Cancer treatment reviewsPub Date : 2026-04-01Epub Date: 2026-03-26DOI: 10.1016/j.ctrv.2026.103124
Mar Teixidó Mulet , Joel Veas Rodriguez , Eduardo Terán , Miquel Piñol , Felip Vilardell , Mar Iglesias , Cinta Hierro , Mariona Calvo , Xavier Matias-Guiu , Antonieta Salud , Josep Tabernero , Robert Montal
{"title":"Biomarker-guided immunotherapy in gastric cancer: current insights and future perspectives","authors":"Mar Teixidó Mulet , Joel Veas Rodriguez , Eduardo Terán , Miquel Piñol , Felip Vilardell , Mar Iglesias , Cinta Hierro , Mariona Calvo , Xavier Matias-Guiu , Antonieta Salud , Josep Tabernero , Robert Montal","doi":"10.1016/j.ctrv.2026.103124","DOIUrl":"10.1016/j.ctrv.2026.103124","url":null,"abstract":"<div><div>Gastric and gastroesophageal junction adenocarcinoma (GC) is a biologically challenging malignancy associated with suboptimal clinical outcomes due to limited effective treatment options. The recent incorporation of immune checkpoint inhibitors (ICIs) into therapeutic algorithms has improved the clinical prospects of subsets of GC patients. However, responses to anti-PD-1/PD-L1 agents remain highly heterogeneous, with only some patients deriving long-term benefits. This variability highlights the importance of identifying optimal biomarkers to enhance patient selection, thereby enabling tailored immunotherapy strategies. Whereas microsatellite instability has demonstrated a potent capacity for predicting immunotherapy benefits in GC, other predictive biomarkers, such as PD-L1 expression, remain suboptimal. Advances in gene expression and epigenetic profiling, liquid biopsy approaches, gut microbiome characterization, and artificial intelligence-driven multimodal algorithms applied to multi-omics or digital pathology are key drivers for the comprehensive characterization of the GC tumour microenvironment (TME), which could be used for better treatment selection. Similarly, elucidating the complex tumour-immune interplay with these technologies will be crucial for the success of novel immunotherapeutic approaches under clinical development, by evaluating alternative immune pathways alone or in combination with current actionable targets of GC. The current review aims to give an overview of the current immunotherapeutic landscape in GC, evaluate standard-of-care and emerging biomarkers of immunotherapy response, and discuss the translational potential of incorporating multi-omic and AI-derived biomarkers into biomarker-enriched clinical decision-making frameworks.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"145 ","pages":"Article 103124"},"PeriodicalIF":10.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer treatment reviewsPub Date : 2026-04-01Epub Date: 2026-02-15DOI: 10.1016/j.ctrv.2026.103109
M. Tanguay , M. Tagliamento , J. Samaniego , B. Besse , A. Renneville , E. Bernard , J.-B. Micol
{"title":"The interplay of clonal hematopoiesis and cancer: Clinical implications in oncology","authors":"M. Tanguay , M. Tagliamento , J. Samaniego , B. Besse , A. Renneville , E. Bernard , J.-B. Micol","doi":"10.1016/j.ctrv.2026.103109","DOIUrl":"10.1016/j.ctrv.2026.103109","url":null,"abstract":"<div><div>Clonal hematopoiesis (CH) refers to the expansion of hematopoietic stem and progenitor cells carrying somatic mutations and is increasingly identified in oncology through cell-free DNA testing. Once regarded mostly as a precursor to myeloid neoplasms and a contributor to cardiovascular disease, CH is now recognized as a major determinant of clinical outcomes in patients with cancer. Specific anticancer agents selectively promote the expansion of clones with DNA damage response gene mutations, particularly those with <em>TP53</em> or <em>PPM1D</em> mutations, which are strongly associated with myeloid neoplasms post cytotoxic therapy (MN-pCT). The extent of clonal growth varies with treatment and, in some cases, may regress once therapy is withdrawn. In addition to therapy-driven clonal selection, inflammatory stress accelerates clonal expansion, creating a self-reinforcing cycle that contributes to atherosclerosis and other inflammation-associated complications. In oncology, CH-derived immune cells can infiltrate the tumor microenvironment and remodel local immunity, influencing tumor growth and treatment response. This tissue-infiltrating form of CH, termed tumor-infiltrating CH, has been associated with inferior survival in some cancer cohorts. Together, these findings establish CH as both a clinical challenge and an opportunity in modern oncology. Dedicated CH clinics and molecular tumor boards are emerging to address its implications for risk stratification, treatment selection, and survivorship care. This review examines the biology and clinical impact of CH in oncology, including its mutational spectrum, clonal evolution, role in MN-pCT, effects on inflammation and the tumor microenvironment, and emerging strategies for risk assessment and patient management.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"145 ","pages":"Article 103109"},"PeriodicalIF":10.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neoantigen-based dendritic cell vaccines in lung cancer: overcoming immunosuppressive barriers for durable antitumor immunity","authors":"Zhang Li , Zhang Feiyue , Huang Luyu , Zhang Wenqiang , Mahmoud Ismail , Jens-C Rueckert","doi":"10.1016/j.ctrv.2026.103125","DOIUrl":"10.1016/j.ctrv.2026.103125","url":null,"abstract":"<div><div>Cancer immunotherapies developed based on mechanisms of tumour immune evasion represent a major breakthrough in the history of cancer treatment, capable of reversing T-cell exhaustion induced by tumours through immune checkpoint blockade. However, the predominant focus on T cells as central players in antitumour immunity may have led to the oversight of the crucial role played by dendritic cells (DCs), which are essential for activating and directing T cells against tumour cells. DCs comprise a diverse group of antigen-presenting cells that play an indispensable role in initiating and regulating both innate and adaptive immune responses. Strategies aimed at modulating DC function to enhance cancer immunotherapy are therefore of critical importance. Beyond the development of novel immune checkpoint inhibitors, neoantigen-based DC vaccines represent a promising approach for developing personalised precision immunotherapies. Here, we review the molecular mechanisms underlying DC immunosuppression within the lung tumour microenvironment, how tumour-infiltrating DCs influence immunity and tolerance in the cancer setting, the mechanisms by which tumour-specific neoantigens elicit immune responses, the identification of neoantigens, and recent clinical advances in neoantigen-targeted vaccines for lung cancer. We also discuss recent progress in DC vaccine-based cancer immunotherapies from both preclinical studies and clinical trials.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"145 ","pages":"Article 103125"},"PeriodicalIF":10.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer treatment reviewsPub Date : 2026-03-01Epub Date: 2026-02-21DOI: 10.1016/j.ctrv.2026.103110
Fausto Petrelli , Lorenzo Dottorini , Alberto Zambelli
{"title":"Phase III placebo-controlled oncology trials in the last decade: evolution, methodological foundations, and clinical impact","authors":"Fausto Petrelli , Lorenzo Dottorini , Alberto Zambelli","doi":"10.1016/j.ctrv.2026.103110","DOIUrl":"10.1016/j.ctrv.2026.103110","url":null,"abstract":"<div><div>Over the past decade, placebo-controlled phase III trials have remained central to therapeutic development in oncology, despite the rapid expansion of effective systemic treatments. In modern practice, placebo rarely represents the absence of therapy; rather, it serves as a methodological tool that preserves blinding, isolates the incremental effect of investigational agents, and minimizes assessment bias. Between 2015 and 2025, placebo-controlled designs underpinned many landmark trials across solid tumors and hematologic malignancies. In add-on first-line studies, placebo combined with standard-of-care therapy enabled accurate attribution of benefit to immune checkpoint inhibitors and targeted agents, including CDK4/6 inhibitors in hormone receptor–positive breast cancer. In the adjuvant setting, where observation historically constituted standard management, placebo provided an ethically appropriate comparator, supporting practice-changing trials in resected lung cancer, melanoma, renal cell carcinoma, and early breast cancer. Maintenance strategies, particularly in ovarian cancer, pancreatic cancer with germline BRCA mutations, and acute myeloid leukemia, relied on placebo to reflect real-world surveillance and to validate prolonged disease control in molecularly selected populations. In refractory disease, placebo-controlled trials remained acceptable when no effective standard therapies existed, allowing the identification of new agents with survival benefit. Across these contexts, placebo use has been essential for reducing bias in time-to-event endpoints, validating surrogate measures, and ensuring regulatory rigor. Collectively, evidence from the last decade indicates that placebo-controlled trials have facilitated, rather than hindered, major advances in oncology and will continue to play a critical role as treatment strategies become increasingly complex and precision driven.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"144 ","pages":"Article 103110"},"PeriodicalIF":10.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer treatment reviewsPub Date : 2026-03-01Epub Date: 2026-02-04DOI: 10.1016/j.ctrv.2026.103097
Salvatore Siena , Myriam Chalabi , Rachel Goodwin , Pia Osterlund , Frédérique Penault-Llorca , Andrea Sartore-Bianchi , Naureen Starling , Sebastian Stintzing , Josep Tabernero
{"title":"Diagnosis and treatment of human epidermal growth factor receptor 2-positive metastatic colorectal cancer: a systematic literature review","authors":"Salvatore Siena , Myriam Chalabi , Rachel Goodwin , Pia Osterlund , Frédérique Penault-Llorca , Andrea Sartore-Bianchi , Naureen Starling , Sebastian Stintzing , Josep Tabernero","doi":"10.1016/j.ctrv.2026.103097","DOIUrl":"10.1016/j.ctrv.2026.103097","url":null,"abstract":"<div><div>Human epidermal growth factor receptor 2 (HER2)-targeted therapies have been investigated for therapeutic benefit in <em>RAS</em>/<em>BRAF</em> wild-type/HER2+ metastatic colorectal cancer (mCRC). Unlike HER2+ breast and gastric cancer, there are no regulatory criteria for determining HER2 overexpression in patients with mCRC. This systematic literature review describes unmet needs for patients with HER2+ mCRC in relation to testing and treatment, highlights the importance of early HER2 testing at mCRC diagnosis, and discusses the evolving treatment landscape. We utilised PubMed and EMBASE databases up to November 2023 to identify journal articles and published congress abstracts relating to the HER2+ disease and treatment landscape, HER2 testing in mCRC, and HER2-targeted treatments in mCRC. Many studies have demonstrated the utility of immunohistochemistry, <em>in situ</em> hybridisation, and next-generation sequencing (tissue- and circulating tumour DNA-based) for detecting HER2 overexpression/amplification in mCRC and have attempted to establish consolidated criteria like those used for breast and gastric cancer. The value of HER2-targeted treatments in patients with HER2+ mCRC has been evidenced by clinical trials and meta-analyses, with strong evidence from MOUNTAINEER and DESTINY-CRC01 which supports the use of tucatinib + trastuzumab or trastuzumab deruxtecan, respectively, among this patient population. However, real-world analyses have confirmed that patients with HER2+ mCRC are not routinely tested for HER2 overexpression. Strong evidence and clinical guidelines support the value of HER2-targeted treatment among patients with HER2+ mCRC. There is a need for increased awareness and earlier uptake of HER2 testing among patients with mCRC to broaden treatment options and optimise outcomes for this patient population.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"144 ","pages":"Article 103097"},"PeriodicalIF":10.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Immunotherapy with anti-PD-1 or PD-L1 in advanced ovarian cancer: A meta-analysis of randomized trials","authors":"Riccardo Vida , Michele Bartoletti , Marcella Montico , Sandro Pignata , Gustavo Baldassarre , Antonino Ditto , Giulia Zapelloni , Monica Rizzetto , Ludovica Lay , Poletto Margherita , Fabio Puglisi","doi":"10.1016/j.ctrv.2026.103094","DOIUrl":"10.1016/j.ctrv.2026.103094","url":null,"abstract":"<div><h3>Background</h3><div>Ovarian cancer remains the gynecological malignancy with the highest mortality rate. Despite advances in treatment, the median overall survival remains suboptimal. Although there is strong biological rationale for the use of immune checkpoint inhibitors (ICIs), their clinical efficacy in ovarian cancer remains uncertain. This study aimed to evaluate the effectiveness of anti–PD-1/PD-L1 agents in advanced ovarian cancer by reviewing randomized trials.</div></div><div><h3>Methods</h3><div>We performed a systematic review and <em>meta</em>-analysis of randomized controlled trials (RCTs). Data sources included PubMed, EMBASE, the Cochrane Library, and major conference abstracts, with searches conducted up to July 1, 2025. Eligible studies included RCTs comparing anti–PD-1/PD-L1 agents (with or without chemotherapy) to standard treatments in patients with advanced ovarian cancer (first-line, platinum-sensitive, or platinum-resistant). Trials with fewer than 50 patients or non-randomized designs were excluded. Two authors independently extracted summary-level data. The primary outcome measure was progression-free survival (PFS) in the intention-to-treat population. A random-effects model was used to estimate pooled hazard ratios (HRs). Risk of bias was assessed using the Cochrane RoB 2 tool. (Supplementary, Fig. S1) The <em>meta</em>-analysis was registered with PROSPERO (CRD420251112816).</div></div><div><h3>Findings</h3><div>Ten RCTs (n = 7,847 patients) met the inclusion criteria. Overall, ICIs did not significantly improve PFS compared to control treatments (HR 0.98, 95% CI 0.85–1.12; I<sup>2</sup> = 67%). No significant benefit was observed in either first-line (HR 0.93) or recurrent settings (HR 1.07), nor in PD-L1–positive, BRCA-mutated, or homologous recombination deficiency (HRD) populations. A non-significant trend favouring ICI + PARP inhibitor combinations was observed in HR-proficient patients (HR 0.77, 95% CI 0.65–0.92). Sensitivity analyses confirmed the robustness of the findings. Overall survival (OS) data were either immature or not reported in most trials. The risk of bias was rated as low to moderate across studies, although there was high heterogeneity.</div></div><div><h3>Interpretation:</h3><div>Anti–PD-1/PD-L1-based ICI strategies have not led to significant improvements in outcomes for ovarian cancer. Future studies should focus on optimizing biomarker selection, evaluating combination therapies, and targeting the tumor microenvironment to enhance the efficacy of immunotherapy.</div><div>Funding:</div><div>This research received no external funding.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"144 ","pages":"Article 103094"},"PeriodicalIF":10.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer treatment reviewsPub Date : 2026-03-01Epub Date: 2026-01-28DOI: 10.1016/j.ctrv.2026.103096
Maria Ibáñez Alda , Thomas Grinda , Barbara Pistilli
{"title":"Integrating antibody-drug conjugates into the management of early breast cancer","authors":"Maria Ibáñez Alda , Thomas Grinda , Barbara Pistilli","doi":"10.1016/j.ctrv.2026.103096","DOIUrl":"10.1016/j.ctrv.2026.103096","url":null,"abstract":"<div><div>Antibody-drug conjugates (ADCs) are a new class of targeted therapies that have demonstrated clinical benefit across various tumor types and disease stages. In breast cancer, following their success in the metastatic setting, ADCs show improved antitumor activity with potentially reduced systemic toxicity, making them a promising option in the neoadjuvant treatment of early breast cancer. This review examines the evolving role of ADCs in early breast cancer, highlighting emerging clinical trial data, innovative trial designs, and the integration of biomarkers, all aimed at optimizing patient outcomes and personalizing neoadjuvant strategies across different breast cancer subtypes.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"144 ","pages":"Article 103096"},"PeriodicalIF":10.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer treatment reviewsPub Date : 2026-03-01Epub Date: 2026-02-09DOI: 10.1016/j.ctrv.2026.103107
Daniela Alterio , Samantha Dicuonzo , Mattia Zaffaroni , Maria Giulia Vincini , Paola Zagami , Carmen Criscitiello , Francesca Braga , Ekaterina Milovanova , Maria Cristina Leonardi , Paolo Veronesi , Anna M. Kirby , Roberto Orecchia , Giuseppe Curigliano , Barbara Alicja Jereczek-Fossa
{"title":"Proton therapy in breast cancer: bridging medical and radiation oncology","authors":"Daniela Alterio , Samantha Dicuonzo , Mattia Zaffaroni , Maria Giulia Vincini , Paola Zagami , Carmen Criscitiello , Francesca Braga , Ekaterina Milovanova , Maria Cristina Leonardi , Paolo Veronesi , Anna M. Kirby , Roberto Orecchia , Giuseppe Curigliano , Barbara Alicja Jereczek-Fossa","doi":"10.1016/j.ctrv.2026.103107","DOIUrl":"10.1016/j.ctrv.2026.103107","url":null,"abstract":"<div><div>Breast cancer remains the most common malignancy among women globally, and postoperative radiotherapy (PORT) is essential for improving local control and overall survival. Proton therapy (PT) is emerging as an alternative to conventional radiotherapy due to its ability to reduce dose exposure to healthy tissues. It could be of particular use in patients requiring radiotherapy to the internal mammary chain, a population that is likely to also be undergoing systemic therapy as part of their breast cancer treatment. This review evaluates current preclinical and clinical data on the integration of PT with systemic treatments in the setting of breast cancer, highlighting its potential role to improve therapeutic outcomes while reducing toxicity. The findings of this review highlight PT’s potential to minimize side effects, particularly cardiotoxicity and potentially to enhance the efficacy of systemic treatments such as immunotherapy.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"144 ","pages":"Article 103107"},"PeriodicalIF":10.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146196194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer treatment reviewsPub Date : 2026-03-01Epub Date: 2026-02-12DOI: 10.1016/j.ctrv.2026.103108
Xinyi Lin , Baiying Liu , Jing Wu , Lina Shi , Yanyan Zhang , Qiaoyu Yang , Haiyun Tang , Shaoting Xu , Yuxuan Gao , Jihong Cui , Yunjian Zhang
{"title":"Circulating tumor DNA in breast cancer: From technological foundation to clinical implementation","authors":"Xinyi Lin , Baiying Liu , Jing Wu , Lina Shi , Yanyan Zhang , Qiaoyu Yang , Haiyun Tang , Shaoting Xu , Yuxuan Gao , Jihong Cui , Yunjian Zhang","doi":"10.1016/j.ctrv.2026.103108","DOIUrl":"10.1016/j.ctrv.2026.103108","url":null,"abstract":"<div><div>Circulating tumor DNA (ctDNA)-based liquid-biopsy has emerged as a transformative tool in breast cancer management, offering non-invasive, real-time insights across the clinical continuum. By capturing tumor-specific genetic and epigenetic alterations-such as mutations, copy number variations, and methylation patterns-ctDNA enables applications in early screening, evaluation of treatment response, minimal residual disease monitoring, and tracking of resistance mechanisms. Technological advances in PCR-based methods, next-generation sequencing, and biosensor-based profiling have significantly enhanced detection sensitivity and specificity, supporting personalized therapeutic guidance and dynamic adaptation of treatment strategies. However, clinical implementation faces challenges related to assay standardization, variable detection sensitivity, high costs, and limited large-scale prospective validation. Future efforts should focus on technological refinement, multi-omics integration, and evidence generation through large-scale multicenter clinical trials to position ctDNA as a cornerstone of precision oncology in breast cancer.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"144 ","pages":"Article 103108"},"PeriodicalIF":10.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer treatment reviewsPub Date : 2026-03-01Epub Date: 2026-02-17DOI: 10.1016/j.ctrv.2026.103111
Anna McCracken , Olivia R. Grafinger , Hon S. Leong , Ana Elisa Lohmann , Katarzyna J. Jerzak , Sunit Das
{"title":"Neoadjuvant therapy and translational biomarkers for metastatic risk in early breast cancer","authors":"Anna McCracken , Olivia R. Grafinger , Hon S. Leong , Ana Elisa Lohmann , Katarzyna J. Jerzak , Sunit Das","doi":"10.1016/j.ctrv.2026.103111","DOIUrl":"10.1016/j.ctrv.2026.103111","url":null,"abstract":"<div><div>Distant recurrence remains a significant cause of mortality in patients with breast cancer (BC). While metastasis was once considered a late event, current evidence suggests that metastatic seeding occurs early. There is thus significant interest in neoadjuvant therapy (NAT) as a window of opportunity to decrease metastatic risk.</div><div>While NAT has classically consisted of chemotherapy, targeted therapies, such as human epidermal growth factor 2 (HER2)-targeted therapies and immune checkpoint inhibitors (ICIs), are now offered to patients with HER2-positive and triple-negative (TN) BC, respectively. As therapies evolve, there is a growing need to identify reliable biomarkers to predict NAT response and monitor microscopic disease post-NAT.</div><div>This review explores the interplay between metastasis biomarkers and NAT for HER2-positive and TNBC. Circulating tumour DNA (ctDNA), circulating tumour cells (CTCs), disseminated cancer cells (DCCs), and tumour-infiltrating lymphocytes (TILs) provide longitudinal insights into residual disease, immune dynamics, and genomic alterations. This review critically examines the established and emerging prognostic, predictive, and response-adaptive roles of these biomarkers in the neoadjuvant setting and beyond.</div><div>Clinical adoption of novel biomarker approaches has been challenging due to reliance on tissue biopsy during an already challenging treatment journey. However, liquid biopsy approaches like CTC and ctDNA analyses provide minimally invasive means of monitoring metastatic risk. Technological advancements, such as methylome sequencing and variant-based ctDNA detection, offer promise for improved sensitivity and validity. While further trials are required to establish their clinical utility, integrating these biomarker-informed assays may inform precise metastasis risk assessment and improve patient outcomes.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"144 ","pages":"Article 103111"},"PeriodicalIF":10.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}