Cancer treatment and research最新文献

Ovarian cancer (OC) remains one of the most challenging gynecologic malignancies due to its late-stage diagnosis, high recurrence rates, and limited survival outcomes. Immunotherapy has emerged as a transformative approach in cancer treatment, leveraging the immune system to target tumor cells. This chapter provides a comprehensive overview of immunotherapy in OC, discussing its mechanisms, key strategies, and clinical advancements. Key areas include the role of immune checkpoint inhibitors (ICIs), adoptive cell therapies (ACT), cancer vaccines, and oncolytic viruses. Despite promising preclinical and clinical outcomes, significant challenges persist, including low immunogenicity, resistance mechanisms, and immune-related adverse events. Strategies to address these barriers, such as combination therapies, biomarker-guided approaches, and the integration of artificial intelligence (AI) for personalization, are discussed. Emerging directions, including next-generation immune checkpoint targets and innovations in epigenetic and metabolic reprogramming, are explored to envision the future of immunotherapy in OC. By addressing these challenges and leveraging innovative strategies, immunotherapy has the potential to redefine the therapeutic landscape, improving survival and quality of life for patients with OC.

Prostate cancer (PCa), a leading cause of cancer mortality in men, has experienced a paradigm shift with the rise of immunotherapy. This chapter examines the immunological landscape of PCa and highlights key immunotherapeutic approaches, including cancer vaccines, immune checkpoint inhibitors (ICIs), adoptive cell therapies, and cytokine-based treatments. Emerging innovations, such as oncolytic viruses, neoantigen-based therapies, and bispecific antibodies, are also examined. Challenges like the immunosuppressive tumor microenvironment (TME), limited predictive biomarkers, and immune-related adverse events (irAEs) are addressed, alongside promising combination strategies with androgen deprivation therapy (ADT), radiotherapy, and targeted therapies. Advances in biomarker discovery and artificial intelligence (AI) are emphasized for their role in optimizing personalized immunotherapy. This chapter underscores the need for equitable access to these advancements and concludes with a vision for integrating immunotherapy into standard care, offering durable and transformative outcomes for PCa patients.

Breast cancer (BC) is the most prevalent malignancy among women in the United States, affecting approximately 13% of the female population. While advancements in treatment strategies have improved survival rates, significant challenges remain due to tumor heterogeneity, metastatic progression, and acquired resistance to therapy. Recent studies have highlighted the potential of immunotherapy in managing various solid tumors, including BC. This growing interest stems from increasing recognition of the immune system's role in both normal breast tissue and BC development, leading to extensive clinical investigations into BC immunotherapy and its tumor immune landscape. Despite its promise, immunotherapy for BC faces hurdles such as low tumor immunogenicity, inadequate T-cell infiltration, and a highly immunosuppressive tumor microenvironment (TME), which limit its efficacy. Among the available approaches, PD-1/PD-L1 inhibitors have shown clinical benefit in a subset of metastatic BC patients, particularly those with PD-L1-positive tumors, triple-negative BC (TNBC), or high tumor-infiltrating lymphocyte (TIL) levels. Notably, atezolizumab and pembrolizumab have demonstrated durable responses in metastatic TNBC, underscoring their therapeutic potential. Current research is focused on developing combination immunotherapy strategies that can overcome resistance, enhance response rates, and convert non-responders to therapy-sensitive cases. A key area of investigation involves identifying biomarkers that can predict immunotherapy responsiveness, guide salvage therapy in progressive disease, and optimize personalized treatment combinations. This review explores the latest advancements and future directions in BC immunotherapy, including novel combination strategies with vaccines and chemotherapeutics aimed at improving treatment efficacy and patient survival outcomes.

Immunotherapeutic approaches have created effective therapy with a manageable toxicity profile as a new treatment approach in a wide variety of cancers, often leading to longer responses and control of disease. In pancreatic cancer, responses to immunotherapy have been difficult to capture. Many obstacles have been identified in the limited efficacy of immunotherapy in pancreatic cancers. The hostile tumor microenvironment plays a large role in therapeutic development of immune-based therapies in pancreatic cancer. The approach to addressing many of these challenges will require a team-based approach to optimize both our understanding of the disease, its microenvironment, and how each component behaves in the development and growth of pancreatic cancer as well as the mechanisms used to best create therapies and combinations of treatment that will have long-standing efficacy for pancreatic cancer patients.

Surgical site infection is a common complication following pancreaticoduodenectomy and is a major source of postoperative morbidity. Surgical site infection is more common among patients who undergo preoperative biliary instrumentation, likely because of the introduction of intestinal flora into the normally sterile biliary tree. Frequently, bacterial isolates from surgical site infections after pancreaticoduodenectomy demonstrate resistance to the antibiotic agents typically used for surgical prophylaxis, suggesting that broad-spectrum coverage may be beneficial. This chapter summarizes the current evidence regarding surgical site infection following pancreatic surgery and describes the rationale and methodology underlying a multicenter randomized trial evaluating piperacillin-tazobactam compared with cefoxitin for surgical site infection prevention following pancreaticoduodenectomy. As the first U.S. randomized surgical trial to utilize a clinical registry for data collection, this study serves as proof of concept for registry-based clinical trials. The trial has successfully completed patient accrual, and study results are forthcoming.

In USA, colorectal cancer is the third most commonly diagnosed cancer in men, second in women, as well as the third leading cause of cancer deaths (Siegel et al. in Cancer J Clin 73:1-112, 2023 [109]). Worldwide, colorectal cancer is the second leading cause of death and causes almost 916,000 deaths each year (Ferlay in Global cancer observatory: cancer today. International Agency for Research on Cancer, Lyon, 2020 [28]). Fortunately, due to the colon's surgical and endoscopic accessibility and functional redundancy, colorectal cancer is very treatable. Colonoscopic surveillance has the potential for not only providing tissue for the diagnosis of precancerous polyps and invasive carcinoma, but also preventing development of invasive carcinoma by the removal of precancerous lesions. This chapter discusses the clinical and pathologic features of the spectrum of epithelial, hematolymphoid, and mesenchymal malignant tumors of the colon, rectum, appendix, and anus.

Gastric cancer is a heterogeneous and prevalent disease. The traditional environmental exposures associated with elevated risk of gastric cancer are less prevalent in the USA today. Genetic risks and risks associated with inflammation remain. Most cases are sporadic, and familial clustering is observed in about 10% of the cases. Hereditary gastric cancer accounts for a very low percentage of cases. Here we review the genetic and environmental risk factors associated with the disease. In addition, we will review screening guidelines and current modalities that are available for screening in high-risk populations.

Cholangiocarcinoma (CC) is a heterogeneous group of malignancies that originates at any point along the biliary tree. CC is an uncommon malignancy as it represents approximately 3% of all gastrointestinal malignancies, though its global incidence is rising. CC can often be asymptomatic in its early stages and as a result, it is frequently diagnosed in later stages, leading to challenges in clinical management.

Management of hepatic malignancies is a multidisciplinary task with the involvement of hepatologists, medical/surgical/radiation oncologists, transplant surgeons, and interventional radiologists. Patients should be selected for a specific targeted therapy after multidisciplinary consensus. Interventional oncology, with image-guided locoregional cancer therapies, can decrease systemic toxicity without compromising tumoricidal effect.

The effect of nutrition in the development and prognosis of cancer has received a lot of attention. Research shows taking vitamins, which are powerful antioxidants, can significantly lower the risk of cancers. Nutritional supplements suited to a patient's background, genetics, diet, tumour histology, and therapy may be beneficial in some cases. A poor diet may have a negative impact on immunity and treatment tolerance, decreasing the efficacy of chemotherapy in destroying malignant cells. Most cancer patients now take vitamins to supplement regular treatment and/or to decrease side effects from the medicine as well as the underlying ailment. This is a new development in recent decades, whereas taking nutritional supplements while receiving cancer treatment may increase the success of chemotherapy. To enhance the quality of life, lengthen the survival rate, and sustain immunotherapy compliance, additional study into the use of micronutrients in medical treatment is required for cancer patients. The main purpose of this book chapter was to highlight the role of vitamins in cancer and to establish a solid foundation for future research on this exciting topic. The possible impact of some vitamins in various malignancies such as colorectal, breast, prostate, lung, pancreatic, and stomach cancers are investigated.