Cancer treatment reviews最新文献

{"title":"Individualizing first-line treatment for advanced urothelial carcinoma: A favorable dilemma for patients and physicians","authors":"Enrique Grande ,&nbsp;Syed A. Hussain ,&nbsp;Philippe Barthélémy ,&nbsp;Ravindran Kanesvaran ,&nbsp;Patrizia Giannatempo ,&nbsp;David J. Benjamin ,&nbsp;Jason Hoffman ,&nbsp;Alison Birtle","doi":"10.1016/j.ctrv.2025.102900","DOIUrl":"10.1016/j.ctrv.2025.102900","url":null,"abstract":"<div><div>The treatment landscape for patients with advanced urothelial carcinoma (UC) has evolved rapidly in recent years. In current guidelines, combination treatment with enfortumab vedotin plus pembrolizumab is the first-line (1L) standard of care, and other recommended 1L treatment options are platinum-based chemotherapy followed by avelumab as switch-maintenance treatment in patients without progression, or combination treatment with nivolumab, cisplatin, and gemcitabine for cisplatin-eligible patients only. Individual patients differ in terms of their health status, disease characteristics, expected toxicities, and treatment preferences; thus, a “one-size-fits-all” approach to treatment is unlikely to be optimal. The availability of several treatment options creates the potential for individualized treatment. In this review, we discuss factors that may be considered when selecting 1L treatment for patients with advanced UC, including efficacy and safety data from phase 3 trials and real-world studies, quality of life, patient priorities for treatment, patient and disease characteristics, treatment sequencing, biomarkers, and treatment access and cost. Patients and physicians should discuss the benefit-risk balance of all available 1L options to enable shared decision-making. Longer follow-up from clinical trials and additional real-world studies are needed to further inform treatment selection.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"134 ","pages":"Article 102900"},"PeriodicalIF":9.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary mediastinal large B-cell Lymphoma: Biological features, clinical characteristics and current treatment strategies","authors":"Livia Donzelli,&nbsp;Alice Di Rocco,&nbsp;Luigi Petrucci,&nbsp;Maurizio Martelli","doi":"10.1016/j.ctrv.2025.102898","DOIUrl":"10.1016/j.ctrv.2025.102898","url":null,"abstract":"<div><div>Primary mediastinal large B-cell lymphoma (PMBCL) is a distinct subtype of B-cell lymphoma, representing a clinical and therapeutic challenge due to its unique presentation, histopathological features, and treatment response. It primarily affects young adults, with a significant female preponderance, and is characterized by a large anterior mediastinal mass that causes compressive symptoms. Despite its aggressive nature, PMBCL patients have a favorable prognosis, with a 5-year survival rate exceeding 80% when early remission is achieved through first-line therapy. Drawing on the significant scientific therapeutic advances over recent years, this review focuses on the evolving treatment strategies for PMBCL patients. Anthracycline- and rituximab-containing regimens are the mainstays of first-line approaches, often followed by mediastinal radiation therapy. However, concerns regarding long-term toxicities have led to a reevaluation of treatment protocols, suggesting that radiotherapy can be safely omitted in patients who achieve a complete metabolic response after induction therapy, according to a PET-guided approach. Furthermore, new targeted therapies such as PD-1 inhibitors and CAR-T cell immunotherapy, have shown promising results in refractory or relapsed PMBCL.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"134 ","pages":"Article 102898"},"PeriodicalIF":9.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386885","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":"How do I treat dMMR/MSI gastro-oesophageal adenocarcinoma in 2025? A position paper from the EORTC-GITCG gastro-esophageal task force","authors":"Christelle de la Fouchardière ,&nbsp;Antonella Cammarota ,&nbsp;Magali Svrcek ,&nbsp;Maria Alsina ,&nbsp;Tania Fleitas-Kanonnikoff ,&nbsp;Radka Lordick Obermannová ,&nbsp;Anna Dorothea Wagner ,&nbsp;Dominic Yap Wei Ting ,&nbsp;Diana Enea ,&nbsp;Angelica Petrillo ,&nbsp;Elizabeth C. Smyth","doi":"10.1016/j.ctrv.2025.102890","DOIUrl":"10.1016/j.ctrv.2025.102890","url":null,"abstract":"<div><div>In less than a decade, immune checkpoint inhibitors (ICIs) have transformed the management of mismatch repair-deficient (dMMR) and microsatellite instability-high (MSI) cancers. However, beyond colorectal cancer (CRC), much of the evidence is mostly derived from non-randomized phase II studies or <em>post-hoc</em> analyses of broader clinical trials. dMMR/MSI tumours represent a specific subgroup of gastro-esophageal adenocarcinomas (GEA), accounting for approximately 9 % of cases, with a higher prevalence in early-stage compared to advanced-stage disease and older female patients. These tumours are predominantly sporadic, often linked to <em>MLH1</em> promoter methylation, and rarely exhibit HER2 overexpression/<em>ERBB2</em> amplification or other oncogenic drivers. The treatment landscape for early stage dMMR/MSI GEA is likely to change substantially soon, as ICIs have shown high pathological complete response (pCR) rates in small phase II trials, raising questions on optimisation of neoadjuvant therapy, and paving the way for organ preservation. The standard of treatment for untreated patients with advanced dMMR/MSI GEA is chemotherapy + ICI irrespectively of PDL-1 status. However, the role of chemotherapy-free regimen consisting of CTLA-4 plus PD-1 inhibitors remains undetermined. This review addresses these and other emerging questions, offering expert opinions and insights into the future therapeutic landscape for dMMR/MSI GEA.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"134 ","pages":"Article 102890"},"PeriodicalIF":9.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing strategies of chemotherapy and radiotherapy-induced oral mucositis","authors":"Yuqi Wu ,&nbsp;Wenjin Shi ,&nbsp;Chunyu Li ,&nbsp;Xiangfei Liu ,&nbsp;Yuchen Jiang ,&nbsp;Yan Qiu ,&nbsp;Qianming Chen ,&nbsp;Xiaobo Luo","doi":"10.1016/j.ctrv.2025.102883","DOIUrl":"10.1016/j.ctrv.2025.102883","url":null,"abstract":"<div><div>Radiotherapy and chemotherapy are widely employed as primary non-surgical cancer treatments; however, their non-selective cytotoxicity often leads to adverse events such as oral mucositis (OM), particularly in head and neck cancer therapies. International guidelines provide recommendations for managing chemoradiotherapy-induced OM in various clinical contexts. Subsequently, emerging researches have introduced evidence supporting novel approaches or existing regimens for OM prevention and treatment. The repurposing of established drugs has garnered significant interest due to its shorter development timeline, improved safety profiles, and lower costs compared to new drug development. For example, clinical trials assessing established drugs such as melatonin, clonidine, and pentoxifylline indicate promising potential for managing OM. Additionally, several emerging pharmacological interventions have demonstrated considerable efficacy; SAMITAL and rhIL-11 are supported by phase II clinical trials and prospective studies, while probiotics like Streptococcus salivarius K12 and curcumin have shown effectiveness in randomized clinical trials. Furthermore, recent high-level studies have reinforced the efficacy of non-pharmacological interventions, such as photobiomodulation (PBM) and cryotherapy, over the past two years. In all, given the evidence supporting different strategies, PBM and oral cryotherapy are highly recommended for managing OM when feasible. Topical clonidine, melatonin, oral pentoxifylline, topical SAMITAL or rhIL-11, oral SsK12, and curcumin may also be utilized but would benefit from validation in larger trials. Besides, Verbascoside, Palifermin, Amifostine, and Avasopasem manganese can be suggested for OM management, while the side effects should be monitored. The accessibility and cost/effectiveness of specific managing strategies of OM should be considered when selecting appropriate options.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"133 ","pages":"Article 102883"},"PeriodicalIF":9.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973686","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":"Therapeutic strategies and landscape of metaplastic breast cancer","authors":"Peilin Dai ,&nbsp;Tianyi Song ,&nbsp;Junzhi Liu ,&nbsp;Zuer He ,&nbsp;Xiaoli Wang ,&nbsp;Ran Hu ,&nbsp;Jiqiao Yang","doi":"10.1016/j.ctrv.2025.102885","DOIUrl":"10.1016/j.ctrv.2025.102885","url":null,"abstract":"<div><div>Metaplastic breast cancer is a rare and heterogeneous subtype of breast cancer, associated with a poor prognosis. Its distinct biological behavior and morphological features contribute to resistance to standard treatment regimens. Hitherto, the optimal therapeutic strategy for metaplastic breast cancer remains underexplored. Herein, we review the literature on the treatment of metaplastic breast cancer, summarizing current local and systemic therapies, and discuss potential therapeutic targets and novel strategies based on its pathological and molecular characteristics. Targeted therapy and immunotherapy may provide more personalized treatment options, with the potential to improve the prognosis of this disease.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"133 ","pages":"Article 102885"},"PeriodicalIF":9.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018339","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":"Incomplete ovarian function suppression in premenopausal breast cancer patients treated with gonadotropin-releasing hormone agonists","authors":"Jinna Lin ,&nbsp;Shuqi Zheng ,&nbsp;Qiang Liu","doi":"10.1016/j.ctrv.2025.102879","DOIUrl":"10.1016/j.ctrv.2025.102879","url":null,"abstract":"<div><h3>Background</h3><div>Ovarian function suppression (OFS) has emerged as a crucial adjuvant therapy for premenopausal breast cancer patients. Some patients fail to achieve complete OFS with commonly used OFS drugs. The definition of incomplete OFS remains unclear, and large-scale data on its incidence are lacking. This review provides a comprehensive overview of the definition, occurrence, impact on therapeutic efficacy and corresponding treatment measures for incomplete OFS.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase and Cochrane Library databases in recent twenty years with keywords as “ovarian function escape”, “incomplete OFS” and “estrogen breakthrough”, and carried out a snowballing of references to important literature. Clinical literature of premenopausal breast cancer patients treated with OFS was screened. The patient characteristics, definition and incidence of incomplete OFS, prognosis, interventions and other information were extracted.</div></div><div><h3>Results</h3><div>A total of 17 studies were included in the analysis, including RCTs, retrospective or prospective cohort studies and case reports. Literature indicates that the incidence of incomplete OFS is around 5–50 % when the estradiol (E2) threshold is set as 2.72 pg/mL, 10 pg/mL, 20 pg/mL, or 30 pg/mL. Young age, high body mass index (BMI), and no prior chemotherapy were the risk factors for incomplete OFS. The treatment of incomplete OFS included dose adjustments, alternative OFS drugs, or the adoption of other OFS measures.</div></div><div><h3>Conclusions</h3><div>The incomplete OFS rate decreased with the extension of treatment time. It is reasonable to monitor E2 levels to ensure successful OFS in the patients with high risk factors for incomplete OFS or with concurrent use of aromatase inhibitor (AI). Transient incomplete OFS seems to have no impact on prognosis, but sustained incomplete OFS needs personalized adjustment of treatment strategy to ensure complete OFS.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"133 ","pages":"Article 102879"},"PeriodicalIF":9.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967542","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":"CAR-T cell therapy for breast cancer: Current status and future perspective","authors":"Giuseppe Buono ,&nbsp;Monica Capozzi ,&nbsp;Roberta Caputo ,&nbsp;Vincenzo Di Lauro ,&nbsp;Daniela Cianniello ,&nbsp;Michela Piezzo ,&nbsp;Stefania Cocco ,&nbsp;Claudia Martinelli ,&nbsp;Annarita Verrazzo ,&nbsp;Margherita Tafuro ,&nbsp;Claudia Calderaio ,&nbsp;Alessandra Calabrese ,&nbsp;Francesco Nuzzo ,&nbsp;Martina Pagliuca ,&nbsp;Michelino De Laurentiis","doi":"10.1016/j.ctrv.2024.102868","DOIUrl":"10.1016/j.ctrv.2024.102868","url":null,"abstract":"<div><div>Within the expanding therapeutic landscape for breast cancer (BC), metastatic breast cancer (MBC) remains virtually incurable and tend to develop resistance to conventional treatments ultimately leading to metastatic progression and death. Cellular immunotherapy (CI), particularly chimeric antigen receptor-engineered T (CAR-T) cells, has emerged as a promising approach for addressing this challenge. In the wake of their striking efficacy against hematological cancers, CAR-T cells have also been used where the clinical need is greatest – in patients with aggressive BCs. Unfortunately, current outcomes fall considerably short of replicating that success, primarily owing to the scarcity of tumor-specific antigens and the immunosuppressive microenvironment within BC. Herein, we provide an up-to-date overview of both preclinical and clinical data concerning the application of CAR-T cell therapy in BC. By surveying the existing literature, we discuss the prevailing constrains of this therapeutic approach and overview possible strategies to advance it in the context of breast malignancies. Possible approaches include employing synthetic biology to refine antigen targeting and mitigate off-target toxicity, utilizing logic-gated CAR constructs to enhance specificity, and leveraging armored CARs to remodel the tumor micro-environment. Temporal and spatial regulation of CAR-T cells using inducible gene switches and external triggers further improves safety and functionality. In addition, promoting T cell homing through chemokine receptor engineering and enhancing manufacturing processes with universal CAR platforms expand therapeutic applicability. These innovations not only address antigen escape and T cell exhaustion but also optimize the efficacy and safety profile of CAR-T cell therapy. We, therefore, outline a trajectory wherein CAR-T cells may evolve from a promising experimental approach to a standard modality in BC therapy.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"133 ","pages":"Article 102868"},"PeriodicalIF":9.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973679","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":"Claudins as diagnostic tools and therapeutic targets—Glimpse of the horizon","authors":"Keiji Sugiyama ,&nbsp;Ian Chau","doi":"10.1016/j.ctrv.2025.102888","DOIUrl":"10.1016/j.ctrv.2025.102888","url":null,"abstract":"<div><div>Claudins (CLDNs) play a crucial and indispensable role as fundamental components within the structure of tight junctions. Due to the distinct and unique distribution pattern exhibited by CLDNs in both normal and malignant tissues, these proteins have garnered significant attention as pivotal targets for systemic anti-cancer therapy and as noteworthy diagnostic markers. This review provides a comprehensive and detailed elucidation of the fundamental understanding surrounding CLDNs, their intricate expression patterns, the potential role they play in cancer diagnosis and therapeutic potentials; all encapsulated within a succinct summary of the cutting-edge advancements and the information derived from various clinical trials.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"133 ","pages":"Article 102888"},"PeriodicalIF":9.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of topical estrogen therapy during adjuvant endocrine treatment among patients with breast cancer: A meta-analysis based expert panel discussion","authors":"Stavroula L. Kastora ,&nbsp;Eirini Pantiora ,&nbsp;Yong Hwa Hong ,&nbsp;Meenakshi Veeramani ,&nbsp;Hatem A Azim Jr ,&nbsp;Rima Chakrabarti ,&nbsp;Jürgen Geisler ,&nbsp;Ann Knoop ,&nbsp;Matteo Lambertini ,&nbsp;Barbro Linderholm ,&nbsp;Icro Meattini ,&nbsp;Ann H Partridge ,&nbsp;Ines Vaz-Luis ,&nbsp;Denise Vorburger ,&nbsp;Gabriella Yongue ,&nbsp;Andreas Karakatsanis ,&nbsp;Antonios Valachis","doi":"10.1016/j.ctrv.2025.102880","DOIUrl":"10.1016/j.ctrv.2025.102880","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Importance&lt;/h3&gt;&lt;div&gt;Endocrine treatments, such as Tamoxifen (TAM) and/or Aromatase inhibitors (AI), are the adjuvant therapy of choice for hormone-receptor positive breast cancer. These agents are associated with menopausal symptoms, adversely affecting drug compliance. Topical estrogen (TE) has been proposed for symptom management, given its’ local application and presumed reduced bioavailability, however its oncological safety remains uncertain.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The present systematic review, &lt;em&gt;meta&lt;/em&gt;-analysis and expert panel review aimed to evaluate the strength of the available evidence on the risk of recurrence and mortality when TE is utilised in congruence with TAM or AI treatment, among BC survivors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data Sources&lt;/h3&gt;&lt;div&gt;Six databases and two prospective registers, were interrogated from inception to January 3rd, 2024. Search terms were Breast cancer AND Hormone replacement therapy AND topical/vaginal oestrogen AND recurrence/mortality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study selection&lt;/h3&gt;&lt;div&gt;All study designs reporting the use vs. non-use of TE in breast cancer survivors receiving adjuvant endocrine treatment were included. Six observational studies were deemed eligible for inclusion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data extraction and synthesis&lt;/h3&gt;&lt;div&gt;Sources of heterogeneity were explored using subgroup analysis by risk of bias, median follow-up period, node positivity and menopausal status. Trial sequential analysis was performed to quantify outcome reliability. A global expert panel was called to deliberate on the data, pinpoint areas of limited understanding, and determine the most important areas for future research.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main outcomes and measures&lt;/h3&gt;&lt;div&gt;Risk ratio effect sizes (RR) and corresponding 95 % Confidence Intervals (CI) of breast cancer recurrence and mortality in survivors on endocrine treatment (TAM and/or AI) exposed to TE were reported. Expert panel appraisal of &lt;em&gt;meta&lt;/em&gt;-analysis evidence with definition of current knowledge gaps and future research aims.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In 38 050 female patients receiving adjuvant endocrine treatment, of whom 1805 had been exposed to TE, TE exposure of those on AI, did not increase all-cause mortality (RR 0.99 [95 %CI 0.58, 1.69], I&lt;sup&gt;2&lt;/sup&gt; = 81 %, P = 0.96; moderate GRADE certainty). However, such exposure may convey an increased risk of recurrence (RR 2.51 [95 % CI 1.10, 5.72], I&lt;sup&gt;2&lt;/sup&gt; = 9 %, P = 0.03; low-GRADE certainty). Exposure to TE during TAM did not increase either recurrence risk or all-cause mortality. Clinical factors such as lymph node positivity at the time of diagnosis and menopausal status and follow-up time appeared to be significant confounders.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions and relevance&lt;/h3&gt;&lt;div&gt;The use of TE does not appear to increase either recurrence or mortality risk among BC survivors treated with TAM. An increased recurrence risk, without an increase in mortality, ","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"133 ","pages":"Article 102880"},"PeriodicalIF":9.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and perspectives in the management of BRAF-mutated metastatic melanoma: Systemic treatment sequencing and brain metastases","authors":"Juan Martin-Liberal ,&nbsp;Iván Márquez-Rodas ,&nbsp;Pablo Cerezuela-Fuentes ,&nbsp;Ainara Soria ,&nbsp;Fernando Garicano ,&nbsp;Javier Medina ,&nbsp;Regina García Galindo ,&nbsp;Juana Oramas ,&nbsp;José Luis Manzano ,&nbsp;Mayte Delgado ,&nbsp;Javier Valdivia ,&nbsp;Pedro Sanchez","doi":"10.1016/j.ctrv.2025.102886","DOIUrl":"10.1016/j.ctrv.2025.102886","url":null,"abstract":"<div><div>The global incidence of metastatic melanoma with BRAF mutations, characterized by aggressive behavior and poor prognosis, is rising. Recent treatment advances, including immune checkpoint inhibitors (ICI) and targeted therapies (TT) such as BRAF and MEK inhibitors, have significantly enhanced patient outcomes. Although guidelines recommend sequencing strategies, real-world implementation can be influenced by clinical scenarios. This article highlights the importance of tailored treatment strategies, emphasizing that the decision to initiate immunotherapy (IT) or TT hinges on multiple factors, including tumor burden, LDH levels, presence of brain metastases, and patient symptomatic status. Managing brain metastases also poses a challenge, as these patients are typically excluded from pivotal clinical trials. While insights from phase II studies provide some guidance, there is a critical need for more quality data to inform comprehensive recommendations. Furthermore, although triple therapy combining IT and TT was initially thought to be promising, it has failed to clearly demonstrate benefit over current treatments. For all these reasons, there is an imperative need for further research on biomarkers and predictive factors, as well as real-world studies, that will help tailor treatment strategies across diverse patient subsets, thereby refining therapeutic approaches for BRAF-mutated metastatic melanoma.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"133 ","pages":"Article 102886"},"PeriodicalIF":9.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}