌症检测方法进行了全面调查。研究回顾了从 Web of Science、IEEE 和 Scopus 数据库中收集的 99 篇研究文章，这些文章发表于 2020 年至 2024 年之间。研究范围涵盖 12 种癌症，包括乳腺癌、宫颈癌、卵巢癌、前列腺癌、食道癌、肝癌、胰腺癌、结肠癌、肺癌、口腔癌、脑癌和皮肤癌。本研究讨论了不同的癌症检测技术，包括医学成像数据、图像预处理、分割、特征提取、深度学习和迁移学习方法以及评估指标。最后，我们总结了数据集和技术，以及研究挑战和局限性。最后，我们提出了加强癌症检测技术的未来方向。
{"title":"Early cancer detection using deep learning and medical imaging: A survey","authors":"Istiak Ahmad , Fahad Alqurashi","doi":"10.1016/j.critrevonc.2024.104528","DOIUrl":"10.1016/j.critrevonc.2024.104528","url":null,"abstract":"<div><div>Cancer, characterized by the uncontrolled division of abnormal cells that harm body tissues, necessitates early detection for effective treatment. Medical imaging is crucial for identifying various cancers, yet its manual interpretation by radiologists is often subjective, labour-intensive, and time-consuming. Consequently, there is a critical need for an automated decision-making process to enhance cancer detection and diagnosis. Previously, a lot of work was done on surveys of different cancer detection methods, and most of them were focused on specific cancers and limited techniques. This study presents a comprehensive survey of cancer detection methods. It entails a review of 99 research articles collected from the Web of Science, IEEE, and Scopus databases, published between 2020 and 2024. The scope of the study encompasses 12 types of cancer, including breast, cervical, ovarian, prostate, esophageal, liver, pancreatic, colon, lung, oral, brain, and skin cancers. This study discusses different cancer detection techniques, including medical imaging data, image preprocessing, segmentation, feature extraction, deep learning and transfer learning methods, and evaluation metrics. Eventually, we summarised the datasets and techniques with research challenges and limitations. Finally, we provide future directions for enhancing cancer detection techniques.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"204 ","pages":"Article 104528"},"PeriodicalIF":5.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Glioma, an aggressive type of brain tumors of glial origin is highly heterogeneous, posing significant treatment challenges due to its intrinsic resistance to conventional therapeutic schemes. It is characterized by an interplay between epigenetic and genetic alterations in key signaling pathways which further endorse their resistance potential. Aberrant DNA methylation patterns, histone modifications and non-coding RNAs may alter the expression of genes associated with drug response and cell survival, induce gene silencing or deregulate key pathways contributing to glioma resistance. There is evidence that epigenetic plasticity enables glioma cells to adapt dynamically to therapeutic schemes and allow the formation of drug-resistant subpopulations. Furthermore, the tumor microenvironment adds an extra input on epigenetic regulation, increasing the complexity of resistance mechanisms. Herein, we discuss epigenetic changes conferring to drug resistance mechanisms in gliomas in order to delineate novel therapeutic targets and potential approaches that will enable personalized treatment.
{"title":"Targeting epigenetic mechanisms of resistance to chemotherapy in gliomas","authors":"Panagiotis Skouras , Mariam Markouli , Ioanna Papadatou , Christina Piperi","doi":"10.1016/j.critrevonc.2024.104532","DOIUrl":"10.1016/j.critrevonc.2024.104532","url":null,"abstract":"<div><div>Glioma, an aggressive type of brain tumors of glial origin is highly heterogeneous, posing significant treatment challenges due to its intrinsic resistance to conventional therapeutic schemes. It is characterized by an interplay between epigenetic and genetic alterations in key signaling pathways which further endorse their resistance potential. Aberrant DNA methylation patterns, histone modifications and non-coding RNAs may alter the expression of genes associated with drug response and cell survival, induce gene silencing or deregulate key pathways contributing to glioma resistance. There is evidence that epigenetic plasticity enables glioma cells to adapt dynamically to therapeutic schemes and allow the formation of drug-resistant subpopulations. Furthermore, the tumor microenvironment adds an extra input on epigenetic regulation, increasing the complexity of resistance mechanisms. Herein, we discuss epigenetic changes conferring to drug resistance mechanisms in gliomas in order to delineate novel therapeutic targets and potential approaches that will enable personalized treatment.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"204 ","pages":"Article 104532"},"PeriodicalIF":5.5,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antibody-drug conjugates (ADCs) are revolutionizing metastatic breast cancer treatment, resulting in a better prognosis and a higher safety profile than chemotherapy. Nevertheless, treatment-related adverse events (TRAE) have been extensively documented. We searched five databases for articles published up to December 2023 and conducted a meta-analysis on 23 clinical trials to estimate TRAE prevalence related to currently approved ADCs.
The prevalence of the most common TRAEs ranged from 12 % to 33 %, depending on the ADC type and study design. Gastrointestinal disorders were highly prevalent during Trastuzumab Deruxtecan, general disorders were extremely common during Trastuzumab Emtansine, and blood system disorders and gastrointestinal disorders were the most prevalent during Sacituzumab Govitecan.
This study provides an estimate of ADC-related TRAEs for each treatment based on study design. Despite each ADC having specific toxicities, gastrointestinal symptoms were highly prevalent in all treatments. This study lays the groundwork for developing personalized risk-stratified care pathways.
{"title":"Prevalence of treatment-related adverse events (TRAEs) with antibody-drug conjugates in metastatic breast cancer patients: A systematic review and meta-analysis","authors":"Silvia Belloni , Paola Tiberio , Rita De Sanctis , Arianna Magon , Armando Santoro , Alberto Zambelli , Rosario Caruso , Cristina Arrigoni","doi":"10.1016/j.critrevonc.2024.104527","DOIUrl":"10.1016/j.critrevonc.2024.104527","url":null,"abstract":"<div><div>Antibody-drug conjugates (ADCs) are revolutionizing metastatic breast cancer treatment, resulting in a better prognosis and a higher safety profile than chemotherapy. Nevertheless, treatment-related adverse events (TRAE) have been extensively documented. We searched five databases for articles published up to December 2023 and conducted a meta-analysis on 23 clinical trials to estimate TRAE prevalence related to currently approved ADCs.</div><div>The prevalence of the most common TRAEs ranged from 12 % to 33 %, depending on the ADC type and study design. Gastrointestinal disorders were highly prevalent during Trastuzumab Deruxtecan, general disorders were extremely common during Trastuzumab Emtansine, and blood system disorders and gastrointestinal disorders were the most prevalent during Sacituzumab Govitecan.</div><div>This study provides an estimate of ADC-related TRAEs for each treatment based on study design. Despite each ADC having specific toxicities, gastrointestinal symptoms were highly prevalent in all treatments. This study lays the groundwork for developing personalized risk-stratified care pathways.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"204 ","pages":"Article 104527"},"PeriodicalIF":5.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.critrevonc.2024.104525
Ying-Ying Zhang , Fang-Hua Liu , Ya-Li Wang , Jia-Xin Liu , Lang Wu , Ying Qin , Wen-Rui Zheng , Wei-Yi Xing , Jin Xu , Xing Chen , He-Li Xu , Qi Bao , Jia-Yi Wang , Ran Wang , Xi-Yang Chen , Yi-Fan Wei , Bing-Jie Zou , Jia-Cheng Liu , Jia-Li Yin , Ming-Qian Jia , Qi-Jun Wu
Meta-analyses have reported conflicting data on the whole blood cell count (WBCC) derived indexes (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and lymphocyte-to-monocyte ratio [LMR]) and cancer prognosis. However, the strength and quality of this evidence has not been quantified in aggregate. To grade the evidence from published meta-analyses of cohort studies that investigated the associations between NLR, PLR, and LMR and cancer prognosis. A total of 694 associations from 224 articles were included. And 219 (97.8%) articles rated as moderate-to-high quality according to AMSTAR. There were four associations supported by convincing evidence. Meanwhile, 165 and 164 associations were supported by highly suggestive and suggestive evidence, respectively. In this umbrella review, we summarized the existing evidence on the WBCC-derived indexes and cancer prognosis. Due to the direction of effect sizes is not completely consistent between studies, further research is needed to assess causality and provide firm evidence.
{"title":"Associations between peripheral whole blood cell counts derived indexes and cancer prognosis: An umbrella review of meta-analyses of cohort studies","authors":"Ying-Ying Zhang , Fang-Hua Liu , Ya-Li Wang , Jia-Xin Liu , Lang Wu , Ying Qin , Wen-Rui Zheng , Wei-Yi Xing , Jin Xu , Xing Chen , He-Li Xu , Qi Bao , Jia-Yi Wang , Ran Wang , Xi-Yang Chen , Yi-Fan Wei , Bing-Jie Zou , Jia-Cheng Liu , Jia-Li Yin , Ming-Qian Jia , Qi-Jun Wu","doi":"10.1016/j.critrevonc.2024.104525","DOIUrl":"10.1016/j.critrevonc.2024.104525","url":null,"abstract":"<div><div>Meta-analyses have reported conflicting data on the whole blood cell count (WBCC) derived indexes (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and lymphocyte-to-monocyte ratio [LMR]) and cancer prognosis. However, the strength and quality of this evidence has not been quantified in aggregate. To grade the evidence from published meta-analyses of cohort studies that investigated the associations between NLR, PLR, and LMR and cancer prognosis. A total of 694 associations from 224 articles were included. And 219 (97.8%) articles rated as moderate-to-high quality according to AMSTAR. There were four associations supported by convincing evidence. Meanwhile, 165 and 164 associations were supported by highly suggestive and suggestive evidence, respectively. In this umbrella review, we summarized the existing evidence on the WBCC-derived indexes and cancer prognosis. Due to the direction of effect sizes is not completely consistent between studies, further research is needed to assess causality and provide firm evidence.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"204 ","pages":"Article 104525"},"PeriodicalIF":5.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.critrevonc.2024.104526
Filippo Gagliardi , Pierfrancesco De Domenico , Silvia Snider, Riccardo Calcagnile, Francesca Roncelli, Lina Raffaella Barzaghi, Pietro Mortini
This is a single-center experience and metanalysis of the safety and efficacy measures of Gamma-knife stereotactic radiosurgery (SRS-GK) for radiation-induced meningiomas (RIMs). This study comprised a single-center analysis of SRS-GK for RIMs at IRCCS San Raffaele Hospital, Milan, Italy, and a systematic literature review and meta-analysis to address the actuarial local control (LC), distant control (DC), progression-free survival (PFS), and toxicity. The original series comprised 13 patients harboring 30 RIMs. Partial response was observed in 26 %, stability in 52 %, and progression in 22 %. The 5-year LC and DC rates were 71 % and 67 %. One patient developed radionecrosis, and an additional 2 presented edema. Metanalysis comprised 4 papers and data from the original series, comprising 146 patients and 308 RIMs. The 5-year LC was 84 %, the DC 67 %, and radionecrosis in 1.4 %. SRS-GK has an efficacy profile falling between that observed for radiologically suspected sporadic meningiomas and confirmed higher-grade lesions.
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