Current Treatment Options in Oncology最新文献

{"title":"Covalent and Non-Covalent BTK Inhibition in Chronic Lymphocytic Leukemia Treatment.","authors":"Pratik V Shah, Douglas E Gladstone","doi":"10.1007/s11864-025-01339-z","DOIUrl":"https://doi.org/10.1007/s11864-025-01339-z","url":null,"abstract":"<p><strong>Opinion statement: </strong>Bruton's tyrosine kinase (BTK) inhibitors are transforming chronic lymphocytic leukemia (CLL) treatment. Given the availability of both covalent and non-covalent BTK inhibitors (BTKis) CLL treatment has become more nuanced. Here the mechanisms of action, efficacy, and resistance patterns associated with both inhibitor classes are reviewed to help create a framework for integrating covalent and non-covalent BTKis into CLL treatment algorithms. Our treatment algorithm based on the available data is as follows, in the frontline setting when oral therapy is preferred/chosen and indefinite therapy is not a deterrent, irrespective of DNA and IGVH mutational status, a second-generation covalent BTK inhibitor (cBTKi) is recommended. In the relapsed/refractory setting when oral therapy is preferred a second-generation cBTKi is preferred. For those suffering disease progression during second generation cBTK, it is recommended to change to an alternative cBTKi and for those exposed to greater than two lines of therapy, challenging to a non-covalent BTKi (ncBTKi) in the form of pirtobrutinib. At the time of disease progression on a BTKi, we recommend testing for resistance mutations. Data on combination therapy's role and time-limited BTKi use remain under active investigation.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Milestone in the Shift from \"Passive Killing\" to \"Active Immunomodulation\" in Cancer Treatment-Progress in Melanoma Vaccine Research.","authors":"Yuke Zhang, Jie Liu, Xiyue Chang, Xuejing Yang, Xinyue Zhang, Wan'an Xiao","doi":"10.1007/s11864-025-01340-6","DOIUrl":"https://doi.org/10.1007/s11864-025-01340-6","url":null,"abstract":"<p><strong>Opinion statement: </strong>Melanoma is the most malignant skin tumor and exhibits extremely aggressive behavior with a high tendency to metastasize. Although the 5-year survival rate of early-stage patients (stage I-II) can reach over 90%, intermediate- and late-stage patients (stage III-IV) still face a high risk of recurrence and metastasis even after surgical resection. Moreover, these patients show low sensitivity to traditional therapies such as chemotherapy and radiotherapy. While immune checkpoint therapies (ICIs) represented by PD-1 inhibitors have significantly improved patient prognosis, they remain ineffective in 30%-40% of cases due to tumor immune escape or microenvironmental suppression. Additionally, long-term use of ICIs may induce autoimmune side effects (e.g., thyroid dysfunction). Therefore, there is an urgent need to develop more precise and durable treatment strategies. Vaccines for the treatment of melanoma represent one of the most promising therapeutic approaches. Melanoma vaccines activate the immune system through antigen recognition, leading to precise tumor killing. The vaccine also induces immune memory, demonstrates safety, and can be combined with immune checkpoint inhibitors to significantly enhance efficacy-making it a vital treatment for postoperative high-risk patients in their pursuit of long-term disease-free survival. With theoretical breakthroughs and technological iterations in immunotherapy, the development of melanoma vaccines has thrived and shown encouraging efficacy in clinical trials. Current mainstream melanoma vaccines are categorized into cell-based, peptide, nucleic acid, and viral types. Remaining challenges include complex and costly production processes, individual variability in therapeutic response, limited efficacy in advanced-stage patients, and potential autoimmune risks. Although melanoma vaccines face many shortcomings and challenges, these difficulties are being actively addressed through innovative strategies. For example, mRNA vaccine optimization involves improving stability and immunogenicity while shortening preparation cycles via enhanced lipid nanoparticle delivery and antigen design; novel vaccine platforms include nanovaccines and phage vaccines; combination therapy strategies entail combining vaccines with immune checkpoint inhibitors or targeted therapies; and using multi-omics analysis and AI to predict neoantigens, screen patients most likely to benefit, and develop efficacy monitoring markers to optimize treatment regimens. Although most melanoma vaccines are still under research, their emergence exemplifies the realization of individualized precision medicine and marks a milestone in the shift from \"passive killing\" to \"active immunomodulation\" in cancer treatment. This study provides an overview of recent research on melanoma vaccines to enable readers to grasp the latest advances in this field.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer-Related Alopecia Risk and Treatment.","authors":"Lily Kaufman, Lilia Valentic, Hannah Moulton, Lucy Rose, Brittany Dulmage","doi":"10.1007/s11864-025-01336-2","DOIUrl":"https://doi.org/10.1007/s11864-025-01336-2","url":null,"abstract":"<p><strong>Opinion statement: </strong>Cancer-related alopecia (CRA) presents a significant challenge for many patients undergoing cancer treatment, often affecting their psychological well-being and sense of identity. In my opinion, the optimal management of CRA requires a proactive, personalized approach that prioritizes both prevention and regrowth, while taking into account the type of cancer therapy, patient goals, and overall clinical context. For patients receiving chemotherapy, especially taxane- or anthracycline-based regimens, scalp cooling should be offered as a first-line preventative option whenever feasible. Its demonstrated effectiveness, particularly when appropriately sequenced with chemotherapy agents, makes it a valuable tool in preserving hair and quality of life. For patients with contraindications to scalp cooling or limited access to this intervention, early counseling and support around hair loss expectations and coping strategies remain critical. In terms of regrowth, topical minoxidil remains the most evidence-based pharmacologic option and should be recommended, especially for patients with endocrine therapy- or chemotherapy-induced alopecia. While oral minoxidil shows promise, it should be used with caution until more robust safety data are available in oncology settings. Spironolactone, tretinoin, prostaglandin analogs, and red light therapy may be considered in select cases, especially when standard options are insufficient, though patients should be counseled on the limitations of available evidence. Ultimately, a patient-centered, multidisciplinary approach is key to optimizing outcomes in CRA care.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Cetuximab in Non-Melanoma Skin Cancer: A Review of Clinical Evidence and Emerging Strategies.","authors":"Imperia Nuzzolese, Stefano Cavalieri, Lisa F Licitra, Salvatore Alfieri","doi":"10.1007/s11864-025-01335-3","DOIUrl":"https://doi.org/10.1007/s11864-025-01335-3","url":null,"abstract":"<p><p>Non-melanoma skin cancers (NMSCs), particularly basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), are the most common malignancies in the Caucasian population. While localized disease has a high cure rate, advanced cases pose therapeutic challenges. The introduction of immune checkpoint inhibitors (ICIs) has revolutionized treatment; however, resistance and contraindications necessitate alternative strategies. Epidermal growth factor receptor (EGFR) inhibition, particularly with cetuximab, has emerged as a potential therapeutic option in cSCC. This review evaluates the role of cetuximab in NMSC, focusing on clinical efficacy, safety, and emerging therapeutic strategies. A literature search was conducted using PubMed and clinical trial databases to identify relevant studies on cetuximab in advanced cSCC and BCC. The review discusses its use as monotherapy, in combination with radiotherapy or chemotherapy, and in the post-ICI setting. Despite the dominance of ICIs in advanced cSCC, cetuximab remains a valuable option, particularly for patients with ICI failure or contraindications. Its role as a radiosensitizer and its potential combination with immunotherapy warrant further investigation. Future studies should clarify optimal sequencing and combination strategies to improve patient outcomes.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Progress of Natural Compounds from Chinese Herbal Medicine in the Treatment of Melanoma.","authors":"Xin Li, Lankang Wang, Baoyi Ni, Jia Wang, Yifeng Sun","doi":"10.1007/s11864-025-01322-8","DOIUrl":"10.1007/s11864-025-01322-8","url":null,"abstract":"<p><strong>Opinion statement: </strong>Melanoma is a malignant tumor that originates from activated or genetically altered epidermal melanocytes, resulting from the interplay of genetic, somatic, and environmental factors. It is the fastest-growing malignancy among the Caucasian population and has a high mortality rate, second only to lung cancer. Current mainstream treatments have led to unavoidable drug resistance and toxic side effects despite improvements in efficacy and prognosis. Traditional Chinese Medicine is a significant component of complementary and alternative medicine, playing a vital role in cancer treatment. Natural compounds derived from Chinese herbal medicines offer notable advantages owing to their multimolecular, multitarget, and multipathway characteristics. These compounds exert anti-melanoma effects through various mechanisms, including antiproliferation, promotion of apoptosis, inhibition of metastasis, suppression of angiogenesis, modulation of autophagy, and enhancement of the immune response. Furthermore, combining natural compounds with mainstream antagonistic medicine not only enhances treatment efficacy but also significantly reverses multidrug resistance. This article discusses the specific mechanisms by which natural compounds combat melanoma and reviews the recent research advancements in this field. It also addresses the challenges faced in the widespread clinical application of these natural compounds in melanoma treatment and outlines the future directions for their development.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"533-568"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desmoplastic Small Round Cell Tumors and the Role of Androgen Receptors.","authors":"Danh D Truong, Roberto Cardenas-Zuniga, Joseph A Ludwig","doi":"10.1007/s11864-025-01334-4","DOIUrl":"10.1007/s11864-025-01334-4","url":null,"abstract":"<p><strong>Opinion statement: </strong>Desmoplastic small round cell tumor (DSRCT) is an aggressive soft-tissue sarcoma driven by the EWSR1::WT1 fusion protein resulting from a chromosomal translocation between the EWSR1 (Ewing sarcoma breakpoint region 1) gene on chromosome 22 and the WT1 (Wilms tumor 1) gene on chromosome 11. This disease typically occurs in post-pubertal adolescent and young adult males, which suggests it may be hormonally driven through the androgen receptor (AR) pathway. Over the years, various groups have established a relationship between AR and DSRCT. Profiling studies have noted a high expression of AR in DSRCT. Fine et al. showed that combined androgen blockade led to a clinical benefit in three (all male) of six patients with stable disease or at least a minor response lasting three months. The AR pathway is relevant not only in prostate cancer but has been discovered to be oncogenic in salivary gland cancers, melanoma, and breast cancer. Though numerous AR-directed therapies are available to treat prostate cancer, AR has not been extensively evaluated as a therapeutic target in DSRCT. Preclinical studies revealed that AR stimulation increased cell proliferation. Conversely, single-agent targeting of the pathway delayed tumor growth in xenograft models. Pharmacodynamic analysis showed that AR inhibition activates the PI3K/Akt/mTOR pathway, and recent epigenetic analysis of AR binding showed that it may interact with EWSR1::WT1 and the forkhead protein family of transcription factors that regulate development and cellular differentiation. A deeper understanding of the impact of AR on the epigenetic landscape and signaling pathway crosstalk of DSRCT promises to expand the therapeutic arsenal of agents available to combat this deadly disease.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"638-647"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventional Therapies to Treat Cancer Associated Pain.","authors":"Kia Lor, Eva Kubrova, Ryan S D'Souza, Chelsey Hoffmann, Dylan Banks, Max Yucheng Jin, Larry J Prokop, Yeng F Her","doi":"10.1007/s11864-025-01337-1","DOIUrl":"10.1007/s11864-025-01337-1","url":null,"abstract":"","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"654-671"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanomedicine-Based Treatments for Rare and Aggressive Ocular Cancers: Advances in Drug Delivery.","authors":"Devesh U Kapoor, Geeta Patel, Bhupendra G Prajapati","doi":"10.1007/s11864-025-01330-8","DOIUrl":"10.1007/s11864-025-01330-8","url":null,"abstract":"<p><strong>Opinion statement: </strong>Ocular cancers, though rare, present significant therapeutic challenges due to their aggressive nature, high metastatic potential and anatomical constraints that limit drug delivery. Conventional therapies, including radiation, enucleation, and chemotherapy, often result in significant side effects and suboptimal outcomes. Recent advancements in nanomedicine offer promising alternatives, utilizing NPs for targeted drug delivery, gene therapy, photodynamic therapy, and brachytherapy. Nanocarriers such as liposomes, polymeric NPs, and lipid-based NPs improve drug bioavailability, reduce systemic toxicity, and enhance treatment efficacy. Additionally, gold and silver NPs serve as effective radiosensitizers, optimizing radiation therapy. Preclinical and clinical studies indicate the potential of nanomedicine-based approaches to revolutionize ocular cancer treatment. However, challenges remain, including optimizing nanoparticle formulations and addressing regulatory hurdles. This review underscores the transformative role of nanotechnology in major and deadly ocular cancers mainly Uveal Melanoma and Retinoblasoma and emphasized cutting-edge drug delivery systems poised to improve therapeutic precision, minimize side effects, and improve patient survival and quality of life.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"569-586"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interrupted Systemic Therapy (Drug Holiday) for Metastatic Sarcoma: Is It Safe?","authors":"Alessandra Maleddu, Cole Wayant","doi":"10.1007/s11864-025-01338-0","DOIUrl":"10.1007/s11864-025-01338-0","url":null,"abstract":"<p><strong>Opinion statement: </strong>Sarcomas are a diverse group of rare, mesenchymal tumors that vary in terms of clinical behavior, aggressiveness, and responsiveness to treatment. The management of metastatic sarcoma is challenging and requires a multidisciplinary approach. Apart from a few subtypes of sarcomas that respond to targeted therapies, the vast majority of metastatic sarcomas are treated with chemotherapy regimens that have been unchanged for decades. These regimens are aggressive and cause clinically relevant toxicity. Despite this, treatment outcomes remain unsatisfactory and prognosis dismal. Metastatic disease is largely incurable, and new strategies are needed to simultaneously control metastatic disease while preserving patients' quality of life. For example, the optimal duration of palliative treatment for patients with metastatic sarcoma is unknown, as is the role and feasibility of planned treatment holidays. Whereas the benefit to patient quality of life from a treatment break can be easily predicted, it is not well understood the influence these treatment \"holidays\" have on overall survival (OS). Herein, we summarize the available literature on drug holidays in sarcoma and offer clinicians updated guidance for managing patients with metastatic disease.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"648-653"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking the Rare but Lethal Cardiac Complications of Immune Checkpoint Inhibitor Therapy: A Review of Mechanisms, Risk Factors, and Management Strategies.","authors":"Laudy Chehade, Noura Abbas, Kristel Dagher, Mohamad Mourad, Ghid Amhez, Mohamad B Moumneh, Lara Kreidieh, Firas Kreidieh, Maria Manuel Pereira, Ali Shamseddine","doi":"10.1007/s11864-025-01329-1","DOIUrl":"10.1007/s11864-025-01329-1","url":null,"abstract":"<p><strong>Opinion statement: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment by enabling the immune system to effectively target and destroy cancer cells. While ICIs offer significant survival benefits across various malignancies, their use is associated with a unique profile of immune-related adverse events, including potentially fatal cardiovascular toxicities. Recent studies have highlighted various cardiac complications associated with ICIs, such as myocarditis, arrhythmias, heart failure, pericarditis, atherosclerosis, and hypertension. These complications arise from mechanisms involving T-cell activation and cytokine release. Patient-related factors such as pre-existing cardiovascular disease, diabetes mellitus, age, gender, and genetic predisposition, along with treatment-related factors like specific ICI regimens, contribute to these toxicities. To manage these complications effectively, comprehensive cardiovascular risk assessment and monitoring before, during, and after ICI therapy are crucial. Adhering to guidelines from the European Society of Cardiology (ESC) and other international organizations allows for early recognition of cardiovascular toxicities and tailored interventions. This review emphasizes the importance of cardioprotective measures, regular monitoring, and multidisciplinary collaboration between oncologists and cardiologists to mitigate cardiovascular risk and optimize patient outcomes. Ongoing research is essential to better understand the mechanisms of ICI-induced cardiovascular toxicities and to develop effective management strategies for affected patients. As we continue to expand the use of ICIs in oncology, balancing oncologic efficacy with cardiovascular safety remains critical.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"605-621"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}