{"title":"Personalized approaches to breast radiotherapy: strategies for treatment refinement.","authors":"Diana A Roth O'Brien, Lior Z Braunstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Radiotherapy (RT) is a crucial component of the adjuvant treatment of breast cancer that often follows breast conservation or mastectomy to further reduce the risk of local recurrence. As outcomes improve and our understanding of disease biology advances, interest is growing in de-escalating RT to minimize the treatment burden and side effects while maintaining oncologic outcomes. This review examines the evidence and summarizes the results of ongoing trials evaluating RT de-escalation strategies in breast cancer. We discuss hypofractionation and ultrahypofractionation for whole breast irradiation, showing efficacy comparable with that of conventional fractionation with improved convenience. The role of accelerated partial breast irradiation is explored, with an emphasis on its benefits and the importance of patient selection. We review data supporting omission of RT in selected patients with low-risk, early-stage disease, particularly older women with hormone receptor-positive disease. Ongoing research into biomarker-guided RT de-escalation is addressed, including trials using genomic assays and immunohistochemistry. Emerging data on RT de-escalation in HER2-positive and triple-negative breast cancers are discussed. Finally, we explore de-escalation strategies for locally advanced disease, including hypofractionation for post-mastectomy RT and potential omission of regional nodal irradiation after neoadjuvant chemotherapy for those with an excellent response. These strategies may allow more personalized approaches to RT, potentially improving quality of life without compromising oncologic outcomes.</p>","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 1","pages":"30-39"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Novel approaches to optimization of drug dosages.","authors":"Charles F Manski","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 1","pages":"26-27"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is MRD testing ready for general use in chronic lymphocytic leukemia?","authors":"Carolyn Owen","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 1","pages":"21-22"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Circulating tumor DNA in early-stage breast cancer: ready for the clinic?","authors":"Heather A Parsons","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"22 10","pages":"507-509"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Highlights in neuroendocrine tumors from the 2024 North American Neuroendocrine Tumor Society (NANETS) Multidisciplinary NET Medical Symposium.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"22 Suppl 8 10","pages":"1-16"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Choosing between CAR T-cell therapy and pirtobrutinib in double-refractory CLL.","authors":"Kerry A Rogers","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"22 10","pages":"494-496"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Forat G Lutfi, Nausheen Ahmed, Marc S Hoffmann, Aung Tun, Joseph P McGuirk
{"title":"The emergence of bispecific T-cell engagers in the treatment of follicular and large B-cell lymphomas.","authors":"Forat G Lutfi, Nausheen Ahmed, Marc S Hoffmann, Aung Tun, Joseph P McGuirk","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The rapid emergence of CD20-targeting T-cell engagers in follicular lymphoma and large B-cell lymphoma has further expanded the treatment options for patients with relapsed or refractory disease. Herein, we review and discuss the standard-of-care products and indications for mosunetuzumab, epcoritamab, and glofitamab. We provide a detailed overview of the registrational clinical trials, as well as a review of ongoing trials and likely future indications. We also address how we incorporate T-cell engagers in our current treatment paradigm, with particular emphasis on their use with and as alternatives to chimeric antigen receptor T-cell therapy. We further discuss our management of immune effector cell-related toxicities.</p>","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"22 10","pages":"510-519"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Targeted immunotherapy in the treatment of childhood and adolescent classic Hodgkin lymphoma.","authors":"Ana C Xavier, Jessica Hochberg, Mitchell S Cairo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Childhood and adolescent classic Hodgkin Lymphoma (cHL) has long been a model for how we balance improved outcomes with increased toxicities in pediatric cancer. The recognition that unacceptable short- and long-term toxicities come with increasing intensity of treatment has led to a decades-long attempt to better understand the patient-specific factors that dictate responses and outcomes. Targeted immunotherapy has emerged as a promising adjunct to cancer treatment; it has been shown to improve outcomes for poorly responding patients, to salvage relapsed disease, and more recently, to replace more toxic therapy modalities such as chemotherapy and radiation while maintaining excellent outcomes. Targeted antibody therapy for cHL--whether it be naked, conjugated, or bispecific--has been proven effective and well tolerated in the pediatric population. Targets include both Reed-Sternberg cells and the tumor microenvironment, and therapy can be directed against cell surface proteins or immune checkpoint blockade. Ongoing adult and pediatric cell therapy trials in which CD30-targeting chimeric antigen receptor T-cell therapy is used for patients with relapsed or refractory disease will determine the best approaches for these high-risk patients. As a result of innovations in tumor biology, the development of novel immunotherapy agents, and a better understanding of toxicities, targeted immunotherapy is now a component not only of the treatment of pediatric cHL but also of cancer treatment paradigms overall.</p>","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"22 10","pages":"520-530"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incorporating PSMA PET imaging into the treatment plan for newly diagnosed and recurrent prostate cancer.","authors":"Neal Shore","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"22 10","pages":"497-499"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}