{"title":"The role of menin inhibitors in acute myeloid leukemia.","authors":"Alessandro Isidori, Giovanni Marconi","doi":"10.1097/CCO.0000000000001185","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001185","url":null,"abstract":"<p><strong>Purpose of review: </strong>Acute myeloid leukemia (AML) characterized by NPM1 mutations or KMT2A rearrangements depends on abnormal epigenetic programs mediated by menin, a critical scaffold protein for sustaining the expression of oncogenic HOX/MEIS1 genes. Therefore, menin inhibitors have become a promising class of AML treatments.</p><p><strong>Recent findings: </strong>Early-phase trials have shown that agents such as revumenib, ziftomenib, bleximenib, and enzomenib are active, particularly in relapsed/refractory disease, with 23-48% of patients achieving composite complete remission. However, the durability of single-agent treatment remains limited, and resistance mechanisms, such as MEN1 mutations or transcriptional reprogramming, have been identified. Consequently, combination approaches involving venetoclax, hypomethylating agents, or chemotherapy are being investigated to improve response depth and duration. Recent SAVE, KOMET-007, and cAMeLot-2 trials have demonstrated high overall response rates (68%-100%) and encouraging MRD-negative complete remissions when combining menin inhibitors with venetoclax-based regimens. This has been observed even in patients who have previously received venetoclax. Combinations with intensive chemotherapy (e.g., 7 + 3) in the frontline setting have also yielded high CRc rates (up to 94% in NPM1-mutated AML) without exacerbating toxicity.</p><p><strong>Summary: </strong>These findings justify the integration of menin inhibitors into the AML therapeutic landscape, and support ongoing randomized trials to confirm their benefit in both frontline and relapse or refractory settings.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945994","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":"Interpreting the clinical outcomes to date for AML-directed CAR T cell therapies.","authors":"Allison J Li, Jae H Park","doi":"10.1097/CCO.0000000000001186","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001186","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chimeric antigen receptor (CAR) T therapies hold potential as a new therapeutic approach for relapsed/refractory acute myeloid leukemia (R/R AML), but development has been challenging due to difficulty identifying the optimal targeting antigen. AML exhibits heterogenous and overlapping antigen expression with normal hematopoietic cells, raising concerns for poor efficacy and on-target/off-tumor hematotoxicity. However, it is not clear that these concerns have been fully borne out in available clinical data. Here, we review clinical studies of AML CAR T therapies with a focus on critically evaluating efficacy and toxicities.</p><p><strong>Recent findings: </strong>Encouraging responses have been reported in a notable proportion of patients in published trials, especially when taking into consideration that patients have treatment-resistant disease after multiple lines of therapy. Rates of cytopenias after AML CAR T therapies vary and there are insufficient data to delineate whether they are due to on-target toxicity or off-target effects such as low marrow reserve and myelosuppressive inflammatory sequelae.</p><p><strong>Summary: </strong>These studies highlight the need for continued optimization of CAR T design and treatment strategies to enhance efficacy and reduce toxicities in AML. Further studies are needed to better understand the frequency/severity of cytopenias after AML CAR T therapies and to clarify the underlying on-/off-target mechanisms.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788508","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":"High-risk smoldering myeloma - a case for early intervention?","authors":"Anupama Krishnamoorthi, Rohit Vijjhalwar, Ananya Kannan, Karthik Ramasamy","doi":"10.1097/CCO.0000000000001182","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001182","url":null,"abstract":"<p><strong>Purpose of review: </strong>Smoldering myeloma (SMM) is an asymptomatic precursor condition of multiple myeloma (MM) with a prevalence of about 0.5% in those aged >40 years age. While the current standard of care is active surveillance, there is a growing interest to determine the effectiveness of early intervention in this condition. This review discusses the contemporary trials focussed on treating SMM and the case for additional data in this space.</p><p><strong>Recent findings: </strong>It is imperative to note that the risk stratification for SMM has constantly evolved over time. A proportion of patients with SLiM-CRAB [≥60% bone marrow plasma cells (BMPCs), free light chain ratio (sFLC-ratio) ≥100, and >1 MRI-defined ≥5 mm focal bony lesion, hypercalcemia, renal insufficiency, anaemia, lytic bone lesions], who were classified as high-risk-SMM in the past, have now been classified as MM, based on the IMWG-2014 diagnostic criteria. Current research on SMM risk stratification is focussed on developing models based on longitudinal trends, rather than single-point measures. Earlier trials were studying disease control strategy, working towards delaying disease progression. As the results were promising, currently, there are more trials utilizing intensive treatment approaches aiming at cure to eradicate disease clone (achieving sustained MRD negativity). Further ongoing trials, are attempting to refine disease control strategy and utilize immunotherapies.</p><p><strong>Summary: </strong>We need more high-quality evidence in post-SLiM-CRAB SMM cohort to better identify the subset of patients most likely to benefit from early intervention. Treatment approaches should be refined considering patient preferences and maintaining quality of life (QoL).</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945996","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":"Circulating tumor DNA in early-stage triple-negative breast cancer: clinical landscape and key open challenges.","authors":"Pietro De Placido, Heather A Parsons","doi":"10.1097/CCO.0000000000001180","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001180","url":null,"abstract":"<p><strong>Purpose of review: </strong>Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for noninvasive detection of minimal residual disease (MRD), prognosis, and treatment monitoring in early-stage triple-negative breast cancer (eTNBC), an aggressive subtype with high relapse risk. This review synthesizes the state-of-the-art and the advances in ctDNA technologies and evaluates their clinical relevance across the neoadjuvant, postneoadjuvant, and adjuvant settings.</p><p><strong>Recent findings: </strong>We highlight the most recent (last 18-24 months) key prospective studies demonstrating ctDNA's potential to predict pathological response and recurrence, emphasizing the prognostic value of the ctDNA dynamics and the implications of persistent positivity. We discuss tumor-informed versus tumor-agnostic assays, address challenges in detecting MRD, and explore future directions, including ultrasensitive detection strategies, novel methylation and machine learning-based approaches, and ctDNA-guided therapeutic interventions.</p><p><strong>Summary: </strong>Despite encouraging results, the clinical utility of ctDNA remains unproven due to technical limitations, especially in assay sensitivity, timing of testing, and low ctDNA shedding/high relapse rate in early-stage disease. Randomized trials are essential to confirm the role of ctDNA in guiding treatment de-escalation or escalation, ultimately aiming to personalize care and improve outcomes in patients with eTNBC.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697760","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}
Zoé Servais, Yves Libert, Charlotte Grégoire, Magali Lahaye, Isabelle Merckaert
{"title":"Psychological interventions in adolescents and young adults with cancer: a scoping review targeting protective factors of resilience.","authors":"Zoé Servais, Yves Libert, Charlotte Grégoire, Magali Lahaye, Isabelle Merckaert","doi":"10.1097/CCO.0000000000001151","DOIUrl":"10.1097/CCO.0000000000001151","url":null,"abstract":"<p><strong>Purpose of review: </strong>Psychological interventions are essential for adolescents and young adults with cancer (AYACs), who experience poor outcomes in their emotional health, social functioning, health behaviors, and cancer-related cognitive impairments (CRCI). This scoping review synthesizes and discusses recent interventions aiming to promote resilience in AYAs with cancer up to 39 years old. The aim is to identify effective intervention strategies and highlight gaps in current research.</p><p><strong>Recent findings: </strong>Twelve studies were identified, covering interventions targeting physical health, cognition and behavior, social support, emotion regulation, and neurobiology. Most interventions focused on physical activity and cognitive-behavioral approaches, demonstrating positive effects on psychological distress, self-efficacy and quality of life. However, there is a lack of interventions addressing social support, neurobiological resilience, and emotion regulation, despite their well established role in fostering adaptation to adversity.</p><p><strong>Summary: </strong>Findings underscore the importance of integrative, multimodal approaches for resilience-building in AYACs. Future research should prioritize interventions that incorporate social, emotional, and neurobiological dimensions while ensuring accessibility through digital health solutions. Additionally, early implementation of psychological interventions during the initial cancer treatment period could be critical for mitigating long-term psychological distress and cognitive impairments. Co-constructing interventions with AYACs through participatory approaches is essential to enhance their effectiveness.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":"37 4","pages":"312-323"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215205","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}
Marie-Aline Echterbille, Florence Horicks, Jennifer Dhont, Virginie De Wilde
{"title":"Implementing an integrative oncology pathway in a comprehensive cancer center: expert insights and perspectives.","authors":"Marie-Aline Echterbille, Florence Horicks, Jennifer Dhont, Virginie De Wilde","doi":"10.1097/CCO.0000000000001150","DOIUrl":"10.1097/CCO.0000000000001150","url":null,"abstract":"<p><strong>Purpose of review: </strong>Integrative oncology (IO) has evolved into an evidence-informed discipline endorsed by major oncology organizations. However, integrating IO into standard oncology care remains a challenge, often dependent on institutional culture and provider attitudes. This exploratory pilot study aimed to assess healthcare professionals' (HCPs) knowledge, communication practices, perceived needs, and perspectives regarding IO in a Belgian Comprehensive Cancer Center with no preexisting IO pathway.</p><p><strong>Recent findings: </strong>Among the 33 participants, 45% understood IO as a patient-centered approach, while 88% acknowledged complementarity to conventional medicine. However, 24% found its definition unclear. Physician-patient communication remains challenging, with 48% of HCPs believing patients hesitate to discuss IO. Key needs include training (88%), standardized communication tools (45%), and a directory of recommended therapists (94%). The interviews facilitated a shift in perception, with 55% of HCPs expressing increased willingness to engage in IO initiatives.</p><p><strong>Summary: </strong>Successfully integrating IO requires tailored training, specialized referents, and a well structured care pathway. The observed shift in mindset among HCPs highlights the importance of awareness and collaborative solution-building for effective IO adoption.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"283-289"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149317","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":"Are epigenetic-targeting approaches ready for prime time in neuroendocrine neoplasms?","authors":"Michel Meyers, Ioannis Karfis, Alain Hendlisz","doi":"10.1097/CCO.0000000000001158","DOIUrl":"10.1097/CCO.0000000000001158","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to evaluate the role of epigenetic-targeting approaches in the management of neuroendocrine neoplasms (NENs), particularly as a priming strategy for subsequent therapies. We explore the molecular basis of epigenetic modifications in NENs, and we review preclinical and clinical studies on DNA methyltransferase and histone deacetylase (HDAC) inhibitors.</p><p><strong>Recent findings: </strong>DNA methyltransferase and HDAC inhibitors can upregulate SSTR2 expression, thereby improving radioligand uptake and treatment response in NENs. The LANTana study investigates ASTX727 as a strategy to restore SSTR2 expression in metastatic NENs, allowing previously ineligible patients to receive PRRT. Preclinical studies demonstrate that combining epigenetic agents with radiotherapy, chemotherapy, or targeted inhibitors can enhance tumour sensitivity and overcome resistance.</p><p><strong>Summary: </strong>Epigenetic modifications play a crucial role in NENs, influencing tumour progression, therapy resistance, and SSTR2 expression. Epigenetic priming with DNA methyltransferase and HDAC inhibitors can enhance SSTR2 expression, improving the efficacy of PRRT in NENs. The LANTana study and other trials are investigating whether epigenetic-targeting approaches can be integrated into NEN treatment to optimize PRRT and overcome therapeutic limitations.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"377-382"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149992","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":"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":"307-311"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","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":"Medical treatment of angiosarcomas.","authors":"Armelle Dufresne, Margaux Dupont, Mehdi Brahmi","doi":"10.1097/CCO.0000000000001147","DOIUrl":"10.1097/CCO.0000000000001147","url":null,"abstract":"<p><strong>Purpose of review: </strong>Medical treatment of angiosarcomas is based on chemotherapy and tyrosine kinase inhibitors with limited efficacy. Immune therapy represents an exciting new therapeutic opportunity in this indication.</p><p><strong>Recent findings: </strong>Several clinicals trials, randomized or not, have been recently released to better define the scope and efficacy of immune therapy in angiosarcoma.</p><p><strong>Summary: </strong>Angiosarcoma is a rare and malignant aggressive soft tissue sarcoma with a wide diversity of presentation in terms of location, aetiology, biology. Medical treatment may be considered as neo adjuvant treatment for locally advanced disease or as palliative treatment in case of metastatic spreading. Doxorubicin and paclitaxel are the two regimens with highest level of evidence of efficacy. Other chemotherapy like gemcitabine or antiangiogenic tyrosine kinase inhibitors may also be efficient. Immune therapy represents an exciting new opportunity under assessment, the selection of patients likely to benefit from this strategy according to clinical or biological criteria remains to be defined. The access to innovative therapy for angiosarcoma is limited by the rarity and heterogeneity of the disease.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":" ","pages":"372-376"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149405","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}
Ilaria Tortorelli, Andrea Napolitano, Yuhong Zhou, Paul Huang, Robin L Jones
{"title":"MDM2 inhibitors in sarcomas: results and next steps.","authors":"Ilaria Tortorelli, Andrea Napolitano, Yuhong Zhou, Paul Huang, Robin L Jones","doi":"10.1097/CCO.0000000000001146","DOIUrl":"https://doi.org/10.1097/CCO.0000000000001146","url":null,"abstract":"<p><strong>Purpose of review: </strong>Murine double minute 2 (MDM2) is an oncogene that plays a crucial role in regulating the activity of the tumor suppressor protein p53. By binding to p53, MDM2 promotes its degradation, thus promoting the malignant proliferation. The MDM2-p53 interaction has thus generated interest as a therapeutic target, particularly in some sarcomas characterized by the amplification of the MDM2 gene. In this manuscript, we provide an overview of the current and emerging targeted therapies for MDM2-amplified sarcomas.</p><p><strong>Recent findings: </strong>Although several agents have been developed with promising results in preclinical studies, these molecules have failed to show conclusive benefit in clinical trials. Nevertheless, the MDM2-p53 pathway inhibition remains an area of ongoing investigation, including the development of novel inhibitors and combination strategies.</p><p><strong>Summary: </strong>In the era of precision medicine, there is an unmet need for new effective therapies in patients with inoperable/metastatic sarcomas. In some histotypes, MDM2 is overexpressed due to gene amplification, leading to a reduced p53 activity and then in oncogenic transformation. By blocking the activity of MDM2, p53 function can be restored, potentially leading to tumor cell death. However, further research is needed to optimize the translation of MDM2 inhibitors into the clinical setting.</p>","PeriodicalId":10893,"journal":{"name":"Current Opinion in Oncology","volume":"37 4","pages":"324-330"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215204","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}