Cancer treatment reviews最新文献

{"title":"Pharmacological prevention and treatment of opioid-induced constipation in cancer patients: A systematic review and meta-analysis","authors":"K.R.J. Kistemaker ,&nbsp;F. Sijani ,&nbsp;D.J. Brinkman ,&nbsp;A. de Graeff ,&nbsp;G.L. Burchell ,&nbsp;M.A.H. Steegers ,&nbsp;L. van Zuylen","doi":"10.1016/j.ctrv.2024.102704","DOIUrl":"https://doi.org/10.1016/j.ctrv.2024.102704","url":null,"abstract":"<div><h3>Background</h3><p>Cancer-related pain often requires opioid treatment with opioid-induced constipation (OIC) as its most frequent gastrointestinal side-effect. Both for prevention and treatment of OIC osmotic (e.g. polyethylene glycol) and stimulant (e.g. bisacodyl) laxatives are widely used. Newer drugs such as the peripherally acting µ-opioid receptor antagonists (PAMORAs) and naloxone in a fixed combination with oxycodone have become available for the management of OIC.</p><p>This systematic review and meta-analysis aims to give an overview of the scientific evidence on pharmacological strategies for the prevention and treatment of OIC in cancer patients.</p></div><div><h3>Methods</h3><p>A systematic search in PubMed, Embase, Web of Science and the Cochrane Library was completed from inception up to 22 October 2022. Randomized and non-randomized studies were systematically selected. Bowel function and adverse drug events were assessed.</p></div><div><h3>Results</h3><p>Twenty trials (prevention: five RCTs and three cohort studies; treatment: ten RCTs and two comparative cohort studies) were included in the review.</p><p>Regarding the prevention of OIC, three RCTs compared laxatives with other laxatives, finding no clear differences in effectivity of the laxatives used. One cohort study showed a significant benefit of magnesium oxide compared with no laxative. One RCT found a significant benefit for the PAMORA naldemedine compared with magnesium oxide. Preventive use of oxycodone/naloxone did not show a significant difference in two out of three other studies compared to oxycodone or fentanyl. A meta-analysis was not possible.</p><p>Regarding the treatment of OIC, two RCTs compared laxatives, of which one RCT found that polyethylene glycol was significantly more effective than sennosides. Seven studies compared an opioid antagonist (naloxone, methylnaltrexone or naldemedine) with placebo and three studies compared different dosages of opioid antagonists. These studies with opioid antagonists were used for the meta-analysis.</p><p>Oxycodone/naloxone showed a significant improvement in Bowel Function Index compared to oxycodone with laxatives (MD −13.68; 95 % CI −18.38 to −8.98; I² = 58 %). Adverse drug event rates were similar amongst both groups, except for nausea in favour of oxycodone/naloxone (RR 0.51; 95 % CI 0.31–0.83; I² = 0 %). Naldemedine (NAL) and methylnaltrexone (MNTX) demonstrated significantly higher response rates compared to placebo (NAL: RR 2.07, 95 % CI 1.64–2.61, I² = 0 %; MNTX: RR 3.83, 95 % CI 2.81–5.22, I² = 0 %). With regard to adverse events, abdominal pain was more present in treatment with methylnaltrexone and diarrhea was significantly more present in treatment with naldemedine. Different dosages of methylnaltrexone were not significantly different with regard to both efficacy and adverse drug event rates.</p></div><div><h3>Conclusions</h3><p>Magnesium oxide and nalde","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0305737224000227/pdfft?md5=71786d5672fa6b4f1ee184e40fb33ac1&pid=1-s2.0-S0305737224000227-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041820","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":"Neoadjuvant EGFR-TKI therapy in Non-Small cell lung cancer","authors":"Christopher Grant, M. Nagasaka","doi":"10.1016/j.ctrv.2024.102724","DOIUrl":"https://doi.org/10.1016/j.ctrv.2024.102724","url":null,"abstract":"","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140406379","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":"Cancer genetic counselling for hereditary breast cancer in the era of precision oncology","authors":"M. Pensabene ,&nbsp;A. Calabrese ,&nbsp;C. von Arx,&nbsp;R. Caputo,&nbsp;M. De Laurentiis","doi":"10.1016/j.ctrv.2024.102702","DOIUrl":"https://doi.org/10.1016/j.ctrv.2024.102702","url":null,"abstract":"<div><p>A relevant percentage of breast cancers (BCs) are tied to pathogenetic (P)/likely pathogenetic (LP) variants in predisposing genes. The knowledge of P/LP variants is an essential element in the management of BC patients since the first diagnosis because it influences surgery and subsequent oncological treatments and follow-up. Moreover, patients with metastatic BCs can benefit from personalized treatment if carriers of P/LP in BRCA1/2 genes. Multigene panels allow the identification of other predisposing genes with an impact on management. Cascade genetic testing for healthy family members allows personalized preventive strategies. Here, we review the advances and the challenges of Cancer Genetic Counseling (CGC). We focus on the area of oncology directed to hereditary BC management describing the peculiar way to lead CGC and how CGC changes over time. The authors describe the impact of genetic testing by targeted approach or universal approach on the management of BC according to the stage at diagnosis. Moreover, they describe the burden of CGC and testing and future perspectives to widely offer testing. A new perspective is needed for models of service delivery of CGC and testing, beyond formal genetic counselling. A broader genetic test can be quickly usable in clinical practice for comprehensive BC management and personalized prevention in the era of precision oncology.</p></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0305737224000203/pdfft?md5=df11a66a33e2c56e6989728f2a516d15&pid=1-s2.0-S0305737224000203-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041819","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":"Incorporation of anti-PD1 or anti PD-L1 agents to platinum-based chemotherapy for the primary treatment of advanced or recurrent endometrial cancer. A meta-analysis","authors":"Michele Bartoletti ,&nbsp;Marcella Montico ,&nbsp;Domenica Lorusso ,&nbsp;Roberta Mazzeo ,&nbsp;Ana Oaknin ,&nbsp;Lucia Musacchio ,&nbsp;Giovanni Scambia ,&nbsp;Fabio Puglisi ,&nbsp;Sandro Pignata","doi":"10.1016/j.ctrv.2024.102701","DOIUrl":"https://doi.org/10.1016/j.ctrv.2024.102701","url":null,"abstract":"<div><h3>Importance</h3><p>Various randomized trials have explored the efficacy of combining immune checkpoint inhibitors (ICIs) with first-line chemotherapy in advanced endometrial cancer. We aimed to summarize available data and clarify the benefit of adding immunotherapy according to the DNA mismatch repair status (deficient, dMMR or proficient, pMMR) and the specific type of agent used (anti-PD1 or anti-PD-L1).</p></div><div><h3>Objective</h3><p>To assess whether the addition of ICIs to standard platinum-based chemotherapy enhances progression-free survival (PFS) for patients with advanced endometrial cancer both overall and based on DNA mismatch repair status.</p></div><div><h3>Data sources</h3><p>Electronic databases (PubMed, Embase and Cochrane Library) and conference proceedings were searched for first line, randomized and controlled trials integrating ICIs with chemotherapy for the treatment of advanced endometrial cancer published or presented by November 1, 2023.</p></div><div><h3>Study selection</h3><p>Five studies, comprising 2456 patients (1308 received ICIs with chemotherapy and 1148 treated with chemotherapy alone) met the selection criteria and were included in the analysis. Experimental arms included pembrolizumab, dostarlimab (anti-PD1) and durvalumab, atezolizumab and avelumab (anti-PD-L1) combined with standard three-weekly carboplatin-paclitaxel chemotherapy backbone. Endometrial carcinosarcoma were included in 3 out of 5 trials.</p></div><div><h3>Data extraction and synthesis</h3><p>For comparison of PFS outcomes, extrapolation of hazard ratios (HRs), 95% confidence intervals (CI) and PFS events was performed for each included study in the overall population and according to subgroups. Data analysis was conducted using a random-effects model.</p></div><div><h3>Results</h3><p>The addition of ICIs to chemotherapy improved PFS compared to chemotherapy alone in the overall population (pooled HR, 0.63; 95 % CI, 0.52––0.76; P &lt;.001). In the dMMR subgroup the benefit was more pronounced (pooled HR, 0.34; 95 % CI, 0.27––0.44; P &lt;.001) and not affected by drugs used with pooled HRs of 0.39 (95 % CI, 0.28––0.55; P &lt;.001) and 0.34 (95 % CI, 0.27––0.44; P &lt;.001) for PD-L1 and PD1 inhibitors, respectively. For pMMR patients, a statistically significant benefit in terms of PFS was confirmed only when anti-PD1 were used (anti-PD-1: HR 0.64, 95 % CI: 0.46–0.90, P =.010 vs anti-PD-L1: HR 0.87, 95 % CI: 0.73–1.03, P =.104)</p></div><div><h3>Conclusions and relevance</h3><p>This <em>meta</em>-analysis confirmed the advantage in terms of PFS of adding ICIs to standard platinum-based chemotherapy. While dMMR patients benefit from the incorporation of both anti PD-1 or anti PD-L1, this benefit is confined to the association of anti-PD1 agents in pMMR patients. Updated analysis of trials is awaited to clarify the impact of immunotherapy on overall survival.</p></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0305737224000197/pdfft?md5=70aba726898887fdf324df961a3425eb&pid=1-s2.0-S0305737224000197-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139993345","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":"Current advances in targeted therapy for metastatic colorectal cancer – Clinical translation and future directions","authors":"David Johnson ,&nbsp;Cheng Ean Chee ,&nbsp;Wesley Wong ,&nbsp;Rachel C.T. Lam ,&nbsp;Iain Bee Huat Tan ,&nbsp;Brigette B.Y. Ma","doi":"10.1016/j.ctrv.2024.102700","DOIUrl":"https://doi.org/10.1016/j.ctrv.2024.102700","url":null,"abstract":"<div><p>The last two decades have witnessed major breakthroughs in the development of targeted therapy for patients with metastatic colorectal cancer (mCRC), an achievement which stems largely from advances in translational research. Precision medicine is now widely practiced in routine oncological care, where systemic therapy is individualized based on clinical factors such as primary tumor sidedness, location and number of metastases, as well as molecular factors such as the RAS and BRAF mutation status, mismatch repair / microsatellite status and presence of other actionable genomic alterations in the tumor. The optimal selection of patients with RAS and BRAF-wild type (WT), left-sided primary tumor for treatment with epidermal growth factor receptor (EGFR) and chemotherapy (chemo) has markedly improved survival in the first-line setting. The pivotal trials of cetuximab in combination with BRAF/ MEK inhibitor for BRAF V600E mutant mCRC, and panitumumab with KRAS G12C inhibitor in KRAS(G12C)-mutant mCRC have been practice-changing. Anti-HER2 small molecular inhibitor, antibodies and antibody-drug conjugates have significantly improved the treatment outcome of patients with HER2 amplified mCRC. Anti-angiogenesis agents are now used across all lines of treatment and novel combinations with immune-checkpoint inhibitors are under active investigation in MSS mCRC. The non-invasive monitoring of molecular resistance to targeted therapies using Next Generation Sequencing analysis of circulating tumor-derived DNA (ctDNA) and captured sequencing of tumors have improved patient selection for targeted therapies. This review will focus on how latest advances, challenges and future directions in the development of targeted therapies in mCRC.</p></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139993344","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":"177Lu-PSMA therapy in metastatic prostate cancer: An updated review of prognostic and predictive biomarkers","authors":"Emilio Francesco Giunta ,&nbsp;Nicole Brighi ,&nbsp;Giorgia Gurioli ,&nbsp;Federica Matteucci ,&nbsp;Giovanni Paganelli ,&nbsp;Ugo De Giorgi","doi":"10.1016/j.ctrv.2024.102699","DOIUrl":"10.1016/j.ctrv.2024.102699","url":null,"abstract":"<div><p>177Lu-PSMA has been approved for the treatment of PSMA-positive metastatic castration-resistant (mCRPC) patients who progressed to androgen receptor pathway inhibitors (ARPIs) and taxane-based chemotherapy. However, a higher proportion of patients do not respond to this type of radioligand therapy (RLT). To date, there is a lack of validated prognostic and predictive biomarkers for 177Lu-PSMA therapy in prostate cancer. Several studies have investigated the prognostic and predictive role of clinical and molecular factors and also the metabolic features of PET imaging. In this review, we aim to take stock of the current scenario, focusing on new emerging data from retrospective/prospective series and clinical trials. Given the high costs and the possibility of primary resistance, it seems essential to identify clinical and molecular characteristics that could allow clinicians to choose the right patient to treat with 177Lu-PSMA. Biomarker-based clinical trials are urgently needed in this field.</p></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0305737224000173/pdfft?md5=160030d37532638066675fd576081b44&pid=1-s2.0-S0305737224000173-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139927631","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":"Salivary gland carcinoma: Towards a more personalised approach","authors":"Layal Rached ,&nbsp;Khalil Saleh ,&nbsp;Odile Casiraghi ,&nbsp;Caroline Even","doi":"10.1016/j.ctrv.2024.102697","DOIUrl":"10.1016/j.ctrv.2024.102697","url":null,"abstract":"<div><p>Salivary Gland carcinomas (SGCs) are rare tumors accounting for less than 1% of all cancers with 21 histologically diverse subtypes. The rarity of the disease presents a challenge for clinicians to conduct large size randomized controlled trials. Surgery and radiotherapy remain the only curative treatment for localized disease, whereas treatments for recurrent and metastatic disease remain more challenging with very disappointing results for chemotherapy.</p><p>The different histological subtypes harbor various genetic alterations, some pathognomonic with a diagnostic impact for pathologists in confirming a difficult diagnosis and others with therapeutic implications regardless of the histologic subtype. Current international guidelines urge pathologists to identify androgen receptor status, HER-2 expression that could be determined by immunohistochemistry, and TRK status in patients with non-adenoid cystic salivary gland carcinoma that are eligible to initiate a systemic treatment, in order to offer them available targeted therapies or refer them to clinical trials based on their mutational profile. A more advanced molecular profiling by next generation sequencing would offer a larger panel of molecular alterations with possible therapeutic implications such as NOTCH, PI3K, BRAF, MYB, and EGFR. In the following review, we present the most common genetic alterations in SGCs as well as actionable mutations with the latest available data on therapeutic options and upcoming clinical trials.</p></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139822311","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":"Theranostics revolution in prostate cancer: Basics, clinical applications, open issues and future perspectives","authors":"Matteo Bauckneht ,&nbsp;Chiara Ciccarese ,&nbsp;Riccardo Laudicella ,&nbsp;Claudia Mosillo ,&nbsp;Francesca D'Amico ,&nbsp;Annunziato Anghelone ,&nbsp;Alessandro Strusi ,&nbsp;Viria Beccia ,&nbsp;Sergio Bracarda ,&nbsp;Giuseppe Fornarini ,&nbsp;Giampaolo Tortora ,&nbsp;Roberto Iacovelli","doi":"10.1016/j.ctrv.2024.102698","DOIUrl":"https://doi.org/10.1016/j.ctrv.2024.102698","url":null,"abstract":"<div><p>In the last years, theranostics has expanded the therapeutic options available for prostate cancer patients. In this review, we explore this dynamic field and its potential to revolutionize precision medicine for prostate cancer. We delve into the foundational principles, clinical applications, and emerging opportunities, emphasizing the potential synergy between radioligand therapy and other systemic treatments. Additionally, we address the ongoing challenges, including optimizing patient selection, assessing treatment responses, and determining the role of theranostics within the broader landscape of prostate cancer treatment.</p></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0305737224000161/pdfft?md5=3dfb0b74c0926897345eea7f47243cf5&pid=1-s2.0-S0305737224000161-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139737226","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":"Preoperative chemotherapy in upfront resectable colorectal liver metastases: New elements for an old dilemma?","authors":"Lorenzo Bernardi ,&nbsp;Raffaello Roesel ,&nbsp;Davit L. Aghayan ,&nbsp;Pietro E. Majno-Hurst ,&nbsp;Sara De Dosso ,&nbsp;Alessandra Cristaudi","doi":"10.1016/j.ctrv.2024.102696","DOIUrl":"https://doi.org/10.1016/j.ctrv.2024.102696","url":null,"abstract":"<div><p>The use of preoperative or “neoadjuvant” chemotherapy (NAC) has long been controversial for resectable colorectal liver metastases (CRLM). The European Society of Medical Oncology (ESMO) 2023 guidelines on metastatic colorectal cancer (CRC) indicate a combination of surgical/technical and oncologic/prognostic criteria as the two determinants for allocating patients to NAC or upfront hepatectomy. However, surgical and technical criteria have evolved, and oncologic prognostic criteria date from the pre-modern chemotherapy era and lack prospective validation.</p><p>The traditional literature is interpreted as not supporting the use of NAC because several studies fail to demonstrate a benefit in overall survival (OS) compared to upfront surgery; however, OS may not be the most appropriate endpoint to consider. Moreover, the commonly quoted studies against NAC contain many limitations that may explain why NAC failed to demonstrate its value. The query of the recent literature focused primarily on other aspects than OS, such as surgical technique, the impact of side effects of chemotherapy, the histological growth pattern of metastases, or the detection of circulating tumor DNA, shows data that support a more widespread use of NAC. These should prompt a critical reappraisal of the use of NAC, leading to a more precise selection of patients who could benefit from it.</p></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0305737224000148/pdfft?md5=1c520914519cc1fac04b67e94eb45b47&pid=1-s2.0-S0305737224000148-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139709732","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":"High-dose chemotherapy for Ewing sarcoma and Rhabdomyosarcoma: A systematic review by the Australia and New Zealand sarcoma association clinical practice guidelines working party","authors":"Ashika Ramamurthy ,&nbsp;Elizabeth A Connolly ,&nbsp;Jasmine Mar ,&nbsp;Jeremy Lewin ,&nbsp;Vivek A Bhadri ,&nbsp;Marianne B Phillips ,&nbsp;Mark Winstanley ,&nbsp;Lisa M Orme ,&nbsp;Peter Grimison ,&nbsp;Joanna Connor ,&nbsp;Smaro Lazarakis ,&nbsp;Angela M Hong ,&nbsp;Natacha Omer ,&nbsp;Julie Cayrol","doi":"10.1016/j.ctrv.2024.102694","DOIUrl":"10.1016/j.ctrv.2024.102694","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with high-risk or metastatic Ewing sarcoma (ES) and rhabdomyosarcoma (RMS) have a guarded prognosis. High-dose chemotherapy (HDT) with autologous stem cell transplant (ASCT) has been evaluated as a treatment option to improve outcomes. However, survival benefits remain unclear, and treatment is associated with severe toxicities.</p></div><div><h3>Methods</h3><p>A systematic review was conducted, using the population, intervention, comparison outcome (PICO) model, to evaluate whether utilization of HDT/ASCT impacts the outcome of patients with ES and RMS compared to standard chemotherapy alone, as part of first line treatment or in the relapse setting. Medline, Embase and Cochrane Central were queried for publications from 1990 to October 2022 that evaluated event-free survival (EFS), overall survival (OS), and toxicities. Each study was screened by two independent reviewers for suitability. A qualitative synthesis of the results was performed.</p></div><div><h3>Results</h3><p>Of 1,172 unique studies screened, 41 studies were eligible for inclusion with 29 studies considering ES, 10 studies considering RMS and 2 studies considering both. In ES patients with high-risk localised disease who received HDT/ASCT after VIDE chemotherapy, consolidation with melphalan-based HDT/ASCT as first line therapy conveyed an EFS and OS benefit over standard chemotherapy consolidation. Efficacy of HDT/ASCT using a VDC/IE backbone, which is now standard care, has not been established. Survival benefits are not confirmed for ES patients with metastatic disease at initial diagnosis. For relapsed/refractory ES, four retrospective studies report improvement in outcomes with HDT/ASCT with the greatest evidence in patients who demonstrate a treatment response before HDT, and in patients under the age of 14. In RMS, there is no proven survival benefit of HDT/ASCT in primary localised, metastatic or relapsed disease.</p></div><div><h3>Conclusion</h3><p>Prospective randomised trials are required to determine the utility of HDT/ASCT in ES and RMS. Selected patients with relapsed ES could be considered for HDT/ASCT.</p></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":null,"pages":null},"PeriodicalIF":11.8,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0305737224000124/pdfft?md5=99cbee155e82f33bb2c334acb5a3b995&pid=1-s2.0-S0305737224000124-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139668862","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}