Thibault Gauduchon, Eve Marie Neidhardt, Jerome Fayette
{"title":"Therapeutic perspectives for recurrent or metastatic head and neck squamous cell carcinoma.","authors":"Thibault Gauduchon, Eve Marie Neidhardt, Jerome Fayette","doi":"10.1097/CCO.0000000000001133","DOIUrl":"10.1097/CCO.0000000000001133","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) remains a significant therapeutic challenge due to its biological complexity and clinical heterogeneity. This review addresses the relevance of exploring novel therapeutic approaches, particularly in light of recent advances and the persistent unmet needs in patient outcomes.</p><p><strong>Recent findings: </strong>Recent phase II and III clinical trials have highlighted promising strategies, including combinations of immunotherapy with targeted therapies, antibody-drug conjugates (ADCs), HPV vaccines, dual immunotherapy approaches, and therapies targeting the tumor microenvironment. These innovations represent emerging directions to overcome resistance mechanisms and improve treatment efficacy.</p><p><strong>Summary: </strong>The findings suggest that integrating innovative strategies such as ADCs, immunotherapy combinations, and tumor microenvironment-targeting therapies may significantly enhance clinical outcomes for patients with R/M HNSCC. Further research is essential to refine these approaches and optimize their application in clinical practice.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"175-183"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Douglas E Peterson, Noam Yarom, Charlotte Duch Lynggaard, Nofisat Ismaila, Deborah Saunders
{"title":"Implementation of the 2024 ASCO guidelines for the prevention and management of osteoradionecrosis in patients with head & neck cancer treated with radiation therapy.","authors":"Douglas E Peterson, Noam Yarom, Charlotte Duch Lynggaard, Nofisat Ismaila, Deborah Saunders","doi":"10.1097/CCO.0000000000001130","DOIUrl":"10.1097/CCO.0000000000001130","url":null,"abstract":"<p><strong>Purpose of review: </strong>Osteoradionecrosis may often be prevented in context of interprofessional healthcare that includes dental specialists prior to and following completion of the patient's head and neck radiation therapy. Important factors, however, compromise delivery of guideline-concordant management of osteoradionecrosis (ORN), including patient access to this interprofessional care. This review is directed to these and related issues, in order to foster enhanced approaches for ORN management.</p><p><strong>Recent findings: </strong>The review is centered in the 2024 Journal of Clinical Oncology publication 'Prevention and Management of Osteoradionecrosis in Patients With Head and Neck Cancer Treated With Radiation Therapy: ISOO-MASCC-ASCO Guideline', and the companion 2024 JCO Oncology Practice publication in which clinical insights for the guideline are addressed. Key recent literature is cited in order to provide contemporary context to clinical decision-making for prevention and early diagnosis and treatment of ORN. Although a relatively infrequent complication in head and neck radiation patients, ORN can have profound clinical and financial impact when it occurs.</p><p><strong>Summary: </strong>Interprofessional oncology care is essential for ORN management. Future research is needed in order to enhance this management, including studies directed to predicting risk of development of ORN based on patient-centered risk factors.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"184-193"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Novel therapeutics in refractory germ cell tumors.","authors":"Noah H Richardson, Nabil Adra","doi":"10.1097/CCO.0000000000001129","DOIUrl":"10.1097/CCO.0000000000001129","url":null,"abstract":"<p><strong>Purpose of review: </strong>Refractory germ cell tumors (GCT), those progressing after known effective salvage therapies, carry a dismal prognosis with minimal treatment options of limited efficacy. This review aims to highlight the advances in understanding refractory GCT and review upcoming and active clinical trials with novel therapeutics in development.</p><p><strong>Recent findings: </strong>Patients with refractory disease after optimal salvage chemotherapy are rarely cured and should be referred to centers with expertise in GCT. While prior investigational agents have not overcome current limitations of salvage therapy, current and upcoming trials of novel agents including tyrosine kinase inhibitors (TKI), chimeric antigen receptor (CAR) T-cell therapies, bispecific T-cell engagers (BiTE), and antibody-drug conjugates (ADC) are promising avenues of therapy.</p><p><strong>Summary: </strong>Outcomes in refractory GCT remain poor. Patients should preferably be evaluated at tertiary care centers with expertise in the management of these patients and access to clinical trials of novel therapeutics. Active research in the understanding of the molecular mechanisms of resistance and targeting of uniquely expressed antigens has broadened the potential therapies in development.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"267-273"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vivian Wong, Taylor Goodstein, Gabriela Bravo Montenegro, Ramaprasad Srinivasan, Eric A Singer
{"title":"Biomarkers in advanced renal cell carcinoma: current practice and future directions.","authors":"Vivian Wong, Taylor Goodstein, Gabriela Bravo Montenegro, Ramaprasad Srinivasan, Eric A Singer","doi":"10.1097/CCO.0000000000001138","DOIUrl":"10.1097/CCO.0000000000001138","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review focuses on contemporary research into potential prognostic and therapeutic biomarkers for advanced renal cell carcinoma (RCC) published over the past 18 months. Beyond serum lab values, there is no consensus on the use of specific biomarkers for this purpose. Potential biomarkers being investigated consist of genetic, protein, immunologic, and radiologic candidates.</p><p><strong>Recent findings: </strong>New insights in genomic biomarkers include a better understanding of VHL mutational heterogeneity, tumor mutational burden, and the importance of genes like PBRM1 and SETD2 . Protein biomarkers such as C-reactive protein (CRP) and PDZK1 have demonstrated utility in predicting disease progression, therapeutic response, and survival, while immunologic biomarkers like PSMD2, cytokines, and Tregs continue to shed light on the tumor microenvironment and immune evasion. Emerging imaging biomarkers, from CAIX-targeted radiotracers to PSMA-based PET-CT, offer noninvasive diagnostic and prognostic tools that may revolutionize RCC management.</p><p><strong>Summary: </strong>There are several promising biomarkers currently under investigation for use in advanced RCC.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"274-282"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Davide Romandini, Pawel Sobczuk, Carlo M Cicala, César Serrano
{"title":"Next questions on gastrointestinal stromal tumors: unresolved challenges and future directions.","authors":"Davide Romandini, Pawel Sobczuk, Carlo M Cicala, César Serrano","doi":"10.1097/CCO.0000000000001145","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001145","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite remarkable progress in the management of gastrointestinal stromal tumors (GISTs), critical challenges persist. Key aspects such as risk stratification, the optimal duration of adjuvant therapy, and strategies to enhance the efficacy of first-line treatment remain subjects of ongoing debate. This review explores emerging concepts and innovative approaches aimed at refining patient selection and optimizing therapeutic decision-making to further improve clinical outcomes.</p><p><strong>Recent findings: </strong>Molecular and genomic parameters have the potential to enhance traditional risk models, enabling more precise stratification of high-risk patients. Innovations in artificial intelligence and liquid biopsy are emerging as powerful tools for refining predictions of recurrence and treatment response. Meanwhile, the definition and prognostic significance of tumor rupture remain pivotal challenges that influence both risk assessment and adjuvant therapy decisions. Furthermore, transcriptomic and multiomic analyses have unveiled distinct GIST subtypes with significant prognostic and therapeutic implications, paving the way for more tailored treatment strategies.</p><p><strong>Summary: </strong>Integrating molecular features into clinical decision making may refine risk assessment and personalize the treatment in patients with GIST. Future research should focus on validating these tools and redefine clinical trial designs to accelerate drug development for this rare disease.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guilherme Falcão Machado, Laura Sterian Ward, Lucas Leite Cunha
{"title":"A global perspective of epidemiological trends in oncological emergencies.","authors":"Guilherme Falcão Machado, Laura Sterian Ward, Lucas Leite Cunha","doi":"10.1097/CCO.0000000000001142","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001142","url":null,"abstract":"<p><strong>Purpose of review: </strong>Oncologic emergencies are a critical interface between oncology and acute-care medicine. As global cancer trends evolve and healthcare disparities persist, this review seeks to address the pressing need to understand the epidemiology, predictors of outcomes, and care strategies for oncological emergencies across diverse healthcare contexts. The limited data available in this field underscores the vast knowledge gaps and the potential for significant scientific discovery.</p><p><strong>Recent findings: </strong>North American research networks have highlighted the variability in emergency department admissions and identified key determinants of outcomes, including functional status and disease staging. European studies have revealed that emergency presentations are frequently linked to advanced disease, whereas data from Asia and Oceania suggest that tumor burden and ethnicity significantly influence emergency care. In resource-limited regions, infection-related malignancies and inadequate healthcare infrastructure exacerbate challenges in managing oncologic emergencies. Despite these regional differences, consistent predictors of clinical outcomes, such as performance status and disease stage, have emerged as universal themes.</p><p><strong>Summary: </strong>This review highlights the need for targeted research and innovative interventions to bridge gaps in knowledge and care delivery. Region-specific strategies based on local epidemiological insights can improve patient outcomes and promote equity in oncological emergency management worldwide.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Collecting information from all sarcoma reference cancer centres worldwide: achievement and next steps.","authors":"Paolo Lasalvia, Roberto Lillini, Annalisa Trama","doi":"10.1097/CCO.0000000000001143","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001143","url":null,"abstract":"<p><strong>Purpose of review: </strong>Sarcomas are a rare and heterogeneous group of tumours, making large-scale data collection crucial for research and ultimately improve patient outcomes. This review highlights recent initiatives in sarcoma data collection through national and international networks, emphasizing results derived from collaborative efforts. Given the increasing availability of electronic medical data, this review is timely assessing the readiness of sarcoma collaborative datasets to exploit innovation and increase sustainability in the long-term as well as international collaboration.</p><p><strong>Recent findings: </strong>Through a systematic review we identified 8 major sarcoma databases (6 national; 2 international). These initiatives all enhanced prognostication and personalized medicine by also integrating clinical and genomic datasets, while increasing data standardization which is the basis for data interoperability and integration across reference centres. Notable efforts, such as the IDEA4RC project, are establishing interoperable data models using sarcoma as use case to enhance global research.</p><p><strong>Summary: </strong>Collaborative data collection is essential when studying sarcomas. Strengthening international networks will generate real world data networks, increase research and its efficiency, and ultimately ameliorate patient care. Future efforts should focus on expanding data-sharing frameworks, implement innovative solutions for ensuring data interoperability and increase value of real-world evidence in research and therapeutic advancements.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing proactive life-sustaining treatment preference documentation in advanced cancer care: barriers and recommendations.","authors":"Lisa Choucroun, Pierre Gérain","doi":"10.1097/CCO.0000000000001144","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001144","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite guidelines, life-sustaining treatment preferences (LSTP) documentation for advanced cancer patients remains limited and reactive to clinical events. As proactive documentation is a core component of early palliative care (EPC), addressing barriers to EPC can in parallel facilitate LSTP documentation. This narrative review examines barriers to both processes and proposes recommendations to overcome them.</p><p><strong>Recent findings: </strong>Barriers stem from patients, oncologists, and the healthcare system. Patients and oncologists face communication challenges. For patients, knowledge gaps on illness and LSTP documentation, family dynamics prioritizing informal over formal discussions, and limited intercultural considerations, compound these challenges. For oncologists, a curative-focused medical culture reinforces them. In the healthcare system, this culture contributes to deprioritizing LSTP documentation.</p><p><strong>Summary: </strong>Addressing these barriers requires multilevel recommendations. For patients: interventions to enhance illness understanding, foster culturally sensitive oncologist communication, and optimize care organization. For oncologists: integrating communication training and palliative care (PC) knowledge into oncology fellowships while cultivating a supportive medical culture for LSTP documentation through role modeling and intervision. For healthcare systems: LSTP documentation benchmarks, proactive EPC integration through automated reminders, telehealth, standardized medical records, and reimbursement codes. Assessing the implementation and sustainability of these recommendations is crucial to enhancing proactive LSTP documentation in advanced cancer care.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Immuno-oncology in the daily practice.","authors":"Ariane Laparra","doi":"10.1097/CCO.0000000000001117","DOIUrl":"10.1097/CCO.0000000000001117","url":null,"abstract":"<p><strong>Purpose of review: </strong>Immune checkpoint inhibitors (ICI) have become an integral part of oncology treatment. ICI currently has approval for more than thirty tumor types with proven efficacy. However, ICI can expose patients to inflammatory side effects, such as immuno-related adverse events (irAE). The spectrum of irAE and the time to onset can be very broad, sometimes leading to the patient's death.Additionally, ICI could be associated with chronic or long-term adverse events that impact quality of life. The expansion of the indications for immunotherapy in the early adjuvant and neoadjuvant stages is altering the benefit-risk balance of these therapies.Furthermore, the combination of immunotherapies with other oncology treatments makes the interpretation of adverse events difficult.To date, no predictive factors have been identified in routine practice to identify patients at risk of developing serious toxicity.</p><p><strong>Recent findings: </strong>This has led us to develop a patient care pathway dedicated to the management of these toxicities, enabling early detection of irAE to improve outcomes.</p><p><strong>Summary: </strong>We have presented a novel care pathway based on a clinical evaluation, encompassing a daily hospital devoted to the management of toxicities, an iTox multidisciplinary board, and a pharmacovigilance database. This pathway involves a translational research program.The toxicity day hospital allowed us to care for patients at an early stage of an adverse event and to establish whether anticancer treatment was responsible for the onset of symptoms and/or biological abnormalities.The objective of this pathway is to enhance the quality of life and compliance of oncology treatment, while minimizing the necessity for unscheduled care.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"136-141"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can febrile neutropenia re-invent its self?","authors":"Aspasia Georgala, Jean Klastersky","doi":"10.1097/CCO.0000000000001116","DOIUrl":"10.1097/CCO.0000000000001116","url":null,"abstract":"<p><strong>Purpose of review: </strong>Febrile neutropenia as a complication of cytotoxic chemotherapies, remains a major event in the medical journey of hematology and oncology patients. In this review, we are trying to review the new elements and highlights that are shaping febrile neutropenia in nowadays.</p><p><strong>Recent findings: </strong>Introduction of risk-stratification, expanded use of granulocyte-colony stimulating factor and oral treatment for selected patients and rapid administration of antibiotics revolutionized the treatment of febrile neutropenia. Oral treatment with moxifloxacine or amoxicillin-clavulanate + ciprofloxacin has already been widely tested and is actually a standard of care for a meticulously selected group of patients managed as ambulatory patients. Intravenous treatment of febrile neutropenia is a major challenge for clinicians and microbiologists since the blast of the \"silent pandemic\" of antimicrobial resistance.</p><p><strong>Summary: </strong>In this setting, strategies that reduce the chances of febrile neutropenia, misuse of antibiotics and enhance the rigorous control of infections may offer a chance to improve the management of febrile neutropenia and offer to our patients the chance to continue their antineoplastic treatment without perturbations.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"163-167"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}