Seminars in oncology最新文献

{"title":"Chemotherapy plus immunotherapy as first line combination in older patients with extensive stage small cell lung cancer: A systematic review and meta-analysis.","authors":"Valentina Bertaglia, Fausto Petrelli, Lorenzo Dottorini, Simona Carnio, Anna Maria Morelli, Alessandro Nepote, Antonio Maccioni, Mario Scartozzi, Cinzia Solinas, Silvia Novello","doi":"10.1053/j.seminoncol.2024.11.001","DOIUrl":"https://doi.org/10.1053/j.seminoncol.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>Small-cell lung cancer (SCLC) accounts for 10%-15% of all lung cancers. At diagnosis, nearly two thirds of patients with SCLC have extensive stage (ES), with a median overall survival (OS) less than 12 months. The combination of protein-death-1/protein-death-ligand-1 (PD-1/PD-L1) immune checkpoint inhibitors (ICIs) with first-line platinum plus etoposide chemotherapy has changed the therapeutic landscape for ES-SCLC. Older adults represent most of the cancers diagnosed and deaths by age group, with an expected increase over the next decade. In the real-world setting, about 30%-40% of patients with a diagnosis of SCLC are reported to be over 70-years-old at the time of diagnosis. However, this subgroup of patients is underrepresented in clinical trials. Based on this evidence, we performed this systematic review to define the activity of ICIs plus chemotherapy in older patients with previously untreated ES-SCLC.</p><p><strong>Methods: </strong>This systematic review was carried out in accordance with the statement in the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search on multiple electronic databases was conducted from inception to the end of April to identify randomized trials that prospectively evaluated chemotherapy ± PD-1/PD-L1 ICIs. When more than one report of the same study was available, the most recent data (with longer follow-up and/or higher number of patients) was considered. The primary endpoint of the study was efficacy, in terms of overall survival, progression-free survival, and disease control rate.</p><p><strong>Results: </strong>We selected six randomized clinical trials that enrolled 3396 patients in the meta-analysis. In the experimental arm, 670 patients were 65 years of age and older compared to 504 in the control arm. In the subgroup of patients ≥65 years, adding ICIs to chemotherapy led to a significant benefit in OS [hazard ratio (HR) 0.80, 95% confidence interval (CI) 0.72-0.90). There was moderate but not-significant heterogenity among the trials (I² = 47%, P = 0.07).</p><p><strong>Conclusion: </strong>This systematic review found that the combination of chemotherapy plus ICIs improved OS among older patients with ES-SCLC. Biomarker and comprehensive geriatric assessment are needed to improve the identification and selection of patients with cancer that are uniformly defined as older.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915573","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":"Gender-Based Differences in the Efficacy of Anti-EGFR/BRAF/MEK Targeted Therapy in Patients with BRAF-Mutated Metastatic Colorectal Cancer.","authors":"Laura Pala, Tommaso De Pas, Emilia Cocorocchio, Chiara Catania, Giovanni Ceresoli, Daniele Laszlo, Emma Zattarin, Giovanna Rossi, Fabio Conforti","doi":"10.1053/j.seminoncol.2024.10.004","DOIUrl":"https://doi.org/10.1053/j.seminoncol.2024.10.004","url":null,"abstract":"<p><strong>Objectives: </strong>We previously showed that men with melanoma harboring BRAF mutations had significantly lower benefit from targeted therapy as compared with women Here we explored the hypothesis that such gender-based dimorphism in the efficacy of BRAF-pathway blockade extends to other tumor histotypes carrying pathogenic BRAF-mutations.</p><p><strong>Methods: </strong>We retrospectively analyzed data from a cohort of patients with advanced colorectal-cancer (CRC) harboring BRAF V600E mutations, treated with anti-EGFR/BRAF/MEK targeted therapy. The primary objective was to assess the association between gender and outcome of patients treated with targeted therapy, in terms of overall response rate (ORR), progression-free survival (PFS) and overall survival (OS).A multivariable Cox proportional hazard regression model was used to assess the association between gender and PFS and OS, adjusted for other relevant clinical, pathological and molecular prognostic factors, including ECOG PS (0 vs 1-2), primary tumor site (right-side vs left-side), microsatellite instability status (instable [MSI] vs stable [MSS]), number of metastatic sites at treatment start, treatment type (double targeted therapy [ie, anti-EGFR + anti-BRAF] vs triple targeted therapy [ie, anti-EGFR + anti-BRAF + anti-MEK]) and mutational status of the RNF43 gene (wild type vs mutated).</p><p><strong>Results: </strong>Ninety-eight patients with advanced CRC were included in the analysis: 59 (60%) were women and 39 (40%) men. The ORR was 43.1% in women vs only 23.7% in men (p-value = .05). Multivariable analysis adjusted for relevant clinical, pathological, and molecular variables associated with patients' prognosis, showed a significantly shorter PFS and OS in men as compared with women: the adjusted-HR was, respectively, 1.65 (95%CI,1.00-2.69; p = .04) for PFS and 1.83 (95%CI,1.08-3.08; p-value = .02) for OS.</p><p><strong>Conclusions: </strong>We confirmed a significant gender-based dimorphism in the efficacy of anti-EGFR/BRAF/MEK therapy in patients with advanced-CRC harboring BRAF mutations that warrant further investigation.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771851","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":"Adenocarcinoma on retrorectal cystic hamartoma: An illustrative image for a very rare diagnosis.","authors":"José Felipe Reoyo Pascual, Evelio Alonso Alonso, Lucia Polanco Pérez, Miguel Álvarez Rico","doi":"10.1053/j.seminoncol.2024.10.003","DOIUrl":"10.1053/j.seminoncol.2024.10.003","url":null,"abstract":"<p><p>Retrorectal cystic hamartoma (also known as tailgut cyst) is a congenital lesion that originates from debris from the embryonic caudal intestine. Incidentally diagnosed in more than half of cases, the treatment of choice is surgical resection. It is a very rare pathology whose oncological transformation constitutes a true pathological rarity.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":" ","pages":"154-155"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626262","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":"Integrated profile of tumor stage and mutational burden predicts disparate clinical responses to immune checkpoint inhibitors: A risk-benefit study.","authors":"Ming Zheng","doi":"10.1053/j.seminoncol.2024.08.003","DOIUrl":"10.1053/j.seminoncol.2024.08.003","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, having demonstrated efficacy and leading to regulatory approvals of ICIs in cancers characterized by high tumor mutation burden (TMB). However, there remains a gap in determining their applicability and risk-benefit profile, across the broad spectrum of patients whose tumors harbor varying TMB levels across distinct tumor stages. By interrogating a large contemporary cohort comprised of 10,233 patients with a diagnosis of cancer across all tumor stages and TMB levels, this study revealed significantly improved overall survival (OS) following ICI therapy (P < .0001) in patients with a combination of ≥10 mut/Mb and stage IV disease. In contrast, ICI therapy is associated with markedly worse OS in patients with low TMB levels <10 mut/Mb and stages I, II, and III cancer. These findings highlight the critical interplay between TMB, tumor stage, and ICI treatment outcomes, underscoring the importance of integrating clinical and genetic characteristics in weighing the risk-benefit balance of ICI therapy. Although maximizing therapeutic benefits is crucial, it is equally important to identify and manage potential risks that may not be immediately apparent. This may require enrolling patients with less-severe or early-stage disease to enable long-term follow-up with effective clinical surveillance. By comprehensively evaluating the added benefit of improved treatment efficacy and the potential risk of adverse treatment outcome, a risk-benefit profile can optimize immunotherapy regimens, with profound implications for clinical decision-making and regulatory approvals of ICI.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":" ","pages":"142-148"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626806","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":"Screening Adherence for Second Primary Malignancies in Breast Cancer Survivors: Behaviors, Facilitators, and Barriers to Enhance Quality Care.","authors":"Fernanda Mesa-Chavez, Misael Salazar-Alejo, Cynthia Villarreal-Garza","doi":"10.1053/j.seminoncol.2024.10.005","DOIUrl":"10.1053/j.seminoncol.2024.10.005","url":null,"abstract":"<p><p>Due to genetic, hormonal, and environmental factors, alongside increased life expectancy, breast cancer (BC) survivors have an increased risk of developing a second primary malignancy. Therefore, regular screening for other types of cancer is of utmost importance for their comprehensive care. This cross-sectional study evaluated BC survivors' compliance with cervical, lung, and colorectal cancer screening, and identified facilitators and barriers influencing adherence. Fifty-two BC survivors answered the study's survey. A total of three (6%) cases of second primary malignancies were self-reported. Cervical cancer screening was performed within the past 3 years among 37/50 (74%) eligible participants. Only 7/24 (29%) eligible participants underwent colorectal cancer screening within the last 10 years, including six colonoscopies and 1 occult blood test. No participant had an indication for lung cancer screening. The primary reason for noncompliance with both cervical and colorectal cancer screening was lack of physician's recommendation, accounting for 79% and 88% of cases, respectively. Nearly all participants (98%) affirmed that BC survivors should undergo screening for other types of cancer. Most (96%) stated that, if recommended by a physician, they would agree to undergo screening for other neoplasms. Even though most BC survivors acknowledged its importance, screening particularly for colorectal cancer exhibited suboptimal rates. Oncologists could play a crucial role in increasing cancer screening uptake by reminding patients of their corresponding recommendations to detect other types of cancer.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":" ","pages":"156-160"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626829","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":"Efficacy of metformin drug in preventing metabolic syndrome associated with androgen deprivation therapy (ADT) in prostate cancer patients: A systematic review and meta-analysis.","authors":"Ibrahim Abdelnasar Yakout, Mohamed Mustafa Gallab, Daie AbdelRahman Mohamed, Hiba Hamdar, Sara I Ibrahim, Adham Mohamed, Abdelrahman Abdelshafi, Mohamed Abd-ElGawad","doi":"10.1053/j.seminoncol.2024.10.001","DOIUrl":"10.1053/j.seminoncol.2024.10.001","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer patients undergoing long-term (Androgen deprivation therapy) ADT will tend to have metabolic changes. Metabolic syndrome represents the accumulation of several medical conditions that significantly increase the risk of developing severe diseases like cardiovascular disorders, insulin resistance, and hyperglycemia. We are conducting this systematic review and meta-analysis to fill up the gap and to resolve the debate regarding the effectiveness of metformin in reducing metabolic syndrome associated with ADT in prostate cancer patients.</p><p><strong>Methods: </strong>We conducted the systematic review and meta-analysis according to the Handbook of Cochrane Systematic Review of Intervention and the PRISMA guidelines. We conducted the search process using the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, and Web of Science. We selected the articles that fit within the following criteria, Randomized Controlled Trials (RCTs) and Cohort studies which evaluate the efficacy of metformin in reducing metabolic syndromes for prostate cancer patients undergoing androgen deprivation therapy (ADT). The efficacy of metformin in metabolic syndrome that resulted from using androgen deprivation therapy for prostate cancer patients was evaluated by the changes from baseline in Body Mass Index (BMI), waist circumference by cm, glycated hemoglobin (HbA1c), and blood pressure both systolic and diastolic. Revman software Version 5.4.1 was used to perform all statistical analyses.</p><p><strong>Results: </strong>Our search retrieved 781 records. Seven records were included in our study: 5 published randomized control clinical trials and 2 cohort studies and only 6 studies were included in the meta-analysis. For BMI the pooled effect estimates of 3 studies favored Metformin over placebo, but this is not a significant difference (MD = -0.9, P = 0.05), for systolic pressure the pooled effect estimates of 3 studies favored Metformin over placebo, but this is not a significantly different placebo (MD = -3.18, P = 0.22), for HBA1c the pooled effect estimates of 3 studies showed that no significant difference between placebo and metformin (MD = -0.01, P = 0.86)002E CONCLUSION: Despite the promising direction in some parameters, our findings underscore the need for further research to establish a clearer understanding of metformin's role in mitigating metabolic changes in prostate cancer patients undergoing ADT.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":" ","pages":"163-174"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639712","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":"Deep Myometrial Infiltration leads to a measurable Inflammatory Response in Endometrial Cancer. A Prospective Observational Study.","authors":"Carlo Ronsini, Irene Iavarone, Eleonora Braca, Maria Giovanna Vastarella, Luigi Della Corte, Clorinda Vitale, Giada Andreoli, Elvira La Mantia, Luigi Cobellis, Pasquale de Franciscis","doi":"10.1053/j.seminoncol.2024.10.002","DOIUrl":"10.1053/j.seminoncol.2024.10.002","url":null,"abstract":"<p><strong>Backgrounds: </strong>This study aims to evaluate the correlation between inflammation indices, such as neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR) and deep myometrial infiltration (≥50%) prospectively in patients with endometrial carcinoma, providing insights into the interaction between these parameters MATERIAL AND METHODS: A prospective observational cohort study was conducted at AOU Vanvitelli in Naples, Italy, from August 2023 to March 2024. Data from 161 patients undergoing surgery for endometrial cancer, including preoperative blood counts and histopathological information, were collected. Statistical analyses were performed using R software.</p><p><strong>Results: </strong>After logistic regression, NLR and MLR showed a statistically significant association with deep myometrial infiltration (NLR log(OR) 0.15, P = .040; MLR log(OR) 0.30, P = .008). However, after multivariate logistic regression which included other risk factors such as grading, histotype, and MSI only NLR retained statistical significance, (Log(Or) 0.18, P = .031).</p><p><strong>Conclusion: </strong>Our results demonstrate noticeable changes in inflammation indices associated with deep myometrial infiltration in endometrial carcinoma. Moreover, a correlation between NLR and deep myometrial infiltration exists regardless of microsatellite instability, histotype, and grading.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":" ","pages":"149-153"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626724","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":"Hepatitis B Virus Reactivation in Cancer Patients Receiving Chemotherapy-A Systematic Review and Meta-Analysis.","authors":"Natee Deepan, Soe Thiha Maung, Pakanat Decharatanachart, Roongruedee Chaiteerakij","doi":"10.1053/j.seminoncol.2024.08.001","DOIUrl":"10.1053/j.seminoncol.2024.08.001","url":null,"abstract":"<p><p>Hepatitis B virus (HBV) reactivation is a critical concern for patients with a diagnosis of cancer receiving chemotherapy worldwide. Our aim was to assess the rate of HBV reactivation during chemotherapy globally. We systematically reviewed PubMed, Embase, Scopus, and Google Scholar databases for chemotherapy-related HBV reactivation studies from inception until July 2023. A random-effects model was used to estimate the pooled reactivation rate. Total 86 studies involving 21,297 patients were included, comprising 62 and 24 studies from Eastern and Western regions. Pooled results indicated a 9% reactivation rate (95%CI: 7%-13%, I² = 95%). Reactivation rates were 10% (95%CI: 7%-14%, I² = 92%) for hematological malignancies and 5% (95%CI: 3%-9%, I² = 94%) for solid tumors. Presence of HBV DNA, HBeAg, and HBsAg were correlated with reactivation rates of 29% (95%CI: 10%-60%, I² = 91%), 23% (95%CI: 14%-36%, I² = 78%), and 15% (95%CI: 11%-20%, I² = 90%), respectively. For patients with positive anti-HBe Ab, anti-HBc, and anti-HBs Ab serology, pooled reactivation rates were 7% (95%CI: 3%-14%, I² = 81%), 4% (95%CI: 3%-7%, I² = 85%), and 3% (95%CI: 2%-6%, I² = 80%), respectively. With antiviral prophylaxis, reactivation rates were 1% (95%CI: 0%-17%, I² = 59%), 1% (95%CI: 0%-5%, I² = 0%), 4% (95%CI: 2%-9%, I² = 85%), and 6% (95%CI: 3%-12%, I² = 32%) for patients receiving tenofovir, entecavir, lamivudine, and telbivudine, respectively. Patients with a diagnosis of cancer undergoing chemotherapy face increased risk of HBV reactivation. This analysis raises public awareness and serves as a resource for future clinical trials.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":" ","pages":"123-134"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626804","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":"Deciphering the US Regulatory Framework: Comparison Between Oncology Biosimilars and Reference Biologics.","authors":"Ankita Tandulje, Priya Varpe, Purva Chaugule, Rajeev Singh Raghuvanshi, Saurabh Srivastava","doi":"10.1053/j.seminoncol.2024.08.002","DOIUrl":"10.1053/j.seminoncol.2024.08.002","url":null,"abstract":"<p><p>Biological oncology agents are vital in cancer care, but their exorbitant expenses present obstacles for patients, families, healthcare professionals, and insurance providers. The advent of biosimilars represents a transformative solution, offering more affordable alternatives after the expiration of biologics patents. Biosimilar agents, similar to biological agents in structure, function, safety, and immunogenicity, enhance healthcare accessibility, improve outcomes, and reduce costs. Thus, the safety of biosimilars in clinical settings is of utmost importance. This review provides a detailed overview of the United States (US) regulatory framework for biosimilars along with a comparative analysis of Food and Drug Administration (FDA) approved biosimilar products. The FDA's \"Biosimilar product information\" database and \"FDA's Purple Book\" database were used to retrieve data on approved biosimilars and reference biologicals respectively. The study compares biosimilars and their reference products, examining their physiological action, pharmacokinetics, indications, adverse reactions, and immunogenicity test results and concludes that biosimilars do not have significant variations from their reference biologic products. This analysis will offer critical insights for medical practitioners, clinicians, and patients. It empowers stakeholders to make informed decisions, assessing whether biosimilars offer an equivalent level of safety compared to their reference products. Biosimilars are endorsed as credible substitutes for originator biologics, improving accessibility and affordability in cancer care, and benefiting patients and healthcare systems.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":" ","pages":"135-141"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626506","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":"Role of neoadjuvant pembrolizumab in advanced melanoma.","authors":"Maheen Amir, Zoha Ali Khan, Ayza Asad, Taha Gul Shaikh","doi":"10.1053/j.seminoncol.2024.09.001","DOIUrl":"10.1053/j.seminoncol.2024.09.001","url":null,"abstract":"<p><p>Melanoma, a malignancy originating from melanocytes, poses a significant global health challenge, with approximately 325,000 cases and 57,000 deaths annually. Advanced melanoma (AM), categorized as stage III and IV, presents considerable treatment challenges due to its complex mutational landscape. Traditional treatment options have included checkpoint inhibitors and BRAF inhibitors, with pembrolizumab emerging as a promising agent. Approved by the FDA and EMA for various stages of melanoma, pembrolizumab is a humanized monoclonal antibody that blocks the PD-1/PD-L1 interaction, thereby enhancing immune system-mediated tumor eradication. This abstract discusses a recent phase 2 clinical trial evaluating the efficacy of neoadjuvant (presurgery) versus adjuvant (postsurgery) pembrolizumab treatment in resectable stage III or IV melanoma. The study, involving 313 patients across 90 US hospitals, found that neoadjuvant-adjuvant pembrolizumab significantly improved event-free survival (72%) compared to adjuvant-only treatment (49%) after 2 years. Treatment-related adverse events were consistent with known profiles, including fatigue, nausea, and diarrhea, without new severe adverse effects. No increase in surgery-related complications was observed with neoadjuvant treatment. These findings suggest that neoadjuvant pembrolizumab offers substantial benefits over adjuvant-only treatment, although further research is warranted. Future studies should focus on larger cohorts, diverse demographics, and extended follow-up to validate these results and potentially integrate neoadjuvant pembrolizumab into standard treatment protocols for advanced melanoma.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":" ","pages":"161-162"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648747","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}