{"title":"Safety management of anti TROP2 ADCs in patients with breast cancer.","authors":"Bianca Malagutti, Giulia Malvezzi, Paola Zagami","doi":"10.1097/CCO.0000000000001276","DOIUrl":"10.1097/CCO.0000000000001276","url":null,"abstract":"<p><strong>Purpose of review: </strong>TROP2-directed antibody-drug conjugates (trophoblast antigen 2-directed ADCs) are becoming increasingly integrated into breast cancer treatment across multiple disease settings. Their expanding use makes a detailed understanding of agent-specific toxicities, underlying mechanisms and practical management strategies increasingly important.</p><p><strong>Recent findings: </strong>Sacituzumab govitecan and datopotamab deruxtecan share TROP2 targeting and topoisomerase I inhibition but exhibit distinct safety profiles. Sacituzumab govitecan is mainly associated with neutropenia and diarrhoea, whereas datopotamab deruxtecan is characterized by stomatitis, ocular surface events and a low but clinically relevant risk of interstitial lung disease/pneumonitis. These differences reflect the integrated effects of payload, linker stability, drug-to-antibody ratio, tissue distribution and target-independent uptake. Recent clinical and real-world evidence has also refined preventive and supportive strategies, including granulocyte colony-stimulating factor (G-CSF) use, UGT1A1-informed risk assessment, steroid mouthwash, ophthalmological monitoring and early interstitial lung disease (ILD) recognition. Combination with immune checkpoint inhibitors appears to produce mainly overlapping rather than entirely new toxicity profiles.</p><p><strong>Summary: </strong>Safety management of TROP2-directed ADCs should be agent-specific, proactive and increasingly individualized. Future approaches may incorporate pharmacogenomics, longitudinal monitoring, patient-reported outcomes and artificial intelligence to improve toxicity prediction, early detection and adaptive management.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"461-470"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988317","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":"The evolving role of nuclear medicine in differentiating pseudoprogression from tumor progression in gliomas.","authors":"Sara Damiani, Laura Evangelista","doi":"10.1097/CCO.0000000000001278","DOIUrl":"10.1097/CCO.0000000000001278","url":null,"abstract":"<p><strong>Purpose of review: </strong>Gliomas remain associated with poor outcomes, despite multimodal treatment. Response assessment relies primarily on MRI; however, treatment-related changes (TRC), particularly pseudoprogression (psPD), may mimic tumor progression disease (PD), creating a major diagnostic challenge. This review focuses on studies published over the past 18 months addressing the role of molecular PET imaging in differentiating TRC from PD in gliomas, highlighting developments with potential implications for clinical practice.</p><p><strong>Recent findings: </strong>Recent evidence emphasizes the increasingly complementary role of molecular PET in glioma response assessment. Static amino acid PET, particularly [ 18 F]FET, may provide diagnostic information comparable to dynamic acquisition while simplifying protocol acquisition, although evidence remains heterogeneous and retrospective. Beyond amino acid tracers, [ 68 Ga]FAPI PET may provide complementary information on tumor microenvironment and presents an emerging research direction. Increasing use of quantitative PET parameters has also highlighted the impact of reconstruction algorithms, reference regions and segmentation strategies on quantitative biomarkers and diagnostic thresholds. Artificial intelligence, radiomics and automated segmentation may further improve the integration of multimodal and quantitative assessment.</p><p><strong>Summary: </strong>Molecular PET imaging provides clinically relevant complementary information to conventional MRI in the assessment of TRC, including psPD. Recent evidence highlights three complementary directions: simpler acquisition protocols, greater standardization of quantitative assessment and integration of complementary biological information. Future prospective multicenter studies are needed to establish the optimal timing and role of repeated PET examinations, validate emerging tracers, quantitative biomarkers and artificial intelligence based approaches, determining their impact on patient outcomes.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"532-538"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988336","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":"Neurotoxicity and cognitive outcomes in modern therapies for primary central nervous system lymphoma.","authors":"Angel Escamilla-Ramírez, Caroline Houillier, Khê Hoang-Xuan","doi":"10.1097/CCO.0000000000001269","DOIUrl":"10.1097/CCO.0000000000001269","url":null,"abstract":"<p><strong>Purpose of review: </strong>Improved survival in primary CNS lymphoma (PCNSL) has increased the importance of delayed treatment-related neurotoxicity as a determinant of functional outcome and quality of life. This review summarizes contemporary evidence on neurocognitive outcomes across modern therapies and discusses the challenge of distinguishing neurotoxicity from relapse.</p><p><strong>Recent findings: </strong>Neurotoxicity differs by treatment modality. Consolidation whole-brain radiotherapy (WBRT) after high-dose methotrexate-based induction remains most strongly associated with delayed cognitive decline, white matter injury, and cerebral atrophy. High-dose chemotherapy followed by autologous stem cell transplantation (HDC-ASCT) in fit patients and low-dose WBRT are effective consolidation strategies with better cognitive preservation. CAR T-cell therapy has introduced distinct inflammatory syndromes usually reversible, including immune effector cell-associated neurotoxicity syndrome (ICANS) characterized by stereotyped cognitive dysfunctions and tumor inflammation-associated neurotoxicity (TIAN), which can mimic focal progression. Bispecific antibodies' neurotoxicity profile resembles to that of CAR T-cell therapy with a lower rate of ICANS. Multimodal monitoring using neuropsychological testing, advanced neuroimaging, cerebrospinal fluid biomarkers, and circulating tumor DNA may improve diagnostic accuracy.</p><p><strong>Summary: </strong>Future therapeutic progress in PCNSL should prioritize prediction, early detection, and prevention of neurotoxicity alongside disease control.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"539-545"},"PeriodicalIF":2.4,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988351","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":"Artificial intelligence for systemic therapy selection and prediction of outcomes in advanced gynecological cancers.","authors":"Jorge Alonso, Jorge Pedregosa, Andrés Redondo","doi":"10.1097/CCO.0000000000001257","DOIUrl":"10.1097/CCO.0000000000001257","url":null,"abstract":"<p><strong>Purpose of review: </strong>Advanced gynecologic cancers are treated broadly, with variable outcomes, even when selected by traditional precision oncology biomarkers. Alternative artificial intelligence (AI)-based biomarkers may improve patient selection, cost efficiency and reduce turnaround times. This review summarizes recent evidence regarding application of AI models for prognostic and predictive biomarker development in gynecological malignancies.</p><p><strong>Recent findings: </strong>AI-based biomarker discovery has focused on harnessing computational pathology and radiomics machine and deep learning models to infer molecular subtypes, BRCA 1/2 and homologous recombination status, as well as platinum and maintenance therapy sensitivity. However, small samples sizes, modest discriminative power, lack of explainability and of prospective validation are significant limitations.</p><p><strong>Summary: </strong>There is retrospective evidence that AI models potentially constitute useful approaches for precision oncology biomarker detection in advanced gynecological cancers, conditional to prospective validation.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"422-428"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519973","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":"Lymphoma beyond the lymph node.","authors":"Virginie Anne De Wilde","doi":"10.1097/CCO.0000000000001263","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001263","url":null,"abstract":"","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":"38 5","pages":"365-366"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697230","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}
Murat Cengiz, Onur Can Zaim, Bilal Esat Temiz, Mihaela Grigore, Murat Gultekin
{"title":"Artificial intelligence in cervical cancer screening and triage: a role-stratified systematic review and bivariate meta-analysis.","authors":"Murat Cengiz, Onur Can Zaim, Bilal Esat Temiz, Mihaela Grigore, Murat Gultekin","doi":"10.1097/CCO.0000000000001255","DOIUrl":"10.1097/CCO.0000000000001255","url":null,"abstract":"<p><strong>Purpose of review: </strong>Artificial intelligence (AI) tools for cervical cancer screening have proliferated, but modality-pooled accuracy estimates conflate clinically distinct uses of AI. We re-examine this evidence base through a role-stratified bivariate meta-analysis to clarify where AI is ready for clinical translation and where gaps remain.</p><p><strong>Recent findings: </strong>Of 97 eligible studies published between 2019 and 2026, 47 with reconstructible 2 × 2 data were pooled using a bivariate Reitsma model stratified by clinical role. Diagnostic assistance during colposcopy showed the most mature evidence ( k = 21; sensitivity 0.908, specificity 0.844; HSROC AUC 0.94). Primary AI-cytology screening showed high sensitivity but unstable specificity ( k = 10; 0.934/0.701 [0.460-0.865]; AUC 0.92). Triage of hrHPV-positive women was the smallest and weakest pool ( k = 4; sensitivity 0.805, 95% CI lower bound 0.624 - below the 90% safety threshold commonly cited for HPV-positive triage). External validation was reported in 10.9% of studies and 49.1% originated from China. Deeks' funnel asymmetry was borderline for screening ( P = 0.082) and significant for diagnostic assistance ( P = 0.007).</p><p><strong>Summary: </strong>AI is closest to translation as diagnostic assistance during colposcopy. PosthrHPV triage - not primary screening - is the critical evidence gap. Future work should prioritize prospective multicentre multimodal (HPV + AI cytology + orthogonal biomarker) risk-calibrated triage models over further modality-pooled accuracy studies.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"393-405"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315980","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":"Peripheral neuropathies associated with immunoglobulin M monoclonal gammopathies and low-grade B-cell lymphomas: diagnostic and therapeutic approach.","authors":"Damien Roos-Weil","doi":"10.1097/CCO.0000000000001260","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001260","url":null,"abstract":"<p><strong>Purpose of review: </strong>Peripheral neuropathies associated with monoclonal gammopathies and low-grade B-cell lymphomas represent a clinically heterogeneous group of disorders encountered by both neurologists and hematologists. This review provides a practical and updated approach to their diagnosis and management, with a particular focus on IgM-associated neuropathies and anti-MAG neuropathy.</p><p><strong>Recent findings: </strong>IgM-related neuropathies encompass immune-mediated disorders - most commonly driven by antibodies against myelin-associated glycoprotein (MAG) - as well as infiltrative mechanisms (neurolymphomatosis, Bing-Neel syndrome) and protein deposition diseases (AL amyloidosis). Anti-MAG neuropathy remains the most common and best-characterized entity. Over the past decade, therapeutic strategies have evolved substantially with the emergence of clone-directed approaches, including anti-CD20-based regimens and covalent Bruton tyrosine kinase inhibitors (cBTKi). However, high-quality evidence remains limited.</p><p><strong>Summary: </strong>Establishing a causal relationship between neuropathy and IgM gammopathy is essential and requires a multidisciplinary approach. Treatment should be individualized and primarily reserved for progressive, functionally impairing disease. Despite therapeutic advances, many patients experience persistent disability, underscoring the need for novel strategies and prospective clinical trials using validated neurological endpoints.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":"38 5","pages":"374-381"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697164","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}
Myriam Gracia, Maria Espias-Alonso, Ignacio Zapardiel
{"title":"Artificial intelligence-augmented robotic surgery in gynecologic oncology: intraoperative assistance and analytics.","authors":"Myriam Gracia, Maria Espias-Alonso, Ignacio Zapardiel","doi":"10.1097/CCO.0000000000001256","DOIUrl":"10.1097/CCO.0000000000001256","url":null,"abstract":"<p><strong>Purpose of review: </strong>Artificial intelligence (AI) is increasingly integrated into robotic-assisted surgery, transforming digital surgical platforms into data-driven environments capable of supporting intraoperative decision-making. In gynecologic oncology, where procedures require high precision and follow relatively standardized workflows, AI technologies may improve surgical quality, reduce variability, and enable safer surgical treatment strategies. This review summarizes recent advances in AI-augmented robotic-assisted surgery, focusing on intraoperative guidance, surgical analytics, and predictive decision support.</p><p><strong>Recent findings: </strong>Recent literature demonstrates rapid progress in computer vision models capable of recognizing surgical phases, anatomical landmarks, and procedural steps in real time. Integration of augmented reality, fluorescence imaging, and multimodal imaging platforms is enhancing intraoperative visualization and anatomical orientation. Surgical data science approaches enable objective assessment of technical performance through video-based metrics and machine learning algorithms. Predictive analytics models integrating clinical and imaging data show promising results for risk stratification and outcome prediction, although most applications remain in early stages of validation.</p><p><strong>Summary: </strong>AI-augmented robotic surgery has the potential to improve precision, standardization, and decision-making in gynecologic oncology. However, clinical implementation requires prospective validation, standardized datasets, and integration into routine workflows. Future developments will likely focus on multimodal data integration and context-aware decision support systems.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"412-421"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327513","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}
David Boutboul, Romain Stammler, Yannick Dieudonné
{"title":"The many facets of Kaposi sarcoma-associated herpesvirus/human herpes virus-8 multicentric Castleman disease: clinical spectrum, diagnostic innovations, and therapeutic management.","authors":"David Boutboul, Romain Stammler, Yannick Dieudonné","doi":"10.1097/CCO.0000000000001258","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001258","url":null,"abstract":"<p><strong>Background: </strong>Castleman diseases encompass three distinct entities: unicentric Castleman disease, KSHV/HHV-8-associated multicentric Castleman disease (MCD), and idiopathic MCD. HHV-8 MCD is a life-threatening B-cell lymphoproliferative disorder driven by KSHV/HHV-8 infection of B cells, resulting in systemic inflammation and diverse clinical phenotypes.</p><p><strong>Objective: </strong>To summarize current knowledge of HHV-8 MCD pathogenesis, clinical presentations, autoimmune complications, and diagnostic advances.</p><p><strong>Methods: </strong>This review synthesizes existing literature on HHV-8 MCD, with particular attention to emerging diagnostic techniques, including liquid-phase detection of circulating viroblasts.</p><p><strong>Results: </strong>Treatment approaches center on rituximab-based regimens, with outcomes varying between HIV-positive and HIV-negative populations. Novel diagnostic tools combining flow cytometry and viral transcript detection offer rapid identification of disease flares.</p><p><strong>Conclusion: </strong>These emerging diagnostic approaches may improve management of HHV-8 MCD, particularly in emergency settings where rapid flare identification is critical.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":"38 5","pages":"367-373"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697333","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}
Veronica Tius, Martina Arcieri, Stefano Restaino, Giuseppe Vizzielli
{"title":"Deep learning assisting the surgical management of gynecologic cancers.","authors":"Veronica Tius, Martina Arcieri, Stefano Restaino, Giuseppe Vizzielli","doi":"10.1097/CCO.0000000000001254","DOIUrl":"10.1097/CCO.0000000000001254","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines the current role of deep learning in the surgical management of gynecologic cancers. It aims to evaluate applications across surgical training, intraoperative guidance, and outcome prediction, while identifying limitations that hinder translation into routine clinical practice.</p><p><strong>Recent findings: </strong>Deep learning-based systems show promising performance in enhancing surgical skills through objective assessment and simulation platforms. Intraoperatively, deep learning models can recognize anatomical structures, surgical phases, and tumor tissue, with high diagnostic accuracy in selected settings. Emerging techniques such as surgical optomics and hyperspectral imaging may further improve tumor detection. Additionally, predictive models integrating clinical, imaging, and intraoperative data demonstrate potential in estimating complications, resource utilization, and survival outcomes. However, most studies are retrospective, based on limited datasets, and lack external validation, with minimal evidence of real-world clinical impact.</p><p><strong>Summary: </strong>Artificial intelligence, particularly deep learning algorithms, represents a rapidly evolving tool in gynecologic oncologic surgery, with potential to standardize and personalize care. Nevertheless, significant gaps remain between experimental performance and clinical implementation.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"406-411"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315982","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}