Pub Date : 2024-05-23DOI: 10.1016/j.critrevonc.2024.104391
Dattatrya Shetti , Venkata Ramana Mallela , Wenjing Ye , Mahyar Sharif , Filip Ambrozkiewicz , Andriy Trailin , Václav Liška , Kari Hemminki
Hepatocellular carcinoma (HCC) is a severe neoplastic disease associated with high morbidity and mortality rates. HCC is often detected at advanced stages leading to ineffective curative treatments. Recently, liquid biopsy has emerged as a non-invasive method to identify highly specific HCC biomarkers in bodily fluids such as blood, serum, urine, and saliva. Circulating cell-free nucleic acids (cfNAs), particularly cell-free DNA (cfDNA) and cell-free RNA (cfRNA), have become promising candidates for biomarkers in liquid biopsy applications. While cfDNA presented significant challenges, researchers have turned their attention to cfRNA, which can be efficiently identified through various methods and is considered a potential biomarker for cancer diagnosis and prognosis. This review primarily focuses on studies related to detecting various cfRNA in body fluids as biomarkers. The aim is to provide a summary of available information to assist researchers in their investigations and the development of new diagnostic and prognostic tools.
{"title":"Emerging role of circulating cell-free RNA as a non-invasive biomarker for hepatocellular carcinoma","authors":"Dattatrya Shetti , Venkata Ramana Mallela , Wenjing Ye , Mahyar Sharif , Filip Ambrozkiewicz , Andriy Trailin , Václav Liška , Kari Hemminki","doi":"10.1016/j.critrevonc.2024.104391","DOIUrl":"10.1016/j.critrevonc.2024.104391","url":null,"abstract":"<div><p>Hepatocellular carcinoma (HCC) is a severe neoplastic disease associated with high morbidity and mortality rates. HCC is often detected at advanced stages leading to ineffective curative treatments. Recently, liquid biopsy has emerged as a non-invasive method to identify highly specific HCC biomarkers in bodily fluids such as blood, serum, urine, and saliva. Circulating cell-free nucleic acids (cfNAs), particularly cell-free DNA (cfDNA) and cell-free RNA (cfRNA), have become promising candidates for biomarkers in liquid biopsy applications. While cfDNA presented significant challenges, researchers have turned their attention to cfRNA, which can be efficiently identified through various methods and is considered a potential biomarker for cancer diagnosis and prognosis. This review primarily focuses on studies related to detecting various cfRNA in body fluids as biomarkers. The aim is to provide a summary of available information to assist researchers in their investigations and the development of new diagnostic and prognostic tools.</p></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1040842824001343/pdfft?md5=0cf73fa52b39b04ca92d32f015dd2be0&pid=1-s2.0-S1040842824001343-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141136146","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 : 2024-05-22DOI: 10.1016/j.critrevonc.2024.104390
Lingzi Yu , Rui Zou , Jiajie He , Changju Qu
Chimeric antigen receptor T-cell (CAR-T) therapy has revolutionized the treatment approach for patients with relapsed/refractory non-Hodgkin lymphoma (R/R NHL). However, the long-term prognosis has been discouraging. Moreover, the urgent resolution of two critical issues is necessary: minimize tumor burden before CAR-T infusion and control fatal toxicities post CAR-T therapy. By combining radiotherapy (RT), the safety and efficacy of CAR-T can be improved. RT can serve as bridging therapy, reducing the tumor burden before CAR-T infusion, thus enabling safe and successful CAR-T infusion, and as salvage therapy in cases of CAR-T therapy failure. This review aims to discuss the current evidence supporting the use of RT in CAR-T therapy for patients with R/R NHL. Although most studies have shown a positive role of RT in combined modality treatments for patients undergoing CAR-T therapy, the synergy gained from these remains uncertain. Furthermore, the optimal dose/fraction and radiation response require further investigation.
{"title":"Role of radiation in chimeric antigen receptor T-cell therapy for patients with relapsed/refractory non-Hodgkin lymphoma: Current studies and future prospects","authors":"Lingzi Yu , Rui Zou , Jiajie He , Changju Qu","doi":"10.1016/j.critrevonc.2024.104390","DOIUrl":"10.1016/j.critrevonc.2024.104390","url":null,"abstract":"<div><p>Chimeric antigen receptor T-cell (CAR-T) therapy has revolutionized the treatment approach for patients with relapsed/refractory non-Hodgkin lymphoma (R/R NHL). However, the long-term prognosis has been discouraging. Moreover, the urgent resolution of two critical issues is necessary: minimize tumor burden before CAR-T infusion and control fatal toxicities post CAR-T therapy. By combining radiotherapy (RT), the safety and efficacy of CAR-T can be improved. RT can serve as bridging therapy, reducing the tumor burden before CAR-T infusion, thus enabling safe and successful CAR-T infusion, and as salvage therapy in cases of CAR-T therapy failure. This review aims to discuss the current evidence supporting the use of RT in CAR-T therapy for patients with R/R NHL. Although most studies have shown a positive role of RT in combined modality treatments for patients undergoing CAR-T therapy, the synergy gained from these remains uncertain. Furthermore, the optimal dose/fraction and radiation response require further investigation.</p></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089507","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 : 2024-05-16DOI: 10.1016/j.critrevonc.2024.104384
David Combarel , Léa Dousset , Stéphane Bouchet , Florent Ferrer , Pauline Tetu , Céleste Lebbe , Joseph Ciccolini , Nicolas Meyer , Angelo Paci
A multitude of TKI has been developed and approved targeting various oncogenetic alterations. While these have provided improvements in efficacy compared with conventional chemotherapies, resistance to targeted therapies occurs. Mutations in the kinase domain result in the inability of TKI to inactivate the protein kinase. Also, gene amplification, increased protein expression and downstream activation or bypassing of signalling pathways are commonly reported mechanisms of resistance. Improved understanding of mechanisms involved in TKI resistance has resulted in the development of new generations of targeted agents. In a race against time, the search for new, more potent and efficient drugs, and/or combinations of drugs, remains necessary as new resistance mechanisms to the latest generation of TKI emerge. This review examines the various generations of TKI approved to date and their common mechanisms of resistance, focusing on TKI targeting BCR-ABL, epidermal growth factor receptor, anaplastic lymphoma kinase and BRAF/MEK tyrosine kinases.
{"title":"Tyrosine kinase inhibitors in cancers: Treatment optimization – Part I","authors":"David Combarel , Léa Dousset , Stéphane Bouchet , Florent Ferrer , Pauline Tetu , Céleste Lebbe , Joseph Ciccolini , Nicolas Meyer , Angelo Paci","doi":"10.1016/j.critrevonc.2024.104384","DOIUrl":"10.1016/j.critrevonc.2024.104384","url":null,"abstract":"<div><p>A multitude of TKI has been developed and approved targeting various oncogenetic alterations. While these have provided improvements in efficacy compared with conventional chemotherapies, resistance to targeted therapies occurs. Mutations in the kinase domain result in the inability of TKI to inactivate the protein kinase. Also, gene amplification, increased protein expression and downstream activation or bypassing of signalling pathways are commonly reported mechanisms of resistance. Improved understanding of mechanisms involved in TKI resistance has resulted in the development of new generations of targeted agents. In a race against time, the search for new, more potent and efficient drugs, and/or combinations of drugs, remains necessary as new resistance mechanisms to the latest generation of TKI emerge. This review examines the various generations of TKI approved to date and their common mechanisms of resistance, focusing on TKI targeting BCR-ABL, epidermal growth factor receptor, anaplastic lymphoma kinase and BRAF/MEK tyrosine kinases.</p></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961070","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}
In the last decade, targeted therapies have shown rapid advancement in biliary tract cancer (BTC). Today, many targeted agents are available and under investigation for patients with BTC. More recently, immune checkpoint inhibitors (ICI) such as durvalumab and pembrolizumab in combination with gemcitabine plus cisplatin (gem/cis) have resulted in improved overall survival and progression-free survival in the first-line setting. However, the efficacy benefit of these novel therapeutics is often short-lived, with literature outlining concerns about both primary and secondary resistance to these agents. Investigators also need to consider toxicity profiles that can emerge using this strategy. There have been efforts to reduce evolving resistance through combinatory approaches, both pre-clinically and in early clinical settings. This review summarizes the emerging targeted therapies in BTC, evolving biomarkers of resistance, strategies to overcome them, and an analysis of ongoing clinical trials of patients with advanced BTC.
{"title":"Emerging targeted therapies and strategies to overcome resistance in biliary tract cancers","authors":"Tarik Demir, Carolyn Moloney, Devalingam Mahalingam","doi":"10.1016/j.critrevonc.2024.104388","DOIUrl":"10.1016/j.critrevonc.2024.104388","url":null,"abstract":"<div><p>In the last decade, targeted therapies have shown rapid advancement in biliary tract cancer (BTC). Today, many targeted agents are available and under investigation for patients with BTC. More recently, immune checkpoint inhibitors (ICI) such as durvalumab and pembrolizumab in combination with gemcitabine plus cisplatin (gem/cis) have resulted in improved overall survival and progression-free survival in the first-line setting. However, the efficacy benefit of these novel therapeutics is often short-lived, with literature outlining concerns about both primary and secondary resistance to these agents. Investigators also need to consider toxicity profiles that can emerge using this strategy. There have been efforts to reduce evolving resistance through combinatory approaches, both pre-clinically and in early clinical settings. This review summarizes the emerging targeted therapies in BTC, evolving biomarkers of resistance, strategies to overcome them, and an analysis of ongoing clinical trials of patients with advanced BTC.</p></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961161","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 : 2024-05-14DOI: 10.1016/j.critrevonc.2024.104378
Joshua J. Thompson , Josh McGovern , Campbell S.D. Roxburgh , Joanne Edwards , Ross D. Dolan , Donald C. McMillan
Introduction
Cancer cachexia is a clinical condition characterized by recognizable “sickness behaviors” accompanied by loss of lean body tissue. The Global Leadership on Malnutrition (GLIM) has proposed phenotypic (unintentional weight loss, low body mass index and low muscle mass) and aetiologic (reduced food intake and inflammation or disease burden) diagnostic criteria. Recent work has suggested serum lactate dehydrogenase (LDH) might represent a 3rd aetiologic criteria. Little is known of its relationship with GLIM. A systematic review and meta-analysis of their comparative prognostic value and association was performed.
Methods
A search of electronic databases (PubMed, Medline, Ovid, Cochrane) up to February 2023 was used to identify studies that compared the prognostic value of LDH and components of the GLIM criteria in cancer. An analysis of the relationship between LDH and the components of GLIM was undertaken where this data was available. RevMan 5.4.1 was used to perform a meta-analysis for each diagnostic criteria that had 3 or more studies which reported hazard ratios with a 95 per cent confidence interval for overall survival (OS).
Results
A total of 119 studies were reviewed. Advanced lung cancer was the most studied population. Included in the meta-analysis were 6 studies (n=2165) on LDH and weight loss, 17 studies (n=7540) on LDH and low BMI, 5 studies (n=758) on LDH and low muscle mass, 0 studies on LDH and food intake and 93 studies (n=32,190) on LDH and inflammation. There was a significant association between elevated serum LDH and each of low BMI (OR 1.39, 1.09 – 1.77; p=0.008), elevated NLR (OR 2.04, 1.57 – 2.65; p<0.00001) and elevated CRP (OR 2.58, 1.81 – 3.67; p<0.00001). There was no association between elevated serum LDH and low muscle mass. Only one study presented data on the association between LDH and unintentional weight loss. Elevated LDH showed a comparative OS (HR 1.86, 1.57 – 2.07; p<0.00001) to unintentional weight loss (HR 1.57, 1.23 – 1.99; p=0.0002) and had a similar OS (HR 2.00, 1.70 – 2.34; p<0.00001) to low BMI (HR 1.57, 1.29–2.90; p<0.0001). LDH also showed an OS (HR 2.25, 1.76 – 2.87; p<0.00001) congruous with low muscle mass (HR 1.93, 1.14 – 3.27; p=0.01) and again, LDH conferred as poor an OS (HR 1.77, 1.64–1.90; p<0.00001) as elevated NLR (HR 1.61, 1.48 – 1.77; p<0.00001) or CRP (HR 1.55, 1.43 – 1.69; p<0.00001).
Conclusion
Current literature suggests elevated serum LDH is associated with inflammation in cancer (an aetiologic GLIM criterion), however more work is required to establish the relationship between LDH and the phenotypic components of GLIM. Additionally, elevated serum LDH appears to be a comparative prognosticator of overall survival in cancer when compared to the GLIM criteria.
{"title":"The relationship between LDH and GLIM criteria for cancer cachexia: Systematic review and meta-analysis","authors":"Joshua J. Thompson , Josh McGovern , Campbell S.D. Roxburgh , Joanne Edwards , Ross D. Dolan , Donald C. McMillan","doi":"10.1016/j.critrevonc.2024.104378","DOIUrl":"10.1016/j.critrevonc.2024.104378","url":null,"abstract":"<div><h3>Introduction</h3><p>Cancer cachexia is a clinical condition characterized by recognizable “sickness behaviors” accompanied by loss of lean body tissue. The Global Leadership on Malnutrition (GLIM) has proposed phenotypic (unintentional weight loss, low body mass index and low muscle mass) and aetiologic (reduced food intake and inflammation or disease burden) diagnostic criteria. Recent work has suggested serum lactate dehydrogenase (LDH) might represent a 3rd aetiologic criteria. Little is known of its relationship with GLIM. A systematic review and meta-analysis of their comparative prognostic value and association was performed.</p></div><div><h3>Methods</h3><p>A search of electronic databases (PubMed, Medline, Ovid, Cochrane) up to February 2023 was used to identify studies that compared the prognostic value of LDH and components of the GLIM criteria in cancer. An analysis of the relationship between LDH and the components of GLIM was undertaken where this data was available. RevMan 5.4.1 was used to perform a meta-analysis for each diagnostic criteria that had 3 or more studies which reported hazard ratios with a 95 per cent confidence interval for overall survival (OS).</p></div><div><h3>Results</h3><p>A total of 119 studies were reviewed. Advanced lung cancer was the most studied population. Included in the meta-analysis were 6 studies (n=2165) on LDH and weight loss, 17 studies (n=7540) on LDH and low BMI, 5 studies (n=758) on LDH and low muscle mass, 0 studies on LDH and food intake and 93 studies (n=32,190) on LDH and inflammation. There was a significant association between elevated serum LDH and each of low BMI (OR 1.39, 1.09 – 1.77; p=0.008), elevated NLR (OR 2.04, 1.57 – 2.65; p<0.00001) and elevated CRP (OR 2.58, 1.81 – 3.67; p<0.00001). There was no association between elevated serum LDH and low muscle mass. Only one study presented data on the association between LDH and unintentional weight loss. Elevated LDH showed a comparative OS (HR 1.86, 1.57 – 2.07; p<0.00001) to unintentional weight loss (HR 1.57, 1.23 – 1.99; p=0.0002) and had a similar OS (HR 2.00, 1.70 – 2.34; p<0.00001) to low BMI (HR 1.57, 1.29–2.90; p<0.0001). LDH also showed an OS (HR 2.25, 1.76 – 2.87; p<0.00001) congruous with low muscle mass (HR 1.93, 1.14 – 3.27; p=0.01) and again, LDH conferred as poor an OS (HR 1.77, 1.64–1.90; p<0.00001) as elevated NLR (HR 1.61, 1.48 – 1.77; p<0.00001) or CRP (HR 1.55, 1.43 – 1.69; p<0.00001).</p></div><div><h3>Conclusion</h3><p>Current literature suggests elevated serum LDH is associated with inflammation in cancer (an aetiologic GLIM criterion), however more work is required to establish the relationship between LDH and the phenotypic components of GLIM. Additionally, elevated serum LDH appears to be a comparative prognosticator of overall survival in cancer when compared to the GLIM criteria.</p></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1040842824001215/pdfft?md5=3e01b1d04518490dde5baa5770bc00b7&pid=1-s2.0-S1040842824001215-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141039293","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 : 2024-05-12DOI: 10.1016/j.critrevonc.2024.104383
Susu Zhou , Parissa Alerasool , Che-Kai Tsao
{"title":"Letter to the Editor regarding the article “A net-work meta-analysis of the cardiac safety for next-generation hormonal agents in treating castration-resistant prostate cancer: How to choose drugs appropriately?”","authors":"Susu Zhou , Parissa Alerasool , Che-Kai Tsao","doi":"10.1016/j.critrevonc.2024.104383","DOIUrl":"10.1016/j.critrevonc.2024.104383","url":null,"abstract":"","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924017","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 : 2024-05-11DOI: 10.1016/j.critrevonc.2024.104381
Diana A. Mitrea , Eliza M. Froicu , Hans Prenen , Maria A. Gambacorta , Paul N. Span , Philip Poortmans
Introduction and purpose
With a significant global impact, treatment of gastrointestinal (GI) cancers still presents with challenges, despite current multimodality approaches in advanced stages. Clinical trials are expanding for checkpoint inhibition (ICI) combined with radiation therapy (RT). This review intends to offer a comprehensive image of the current data regarding the effectiveness of this association, and to reflect on possible directions to further optimize the results.
Results
Several early phase studies demonstrated encouraging potential. However, translating preclinical outcomes to clinical settings proves challenging, especially in immunologically "cold" environments. GI cancers exhibit heterogeneity, requiring tailored approaches based on disease stage and patient characteristics. Current results, though promising, lack the power of evidence to influence the general practice.
Conclusions
Finding biomarkers for identifying or converting resistant cancers is essential for maximizing responses, moreover in this context strategic RT parameters need to be carefully considered. Our review emphasizes the significance of having a thorough grasp of how immunology, tumour biology, and treatment settings interact in order to propose novel research avenues and efficient GI cancer therapy.
{"title":"Combining immunotherapy and radiation therapy in gastrointestinal cancers: A review","authors":"Diana A. Mitrea , Eliza M. Froicu , Hans Prenen , Maria A. Gambacorta , Paul N. Span , Philip Poortmans","doi":"10.1016/j.critrevonc.2024.104381","DOIUrl":"10.1016/j.critrevonc.2024.104381","url":null,"abstract":"<div><h3>Introduction and purpose</h3><p>With a significant global impact, treatment of gastrointestinal (GI) cancers still presents with challenges, despite current multimodality approaches in advanced stages. Clinical trials are expanding for checkpoint inhibition (ICI) combined with radiation therapy (RT). This review intends to offer a comprehensive image of the current data regarding the effectiveness of this association, and to reflect on possible directions to further optimize the results.</p></div><div><h3>Results</h3><p>Several early phase studies demonstrated encouraging potential. However, translating preclinical outcomes to clinical settings proves challenging, especially in immunologically \"cold\" environments. GI cancers exhibit heterogeneity, requiring tailored approaches based on disease stage and patient characteristics. Current results, though promising, lack the power of evidence to influence the general practice.</p></div><div><h3>Conclusions</h3><p>Finding biomarkers for identifying or converting resistant cancers is essential for maximizing responses, moreover in this context strategic RT parameters need to be carefully considered. Our review emphasizes the significance of having a thorough grasp of how immunology, tumour biology, and treatment settings interact in order to propose novel research avenues and efficient GI cancer therapy.</p></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913484","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 : 2024-05-10DOI: 10.1016/j.critrevonc.2024.104387
Justin Mencel, Anneke Alves, Vasileios Angelis, Marco Gerlinger, Naureen Starling
DNA mismatch repair (MMR) deficiency and the associated microsatellite instability (MSI) phenotype has become a subject of enormous interest in recent years due to the demonstrated efficacy of immune checkpoint inhibitors (ICI) in advanced tumours. Assessing MSI in patients with gastrointestinal tract (GI) cancers is useful to exclude Lynch syndrome, but also to predict benefit for ICI. Following review of the relevant literature, this review article aims to outline the clinicopathologic spectrum of MSI and mismatch repair deficiency (dMMR) in the GI tract, hepatobiliary system and pancreas and discuss the therapeutic consideration in this disease.
{"title":"State of the art: Targeting microsatellite instability in gastrointestinal cancers","authors":"Justin Mencel, Anneke Alves, Vasileios Angelis, Marco Gerlinger, Naureen Starling","doi":"10.1016/j.critrevonc.2024.104387","DOIUrl":"10.1016/j.critrevonc.2024.104387","url":null,"abstract":"<div><p>DNA mismatch repair (MMR) deficiency and the associated microsatellite instability (MSI) phenotype has become a subject of enormous interest in recent years due to the demonstrated efficacy of immune checkpoint inhibitors (ICI) in advanced tumours. Assessing MSI in patients with gastrointestinal tract (GI) cancers is useful to exclude Lynch syndrome, but also to predict benefit for ICI. Following review of the relevant literature, this review article aims to outline the clinicopathologic spectrum of MSI and mismatch repair deficiency (dMMR) in the GI tract, hepatobiliary system and pancreas and discuss the therapeutic consideration in this disease.</p></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909520","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 : 2024-05-10DOI: 10.1016/j.critrevonc.2024.104389
Oscar Hernán Rodríguez-Bejarano , Carlos Parra-López , Manuel Alfonso Patarroyo
Breast cancer (BC) is currently the most common malignant tumour in women and one of the leading causes of their death around the world. New and increasingly personalised diagnostic and therapeutic tools have been introduced over the last few decades, along with significant advances regarding the study and knowledge related to BC. The tumour microenvironment (TME) refers to the tumour cell-associated cellular and molecular environment which can influence conditions affecting tumour development and progression. The TME is composed of immune cells, stromal cells, extracellular matrix (ECM) and signalling molecules secreted by these different cell types. Ever deeper understanding of TME composition changes during tumour development and progression will enable new and more innovative therapeutic strategies to become developed for targeting tumours during specific stages of its evolution. This review summarises the role of BC-related TME components and their influence on tumour progression and the development of resistance to therapy. In addition, an account on the modifications in BC-related TME components associated with therapy is given, and the completed or ongoing clinical trials related to this topic are presented.
乳腺癌(BC)是目前全球女性最常见的恶性肿瘤,也是导致女性死亡的主要原因之一。过去几十年来,随着乳腺癌相关研究和知识的长足进步,新的、越来越个性化的诊断和治疗工具不断问世。肿瘤微环境(TME)是指与肿瘤细胞相关的细胞和分子环境,可影响肿瘤发生和发展的条件。肿瘤微环境由免疫细胞、基质细胞、细胞外基质(ECM)和这些不同类型细胞分泌的信号分子组成。加深对肿瘤发生和发展过程中TME组成变化的了解,将有助于开发新的、更具创新性的治疗策略,在肿瘤演变的特定阶段对其进行靶向治疗。本综述总结了与 BC 相关的 TME 成分的作用及其对肿瘤进展和耐药性发展的影响。
{"title":"A review concerning the breast cancer-related tumour microenvironment","authors":"Oscar Hernán Rodríguez-Bejarano , Carlos Parra-López , Manuel Alfonso Patarroyo","doi":"10.1016/j.critrevonc.2024.104389","DOIUrl":"10.1016/j.critrevonc.2024.104389","url":null,"abstract":"<div><p>Breast cancer (BC) is currently the most common malignant tumour in women and one of the leading causes of their death around the world. New and increasingly personalised diagnostic and therapeutic tools have been introduced over the last few decades, along with significant advances regarding the study and knowledge related to BC. The tumour microenvironment (TME) refers to the tumour cell-associated cellular and molecular environment which can influence conditions affecting tumour development and progression. The TME is composed of immune cells, stromal cells, extracellular matrix (ECM) and signalling molecules secreted by these different cell types. Ever deeper understanding of TME composition changes during tumour development and progression will enable new and more innovative therapeutic strategies to become developed for targeting tumours during specific stages of its evolution. This review summarises the role of BC-related TME components and their influence on tumour progression and the development of resistance to therapy. In addition, an account on the modifications in BC-related TME components associated with therapy is given, and the completed or ongoing clinical trials related to this topic are presented.</p></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S104084282400132X/pdfft?md5=0b67699f84965db79fa69885a2d12889&pid=1-s2.0-S104084282400132X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909476","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 : 2024-05-10DOI: 10.1016/j.critrevonc.2024.104386
Introduction
Nanoliposomal irinotecan (nal-IRI) is a novel regimen for pancreatic cancer, featuring a longer half-life and an increased area under the concentration-time curve. This study aims to assess the safety and efficacy of nal-IRI as a second-line treatment for advanced pancreatic cancer.
Methods
A systemic literature search was conducted based on articles published before September 26th, 2023 in databases, including PubMed, Cochrane Library, EMBASE and Web of Science. The fixed effects model was used to calculate the pooled mean difference for overall survival (OS) and progression-free survival (PFS), as well as the pooled odds ratio for the overall response rate (ORR) and the risk of adverse events.
Results
A total of 21 studies, including 3044 patients with locally advanced unresectable or metastatic pancreatic cancers, were considered eligible. The use of nal-IRI, combined with 5-fluorouracil and leucovorin, resulted in significantly improved PFS (pooled mean difference=1.01 months, 95 % confidence interval [CI]=0.97–1.05, p<0.01) and OS (pooled mean difference=0.29 months, 95 %CI=0.18–0.39, p<0.01), as well as significantly better ORR (pooled odds ratio=2.06, 95 %CI=1.30–3.27, p=0.002) compared to other second-line regimens. Nonetheless, an increased risk of grade 3 or greater neutropenia, anemia, hypokalemia, diarrhea, and vomiting was also noted.
Conclusion
Second-line treatments based on nal-IRI exhibited significantly improved PFS, OS, and ORR compared to other available treatments in advanced pancreatic cancer. Further research is necessary to corroborate these findings and define the role of nal-IRI in both first and later lines of therapy.
简介使用纳米脂质体伊立替康(nal-IRI)治疗胰腺癌是一种新型疗法,其特点是半衰期更长、浓度-时间曲线下面积增大。然而,很少有全面的系统综述或荟萃分析对其作为二线治疗的疗效进行评估。因此,本研究旨在回顾目前有关纳尔-IRI的证据,评估其对该疾病的整体临床表现:方法:根据 2023 年 9 月 26 日之前在 PubMed、Cochrane Library、EMBASE 和 Web of Science 数据库中发表的文章进行系统文献检索。采用固定效应模型计算总生存期(OS)、无进展生存期(PFS)、总反应率(ORR)和不良事件等基本结果的集合平均差和几率:共有 21 项研究符合条件,其中包括 3017 例局部晚期不可切除或转移性胰腺癌患者。纳尔-IRI与5-氟尿嘧啶和亮菌甲素一起使用可显著改善PFS和OS,汇总平均差异为1.01个月(95%置信区间(95%CI)=0.97-1.05,p):与其他现有疗法相比,基于Nal-IRI的晚期胰腺癌二线疗法的PFS、OS和ORR均有明显改善。有必要开展进一步研究,以证实这些发现,并确定纳尔-IRI在一线和二线治疗中的作用。
{"title":"Safety and efficacy of liposomal irinotecan as the second-line treatment for advanced pancreatic cancer: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.critrevonc.2024.104386","DOIUrl":"10.1016/j.critrevonc.2024.104386","url":null,"abstract":"<div><h3>Introduction</h3><p>Nanoliposomal irinotecan (nal-IRI) is a novel regimen for pancreatic cancer, featuring a longer half-life and an increased area under the concentration-time curve. This study aims to assess the safety and efficacy of nal-IRI as a second-line treatment for advanced pancreatic cancer.</p></div><div><h3>Methods</h3><p>A systemic literature search was conducted based on articles published before September 26th, 2023 in databases, including PubMed, Cochrane Library, EMBASE and Web of Science. The fixed effects model was used to calculate the pooled mean difference for overall survival (OS) and progression-free survival (PFS), as well as the pooled odds ratio for the overall response rate (ORR) and the risk of adverse events.</p></div><div><h3>Results</h3><p>A total of 21 studies, including 3044 patients with locally advanced unresectable or metastatic pancreatic cancers, were considered eligible. The use of nal-IRI, combined with 5-fluorouracil and leucovorin, resulted in significantly improved PFS (pooled mean difference=1.01 months, 95 % confidence interval [CI]=0.97–1.05, <em>p<</em>0.01) and OS (pooled mean difference=0.29 months, 95 %CI=0.18–0.39, <em>p</em><0.01), as well as significantly better ORR (pooled odds ratio=2.06, 95 %CI=1.30–3.27, <em>p</em>=0.002) compared to other second-line regimens. Nonetheless, an increased risk of grade 3 or greater neutropenia, anemia, hypokalemia, diarrhea, and vomiting was also noted.</p></div><div><h3>Conclusion</h3><p>Second-line treatments based on nal-IRI exhibited significantly improved PFS, OS, and ORR compared to other available treatments in advanced pancreatic cancer. Further research is necessary to corroborate these findings and define the role of nal-IRI in both first and later lines of therapy.</p></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913490","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}