Mohammad Hossein Sadeghi , Zahra Siavashpour , Sedigheh Sina
{"title":"Tissue spacers in brachytherapy: A systematic review and meta-analysis","authors":"Mohammad Hossein Sadeghi , Zahra Siavashpour , Sedigheh Sina","doi":"10.1016/j.critrevonc.2025.104790","DOIUrl":"10.1016/j.critrevonc.2025.104790","url":null,"abstract":"<div><div>To systematically evaluate the impact of tissue spacers on radiation dose reduction to organs at risk (OARs), treatment-related toxicity, and overall clinical outcomes in brachytherapy, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A thorough search of PubMed, Scopus, IEEE Xplore, Embase, and Web of Science was conducted (1990–2024). Eligible studies included randomized trials, prospective or retrospective cohorts, and dosimetric analyses examining spacer use in brachytherapy. Data were extracted on patient demographics, spacer characteristics, dosimetric outcomes, and toxicity. Meta-analyses were performed where at least three studies reported comparable quantitative data, using random-effects models to pool effect sizes. Forty-five studies met inclusion criteria; 24 contributed to quantitative pooling. In prostate brachytherapy, hydrogel or balloon spacers consistently lowered rectal dose metrics by approximately 15–50 % and significantly reduced Grade ≥ 2 gastrointestinal toxicity (risk ratio ∼0.42). For head and neck brachytherapy, custom acrylic or silicone spacers decreased jaw dose and markedly lowered osteoradionecrosis rates. In gynecologic cancers, spacer balloons or injectable gels yielded 10–20 % reductions in bladder or rectal doses. Across all sites, spacers generally did not compromise tumor coverage and were associated with fewer late complications and improved patient quality of life. Spacers substantially improve the therapeutic ratio in brachytherapy by reducing OAR doses and lowering clinically significant toxicities. While the evidence base supports integrating spacers into standard practice, further randomized, multicenter trials are warranted to refine optimal spacer designs, placement techniques, and cost-effectiveness analyses.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104790"},"PeriodicalIF":5.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neha Pathak , Massimo Di Iorio , Diego Malon Gimenez , Yael Berner-Wygoda , Jacqueline Savill , Amal Aljuhani , Abhenil Mittal , Vikaash Kumar , Eitan Amir
{"title":"Adverse effect of trastuzumab deruxtecan in solid tumours: A systematic review and meta-analysis","authors":"Neha Pathak , Massimo Di Iorio , Diego Malon Gimenez , Yael Berner-Wygoda , Jacqueline Savill , Amal Aljuhani , Abhenil Mittal , Vikaash Kumar , Eitan Amir","doi":"10.1016/j.critrevonc.2025.104787","DOIUrl":"10.1016/j.critrevonc.2025.104787","url":null,"abstract":"<div><h3>Introduction</h3><div>Trastuzumab deruxtecan (T-DXd) is approved for use in numerous solid tumours. Here we summarize its safety and tolerability profile.</div></div><div><h3>Methods</h3><div>Studies were identified from MEDLINE, EMBASE and recent conference proceedings. Analysis comprised clinical trials (phases 1 [dose-expansion], 2 or 3) reporting safety and tolerability of T-DXd. Data were pooled as the mean weighted by individual study sample size from single arm studies. Randomized studies were analyzed separately to compare T-DXd to chemotherapy and to trastuzumab emtansine. Meta regression comprised linear regression weighted by sample size was performed.</div></div><div><h3>Results</h3><div>A total of 35 studies with 48 distinct cohorts were included in the analysis. All grade adverse effects (AEs) and grade ≥ 3 AEs occurred in 97.2 % and 54.9 % of patients respectively. Most common all grade AEs included: nausea (66.2 %), fatigue (41.8 %) and anemia (33.8 %). Common grade ≥ 3 AEs included anemia (12.9 %), thrombocytopenia (6.7 %) and fatigue (5.3 %). Pooled incidence rate of interstitial lung disease (ILD) and grade≥ 3 ILD were 13.2 % and 2.3 % respectively, and 2 % had febrile neutropenia. Cardiotoxicity was rare. Treatment- and ILD- related deaths were reported in 5 % and ILD 1.4 %, respectively. Compared to chemotherapy, T-DXd had higher odds of AEs and treatment discontinuation. Higher dose, non-Caucasian ethnicity and cancer sites other than breast were associated with grade ≥ 3 AE, grade ≥ 3 ILD, AE- and ILD- related deaths and serious AEs.</div></div><div><h3>Conclusions</h3><div>T-DXd has a safety and tolerability profile less favorable than classical chemotherapy. Dose, ethnicity and cancer site are associated with differential safety and tolerability.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104787"},"PeriodicalIF":5.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anaemia in cancer patients: Advances and challenges in the era of precision oncology","authors":"Federica Miglietta , Mario Pirozzi , Michele Bottosso , Carla Pisani , Pierfrancesco Franco , Valentina Guarnieri , Alessandra Gennari","doi":"10.1016/j.critrevonc.2025.104788","DOIUrl":"10.1016/j.critrevonc.2025.104788","url":null,"abstract":"<div><div>Anaemia in cancer patients is an independent prognostic factor associated with reduced survival and increased morbidity. Aetiology of anaemia in cancer patients is multifactorial, involving complex interactions between the cancer itself, treatment modalities, and patient-specific factors. Although anaemia is traditionally associated with cytotoxic chemotherapy, newer drugs can still cause haemoglobin reduction by blood loss, erythrocytes impaired production and increased destruction or reduced survival. A view on the different impact of newer drugs will be presented in our review. Data on the impact of anaemia on quality of life, according to several scales specifically designed for cancer-associated anaemia, will also be reported. Finally, we report on recent guidelines and advances in anaemia management: oral and intravenous iron supplementation, red blood cells transfusions and erythropoiesis-stimulating agents.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104788"},"PeriodicalIF":5.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessé Lopes da Silva , Ana Verena Silvany Sampaio de Miranda , Gustavo Viani Arruda , Diocésio Alves Pinto de Andrade , Larissa Müller Gomes , Marcela Bonalumi dos Santos , Kleyton Santos de Medeiros , Andréia Cristina de Melo
{"title":"Stereotactic body radiotherapy as an alternative to brachytherapy in cervical cancer (SCORE): A systematic review and meta-analysis","authors":"Jessé Lopes da Silva , Ana Verena Silvany Sampaio de Miranda , Gustavo Viani Arruda , Diocésio Alves Pinto de Andrade , Larissa Müller Gomes , Marcela Bonalumi dos Santos , Kleyton Santos de Medeiros , Andréia Cristina de Melo","doi":"10.1016/j.critrevonc.2025.104789","DOIUrl":"10.1016/j.critrevonc.2025.104789","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the efficacy and safety of Stereotactic Body Radiotherapy (SBRT) as an alternative to brachytherapy (BCT) for patients with locally advanced cervical cancer (CC) who face barriers such as resource constraints, anatomical challenges, or comorbidities precluding standard treatment.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis, registered with PROSPERO and adhered to PRISMA standards, was conducted to evaluate SBRT in place of BCT for CC treatment. Eligible studies were systematically sourced from PubMed, Embase, and Cochrane databases. A random-effects model was applied to address study heterogeneity. The analysis focused on outcomes including local control (LC), late gastrointestinal (GI) and genitourinary (GU) toxicity, and overall survival (OS) rates with meta-regression exploring correlations between treatment variables and outcomes.</div></div><div><h3>Results</h3><div>The review analyzed thirteen studies from 2012 to 2024 across diverse regions, with participant ages ranging from 52 to 80 years and sample sizes from 6 to 55 patients. The combined LC rate was 94 % (95 % CI: 91–97 %), and the OS rate was 56 % (95 % CI: 48–63 %), showing no heterogeneity. Late grade ≥ 3 GI and GU toxicity were both 2 %. Meta-regression analysis found no significant associations between treatment parameters and the analyzed outcomes.</div></div><div><h3>Conclusion</h3><div>SBRT is a viable boost therapy for CC patients unable to undergo BCT. It demonstrates strong LC and low levels of severe late toxicity. Further prospective randomized trials are necessary to refine SBRT protocols and confirm long-term outcomes.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104789"},"PeriodicalIF":5.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sebastian Villamizar Castellanos , Maria Paula Rodriguez Castellanos , Maria Camila Gil Avendaño , Mary Cielo Arias Asprilla , Miguel Santiago Garcia Leal , Gloria Tirado
{"title":"Impact of the tumor microenvironment on progression and treatment response in lymphoma and chronic lymphocytic leukemia: A systematic review of the literature","authors":"Sebastian Villamizar Castellanos , Maria Paula Rodriguez Castellanos , Maria Camila Gil Avendaño , Mary Cielo Arias Asprilla , Miguel Santiago Garcia Leal , Gloria Tirado","doi":"10.1016/j.critrevonc.2025.104782","DOIUrl":"10.1016/j.critrevonc.2025.104782","url":null,"abstract":"<div><h3>Introduction</h3><div>The tumor microenvironment (TME) plays a critical role in the progression of lymphomas and chronic lymphocytic leukemia (CLL). Comprising immune cells, cytokines, growth factors, and the extracellular matrix, it modulates therapeutic resistance and tumor aggressiveness. Key elements such as Tregs and TAMs induce immunosuppression, while cytokines like IL-6 promote malignant cell proliferation and survival.</div></div><div><h3>Objective</h3><div>To synthesize evidence regarding the influence of the TME on the progression and treatment response in lymphoma and CLL, identifying knowledge gaps and potential therapeutic targets.</div></div><div><h3>Methods</h3><div>A systematic review was conducted following PRISMA guidelines, including 17 studies published between 2000–2024 on the TME in lymphoma and CLL. Primary outcomes included overall survival (OS), progression-free survival (PFS), and treatment response rates. Searches included databases such as PubMed, Scopus, and Cochrane.</div></div><div><h3>Results</h3><div>Elevated IL-6 levels were associated with worse OS in aggressive lymphomas (mean OS 43.3 months in IL-6 positive patients vs. 96.0 months in negative, <em>p</em> < 0.001). A high proportion of Tregs in the TME correlated with shorter PFS (53 % at 5 years vs. 72 %, <em>p</em> = 0.013). In CLL, treatment with BTK inhibitors favorably modified the Th2/Th1 ratio (<em>p</em> < 0.002), improving clinical responses.</div></div><div><h3>Discussion</h3><div>The findings confirm the relevance of the TME as a determinant of clinical and prognostic heterogeneity. IL-6 and Tregs emerge as key biomarkers and therapeutic targets. Strategies aimed at reversing immunosuppression could optimize clinical outcomes; however, methodological limitations persist, such as heterogeneity in TME characterization methods.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104782"},"PeriodicalIF":5.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ying Yang , Nan Zhang , Dan Wang , Yun Zhang , Xiaoju Li
{"title":"A new approach to the treatment of ovarian cancer: The application of CAR-T cell therapy","authors":"Ying Yang , Nan Zhang , Dan Wang , Yun Zhang , Xiaoju Li","doi":"10.1016/j.critrevonc.2025.104785","DOIUrl":"10.1016/j.critrevonc.2025.104785","url":null,"abstract":"<div><div>Ovarian cancer poses a significant threat to women’s health, and the limitations of current treatments demand the exploration of new therapeutic solutions. Chimeric antigen receptor (CAR) T cell therapy, a novel form of immunotherapy, has demonstrated substantial efficacy in the treatment of hematological malignancies and holds considerable promise for ovarian cancer treatment. This paper provides a comprehensive review of the application of CAR-T cell therapy in ovarian cancer, with a detailed discussion of therapeutic targets such as mesothelin, MUC16, and FOLR1, along with associated clinical trials. Presently, the application of CAR-T cell therapy in ovarian cancer is confronted with challenges including immunosuppression within the tumor microenvironment (TME), tumor heterogeneity, target-related issues, toxic reactions, and limitations in cell efficacy. To address these challenges, strategies such as modulating immunosuppressive cells, employing dual-target strategies, optimizing target selection and CAR structure, enhancing cell performance, and utilizing combination therapies are proposed. Future research directions are likely to focus on the expansion of combination therapies, the application of nanotechnology, the advanced development of personalized medicine, and the exploration of immune cell diversification. Although CAR-T cell therapy remains in its nascent stages for the treatment of ovarian cancer, ongoing research and technological advancements are anticipated to yield significant breakthroughs, potentially offering more effective treatment options for patients with ovarian cancer.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104785"},"PeriodicalIF":5.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roberto Borea , Erick F. Saldanha , Shivahamy Maheswaran , Eleonora Nicolo , Surbhi Singhal , Letizia Pontolillo , Diego de Miguel Perez , Konstantinos Venetis , Angelo Dipasquale , Nadia Ghazali , Pasquale Pisapia , Ana Ortega Franco , Mohamed A. Gouda , Carolina Reduzzi
{"title":"Cancer in a drop: Advances in liquid biopsy in 2024","authors":"Roberto Borea , Erick F. Saldanha , Shivahamy Maheswaran , Eleonora Nicolo , Surbhi Singhal , Letizia Pontolillo , Diego de Miguel Perez , Konstantinos Venetis , Angelo Dipasquale , Nadia Ghazali , Pasquale Pisapia , Ana Ortega Franco , Mohamed A. Gouda , Carolina Reduzzi","doi":"10.1016/j.critrevonc.2025.104776","DOIUrl":"10.1016/j.critrevonc.2025.104776","url":null,"abstract":"<div><div>Over the past decade, liquid biopsy (LB) has emerged as a key tool in oncology. Its utility in non-invasive sampling and real-time monitoring has made it a cornerstone in precision medicine. Since 2020, publications on LB in solid tumors have doubled, underscoring its pivotal role in advancing cancer care. Notably, 2024 marked a peak in scientific papers on this topic. Blood remained the most studied biofluid, with circulating tumor DNA (ctDNA) as the most frequently analyzed analyte, followed by circulating tumor cells, extracellular vesicles, and microRNAs. Among tumor types, gastrointestinal, lung, breast, and genitourinary cancers were the most investigated, collectively accounting for more than half of the studies. Early cancer and minimal residual disease detection are critical areas of interest, emphasizing the expanding potential of fragmentomics and methylation profiling, as well as the prognostic significance of ctDNA across various cancer types. Moreover, serial ctDNA monitoring demonstrated the ability to predict relapse and guide treatment (de)-escalation strategies. In metastatic setting, ctDNA profiling plays a crucial role in capturing tumor heterogeneity, detecting resistance mechanisms, and informing treatment selection. Non-blood biofluids gained interest for their potential to enhance the detection of clinically relevant alterations in different cancer types such as central nervous system and head and neck cancers. Other than biomarkers selection, the technological advancements and artificial intelligence significantly improved the sensitivity and specificity of LB assays. This evidence in combination with the rapid advancement of machine learning and other computational approaches, are paving the way for a new chapter of LB research.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104776"},"PeriodicalIF":5.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advances in improving the efficacy of anti-PD-1/PD-L1 therapy in intrahepatic cholangiocarcinoma","authors":"Shanhe Huang , Chenguang Hua , Bo Ding , Junru Chen , Shusen Zheng , Chaofeng Ding","doi":"10.1016/j.critrevonc.2025.104784","DOIUrl":"10.1016/j.critrevonc.2025.104784","url":null,"abstract":"<div><div>Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer following hepatocellular carcinoma (HCC), characterized by high malignancy and limited therapeutic options. For the majority of patients with advanced or recurrent ICC who are not candidates for surgical resection, non-surgical treatments have become the primary intervention. In recent years, immunotherapy, particularly immune checkpoint inhibitors (ICIs) either alone or in combination, has emerged as a promising systemic treatment for ICC. The programmed cell death protein 1 (PD-1) is a type I transmembrane glycoprotein primarily expressed in tumor-infiltrating lymphocytes, while its ligand PD-L1 is mainly expressed in tumor cells and antigen-presenting cells (APCs). As one of the best-known immune checkpoint molecules, PD-1 is a key mediator of immune tolerance in the human immune system and helps tumor cells evade immune surveillance by suppressing T cell function. Anti-PD-1/PD-L1 therapies are currently widely applied in the clinical care of ICC, however their low response rates limit the benefits for ICC patients. In this review, we focus on the latest research progress in enhancing the efficacy or reversing resistance to anti-PD-1/PD-L1 therapies in ICC, from three perspectives: characterizing relevant cellular components in the tumor immune microenvironment (TIME), identifying ICC subtypes with higher response rates, and investigating potential molecular targets for combination therapies. In summary, the core of the vast majority of therapeutic strategies focuses on how to reshape the TIME or modulate the expression levels of PD-1/PD-L1 in tumors.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104784"},"PeriodicalIF":5.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Al Dali , Abdulrahman F. Al-Mashdali , Anas Kalfah , Shehab F. Mohamed
{"title":"Menin inhibitors in KMT2A-rearranged and NPM1-mutated acute leukemia: A scoping review of safety and efficacy","authors":"Sara Al Dali , Abdulrahman F. Al-Mashdali , Anas Kalfah , Shehab F. Mohamed","doi":"10.1016/j.critrevonc.2025.104783","DOIUrl":"10.1016/j.critrevonc.2025.104783","url":null,"abstract":"<div><h3>Background</h3><div>Menin inhibitors represent a novel therapeutic approach targeting the Menin-KMT2A interaction in acute leukemias with KMT2A rearrangements or NPM1 mutations. This scoping review synthesizes current clinical evidence for emerging Menin inhibitors in development.</div></div><div><h3>Methods</h3><div>We systematically analyzed clinical trials, conference proceedings, and regulatory documents regarding Menin inhibitors in clinical development through December 2024. Primary outcomes included response rates, minimal residual disease (MRD) status, and safety profiles.</div></div><div><h3>Results</h3><div>Thirteen clinical trials investigating six Menin inhibitors (Revumenib, Ziftomenib, Bleximenib, BMF-219, DS-1594, and Enzomenib) were identified. Revumenib demonstrated consistent efficacy across five pivotal trials, achieving MRD-negative rates of 70–90 % in both KMT2A-rearranged and NPM1-mutated leukemias, leading to FDA approval in November 2024. Ziftomenib showed particular efficacy in NPM1-mutated cases but exhibited a higher incidence of differentiation syndrome (30 %) in KMT2A-rearranged patients. Bleximenib reported a 93 % overall response rate, pending MRD validation. Early resistance emergence, primarily through MEN1 mutations, was observed across trials, emerging as early as two treatment cycles.</div></div><div><h3>Conclusions</h3><div>Menin inhibitors demonstrate promising clinical activity in molecularly defined leukemias, with Revumenib establishing proof-of-concept for this therapeutic approach. However, challenges remain, including resistance development, optimal timing of therapy initiation, and determination of effective combination strategies. Larger randomized trials with extended follow-up are needed to establish long-term efficacy and safety profiles. The rapid clinical development of multiple agents in this class suggests an expanding role for Menin inhibitors in leukemia treatment paradigms.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104783"},"PeriodicalIF":5.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The loop between inflammation and late systemic toxicity in head and neck cancer survivors","authors":"Ilaria Mascagni , Paolo Bossi","doi":"10.1016/j.critrevonc.2025.104781","DOIUrl":"10.1016/j.critrevonc.2025.104781","url":null,"abstract":"<div><div>Curative treatment for head and neck cancers (HNC) typically involves a multidisciplinary approach, combining surgery, chemotherapy, and radiotherapy. Although a curative outcome is achieved in approximately 50 % of cases, long-term survivors frequently experience significant treatment-related sequelae, which substantially diminish both quality of life and overall life expectancy. These toxicities commonly manifest in clusters and encompass both local and systemic symptoms, the latter including asthenia, fatigue, sleep disturbances, thermoregulatory dysfunction, pain, gastrointestinal and neurocognitive impairments, and mood disorders. Emerging evidence over the past decades has increasingly implicated systemic inflammation as a central driver of these late effects. In this review, we summarize current evidence on late systemic toxicity in HNC survivors and examine the intricate relationship between systemic inflammation and said toxicity. Importantly, we highlight the need to recognize these symptoms not as isolated entities, but as components of an inflammatory symptom cluster, thus necessitating a therapeutic approach that targets underlying inflammation.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104781"},"PeriodicalIF":5.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}