Current oncology最新文献

{"title":"Peripheral Neuropathy Instruments for Individuals with Cancer: A COSMIN-Based Systematic Review of Measurement Properties.","authors":"Silvia Belloni, Arianna Magon, Chiara Giacon, Francesca Savioni, Gianluca Conte, Rosario Caruso, Cristina Arrigoni","doi":"10.3390/curroncol31120577","DOIUrl":"10.3390/curroncol31120577","url":null,"abstract":"<p><p>Although the literature on patient-reported outcomes (PROMs) continues to expand, challenges persist in selecting reliable and valid instruments for assessing peripheral neuropathy (PN) in patients with cancer. This systematic review aimed to identify all validated self-report PN scales and critically appraise their measurement properties. This review was conducted using the COSMIN methodology for PROMs and the PRISMA statement. Five databases were searched from inception to August 2024, identifying 46 eligible studies and 16 PROMs. Evidence quality ranged from \"very low\" to \"moderate\", with notable inconsistencies in the content and structural validity phases of most instruments. Instruments such as the Chemotherapy-induced peripheral neuropathy assessment tool and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity demonstrated moderate quality and potential utility in clinical practice, while others, including the Location-based assessment of sensory symptoms in cancer and the Measure of Ovarian Symptoms and Treatment, had insufficient evidence to support their use. Importantly, all PROMs focused on chemotherapy-induced peripheral neuropathy, highlighting a significant gap in instruments addressing other PN causes, such as radiotherapy or tumor-related nerve damage. Further research should prioritize developing and validating instruments for distinct cancer populations, ensuring robust psychometric properties and clinical applicability.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"31 12","pages":"7828-7851"},"PeriodicalIF":2.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892478","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}

{"title":"The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer.","authors":"Efthymios Papadopoulos, Andy Kin On Wong, Sharon Hiu Ching Law, Sarah Costa, Angela M Cheung, Dmitry Rozenberg, Shabbir M H Alibhai","doi":"10.3390/curroncol31120578","DOIUrl":"10.3390/curroncol31120578","url":null,"abstract":"<p><p>Frailty and myosteatosis are each prognostic of all-cause mortality (ACM) in patients with cancer. However, it is unclear whether myosteatosis adds value to frailty for predicting ACM. We assessed whether myosteatosis improves the predictive ability of frailty for ACM in older adults undergoing chemotherapy. This was a retrospective study of older adults (≥65 years) initiating chemotherapy between June 2015 and June 2022. Frailty was assessed using a 24-item frailty index (FI). Myosteatosis was evaluated via computed tomography scans at the third lumbar vertebra (L3).. Multivariable Cox regression and Uno's c-statistic determined the predictive performance of the FI and myosteatosis. In total, 115 participants (mean age: 77.1 years) were included. Frailty alone (adjusted hazards ratio (aHR) = 1.68, 95% confidence intervals (CIs) = 1.03-2.72, <i>p</i> = 0.037) and myosteatosis alone (aHR = 2.14, 95%CI = 1.07-4.30, <i>p</i> = 0.032) exhibited similar performance (c-statistic = 0.66) in predicting ACM in multivariable analyses adjusted for age, sex, body mass index, and treatment intent. However, the highest predictive performance for ACM was observed after inclusion of both myosteatosis and frailty in the multivariable model (c-statistic = 0.70). Myosteatosis improves the performance of frailty for predicting ACM in older adults with cancer. Prospective studies to assess the effect of exercise on myosteatosis in older patients are warranted.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"31 12","pages":"7852-7862"},"PeriodicalIF":2.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892863","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}

{"title":"Oncologic and Operative Outcomes of Robotic Staging Surgery Using Low Pelvic Port Placement in High-Risk Endometrial Cancer.","authors":"Jeeyeon Kim, Jiheum Paek","doi":"10.3390/curroncol31120576","DOIUrl":"10.3390/curroncol31120576","url":null,"abstract":"<p><p>Upper para-aortic lymph node dissection (PALND) is one of the most challenging gynecologic robotic procedures. This study aimed to evaluate the oncologic and operative outcomes of robotic staging surgery, including upper PALND, using low pelvic port placement (LP3) in 22 patients with high-risk endometrial cancer. High-risk was defined as patients who showed deep myometrial invasion with grade III, cervical involvement, or high-risk histology. The mean patient age and body mass index were 58 years and 24 kg/m². The mean operative time was 263 min. The mean number of total LNs and upper PALNs obtained was 31 and 10. Two patients received lymphangiography to reduce the amount of drained lymphatic fluid after surgery. The recurrence rate was 13.6% (3/22). There were two LN recurrences and one at the peritoneum in the intra-abdominal cavity. Robotic staging surgery using LP3 was feasible for performing PALND as well as procedures in the pelvic cavity simultaneously. It provides important techniques for performing optimal surgical procedures when surgeons decide to perform comprehensive PALND in instances of isolated recurrence or unexpected LN enlargement as well as high-risk endometrial cancer. Consequently, surgeons can achieve surgical consistency and reproducibility for PALND, leading to improved operative and survival outcomes in high-risk endometrial cancer.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"31 12","pages":"7820-7827"},"PeriodicalIF":2.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11675065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892477","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}

{"title":"Planned Abscopal Effect with Concurrent Pembrolizumab and Ablative Radiotherapy to Pulmonary Metastasis: A Case Report and Review of the Literature.","authors":"Yu-Ting Lee, Chien-Chin Chen, Hsiya Chao, Chih-Chia Chang, Cheng-Yen Lee","doi":"10.3390/curroncol31120573","DOIUrl":"10.3390/curroncol31120573","url":null,"abstract":"<p><p>Most abscopal effects are reported as sporadic and unpredictable events following radiotherapy at symptomatic sites. Herein, we report a case in which a planned abscopal effect was induced following deliberate radiotherapy and concurrent systemic immunotherapy. A 53-year-old man with a combined positive score ≥10 developed extensive metastatic bladder cancer after progressing on conventional chemotherapy. Extensive metastases were identified in his liver, lungs, and bones. He later had four cycles of single-agent pembrolizumab and planned hypofractionated radiotherapy at an ablative dose to selected metastatic lung tumors and developed complete remission of disease even when pembrolizumab was discontinued. This is a clear demonstration that the abscopal effect could be harnessed in a systematic manner with a combined positive score and aggressive local radiotherapy.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"31 12","pages":"7787-7792"},"PeriodicalIF":2.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892755","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}

{"title":"Brief Report: Trends in Incidence, Mortality, and Disability-Adjusted Life Years for Early-Onset Colorectal Cancer in Canada Between 1990 and 2019.","authors":"Igor Stukalin, Mehul Gupta, Katherine Buhler, Nauzer Forbes, Steven J Heitman, Christopher Ma","doi":"10.3390/curroncol31120571","DOIUrl":"10.3390/curroncol31120571","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer is the third most common malignancy globally. Early-onset colorectal cancer (EOCRC) is becoming a growing healthcare focus globally, particularly in North America. We estimated trends in incidence, mortality, and disability-adjusted life years (DALYs) for EOCRC in Canada between 1990 and 2019.</p><p><strong>Methods: </strong>We used the Global Burden of Diseases Study to evaluate trends in incidence, mortality, and DALYs for EOCRC in Canada between 1990 and 2019. Rates were estimated per 100,000 persons at risk with associated uncertainty intervals (UIs). Annual percentage changes (APC) were estimated using joinpoint regression with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>In 2019, the incidence, mortality, and DALYs rates for EOCRC were 10.89 (95% UI 8.09, 14.34), 2.24 (95% UI 2.00, 2.51), and 111.37 (95% UI 99.34, 124.78) per 100,000 individuals, respectively. Incidence increased during the study period by 1.12%/year (95% CI 1.03%, 1.22%; <i>p</i> < 0.001). The largest increase in incidence in EOCRC occurred between 1990 and 2007, with an APC of 2.23% (95% CI 2.09%, 2.37%; <i>p</i> < 0.001). Mortality (APC 2.95%, 95% CI 1.89%, 4.02%; <i>p</i> < 0.001) and DALY (APC 2.96%, 95% CI 1.84%, 4.09%; <i>p</i> < 0.001) rates increased for males between 2001 and 2006.</p><p><strong>Conclusions: </strong>Our study reveals a substantial burden in EOCRC in Canada, with a significant increase in incidence.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"31 12","pages":"7765-7769"},"PeriodicalIF":2.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892826","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}

{"title":"Survival Outcomes with Regorafenib and/or Trifluridine/Tipiracil Sequencing to Rechallenge with Third-Line Regimens in Metastatic Colorectal Cancer: A Multicenter Retrospective Real-World Subgroup Comparison from the ReTrITA Study.","authors":"Carlo Signorelli, Maria Alessandra Calegari, Annunziato Anghelone, Alessandro Passardi, Giovanni Luca Frassineti, Alessandro Bittoni, Jessica Lucchetti, Lorenzo Angotti, Emanuela Di Giacomo, Ina Valeria Zurlo, Cristina Morelli, Emanuela Dell'Aquila, Adele Artemi, Donatello Gemma, Domenico Cristiano Corsi, Alessandra Emiliani, Marta Ribelli, Federica Mazzuca, Giulia Arrivi, Federica Zoratto, Mario Giovanni Chilelli, Marta Schirripa, Maria Grazia Morandi, Fiorenza Santamaria, Manuela Dettori, Antonella Cosimati, Rosa Saltarelli, Alessandro Minelli, Emanuela Lucci-Cordisco, Michele Basso","doi":"10.3390/curroncol31120574","DOIUrl":"10.3390/curroncol31120574","url":null,"abstract":"<p><strong>Background: </strong>There is ongoing discussion around the optimal course of treatment for metastatic colorectal cancer (mCRC) following the second line. Trifluridine/tipiracil (T) and regorafenib (R) have been the mainstay of therapy in this situation, as they both increased overall survival (OS) in comparison to a placebo. Despite the paucity of evidence, therapy rechallenge is also recognized as an option for practical use. In the third-line scenario of mCRC, we planned to investigate the survival outcomes using (T) and (R), both with and without prior rechallenge treatment.</p><p><strong>Materials and methods: </strong>Between 2012 and 2023, we examined the medical records of 1156 patients with refractory mCRC who were enrolled in the multicenter retrospective ReTrITA study. We then separated the patients into two cohorts based on the rechallenge therapy that was given before regorafenib and/or trifluridine/tipiracil at 17 Italian centres.</p><p><strong>Results: </strong>A total of 981 patients underwent T and/or R therapy, while 175 patients had therapy rechallenge before T and/or R. The median overall survival (mOS) for patients treated with T/R and R/T sequences in the rechallenge therapy cohort was 14.5 months and 17.6 months, respectively (<i>p</i> = 0.1955). A statistically significant survival benefit was observed in patients who received monotheraphy with R (mOS: 6 months) compared to the T group (mOS: 4.2 months) (<i>p</i> = 0.0332). In the same cohort, a median progression-free survival (mPFS) benefit was demonstrated in favour of the R/T group (11.3 months) vs. 9 months of the reverse sequence (<i>p</i> = 0.4004). In the no-rechallenge cohort, the mOS was statistically longer in the R/T sequence than in the T/R sequence (16.2 months vs. 12.3 months, respectively; <i>p</i> = 0.0014). In terms of the mPFS, we saw the same significant result for the adoption of R/T treatment (11.5 months vs. 8.4 months, respectively; <i>p</i> < 0.0001). The two monotherapy groups did not reveal any significant differences.</p><p><strong>Conclusions: </strong>This study suggests that rechallenge therapy may improve survival rates in the third-line treatment of mCRC, particularly if it is administered before sequential R/T treatment. This could allow for the extension of mCRC treatment choices until prospective studies are finished or randomised trials are performed.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"31 12","pages":"7793-7808"},"PeriodicalIF":2.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892823","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}

{"title":"Implementation of an Oncogeriatric Unit for Frail Older Patients with Breast Cancer: Preliminary Results.","authors":"Helena Hipólito-Reis, Joana Santos, Paulo Almeida, Luciana Teixeira, Fernando Rodrigues, Nuno Teixeira Tavares, Darlene Rodrigues, Jorge Almeida, Fernando Osório","doi":"10.3390/curroncol31120575","DOIUrl":"10.3390/curroncol31120575","url":null,"abstract":"<p><p>(1) Background: Breast cancer (BC) has a high incidence in Europe, particularly in older adults. Traditionally under-represented in clinical trials, this age group is often undertreated due to ageism. This study aims to characterize frail older adults (≥70 years) with BC based on a comprehensive geriatric assessment, to guide individualized treatment decision-making. (2) Methods: A descriptive analysis of older adults with BC treated from January 2021 to December 2022 was performed. Data were analyzed based on anonymized electronic medical records. (3) Results: Of 123 patients (mean age 84.0 ± 5.6 years), 122 (99.2%) were women. The mean G8 screening score was 12.1 ± 2.5. Most had functional dependence (69.9% Barthel Index, 81.3% Lawton/Brody Scale) and a moderate-to-high risk of falling (76.4% Tinetti index). Cognitive impairment and malnutrition risk were present in 15.4% and 30.1%, respectively. Prehabilitation inclusive strategies led to adapted treatment in 55.3% of cases. Endocrine therapy, surgery, radiotherapy, and chemotherapy was used in 99.2%, 56.1%, 35.0%, and 8.9% of patients, respectively. (4) Conclusions: Our comprehensive oncogeriatric strategy promotes personalized oncologic treatment, improves outcomes by addressing frailty, and enhances treatment tolerability in older patients with BC, validating the expansion of this combined team approach to other cancer types and institutions.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"31 12","pages":"7809-7819"},"PeriodicalIF":2.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892846","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}

{"title":"Canadian Consensus Recommendations for Predictive Biomarker Testing in Gastric and Gastroesophageal Junction Adenocarcinoma.","authors":"Christine Brezden-Masley, Pierre O Fiset, Carol C Cheung, Thomas Arnason, Justin Bateman, Martin Borduas, Gertruda Evaristo, Diana N Ionescu, Howard J Lim, Brandon S Sheffield, Sara V Soldera, Catherine J Streutker","doi":"10.3390/curroncol31120572","DOIUrl":"10.3390/curroncol31120572","url":null,"abstract":"<p><p>Gastric cancer is common globally and has a generally poor prognosis with a low 5-year survival rate. Targeted therapies and immunotherapies have improved the treatment landscape, providing more options for efficacious treatment. The use of these therapies requires predictive biomarker testing to identify patients who can benefit from their use. New therapies on the horizon, such as CLDN18.2 monoclonal antibody therapy, require laboratories to implement new biomarker tests. A multidisciplinary pan-Canadian expert working group was convened to develop guidance for pathologists and oncologists on the implementation of CLDN18.2 IHC testing for gastric and gastroesophageal junction (G/GEJ) adenocarcinoma in Canada, as well as general recommendations to optimize predictive biomarker testing in G/GEJ adenocarcinoma. The expert working group recommendations highlight the importance of reflex testing for HER2, MMR and/or MSI, CLDN18, and PD-L1 in all patients at first diagnosis of G/GEJ adenocarcinoma. Testing for NTRK fusions may also be included in reflex testing or requested by the treating clinician when third-line therapy is being considered. The expert working group also made recommendations for pre-analytic, analytic, and post-analytic considerations for predictive biomarker testing in G/GEJ adenocarcinoma. Implementation of these recommendations will provide medical oncologists with accurate, timely biomarker results to use for treatment decision-making.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"31 12","pages":"7770-7786"},"PeriodicalIF":2.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892830","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}

{"title":"Vulnerability in Colorectal Cancer: Adjusted Gross Income and Geography as Factors in Determining Overall Survival in Colorectal Cancer: A Single-Center Study Across a Broad Income Inequality in an American Context.","authors":"Cataldo Doria, Patrick G De Deyne, Papachristou Charalampos","doi":"10.3390/curroncol31120570","DOIUrl":"10.3390/curroncol31120570","url":null,"abstract":"<p><p><b>Introduction</b>: Regional differences in socioeconomic status (SES) are well known, and we believe that the use of geocoding (zip code) can facilitate the introduction of targeted interventions for underserved populations. This is a single-center, retrospective analysis of data extracted from the cancer registry at the Capital Health Cancer Center in Pennington, N. The Capital Health Cancer Center in central New Jersey primarily serves two counties, catering to a diverse patient population from a wide range of socioeconomic backgrounds. <b>Methods</b>: We abstracted 1269 consecutive cases of colorectal cancer (CRC) diagnosed and treated between 2000 and 2019 from the Cancer Registry of the Capital Health Cancer Center (CHCC). Using the definition of SES based on previously published work, and zip codes (geocoding), we created four SES levels. We stratified our subjects according to their stage at diagnosis, age at diagnosis, race, and ethnicity. The primary outcome variable was overall survival (OS). <b>Results</b>: There was a statistically significant difference in OS based on SES, with the highest overall survival (OS) in the high-SES group (47 months) and the shortest OS in the low and mid-low-SES groups (40.4 and 30 months, respectively). Subjects living in high-SES areas were predominantly white (88.2%) and diagnosed at a later age (mean of 68.9 years of age) compared to individuals who lived in a low-SES area, who were predominantly non-white (72.6%) and diagnosed somewhat earlier in life (65.1 years of age). White people were diagnosed later in life (70.9 years of age) compared to non-white populations, including Black (66.5), Asian (61.7), and Hispanic (58.5) (<i>p</i> = 0.001) populations, but this did not lead to a significant difference in OS (<i>p</i> = 0.56). Stage at diagnosis was a significant predictor of OS, but was unrelated to SES (<i>p</i> = 0.066). A Cox proportional hazard ratio (HR) model showed that the risk of dying from colorectal cancer decreases with a higher socioeconomic status (SES). Those from mid-high-SES backgrounds had a 19% lower risk (HR 0.81), and those from high-SES areas had a 45% lower risk (HR 0.55) compared to individuals from low-SES areas. <b>Conclusions</b>: The vulnerability of patients with CRC in central New Jersey is a complex issue, influenced by many different variables. Our results indicate that SES is the most critical factor affecting OS after being diagnosed with CRC.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"31 12","pages":"7754-7764"},"PeriodicalIF":2.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892878","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}

{"title":"Braf-Mutant Melanomas: Biology and Therapy.","authors":"Elvira Pelosi, Germana Castelli, Ugo Testa","doi":"10.3390/curroncol31120568","DOIUrl":"10.3390/curroncol31120568","url":null,"abstract":"<p><p>The incidence of melanoma, the most lethal form of skin cancer, has increased mainly due to ultraviolet exposure. The molecular characterization of melanomas has shown a high mutational burden led to the identification of some recurrent genetic alterations. <i>BRAF</i> gene is mutated in 40-50% of melanomas and its role in melanoma development is paramount. <i>BRAF</i> mutations confer constitutive activation of MAPK signalling. The large majority (about 90%) of <i>BRAF</i> mutations occur at amino acid 600; the majority are <i>BRAF^V600E</i> mutations and less frequently <i>BRAF^{v600K, V600D}</i> and <i>^V600M</i>. The introduction of drugs that directly target <i>BRAF</i>-mutant <i>protein (BRAF inhibitors)</i> and of agents that stimulate immune response through targeting of immune check inhibitor consistently improved the survival of melanoma <i>BRAF^V600</i>-mutant patients with unresectable/metastatic disease. In parallel, studies in melanoma stage II-III patients with resectable disease have shown that adjuvant therapy with ICIs and/or targeted therapy improves PFS and RFS, but not OS compared to placebo; however, neoadjuvant therapy plus adjuvant therapy improved therapeutic response compared to adjuvant therapy alone.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"31 12","pages":"7711-7737"},"PeriodicalIF":2.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892790","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}