Critical reviews in oncology/hematology最新文献

{"title":"Impact of adding immune checkpoint inhibitors to standard therapies in non-small cell lung cancer: A systematic review of efficacy outcomes","authors":"Ana Pinto Correia ,&nbsp;Adriana Marques ,&nbsp;Bruno Sepodes ,&nbsp;Carla Torre ,&nbsp;João Rocha","doi":"10.1016/j.critrevonc.2025.105098","DOIUrl":"10.1016/j.critrevonc.2025.105098","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer remains the leading cause of cancer-related mortality worldwide, with non-small cell lung cancer (NSCLC) accounting for 85 % of all cases. Although immune checkpoint inhibitors (ICIs) have revolutionized NSCLC treatment, the extent to which they improve survival when combined with standard therapies, rather than used alone, remains unclear. Here, we systematically review published clinical trials evaluating ICIs combined with other standard systemic therapies versus each strategy alone. Methods: A systematic review was conducted using MEDLINE (via PubMed) and EMBASE, following PRISMA guidelines. Randomized controlled trials published until December 2024 that studied the efficacy of immunotherapy regimens combining approved ICIs and other systemic therapies in NSCLC were included. Results We included 36 RCTs with a combined 24,495 participants. Most were open-label (n = 21, 58.3 %), while the remaining studies were double-blinded (n = 15, 41.7 %). Most studies were phase 3 trials (n = 33, 91.7 %) and only three trials were phase 2 (8.3 %). Included trials utilized platinum-doublet chemotherapy as the backbone, with some also incorporating bevacizumab and/or additional immunotherapy. In the included studies, combining immunotherapy with other standard therapies significantly improved survival outcomes compared to either strategy alone. These benefits were consistent across histological subtypes, PD-L1 expression levels, and disease stage. However, the efficacy of this combined approach was limited in EGFR-mutated NSCLC after progression on tyrosine kinase inhibitors. Conclusions: By synthesizing existing evidence from RCTs, this systematic review demonstrates the benefits and limitations of combining immune checkpoint inhibitors with other systemic treatments, clarifying which clinical situations may benefit the most from a combined approach.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105098"},"PeriodicalIF":5.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806802","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}

{"title":"Androgen receptor as a prognostic biomarker in breast cancer: A systematic review and meta-analysis","authors":"Manjusha Pal ,&nbsp;Ankita Chakrawal ,&nbsp;Bhavana Singh ,&nbsp;Atindra Pandey ,&nbsp;Ruhi Dixit ,&nbsp;Manoj Pandey","doi":"10.1016/j.critrevonc.2025.105112","DOIUrl":"10.1016/j.critrevonc.2025.105112","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) is the most prevalent malignancy and a leading cause of cancer-related death among women globally. The androgen receptor (AR), a nuclear receptor, exhibits both pro- and anti-tumorigenic effects, but its prognostic value in BC remains unclear.</div></div><div><h3>Objective</h3><div>To evaluate the association between AR expression and clinical outcomes like disease-free survival (DFS) and overall survival (OS) in BC across different subtypes.</div></div><div><h3>Methods</h3><div>This study is registered with PROSPERO (CRD4251023927) and follows PRISMA guidelines. We searched PubMed, Scopus, Web of Science, Embase, and Cochrane Library. Inclusion criteria encompassed original studies with female patients, survival data based on AR status, and at least one additional clinicopathological marker (e.g., ER, PR, HER2, TNBC). Pooled hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed with the I² statistics.</div></div><div><h3>Results</h3><div>Twenty-four studies with 17329 patients were included. In multivariate analysis, AR positivity showed a trend towards better OS (HR=0.59, 95 % CI: 0.18–1.95, p = 0.39) and DFS (HR=0.62, 95 % CI: 0.30–1.25, p = 0.18), though not statistically significant. Subgroup analysis showed significant benefits in AR and ER-positive BC for both OS (HR=0.66, 95 % CI: 0.56–0.77) and DFS (HR=0.78, 95 % CI: 0.60–1.02), while it was ambiguous in other subsets.</div></div><div><h3>Conclusion</h3><div>AR expression is associated with improved prognosis in ER-positive BC, but its role in TNBC and HER2-positive BC remains unclear due to heterogeneity and non-significant results. Standardized AR evaluation and prospective studies are needed to confirm its prognostic and predictive value for personalized BC treatment.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105112"},"PeriodicalIF":5.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907326","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}

{"title":"The role of MHC molecules in cancer immunotherapy: Insights into tumor immune evasion and therapeutic strategies","authors":"Ziyang Huang ,&nbsp;Jingli Xu ,&nbsp;Yuqi Wang ,&nbsp;Zhenjie Fu ,&nbsp;Yangyang Zhang ,&nbsp;Qianyu Zhao ,&nbsp;Ruolan Zhang ,&nbsp;Xiaomin Hu ,&nbsp;Xiangdong Cheng ,&nbsp;Can Hu","doi":"10.1016/j.critrevonc.2025.105057","DOIUrl":"10.1016/j.critrevonc.2025.105057","url":null,"abstract":"<div><div>Major histocompatibility complex (MHC) molecules, as core mediators of antigen presentation in the immune system, play pivotal roles in activating anti-tumor immune responses by presenting antigens to CD8⁺ and CD4⁺ T cells. However, tumor cells and immunosuppressive cells within the tumor microenvironment (TME) employ multi-dimensional mechanisms to dysregulate MHC expression and function—including epigenetic silencing, autophagic degradation, and interference with transcription factors such as NLRC5 (for MHC-I) and CIITA (for MHC-II). These mechanisms enable immune escape and limit the efficacy of cancer immunotherapy. Additionally, we review MHC-based therapeutic strategies—such as cytokine therapy, TCR-T cell therapy, immune checkpoint inhibitor (ICI) combination therapy, and tumor vaccine therapies—that have been developed to restore MHC function and overcome immune escape. A deeper understanding of the regulatory networks governing MHC molecules in tumor immunity will provide critical insights for the development of precise and effective immunotherapeutic strategies, ultimately improving clinical outcomes for cancer patients.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105057"},"PeriodicalIF":5.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650141","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}

{"title":"Unravelling the crosstalk: Anti-fibrotic agents and MAPK inhibitors in the treatment of melanoma","authors":"R. Swathika ,&nbsp;Yogendra Nayak ,&nbsp;Bharath Prasad AS ,&nbsp;Usha Yogendra Nayak","doi":"10.1016/j.critrevonc.2025.105084","DOIUrl":"10.1016/j.critrevonc.2025.105084","url":null,"abstract":"<div><div>Melanoma, an aggressive and frequently treatment-resistant kind of skin cancer, poses substantial therapeutic hurdles, especially because it is resistant to inhibitors of the MAPK (mitogen-activated protein kinase) pathway. Even though targeted therapies like BRAF and MEK inhibitors are advanced melanoma therapies, tumour cell plasticity and TME interactions can lead to resistance. Recent research demonstrates that CAFs play a role in fibrotic remodelling in the TME, which promotes tumour growth, immunological suppression, and treatment resistance. Stiffening of ECM because of the pro-fibrotic and pro-tumorigenic substances secreted by CAFs. This, in turn, activates survival pathways and fosters treatment resistance. Anti-fibrotic drugs are meant to treat fibrotic conditions, including idiopathic pulmonary fibrosis, but because of their ability to alter ECM structure and prevent fibroblast activation, they have recently attracted interest in oncology. Targeting fibrotic pathways such as TGF-β, FGF, and PDGF signalling, with medications like nintedanib and pirfenidone, may help overcome the resistance mechanisms associated with MAPK inhibitor therapy. Through the disruption of stromal signalling and the reduction of stress caused by fibrosis, these medicines have the potential to improve drug penetration, decrease tumour plasticity, and restore sensitivity to treatments that target MAPK. This review unravels the complex interactions between MAPK inhibitors and anti-fibrotic drugs in the treatment of melanoma, highlighting how they might work together to remodel the TME and overcome treatment resistance. Implementing this combinatorial method could lead to novel approaches for long-term melanoma control and provide a model for anti-fibrotic-based treatments for other solid cancers.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105084"},"PeriodicalIF":5.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764724","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}

{"title":"Aromatase inhibitors and medication-related osteonecrosis of the jaw: Friends, foes, or bystanders?","authors":"Soraia Macari ,&nbsp;Jôice Dias Corrêa ,&nbsp;Victor Zanetti Drumond ,&nbsp;Breno Amaral Rocha ,&nbsp;Paula Alves da Silva Rocha ,&nbsp;Lucas Guimarães Abreu ,&nbsp;François Côme Ferré ,&nbsp;Benjamin P.J. Fournier ,&nbsp;José Alcides Almeida de Arruda ,&nbsp;Tarcília Aparecida Silva","doi":"10.1016/j.critrevonc.2025.105071","DOIUrl":"10.1016/j.critrevonc.2025.105071","url":null,"abstract":"<div><div>Since the 1980s, aromatase inhibitors (AI) have been a cornerstone in the management of hormone receptor-positive breast cancer. However, because of their frequent co-prescription with antiresorptive agents, concerns have been raised regarding the potential contribution of AI to medication-related osteonecrosis of the jaw (MRONJ). We conducted a scoping review to investigate the possible association between AI use and MRONJ. Electronic searches were performed across five databases and supplemented with manual screening and gray literature. Observational studies and clinical trials were included. Fifty-four studies comprising 1,613,480 individuals (45,121 AI users) from 17 countries were analyzed. Most samples consisted of women with breast cancer/metastatic breast cancer in pre- and/or postmenopausal stages. Letrozole was the most frequently prescribed AI, followed by anastrozole and exemestane. MRONJ was reported in 43 studies, with 1147 cases among 45,121 AI users (2.5 % of AI users in the included samples), the majority of whom were concomitantly treated with zoledronic acid and/or denosumab. Three studies documented MRONJ in patients receiving AI monotherapy. Data demonstrate the difficulty of disentangling the effects of AI from those of antiresorptive therapy in MRONJ pathogenesis. Future research should consider AI as potential confounders in analytical studies to clarify their independent contribution, if any, to observed MRONJ occurrences.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105071"},"PeriodicalIF":5.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703431","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}

{"title":"The crosstalk between ferroptosis and the immune system in urological cancers: Mechanisms, prognostic value, and therapeutic implications","authors":"Shuwen Li,&nbsp;Zeli Li","doi":"10.1016/j.critrevonc.2025.105070","DOIUrl":"10.1016/j.critrevonc.2025.105070","url":null,"abstract":"<div><div>Ferroptosis—an iron-dependent, lipid peroxidation–driven cell death—has emerged as a central regulator of tumor biology and antitumor immunity in prostate, bladder, and renal cancers. Beyond direct cytotoxicity, it bidirectionally reshapes the tumor immune microenvironment. CD8 + and NK cells induce ferroptosis via IFN-γ–mediated suppression of system Xc−, whereas ferroptotic cells release DAMPs and antigens that mature dendritic cells and activate T cells. Conversely, ferroptosis in effector lymphocytes and tumor antioxidant, metabolic, and myeloid programs can enforce immune suppression. mRNA and lncRNA ferroptosis signatures stratify prognosis and immunotherapy response, often separating checkpoint-restrained “hot” tumors from immune-excluded/desert states. Mechanistic nodes (SLC7A11, GPX4, PRMT5, ATF4/NUPR1) and stromal/macrophage circuits link ferroptosis resistance to immune evasion. Emerging strategies combine ferroptosis induction with checkpoint blockade, adoptive cellular therapies, nano-delivery, and microenvironment reprogramming to convert “cold” disease into durable responders.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105070"},"PeriodicalIF":5.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703430","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}

{"title":"Clinical presentation, prognosis, and treatment strategies for thymoma-associated multiorgan autoimmunity: A pooled analysis","authors":"Giorgia Carola ,&nbsp;Vito Amoroso ,&nbsp;Deborah Cosentini ,&nbsp;Francesca Consoli ,&nbsp;Simonetta Battocchio ,&nbsp;Pierluigi Di Mauro ,&nbsp;Elena Fassi ,&nbsp;Filippo Morocutti ,&nbsp;Marco Bergamini ,&nbsp;Martina Buffoni ,&nbsp;Marta Laganà ,&nbsp;Alfredo Berruti ,&nbsp;Salvatore Grisanti","doi":"10.1016/j.critrevonc.2025.105052","DOIUrl":"10.1016/j.critrevonc.2025.105052","url":null,"abstract":"<div><h3>Background</h3><div>Thymoma-associated multiorgan autoimmunity (TAMA) is a rare autoimmune disease related to thymoma, defined as a disorder of the skin, liver, and gastrointestinal tract similar to graft-versus-host disease.</div></div><div><h3>Methods</h3><div>We performed a systematic review and a pooled analysis of confirmed TAMA cases published in the literature. Additionally, a case of TAMA diagnosed and treated at our institution was also described and included.</div></div><div><h3>Results</h3><div>We identified 44 eligible publications providing data on 50 patients. At presentation, 82 % of patients had cutaneous lesions, 46 % gastrointestinal symptoms, 26 % hepatic manifestations, and 2 % had other less common manifestations. The main strategy for TAMA was to control neoplastic disease, however, only 20 % of patients underwent surgery and 10 % received chemotherapy. Immunosuppressive therapy was the complementary approach, with 78 % of patients receiving corticosteroids and 54 % receiving other immunosuppressive drugs. In the pooled analysis, the median overall survival from diagnosis of TAMA was 7 months (95 % CI: 0.03–14.0 months). An explorative analysis of potential prognostic factors showed that older age had a protective effect (HR 0.37; 95 % CI, 0.14–0.95; p = 0.04) and active treatment of thymoma may prolong survival of patients with TAMA (HR 0.30, 95 % CI: 0.08–1.00, p = 0.05).</div></div><div><h3>Conclusions</h3><div>This pooled analysis shows that TAMA's onset is associated with a poor prognosis in patients with thymoma and needs to be recognized early to provide effective treatments. Combining antineoplastic and immunosuppressive therapy is the most effective way to manage TAMA symptoms and improve patient outcomes.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105052"},"PeriodicalIF":5.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688815","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}

{"title":"Antibody-Drug Conjugates in urothelial, prostate, and renal cell cancers: A review of current and emerging therapies","authors":"Anne Perera ,&nbsp;Naoko Atsumi ,&nbsp;Anton Hettiarachchige Don ,&nbsp;Giuseppe Luigi Banna ,&nbsp;Akash Maniam","doi":"10.1016/j.critrevonc.2025.105067","DOIUrl":"10.1016/j.critrevonc.2025.105067","url":null,"abstract":"<div><div>This review explores the therapeutic potential of Antibody-Drug Conjugates (ADC) in urological malignancies, emphasizing treatment efficacy, safety, and future prospects. ADC selectively deliver cytotoxic agents to cancer cells, reducing off-target toxicity compared to conventional therapies. Comprising a monoclonal antibody (mAb) linked to a cytotoxic payload, ADC exert their effects through apoptosis, antibody-dependent cellular cytotoxicity (ADCC), and complement-dependent cytotoxicity (CDC). This review highlights ADC advancements in urothelial cancer (UC), prostate cancer (PC), and renal cell carcinoma (RCC). Recent trials demonstrate encouraging outcomes with ADC such as Enfortumab Vedotin (EV), Sacituzumab Govitecan (SG), Trastuzumab Deruxtecan (T-DXd), and Disitamab Vedotin (DV) in UC, improving response rates and Progression-Free Survival (PFS). The influence of antigen expression, particularly Nectin-4 and Trop-2, on ADC treatment outcomes is investigated. In addition, efficacy and safety of ADC combinations with anti–PD-(L)1 therapies and dual immune checkpoint inhibitors to further enhance therapeutic benefit are explored. In PC, ADC targeting prostate-specific membrane antigen (PSMA), Trop-2, and B7-H3 exhibit promising antitumor activity, with research optimizing safety, efficacy, and monitoring strategies. In RCC, ADC against ENPP3, CD70, and TIM-1 show durable responses in early trials, though challenges such as dose-limiting toxicities require further investigation. Overall, this review underscores ADC as a transformative approach in uro-oncology, highlighting ongoing advancements in combination strategies and biomarker-driven applications to refine therapeutic outcomes and expand treatment options for these challenging malignancies.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105067"},"PeriodicalIF":5.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679650","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}

{"title":"Role of extracellular matrix in chordoma progression and therapeutic resistance","authors":"Chongmin Ren ,&nbsp;Francis J. Hornicek ,&nbsp;Andrew E. Rosenberg ,&nbsp;Bin Yue ,&nbsp;Zhenfeng Duan","doi":"10.1016/j.critrevonc.2025.105073","DOIUrl":"10.1016/j.critrevonc.2025.105073","url":null,"abstract":"<div><div>Chordoma is a rare malignant bone tumor with a challenging treatment landscape, presenting resistance to chemotherapy and limited efficacy to radiotherapy. While the basis of this resistance remains unknown, chordoma is characterized by the production of an abundant extracellular matrix (ECM), which plays a crucial role in tumor progression and therapeutic resistance. Investigations for chordoma have demonstrated that various components of ECM influence tumor progression and prognosis. Targeting ECM and disrupting tumor-ECM interactions can potentially overcome therapy resistance and improve treatment outcomes. This review summarizes recent studies and discoveries related to the ECM in chordoma. We highlight the specific functions of distinct ECM molecules in regulating chordoma progression and therapy resistance. Moreover, we discuss key factors and signaling pathways involved in ECM and their therapeutic potential in the management of chordoma. Future research and clinical trials on ECM-targeted therapies hold promise for advancing chordoma treatment.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105073"},"PeriodicalIF":5.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735277","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}

{"title":"Efficacy and safety of boron neutron capture therapy for locally recurrent head and neck cancer","authors":"Xing Sun ,&nbsp;Yuchen Liu ,&nbsp;Zhiyi Xue ,&nbsp;Bo Cheng ,&nbsp;Ruiping Zhang ,&nbsp;Liping Li ,&nbsp;Weicheng Huang ,&nbsp;Qingxu Song ,&nbsp;Yufeng Cheng","doi":"10.1016/j.critrevonc.2025.105101","DOIUrl":"10.1016/j.critrevonc.2025.105101","url":null,"abstract":"<div><h3>Purpose</h3><div>Boron neutron capture therapy (BNCT) has emerged as a promising radiotherapy option for locally recurrent head and neck cancer (LRHNC). This study aims to evaluate the efficacy and safety of BNCT in patients with LRHNC and explore predictive factors for tumor control and overall survival.</div></div><div><h3>Materials and methods</h3><div>A meta-analysis was conducted on the relevant studies up to April 2024 from PubMed, Embase, Cochrane, and Web of Science databases. The random-effects model was employed. The primary outcomes were the objective response rate (ORR), 2-year overall survival (2-year OS),and adverse events (AEs). Subgroup analysis was performed based on fraction design, the mean minimum dose (Dmin) of tumor, and histologic type.</div></div><div><h3>Results</h3><div>Seven studies involving a total of 361 patients were included. The ORR was 70 % (95 % CI: 65 %-75 %; <em>P</em> = 0.8187) and the 2-year OS rate was 45 % (95 % CI: 39 %-50 %; <em>P</em> &lt; 0.0001). Subgroup analysis revealed that the ORR of multiple-fraction irradiation was essentially the same as single-fraction irradiation (76 % vs. 75 %), and a higher mean tumor Dmin correlated with significantly increased ORR and 2-year OS rates, with the remarkable effect at approximately 20 Gy (80 %vs. 54 %, 66 %vs.12 %). The ORR of patients with non-squamous cell carcinoma (NSCC) was higher than those with squamous cell carcinoma (SCC) (82 % vs. 72 %), while the 2-year OS rates were similar (50 % vs. 49 %). The most frequent acute AEs included hyperamylasemia (75 %, 95 % CI: 70 %-80 %), alopecia (61 %, 95 % CI: 55 %-67 %), and submandibular gland inflammation (61 %, 95 % CI: 49 %-72 %). The most common late AEs were alopecia (72 %, 95 % CI: 61 %-82 %), fatigue (35 %), and pain (27 %, 95 % CI: 12 %-46 %). The most frequent ≥ grade 3 acute AEs included hyperamylasemia (60 %, 95 % CI: 54 %-66 %), oral mucositis (11 %, 95 % CI: 7 %-14 %), and hemorrhage (11 %). The most frequent ≥grade 3 late AEs included cranial neuropathy (12 %), intracranial infection (8 %), and osteonecrosis of jaw (8%). The incidence of grade 3 and grade 4 acute AEs were 31.2 % and 5.7 %, respectively. There was only one case of grade 5 acute AE (0.4 %). Grade 3 and grade 4 late AEs were observed in 3.4 % and 0.4 % of patients, respectively. No grade 5 late AEs were reported. Severe AEs (SAEs) included carotid hemorrhage (4.8 %) and malnutrition (1.6 %).</div></div><div><h3>Conclusion</h3><div>BNCT has shown favorable efficacy and safety in LRHNC. A high minimum tumor dose from BNCT correlated with a significantly increased response rate and survival. Further research is needed to support BNCT as a standard therapeutic option.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105101"},"PeriodicalIF":5.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847052","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}