Natasha Hongsermeier-Graves, Mohammed Hasen, Noah Yaffe, Andrew Ajisebutu, Rachna Malani
{"title":"Liquid biopsy in early detection and monitoring of CNS metastases.","authors":"Natasha Hongsermeier-Graves, Mohammed Hasen, Noah Yaffe, Andrew Ajisebutu, Rachna Malani","doi":"10.1016/bs.acr.2025.04.007","DOIUrl":"https://doi.org/10.1016/bs.acr.2025.04.007","url":null,"abstract":"<p><p>The treatment of human cancer has shifted toward a precision-medicine paradigm that increasingly relies on the genomic annotation of each patient's tumor tissue. This trend is supported by the observation that treatment response is often dependent on tumor mutations in targeted pathways, by the discovery of particular drug-resistance mutations in tumors that resume growth during therapy, and by the recent association between effective immunotherapy and tumor-specific missense mutations. Early detection of cancer and accurate characterization of tumors improve patient outcomes, so research into noninvasive means of obtaining this information is of significant clinical relevance. Furthermore, the outgrowth of drug-resistant tumor cell clones during therapy can limit the clinical relevance of the initial tumor profile and has motivated the development of technologies that can track the evolution of the cancer genome in accessible body fluids.</p>","PeriodicalId":94294,"journal":{"name":"Advances in cancer research","volume":"165 ","pages":"255-290"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304207","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}
Hannah Kim, Sofia Chernet, Priya Kumthekar, Akanksha Sharma
{"title":"Molecular drivers in CNS metastatic disease.","authors":"Hannah Kim, Sofia Chernet, Priya Kumthekar, Akanksha Sharma","doi":"10.1016/bs.acr.2025.04.004","DOIUrl":"https://doi.org/10.1016/bs.acr.2025.04.004","url":null,"abstract":"<p><p>The incidence and prevalence of CNS metastases of systemic cancer is only increasing worldwide, especially as our available systemic therapies have improved, resulting in longer survival and more time to allow for CNS progression. Fortunately, we have made substantial therapeutic advances in drug development in the last decade, with newer agents demonstrating significant penetration into the nervous system and notable efficacy. Treatments specifically targeted for certain mutations in the cancer pathway have been especially successful in aborting the onward trajectory and growth of cancer cells in the nervous system. In this review, we provide an overview and update of the drugs that have demonstrated benefit in achieving intracranial control (at times including leptomeningeal disease), many of which have already received or are pending regulatory approval. We also provide a brief look into the landscape of ongoing clinical research including challenges in the field.</p>","PeriodicalId":94294,"journal":{"name":"Advances in cancer research","volume":"165 ","pages":"1-56"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304246","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":"Advances in minimally invasive surgery for brain metastases.","authors":"Nicole A Perez, Bryan D Choi, Brian V Nahed","doi":"10.1016/bs.acr.2025.04.003","DOIUrl":"https://doi.org/10.1016/bs.acr.2025.04.003","url":null,"abstract":"<p><p>Brain metastases (BMs) affect approximately 10-30 % of cancer patients, and their prevalence is growing as patients live longer with controlled primary disease. Surgical resection remains a cornerstone of treatment for both solitary and multifocal lesions. Since the advent of intracranial tumor surgery, neurosurgery has trended towards less invasive surgical approaches, facilitated by a proliferation of surgical innovations ranging from intraoperative MRI to tubular retractors. Minimally invasive cranial surgery (MICS) incorporates approaches such as keyhole craniotomies and tubular retraction with the goal of maximizing extent of resection and reducing iatrogenic tissue injury. Supramarginal resection builds upon this approach, expanding the boundaries of the resection cavity to ensure removal of microscopic tumor fragments and decrease recurrence. Because MICS is generally performed through craniotomies< 5 cm in diameter with limited ability to change predefined surgical corridors intraoperatively, meticulous attention must be given to the preoperative workup. Imaging modalities, including CT, MRI, DWI, and DTI, may reveal characteristics of the intra-tumoral environment and are important in defining the anatomical relationship of BMs to surrounding functional tissue and neurovascular structures. Intraoperatively, neuronavigation helps maintain alignment within predefined surgical corridors, and adjunctive modalities such as intraoperative ultrasound and brain mapping help compensate for brain shift. Advancements in visual augmentation tools such as fluorescence, endoscopes, and exoscopes further enable intraoperative delineation of tumor boundaries and allow for expanded utilization of MICS in deep-seated, complex BMs. The ever-growing armamentarium of minimally invasive surgical tools has made neurosurgery an increasingly safe and effective option for patients with BMs.</p>","PeriodicalId":94294,"journal":{"name":"Advances in cancer research","volume":"165 ","pages":"165-230"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304206","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":"Precision medicine approaches to CNS metastatic disease.","authors":"Toni Cao, Meaghan Roy-O'Reilly, Seema Nagpal","doi":"10.1016/bs.acr.2025.04.005","DOIUrl":"https://doi.org/10.1016/bs.acr.2025.04.005","url":null,"abstract":"<p><p>Brain metastases (BrM) and leptomeningeal metastases (LM) are increasingly common neurologic complications of cancer. The era of precision oncology has ushered in a deeper understanding of the molecular alterations that drive oncogenesis, subsequently informing and accelerating the drug development process. New systemic treatments, including oral tyrosine kinase inhibitors (TKIs), immune checkpoint inhibitors (ICIs) as well as antibody-drug conjugates (ADCs), have substantial intracranial efficacy with meaningful clinical benefit for BrM patients. Our understanding of LM continues to evolve with the development of improved detection methods and an increasing number of brain penetrant therapies. Targeted therapeutics continue to transform the existing treatment landscape and add both choice and complexity to the clinician's calculus when managing patients with BrM and/or LM. Multidisciplinary discussion should ultimately guide all treatment decisions and explore both the benefits and toxicities of various therapy options. Systemic targeted therapies should be considered for patients with asymptomatic or minimally symptomatic small BrM and/or LM. Future studies investigating treatment timing and effective combinatorial strategies are urgently needed.</p>","PeriodicalId":94294,"journal":{"name":"Advances in cancer research","volume":"165 ","pages":"57-114"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304247","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":"Radiation therapy for cerebral metastases: Non-stereotactic treatment options.","authors":"John G Roubil, Timothy J Harris","doi":"10.1016/bs.acr.2025.04.008","DOIUrl":"https://doi.org/10.1016/bs.acr.2025.04.008","url":null,"abstract":"<p><p>Human development of the blood-brain-barrier - a semi-permeable membrane that both separates and protects the brain and spinal cord from potential toxins coursing through the human circulatory system, while simultaneously permitting oxygen and nutrient delivery - also lead to the creation of the largest sanctuary site for malignancy in the human body: the central nervous system (CNS) . The most commonly used cocktails of chemotherapeutic treatments are unable to breach the blood-brain-barrier and treat metastatic cancer cells seeking asylum behind its walls, and other sanctuary sites (e.g. genital tract, testicles, placenta and umbilical cord in pregnancy, etc.). As a result, therapies that are unobstructed by the blood-brain-barrier are of paramount importance when treating CNS metastases. Radiation therapy (RT) is among these commonly employed modalities and can be used as both a first line treatment and, in some cases, as prophylaxis against microscopic disease armed with the potential to mature into symptomatic cerebral metastases.</p>","PeriodicalId":94294,"journal":{"name":"Advances in cancer research","volume":"165 ","pages":"231-254"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304248","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}
Stylianos Pikis, Maria Protopapa, Georgios Mantziaris, Mahmoud Osama, Jason Sheehan
{"title":"Stereotactic radiosurgery for brain metastases.","authors":"Stylianos Pikis, Maria Protopapa, Georgios Mantziaris, Mahmoud Osama, Jason Sheehan","doi":"10.1016/bs.acr.2025.04.001","DOIUrl":"https://doi.org/10.1016/bs.acr.2025.04.001","url":null,"abstract":"<p><p>Brain metastases are the most common intracranial malignancies in adults, and, depending on primary tumor type, they may affect up to 50 % of cancer patients. Although advances in systemic and local therapies have led to improvements in patient overall survival and progression free survival, there remains substantial opportunities to improve patient outcomes. Stereotactic radiosurgery (SRS) delivers high doses of ionizing radiation with sub-millimeter accuracy to discrete intracranial tumors. It has emerged as the standard of care for patients with limited number of brain metastases, and it serves as a valuable adjuvant after resection. Moreover, SRS is typically seamlessly integrated into systemic therapy treatment regimens. Continued improvement in SRS technology and growing evidence have led to expansion of SRS indications and introduction of new SRS techniques. Frameless SRS technologies have allowed for treatment of larger lesions and even lesions adjacent to critical structures for which single session SRS would not be prudent. Neoadjuvant SRS has recently been proposed as an alternative to adjuvant SRS and appears to help reduce the risk of leptomeningeal dissemination. These novel SRS techniques require further evaluation through prospective clinical trials and registry based studies. In addition, the concurrent combination of systemic therapies with central nervous system (CNS) activity and SRS has yielded promising results with respect to local control and adverse radiation events rates. The concurrent delivery of SRS, precision medicine, and/or immunotherapy requires further refinements to fully optimize patient outcomes. In this review, we detail the current literature on established and forthcoming indications of SRS for brain metastases.</p>","PeriodicalId":94294,"journal":{"name":"Advances in cancer research","volume":"165 ","pages":"115-143"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304249","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 history of LITT for the treatment of active brain metastasis and radiation necrosis.","authors":"Theresa Gammel, Shawn D'Souza, William Broaddus","doi":"10.1016/bs.acr.2025.04.002","DOIUrl":"https://doi.org/10.1016/bs.acr.2025.04.002","url":null,"abstract":"<p><p>Treatment of brain metastasis has traditionally included surgical resection for single lesions in accessible locations. However, multiple lesions, small size, location within deeper structures or need for transgression of eloquent cortex renders surgical resection a less viable option. Stereotactic radiosurgery and whole brain radiation are additional treatment options, however risks of worsening neurocognitive symptoms, post-radiation edema, and most significant, radiation necrosis are apparent. With advances in minimally invasive laser delivery systems and magnetic resonance imaging, laser interstitial thermal therapy (LITT) has become an increasingly popular option for brain metastasis and radiation necrosis. This chapter will review the history and physics of LITT, discuss pioneering cases which pushed the boundaries of this therapy, and seminal trials which have explored its efficacy in treating brain metastasis and radiation necrosis.</p>","PeriodicalId":94294,"journal":{"name":"Advances in cancer research","volume":"165 ","pages":"145-164"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304250","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}
Pedro P Gonçalves, Cláudia L da Silva, Nuno Bernardes
{"title":"Advancing cancer therapeutics: Integrating scalable 3D cancer models, extracellular vesicles, and omics for enhanced therapy efficacy.","authors":"Pedro P Gonçalves, Cláudia L da Silva, Nuno Bernardes","doi":"10.1016/bs.acr.2024.07.001","DOIUrl":"https://doi.org/10.1016/bs.acr.2024.07.001","url":null,"abstract":"<p><p>Cancer remains as one of the highest challenges to human health. However, anticancer drugs exhibit one of the highest attrition rates compared to other therapeutic interventions. In part, this can be attributed to a prevalent use of in vitro models with limited recapitulative potential of the in vivo settings. Three dimensional (3D) models, such as tumor spheroids and organoids, offer many research opportunities to address the urgent need in developing models capable to more accurately mimic cancer biology and drug resistance profiles. However, their wide adoption in high-throughput pre-clinical studies is dependent on scalable manufacturing to support large-scale therapeutic drug screenings and multi-omic approaches for their comprehensive cellular and molecular characterization. Extracellular vesicles (EVs), which have been emerging as promising drug delivery systems (DDS), stand to significantly benefit from such screenings conducted in realistic cancer models. Furthermore, the integration of these nanomedicines with 3D cancer models and omics profiling holds the potential to deepen our understanding of EV-mediated anticancer effects. In this chapter, we provide an overview of the existing 3D models used in cancer research, namely spheroids and organoids, the innovations in their scalable production and discuss how omics can facilitate the implementation of these models at different stages of drug testing. We also explore how EVs can advance drug delivery in cancer therapies and how the synergy between 3D cancer models and omics approaches can benefit in this process.</p>","PeriodicalId":94294,"journal":{"name":"Advances in cancer research","volume":"163 ","pages":"137-185"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305454","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":"Mitochondrial metallopeptidase OMA1 in cancer.","authors":"Gunjan Purohit, Polash Ghosh, Oleh Khalimonchuk","doi":"10.1016/bs.acr.2024.05.001","DOIUrl":"10.1016/bs.acr.2024.05.001","url":null,"abstract":"<p><p>Our understanding of the roles that mitochondria play in cellular physiology has evolved drastically-from a mere cellular energy supplier to a crucial regulator of metabolic and signaling processes, particularly in the context of development and progression of human diseases such as cancers. The present review examines the role of OMA1, a conserved, redox-sensitive metallopeptidase in cancer biology. OMA1's involvement in mitochondrial quality control, redox activity, and stress responses underscores its potential as a novel target in cancer diagnosis and treatment. However, our incomplete understanding of OMA1's regulation and structural detail presents ongoing challenges to target OMA1 for therapeutic purposes. Further exploration of OMA1 holds promise in uncovering novel insights into cancer mechanisms and therapeutic strategies. In this chapter, we briefly summarize our current knowledge about OMA1, its redox-regulation, and emerging role in certain cancers.</p>","PeriodicalId":94294,"journal":{"name":"Advances in cancer research","volume":"162 ","pages":"75-97"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790737","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}
Sheeraz Un Nazir, Juhi Mishra, Shailendra Kumar Maurya, Negin Ziamiavaghi, Sanika Bodas, Benjamin A Teply, Samikshan Dutta, Kaustubh Datta
{"title":"Deciphering the genetic and epigenetic architecture of prostate cancer.","authors":"Sheeraz Un Nazir, Juhi Mishra, Shailendra Kumar Maurya, Negin Ziamiavaghi, Sanika Bodas, Benjamin A Teply, Samikshan Dutta, Kaustubh Datta","doi":"10.1016/bs.acr.2024.06.001","DOIUrl":"https://doi.org/10.1016/bs.acr.2024.06.001","url":null,"abstract":"<p><p>Prostate cancer, one of the most frequently diagnosed cancers in men, leads to significant mortality worldwide. Its study is important due to the complexity and diversity in its progression, highlighting the urgent need for improved therapeutic strategies. This chapter probes into the genetic and epigenetic factors influencing prostate cancer progression, underscoring the importance of understanding the disease's molecular fundamentals for the development of targeted therapies. It specifically reviews the role of key genetic mutations in genes such as Androgen Receptor, TP53, SPOP, FOXA1 and PTEN which are crucial for the disease onset and a progression. Furthermore, it examines the impact of epigenetic modifications, including DNA methylation and histone modification, which contribute to the cancer's progression by affecting gene expression and cellular behavior. Further, in this chapter we delve into the underlying signaling mechanism, the advancements in targeting genetic and epigenetic alterations in prostate cancer. These findings have revealed promising targets for therapeutic advancements, aiming to understand and identify promising avenues for future therapies. This chapter improves our current understanding of prostate cancer genetic and epigenetic landscape, emphasizing the necessity of advancing our knowledge to refine and expand treatment options for prostate cancer patients.</p>","PeriodicalId":94294,"journal":{"name":"Advances in cancer research","volume":"161 ","pages":"191-221"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736277","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}