American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting最新文献

Rare uterine malignancies present treatment challenges because of their clinical and biological heterogeneity. Among the rarest of the uterine cancers are leiomyosarcomas, uterine stromal tumors, and the mesonephric-like and serous carcinomas. In this article, we review recent advancements in diagnostic precision, risk stratification, and identification of biomarker-guided therapeutic options for these rare subtypes of uterine tumors. The improved understanding of the molecular profile of these tumors has led to the development of targeted treatment approaches. Further progress will depend on a coordinated, global effort to further characterize these diseases and enroll patients on biomarker-driven clinical trials.

Modified, autologous T-cell immunotherapies have been transformative in the treatment of hematologic malignancies with several approvals of chimeric antigen receptor T-cell therapies to treat lymphoma, leukemia, and multiple myeloma. Treatment in these settings has resulted in durable response rates as high at 80%-90%. These findings have not been replicated in clinical trials of solid tumor malignancies because of the complex tumor microenvironment, antigen heterogeneity, and immunosuppressive mechanisms that hinder antitumor T-cell responses in solid tumors. Several strategies are being investigated and have proven successful in overcoming these hurdles. This paper provides an overview of the current landscape of autologous T-cell therapies, with a particular focus on their use as treatments for refractory solid tumor malignancies, highlighting promising targets being investigated in ongoing clinical trials and toxicities associated with these therapeutic approaches.

Cellular therapies, including chimeric antigen receptor T-cell therapy and bispecific antibodies (BsAbs), have revolutionized the treatment of various B-cell non-Hodgkin lymphomas. A number of agents are now approved by regulatory agencies for treatment of large B-cell lymphoma, follicular lymphoma, and mantle cell lymphoma, and more agents are currently under review. Notably, while the current approvals are for single agents in the relapsed/refractory setting, clinical trials are now investigating combination approaches as well as incorporating cellular therapies and BsAbs into earlier lines of treatment. This article focuses on cellular therapies and BsAbs for treatment of various lymphomas, including review of completed or ongoing trials of using these platforms in earlier lines which have the potential to be practice changing in the near future.

Bispecific antibodies have ushered in a transformative era in treating non-small cell lung cancer (NSCLC), enabling dual-pathway targeting with promising clinical outcomes in previously refractory disease subsets. Recent US Food and Drug Administration approvals-including amivantamab, an epidermal growth factor receptor (EGFR)/mesenchymal-epithelial transition factor-targeting monoclonal antibody for EGFR exon 20 insertions and frontline EGFR-mutant (Exon 19 and 21) NSCLC, and zenocutuzumab for tumors harboring neuregulin 1 fusions-highlight their expanding therapeutic footprint. However, a new spectrum of on-target toxicities and implementation challenges are essential considerations as part of this innovation. This review dissects the evolving clinical data for bispecific antibodies in NSCLC, focusing on amivantamab, and provides a practical framework for managing dermatologic, infusion-related, and class-specific adverse events. We explore quality-of-life outcomes, financial toxicity, and the role of subcutaneous formulations in improving patient adherence and treatment experience. Furthermore, we highlight an emerging PD-1/vascular endothelial growth factor-A bispecific antibody (ivonescimab) and its potential to reshape frontline therapy paradigms in NSCLC. By integrating clinical trial evidence with real-world considerations, this review aims to equip oncologists with the tools to optimize the use of bispecific antibodies in NSCLC and guide future therapeutic integration.

Chronic lymphocytic leukemia (CLL) remains an incurable disease, except in rare cases treated with allogeneic stem-cell transplantation or favorable-risk CLL treated with chemoimmunotherapy. Treatment initiation follows the Rai and Binet staging systems, but the International Workshop on Chronic Lymphocytic Leukemia criteria emphasize active disease rather than stage alone. Early treatment in asymptomatic, high-risk patients has not shown an overall survival benefit, even with targeted therapies such as Bruton's tyrosine kinase and BCL2 inhibitors. The watch-and-wait strategy remains standard, although future trials may refine early treatment indications for specific high-risk groups.

Muscle-invasive bladder cancer (MIBC) is an aggressive disease, with substantial recurrence risk after radical cystectomy and pelvic lymph node dissection alone. In cisplatin-eligible patients, administration of neoadjuvant cisplatin-based chemotherapy followed by radical cystectomy has been shown to improve overall survival (OS) and has become the standard of care. Nevertheless, approximately 40%-50% of patients will still experience disease recurrence after curative-intent treatment. Moreover, a significant proportion of patients with MIBC are ineligible for cisplatin and represent a challenging clinical scenario. In recent years, different strategies aiming to improve patient outcomes by incorporating immune checkpoint inhibitors in the treatment paradigm were explored. Two key management approaches emerged: neoadjuvant chemotherapy with risk-adapted adjuvant immunotherapy and universal perioperative immunotherapy-based treatment. We review the rationale, current evidence, challenges, and future directions for the perioperative management of muscle-invasive urothelial carcinoma.

The integration of targeted therapies into neuro-oncology is revolutionizing the management of primary CNS malignancies. Advances in sequencing technologies and the incorporation of molecular alterations into CNS tumor classification have led to more precise tumor prognosis and enabled the identification of actionable oncogenic drivers. However, challenges such as drug delivery, tumor and microenvironment heterogeneity, and limitations of preclinical models complicate the selection of effective therapies. This review presents a comprehensive framework for optimizing drug selection in neuro-oncology. We discuss strategies to enhance drug development and improve clinical trial success, including window-of-opportunity trials and advanced imaging techniques. Additionally, we highlight recent advances in the treatment of isocitrate dehydrogenase-mutant gliomas, focusing on the INDIGO study and its role in the regulatory approval of vorasidenib. The review also examines the use of MAPK inhibitors, from BRAF inhibitors to PAN-RAF inhibitors, in both pediatric and adult patients, as well as novel investigational agents. Finally, we explore emerging targeted therapies for rarer oncogenic drivers, such as FGFR and NTRK alterations, emphasizing the need for CNS-specific drug development strategies.

Although still limited, the integration of artificial intelligence (AI) in health care has rapidly expanded in the past few years, especially in oncology clinics. In this article, AI refers to the development and implementation of computer systems capable of performing tasks that typically require human intelligence, such as language understanding, learning, and reasoning. AI technology is currently being used as ambient listening technology (AI-driven systems that passively capture verbal interactions between patients and health care providers), patient messaging chatbots (AI-enabled conversational agents designed to interact with patients by text or voice platforms), and as tools for inbox management and patient care delivery. However, the question remains: Is AI truly fostering harmony in health care, or just adding noise to an already complex system? Although the current applications of this technology have shown promising results in affecting routine care provided by physicians, this article will focus on AI's broader impact on the health care system-highlighting how ambient listening technology can improve the clinical experience for both patients and physicians, whether AI can reduce physician burnout through minimizing in-basket workload (the volume of messages that clinicians must manage within the electronic health record system), and AI's usage as a diagnostic tool. Key concerns addressed in this article include the potential pitfalls associated with AI integration, such as the need for proper clinician training to optimize AI algorithms while ensuring patient safety. The ambiguities surrounding the disclosure of AI in health care and the lack of a legal framework also raise significant concerns regarding patient autonomy, data privacy, trust, and beneficence. Future directions of AI in addressing these challenges are explored, alongside its potential integration into overburdened hospitals, underserved communities, telemedicine, and rural health care settings.

Artificial intelligence (AI) is transforming multidisciplinary oncology at an unprecedented pace, redefining how clinicians detect, classify, and treat cancer. From earlier and more accurate diagnoses to personalized treatment planning, AI's impact is evident across radiology, pathology, radiation oncology, and medical oncology. By leveraging vast and diverse data-including imaging, genomic, clinical, and real-world evidence-AI algorithms can uncover complex patterns, accelerate drug discovery, and help identify optimal treatment regimens for each patient. However, realizing the full potential of AI also necessitates addressing concerns regarding data quality, algorithmic bias, explainability, privacy, and regulatory oversight-especially in low- and middle-income countries (LMICs), where disparities in cancer care are particularly pronounced. This study provides a comprehensive overview of how AI is reshaping cancer care, reviews its benefits and challenges, and outlines ethical and policy implications in line with ASCO's 2025 theme, Driving Knowledge to Action. We offer concrete calls to action for clinicians, researchers, industry stakeholders, and policymakers to ensure that AI-driven, patient-centric oncology is accessible, equitable, and sustainable worldwide.

In the rapidly evolving field of oncology, education and knowledge sharing have become essential aspects of oncology practice and must-needed tools to help patients conquer cancer. Oncology education is an art that needs to be mastered by applying scientific learning methods through structured frameworks into it, in order to have an impact. To effectively educate and share knowledge with oncology professionals, we propose following a "chain of education". This chain consists of five links that are essential for creating a successful educational activity: "who", "why", "where", "what", and "how". By following the "chain of education" through all links leading to the final key of how to educate, and guided by learning science principles, educators can optimize and enhance their teaching and knowledge-sharing skills and educate learners with more impact. Two common scenarios of medical education in oncology are the education of trainees and the education of community oncologists. In this article, we review them through the prism of the "chain of education". We discuss how using effective learning science principles can guide small changes that lead to significant impacts in trainees' education and can also leverage social media platforms in the education of community oncologists. Alongside this described framework, we briefly review some available oncology education resources, and we discuss incorporating the "chain of education" into future technologies.