Therapeutic Advances in Medical Oncology最新文献

{"title":"Role of radiotherapy in the treatment of <i>EGFR</i>-mutant non-small-cell lung cancer: a narrative review.","authors":"Qian Wang, Fengxin Sun, Meng Wu, Zhaoyun Liu, Shuangqing Lu, Rong Xiao, Xueqi Xie, Minxin Chen, Xiaozheng Sun, Xiaoke Xing, Baochao Wei, Jinming Yu, Dawei Chen","doi":"10.1177/17588359261432059","DOIUrl":"https://doi.org/10.1177/17588359261432059","url":null,"abstract":"<p><p>The emergence of targeted therapies, such as epidermal growth factor receptor (<i>EGFR</i>) and anaplastic lymphoma kinase inhibitors, has marked a new chapter in the management of non-small-cell lung cancer (NSCLC). However, monotherapy with targeted agents often falls short in achieving optimal outcomes. The addition of radiotherapy (RT) has been shown to enhance therapeutic efficacy in various clinical settings. The LAURA trial (consolidation osimertinib) and POLESTAR trial (consolidation aumolertinib) suggest that targeted consolidation therapy following chemoradiotherapy is a promising approach for Stage III unresectable <i>EGFR</i>-mutant NSCLC. The integration of radiation with targeted therapies, while promising, is complex and requires ongoing research and multidisciplinary efforts to optimize patient outcomes. This review examines the role of radiotherapy in treating <i>EGFR</i>-mutant NSCLC across various stages, highlighting the significance of minimal residual disease and circulating tumor DNA, and identifies key challenges for advancing the field.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"18 ","pages":"17588359261432059"},"PeriodicalIF":4.2,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-level HBV viremia independently predicts poor outcomes in patients with intermediate-to-advanced HBV-related hepatocellular carcinoma receiving systemic therapy: a multicenter retrospective study.","authors":"Jin Lei, Huaxing Ma, Xiong Chen, Ling Lin, Zhipeng Liang, Guangling Ou, Jiliang Jin, Hongyuan Dai, Ya Zhang, Mei Liu, Haiyang Li, Yinying Lu","doi":"10.1177/17588359261435330","DOIUrl":"https://doi.org/10.1177/17588359261435330","url":null,"abstract":"<p><strong>Background: </strong>Low-level hepatitis B viremia is recognized as a potential driver of hepatocarcinogenesis; however, its prognostic impact on patients with advanced hepatocellular carcinoma (HCC) receiving systemic therapy remains poorly defined.</p><p><strong>Objective: </strong>To determine the independent prognostic impact of low-level viremia (LLV; HBV DNA 20-2000 IU/mL) compared with maintained virologic response (MVR; HBV DNA < 20 IU/mL) in patients with intermediate-to-advanced HBV-related HCC undergoing systemic therapy, and to evaluate whether on-treatment viral status serves as a superior predictor to baseline HBV DNA levels.</p><p><strong>Design: </strong>This was a multicenter retrospective cohort study.</p><p><strong>Methods: </strong>A total of 1814 patients treated at three centers between 2020 and 2024 were retrospectively enrolled. After ⩾4 months of follow-up, patients were classified into LLV (<i>n</i> = 860) or maintained virologic response (MVR; HBV DNA < 20 IU/mL, <i>n</i> = 954) groups. Overall survival (OS) and progression-free survival (PFS) were the primary endpoints. Logistic regression identified risk factors for LLV; Cox proportional hazards models assessed independent prognostic factors. Subgroup analyses were performed by treatment regimen and baseline HBV DNA load.</p><p><strong>Results: </strong>Multifactorial analysis identified HBeAg positivity (OR 1.971, 95% CI 1.53-2.541, <i>p</i> < 0.001), AST > 40 U/L (OR 1.437, 95% CI 1.126-1.832, <i>p</i> = 0.004), extrahepatic metastasis (OR 1.640, 95% CI 1.187-2.266, <i>p</i> = 0.003), and detectable baseline HBV DNA (OR 2.482, 95% CI 2.002-3.077, <i>p</i> < 0.001) as independent risk factors for LLV. Compared with the MVR group, patients in the LLV group had significantly reduced PFS (8.3 vs 14.3 months, <i>p</i> < 0.001) and OS (25.5 vs 37.8 months, <i>p</i> < 0.001). Multivariate analysis identified LLV as an independent predictor of worse OS (HR 1.506, 95% CI 1.299-1.746). Baseline HBV DNA load was not associated with survival.</p><p><strong>Conclusion: </strong>LLV is a robust, independent indicator of poor prognosis in systemic-treated intermediate-to-advanced HBV-HCC and should be preferred to baseline HBV DNA load for risk stratification and to guide intensified antitumor therapy.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"18 ","pages":"17588359261435330"},"PeriodicalIF":4.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S100A4 characterize antigen-presenting cancer-associated fibroblasts and predicts surgical outcomes in relapsed ovarian cancer.","authors":"Yilizhati Maimaiti, Yulian Chen, Longxia Li, Meichun Cai, Zeyun Li, Lifeng Lin, Shangbing Gao, Guanglei Zhuang, Wei Wu, Rongyu Zang","doi":"10.1177/17588359261436959","DOIUrl":"https://doi.org/10.1177/17588359261436959","url":null,"abstract":"<p><strong>Background: </strong>Relapsed ovarian cancer (ROC) presents significant therapeutic challenges, and complete resection during secondary cytoreductive surgery (SCR) has been associated with improved survival. However, the contribution of the tumor microenvironment (TME), particularly cancer-associated fibroblasts (CAFs), to surgical outcomes remains unclear.</p><p><strong>Objectives: </strong>This study aimed to characterize CAFs heterogeneity in ROC and identify specific CAF subsets associated with immune modulation and surgical prognosis.</p><p><strong>Design: </strong>A multi-platform integrative study combining spatial, single-cell, and transcriptomic analyses to investigate CAF phenotypes and their clinical relevance in ROC.</p><p><strong>Methods: </strong>Multiplex immunohistochemistry and spatial digital phenotyping were performed on 31 ROC samples. Single-cell RNA sequencing (scRNA-seq) was conducted on 11 tumors to define CAF clusters. Transcriptomic meta-analysis across multiple external datasets was used to evaluate prognostic significance. Spatial relationships between CAF subsets and immune cells were analyzed, and antigen-presenting CAF signatures were assessed based on marker co-expression patterns.</p><p><strong>Results: </strong>We identified a predominant S100A4⁺ CAFs population enriched in the tumor-adjacent stroma, characterized by extracellular matrix remodeling and immune-regulatory gene expression. S100A4⁺ CAFs displayed closer spatial proximity to T cells and were significantly associated with complete tumor resection (R0) outcomes. Furthermore, a distinct antigen-presenting subset co-expressing CD74 (S100A4⁺apCAFs) exhibited enhanced interaction with CD4⁺ T cells and was significantly enriched in R0 patients. Meta-analysis across multiple transcriptomic datasets revealed that high expression of S100A4⁺apCAFs-related genes correlated with improved overall survival (hazard ratio = 0.81, 95% confidence interval: 0.69-0.95).</p><p><strong>Conclusion: </strong>This study identifies S100A4⁺ CAFs-particularly the antigen-presenting S100A4⁺apCAF subset-as key components of the ROC microenvironment linked to favorable immune contexture and surgical outcomes. These findings highlight S100A4⁺apCAFs as potential prognostic biomarkers and immunomodulatory targets, offering new perspectives for personalized therapeutic strategies in ROC.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"18 ","pages":"17588359261436959"},"PeriodicalIF":4.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of CMTM6 expression with clinicopathological characteristics and prognostic implications in renal cell carcinoma.","authors":"Gennadi Tulchiner, Josef Fritz, Peter Rehder, Jasmin Bektic, Bettina Zelger, Lukas Jelisejevas, Andrea Brunner, Michael Ladurner","doi":"10.1177/17588359261430569","DOIUrl":"https://doi.org/10.1177/17588359261430569","url":null,"abstract":"<p><strong>Background: </strong>Renal cell carcinoma (RCC) is characterized by considerable heterogeneity and variable clinical outcomes. The identification of reliable biomarkers is crucial to improve prognostic assessment and therapeutic decision-making. CMTM6 (chemokine-like factor-like MARVEL transmembrane domain-containing protein 6) has emerged as a regulator of programmed death ligand-1 (PD-L1), a key immune checkpoint protein involved in tumor immune evasion.</p><p><strong>Objectives: </strong>The main objective of the study was to investigate the expression and prognostic significance of CMTM6 and to establish an automated immunohistochemical analysis.</p><p><strong>Design: </strong>This was a retrospective analysis conducted at a single center.</p><p><strong>Methods: </strong>Tumor samples from 111 patients who underwent partial nephrectomy for localized RCC between 2006 and 2019 were retrospectively analyzed. CMTM6 expression in tumor cells and tumor-infiltrating immune cells (ICs) was quantified using automated digital image analysis of immunohistochemically stained slides. Associations between CMTM6 expression, clinicopathological features, and patient outcomes were evaluated.</p><p><strong>Results: </strong>CMTM6 expression was heterogeneous across RCC samples, with significantly higher levels observed in clear cell RCC compared to non-clear cell subtypes. Elevated CMTM6 expression in ICs correlated with reduced overall survival (<i>p</i> = 0.049) and shorter time to metastasis (<i>p</i> = 0.009). Conversely, in patients with metastatic RCC receiving systemic therapy, lower CMTM6 expression was associated with shorter progression-free survival (<i>p</i> = 0.047). However, lower CMTM6 scores were also significantly associated with more unfavorable outcome according to prognostic group defined by the Stage, Size, Grade, and Necrosis risk model for localized RCC.</p><p><strong>Conclusion: </strong>CMTM6 expression represents a promising prognostic biomarker in RCC, with differential associations depending on disease stage and treatment setting. Its correlation with established clinical risk classifications underscores its potential utility in prognostic refinement. Given its regulatory role in PD-L1 expression, CMTM6 may also represent a therapeutic target, with implications for optimizing immunotherapeutic strategies in RCC. Further validation in larger cohorts and prospective studies are warranted.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"18 ","pages":"17588359261430569"},"PeriodicalIF":4.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updated cost comparison of home care subcutaneous versus outpatient intravenous trastuzumab for HER2-positive breast cancer in Singapore.","authors":"Yanting Ouyang, Yi Ting Ng, Wei Wei Hong, Nicholas Graves","doi":"10.1177/17588359261421557","DOIUrl":"10.1177/17588359261421557","url":null,"abstract":"<p><strong>Background: </strong>With major changes in effective drug prices, we updated our earlier cost-minimization analysis comparing home-based subcutaneous (SC) trastuzumab with outpatient intravenous (IV) trastuzumab for HER2-positive breast cancer in Singapore.</p><p><strong>Objectives: </strong>To compare updated annual per-patient costs of home care SC versus outpatient IV trastuzumab.</p><p><strong>Design: </strong>A cost-minimization analysis was performed.</p><p><strong>Methods: </strong>We conducted a model-based cost-minimization analysis using micro-costing from a societal perspective, incorporating both direct and indirect costs. A Monte Carlo simulation was performed to account for parameter uncertainties.</p><p><strong>Results: </strong>Annual per-patient cost was S$21,790 (95% uncertainty interval (UI): S$19,662-23,922) for home care versus S$6949 (95% UI: S$5347-10,782) for outpatient care, representing a 214% increase. While service delivery (manpower, facility, consumables) and productivity loss remained cheaper in home care, drug cost is the dominant factor of overall expenditure in trastuzumab delivery.</p><p><strong>Conclusion: </strong>At current drug prices, outpatient IV trastuzumab administration is the cost-saving option, compared with home care SC trastuzumab.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"18 ","pages":"17588359261421557"},"PeriodicalIF":4.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13018705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness, safety, and biomarker analysis of sacituzumab govitecan in Chinese metastatic breast cancer: a multicenter real-world study.","authors":"Mu Li, Die Sang, Jin-Feng Zhang, Peng Yuan, Gang Li, Mei Yang, Cheng-Cheng Gong, Yi-Zhao Xie, Yi-Fan Chen, Shu-Ting Li, Qi-Xuan Zhao, Yan-Nan Zhao, Bi-Yun Wang","doi":"10.1177/17588359261430556","DOIUrl":"10.1177/17588359261430556","url":null,"abstract":"<p><strong>Background: </strong>Sacituzumab govitecan (SG), an anti-Trop-2 antibody-drug conjugate (ADC), was approved for metastatic triple-negative breast cancer (mTNBC) with ⩾1 prior therapy and hormone receptor-positive (HoR+) breast cancer progressing on cyclin-dependent kinase 4/6 inhibitor and chemotherapy. However, little real-world evidence is available in China, and the potential predictive biomarker of SG has not been fully investigated.</p><p><strong>Objectives: </strong>Our study aimed to evaluate the effectiveness, safety, and biomarker of SG in Chinese metastatic breast cancer (MBC) patients.</p><p><strong>Design: </strong>A total of 165 MBC patients treated with SG between June 2023 and December 2024 in 4 institutions nationwide were included in this study. SG was administered intravenously at a dosage of 10 mg/kg on days 1 and 8 of a 21-day treatment cycle.</p><p><strong>Methods: </strong>Demographic and clinical data were retrospectively collected and analyzed. Clinical outcomes included real-world progression-free survival (rwPFS), overall survival (OS), objective response rate (ORR), disease control rate, and toxicity.</p><p><strong>Results: </strong>In 103 mTNBC patients, median rwPFS was 5.1 months (95% confidence interval (CI): 3.8-7.4) and median rwOS was 19.7 months (95% CI: 17.3-not reached); in 62 HoR+HER2- patients, median rwPFS was 5.8 months (95% CI: 4.7-7.9), and OS data were immature. Prior PD-1/PD-L1 inhibitors exposure in TNBC showed significantly shorter rwPFS (<i>p</i> = 0.025) in multivariate analysis. Longer rwPFS was observed in patients receiving SG as front line (line 1-2) compared to later line (line ⩾3) in both populations. mTNBC patients harboring <i>PIK3CA</i> mutation were associated with reduced PFS of SG (<i>p</i> = 0.034). No new safety signal was observed in this study.</p><p><strong>Conclusion: </strong>In conclusion, SG showed similar effectiveness with ASCENT and TROPiCS-02 study in heavily pretreated Chinese MBC patients. Given the compromised effectiveness in patients with prior PD-1/PD-L1 inhibitors or <i>PIK3CA</i> mutation, future investigations are warranted to explore SG-based combination regimens or novel therapeutic strategies in the above population.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"18 ","pages":"17588359261430556"},"PeriodicalIF":4.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13018686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic disease progression in non-metastatic nasopharyngeal carcinoma post-radical radiotherapy: a Markov model-based analysis in a Chinese cohort.","authors":"Ying Li, Zongwei Huang, Zihan Chen, Ting Lin, Jue Wang, Qisi Zhang, Jiajia Zheng, Yuye Lin, Jinghua Lai, Zhiming Zhong, Sufang Qiu","doi":"10.1177/17588359261433798","DOIUrl":"10.1177/17588359261433798","url":null,"abstract":"<p><strong>Background: </strong>The evolution of nasopharyngeal carcinoma (NPC) involves potential transitions among states of recurrence, metastasis, and/or remission. Understanding the dynamics of NPC progression following radical radiotherapy may help optimize surveillance protocols and patient management.</p><p><strong>Objectives: </strong>To characterize the progression dynamics of NPC following radical radiotherapy.</p><p><strong>Design: </strong>A retrospective study.</p><p><strong>Methods: </strong>The cohort comprised NPC patients who underwent radical intensity-modulated radiotherapy between 2016 and 2022. A multi-state Markov model was employed to estimate transition intensities and probabilities across various disease states, including failure-free, single failure event (recurrence or metastasis, R/M), multi-event progression (recurrence and metastasis, R&M), and death. A Shiny-based web tool was developed to facilitate the clinical translation of the model.</p><p><strong>Results: </strong>A total of 4800 NPC patients were included, yielding 18,641 disease-state assessments, with a median follow-up of 3.3 years. The transition intensity from metastasis to death (0.025, 95% confidence interval (CI), 0.021-0.029) was 2.3 times greater than that from recurrence to death (0.011, 95% CI, 0.009-0.014). The estimated probabilities of remaining failure-free, experiencing R/M, and deteriorating to death were 89.9%, 7.7%, and 2.1% at 2 years, respectively. Among patients with recurrence, the probabilities of progression to metastasis and death were 3.8% and 24.5%; among those with metastasis, the probabilities of progression to recurrence and death were 2.1% and 45.0%, respectively. Increasing age, male sex, advanced TNM stage, higher pre-treatment Epstein-Barr virus (EBV) DNA, and detectable post-treatment EBV DNA were associated with treatment failure. A web tool was developed to predict NPC disease-state transitions at 2 years.</p><p><strong>Conclusion: </strong>These findings provide initial evidence on the dynamic progression of NPC, which may inform clinical management and patient counseling. Risk-stratified screening and targeted interventions could help mitigate disease progression.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"18 ","pages":"17588359261433798"},"PeriodicalIF":4.2,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of concomitant use of renin-angiotensin system inhibitors on survival in patients with pancreatic ductal adenocarcinoma: a systematic review and meta-analysis.","authors":"Leszek Kraj, Paulina Chmiel, Alicja Skrobucha, Hanna Grabowska, Łukasz Szymański, Piotr T Wysocki, Michał Peller","doi":"10.1177/17588359251404266","DOIUrl":"10.1177/17588359251404266","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic ductal adenocarcinoma (PDAC) is characterized by poor prognosis and limited therapeutic options, particularly in the metastatic setting. Novel strategies to overcome treatment resistance are highly anticipated and may potentially include the repurposing of existing pharmacologic agents.</p><p><strong>Objectives: </strong>To prove the positive effect of angiotensin II receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs) on survival in PDAC.</p><p><strong>Design: </strong>A systematic review and meta-analysis were conducted based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.</p><p><strong>Data sources and methods: </strong>A systematic search of PubMed, Web of Science, and Cochrane databases was conducted to identify studies evaluating survival outcomes in patients with PDAC receiving concomitant treatment with ARBs or ACEIs. Survival outcomes were analyzed with random-effects models using hazard ratios (HRs) and 95% confidence intervals (CIs) extracted from included trials. Studies without sufficient survival data were reviewed qualitatively only.</p><p><strong>Results: </strong>A total of 14 studies, comprising a total of 19,287 patients, met the inclusion criteria. Results indicated that the concurrent treatment with ACEIs or ARBs in patients with PDAC was associated with significantly improved overall survival compared to no use (HR = 0.80; 95% CI: 0.76-0.86; <i>p</i> < 0.001). The survival benefit associated with the concomitant ACEI/ARB treatment was observed both in the curative setting (HR = 0.78, 95% CI 0.65-0.93, <i>p</i> = 0.007) and the non-curative setting (HR = 0.83, 95% CI 0.76-0.90, <i>p</i> < 0.001). Three studies without sufficient survival data for meta-analysis reported other potential benefits associated with the ACEI/ARB use.</p><p><strong>Conclusion: </strong>Our meta-analysis supports the efficacy of renin-angiotensin system inhibitors as concomitant therapy in patients with PDAC. Prospective randomized clinical trials are warranted to validate ACEI/ARB as adjunctive therapy in well-defined PDAC patient populations.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"18 ","pages":"17588359251404266"},"PeriodicalIF":4.2,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An intriguing journey into the hereditary syndromes predisposing to endometrial cancer: more than believed.","authors":"Daniele Fanale, Luigi Magrin, Lidia Rita Corsini, Erika Pedone, Chiara Brando, Tancredi Didier Bazan Russo, Pietro Ferraro, Karen Carobene, Elga Adriana Cipolla, Giovanni Colletta, Mattia Puglisi, Antonio Galvano, Salvatore Vieni, Gianni Pantuso, Antonino Giulio Giannone, Giuseppe Badalamenti, Lorena Incorvaia, Antonio Russo, Viviana Bazan","doi":"10.1177/17588359261425078","DOIUrl":"10.1177/17588359261425078","url":null,"abstract":"<p><p>Endometrial cancer (EC) is a gynecologic neoplasm with a constantly increasing incidence, especially in high-income countries. Obesity, diabetes, old age, and genetic predisposition account for the main risk factors. Genetic knowledge has steadily increased from the historical clinicopathological classification into two pathogenic types to the molecular subdivision into four groups, highlighting that EC is not a single entity, but rather the sum of different molecular diseases with different prognoses. About 5%-10% of ECs show a hereditary basis attributable to germline pathogenic variants (PVs) in different susceptibility genes, including <i>MMR</i> (<i>MLH1</i>, <i>MSH2</i>, <i>MSH6</i>, and <i>PMS2</i>), <i>POLE/POLD1</i>, <i>PTEN</i>, <i>BRCA1/2</i>, <i>MUTYH</i>, <i>NTHL1</i>, <i>STK11</i>, which confer an increased risk of developing an early onset EC. Lynch syndrome is the main inherited disorder predisposing to EC, followed by other hereditary conditions, including Cowden syndrome, polymerase proof-reading associated polyposis, <i>NTHL1</i>-associated syndrome, hereditary breast and ovarian cancer syndrome, <i>MUTYH</i>-associated polyposis, and Peutz-Jeghers syndrome. Genetics has been shown to affect several aspects of disease, including carcinogenesis, onset age, clinicopathological features, prognosis, and therapy response. In this review, we will investigate the impact of germline PVs in different genes on genetic susceptibility to the development of inherited EC, discussing the potential cancer risk in mutation carriers as well as prognostic implications and current therapeutic approaches, also evaluating the possibility of carrying out a more extensive routine genetic analysis for EC women, in order to increase the diagnostic power, improve prevention and surveillance strategies in genetically predisposed subjects, and implement tailored therapies.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"18 ","pages":"17588359261425078"},"PeriodicalIF":4.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary report on advanced biliary cancer patients receiving multimodality treatment in the immunotherapy era: a real-world multicentre experience.","authors":"Massimiliano Salati, Eleonora Borghi, Riccardo Cuoghi Costantini, Alessandro Parisi, Alessia Lancianese, Andrea Palloni, Chiara Ricci, Ingrid Garajova, Elena Orlandi, Ina Valeria Zurlo, Angelica Petrillo, Anna Diana, Angela Dalia Ricci, Alessandro Rizzo, Martina Manni, Ornella Garrone, Massimo Dominici, Michele Ghidini","doi":"10.1177/17588359261426823","DOIUrl":"10.1177/17588359261426823","url":null,"abstract":"<p><strong>Background: </strong>Advanced biliary cancer (ABC) is still regarded as an incurable condition. However, the improved depth and duration of response enabled by chemo-immunotherapy may foster intensified strategies, including surgical procedures, radiotherapy and intra-arterial techniques.</p><p><strong>Objectives: </strong>The prevalence, clinical features and treatment outcomes of ABC receiving multimodality treatment in the immunotherapy era are unknown.</p><p><strong>Design: </strong>Newly diagnosed ABC treated with chemo-immunotherapy and loco-regional procedures from February 2022 to December 2024 were retrospectively identified at 10 tertiary referral cancer centres in Italy.</p><p><strong>Methods: </strong>Categorical variables were compared using the chi-squared test, and the inverse probability of treatment weighting analysis was performed to reduce selection biases.</p><p><strong>Results: </strong>Of 241 ABC receiving first-line treatment, 12 (4.9%) fulfilled the inclusion criteria. The median age was 69 (range 36-80), and 9 patients (75%) had intrahepatic cholangiocarcinoma (iCCA). Ten (83.3%) presented with de novo unresectable ABC: 3 (25%) had locally advanced, and 7 (50.3%) had metastatic disease. The median number of metastatic sites was one, with lymph nodes being the most commonly involved location (41.6%, <i>n</i> = 5). Patients treated with intensified therapy were more likely to have low tumour burden (<i>p</i> = 0.03) and iCCA (<i>p</i> = 0.06). Overall, four patients underwent surgery, three transarterial radioembolization, three stereotactic body radiotherapy and two liver transplants. As of data cut-off, 11 patients were alive (91.6%), and five patients were disease-free (41.6%). After adjusting for age, gender, Eastern Cooperative Group Performance Status (ECOG PS), primary site, disease status and number of metastases, the overall survival for the multimodality strategy versus systemic treatment alone was not reached versus 14.1 months (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>This study, the first on multimodality treatment of ABC in the immunotherapy era, suggests that a highly selected subset of patients may achieve long-term disease control with an intensified approach. Oligometastatic patients and those affected by iCCA appear as the best candidates. Future studies are needed to confirm these preliminary findings.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"18 ","pages":"17588359261426823"},"PeriodicalIF":4.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}