{"title":"Insights into RAS-driven melanoma and its therapeutic implications","authors":"Eftychia Chatziioannou , Konstantinos Lallas , Tobias Sinnberg , Heike Niessner , Alexander J. Stratigos , Lukas Flatz , Teresa Amaral","doi":"10.1016/j.ctrv.2026.103090","DOIUrl":"10.1016/j.ctrv.2026.103090","url":null,"abstract":"<div><div><em>NRAS</em> mutations are present in 15–25 % of cutaneous melanomas, predominantly affecting codon 61 (Q61R > Q61K). Mutations at codons 12 and 13 are rare although they appear to be relatively enriched in mucosal subtype. <em>KRAS</em> alterations, while rare in cutaneous melanomas, are more frequently observed in melanoma brain metastases as well as in acral and mucosal subtypes, where <em>NRAS</em> mutations are less prevalent. For advanced <em>RAS</em>-mutant melanoma, systemic therapy currently relies on anti-PD-1-based immune checkpoint inhibition. MEK inhibitors have demonstrated only modest clinical benefit due to the development of resistance and are not approved outside of China for this subtype. Ongoing combination strategies include MEK inhibition with type II RAF inhibitors (naporafenib plus trametinib in phase III trial), ERK1/2 or ERK5 inhibitors, PI3K/mTOR pathway blockade, or CDK4/6 inhibition. Additional investigational approaches include mutation-specific RAS inhibitors (G12C inhibitors already approved for other cancers), NRAS-specific or pan-RAS inhibitors (daraxonrasib in phase III trial for other cancers), targeted protein degradation, RAS-directed peptide and mRNA vaccines (mRNA-4157). <em>NRAS</em> Q61K-derived neoepitopes bound to HLA-A*01:01 have been recognized as immunogenic, suggesting that mutation-specific immunotherapies could represent a promising future strategy. In conclusion, the advent of promising and emerging therapies is set to transform the management of RAS-driven melanoma, making a personalized, biomarker-informed treatment strategy essential for optimizing patient outcomes.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"143 ","pages":"Article 103090"},"PeriodicalIF":10.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023376","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 : 2026-02-01Epub Date: 2025-12-02DOI: 10.1016/j.ctrv.2025.103062
Chikashi Ishioka
{"title":"Harnessing epigenetics: Genome-wide DNA methylation assay for colorectal cancer therapy","authors":"Chikashi Ishioka","doi":"10.1016/j.ctrv.2025.103062","DOIUrl":"10.1016/j.ctrv.2025.103062","url":null,"abstract":"<div><div>Despite dramatic advances in cancer genomic medicine over the past decade, the complex and diverse nature of cancer makes it difficult to identify biomarkers for predicting treatment and prognosis in personalized medicine. The epigenome is a universal system that regulates genomic information and its expression and is involved in the development and progression of cancer. DNA methylation is a key epigenetic modification in cancer, leading to the inactivation of tumor suppressors and the activation of oncogenes through aberrant gene expression patterns. Therefore, epigenomic information may contain robust cancer biomarkers, suggesting that the development of epigenetic diagnostics will enable accurate disease stratification, prediction of treatment response and prognosis. However, in managing advanced colorectal cancer, as in other cancers, gene mutations and the expression of their products, but not epigenomic information, have been used to guide treatment or predict prognosis. This review explores the significance of DNA methylation in advanced colorectal cancer, focusing on its role in carcinogenesis and as a biomarker for predicting the efficacy of anti-EGFR antibody and prognosis. It also reviews the clinical application of recently developed genome-wide DNA methylation diagnostics and predicts the future of epigenomic diagnostics in cancer treatment.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"143 ","pages":"Article 103062"},"PeriodicalIF":10.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973595","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 : 2026-02-01Epub Date: 2026-01-20DOI: 10.1016/j.ctrv.2026.103095
Tiia Snäkä , Alex Friedlaender , Michele Graciotti , Miriam Hernandez , Laetitia Rossier , Volker Kirchner , Lana Kandalaft
{"title":"Personalized cancer vaccines and their integration with standard of care modalities","authors":"Tiia Snäkä , Alex Friedlaender , Michele Graciotti , Miriam Hernandez , Laetitia Rossier , Volker Kirchner , Lana Kandalaft","doi":"10.1016/j.ctrv.2026.103095","DOIUrl":"10.1016/j.ctrv.2026.103095","url":null,"abstract":"<div><div>Cancer vaccines have matured significantly with advances in antigen discovery, delivery platforms, and personalized design driven by breakthroughs in genomics and artificial intelligence − yet they remain underutilized in clinical oncology. A growing body of evidence now demonstrates that the key to unlocking their full potential lies not in using them in isolation, but in strategically combining them with other treatment modalities. Vaccines exert their greatest efficacy when administered during defined immunologic windows—periods in which the patient’s immune system is most amenable to activation and durable antigen-specific priming. Crucially, combination with standard-of-care (SOC) therapies such as chemotherapy, radiotherapy, and immune checkpoint inhibitors can generate synergistic effects that reshape the tumor–immune interface. Cytotoxic and targeted agents can enhance antigen release, modulate the tumor microenvironment, and promote immune infiltration, thereby creating a more permissive milieu for vaccine-induced responses. In reciprocity, vaccination can potentiate the efficacy of SOC regimens by amplifying tumor-specific immunity, counteracting resistance mechanisms, and sustaining immune surveillance. Thus, the emerging paradigm positions cancer vaccines not as standalone interventions, but as integral components of a multimodal therapeutic architecture. Strategic co-deployment of vaccines within SOC frameworks represents a scientifically grounded and clinically actionable approach to achieving durable tumor control and long-term remission in patients with solid malignancies. This review delineates the mechanistic rationale and clinical evidence supporting such integration across the continuum of disease stages.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"143 ","pages":"Article 103095"},"PeriodicalIF":10.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023378","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 : 2026-02-01Epub Date: 2025-12-27DOI: 10.1016/j.ctrv.2025.103073
Edoardo Agosti , Pier Paolo Panciani , Giuseppe Lombardi , Matthias Preusser , Giorgia De Rosa , Karen Mapelli , Amedeo Piazza , Daniele Tognetto , Caterina Gagliano , Luca Denaro , Marta Padovan , Marco Maria Fontanella , Marco Zeppieri , Tamara Ius
{"title":"Targeted therapies in optic pathway gliomas","authors":"Edoardo Agosti , Pier Paolo Panciani , Giuseppe Lombardi , Matthias Preusser , Giorgia De Rosa , Karen Mapelli , Amedeo Piazza , Daniele Tognetto , Caterina Gagliano , Luca Denaro , Marta Padovan , Marco Maria Fontanella , Marco Zeppieri , Tamara Ius","doi":"10.1016/j.ctrv.2025.103073","DOIUrl":"10.1016/j.ctrv.2025.103073","url":null,"abstract":"<div><h3>Aim</h3><div>This study provides a systematic synthesis of current evidence on targeted therapies for optic pathway gliomas (OPGs), emphasizing their molecular rationale, clinical effectiveness, safety profiles, relevance in both Neurofibromatosis type 1 (NF1) −associated and sporadic cases.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted in accordance with PRISMA guidelines using PubMed, Web of Science, and Scopus databases up to April 2025. Eligible studies focused on systemic targeted therapies for OPGs, evaluating efficacy, molecular targets, and adverse events. Both preclinical and clinical data were included, with study quality assessed using the Newcastle-Ottawa Scale.</div></div><div><h3>Results</h3><div>Of 414 records screened, 13 studies (11 clinical and 2 preclinical) met inclusion criteria. Targeted agents included MEK inhibitors, mTOR inhibitors, anti-VEGF agents, and BRAF inhibitors. MEK inhibitors showed promising progression-free survival outcomes, particularly in NF1-associated OPGs, while anti-VEGF therapies rapidly improved visual symptoms in select cases.</div><div>MEK inhibitors showed the most consistent progression-free survival benefits, particularly in NF1-associated OPGs, with selumetinib emerging as the leading agent with favorable efficacy and safety profiles. These findings support the growing role of biomarker-driven targeted strategies while underscoring unresolved challenges related to long-term safety and optimal treatment duration.</div></div><div><h3>Conclusion</h3><div>Targeted therapies constitute a potentially paradigm-shifting development in the management of OPGs, enhancing disease control while improving the prospects for long-term visual preservation. This review underscores the need for individualized, biomarker-driven approaches and highlights challenges including resistance, long-term safety, and therapy duration.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"143 ","pages":"Article 103073"},"PeriodicalIF":10.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882444","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 : 2026-02-01Epub Date: 2025-12-08DOI: 10.1016/j.ctrv.2025.103065
Hung-Ju Lin , Shang-Gin Wu , Yin Lo , Po-Hao Feng , Yen-Wen Wu , Kuan-Yu Chen
{"title":"Recommendations on the management of kinase inhibitor-associated hyperlipidemia in patients with lung cancer","authors":"Hung-Ju Lin , Shang-Gin Wu , Yin Lo , Po-Hao Feng , Yen-Wen Wu , Kuan-Yu Chen","doi":"10.1016/j.ctrv.2025.103065","DOIUrl":"10.1016/j.ctrv.2025.103065","url":null,"abstract":"<div><h3>Introduction</h3><div>Kinase inhibitors (KIs) play an important role in targeted therapy for lung cancer. Lorlatinib as a third-generation anaplastic lymphoma kinase (ALK) inhibitor, provided unprecedentedly prolonged survival for patients with advanced non-small cell lung cancer harboring <em>ALK</em> rearrangements. However, this benefit comes at a cost of hyperlipidemia with possible implications for cardiovascular disease (CVD) in long-term survivors. This review aims to provide multidisciplinary evidence-based recommendations for managing hyperlipidemia related to KIs.</div></div><div><h3>Methods</h3><div>We established a collaborative study group comprising cardiologists, thoracic oncologists, and a pharmacist. The working group conducted a comprehensive literature search to identify KIs investigated or approved for lung cancer treatment and associated with hyperlipidemia. In addition, the most recent clinical trials and atherosclerotic CVD guidelines for the general and cancer patient populations were also reviewed.</div></div><div><h3>Results</h3><div>Among KIs, ALK inhibitors, mammalian target of rapamycin inhibitors, Janus kinase inhibitors, and multikinase inhibitors demonstrated clinical benefits for patients with lung cancer but are also associated with hyperlipidemia. Optimal target levels for total cholesterol, low-density lipoprotein cholesterol, and triglycerides in managing KI-associated hyperlipidemia for the primary and secondary prevention of CVD were recommended. Furthermore, we proposed strategies that include baseline risk assessment, regular blood lipid monitoring, and timely pharmacological interventions. Dose adjustments and discontinuation, evaluation for drug-drug interactions, patient education, and lifestyle modifications were also detailed.</div></div><div><h3>Conclusions</h3><div>A multifaceted approach is proposed for lung cancer patients receiving KI therapy to manage hyperlipidemia, minimize CVD risks, optimize treatment outcomes, and improve quality of life.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"143 ","pages":"Article 103065"},"PeriodicalIF":10.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020901","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 : 2026-02-01Epub Date: 2025-11-16DOI: 10.1016/j.ctrv.2025.103050
Sandip Pravin Patel , Shirish Gadgeel , Mari Mino-Kenudson , Jarushka Naidoo , Nan Sethakorn
{"title":"Clinical overview of trophoblast surface antigen 2 antibody-drug conjugates in non–small cell lung cancer","authors":"Sandip Pravin Patel , Shirish Gadgeel , Mari Mino-Kenudson , Jarushka Naidoo , Nan Sethakorn","doi":"10.1016/j.ctrv.2025.103050","DOIUrl":"10.1016/j.ctrv.2025.103050","url":null,"abstract":"<div><div>Lung cancer remains the leading cause of cancer-related death in the United States, with non–small cell lung cancer (NSCLC) accounting for most lung cancer cases. Improvements in first-line treatment with immuno-oncology and targeted therapies have been observed in patients with NSCLC, but benefits may be limited for those with advanced or metastatic NSCLC (mNSCLC). Following progression on frontline therapies, later-line therapies offer modest benefits and are associated with pronounced adverse effects. Accordingly, there is a need for new, more effective options to improve survival and quality of life. Trophoblast surface antigen 2 (TROP2) antibody-drug conjugates (ADCs) are a novel approach to address unmet treatment needs in NSCLC. There are 5 TROP2-directed ADCs currently under investigation for treatment of NSCLC: datopotamab deruxtecan, sacituzumab govitecan, sacituzumab tirumotecan, DB-1305, and SHR-A1921. Here, we provide an overview of the properties of each ADC as well as efficacy and safety data from clinical trials of patients with NSCLC with or without actionable genomic alterations (AGAs). The unique characteristics of each ADC and its components, particularly the linker chemistry and payload attributes, define the mechanism of action and subsequently influence dosing, efficacy, and safety. TROP2 ADCs have shown antitumor responses with a manageable safety profile in patients with mNSCLC in several ongoing and completed trials. Additional studies are required to understand how these agents can be effectively integrated into the treatment paradigm for lung cancer, taking into consideration sequential use of multiple ADCs, resistance mechanisms, combination therapies, and use in special populations.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"143 ","pages":"Article 103050"},"PeriodicalIF":10.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922948","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 : 2026-02-01Epub Date: 2026-01-04DOI: 10.1016/j.ctrv.2025.103086
Chiara Fabbroni , Edward.W. Johnston , Roberta Sanfilippo , Dirk C. Strauss , Sylvie Bonvalot , Mateusz Spalek , Winan. J. Van Houdt , Samuel J. Ford , Kyo Won Lee , Abdulazeez Salawu , Carol J. Swallow , Susie Bae , David E. Gyorki , Chandrajit P. Raut , John E. Mullinax , Markus Albertsmeier , Ferdinando Cananzi , David Konieczkowski , Valerie P. Grignol , Elisabetta Pennacchioli , William W. Tseng
{"title":"Management of multifocal and metastatic retroperitoneal sarcoma: an updated consensus approach from the transatlantic retroperitoneal sarcoma working group (TARPSWG)","authors":"Chiara Fabbroni , Edward.W. Johnston , Roberta Sanfilippo , Dirk C. Strauss , Sylvie Bonvalot , Mateusz Spalek , Winan. J. Van Houdt , Samuel J. Ford , Kyo Won Lee , Abdulazeez Salawu , Carol J. Swallow , Susie Bae , David E. Gyorki , Chandrajit P. Raut , John E. Mullinax , Markus Albertsmeier , Ferdinando Cananzi , David Konieczkowski , Valerie P. Grignol , Elisabetta Pennacchioli , William W. Tseng","doi":"10.1016/j.ctrv.2025.103086","DOIUrl":"10.1016/j.ctrv.2025.103086","url":null,"abstract":"<div><h3>Background</h3><div>Retroperitoneal sarcoma (RPS) encompasses a heterogenous group of rare malignancies that develop in the back of the abdomen. For localized primary disease, the mainstay of treatment is surgery. Beyond the primary site, patterns of disease manifestation vary by histologic type and include visceral organ metastasis, as well as intraabdominal multifocal disease. Although cure is extremely rare, some patients may still derive significant benefit from treatment.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed and international, key opinion leaders for RPS met together to discuss principles of practice for multifocal and metastatic disease, summarized in 45 statements, each given a level of evidence and grade of recommendation.</div></div><div><h3>Results</h3><div>Patients should be evaluated in a multidisciplinary sarcoma center with experience in RPS and recognition of histologic type is critical to guide management. After pretreatment assessment that includes imaging and pathology review, the goals of treatment should be clarified upfront and aligned with the anticipated ability for the patient to tolerate treatment. Disease biology (e.g., disease-free interval) should be thoroughly understood. Treatment modalities can include a combination of surgery, non-surgical local therapy (radiation therapy, percutaneous tumor ablation and embolization) and systemic therapy.</div></div><div><h3>Conclusions</h3><div>This updated consensus document gives comprehensive and practical clinical guidance to providers for the management of multifocal and metastatic RPS. The current document also serves as the foundation for future clinical and translational investigation, as we continue to optimize patient care in these complex and challenging cases.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"143 ","pages":"Article 103086"},"PeriodicalIF":10.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922949","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 : 2026-02-01Epub Date: 2026-01-16DOI: 10.1016/j.ctrv.2026.103092
Irene Persano , Luca Licata , Marta Piras , Arisa Ata-Shiroshita , Matteo Maria Naldini , Carlo Bosi , Giulia Notini , Marco Mariani , Antonella Chiavassa , Francesca Patanè , Caterina Zanibelli , Alessia Rognone , Lorenzo Sica , Stefania Zambelli , Patrizia Zucchinelli , Alessandra Guarino , Marcella Pasetti , Rosa Di Micco , Oreste Davide Gentilini , Giampaolo Bianchini , Giulia Viale
{"title":"De-escalation strategies for axillary management at primary surgery in early breast cancer: insights and implications for medical oncology practice","authors":"Irene Persano , Luca Licata , Marta Piras , Arisa Ata-Shiroshita , Matteo Maria Naldini , Carlo Bosi , Giulia Notini , Marco Mariani , Antonella Chiavassa , Francesca Patanè , Caterina Zanibelli , Alessia Rognone , Lorenzo Sica , Stefania Zambelli , Patrizia Zucchinelli , Alessandra Guarino , Marcella Pasetti , Rosa Di Micco , Oreste Davide Gentilini , Giampaolo Bianchini , Giulia Viale","doi":"10.1016/j.ctrv.2026.103092","DOIUrl":"10.1016/j.ctrv.2026.103092","url":null,"abstract":"<div><div>The recognition that axillary surgery in early breast cancer primarily serves as a staging tool rather than a curative treatment, along with the shift from axillary lymph node dissection (ALND) to sentinel lymph node biopsy (SLNB) as the standard procedure for clinically node-negative patients, has paved the way for further de-escalation of axillary treatment. This strategy aims to reduce treatment-related morbidity while preserving survival outcomes. Multiple studies have provided compelling evidence that ALND can be safely omitted in cases of limited SLN involvement. Moreover, even the omission of SLNB in selected low-risk cohorts has been shown not to increase recurrence rates. On the other side, from the oncological perspective, research has moved toward an escalation of adjuvant treatments, aiming to reduce recurrence rates and improve overall survival. Thus, while residual axillary disease does not affect patient outcomes, limited axillary staging may hinder access to certain adjuvant therapies. Here, we aim to critically assess the potential impact of recent advances in axillary surgical de-escalation on adjuvant systemic therapy decision-making especially in hormone receptor positive/HER2 negative early breast cancer, with a particular focus on the appropriate selection of patients for adjuvant chemotherapy, CDK4/6 inhibitors, and PARP inhibitors. We argue that decisions on surgical de-escalation should be carefully tailored, balancing its potential benefits with the need for accurate staging to guide adjuvant therapies. A patient-centered, multidisciplinary approach remains essential to ensure that de-escalation does not impact negatively on adjuvant treatment decision making and long-term survival.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"143 ","pages":"Article 103092"},"PeriodicalIF":10.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023377","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}