Aditya Mahadevan, Armon Azizi, Nadine Abi-Jaoudeh, Jennifer Valerin, April Choi, Harry Nguyen, Farshid Dayyani
{"title":"First-line use of antiangiogenic agents in unresectable hepatocellular carcinoma: a double-edged sword?","authors":"Aditya Mahadevan, Armon Azizi, Nadine Abi-Jaoudeh, Jennifer Valerin, April Choi, Harry Nguyen, Farshid Dayyani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Treatment options for hepatocellular carcinoma (HCC), the most prevalent primary liver malignancy, have historically been limited, particularly in unresectable cases with underlying cirrhosis. Initial systemic therapy with antiangiogenic agents, notably vascular endothelial growth factor (VEGF) inhibitors such as sorafenib, showed modest survival gains but lacked durable responses. Subsequent trials with more potent VEGF pathway inhibitors failed to improve overall survival significantly, raising concerns about the long-term utility and potential hepatic and renal toxicities of prolonged VEGF blockade. The advent of immune checkpoint inhibitors (ICIs) marked a paradigm shift. Trial results demonstrating that dual-ICI regimens induced more durable responses and achieved higher long-term survival rates have challenged the prior VEGF-centric therapeutic approach and suggest that early use of dual ICIs may offer a more transformative effect on disease trajectory. Although anti-VEGF therapies remain valuable for initial tumor shrinkage, prolonged use may compromise liver regeneration and worsen portal hypertension. A refined treatment strategy emphasizing VEGF inhibition for a limited duration followed by or combined with ICIs may optimize both efficacy and safety. Future research should focus on identifying predictive biomarkers for ICI response and on developing regimens that maximize long-term survival in unresectable HCC.</p>","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 5","pages":"301-306"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735214","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":"Reducing drug toxicity and costs through off-label dosing.","authors":"Mark J Ratain","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 5","pages":"328-330"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735217","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 doublet therapy becoming a standard of care in myelofibrosis?","authors":"Raajit K Rampal","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 5","pages":"320-322"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735216","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":"Sequencing antibody-drug conjugates in patients with hormone receptor-positive, HER2-negative metastatic breast cancer.","authors":"Javier Cortés","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 5","pages":"331-333"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735219","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":"Update on LAG3 and immunotherapy combinations in melanoma.","authors":"Hussein A Tawbi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 4","pages":"229-231"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546090","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":"The use of biomarkers in advanced, locally advanced, and early-stage lung cancer.","authors":"Narjust Florez","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 4","pages":"207-209"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546089","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":"Dual therapy: danicopan as add-on therapy to C5 inhibitors.","authors":"Catherine M Broome","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 Suppl 8 4","pages":"12-14"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546097","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":"Non-clear cell renal cell carcinoma: unpacking a messy term.","authors":"Angelina Bania, Giannicola Genovese, Pavlos Msaouel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Non-clear cell renal cell carcinoma (nccRCC) is a heterogeneous category comprising approximately 25% of epithelial renal tumors. Unlike their far more common clear cell counterpart, many nccRCC subtypes are rare, poorly understood, and often aggressive in nature. Treatment options are very limited and generally have been unsuccessfully extrapolated from ccRCC trials. Numerous subtypes also seem to emerge in the context of inherited conditions or syndromes affecting younger individuals. In recent years, the World Health Organization classification of renal tumors has been frequently updated with the recognition of novel entities beyond ccRCC. The recommendations currently demonstrate a shift from morphology-based to molecularly based classification. Thus, aberrations in genes such as TFE3, TFEB, FH, SDH, SMARCB1, ELOC, and ALK define separate entities that cannot be distinguished on the basis of microscopic appearance alone. This review aims to deconstruct the general and nondescriptive term of nccRCC to provide a comprehensive presentation of specific subtypes, highlighting their epidemiologic associations and distinctive biological and clinicopathologic features. Delineating these complexities reveals areas that warrant improvement, which will translate into optimal diagnosis, treatment, and overall patient care.</p>","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 4","pages":"253-262"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546087","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":"Complement inhibitors: a significant advance in the treatment of PNH.","authors":"Ilene C Weitz","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":51585,"journal":{"name":"Clinical Advances in Hematology & Oncology","volume":"23 Suppl 8 4","pages":"5-7"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546096","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}