Current Treatment Options in Oncology最新文献

{"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":"<p><p>OPINION STATEMENT: Cancer associated pain (CAP) is challenging to treat and may be complicated by type of cancer, location, presence of metastases, cancer therapies, medical co-morbidities, psychosocial factors, and barriers to treatment. Inadequate CAP management can lead to delays in receiving chemo/radiation therapy, and medications or interventions that provide analgesia. In this narrative review, we aim to provide an evidence-based overview of current and emerging interventional pain techniques used to manage CAP. Intractable visceral cancer pain refractory to conservative medical management can be targeted with ganglion plexus block/neurolysis at the celiac plexus, splanchnic nerve, superior hypogastric plexus, or ganglion impar. Chest wall pain secondary to cancer may benefit from intercostal nerve block or peripheral nerve ablation. Meanwhile, soft tissue pain can be targeted with cryoablation and high intensity focused ultrasound therapies. Vertebral augmentation can be used to treat cancer-related compression fractures. Neuromodulation such as spinal cord stimulation, dorsal root ganglion stimulation, and peripheral nerve stimulation are emerging tools that have been shown to be effective in managing neuropathy and mechanical axial spine CAP. Lastly, the intrathecal drug delivery system has been a mainstay in CAP treatment, especially in patients who cannot tolerate the side effects of oral and intravenous opioids. It has been argued that to effectively manage CAP, interventional procedures should be offered concurrently with conservative medical management.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"654-671"},"PeriodicalIF":5.8,"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":5.8,"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":5.8,"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":"Alternate Dosing Regimens for Vismodegib: A Literature Review.","authors":"Kevin Yang, Hoang Ho-Pham, Collin Pieper, Conway C Huang, Daniel J Bergman","doi":"10.1007/s11864-025-01332-6","DOIUrl":"10.1007/s11864-025-01332-6","url":null,"abstract":"<p><strong>Opinion statement: </strong>Vismodegib is a hedgehog inhibitor used in the treatment of basal cell carcinomas and basal cell nevus syndrome. However, treatment is associated with significant side effects that can impact compliance, including fatigue, muscle cramps, hair loss, and taste disturbance. Multiple strategies to change dosing frequency have been implemented to improve the tolerability. Vismodegib may be administered with non-daily dosing or with drug holidays to improve the side effects associated with administration. Intermittent dosing of vismodegib may be more appropriate for patients with locally advanced BCC and drug holidays may be more suited for patients with basal cell nevus syndrome. The most appropriate strategy in each case though will ultimately depend on patient preference.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"587-591"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144108","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":5.8,"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}

{"title":"The Evolving Landscape of Ovarian Cancer: Innovations in Biotechnology and Artificial Intelligence- Based Screening and Treatment.","authors":"Revathi Unni K, Amrisa Pavithra Elango, Roobanayaki Subramanian, Santhy Ks","doi":"10.1007/s11864-025-01331-7","DOIUrl":"10.1007/s11864-025-01331-7","url":null,"abstract":"<p><strong>Opinion statement: </strong>Ovarian Cancer (OC) is a serious health problem that affects a great number of women globally. It is still one of the deadliest gynecological cancers due to restricted treatment choices and late-stage diagnosis. Worldwide, OC ranks as the seventh most commonly diagnosed kind of malignant neoplasm in women and the eighth leading cause of death in them. Because of several reasons such as genetic and economic ones, the epidemiology of OC shows disparities between races and countries. Lack of public screening program makes it difficult to diagnose this cancer earlier and as a result, most OCs are detected after they have progressed to other parts. However, advances in biotechnology and artificial intelligence (AI) are transforming both early detection and treatment strategies. Over the years, the application of AI in OC screening has shown promising results. The best way to get the drawbacks of traditional treatment methods is to combine newly developed strategies with existing treatment choices. Additionally, clinical researches are crucial to ensure the practical implementation of these advancements in healthcare settings. Utilizing state-of-the-art technologies and creative strategies will offer significant opportunity to lessen the worldwide impact of this curable cancer thereby enhancing women's quality of life in low and middle income countries (LMICs) and beyond. Hence, this review explores recent breakthroughs in ovarian cancer screening and therapy, highlighting the synergistic role of biotechnology and AI in improving patient outcomes that reshapes the ovarian cancer treatment landscape.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"622-637"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250665","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":"Targeted Therapy and Immunotherapy in Elderly Patients with Metastatic Colorectal Cancer.","authors":"Wenjie Huang, Yunpeng Liu","doi":"10.1007/s11864-025-01326-4","DOIUrl":"10.1007/s11864-025-01326-4","url":null,"abstract":"<p><strong>Opinion statement: </strong>At initial diagnosis, over half of the patients with metastatic colorectal cancer (mCRC) are aged 65 years or older. In this population, age-related declines in organ reserve and the presence of comorbidities can significantly weaken drug tolerance and affect treatment outcomes. However, existing clinical guidelines, largely based on clinical trials involving younger, fitter adults, may not be fully applicable to older patients, particularly those are vulnerable. Moreover, chronologic age and commonly used performance assessment tools, such as the Eastern Cooperative Oncology Group and Karnofsky Performance Status scores, are insufficient for accurate evaluation of physiological fitness in older adults. To provide evidence-based references for clinicians, this review summarizes advances in targeted therapy and immunotherapy for elderly patients with mCRC over the past five years, with a focus on vascular endothelial growth factor (VEGF) targeting agents, epidermal growth factor receptor (EGFR) inhibitors, multi-targeted tyrosine kinase inhibitors (TKIs) and single-agent immunotherapy. Overall, for elderly patients assessed as fit, first-line treatment may include dose-reduced doublet chemotherapy combined with VEGF targeting agents, or alternatively, single-agent chemotherapy plus VEGF targeting agents. For vulnerable elderly patients with mCRC, single-agent chemotherapy with VEGF targeting agents remains the preferred first-line strategy, while RAS wild-type left-sided tumors may benefit from single-agent chemotherapy plus EGFR inhibitors. Although multi-targeted TKIs have shown positive outcomes in elderly patients who are intolerant to other therapies. There is currently no evidence supporting their use in first-line treatment or combination therapy. In terms of immunotherapy, similar to the general mCRC population, single-agent immunotherapy is recommended as a first-line option for elderly microsatellite instability-high/mismatch repair-deficient patients. Notably, integrating comprehensive geriatric assessment into clinical practice can facilitate personalized treatment strategies, particularly for vulnerable and frail patients.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"592-604"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086191","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 Improving Outcomes in Relapsed-Refractory Diffuse Large B Cell Lymphoma: The Role of CAR T-Cell Therapy.","authors":"Vibor Milunović, Dora Dragčević, Martina Bogeljić Patekar, Inga Mandac Smoljanović, Slavko Gašparov","doi":"10.1007/s11864-025-01305-9","DOIUrl":"10.1007/s11864-025-01305-9","url":null,"abstract":"<p><strong>Opinion statement: </strong>Diffuse large B cell lymphoma, not otherwise specified (DLBCL-NOS) is the most common aggressive lymphoma and can be cured with CHOP-R immunochemotherapy in 60% of cases. The second-line therapy includes salvage regimens followed by autologous stem cell transplantation (ASCT), which offers a cure to a minority of patients due to limitations in efficacy and eligibility. These data present the unmet need in the field, and this review article focuses on how second-generation chimeric antigen receptor T (CAR T) cell therapy targeting CD19 antigen may improve the outcomes with relapsed/refractory DLBCL. In heavily pretreated patients, who have dismal outcomes with conventional therapy, all three approved products-tisangenlecleucel (tisa-cel), axicabtagene ciloleucel (axi-cel), and lisocabtagene maraleucel (liso-cel) have shown durable, unprecedented complete responses with the potential for cure. When compared to salvage regimens and ASCT as the standard of care, axi-cel and liso-cel, unlike tisa-cel, have demonstrated superiority in long-term control. In ASCT-ineligible r/r DLBCL, liso-cel has shown a favourable benefit-risk ratio. Regarding safety, two adverse events of interest have emerged: cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, both of which are manageable. Real-world evidence reflects the results of pivotal trials while favouring axi-cel in heavily pretreated patients, albeit with higher toxicity. The main barrier to the implementation of this treatment modality is the cost associated with the process of CAR T therapy, along with complications and reimbursement issues. However, the barriers can be overcome, and CAR T therapy has the potential to become the standard of care in relapsed/refractory DLBCL. Furthermore, with advances in the scientific engineering of CAR products and the understanding of novel treatment modalities currently being tested in clinical trials, we believe that targeted cellular therapy will become the future of relapsed/refractory DLBCL treatment.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"445-464"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052057","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":"Advances in Targeted Therapy for Metastatic Prostate Cancer.","authors":"Kabir Grewal, Tanya B Dorff, Sagar S Mukhida, Neeraj Agarwal, Andrew W Hahn","doi":"10.1007/s11864-025-01323-7","DOIUrl":"10.1007/s11864-025-01323-7","url":null,"abstract":"<p><strong>Opinion statement: </strong>Over the past few years, treatment for advanced prostate cancer has begun shifting away from a one-size-fits-all approach toward biomarker-based therapies for select groups of patients. This review highlights the role of poly-ADP-ribose-polymerase (PARP) inhibitors in metastatic prostate cancer, emerging strategies to target the androgen receptor (AR), and innovative therapies aimed at cell surface proteins, including radioligand therapies, bispecific T cell engagers, and antibody-drug conjugates. For patients with homologous recombination repair (HRR)-mutated metastatic castration-resistant prostate cancer (CRPC), we favor combining a PARP inhibitor (PARPi) with an AR pathway inhibitor (ARPI), provided they can tolerate a more aggressive treatment strategy. In our opinion, patients with BRCA1 or BRCA2 mutations who are unable to handle combination therapy benefit from PARPi monotherapy. We are enthusiastic about the potential of ongoing clinical trials for new AR-directed therapies, such as AR ligand-directed degraders and CYP11A1 inhibitors, in metastatic CRPC. These treatments are expected to be most beneficial for patients whose cancer continues to rely on AR pathway signaling, suggesting they might also be effective in earlier stages of the disease. Progress in drug development and understanding of protein structures has led to new therapies that target cell surface proteins predominantly found in prostate cancer. We use ¹⁷⁷Lu-PSMA-617 for patients with PSMA avid metastatic CRPC who have progressed on an ARPI and a taxane chemotherapy. Additionally, we see promising potential in bispecific T-cell engagers (e.g., STEAP1-CD3 and PSMA-CD3) and novel radioligand therapies, including those utilizing actinium, to target these proteins. These advances show great promise in further enhancing survival for patients with metastatic prostate cancer.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"465-475"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055431","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":"Role of Radiotherapy in PCNSL within the Current Therapeutic Landscape: a Comprehensive Review.","authors":"Min Li, Ran Peng, Fang Bao, Hongmei Jing, Hao Wang","doi":"10.1007/s11864-025-01327-3","DOIUrl":"10.1007/s11864-025-01327-3","url":null,"abstract":"<p><strong>Opinion statement: </strong>The therapeutic landscape for primary central nervous system lymphoma (PCNSL) continues to evolve, raising critical questions about the optimal integration of whole-brain radiotherapy (WBRT) to improve patient outcomes. Historically, WBRT has been a cornerstone in PCNSL management, offering effective disease control and relapse prevention. However, the use of high-dose WBRT (HD-WBRT) (≥ 36 Gy), while efficacious, has been associated with significant neurotoxicity, particularly in elderly patients, which has curtailed its long-term applicability. In recent years, high-dose chemotherapy combined with autologous stem cell transplantation (HDT-ASCT) has emerged as a consolidative treatment option, demonstrating efficacy comparable to WBRT, especially in younger patients and those with better performance status, thereby reshaping the therapeutic paradigm. As the therapeutic paradigm shifts, efforts to explore advances in WBRT techniques, such as dose reduction (23.4 Gy) and hyperfractionated protocols, have been aimed at mitigating neurotoxicity while maintaining therapeutic efficacy. These innovations make WBRT a viable option for carefully selected patient populations. Furthermore, this review explores emerging strategies, including localized radiotherapy, novel therapeutic combinations, and individualized treatment paradigms, while identifying key directions for future research to optimize outcomes for PCNSL patients.</p>","PeriodicalId":50600,"journal":{"name":"Current Treatment Options in Oncology","volume":" ","pages":"486-499"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038959","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}