Current Problems in Cancer最新文献_第3页

MAGE-A3 as a target for cancer immunotherapy: A systematic review of clinical and preclinical evidence MAGE-A3作为癌症免疫治疗的靶点：临床和临床前证据的系统综述

IF 2.3 4区医学 Q3 ONCOLOGY

Current Problems in Cancer

Pub Date : 2025-07-30 DOI: 10.1016/j.currproblcancer.2025.101237

Gaurang Telang , Smriti Mishra , Anurag Sureshbabu , Samruddhi Kulkarni , Shantanu Joshi , Rajshri Singh

Background

MAGE-A3, a cancer-testis antigen, is a promising immunotherapeutic target due to its high expression in various malignancies and limited expression in normal tissues. However, clinical outcomes with MAGE-A3-based therapies have been inconsistent.

Purpose

This systematic review evaluates the effectiveness of MAGE-A3 immunotherapy in cancer by synthesizing clinical and in vitro evidence regarding efficacy, immunogenicity, safety, and predictive biomarkers.

Methods

The review was registered with PROSPERO (CRD42024577090). A comprehensive search was conducted in PubMed, MEDLINE, and Cochrane for articles published until February 8, 2024, supplemented by a manual review of bibliographies. Two independent reviewers followed PRISMA guidelines for study selection, data extraction, and quality assessment, including Risk of Bias evaluation using the ROBVIS tool.

Results

Ninety-three studies were included. Clinical investigations, mainly in melanoma and non-small-cell lung cancer (NSCLC), demonstrated that MAGE-A3 immunotherapy is generally safe and elicits antigen-specific immune responses. However, large phase III trials (e.g., MAGRIT, DERMA) failed to show significant improvements in disease-free or overall survival. A subset of studies identified predictive gene signatures correlating with better outcomes. In vitro studies provided mechanistic insights, revealing enhanced antigen expression through epigenetic modulation, improved dendritic cell-mediated antigen presentation, and promising results from advanced T-cell receptor engineering.

Conclusion

Although MAGE-A3 immunotherapy induces immune responses with a favorable safety profile, its clinical efficacy remains limited. Future strategies should focus on optimized patient selection via predictive biomarkers and combination therapies to enhance antitumor effectiveness.

mage - a3是一种睾丸癌抗原，由于其在各种恶性肿瘤中高表达而在正常组织中表达有限，是一种很有前景的免疫治疗靶点。然而，基于mage - a3的治疗的临床结果并不一致。目的：本系统综述通过综合临床和体外证据，评价MAGE-A3免疫疗法在癌症治疗中的有效性，包括疗效、免疫原性、安全性和预测性生物标志物。方法本综述在PROSPERO注册（CRD42024577090）。我们在PubMed、MEDLINE和Cochrane中对2024年2月8日之前发表的文章进行了全面的搜索，并辅以对参考书目的人工审查。两名独立审稿人遵循PRISMA指南进行研究选择、数据提取和质量评估，包括使用ROBVIS工具进行偏倚风险评估。结果共纳入93项研究。主要针对黑色素瘤和非小细胞肺癌（NSCLC）的临床研究表明，MAGE-A3免疫疗法通常是安全的，并能引发抗原特异性免疫反应。然而，大型III期试验（例如，MAGRIT， DERMA）未能显示无病生存期或总生存期的显着改善。一部分研究确定了与更好的结果相关的预测性基因特征。体外研究提供了机制见解，揭示了通过表观遗传调节增强抗原表达，改善树突状细胞介导的抗原呈递，以及先进的t细胞受体工程带来的有希望的结果。结论MAGE-A3免疫疗法虽能诱导免疫应答，且具有良好的安全性，但其临床疗效仍然有限。未来的策略应侧重于通过预测性生物标志物和联合治疗来优化患者选择，以提高抗肿瘤效果。

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引用次数: 0

Patient reported outcomes for symptom toxicity in breast cancer patients undergoing radiotherapy 患者报告了接受放射治疗的乳腺癌患者的症状毒性结果

IF 2.3 4区医学 Q3 ONCOLOGY

Current Problems in Cancer

Pub Date : 2025-07-28 DOI: 10.1016/j.currproblcancer.2025.101236

Nidhi Gupta , Aanchal Arora , Kislay Dimri , Awadhesh Kumar Pandey

Background

Patient reported outcomes (PRO) usually report greater symptom toxicity compared to physician reported outcomes (PhyRO). In the present study, we measured PRO about symptom toxicity in breast cancer patients undergoing adjuvant radiotherapy and compared them with the PhyRO. We analysed the factors responsible for greater symptom severity on PRO. We also assessed the health-related Quality of Life (QoL).

Materials and methods

Sixty-seven breast cancer patients undergoing adjuvant radiotherapy were prospectively enrolled. PhyRO were reported using the CTCAE v5.0 while PRO were reported using PRO CTCAE v1.0. To determine the level of agreement between the PRO and PhyRO, we employed weighted Kappa statistics. EQ-5D-5 L scale was used to assess the QoL.

Results

Post radiotherapy, when PRO were compared with PhyRO, fair agreement (K = 0.21–0.40) was seen for nausea, vomiting, dysphagia, dysgeusia, anorexia and fatigue; moderate agreement (K = 0.41–0.60) was seen for pain; slight agreement (K = 0.01–0.20) was seen for myalgia; almost perfect agreement (K = 0.81–1.00) was seen for pruritis and substantial agreement (K = 0.61–0.80) was seen for dermatitis. Overall, the concordance between PhyRO and PRO appeared poor. Factors which were significantly associated with lesser symptom toxicity on PhyRO were patient age (41-60 years), literacy, housewives, married females, rural background, poor financial status, stage II, treated with three fields, treated with hypofractionation and male gender of the physician. There was no difference in the mean utility values of patients corresponding to the severity of toxicities reported by PhyRO or PRO.

Conclusion

This study strongly supports the inclusion of PRO in routine clinical care as complimentary information to PhyRO to improve patient care, compliance and clinical outcomes.

背景：与医生报告的结果（PhyRO）相比，患者报告的结果（PRO）通常报告的症状毒性更大。在本研究中，我们测量了乳腺癌辅助放疗患者的症状毒性PRO，并与PhyRO进行了比较。我们分析了导致PRO症状严重程度加重的因素。我们还评估了与健康相关的生活质量（QoL）。材料与方法前瞻性纳入67例接受辅助放疗的乳腺癌患者。PhyRO报告使用CTCAE v5.0， PRO报告使用PRO CTCAE v1.0。为了确定PRO和PhyRO之间的一致程度，我们采用加权Kappa统计。采用eq - 5d - 5l量表评定生活质量。结果放疗后，将PRO与PhyRO进行比较，在恶心、呕吐、吞咽困难、吞咽困难、厌食、疲劳等症状上具有相当的一致性（K = 0.21 ~ 0.40）；疼痛的一致性中等（K = 0.41-0.60）；在肌痛方面有轻微的一致性（K = 0.01 ~ 0.20）；瘙痒的诊断结果几乎完全一致（K = 0.81-1.00），皮炎的诊断结果基本一致（K = 0.61-0.80）。总体而言，PhyRO和PRO之间的一致性较差。患者年龄（41-60岁）、文化程度、家庭主妇、已婚女性、农村背景、经济状况不佳、II期、三场治疗、低分割治疗和医生的男性是与PhyRO症状毒性较小显著相关的因素。根据PhyRO和PRO报告的毒性严重程度，患者的平均效用值没有差异。结论：本研究强烈支持将PRO纳入常规临床护理，作为对PhyRO的补充信息，以改善患者护理，依从性和临床结果。

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引用次数: 0

Advances in breast cancer therapy: “Exploring the therapeutic potential of CDK 4/6 inhibitors and their clinical impact.” 乳腺癌治疗进展：“探索cdk4 /6抑制剂的治疗潜力及其临床影响。”

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer

Pub Date : 2025-07-25 DOI: 10.1016/j.currproblcancer.2025.101235

Gayatri D. Ambere , Devesh N. Prajapati , Dyandevi Mathure , Dileep Kumar

One of the most common malignancies diagnosed globally is breast cancer, a condition that is impacted by both environmental and genetic causes, there are three distinct molecular subtypes of breast cancer: hormone receptor-positive (HR+), HER2-positive (HER2+), and triple-negative (TNBC). About 70–75 % of instances of breast cancer are HR+, whereas 15–25 % of cases are HER2+ tumours, which can be successfully treated with targeted therapy. TNBC poses specific treatment problems and is linked to an increased risk of early recurrence because it lacks expression of ER, PR, and HER2. With the discovery of Inhibitors of cyclin-dependent kinases 4 and 6 (CDK4/6), such as ribociclib, palbociclib, and abemaciclib, the treatment of advanced HR+/HER2− breast cancer has shifted. These drugs are essential for arresting the cell cycle and limiting tumour growth. These inhibitors particularly target the cell cycle development from the G1 to the S phase, which is frequently dysregulated in breast cancer. CDK4/6 inhibitors' full potential is still being investigated, including the way they might be applied to various breast cancer subtypes and in conjunction with other treatments.

This review comprehensively examines the utilization strategies of CDK 4/6 inhibitors across various breast cancer subtypes, explores the mechanism of resistance, and highlights potential applications in combination with other treatments. Through a detailed analysis of clinical trials and real-world data, The review highlights how CDK4/6 inhibitors have revolutionized the treatment landscape for breast cancer, paving the way for optimized treatment outcomes.

全球诊断出的最常见的恶性肿瘤之一是乳腺癌，这种疾病受环境和遗传原因的影响，乳腺癌有三种不同的分子亚型：激素受体阳性（HR+）、HER2阳性（HER2+）和三阴性（TNBC）。大约70 - 75%的乳腺癌病例是HER2+，而15 - 25%的病例是HER2+肿瘤，这可以通过靶向治疗成功治疗。TNBC具有特殊的治疗问题，并且由于缺乏ER、PR和HER2的表达，与早期复发的风险增加有关。随着周期蛋白依赖性激酶4和6 （CDK4/6）抑制剂的发现，如ribociclib、palbociclib和abemaciclib，晚期HR+/HER2−乳腺癌的治疗发生了变化。这些药物对阻止细胞周期和限制肿瘤生长至关重要。这些抑制剂特别针对从G1期到S期的细胞周期发育，这在乳腺癌中经常失调。CDK4/6抑制剂的全部潜力仍在研究中，包括它们可能应用于各种乳腺癌亚型的方式以及与其他治疗方法的结合。本文综述了cdk4 /6抑制剂在不同乳腺癌亚型中的应用策略，探讨了耐药机制，并强调了与其他治疗联合的潜在应用。通过对临床试验和真实世界数据的详细分析，该综述强调了CDK4/6抑制剂如何彻底改变了乳腺癌的治疗前景，为优化治疗结果铺平了道路。

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引用次数: 0

Title Page 标题页

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer

Pub Date : 2025-07-14 DOI: 10.1016/S0147-0272(25)00053-4

引用次数: 0

Information for Readers 读者资讯

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer

Pub Date : 2025-07-14 DOI: 10.1016/S0147-0272(25)00054-6

引用次数: 0

Hormonal treatment of aggressive angiomyxoma 侵袭性血管粘液瘤的激素治疗

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer

Pub Date : 2025-07-04 DOI: 10.1016/j.currproblcancer.2025.101223

Aleksandra Maciejczyk , Karol Bartecki , Anna M. Czarnecka , Anna Szumera-Ciećkiewicz , Piotr Rutowski , Tomasz Świtaj

Purpose

This review aims to evaluate the efficacy of hormonal therapy, including gonadotropin-releasing hormone agonists (GnRH agonists), aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs) and combination therapy in the management of aggressive angiomyxoma (AAM).

Methods

A comprehensive literature search was conducted to identify studies reporting the use of hormonal interventions in AAM treatment. Seventy-five scientific papers were analyzed to gather data on treatment modalities, response rates, and adverse effects, which were then extracted and synthesized. The review was structured according to the PICO(S/T) framework to ensure consistency in data synthesis and interpretation. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure methodological transparency and rigor.

Results

Gonadotropin-releasing hormone agonists demonstrated anti-tumoral activity by inducing hypoestrogenism, resulting in tumor shrinkage and prevention of recurrence. Aromatase inhibitors stabilized disease progression and improved symptoms. Selective estrogen receptor modulators administered postoperatively prolonged progression-free survival. Combination therapies exhibited synergistic effects, with notable responses observed in neoadjuvant and adjuvant settings.

Conclusions

Hormonal therapy presents an effective adjunct to surgical resection in AAM management, especially in cases demonstrating estrogen receptor (ER) and progesterone receptor (PR) positivity. While effective, careful monitoring for adverse effects and individualized treatment approaches are necessary to optimize outcomes and minimize risks. This review highlights the evolving role of hormonal interventions in the multidisciplinary management of AAM, emphasizing the need for further research to refine treatment strategies and improve patient outcomes.

目的本综述旨在评价激素治疗，包括促性腺激素释放激素激动剂（GnRH激动剂）、芳香化酶抑制剂（AIs）、选择性雌激素受体调节剂（SERMs）和联合治疗在侵袭性血管粘液瘤（AAM）治疗中的疗效。方法进行全面的文献检索，以确定报告使用激素干预治疗AAM的研究。对75篇科学论文进行了分析，以收集有关治疗方式、反应率和不良反应的数据，然后对这些数据进行提取和合成。审查是根据PICO（S/T）框架进行的，以确保数据综合和解释的一致性。本系统评价遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目，以确保方法的透明度和严谨性。结果促性腺激素释放激素激动剂通过诱导低雌激素水平，使肿瘤缩小，防止肿瘤复发，具有抗肿瘤活性。芳香酶抑制剂稳定了疾病进展并改善了症状。术后给予选择性雌激素受体调节剂延长无进展生存期。联合治疗表现出协同效应，在新辅助和辅助设置中观察到显著的反应。结论雌激素受体（ER）和孕激素受体（PR）阳性是治疗AAM的有效辅助手段。虽然有效，但仔细监测不良反应和个性化治疗方法对于优化结果和最小化风险是必要的。这篇综述强调了激素干预在AAM多学科管理中的作用，强调了进一步研究以完善治疗策略和改善患者预后的必要性。

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引用次数: 0

Roles for epigenetic and other biomarkers in upper tract urothelial carcinoma diagnosis and surveillance 表观遗传学和其他生物标志物在上尿路上皮癌诊断和监测中的作用

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer

Pub Date : 2025-07-04 DOI: 10.1016/j.currproblcancer.2025.101222

Gabriele Ricciardi , Pietro Tralongo , Vincenzo Fiorentino , Emanuela Germanà , Mariagiovanna Ballato , Walter Giuseppe Giordano , Ludovica Pepe , Vincenzo Ficarra , Cristina Pizzimenti , Giuseppe Giuffrè , Valeria Zuccalà , Antonio Ieni , Guido Fadda , Francesco Pierconti , Maurizio Martini

Upper tract urothelial carcinoma (UTUC) is a rare but aggressive malignancy with increasing incidence, often diagnosed at advanced stages due to the limitations of current diagnostic tools. Conventional methods such as urinary cytology, imaging, and ureteroscopy have important drawbacks, including low sensitivity, high costs, and procedural invasiveness. As a result, there is a growing need for non-invasive, highly accurate diagnostic approaches.

Epigenetic biomarkers, particularly DNA methylation-based assays, have emerged as promising alternatives for UTUC detection and surveillance. Among these, Bladder EpiCheck® (BE) has shown remarkable sensitivity and specificity, particularly for high-grade tumors, making it a valuable adjunct to standard diagnostic techniques. By analyzing tumor-specific methylation patterns in urine samples, BE offers a practical and non-invasive solution that could improve early detection, reduce the need for ureteroscopy, and enhance risk stratification. Several studies have demonstrated its superior diagnostic accuracy, with sensitivity reaching 97.4 % and specificity up to 100 % for high-grade UTUC.

Despite these advantages, challenges remain regarding the standardization of testing protocols, validation in larger patient cohorts, and evaluation of cost-effectiveness. Moreover, the role of DNA methylation biomarkers in guiding clinical decisions and predicting disease progression requires further investigation. This review explores the current state of UTUC diagnosis, compares BE with conventional and emerging biomarkers, and discusses its clinical applications, limitations, and future perspectives. The integration of molecular biomarkers like BE into clinical practice has the potential to revolutionize UTUC diagnosis, improving patient outcomes through more precise, non-invasive detection strategies.

上尿路上皮癌（UTUC）是一种罕见但侵袭性的恶性肿瘤，发病率越来越高，由于目前诊断工具的限制，通常在晚期诊断出来。传统的方法，如泌尿细胞学、影像学和输尿管镜检查有重要的缺点，包括低灵敏度、高成本和程序性侵入性。因此，对非侵入性、高度准确的诊断方法的需求日益增长。表观遗传生物标志物，特别是基于DNA甲基化的测定，已经成为UTUC检测和监测的有希望的替代方法。其中，膀胱EpiCheck®（BE）已显示出显著的敏感性和特异性，特别是对高级别肿瘤，使其成为标准诊断技术的宝贵辅助手段。通过分析尿液样本中肿瘤特异性甲基化模式，BE提供了一种实用且无创的解决方案，可以提高早期发现，减少输尿管镜检查的需要，并增强风险分层。几项研究证明了其优越的诊断准确性，对高级别UTUC的敏感性达到97.4%，特异性高达100%。尽管有这些优势，但在测试方案的标准化、在更大患者群体中的验证以及成本效益评估方面仍然存在挑战。此外，DNA甲基化生物标志物在指导临床决策和预测疾病进展中的作用需要进一步研究。本文探讨了UTUC诊断的现状，将BE与传统和新兴的生物标志物进行了比较，并讨论了其临床应用、局限性和未来前景。将BE等分子生物标志物整合到临床实践中，有可能彻底改变UTUC的诊断，通过更精确、非侵入性的检测策略改善患者的预后。

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引用次数: 0

Management of fertility preservation in young female patients with gastrointestinal cancer: A case series and systematic literature review 年轻女性胃肠道肿瘤患者生育能力保存的管理：一个病例系列和系统的文献综述

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer

Pub Date : 2025-06-17 DOI: 10.1016/j.currproblcancer.2025.101221

Gabriella Gentile , Mariavita Ciccarone

Gastrointestinal (GI) cancers in young women pose significant challenges to fertility due to the gonadotoxic effects of chemotherapy, radiotherapy, and surgical interventions. While fertility preservation options exist, counseling remains underutilized, limiting patients' reproductive choices. This systematic review and case series examine the impact of GI cancer treatments on female fertility, available preservation techniques, pregnancy outcomes and sexual dysfunction. Despite advancements in fertility preservation, implementation remains suboptimal, underscoring the need for a multidisciplinary approach to improve counseling and reproductive outcomes. Raising awareness and promoting early intervention can enhance fertility preservation efforts and improve the quality of life for young female cancer survivors.

由于化疗、放疗和手术干预的促性腺毒性作用，年轻女性的胃肠道（GI）癌症对生育能力构成了重大挑战。虽然有保留生育能力的选择，但咨询仍然没有得到充分利用，限制了患者的生育选择。本系统综述和病例系列研究了胃肠道肿瘤治疗对女性生育能力、可用保存技术、妊娠结局和性功能障碍的影响。尽管在保持生育能力方面取得了进步，但实施仍然不够理想，强调需要采用多学科方法来改善咨询和生殖结果。提高认识和促进早期干预可以加强生育能力保存工作，改善年轻女性癌症幸存者的生活质量。

引用次数: 0

Sensitivity of core needle biopsy in the diagnosis of lymphoma: A meta-analysis 核心针活检诊断淋巴瘤的敏感性：一项荟萃分析

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer

Pub Date : 2025-05-14 DOI: 10.1016/j.currproblcancer.2025.101203

Chloe Cottone , Katherine Kozlowski , Joshua Sorrentino , Kelly Stahovic , Xiaoyi Ma , Vishal Gupta , Ayham Al Afif

Objective

Lymphoma commonly presents in the head and neck. Studies on the sensitivity of core needle biopsy (CNB) in diagnosing subtypes of lymphoma are mixed. We performed a meta-analysis of the existing literature to uncover the sensitivity of CNB in diagnosing lymphoma subtypes.

Data sources

PubMed, Embase by Elsevier

Review methods

Articles included examined the sensitivity of CNB by lymphoma subtype. We excluded articles that did not use CNB and lacked sufficient data. A random effect logistic regression model was used to pool sensitivity data. Pooled sensitivity estimates and corresponding 95 % confidence intervals were obtained from model estimates and all analyses were conducted at a significance of 0.05.

Results

Screening yielded 32 articles (15 including Head and Neck nodes) with 3,027 biopsies. Across all subtypes, estimated sensitivity was 86.4 % (CI:76.1–96.7). There was significant heterogeneity among disease subtypes (p < 0.001). Chronic Lymphocytic Leukemia (CLL), Mantle Cell (MCL) and Diffuse Large B Cell (DLBCL) lymphoma exhibited highest sensitivities at 97.8 % (CI:94.2–99.1), 97.0 % (CI:92.2–98.9), and 94.5 % (CI:91.44–96.5), respectively. Low Grade B Cell not otherwise specified, Natural Killer/T cell, and Angioimmunoblastic Lymphomas demonstrated lowest sensitivities at 71.0 % (CI:44.5–88.2), 75.4 % (CI:23.0–96.9), and 77.1 % (CI:54.2–90.5), respectively.

Conclusion

CNB is highly sensitive in the diagnosis of some lymphoma subtypes, particularly MCL, DLBCL and CLL. Knowledge of CNB performance relative to each subtype can aid in clinical decision making, as it pertains to treatment and the need for excisional biopsy.

目的：淋巴瘤常见于头颈部。关于核心针活检（CNB）诊断淋巴瘤亚型的敏感性的研究褒贬不一。我们对现有文献进行了荟萃分析，以揭示CNB在诊断淋巴瘤亚型中的敏感性。数据来源pubmed， Embase by elsevier综述方法纳入的文章按淋巴瘤亚型检测了CNB的敏感性。我们排除了没有使用CNB和缺乏足够数据的文章。采用随机效应logistic回归模型对敏感性数据进行汇总。从模型估计值中获得合并敏感性估计值和相应的95%置信区间，所有分析均以0.05的显著性进行。结果32篇（包括头颈部淋巴结15篇）共3027例活检。在所有亚型中，估计敏感性为86.4% （CI: 76.1-96.7）。不同疾病亚型间存在显著异质性(p <；0.001)。慢性淋巴细胞白血病（CLL）、套细胞淋巴瘤（MCL）和弥漫性大B细胞淋巴瘤（DLBCL）的敏感性最高，分别为97.8% （CI: 94.2-99.1）、97.0% （CI: 92.2-98.9）和94.5% （CI: 91.44-96.5）。低级别B细胞（未另行指定）、自然杀伤/T细胞和血管免疫母细胞淋巴瘤的最低敏感性分别为71.0% （CI: 44.5-88.2）、75.4% （CI: 23.0-96.9）和77.1% （CI: 54.2-90.5）。结论cnb对某些淋巴瘤亚型的诊断具有较高的敏感性，尤其是对MCL、DLBCL和CLL的诊断。了解每个亚型的CNB表现可以帮助临床决策，因为它与治疗和切除活检的需要有关。

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引用次数: 0

Acute lymphoblastic leukemia following lenalidomide therapy in multiple myeloma patients: Two case reports and review of the literature 多发性骨髓瘤患者来那度胺治疗后急性淋巴细胞白血病：两例报告和文献回顾

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer

Pub Date : 2025-05-14 DOI: 10.1016/j.currproblcancer.2025.101219

Ozlem Candan, Derya Demirtas, Fatma Temiz, Ahmet Mert Yanik, Asu Fergun Yilmaz, Isik Atagunduz, Ayse Tulin Tuglular, Tayfur Toptas

Background

Lenalidomide, as an immunomodulatory drug, has significantly contributed to advancements in hematologic malignancies. However, lenalidomide therapy has been associated with rare but severe complications, particularly therapy-related acute lymphoblastic leukemia (t-ALL). This study aims to contribute to understanding the clinical, genetic, and therapeutic characteristics of t-ALL following lenalidomide therapy. To achieve this, cases reported in the literature were reviewed, and a comprehensive evaluation was conducted with the addition of two new case reports.

Methods

A comprehensive review of published cases was conducted using databases such as PubMed and Scopus. Inclusion criteria focused on patients who developed ALL following lenalidomide therapy. Clinical findings, cytogenetic data, treatment protocols, and outcomes were analyzed alongside two new cases from our institution.

Results

The findings revealed a diverse genetic landscape among patients with lenalidomide-associated t-ALL, with common abnormalities including TP53 mutations and hypodiploidy. The latency period for developing t-ALL after lenalidomide therapy varied widely, with a median duration of approximately 50 months (range: 6-126). Treatment strategies, such as intensive chemotherapy and allogeneic hematopoietic stem cell transplantation, showed variable efficacy, heavily influenced by cytogenetic risk factors and the presence of infections.

Conclusion

Lenalidomide-associated t-ALL represents a rare but clinically significant complication. Vigilant monitoring, early detection, and personalized therapeutic strategies are crucial for improving outcomes. This study emphasizes the importance of balancing the therapeutic benefits of lenalidomide against its potential risks and advocates for further multicenter studies to refine management protocols and discover predictive biomarkers.

来那度胺作为一种免疫调节药物，在血液恶性肿瘤的治疗中发挥了重要作用。然而，来那度胺治疗与罕见但严重的并发症有关，特别是治疗相关性急性淋巴细胞白血病（t-ALL）。本研究旨在了解来那度胺治疗后t-ALL的临床、遗传和治疗特点。为了实现这一目标，我们回顾了文献中报道的病例，并进行了全面的评估，并增加了两个新的病例报告。方法利用PubMed、Scopus等数据库对已发表病例进行综合分析。纳入标准集中在来那度胺治疗后发生ALL的患者。临床表现、细胞遗传学数据、治疗方案和结果与我们机构的两个新病例一起分析。研究结果揭示了来那度胺相关t-ALL患者的不同遗传格局，常见的异常包括TP53突变和次二倍体。来那度胺治疗后发生t-ALL的潜伏期变化很大，中位持续时间约为50个月（范围：6-126）。治疗策略，如强化化疗和同种异体造血干细胞移植，显示出不同的疗效，严重受细胞遗传学危险因素和感染的影响。结论来那度胺相关t-ALL是一种罕见但具有临床意义的并发症。警惕监测、早期发现和个性化治疗策略对改善预后至关重要。本研究强调了平衡来那度胺的治疗益处及其潜在风险的重要性，并倡导进一步的多中心研究，以完善管理方案和发现预测性生物标志物。

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引用次数: 0