Joshua Shain , Alissa Michel , Michael S. May , Lindor Qunaj , Wafaa El-Sadr , Wendy K. Chung , Paul S. Appelbaum , Judith S. Jacobson , Jessica Justman , Alfred I. Neugut
{"title":"Cancer genetic mutation prevalence in sub-Saharan Africa: A review of existing data","authors":"Joshua Shain , Alissa Michel , Michael S. May , Lindor Qunaj , Wafaa El-Sadr , Wendy K. Chung , Paul S. Appelbaum , Judith S. Jacobson , Jessica Justman , Alfred I. Neugut","doi":"10.1053/j.seminoncol.2023.12.001","DOIUrl":"10.1053/j.seminoncol.2023.12.001","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Cancer represents a leading cause of death worldwide. Germline mutations<span> in several genes increase the risk of developing several cancers, including cancers of the breast, ovary, pancreas, colorectum, and melanoma. An understanding of the population prevalence of pathogenic </span></span>germline<span> variants can be helpful in the design of public health interventions, such as </span></span>genetic<span> testing, which has downstream implications for cancer screening, prevention, and treatment. While population-based studies of pathogenic germline variants exist, most such studies have been conducted in White populations. Limited data exist regarding the prevalence of germline mutations within sub-Saharan African populations.</span></div></div><div><h3>Materials and Methods</h3><div>We identified countries defined as sub-Saharan Africa by the World Bank and conducted a scoping literature review using PubMed<span>. For each country, we identified and summarized studies that focused on the prevalence of germline genetic mutations<span> with sample sizes<span> >10 and in a population directly from sub-Saharan Africa, either with or without diseases associated with the relevant genetic mutations. Studies that evaluated the prevalence of somatic or likely benign variants were excluded.</span></span></span></div></div><div><h3>Results</h3><div>Within the 48 countries in sub-Saharan Africa, we identified 34 studies which meet the inclusion criteria. Twenty studies were conducted in South Africa, Nigeria, or Burkina Faso; four countries had more than two published papers. We found that 33 of 48 countries in sub-Saharan Africa lacked any genetic studies. Notably, there has been an increase in relevant studies starting in 2020. Importantly, of the 34 studies identified, 29 included data on <em>BRCA</em>1 or <em>BRCA</em><span>2. Data on the prevalence of mutations contributing to familial cancer syndromes other than </span><em>BRCA</em>1 and <em>BRCA</em>2 was limited.</div></div><div><h3>Conclusions</h3><div><span>While some progress has been made towards understanding the prevalence of germline mutations in cancer susceptibility genes, the characterization of genetic mutations among sub-Saharan African populations remains strikingly incomplete. Given the </span>genetic diversity in the region, there remains a great need for large-scale, population-based studies to understand the prevalence of germline pathogenic variants and adequately capture all the subpopulations in this part of the world.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"50 6","pages":"Pages 123-130"},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139052412","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}
Laura Pala MD , Tommaso De Pas MD , Erika Stucchi MD , Chiara Catania MD , Emilia Cocorocchio MD , Maria Giulia Zampino MD , Giovanna Rossi MD , Emma Zattarin MD , Antonio Di Muzio MD , Daniele Laszlo MD , Sara Stucchi DSc , Fabio Conforti MD
{"title":"Immune-checkpoint inhibitors in anal squamous cell carcinoma: a systematic review and meta-analysis","authors":"Laura Pala MD , Tommaso De Pas MD , Erika Stucchi MD , Chiara Catania MD , Emilia Cocorocchio MD , Maria Giulia Zampino MD , Giovanna Rossi MD , Emma Zattarin MD , Antonio Di Muzio MD , Daniele Laszlo MD , Sara Stucchi DSc , Fabio Conforti MD","doi":"10.1053/j.seminoncol.2023.11.002","DOIUrl":"10.1053/j.seminoncol.2023.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div><span><span>Squamous cell carcinoma of the anus (SCCA) is a rare tumor. While most patients with locally advanced disease are cured with chemo-radiotherapy, about a quarter eventually experience metastatic recurrence. Standard treatment for advanced disease is chemotherapy, but recently evidence on the activity of </span>immunotherapy has been reported. We performed a </span>systematic review and meta-analysis of prospective trials testing immune-checkpoint inhibitors (ICIs) in patients with SCCA.</div></div><div><h3>Objective</h3><div>We aimed to evaluate the overall response rate (ORR) and the disease control rate (DCR) of ICIs in patients with advanced SCCA.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, and Scopus, through December 31, 2022, for prospective trials assessing ICIs in patients with advanced SCCA. The primary and secondary endpoints were respectively ORR and DCR.</div></div><div><h3>Results</h3><div><span>Six prospective trials were included in the analysis, one of which was randomized. Overall, seven treatment arms and 347 patients have been analyzed. Five treatment arms tested ICIs as monotherapy and two arms examined ICIs in combination with </span>cetuximab<span> and bevacizumab, respectively. The pooled ORR was 13% (95%CI, 10%–17%), with a DCR of 57% (95%CI, 40%–74%). Results did not change in a sensitivity analysis, which excluded the two treatment arms testing the combination of ICIs with other drugs.</span></div></div><div><h3>Conclusions</h3><div>The efficacy of ICIs in SCCAs is low. Combination strategies with targeted drugs or chemotherapy might represent a better therapeutic strategy for these patients. Further studies are awaited to identify resistance mechanisms to ICIs and optimize their efficacy.</div></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"50 6","pages":"Pages 140-143"},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138520692","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":"Practice change: No benefit of extended lymphadenectomy at radical cystectomy in patients with muscle invasive bladder cancer","authors":"Omar Fahmy , Maxim Kochergin , Anastasios D. Asimakopoulos , Georgios Gakis","doi":"10.1053/j.seminoncol.2023.09.001","DOIUrl":"10.1053/j.seminoncol.2023.09.001","url":null,"abstract":"<div><p><span>For many decades, extended pelvic lymph node dissection has been an integral part during </span>radical cystectomy<span> for patients with muscle invasive bladder cancer<span>. This practice was based on large retrospective meta-analyses suggesting an oncologic benefit to an extended dissection. This mini review and meta-analysis includes the two available randomized trials in the current literature. Therefore, it can be considered as the strongest level of evidence regarding the prognostic benefit of an extended pelvic lymphadenectomy. Based on current randomized data, standard pelvic lymph node dissection up to the level of iliac bifurcation is sufficient, and extension of the dissection above this level does not provide any additional oncologic benefit.</span></span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"50 3","pages":"Pages 102-104"},"PeriodicalIF":4.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286453","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}
Haripriya Parapparambil Surendran , Sujit Kumar Sah , Dhanya Mary Louis , Sruthi Kalavagunta , Narmadha Mukunthu Poornachary , Selin Chiriyankandath Joy , Debnarayan Dutta
{"title":"Efficacy of memantine in preventing neurocognitive dysfunction induced by radiation therapy in patients with brain metastases: A systematic review of clinical trials","authors":"Haripriya Parapparambil Surendran , Sujit Kumar Sah , Dhanya Mary Louis , Sruthi Kalavagunta , Narmadha Mukunthu Poornachary , Selin Chiriyankandath Joy , Debnarayan Dutta","doi":"10.1053/j.seminoncol.2023.09.004","DOIUrl":"10.1053/j.seminoncol.2023.09.004","url":null,"abstract":"<div><h3>Purpose</h3><p><span><span>About 50%–90% of patients with brain metastases who receive radiation therapy experience </span>cognitive impairment. This </span>systematic review<span> aims to gather credible sources of comprehensive information on the efficacy of memantine in preventing cognitive dysfunction.</span></p></div><div><h3>Methods</h3><p>A comprehensive review conducted in compliance with the PRISMA statement and systematic search was performed across five databases included PubMed<sup>Ⓡ</sup><span>, Embase</span><sup>Ⓡ</sup><span>, Scopus</span><sup>Ⓡ</sup><span>, Cochrane Library</span><sup>Ⓡ</sup>, and ClinicalTrial.gov.in from inception until November 2021.</p></div><div><h3>Results</h3><p>A total of four eligible studies were selected in this review that included 1,444 patients with brain metastases who received radiation therapy (Intervention group [n = 729] and control group [n = 715]). Overall, three of the four studies reported some improvement in neurocognitive function in at least one or more parameters such as recall and recognition (<em>P</em> = .39, <em>P</em> = .10 and <em>P</em> = .05), verbal fluency (<em>P</em> = .03 and <em>P</em> < .0001), complex attention (<em>P</em> = .59) executive function (<em>P =</em> .92) and normal appearing white matter (<em>P</em><span> = .01) following memantine therapy compared to control group. Further, two of the four studies reported an improvement in the patients’ quality of life following memantine therapy compared to the control group, and there was no significant difference in the toxicity profile of the interventional compared to the control group as reported from two studies.</span></p></div><div><h3>Conclusion</h3><p>This review embraces the comprehensive evidence that the use of memantine therapy in patients<span><span> with brain metastases to prevent radiation-induced neurocognitive dysfunction has a modest and statistically significant beneficial impact in improving quality of life and preserving some neurocognitive function without any complications. Pending the completion of additional ongoing studies, one can argue that memantine is a reasonable treatment to consider in patients with brain metastases while they receive </span>whole brain radiation therapy.</span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"50 3","pages":"Pages 113-122"},"PeriodicalIF":4.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41150643","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}
Jinyoung Kim , Chaiho Jeong , Jeongmin Lee , Jeonghoon Ha , Ki-Hyun Baek , Seohyun Kim , Tai Joon An , Chan Kwon Park , Hyoung Kyu Yoon , Jeong Uk Lim
{"title":"Bone-modifying agents for non–small-cell lung cancer patients with bone metastases during the era of immune checkpoint inhibitors: A narrative review","authors":"Jinyoung Kim , Chaiho Jeong , Jeongmin Lee , Jeonghoon Ha , Ki-Hyun Baek , Seohyun Kim , Tai Joon An , Chan Kwon Park , Hyoung Kyu Yoon , Jeong Uk Lim","doi":"10.1053/j.seminoncol.2023.09.002","DOIUrl":"10.1053/j.seminoncol.2023.09.002","url":null,"abstract":"<div><p><span>During the course of lung cancer progression, bone metastases occur in about 40% of patients. Common complications associated with bone metastases in lung cancer patients include </span>musculoskeletal pain<span><span><span>, pathologic fractures<span>, spinal cord compression, and </span></span>hypercalcemia. We discuss the efficacy of bone-modifying agents (BMAs) in reducing skeletal-related events (SREs) and improving cancer-related outcomes, particularly </span>in patients<span> with stage IV non–small-cell lung cancer with bone metastases. In addition, the combined effects of BMAs with radiotherapy or immunotherapy in reducing SREs in patients with lung cancer and bone metastases are explored.</span></span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"50 3","pages":"Pages 105-112"},"PeriodicalIF":4.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10301511","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}
Riad El Fakih, Abdulwahab A. Albabtain, Saud Alhayli, Khawlah Farhan, Walid Rasheed, Alfadel Alshaibani, Naeem Chaudhri, Mahmoud Aljurf
{"title":"Successful restoration of checkpoint inhibitors efficacy after allogeneic hematopoietic cell transplant for classic Hodgkin lymphoma patients","authors":"Riad El Fakih, Abdulwahab A. Albabtain, Saud Alhayli, Khawlah Farhan, Walid Rasheed, Alfadel Alshaibani, Naeem Chaudhri, Mahmoud Aljurf","doi":"10.1053/j.seminoncol.2023.05.001","DOIUrl":"10.1053/j.seminoncol.2023.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Classic Hodgkin lymphoma<span> (cHL) is a highly-curable disease. However, relapses after bone marrow transplant are challenging especially relapses after allogeneic transplant.</span></p></div><div><h3>Methods</h3><p>A retrospective chart review of the institution transplant database to summarize the safety and efficacy of checkpoint inhibitors (CPIs) use for cHL relapses postallo-HCT in patients who already failed to derive sustained benefit from CPIs received prior to allo-HCT.</p></div><div><h3>Results</h3><p>Six cases were identified and reviewed. All patients received and failed to derive sustained benefit from CPIs and brentuximab vedotin<span> preallo-HCT. The median age at the time of allo-HCT was 28.6 years (IQR 23.6–34.2), the median number of lines received prior to allo-HCT was 6.5 (range 5–9). The median duration of CPI therapy prior to allo-HCT was 8.1 months (IQR 6.7–12.9). The median time between the discontinuation of CPI and allo-HCT was 5.78 months (IQR 3.15–15.8). The median time to progression postallo-HCT was 5.75 months (IQR 2.6–11.7). The median time between allo-HCT and re-challenge with a CPI was 7.6 months (IQR 3.2–28.6). The median time of follow up after starting postallo-HCT CPIs was 16 months (IQR 7.25–25.75). Five out six patients responded and two patients developed GvHD.</span></p></div><div><h3>Conclusion</h3><p>Our report shows preserved efficacy without any new safety signals by using CPIs postallo-HCT despite using and having failed to derive sustained benefit from CPIs preallo-HCT.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"50 3","pages":"Pages 76-85"},"PeriodicalIF":4.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10084798","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}
Patricia López Pardo , Miguel Soria Tristán , Mercedes Margarita Cavanagh Podesta , Santos Enrech Francés
{"title":"NTRK fusion-positive cancer in nonagenarian patient. The importance of comprehensive geriatric assessment in older people for the inclusion in clinical trials","authors":"Patricia López Pardo , Miguel Soria Tristán , Mercedes Margarita Cavanagh Podesta , Santos Enrech Francés","doi":"10.1053/j.seminoncol.2023.06.001","DOIUrl":"10.1053/j.seminoncol.2023.06.001","url":null,"abstract":"","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"50 3","pages":"Pages 86-89"},"PeriodicalIF":4.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10131366","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":"Bleeding risk with concomitant administration of VEGF-TKIs and anticoagulant agents","authors":"Melina Verso , Andres Munoz , Giancarlo Agnelli","doi":"10.1053/j.seminoncol.2023.05.002","DOIUrl":"10.1053/j.seminoncol.2023.05.002","url":null,"abstract":"<div><p><span><span><span>Anti-cancer treatment is considered an independent risk factor for emergent bleeding during </span>anticoagulant treatment </span>in patients<span> with cancer-associated thrombosis. This increased bleeding risk is perceived as major concern particularly when tyrosine kinase inhibitors (TKIs) targeting the vascular endothelial derived </span></span>growth factor receptor<span> (VEGFR-TKIs) are co-administered with anticoagulants<span><span><span>. We evaluated the effects of the combined administration of a VEGF-TKI and the oral direct anticoagulant (apixaban) or the low-molecular weight-heparin </span>dalteparin<span> in a sub-analysis of the Caravaggio study in patients with a diagnosis of cancer patients with venous thromboembolism<span>. The rate of major bleeding was 4.2% in the 668 patients who received any type of anti-cancer treatment and 3.5% in the 487 patients who did not receive any anti-cancer treatment. The relative risk for patients treated with a VEGF-TKI was 1.58 (95% CI: 0.69–3.68), compared to patients treated with anticancer agents other than a VEGF-TKI and 1.73 (95% CI: 0.73–4.07) compared to patients who did not receive any anticancer treatment. The administration of a VGEF-TKI did not have any impact on the recurrence rate of venous thromboembolism. We observed a numerically not statistically significant increase in major bleeding events in patients on concurrent VEGF-TKI and therapeutic </span></span></span>anticoagulation<span> with no excess in those who received apixaban. Further prospective well-designed studies are needed to evaluate whether the concomitant administration of VGEF-TKI and anticoagulant agents may result in an increase of bleeding in patients with a diagnosis of cancer treated for venous thromboembolism.</span></span></span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"50 3","pages":"Pages 67-70"},"PeriodicalIF":4.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10084797","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}
Rocío González Grande, Ana Bravo Aranda, Inmaculada Santaella Leiva, Susana López Ortega, Miguel Jiménez Pérez
{"title":"Acute liver failure secondary to malignant infiltration: A single center experience","authors":"Rocío González Grande, Ana Bravo Aranda, Inmaculada Santaella Leiva, Susana López Ortega, Miguel Jiménez Pérez","doi":"10.1053/j.seminoncol.2023.05.003","DOIUrl":"10.1053/j.seminoncol.2023.05.003","url":null,"abstract":"<div><p><span><span>Acute liver failure (ALF) requires early and very precise </span>treatment decisions for a diagnosis that is not often easy and may lead to erroneous decisions. Accordingly, we undertook a review of ALF secondary to malignant infiltration given the rarity of the condition, plus its singularity and therapeutic implications. This review should aid in establishing future frameworks for action. Analyze cases of ALF secondary to malignant infiltration in our center during the last 5 years and review the literature. We undertook a retrospective review of all cases of ALF due to malignant infiltration in our center between January 2015 and December 2019. Data were recorded on demographic characteristics, clinical presentation, type of tumor, diagnostic techniques used, treatment and evolution. We also undertook a literature review on the subject and compared the results. AFL secondary to malignant infiltration was diagnosed in five patients, four women and one man with a median age 58 years. The most common clinical presentation was jaundice. Three cases were due to infiltration by hematological tumors (non-Hodgkin lymphoma and histiocytosis), one a </span>cholangiocarcinoma<span> and one lung cancer. In all cases a liver biopsy<span> was required for diagnosis, this being conclusive in four cases; diagnosis in the non-conclusive case was by analysis of the hepatectomy sample after transplantation. Three patients died due to AFL in a mean of 13.8 days, another died 5 months after diagnosis as a consequence of the tumor while the patient with a diagnosis of non-Hodgkin lymphoma and transplant recipient remains alive after a follow-up of 6 years and after receiving chemotherapy. AFL due to malignant infiltration is a very unusual condition but with a high rate of mortality. It requires a rapid and precise diagnosis given the relevant treatment options.</span></span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"50 3","pages":"Pages 71-75"},"PeriodicalIF":4.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9683953","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}