Cancer treatment reviews最新文献_第2页

Corrigendum to “T-cell engager toxicity in clinical phase trials; A systematic review and meta-analysis”. [Cancer Treat Rev. 139 (2025) 102991. doi: 10.1016/j.ctrv.2025.102991] “临床阶段试验中的t细胞接合物毒性；系统回顾和荟萃分析”。[癌症治疗杂志]139(2025)102991。doi: 10.1016 / j.ctrv.2025.102991]。

IF 10.5 1区医学 Q1 ONCOLOGY

Cancer treatment reviews

Pub Date : 2026-01-01 DOI: 10.1016/j.ctrv.2025.103052

Zoulikha M. Zaïr , Gemma Butterworth , Mariam Shalaby , Eduard Oštarijaš , Fiona Thistlethwaite

引用次数: 0

Mechanisms and biomarkers for musculoskeletal signs and symptoms in patients treated with aromatase inhibitors: A comprehensive systematic review 芳香酶抑制剂治疗患者肌肉骨骼体征和症状的机制和生物标志物：一项全面的系统综述

IF 10.5 1区医学 Q1 ONCOLOGY

Cancer treatment reviews

Pub Date : 2026-01-01 DOI: 10.1016/j.ctrv.2025.103075

Noora Jatan , Sami Talo , Aida J. Azar , Thomas E. Adrian , Catherine F. Kellett

Background

Aromatase inhibitors anastrozole and letrozole (non-steroidal, reversible), and exemestane (steroidal, irreversible) are approved standard therapies (Food and Drug Administration) for hormone receptor–positive breast cancer. Their use is limited by Aromatase Inhibitor-induced Musculoskeletal Signs and Symptoms (AIMSS).

Methods

Articles on AIMSS mechanisms and biomarkers published between January 1, 1990, and October 31, 2024, in PubMed, EMBASE, and Cochrane Library were identified. Included study designs were randomized and non-randomized trials, observational cohorts, cross-sectional studies, and preclinical animal models. Risk of bias was assessed using the Critical Appraisal Skills Programme tool for observational studies and Risk of Bias 2 for randomized trials.

Results

Fifty studies were included (43 human and seven animal). Estrogen deprivation was the central mechanism, affecting immune function, bone remodeling, and nociceptive sensitivity. Genetic variants in Estrogen Receptor 1, CYP19A1, and T-cell Leukemia/Lymphoma 1A were frequently associated with AIMSS. Vitamin D deficiency, polymorphisms in RANKL and Osteoprotegerin contributed to bone-related symptoms. Imaging studies identified tenosynovial thickening, tendon sheath fluid, and subclinical inflammation. Systemic inflammatory markers C-Reactive Protein and Interleukin 6 were elevated in human and animal studies.

Transient Receptor Potential Ankyrin 1 and Transient Receptor Potential Vanilloid 4 ion channels were implicated in peripheral sensitization. Insulin-like Growth Factor 1 during AI therapy was independently associated with symptoms.

Conclusion

AIMSS involves intersecting hormonal, genetic, inflammatory, and neural pathways. Identification of mechanistic biomarkers may support AIMSS risk stratification and targeted interventions. Further research should validate multi-omic models and explore new strategies to reduce AIMSS and improve treatment compliance.

Registration

PROSPERO Registration: CRD42025642540.

daromatase抑制剂阿那曲唑和来曲唑（非甾体，可逆）和依西美坦（甾体，不可逆）被批准为激素受体阳性乳腺癌的标准疗法（食品和药物管理局）。它们的使用受到芳香酶抑制剂诱导的肌肉骨骼体征和症状（AIMSS）的限制。方法选取1990年1月1日至2024年10月31日在PubMed、EMBASE和Cochrane图书馆发表的有关AIMSS机制和生物标志物的文章。纳入的研究设计包括随机和非随机试验、观察性队列、横断面研究和临床前动物模型。观察性研究使用Critical evaluation Skills program工具评估偏倚风险，随机试验使用Risk of bias 2工具评估偏倚风险。结果共纳入50项研究（人43项，动物7项）。雌激素剥夺是影响免疫功能、骨重塑和伤害敏感性的主要机制。雌激素受体1、CYP19A1和t细胞白血病/淋巴瘤1A的遗传变异通常与AIMSS相关。维生素D缺乏、RANKL多态性和骨保护素导致骨相关症状。影像学检查发现腱鞘增厚、腱鞘积液和亚临床炎症。在人类和动物研究中，全身炎症标志物c反应蛋白和白细胞介素6升高。瞬时受体电位锚蛋白1和瞬时受体电位香草蛋白4离子通道参与外周致敏。AI治疗期间胰岛素样生长因子1与症状独立相关。结论aimss涉及激素、遗传、炎症和神经通路的交叉。鉴定机制生物标志物可能支持AIMSS风险分层和有针对性的干预。进一步的研究应验证多组学模型，探索降低AIMSS和提高治疗依从性的新策略。注册号：CRD42025642540。

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引用次数: 0

Intracranial activity of antibody-drug conjugates in advanced non-small cell lung cancer: What have we accomplished so far? 抗体-药物偶联物在晚期非小细胞肺癌中的颅内活性：到目前为止我们完成了什么？

IF 10.5 1区医学 Q1 ONCOLOGY

Cancer treatment reviews

Pub Date : 2025-12-31 DOI: 10.1016/j.ctrv.2025.103083

Seng Wee Cheo , Molly S.C. Li , Derek De-Rui Huang , Stephanie P.L. Saw , Lizza E.L. Hendriks , Jordi Remon , Jessica Menis , Alfredo Addeo , Pei Jye Voon

Antibody-drug conjugates (ADCs) represent a rapidly evolving class of therapeutics in non-small cell lung cancer (NSCLC), offering targeted delivery of cytotoxic payloads to tumor cells while minimizing off-target toxicity. Although ADCs have demonstrated promising results in NSCLC, their efficacy in treating central nervous system (CNS) metastases has been uncertain due to concerns over blood–brain barrier (BBB) penetration and the lack of dedicated CNS-specific evaluations in clinical trials. However, emerging evidence challenges this paradigm. While earlier-generation ADCs such as T-DM1 exhibited limited CNS efficacy, newer ADCs employing optimized linkers and cytotoxins demonstrate more favorable efficacy and toxicity profiles. Selected agents, including trastuzumab deruxtecan, datopotamab deruxtecan and patritumab deruxtecan, have all shown intracranial responses in patients with advanced NSCLC with brain metastases (BM). Proposed mechanisms facilitating CNS activity include BBB disruption by BM, membrane-permeable and highly potent cytotoxic payloads, and bystander effects that enable tumor cell killing beyond the target antigen. Nevertheless, several limitations remain, including variability in trial designs, limited number of patients with untreated CNS disease, and a lack of CNS-specific endpoints. Given the high incidence of BM in NSCLC and their significant impact on patient outcomes, there is an urgent need to better understand the intracranial activity of ADCs and whether they can prevent the development of CNS metastases, especially as some of these ADCS are being tested in the curative-intent setting. This review synthesizes current evidence and highlights ongoing trials, with a focused examination of the evolving role of ADCs in the management of BM.

抗体-药物偶联物（adc）代表了非小细胞肺癌（NSCLC）中快速发展的一类治疗方法，提供靶向递送细胞毒性有效载荷到肿瘤细胞，同时最大限度地减少脱靶毒性。尽管adc在非小细胞肺癌治疗中表现出良好的效果，但由于对血脑屏障（BBB）渗透的担忧以及临床试验中缺乏专门的中枢神经系统特异性评估，其治疗中枢神经系统（CNS）转移的疗效尚不确定。然而，新出现的证据挑战了这一范式。虽然早期adc（如T-DM1）对中枢神经系统的疗效有限，但采用优化的连接物和细胞毒素的新型adc显示出更有利的疗效和毒性。选定的药物，包括曲妥珠单抗德uxtecan， datopotamab德uxtecan和patritumab德uxtecan，在晚期NSCLC脑转移（BM）患者中都显示出颅内反应。目前提出的促进中枢神经系统活性的机制包括脑脊髓炎破坏血脑屏障、膜渗透性和高效的细胞毒性有效载荷，以及使肿瘤细胞在靶抗原之外被杀死的旁观者效应。然而，仍然存在一些局限性，包括试验设计的可变性，未经治疗的中枢神经系统疾病患者数量有限，以及缺乏中枢神经系统特异性终点。鉴于脑转移在非小细胞肺癌中的高发病率及其对患者预后的重大影响，迫切需要更好地了解adc的颅内活动，以及它们是否可以预防中枢神经系统转移的发展，特别是其中一些adc正在治疗目的环境中进行测试。这篇综述综合了目前的证据，并强调了正在进行的试验，重点研究了adc在BM管理中不断发展的作用。

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引用次数: 0

Targeted therapies in optic pathway gliomas 视神经胶质瘤的靶向治疗

IF 10.5 1区医学 Q1 ONCOLOGY

Cancer treatment reviews

Pub Date : 2025-12-27 DOI: 10.1016/j.ctrv.2025.103073

Edoardo Agosti , Pier Paolo Panciani , Giuseppe Lombardi , Matthias Preusser , Giorgia De Rosa , Karen Mapelli , Amedeo Piazza , Daniele Tognetto , Caterina Gagliano , Luca Denaro , Marta Padovan , Marco Maria Fontanella , Marco Zeppieri , Tamara Ius

Aim

This study provides a systematic synthesis of current evidence on targeted therapies for optic pathway gliomas (OPGs), emphasizing their molecular rationale, clinical effectiveness, safety profiles, relevance in both Neurofibromatosis type 1 (NF1) −associated and sporadic cases.

Methods

A systematic literature review was conducted in accordance with PRISMA guidelines using PubMed, Web of Science, and Scopus databases up to April 2025. Eligible studies focused on systemic targeted therapies for OPGs, evaluating efficacy, molecular targets, and adverse events. Both preclinical and clinical data were included, with study quality assessed using the Newcastle-Ottawa Scale.

Results

Of 414 records screened, 13 studies (11 clinical and 2 preclinical) met inclusion criteria. Targeted agents included MEK inhibitors, mTOR inhibitors, anti-VEGF agents, and BRAF inhibitors. MEK inhibitors showed promising progression-free survival outcomes, particularly in NF1-associated OPGs, while anti-VEGF therapies rapidly improved visual symptoms in select cases.

MEK inhibitors showed the most consistent progression-free survival benefits, particularly in NF1-associated OPGs, with selumetinib emerging as the leading agent with favorable efficacy and safety profiles. These findings support the growing role of biomarker-driven targeted strategies while underscoring unresolved challenges related to long-term safety and optimal treatment duration.

Conclusion

Targeted therapies constitute a potentially paradigm-shifting development in the management of OPGs, enhancing disease control while improving the prospects for long-term visual preservation. This review underscores the need for individualized, biomarker-driven approaches and highlights challenges including resistance, long-term safety, and therapy duration.

目的本研究系统地综合了目前针对视神经通路胶质瘤（OPGs）的靶向治疗的证据，强调了它们的分子原理、临床有效性、安全性以及在1型神经纤维瘤病（NF1）相关病例和散发性病例中的相关性。方法采用截至2025年4月的PubMed、Web of Science和Scopus数据库，按照PRISMA指南进行系统文献综述。合格的研究集中于OPGs的全身靶向治疗，评估疗效、分子靶点和不良事件。包括临床前和临床数据，并使用纽卡斯尔-渥太华量表评估研究质量。结果在筛选的414条记录中，13项研究（11项临床研究和2项临床前研究）符合纳入标准。靶向药物包括MEK抑制剂、mTOR抑制剂、抗vegf药物和BRAF抑制剂。MEK抑制剂显示出有希望的无进展生存结果，特别是在nf1相关的OPGs中，而抗vegf治疗在某些病例中迅速改善了视觉症状。MEK抑制剂显示出最一致的无进展生存益处，特别是在nf1相关的OPGs中，selumetinib以良好的疗效和安全性成为领先的药物。这些发现支持了生物标志物驱动的靶向策略日益增长的作用，同时强调了与长期安全性和最佳治疗持续时间相关的未解决的挑战。结论靶向治疗在OPGs的治疗中具有潜在的范式转变，增强了疾病控制，同时改善了长期视力保护的前景。这篇综述强调了个体化、生物标志物驱动的方法的必要性，并强调了包括耐药性、长期安全性和治疗持续时间在内的挑战。

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引用次数: 0

Ex vivo drug screening on patient-derived tumor material to advance functional precision in oncology: an overview on current approaches and unresolved challenges 对患者源性肿瘤材料进行体外药物筛选以提高肿瘤功能精度：当前方法和未解决的挑战概述

IF 10.5 1区医学 Q1 ONCOLOGY

Cancer treatment reviews

Pub Date : 2025-12-22 DOI: 10.1016/j.ctrv.2025.103072

Zoltán Spiró , Amin El-Heliebi , Maximilian J. Mair , Thomas R. Pieber , Barbara Prietl , Sabine Spiegl-Kreinecker , Stefanie Stanzer , Adelheid Wöhrer , Matthias Preusser , Anna Sophie Berghoff

The advent of mutation-informed targeted therapies has transformed medical oncology, delivering durable responses in several cancer types. However, this success has not been universal. Tumors such as glioblastoma have largely remained unresponsive to genomics-guided personalized treatments, and in many cancers, the correlation between genetic alterations and therapeutic response remains inconsistent.

To address these limitations, functional precision oncology − based on ex vivo drug screening using patient-derived tumor cells − has emerged as a compelling complementary approach. By directly testing drug responses in tumor cells, this strategy seeks to bypass the shortcomings of purely genomic prediction models, particularly in malignancies that have proven refractory to current targeted approaches.

This review outlines the state-of-the-art methodologies for patient-derived cell-based drug screening, examining their application across various tumor types and highlighting the current challenges and opportunities in implementing functional precision medicine in clinical oncology.

突变知情的靶向治疗的出现已经改变了肿瘤医学，在几种癌症类型中提供持久的反应。然而，这种成功并不是普遍的。像胶质母细胞瘤这样的肿瘤在很大程度上对基因组学指导的个性化治疗没有反应，而且在许多癌症中，遗传改变和治疗反应之间的相关性仍然不一致。为了解决这些限制，功能性精确肿瘤学-基于体外药物筛选使用患者来源的肿瘤细胞-已经成为一个引人注目的补充方法。通过直接测试肿瘤细胞中的药物反应，该策略试图绕过纯基因组预测模型的缺点，特别是在已被证明对当前靶向方法难治的恶性肿瘤中。本文概述了基于患者来源的细胞药物筛选的最新方法，研究了它们在各种肿瘤类型中的应用，并强调了在临床肿瘤学中实施功能精准医学的当前挑战和机遇。

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引用次数: 0

Circulating tumour DNA in head and neck squamous-cell carcinomas: A literature review 头颈部鳞状细胞癌循环肿瘤DNA：文献综述。

IF 10.5 1区医学 Q1 ONCOLOGY

Cancer treatment reviews

Pub Date : 2025-12-18 DOI: 10.1016/j.ctrv.2025.103070

Léo Ventelou , Angeline Ginzac , Marie-Céleste Ferreira , Laurie Canetti , Soline Philippe , Céleste Pinard , Xavier Durando , Maureen Bernadach

Background

In 60 % of cases, head and neck cancers (HNCs) are diagnosed at an advanced stage and therefore have a poor prognosis with survival rates of only 49 months. Circulating tumour DNA (ctDNA) has emerged as a minimally invasive biomarker able to improve early detection, assess minimal residual disease, monitor systemic treatment response and identify therapeutic targets. This literature review aims to critically synthesise evidence from the past decade on the clinical use of ctDNA in both HPV-related and HPV-unrelated HNCs.

Patients and methods

A literature review was performed using PubMed and Cochrane Library on March 11th 2024, updated on November 21st, 2025, using the keywords: “circulating tumour DNA”, “head and neck cancer”, “ctHPV-DNA associated with HNSCC”, “liquid biopsy and HNSCC”.

Results

After evaluation of 363 articles identified, 92 were included. ctDNA has been investigated for screening, diagnosis, prognostic stratification, treatment-response assessment, relapse detection and identification of therapeutic targets. However, performance varies considerably across studies due to methodological and biological heterogeneity.

Conclusion

ctDNA shows strong potential for response assessment and post-treatment monitoring, particularly in HPV-related disease. Nevertheless, its integration into clinical practice requires methodological standardisation and validation in larger prospective studies.

背景：在60%的病例中，头颈癌（HNCs）在晚期被诊断出来，因此预后较差，生存率仅为49个月。循环肿瘤DNA （ctDNA）已成为一种微创生物标志物，能够改善早期发现，评估最小残留疾病，监测全身治疗反应并确定治疗靶点。本文献综述旨在批判性地综合过去十年中ctDNA在hpv相关和非hpv相关HNCs临床应用的证据。患者和方法：检索PubMed和Cochrane图书馆于2024年3月11日更新至2025年11月21日的文献，检索关键词：“循环肿瘤DNA”、“头颈癌”、“ctHPV-DNA与HNSCC相关”、“液体活检和HNSCC”。结果：经鉴定363篇文献，纳入92篇。ctDNA已被用于筛查、诊断、预后分层、治疗反应评估、复发检测和治疗靶点识别。然而，由于方法和生物学的异质性，不同研究的表现差异很大。结论：ctDNA在反应评估和治疗后监测方面具有很强的潜力，特别是在hpv相关疾病中。然而，将其纳入临床实践需要方法标准化和在更大的前瞻性研究中进行验证。

{"title":"Circulating tumour DNA in head and neck squamous-cell carcinomas: A literature review","authors":"Léo Ventelou , Angeline Ginzac , Marie-Céleste Ferreira , Laurie Canetti , Soline Philippe , Céleste Pinard , Xavier Durando , Maureen Bernadach","doi":"10.1016/j.ctrv.2025.103070","DOIUrl":"10.1016/j.ctrv.2025.103070","url":null,"abstract":"<div><h3>Background</h3><div>In 60 % of cases, head and neck cancers (HNCs) are diagnosed at an advanced stage and therefore have a poor prognosis with survival rates of only 49 months. Circulating tumour DNA (ctDNA) has emerged as a minimally invasive biomarker able to improve early detection, assess minimal residual disease, monitor systemic treatment response and identify therapeutic targets. This literature review aims to critically synthesise evidence from the past decade on the clinical use of ctDNA in both HPV-related and HPV-unrelated HNCs.</div></div><div><h3>Patients and methods</h3><div>A literature review was performed using PubMed and Cochrane Library on March 11th 2024, updated on November 21st, 2025, using the keywords: “circulating tumour DNA”, “head and neck cancer”, “ctHPV-DNA associated with HNSCC”, “liquid biopsy and HNSCC”.</div></div><div><h3>Results</h3><div>After evaluation of 363 articles identified, 92 were included. ctDNA has been investigated for screening, diagnosis, prognostic stratification, treatment-response assessment, relapse detection and identification of therapeutic targets. However, performance varies considerably across studies due to methodological and biological heterogeneity.</div></div><div><h3>Conclusion</h3><div>ctDNA shows strong potential for response assessment and post-treatment monitoring, particularly in HPV-related disease. Nevertheless, its integration into clinical practice requires methodological standardisation and validation in larger prospective studies.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"142 ","pages":"Article 103070"},"PeriodicalIF":10.5,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

KELIM score: A marker of chemosensitivity in ovarian cancer KELIM评分：卵巢癌化疗敏感性的标志

IF 10.5 1区医学 Q1 ONCOLOGY

Cancer treatment reviews

Pub Date : 2025-12-18 DOI: 10.1016/j.ctrv.2025.103071

Federica Adele Ambrosino , Carmela Pisano , Marilena Di Napoli , Jole Ventriglia , Rosa Tambaro , Sabrina Rossetti , Anna Passarelli , Ernesta Cavalcanti , Rossella De Cecio , Francesco Fiore , Sergio Venanzio Setola , Teresa Troiani , Lorenzo Lobianco , Erica Perri , Mariarosaria Lamia , Gabriele Calvanese , Sandro Pignata , Sabrina Chiara Cecere

Ovarian cancer is the gynecological cancer with the worst prognosis and the highest mortality rate, primarily because 75% of patients are diagnosed with advanced FIGO stage III-IV disease. About 50% of patients are now treated with neoadjuvant chemotherapy followed by interval debulking surgery. In that context, there is a need for accurate predictors of tumor primary chemosensitivity, as it may impact the feasibility of subsequent interval debulking surgery. The cancer antigen 125 ELIMination rate constant K (KELIM) score, a modeled kinetic parameter, is a potential marker of tumor chemosensitivity in patients with ovarian cancer treated with adjuvant or neoadjuvant chemotherapy before interval debulking surgery. This review aims to provide a comprehensive overview of potential predictive factors for response to platinum therapy, focusing on the KELIM score, a marker increasingly used in clinical practice.

卵巢癌是预后最差、死亡率最高的妇科癌症，主要原因是75%的患者被诊断为晚期FIGO III-IV期疾病。大约50%的患者现在接受新辅助化疗，然后进行间歇减容手术。在这种情况下，需要对肿瘤原发化疗敏感性进行准确的预测，因为这可能会影响后续间隔减容手术的可行性。肿瘤抗原125消除率常数K （KELIM）评分是一个模型动力学参数，是卵巢癌患者在间隔减积手术前接受辅助或新辅助化疗时肿瘤化疗敏感性的潜在标志。本综述旨在提供对铂治疗反应的潜在预测因素的全面概述，重点关注临床实践中越来越多使用的标志物KELIM评分。

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引用次数: 0

AMH as a marker for resumption of ovarian function after chemotherapy: an IPD meta-analysis and systematic review AMH作为化疗后卵巢功能恢复的标志物：一项IPD荟萃分析和系统评价。

IF 10.5 1区医学 Q1 ONCOLOGY

Cancer treatment reviews

Pub Date : 2025-12-16 DOI: 10.1016/j.ctrv.2025.103068

Charissa van Zwol – Janssens , Mandy van M. Rosmalen , Joop S.E. Laven , Kazem Nasserinejad , Jenny A. Visser , Richard A. Anderson , Irit Ben-Aharon , Thomas Freour , Kathryn J. Ruddy , H. Irene Su , Yvonne V. Louwers , Agnes Jager

Background

In premenopausal women with breast cancer, chemotherapy often leads to amenorrhea that could be temporary or permanent. Anti-Müllerian hormone (AMH) is a potential biomarker predicting resumption of ovarian function, an outcome that aids in the decision making for endocrine therapy. This study aimed to determine the predictive value of pre-chemotherapy AMH levels for resumption of ovarian function.

Methods

We conducted a systematic review and individual patient data (IPD) meta-analysis. Online databases were searched using terms including: AMH, prediction, menses, menses recovery, amenorrhea, chemotherapy-related amenorrhea, anovulation, menopause, infertility, ovarian reserve, premenopausal, breast cancer, chemotherapy. The study protocol was registered with PROSPERO (CRD42021233966).

Results

The systematic review included 31 studies, with 26 contributing to the meta-analysis. Eleven studies provided IPD from 1,029 women. Ovarian function resumption rates varied from 24 % to 61 % depending on follow-up time. Pre-chemotherapy AMH was significantly higher in women whose ovarian function resumed, standardized mean difference 0.94 (95 % CI 0.65–1.22) and showed good predictive ability for resumption of ovarian function (AUC 0.79–0.83). However, the identified cut-off values for pre-chemotherapy AMH gave high false negative rates and differed a lot between studies which was much determined by follow-up time, age and used AMH assay.

Conclusion

Pre-chemotherapy AMH shows association with ovarian function resumption, but a clinically reliable cut-off across assays could not be established using individual patient data. Therefore, due to high inter-assay variability, AMH is not suitable for optimizing endocrine therapy in premenopausal breast cancer patients at this time. Standardizing AMH assays can help in further research into a cut-off value.

背景：绝经前乳腺癌患者，化疗常导致暂时或永久性闭经。抗勒氏激素（AMH）是预测卵巢功能恢复的潜在生物标志物，有助于内分泌治疗的决策。本研究旨在确定化疗前AMH水平对卵巢功能恢复的预测价值。方法：我们进行了系统评价和个体患者数据（IPD）荟萃分析。在线数据库的检索词包括：AMH、预测、月经、月经恢复、闭经、化疗相关闭经、无排卵、绝经、不孕、卵巢储备、绝经前、乳腺癌、化疗。研究方案已在PROSPERO注册（CRD42021233966）。结果：系统评价包括31项研究，其中26项用于荟萃分析。11项研究提供了1029名女性的IPD。卵巢功能恢复率根据随访时间从24%到61%不等。卵巢功能恢复的女性化疗前AMH明显增高，标准化平均差值0.94 (95% CI 0.65 ~ 1.22)，对卵巢功能恢复有较好的预测能力（AUC 0.79 ~ 0.83）。然而，化疗前AMH鉴定的临界值存在较高的假阴性率，且研究之间存在很大差异，这在很大程度上取决于随访时间、年龄和使用的AMH测定。结论：化疗前AMH显示与卵巢功能恢复相关，但无法通过个体患者数据建立临床可靠的检测截止值。因此，由于AMH在各试验间具有较高的变异性，因此不适合在此时优化绝经前乳腺癌患者的内分泌治疗。标准化抗真菌毒素检测有助于进一步研究临界值。

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引用次数: 0

Risk of QTc prolongation, and major cardiovascular adverse events associated with CDK4/6 inhibitors in hormone receptor-positive HER2-negative breast cancer – A systematic review and meta-analysis 激素受体阳性her2阴性乳腺癌患者与CDK4/6抑制剂相关的QTc延长风险和主要心血管不良事件——一项系统综述和荟萃分析

IF 10.5 1区医学 Q1 ONCOLOGY

Cancer treatment reviews

Pub Date : 2025-12-16 DOI: 10.1016/j.ctrv.2025.103069

Yee-Yin Hoo , Wei-Wei Sia , Sharminii Jaya-Prakason , Bogda Koczwara , Yek-Ching Kong , Joe-Elie Salem , Agnès Dechartres , Nirmala Bhoo-Pathy

Background

Cyclin-Dependent Kinase 4/6 inhibitors (CDK4/6i) improve survival in HR+/HER2- breast cancer, but agent-specific cardiotoxicity remains a concern. We evaluated the risk of QTc prolongation, and other cardiovascular adverse events (CVAEs) associated with ribociclib, palbociclib, and abemaciclib.

Method

We conducted a systematic review and meta-analysis (up to May 31st, 2025), assessing QTc prolongation and other CVAEs in patients with HR+/HER2- breast cancer receiving CDK4/6i plus endocrine therapy versus endocrine therapy alone. (PROSPERO: CRD42023460559; UICC Technical Fellowship (TF-20–716796).

Results

Twenty-three studies (22 RCTs, 1 cohort) were included. CDK4/6i increased the risk of grade 3/4 QTc prolongation (RR 1.83, 95% CI 1.23–2.74), driven by ribociclib (RR 1.95, 95% CI 1.27–2.98). Palbociclib showed no association, whereas no abemaciclib trials reported QTc data. VTE risk was elevated overall (RR 2.57, 95% CI 1.53–4.32), highest with abemaciclib (RR 5.14, 95% CI 3.09–8.54), while palbociclib was borderline (RR 2.13, 95% CI 0.99–4.57). Subgroup analyses revealed no consistent effect modifiers for ribociclib (QTc) or abemaciclib (VTE). No significant increase was observed for other composite CVAEs (RR 0.99, 95% CI 0.83–1.19) or for individual CVAEs. A hypothesis-generating signal for supraventricular arrhythmias was noted with abemaciclib (RR 3.87, 95% CI 1.19–12.53), based on sparse events. Heterogeneity was low across analyses.

Conclusion

Our findings mandate drug-tailored rather than class-wide cardiovascular monitoring in patients receiving CDK4/6i: ribociclib warrants routine ECG surveillance, abemaciclib requires intensified monitoring for VTE, and palbociclib shows no consistent signal but still merits vigilance.

细胞周期蛋白依赖性激酶4/6抑制剂（CDK4/6i）可提高HR+/HER2-乳腺癌患者的生存率，但药物特异性心脏毒性仍然值得关注。我们评估了与ribociclib、palbociclib和abemaciclib相关的QTc延长风险和其他心血管不良事件（CVAEs）。方法我们进行了一项系统回顾和荟萃分析（截至2025年5月31日），评估HR+/HER2-乳腺癌患者接受CDK4/6i联合内分泌治疗与单独内分泌治疗的QTc延长和其他CVAEs。(普洛斯彼罗：CRD42023460559； UICC技术奖学金（TF-20-716796）。结果共纳入23项研究（22个随机对照试验，1个队列）。CDK4/6i增加了3/4级QTc延长的风险（RR 1.83, 95% CI 1.23-2.74），由ribociclib驱动（RR 1.95, 95% CI 1.27-2.98）。Palbociclib没有显示出相关性，而abemaciclib试验没有报告QTc数据。静脉血栓栓塞风险总体升高（RR 2.57, 95% CI 1.53-4.32）， abemaciclib组最高（RR 5.14, 95% CI 3.09-8.54），而palbociclib组处于边缘（RR 2.13, 95% CI 0.99-4.57）。亚组分析显示，ribociclib （QTc）或abemaciclib （VTE）没有一致的效果调节剂。其他复合CVAEs （RR 0.99, 95% CI 0.83-1.19）或单个CVAEs均未观察到显著增加。基于稀疏事件，abemaciclib发现了室上性心律失常的假设生成信号（RR 3.87, 95% CI 1.19-12.53）。分析的异质性较低。结论：我们的研究结果要求对接受CDK4/6i治疗的患者进行量身定制的心血管监测，而不是全类别的心血管监测：ribociclib需要常规ECG监测，abemaciclib需要加强VTE监测，palbociclib没有一致的信号，但仍值得警惕。

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引用次数: 0

Primary tumor and metastasis-directed treatment for oligometastatic prostate cancer: An umbrella review of meta-analyses 原发性肿瘤和转移性前列腺癌的定向治疗：荟萃分析综述。

IF 10.5 1区医学 Q1 ONCOLOGY

Cancer treatment reviews

Pub Date : 2025-12-09 DOI: 10.1016/j.ctrv.2025.103064

Fausto Petrelli , Francesca Trevisan , Lorenza Bruschieri , Valentina Riboldi , Ivano Vavassori , Silvia Seghezzi , Andrea Esposito , Lorenzo Dottorini , Agostina De Stefani

<div><h3>Background</h3><div>The management of metastatic prostate cancer (mPC) has shifted from a purely systemic approach to an integrated paradigm incorporating local and metastasis-directed therapies. Advances in imaging and improved characterization of the <em>oligometastatic state</em> have stimulated renewed interest in aggressive multimodal treatment strategies.</div></div><div><h3>Objective</h3><div>To systematically evaluate and grade the evidence from published <em>meta</em>-analyses investigating the efficacy, safety, and credibility of local and metastasis-directed treatments in metastatic or oligometastatic prostate cancer.</div></div><div><h3>Design, setting, and participants</h3><div>This umbrella review followed PRISMA 2020 recommendations and Ioannidis umbrella-review methodology. PubMed, Embase, Web of Science, and Cochrane Library were searched through June 2025. Eligible studies were systematic reviews or <em>meta</em>-analyses with quantitative pooling of outcomes for local treatment (LT; prostate radiotherapy [RT] or radical prostatectomy [RP]), cytoreductive radical prostatectomy (CRP), or metastasis-directed therapy (MDT) using stereotactic body radiotherapy (SBRT). Twenty-one <em>meta</em>-analyses published between 2018 and 2025, enrolling > 160 000 patients, were included.</div></div><div><h3>Outcome measurements and statistical analysis</h3><div>Primary endpoints were overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS). Secondary endpoints included local control, toxicity, and prevention of symptomatic pelvic events. When multiple <em>meta</em>-analyses assessed the same association, second-level pooling was performed. Evidence credibility was graded as <em>strong, highly suggestive, suggestive,</em> or <em>weak.</em></div></div><div><h3>Results and limitations</h3><div>Prostate RT improved OS in <em>low-volume metastatic hormone-sensitive disease</em> (pooled HR ≈ 0.64–0.73) with minimal grade ≥ 3 toxicity (∼5%) and low heterogeneity (I<sup>2</sup> ≈ 0 %). CRP demonstrated suggestive OS and CSS advantages (HR/OR ≈ 0.6–0.8; CSS ≈ 0.5) versus systemic therapy alone but no superiority over RT. MDT/SBRT significantly prolonged PFS (HR ≈ 0.48) and showed emerging OS benefit (HR ≈ 0.60) across randomized trials, with very low rates of serious toxicity (<2%). Local therapy halved the risk of symptomatic pelvic complications (RR 0.50). Limitations include residual heterogeneity in imaging, disease definitions, and non-randomized data for surgical outcomes.</div></div><div><h3>Conclusions</h3><div>Across 21 <em>meta</em>-analyses, <em>prostate RT</em> provides highly suggestive evidence of survival benefit in low-volume mHSPC, <em>CRP</em> offers suggestive survival improvement in selected patients, and <em>MDT/SBRT</em> achieves highly suggestive evidence for progression control with emerging OS benefit. These strategies represent validated, evidence-based components of modern mul

背景：转移性前列腺癌（mPC）的治疗已经从纯粹的系统性方法转变为结合局部和转移导向治疗的综合范式。影像学的进步和对低转移状态特征的改进激发了对积极的多模式治疗策略的新兴趣。目的：对已发表的荟萃分析的证据进行系统评价和分级，这些荟萃分析调查了局部和转移性前列腺癌治疗的有效性、安全性和可信度。设计、设置和参与者：该伞状审查遵循PRISMA 2020建议和Ioannidis伞状审查方法。PubMed、Embase、Web of Science和Cochrane Library的检索截止到2025年6月。符合条件的研究是系统评价或荟萃分析，对局部治疗（LT；前列腺放疗[RT]或根治性前列腺切除术[RP]）、细胞减减性根治性前列腺切除术（CRP）或使用立体定向体放疗（SBRT）的转移性治疗（MDT）的结果进行定量汇总。纳入了2018年至2025年间发表的21项荟萃分析，纳入了160,000名患者。结果测量和统计分析：主要终点是总生存期（OS）、癌症特异性生存期（CSS）和无进展生存期（PFS）。次要终点包括局部控制、毒性和盆腔症状事件的预防。当多个荟萃分析评估相同的关联时，进行二级合并。证据可信度分为强、高暗示性、暗示性和弱。结果和局限性：前列腺RT改善了小体积转移性激素敏感疾病的OS（合并HR≈0.64-0.73），最低级别≥3级毒性（~ 5%）和低异质性（I2≈0%）。CRP具有OS和CSS优势(HR/OR≈0.6-0.8；在随机试验中，MDT/SBRT显著延长了PFS (HR≈0.48)，并显示出新的OS获益（HR≈0.60），严重毒性发生率非常低(结论：在21项荟萃分析中，前列腺RT为低容量mHSPC患者的生存获益提供了高度提示性的证据，CRP在选定的患者中提供了提示性的生存改善，MDT/SBRT在进展控制和新出现的OS获益方面获得了高度提示性的证据。这些策略代表了现代多模式mPC管理中经过验证的、基于证据的组成部分。

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