Simone Rota, Melanie Claps, Eleonora Gusmaroli, Amedeo Nuzzo, Alessandro Rametta, Marco Stellato, Elena Verzoni, Giuseppe Procopio, Valentina Guadalupi
{"title":"Local treatment of the primary tumor in mHSPC in the ARPI era: incremental value or overtreatment?","authors":"Simone Rota, Melanie Claps, Eleonora Gusmaroli, Amedeo Nuzzo, Alessandro Rametta, Marco Stellato, Elena Verzoni, Giuseppe Procopio, Valentina Guadalupi","doi":"10.1080/14737140.2026.2688296","DOIUrl":"10.1080/14737140.2026.2688296","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment landscape of metastatic hormone-sensitive prostate cancer (mHSPC) has changed substantially with the introduction of androgen receptor pathway inhibitors (ARPIs), which have improved survival outcomes and raised the threshold for demonstrating additional benefit from local interventions. In this setting, the role of local treatment of the primary tumor remains clinically relevant but requires reassessment, taking into account modern systemic intensification.</p><p><strong>Areas covered: </strong>This expert opinion discusses the current role of local treatment of the primary tumor in mHSPC patients eligible for ARPIs therapy, focusing on prostate radiotherapy and surgery. It examines the evidence supporting radiotherapy in the androgen deprivation therapy era, the uncertainties emerging in the ARPI era, the implications for toxicity and local symptom control, and the rationale for ongoing trials evaluating local treatment in combination with contemporary systemic therapy.</p><p><strong>Expert opinion: </strong>In the ARPI era, local treatment should be considered within an individualized, multidisciplinary framework rather than as an automatic standard for patients with mHSPC. Its main value may increasingly lie in preventing local progression and genitourinary complications in selected patients, while a definitive overall survival benefit on top of intensified systemic therapy remains unproven.</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":" ","pages":"1-5"},"PeriodicalIF":2.8,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Di Wu, Zirong Wang, Wei Yang, Fen Cheng, Jiaheng Li, Jianrong He, Ping Shi
{"title":"Quality of life in ovarian cancer patients receiving maintenance therapy with bevacizumab versus PARPi: a network meta-analysis.","authors":"Di Wu, Zirong Wang, Wei Yang, Fen Cheng, Jiaheng Li, Jianrong He, Ping Shi","doi":"10.1080/14737140.2025.2610267","DOIUrl":"10.1080/14737140.2025.2610267","url":null,"abstract":"<p><strong>Introduction: </strong>Bevacizumab and poly (ADP-ribose) polymerase inhibitors (PARPi) administered as maintenance therapies after platinum-based chemotherapy have shown a progression-free survival benefit in patients with ovarian cancer. However, there is no head-to-head trial comparing the quality of life (QOL) between bevacizumab and PARPi. We conducted a Bayesian network meta-analysis to compare the QOL between bevacizumab and PARPi.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. were searched for trials reporting QOL in ovarian cancer treated with bevacizumab or PARPi. The primary outcome was the difference in QOL change between bevacizumab and PARPi.</p><p><strong>Results: </strong>Eight RCTs with a total of 5822 participants were included in our analyses. We found no significant difference in QOL change between patients treated with bevacizumab and those treated with PARPi (SMD = -0.058, 95% CrI -0.431 to 0.331). Subgroup analyses stratified by treatment setting and BRCA status showed no significant influence on the network estimates.</p><p><strong>Conclusions: </strong>Both bevacizumab and PARPi demonstrated no significant adverse effects on QOL when compared to standard chemotherapy. There was no clear superiority of one treatment over the other in terms of QOL. The acceptable QOL further supports the benefit of these maintenance treatments for ovarian cancer.</p><p><strong>Registration: </strong>PROSPERO (CRD42024607491).</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":" ","pages":"759-765"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martyna Bednarczyk, Nicola Dąbrowska-Szeja, Dariusz Łętowski, Anna Kozub, Aleksandra Nasiek, Sebastian Grosicki
{"title":"The importance of autophagy in multiple myeloma.","authors":"Martyna Bednarczyk, Nicola Dąbrowska-Szeja, Dariusz Łętowski, Anna Kozub, Aleksandra Nasiek, Sebastian Grosicki","doi":"10.1080/14737140.2025.2610261","DOIUrl":"10.1080/14737140.2025.2610261","url":null,"abstract":"<p><strong>Introduction: </strong>Autophagy is a highly conservative self-degradative process. Previous research confirmed its importance in cancer pathogenesis. PubMed and Google Scholar databases were searched, analyzing studies on the role of autophagy in the development of multiple myeloma. The manuscript focuses on meta-analyses, case-control studies, and observational studies involving people with multiple myeloma.</p><p><strong>Areas covered: </strong>This article explores the role of autophagy in the development of MM. Autophagy can either promote or inhibit carcinogenesis. Autophagy is crucial in determining the fate of B cells, either supporting their survival or triggering cell death. Drugs that target autophagy may be the focus of 'molecular targeted therapy.' Autophagy mechanisms potentially effective in MM cells are discussed within the context of the unfolded protein response (UPR), the bone marrow microenvironment (BMME), drug resistance, hypoxia, and DNA repair. The genes and pathways involved in MM cell survival and drug resistance, which could serve as new targets for effective treatment, are highlighted.</p><p><strong>Expert opinion: </strong>The analysis of autophagy gene expression in MM could be a important factor in the diagnostic process and treatment individualization. The autophagy modulation seems to be a relevant target in oncological therapy, it could limit disease progression and increase the effectiveness of treatment.</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":" ","pages":"683-696"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prognostic factors of undifferentiated embryonal sarcoma of the liver in children: a SEER-based study.","authors":"Qiu Jin, Yehang Zhu, Zhaopeng He","doi":"10.1080/14737140.2025.2612042","DOIUrl":"10.1080/14737140.2025.2612042","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the clinical characteristics and identify prognostic variables affecting overall survival (OS) in children with undifferentiated embryonal sarcoma of the liver (UESL) using data from the SEER database.</p><p><strong>Research design and methods: </strong>We performed a retrospective cohort analysis of 101 patients aged ≤19 years diagnosed with UESL between 2000 and 2022 from the SEER database. Kaplan - Meier survival analysis and Cox proportional hazards regression were applied to determine independent prognostic factors. A nomogram was constructed based on significant predictors.</p><p><strong>Results: </strong>Tumor size, surgical resection, and chemotherapy emerged as independent prognostic factors. Patients with tumors larger than 15 cm had a markedly increased risk of mortality. Surgical resection and chemotherapy were associated with improved survival outcomes. A nomogram incorporating these factors was developed to predict OS. Larger tumor size was linked to higher mortality, whereas chemotherapy significantly reduced death risk.</p><p><strong>Conclusions: </strong>Tumor size, surgery, and chemotherapy are crucial determinants of survival in pediatric UESL. Surgical intervention combined with chemotherapy appears essential for improving prognosis. Further external validation is warranted to refine treatment strategies.</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":" ","pages":"767-772"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Taha Koray Sahin, Binura Makasheva, Deniz Can Guven, Sercan Aksoy, Vincenzo Di Lauro, Alessandro Rizzo
{"title":"Elacestrant in metastatic breast cancer: current advancements and future perspectives.","authors":"Taha Koray Sahin, Binura Makasheva, Deniz Can Guven, Sercan Aksoy, Vincenzo Di Lauro, Alessandro Rizzo","doi":"10.1080/14737140.2025.2610263","DOIUrl":"10.1080/14737140.2025.2610263","url":null,"abstract":"<p><strong>Introduction: </strong>Hormone receptor-positive and HER2-negative advanced breast cancer is the most prevalent subtype and poses therapeutic challenges. While endocrine therapy remains the cornerstone of management, acquired resistance, particularly stemming from ESR1 mutations, limits long-term efficacy. Consequently, novel endocrine agents with enhanced potency, oral bioavailability, and favorable tolerability are crucial for overcoming resistance and improving patient outcomes.</p><p><strong>Areas covered: </strong>This review provides a comprehensive evaluation of elacestrant, an orally active selective estrogen receptor degrader that has transformed the treatment paradigm for endocrine resistant disease. The pharmacologic properties, antitumor activity, and clinical outcomes associated with elacestrant are discussed in detail, along with ongoing research exploring its integration into combination regimens and in earlier disease settings.</p><p><strong>Expert opinion: </strong>Elacestrant has become an important therapeutic option for patients with ESR1-mutated disease, offering durable estrogen receptor suppression and favorable tolerability. Combination therapies targeting CDK4/6 and PI3K-AKT-TOR signaling pathways represent promising directions for extending endocrine sensitivity. With the growing integration of liquid biopsy technologies and molecular monitoring into clinical practice, dynamic treatment adaptation guided by real time molecular profiling is expected to refine therapy selection. Elacestrant is a benchmark in the shift toward individualized endocrine therapy in metastatic breast cancer, bridging molecular precision with clinical practicality.</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":" ","pages":"697-706"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of steroid therapy on survival in patients with metastatic solid tumors experiencing immune-related adverse events.","authors":"Caner Acar, Gökhan Şahin, Haydar Çağatay Yüksel, Fatma Pinar Açar, Burçak Karaca, Erdem Göker","doi":"10.1080/14737140.2026.2614710","DOIUrl":"10.1080/14737140.2026.2614710","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) improve survival in solid tumors but can cause immune-related adverse events (irAEs) that often require systemic steroids. The impact of steroid dose and timing on ICI efficacy remains unclear.</p><p><strong>Methods: </strong>We conducted a single-center retrospective study of 466 patients with metastatic solid tumors treated with ICIs between June 2016 and September 2024. Steroids for irAEs were categorized as high dose (≥1 mg/kg prednisolone-equivalent) or low dose (≤0.5 mg/kg). Overall survival (OS), progression-free survival (PFS), and post-irAE OS/PFS were evaluated.</p><p><strong>Results: </strong>IrAEs occurred in 182 (39.1%) patients, and 81 (17.4%) received systemic steroids. IrAE occurrence was associated with reduced mortality risk. Among patients with irAEs, steroid use increased mortality (<i>p</i> = 0.035) without significantly affecting PFS. High-dose steroids were linked to worse post-irAE OS (<i>p</i> = 0.002) and PFS (<i>p</i> = 0.034), while low-dose steroids showed no detrimental effect. Early initiation ( < 2 months) of high-dose steroids demonstrated the strongest negative association.</p><p><strong>Conclusions: </strong>High-dose steroids, particularly when started early, are associated with significantly worse survival after irAEs in metastatic solid tumors. These findings support managing irAEs with the lowest effective steroid dose and encourage exploration of steroid-sparing strategies. Subtype-specific analyses were limited by small sample sizes and should be interpreted cautiously.</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":" ","pages":"773-784"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New horizons for hope of cure in acute myeloid leukemia through immunotherapy: a narrative review.","authors":"Pasquale Niscola, Valentina Gianfelici, Gloria Pasqualini, Eliezer Espina Barroso, Marco Giovannini, Gianfranco Catalano, Carla Mazzone, Nelida Inés Noguera","doi":"10.1080/14737140.2026.2614720","DOIUrl":"10.1080/14737140.2026.2614720","url":null,"abstract":"<p><strong>Introduction: </strong>Acute Myeloid Leukemia (AML) is a challenging blood cancer characterized by a high rate of relapse and often unfavorable outcomes. Immunotherapies can pave the way for a changing paradigm in AML treatment and improve therapeutic outcomes, ultimately leading to a possible cure for this challenging disease. This narrative review aims to summarize the progress of immunotherapy and highlight the future landscape of these measures in the context of AML.</p><p><strong>Area covered: </strong>By searching English-language literature and querying the PubMed database using pertinent Medical Subject Headings, this review traces the development of AML immunotherapy, from the first antibody-drug conjugate, gemtuzumab ozogamicin, to newer approaches, including other monoclonal antibody formats, immune checkpoint inhibitors, chimeric antigen receptor T-cell therapy, and vaccinations.</p><p><strong>Expert review: </strong>Although there have been significant advances, the outcomes of both traditional and novel therapies are still unsatisfactory. Immunotherapies could eliminate leukemia stem cells, which contribute to treatment resistance and disease relapse in AML. The positioning of these new therapeutic measures in development within the management algorithm for AML and their precise place in each patient's therapeutic plan are future challenges for enhancing targeted, personalized clinical programs.</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":" ","pages":"719-734"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The real-world use of medicines for the management of haematological malignancies in pediatric populations: a scoping review.","authors":"Rahaf Alkhlaifat, Faisal Madanat, Hanan Abunimeh, Natalie M Weir, Tanja Mueller","doi":"10.1080/14737140.2025.2610260","DOIUrl":"10.1080/14737140.2025.2610260","url":null,"abstract":"<p><strong>Introduction: </strong>There is limited research on the real-world use of medicines for the management of pediatric cancers, with insufficient understanding of the varied approaches toward treatment across the globe. This scoping review aimed to identify publications focusing on systematic anti-cancer therapy (SACT), along with supplementary medicines, for pediatric patients with hematological malignancies in routine clinical practice globally to provide insights into current practice and identify gaps in the literature.</p><p><strong>Areas covered: </strong>A scoping review methodology, following the Joanna Briggs Institute guidance, was used to identify observational studies, published between January 2013 and February 2023 in PubMed, Embase, and Scopus databases. A total of 82 studies were identified, describing the use of 50 SACT agents and 74 supplementary care medicines. Findings highlighted the implementation of multi-drug therapeutic plans to treat hematological malignancies and the diversity of treatments across settings. Cancer treatment was commonly complemented by the administration of various supplementary medicines.</p><p><strong>Expert opinion: </strong>Further observational studies should be conducted to provide additional insights into pharmacological interventions in under-researched therapeutic areas; in addition, descriptive drug utilization studies would be beneficial from clinical settings where pediatric cancer patients are commonly included in clinical trials to address knowledge gaps on treatments in these settings.</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":" ","pages":"707-718"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Margaux Dupont, Armelle Dufresne, Mehdi Brahmi, Clémence Romeo, Jean Yves Blay
{"title":"An evaluation of afamitresgene autoleucel for the treatment of advanced synovial sarcoma and myxoid round cell liposarcoma.","authors":"Margaux Dupont, Armelle Dufresne, Mehdi Brahmi, Clémence Romeo, Jean Yves Blay","doi":"10.1080/14737140.2025.2612043","DOIUrl":"10.1080/14737140.2025.2612043","url":null,"abstract":"<p><strong>Introduction: </strong>Synovial sarcoma (SyS) and myxoid round-cell liposarcoma (MRCL) are rare, aggressive soft tissue sarcomas with poor outcomes at the advanced and metastatic stage. Novel therapeutic strategies are urgently needed. Afamitresgene autoleucel (afami-cel) is the first Food and Drug Administration (FDA)-approved, affinity-enhanced T-cell receptor (TCR) therapy targeting the cancer-testis antigen MAGE-A4 in HLA-A*02-positive patients.</p><p><strong>Areas covered: </strong>This review summarizes clinical evidence from one early-phase study and the pivotal phase 2 SPEARHEAD-1 trial. Afami-cel achieved objective response rates of 39% in SyS and 25% in MRCL, with durable responses exceeding 11 months in SyS. The safety profile is manageable, with hematological toxicities from lymphodepletion and predominantly low-grade cytokine release syndrome; no treatment-related deaths occurred in SPEARHEAD-1.</p><p><strong>Expert opinion: </strong>Afami-cel represents a milestone in sarcoma therapy, establishing proof of concept for engineered TCR T-cell therapies in solid tumors. However, challenges remain regarding HLA restriction, tumor microenvironment resistance, manufacturing delays and cost. Future efforts should focus on broadening applicability, optimizing combinations, and ensuring equitable access.</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":" ","pages":"661-670"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gamze Sonmez, Yigit Yazarkan, Taha Koray Sahin, Deniz Can Guven
{"title":"Harnessing the power of artificial intelligence for clinical trials in cancer.","authors":"Gamze Sonmez, Yigit Yazarkan, Taha Koray Sahin, Deniz Can Guven","doi":"10.1080/14737140.2026.2642221","DOIUrl":"10.1080/14737140.2026.2642221","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer research has become increasingly data-intensive, with digital pathology, imaging, and genomic sequencing generating vast, heterogeneous datasets. Artificial intelligence (AI) now plays a growing role across the oncology continuum, offering tools to interpret complex data, streamline workflows, and enhance clinical decision-making. In the context of clinical trials, AI is emerging as a catalyst for more efficient, inclusive, and data-driven research.</p><p><strong>Areas covered: </strong>This review summarizes how AI, encompassing foundational machine learning (ML) models alongside advanced deep learning (DL) and large language model (LLM) systems, is being applied across the oncology trial lifecycle - from design and recruitment to data management and outcome assessment. Tools such as Trial Pathfinder, TrialGPT, and PRISM demonstrate the ability to emulate trial criteria, accelerate patient matching, and improve eligibility accuracy. The review also highlights key challenges related to algorithmic bias, explainability, accountability, and evolving regulatory oversight by the FDA and EMA.</p><p><strong>Expert opinion: </strong>AI is transitioning from conceptual promise to operational utility in oncology clinical research. As regulatory frameworks mature, harmonizing innovation with patient protection will be essential. When responsibly implemented, AI can bridge the gap between research and real-world care, transforming oncology trials into faster, fairer, and more reliable engines of discovery.</p>","PeriodicalId":12099,"journal":{"name":"Expert Review of Anticancer Therapy","volume":" ","pages":"735-749"},"PeriodicalIF":3.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}