Seminars in oncology最新文献

{"title":"Risk of intensive care unit admission after immune checkpoint inhibitor use in cancer.","authors":"Maun R Baral, Sambhawana Bhandari, Daniel Morgensztern, Colleen McEvoy, Geneva Guarin, Prabha Ranganathan","doi":"10.1016/j.seminoncol.2026.152499","DOIUrl":"https://doi.org/10.1016/j.seminoncol.2026.152499","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have transformed cancer therapy but can cause excessive immune activation, leading to severe adverse events, including intensive care unit (ICU) admission. Existing evidence on critical illness after ICI use is limited, largely single center, and focused on immune related adverse events. This study evaluates the risk of inpatient and ICU admissions after ICI initiation using two large national databases. We retrospectively analyzed MarketScan Commercial and Multi-state Medicaid Research Databases (2016-2022) to identify adults with solid organ malignancies treated with ICIs and determined if ICU admission was required within 90 days of ICI administration. The primary diagnosis for ICU admission was identified and categorized. Associations between cancer type, ICI type, and ICU admission were analyzed. About 33,040 patients received ICIs during the study period. About 48.9% were male and 51.1% female. Pembrolizumab was the most used (49.3%), followed by nivolumab (31.9%), and ipilimumab (9.4%). Lung cancer was the most common malignancy (40.8%), followed by genitourinary (16%), melanoma (13%), gastrointestinal (12%), and breast (10%). About 22.0% (n = 7,216) of patients were hospitalized, and 8.7% (n = 2,872) required ICU admission. Infection was the most frequent reason for ICU admission, followed by respiratory causes. The odds of being admitted to the ICU were higher with combination ICI (OR = 1.51, P < .001) compared to ICI monotherapy. In conclusion, among patients with solid organ malignancies, nearly 9% required ICU admission within 90 days of ICI initiation, most commonly for infectious causes. These findings highlight the need for heightened vigilance for critical illness in patients treated with ICIs.</p>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"53 4","pages":"152499"},"PeriodicalIF":2.5,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857035","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":"Artificial intelligence in gynecologic oncology: A cautionary look in the Indian context","authors":"Sarita Kumari ,&nbsp;Rudrika Chandra ,&nbsp;Abhinav Tiwari","doi":"10.1016/j.seminoncol.2025.152456","DOIUrl":"10.1016/j.seminoncol.2025.152456","url":null,"abstract":"<div><div>Artificial intelligence (AI) is making remarkable strides in the field of oncology. The potential is humongous, but the perils are understated. From the perspective of gynecologic oncologists from India, we urge everyone to take a cautionary look at the rapid AI evolution in oncology.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"53 2","pages":"Article 152456"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898150","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":"Prostate cancer: Evolution of multiparametric MRI PI-RADS v2.1 toward biparametric MRI S-PI-RADS","authors":"Michele Scialpi ,&nbsp;Giovanni Battista Scalera ,&nbsp;Pietro Scialpi ,&nbsp;Arianna Evangelisti ,&nbsp;Giuseppe Nazareno Antogiovanni ,&nbsp;Paola Comite ,&nbsp;Umberto Faralli ,&nbsp;Aldo Di Blasi ,&nbsp;Eugenio Martorana","doi":"10.1016/j.seminoncol.2026.152471","DOIUrl":"10.1016/j.seminoncol.2026.152471","url":null,"abstract":"","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"53 2","pages":"Article 152471"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491527","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":"Machine learning-based integration develops a lactate metabolism related gene signature for improving outcomes in pancreatic ductal adenocarcinoma","authors":"Wan-Li Ge ,&nbsp;Chao-Qun Hou ,&nbsp;Qing-Qing Zong ,&nbsp;Dan-Rui Li ,&nbsp;Yun-Peng Peng ,&nbsp;Qiang Li","doi":"10.1016/j.seminoncol.2025.152428","DOIUrl":"10.1016/j.seminoncol.2025.152428","url":null,"abstract":"<div><h3>Objectives</h3><div>Given its high global mortality rate, pancreatic ductal adenocarcinoma (PDAC) remains a significant area of investigation. However, a robust gene signature linked to lactate metabolism for PDAC patients has not yet been established. Our objective was therefore to construct a novel lactate metabolism related gene signature (LMRGS) capable of predicting patient outcomes and informing therapeutic decisions.</div></div><div><h3>Methods</h3><div>Genes associated with lactate metabolism were sourced from the Molecular Signatures Database (MsigDB). The LMRGS was constructed using distinct algorithmic combinations and its performance was subsequently verified in 8 separate patient cohorts. Multiomics analyses were employed to evaluate the signature’s impact on biological functions and to investigate its relationship with the immune microenvironment. EdU, colony formation and wound-healing assays were used to demonstrate the effects of lactate on pancreatic cancer cells.</div></div><div><h3>Results</h3><div>An artificial intelligence framework enabled the creation of an LMRGS that serves as an independent prognostic predictor for individuals with PDAC. This signature demonstrated considerable accuracy in forecasting overall survival. When patients were stratified into high- and low-risk groups, the high-risk group showed reduced immune cell infiltration and a poorer response to immunotherapy. Further investigation confirmed a strong correlation between the LMRGS and the immune milieu in PDAC. In vitro experiments demonstrated that lactate promotes the proliferation and migration of pancreatic cancer cells.</div></div><div><h3>Conclusion</h3><div>We have formulated a new LMRGS for PDAC which holds potential for informing personalized treatment plans. Interventions aimed at the lactate metabolic pathway could represent a promising strategy to boost therapeutic effectiveness and extend survival for patients diagnosed with this disease.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"53 1","pages":"Article 152428"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401775","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":"Colchicine as an anti-inflammatory agent improving cancer prognosis: A therapeutic repurposing perspective","authors":"Sigal Matza Porges PhD ,&nbsp;Oded Shamriz MD, PhD ,&nbsp;Shlomo Z Ben-Sasson PhD","doi":"10.1016/j.seminoncol.2025.152437","DOIUrl":"10.1016/j.seminoncol.2025.152437","url":null,"abstract":"<div><div>In this Perspective, we highlight colchicine, a centuries-old, widely available anti-inflammatory drug, as a promising therapeutic candidate in oncology. We synthesize evidence demonstrating its ability to target central pathways of cancer biology, including chronic inflammation, angiogenesis, cytoskeletal remodeling, and autophagy, while also mitigating treatment-related comorbidities such as cardiovascular disease.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"53 1","pages":"Article 152437"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568831","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 role of circular RNAs in driving cancer advancement in low-oxygen conditions","authors":"Hamza Abu Owida ,&nbsp;Raed Obaid Saleh ,&nbsp;Suleiman Ibrahim Mohammad ,&nbsp;Asokan Vasudevan ,&nbsp;Roopashree R ,&nbsp;Aditya Kashyap ,&nbsp;Anima Nanda ,&nbsp;Subhashree Ray ,&nbsp;Ahmed Hussein ,&nbsp;Hatif Abdulrazaq Yasin","doi":"10.1016/j.seminoncol.2025.152435","DOIUrl":"10.1016/j.seminoncol.2025.152435","url":null,"abstract":"<div><div>Oxygen shortage, or hypoxia, is a unifying feature of solid tumors that broadly characterizes cancer biology and therapeutic outcome. In expanding tumors, cells adapt to low oxygen tensions by undergoing extensive metabolic reorganization, which is mainly orchestrated by hypoxia-inducible factor-1α (HIF-1α). The adaptive response initiates epithelial–mesenchymal transition (EMT), promotes metastatic dissemination, and facilitates the formation of cancer stem-like states that drive therapy resistance. Apart from such cellular reorganization, hypoxia also affects circular RNA (circRNA) biogenesis and function, a unique category of non-coding RNAs. CircRNAs are deposited into the tumor microenvironment to function as gene-expression regulators and signaling cascade modulators that are critical for survival, invasion, and drug resistance. Their unique hypoxia-associated expression patterns render them the first choice for diagnosis and prognosis. In this work, we examine the intricate relationship between circRNAs and hypoxia as well as associated molecular mechanisms. We also emphasize their role as ceRNAs, about microRNA binding and RNA-binding proteins, and their oncogenic role. Finally, we underscore the potential of targeting hypoxia-responsive circRNAs as novel therapeutic strategies for cancer.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"53 1","pages":"Article 152435"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614815","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":"Comparative efficacy of osimertinib with and without radiation therapy in EGFR-mutated nonsmall cell lung cancer with brain metastases","authors":"Rafi Aibani ,&nbsp;Jennifer Collins ,&nbsp;Amir-Kabirian Borna ,&nbsp;Amir Kamran","doi":"10.1016/j.seminoncol.2025.152436","DOIUrl":"10.1016/j.seminoncol.2025.152436","url":null,"abstract":"<div><div>Brain metastases are common in patients with EGFR-mutant nonsmall cell lung cancer (NSCLC), yet optimal management remains under investigation. Osimertinib has demonstrated central nervous system (CNS) activity, but the added benefit of combining it with upfront local therapy is unclear. This study evaluated the comparative efficacy of osimertinib alone versus in combination with radiation therapy (RT) or stereotactic radiosurgery (SRS) in patients with EGFR-mutant NSCLC and brain metastases. We conducted a retrospective cohort study using the TriNetX Research Network, identifying adult patients diagnosed between 2010 and 2024 with EGFR-mutant NSCLC and brain metastases who received osimertinib. Patients were grouped into those who received RT or SRS within 6 months of starting osimertinib (cohort 1) and those who received osimertinib alone (cohort 2). Propensity score matching (1:1) was used to balance baseline characteristics. The primary outcome was 3-year survival; secondary outcomes included CNS complications, healthcare utilization, and second-line therapy initiation. Among 743 eligible patients, 217 in each cohort were matched. Three-year survival was significantly higher in cohort 1 (43% v 29%; HR 0.67, <em>P</em> = .003). Median survival was 25 months v 16 months, respectively. CNS complication rates were not significantly different overall, though sensitivity analysis excluding prior CNS history showed increased complications with osimertinib alone (HR 2.0, <em>P</em> = .007). SRS was independently associated with reduced mortality (HR 0.49, <em>P</em> = .003). Upfront local therapy with osimertinib may improve survival in EGFR-mutant NSCLC with brain metastases, though careful patient selection is warranted.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"53 1","pages":"Article 152436"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597169","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":"Targeting TRP channels in oral cancer: Mechanistic potential and therapeutic promise","authors":"Kaviyarasi Renu ,&nbsp;Vishnu Priya Veeraraghavan ,&nbsp;Harishkumar Madhyastha","doi":"10.1016/j.seminoncol.2025.152440","DOIUrl":"10.1016/j.seminoncol.2025.152440","url":null,"abstract":"<div><div>Oral cavity cancer remains a major clinical challenge due to its aggressive nature, rapid lymphatic spread, and limited therapeutic options. Despite advancements in diagnosis and treatment, patient prognosis continues to be poor, highlighting the urgent need for novel molecular targets. This review systematically examines the critical role of calcium (Ca²⁺) ion channels, particularly transient receptor potential (TRP) channels, in the initiation and progression of oral cancer. Comprehensive searches were conducted in Scopus, Embase, Web of Science, and Google Scholar databases up to January 2025. The focus centers on TRPA1, TRPV1-4, TRPM2, TRPM6, and TRPM8 channels, emphasizing their dysregulated expression, altered functionality, and downstream signaling in oral squamous cell carcinoma (OSCC). Emerging evidence demonstrates that aberrant TRP channel activity contributes to enhanced cell proliferation, migration, invasion, and survival, thereby promoting oral carcinogenesis. Additionally, the review explores the interplay between TRP-mediated calcium signaling and oncogenic pathways such as PI3K/AKT and MAPK, elucidating their collective impact on tumor behavior. By integrating insights from molecular biology, pharmacology, and clinical studies, this work underscores the therapeutic potential of targeting TRP channels as a novel approach in oral cancer management. Future research directions include delineating channel-protein interactions and developing selective TRP inhibitors to improve treatment outcomes.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"53 1","pages":"Article 152440"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661101","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":"Physics-informed deep learning sharpens nano diagnostics for elusive pancreatic cancer","authors":"Abbas Rahdar ,&nbsp;Vahideh Mhammadzadeh ,&nbsp;Sobia Razzaq ,&nbsp;Maryam Shirzad ,&nbsp;Sonia Fathi-karkan ,&nbsp;Ali Bakhshi ,&nbsp;Razieh Behzadmehr ,&nbsp;Zelal Kharaba ,&nbsp;Luiz Fernando Romanholo Ferreira","doi":"10.1016/j.seminoncol.2025.152427","DOIUrl":"10.1016/j.seminoncol.2025.152427","url":null,"abstract":"<div><div>Pancreatic disease affects over 10% of the world population, and the most dangerous is pancreatic cancer (PC). The disease is mostly of late age of onset, especially in developed countries, and is associated with poor prognosis due to late presentation. Present screening tests like imaging and biomarkers are insensitive for the high-risk group. Invasive and noninvasive imaging modalities are other diagnostic tests with variable accuracy and accompanying risks. Chemotherapy and surgery are the first lines of treatment, but only 15%–20% of patients are eligible for surgery and the rate of recurrence is very high. Emerging technologies, including physics-informed deep learning (PIDL) and artificial intelligence (AI), are improving early detection techniques by evaluating images and synthesizing data more efficiently. Nanomedicine and AI-driven radiomics are individualizing diagnoses, enhancing drug delivery, and tackling tumor microenvironment issues. Hybrid model methodologies are improving prediction precision in oncology research, while computational drug development and liquid biopsy technologies enable early diagnosis and personalized treatment. The amalgamation of AI, imaging, nanomedicine, and physics-informed models has the potential to transform PC diagnostics, enhancing early detection and patient prognoses.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"53 1","pages":"Article 152427"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335221","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":"Immuno-oncology approaches to overcome T cell exhaustion in melanoma","authors":"Amr Ali Mohamed Abdelgawwad El-Sehrawy ,&nbsp;Mohammad Y Alshahrani ,&nbsp;Muzdalifa Mejbel Fedwi ,&nbsp;Subbulakshmi Ganesan ,&nbsp;Zahraa Abbas Al-Khafaji ,&nbsp;Vimal Arora ,&nbsp;Amrita Pal ,&nbsp;Priya Priyadarshini Nayak ,&nbsp;Sarvar Islomov ,&nbsp;Chou-Yi Hsu","doi":"10.1016/j.seminoncol.2025.152454","DOIUrl":"10.1016/j.seminoncol.2025.152454","url":null,"abstract":"<div><div>Melanoma, a highly aggressive type of skin cancer, has undergone incredible developments in immunotherapy, particularly in modulating T-cell immunity. T cells are essential components of the antitumor immune response and can undoubtedly influence the effectiveness of melanoma treatment. This review will evaluate the roles of the different T cell subsets (CD8⁺, CD4⁺, and Tregs) in melanoma immunity. CD8⁺ T cells are important effectors, as they primarily recognize and kill tumor cells. However, CD8+ T cells are often dysfunctional due to exhaustion driven by chronic antigen exposure and dysfunctional immune checkpoint pathways, specifically PD-1 and CTLA-4. On the other hand, CD4⁺ T cells, also known as T helper cells, play a crucial role in coordinating both pro- and antitumor immune responses. In contrast to T cells, Tregs, which are often present in the tumor microenvironment, lead to immune suppression through their activity, limiting T cell activity. This review will also examine the mechanisms of T-cell exhaustion, metabolic reprogramming within the tumor microenvironment (TME) of T-cell subsets, and the role of immune checkpoint pathways, such as CTLA-4 and PD-1, in T-cell immunity. Adoptive cell therapies (ACT), specifically Tumor-Infiltrating Lymphocyte (TIL) therapy and Chimeric Antigen Receptor (CAR) T-cell therapy, have shown the ability to rejuvenate T-cells to enhance clinical outcomes. However, several resistance mechanisms and the suppressive TME presents difficulties. Future efforts will focus on combination therapies, metabolic interventions, and novel engineering techniques to overcome barriers to T-cell function exhaustion and T-cell persistence. Evaluating biomarkers associated with early prediction for therapeutic benefit and associated toxicity is important for personalizing a particular treatment. Ultimately, this review highlights the potential of targeting T-cell exhaustion to enhance the effectiveness of T-cell-based therapies in improving outcomes for melanoma patients.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"53 1","pages":"Article 152454"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839637","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}