Cancer treatment reviews最新文献

{"title":"Invasive lobular carcinoma: Strategies and perspectives from the lobular breast cancer research group","authors":"Giovanni Corso ,&nbsp;Sherry Shen ,&nbsp;Carmen Criscitiello ,&nbsp;Rita Mukhtar ,&nbsp;Lauren Gamble ,&nbsp;Elena Guerini Rocco ,&nbsp;Filippo Pesapane ,&nbsp;Luca Nicosia ,&nbsp;Komal Jhaveri ,&nbsp;Beatrice Taurelli Salimbeni ,&nbsp;Giulia Massari ,&nbsp;Eleonora Meduri ,&nbsp;Alessandra Margherita De Scalzi ,&nbsp;Alberto Concardi ,&nbsp;Francesca Magnoni ,&nbsp;Anita Mamtani ,&nbsp;Fresia Pareja ,&nbsp;Maria Cristina Leonardi ,&nbsp;Virgilio Sacchini ,&nbsp;Giorgio Bogani ,&nbsp;Mark E. Robson","doi":"10.1016/j.ctrv.2025.103001","DOIUrl":"10.1016/j.ctrv.2025.103001","url":null,"abstract":"<div><div>Invasive lobular carcinoma (ILC) represents approximately 10–15% of all breast cancers and is defined by a unique discohesive morphology due to loss of E-cadherin. Despite its prevalence, ILC has been historically underrepresented in clinical and translational research, contributing to diagnostic, therapeutic, and prognostic uncertainties. This narrative review, conducted by the Invasive Lobular Carcinoma Research Group, synthesizes current evidence on ILC with expert perspectives to inform future research and clinical strategies.</div><div>We highlight the distinct biology of ILC, including characteristic genomic alterations (e.g., <em>CDH1</em>, <em>PIK3CA</em>, <em>ERBB2</em> mutations) and its relationship with endocrine sensitivity and limited immune infiltration. Diagnostic challenges are underscored by ILC’s subtle imaging presentation and underestimation of tumor extent on mammography and ultrasound, with MRI and contrast-enhanced mammography offering improved accuracy. The review discusses evolving surgical approaches, axillary staging considerations, and radiotherapy strategies, with an emphasis on adapting techniques to ILC’s infiltrative growth.</div><div>Endocrine therapy remains central for hormone receptor–positive ILC, with emerging evidence supporting CDK4/6 inhibitors and extended endocrine therapy in high-risk cases. Investigational therapies targeting ILC-enriched mutations and synthetic lethality mechanisms (e.g., ROS1 inhibition in <em>CDH1</em>-deficient tumors) hold promise for personalized treatment.</div><div>This comprehensive review identifies knowledge gaps and advocates for histology-specific clinical trials, biomarker-driven treatment strategies, and tailored imaging and surgical techniques to improve outcomes for patients with ILC.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"140 ","pages":"Article 103001"},"PeriodicalIF":10.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842985","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":"Opportunities and challenges for non–small cell lung cancer brain metastases in the immunotherapy era","authors":"Ying Yu,&nbsp;Yuxi Luo,&nbsp;Fujuan Zeng,&nbsp;Anwen Liu","doi":"10.1016/j.ctrv.2025.103014","DOIUrl":"10.1016/j.ctrv.2025.103014","url":null,"abstract":"<div><div>Brain radiotherapy (BRT) has traditionally been the mainstay of treatment for non-small cell lung cancer brain metastases (NSCLC-BM), given the low intracranial efficacy of conventional systemic therapies. In recent years, immune checkpoint inhibitors (ICIs) have emerged as a standard treatment for advanced NSCLC without actionable driver mutations and have shown promising benefits in patients with BM. However, their intracranial efficacy remains modest, as the highest reported intracranial objective response rate and median intracranial progression-free survival in first-line populations reaching only 56.3 % and 12.7 months, respectively, which is likely explained by restricted blood-brain barrier permeability, the immunosuppressive tumor microenvironment within BM, and both primary and acquired resistance to ICIs. Preclinical evidence suggests that BRT can synergize with ICIs by enhancing antitumor immunity and overcoming immune resistance, primarily through blood-brain barrier disruption and tumor microenvironment remodeling. Consistently, encouraging clinical outcomes have been reported with the combination of BRT and ICI (BRT-ICI) in NSCLC-BM, while prospective data remain scarce. A recent phase II trial reported some of the most favorable outcomes to date with BRT-ICI plus chemotherapy, showing an intracranial objective response rate of 82.5 %, a median intracranial progression-free survival of 16.1 months, and a median overall survival of 20.9 months in treatment-naive patients with NSCLC-BM. Despite these advances, the optimal schedule of BRT-ICI remains controversial, with ongoing debates on treatment sequencing, timing, and radiation dose-fractionation. Additionally, critical challenges persist, including the risk of neurological toxicity, particularly radiation necrosis, and the absence of predictive biomarkers for patient selection. This review summarizes the current advances in ICI-based systemic therapies for NSCLC-BM, discusses the existing opportunities and progress of BRT-ICI, and reflects on challenges in optimizing this strategy in the immunotherapy era.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"140 ","pages":"Article 103014"},"PeriodicalIF":10.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907517","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":"Fecal microbiota transplantation to enhance cancer treatment outcomes across different cancer types: A systematic literature review","authors":"Demi Wekking ,&nbsp;Tom van den Ende ,&nbsp;Maarten F. Bijlsma ,&nbsp;Andrés Vidal-Itriago ,&nbsp;Max Nieuwdorp ,&nbsp;Hanneke W.M. van Laarhoven","doi":"10.1016/j.ctrv.2025.103025","DOIUrl":"10.1016/j.ctrv.2025.103025","url":null,"abstract":"<div><h3>Background</h3><div>The gut microbiome is increasingly recognized as a critical modulator of cancer therapy response. This systematic review evaluates Fecal Microbiota Transplantation (FMT)’s impact on cancer treatment outcomes and treatment-related toxicity and explores its mode of action.</div></div><div><h3>Methods</h3><div>A systematic search was conducted for prospective or retrospective clinical studies published until May 2025 that investigated FMT in cancer patients undergoing immunotherapy, chemotherapy, radiotherapy, targeted therapy, or a combination regimen.</div></div><div><h3>Results</h3><div>45 studies were included. No large-scale RCTs with published efficacy data were available, and most findings were derived from studies that lacked statistical power to assess efficacy. The majority of the articles demonstrated the safety and feasibility of FMT. Most toxicities reported were grade 1 or 2. Mechanistically, donor FMT restores gut microbiota diversity and reprograms the gut ecosystem, with increases in tumor-infiltrating lymphocytes and lower levels of regulatory T cells being observed. Furthermore, studies reported clinical improvement and endoscopic and/or histologic remission of treatment-induced colitis following FMT, alongside decreased colonic CD8+ T cell infiltration.</div></div><div><h3>Conclusion</h3><div>Donor FMT appears to be a safe and feasible adjunctive strategy during both first and later-line therapy and has potential for managing treatment-related colitis; however, its efficacy and its role in preventing immune-related adverse events remain to be elucidated in RCTs, as well as its application for graft-versus-host disease. The variability in clinical outcomes and context-dependent microbiota-host interactions that result in inconsistent findings underscores the complexity of FMT as a therapeutic modality. Furthermore, subclassifying recipient cancer patients could (based on gut microbiome ecosystem features) enhance biomarker identification for treatment responses.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"140 ","pages":"Article 103025"},"PeriodicalIF":10.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254003","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":"Advances in treatment strategies for low-grade serous ovarian cancer","authors":"Lucia Musacchio ,&nbsp;Domenica Lorusso ,&nbsp;Giulia Sabetta ,&nbsp;Alessandra Giustozzi ,&nbsp;Elena Giudice ,&nbsp;Maria Chiara Cannizzaro ,&nbsp;Maria Teresa Perri ,&nbsp;Anna Fagotti ,&nbsp;Vanda Salutari","doi":"10.1016/j.ctrv.2025.103019","DOIUrl":"10.1016/j.ctrv.2025.103019","url":null,"abstract":"<div><div>Low-grade serous ovarian carcinoma (LGSOC) represents a unique therapeutic challenge in gynecologic oncology. While it accounts for a minority of epithelial ovarian cancers (EOC), its distinct molecular landscape and limited sensitivity to conventional chemotherapy underscore the urgent need for alternative treatment paradigms. Over the past decade, advances in genomic profiling have led to a deeper understanding of its biology, revealing recurrent alterations in key signaling pathways such as (mitogen-activated protein kinase) MAPK, PI3K, and cell cycle regulators. These insights have catalyzed a shift toward precision medicine, with targeted agents and endocrine strategies emerging as promising avenues. However, despite encouraging signals from clinical trials, the rarity of LGSOC continues to hinder the development of robust, evidence-based standards. In this review, we critically examine the current treatment landscape and explore evolving therapeutic strategies, including ongoing efforts to integrate molecular biomarkers into clinical decision-making. By synthesizing recent evidence and highlighting key areas of unmet need, this review aims to provide a forward-looking perspective on the treatment of LGSOC. Future progress will depend on collaborative research, biomarker-driven clinical trial design, and a commitment to tailoring therapy based on the unique biology of this rare tumor type.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"140 ","pages":"Article 103019"},"PeriodicalIF":10.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026391","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":"Does the benefit of neoadjuvant chemotherapy at six months predict long-term outcomes in colon or rectal cancer? A meta-analysis of randomised studies","authors":"Joanna Socha ,&nbsp;Wojciech Michalski ,&nbsp;Rob Glynne-Jones ,&nbsp;Bengt Glimelius ,&nbsp;Krzysztof Bujko","doi":"10.1016/j.ctrv.2025.103020","DOIUrl":"10.1016/j.ctrv.2025.103020","url":null,"abstract":"<div><h3>Introduction</h3><div>The RAPIDO and PRODIGE-23 randomised trials of neoadjuvant versus adjuvant chemotherapy for rectal cancer showed that disease-free survival (DFS) curves diverged early, suggesting that much of the benefit from neoadjuvant chemotherapy occurred within six months. We aimed to determine whether the DFS benefit at six months in trials evaluating neoadjuvant chemotherapy can predict the benefit at 36 months, and to compare the timing of DFS benefit in trials of neoadjuvant versus in those of adjuvant chemotherapy.</div></div><div><h3>Material and methods</h3><div>A systematic review identified ten randomised trials comparing neoadjuvant with adjuvant chemotherapy and 37 randomised trials of adjuvant chemotherapy eligible for <em>meta</em>-analysis in rectal or colon cancer. Absolute differences in DFS between experimental and control groups at six and 36 months were extracted from Kaplan–Meier curves. The increment in the DFS benefit between the sixth and 36th months was calculated.</div></div><div><h3>Results</h3><div>In neoadjuvant chemotherapy trials, DFS benefit at six months (3.7 %, 95 % confidence interval [CI]: 1.9 to 5.4) did not differ significantly from that at 36 months (4.1 %, 95 % CI: 2.0 to 6.3), and the pooled absolute increment in DFS benefit between the sixth and 36th months was only 0.8 % (95 % CI: −1.6 to 3.2). The DFS benefit emerged earlier in neoadjuvant than in adjuvant chemotherapy trials.</div></div><div><h3>Conclusion</h3><div>In randomised trials comparing neoadjuvant with adjuvant chemotherapy, most of the DFS benefit from neoadjuvant chemotherapy manifests itself within the first six months. Therefore, assessing DFS at six months may potentially serve as an early indicator of long-term efficacy.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"140 ","pages":"Article 103020"},"PeriodicalIF":10.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044457","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":"Radioimmunotherapy for lung and head and neck cancers: A comparative review of clinical trial results and sequencing strategies","authors":"Danny Lavigne ,&nbsp;Yungan Tao ,&nbsp;Cecile Le Péchoux ,&nbsp;Angela Botticella ,&nbsp;France Nguyen ,&nbsp;Roger Sun ,&nbsp;Pierre Blanchard ,&nbsp;Jordi Remon ,&nbsp;Eric Deutsch ,&nbsp;Antonin Levy","doi":"10.1016/j.ctrv.2025.103017","DOIUrl":"10.1016/j.ctrv.2025.103017","url":null,"abstract":"<div><div>Immunotherapy has become standard of care for numerous cancer types in the past decade. Combining radiotherapy and immunotherapy has the potential to further improve outcomes by taking advantage of their theoretical synergy on antitumoral immune response. Despite promising preclinical and early clinical studies, along with significant improvements reported in specific settings, results from larger trials attempting to expand radioimmunotherapy to diverse clinical scenarios are markedly inconsistent. This review examines published and ongoing clinical trials evaluating this treatment strategy in patients with lung and head and neck cancers, where various sequencing strategies and settings were explored, including the consolidation, concurrent, induction, resectable, and metastatic settings. We highlight similarities and differences between these two tumor sites, discussing factors contributing to the variable efficacy of this therapeutic approach across diverse clinical settings.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"140 ","pages":"Article 103017"},"PeriodicalIF":10.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920379","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 to foster new treatment development in ultra-rare tumours? Joint EMA-EORTC multi-stakeholder workshops on ultra-rare sarcomas as a model for rare cancers","authors":"Silvia Stacchiotti ,&nbsp;Pan Pantziarka ,&nbsp;Hugh Leonard ,&nbsp;Caroline Voltz ,&nbsp;Laura Abatedaga ,&nbsp;Gauthier Bouche ,&nbsp;Christelle Bouygues ,&nbsp;Judith V.M.G. Bovee ,&nbsp;Winette T.A. Van der Graaf ,&nbsp;Teresa De Rojas ,&nbsp;Lorenzo D’Ambrosio ,&nbsp;Martha Donoghue ,&nbsp;Harald Enzmann ,&nbsp;Gerry Feeney ,&nbsp;Paolo Foggi ,&nbsp;Anna Maria Frezza ,&nbsp;Ralf Herold ,&nbsp;Robin L. Jones ,&nbsp;Bernd Kasper ,&nbsp;Kit Roes ,&nbsp;Pierre Demolis","doi":"10.1016/j.ctrv.2025.103003","DOIUrl":"10.1016/j.ctrv.2025.103003","url":null,"abstract":"<div><div>Ultra-rare sarcomas (URS) and ultra-rare cancers (URC) represent a unique challenge in oncology due to their rarity, heterogeneity, and the severe unmet clinical needs of affected patients. In 2024, the European Medicines Agency (EMA) and the European Organisation for Research and Treatment of Cancer (EORTC) convened two multi-stakeholder workshops, bringing together regulators, clinicians, researchers, and patient advocates. These workshops aimed to explore innovative strategies for treatment development and establish a framework for future collaboration.</div><div>Key issues were discussed, including the scarcity of biological and clinical data, major barriers in conducting randomized trials, and limited pharmaceutical investment. A key outcome was the unanimous commitment of all stakeholders, including regulatory agencies such as EMA and the U.S. FDA, to work together towards pragmatic solutions. Participants recognized the necessity of flexible regulatory approaches, alternative trial designs, and meaningful endpoints tailored to ultra-rare conditions. The workshops also highlighted the importance of global collaboration, early regulatory engagement, and leveraging existing mechanisms like orphan drug designation and conditional approvals.</div><div>The discussions emphasized that while scientific rigor must be upheld, regulatory frameworks must adapt to the specific challenges posed by URS. Stakeholders pledged to maintain open dialogue, share expertise, and develop innovative infrastructures to accelerate progress.</div><div>This collaborative commitment marks a critical step forward in addressing the high unmet needs of URS. By fostering a unified effort among diverse stakeholders, the workshops established a model for advancing treatments in other URC, prioritizing patient outcomes while navigating the complexities of drug development for these challenging diseases.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"140 ","pages":"Article 103003"},"PeriodicalIF":10.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809702","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":"The emerging role of PARP inhibitors in prostate cancer: A narrative review","authors":"Lorenzo Lobianco ,&nbsp;Gabriele Calvanese ,&nbsp;Debora D’Ausilio ,&nbsp;Sabrina Rossetti ,&nbsp;Sabrina Chiara Cecere ,&nbsp;Jole Ventriglia ,&nbsp;Carmela Pisano ,&nbsp;Rosa Tambaro ,&nbsp;Marilena Di Napoli ,&nbsp;Anna Passarelli ,&nbsp;Cristin Roma ,&nbsp;Antonella De Luca ,&nbsp;Filippo Sepe ,&nbsp;Silvana Cozzolino ,&nbsp;Erica Perri ,&nbsp;Maria Rosaria Lamia ,&nbsp;Carlo Moccia ,&nbsp;Sandro Pignata","doi":"10.1016/j.ctrv.2025.103000","DOIUrl":"10.1016/j.ctrv.2025.103000","url":null,"abstract":"<div><div>Prostate cancer (PC) is the second most common cancer and the fifth leading cause of cancer mortality in men, worldwide. Genomic analysis identified alterations in DNA damage repair (DDR) pathways, in up to 30% of metastatic castration-resistant prostate cancer (mCRPC). Homologous recombination repair (HRR) mutations in <em>BRCA1/2</em> emerged as a relevant biomarker in PC, linked to aggressive behavior, unfavorable outcomes and notable responses to poly-ADP ribose polymerase inhibitors (PARPi). While PARPi efficacy in BRCA-mutated mCRPC is well established, their role in earlier disease stages is currently under investigation. This non-systematic narrative review aims to summarize current evidence on PARPi in PC, outlining approved indications, ongoing clinical trials, and emerging therapeutic strategies across different disease settings.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"140 ","pages":"Article 103000"},"PeriodicalIF":10.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887306","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":"Datopotamab deruxtecan: rational strategies, novel advancements, challenges, and future perspectives","authors":"Vincenzo Di Lauro ,&nbsp;Alessandro Rizzo ,&nbsp;Margherita Tafuro ,&nbsp;Emanuela Fina ,&nbsp;Claudia Martinelli ,&nbsp;Claudia Calderaio ,&nbsp;Rossana Di Rienzo ,&nbsp;Miriam Pirolo ,&nbsp;Annarita Fanizzi ,&nbsp;Raffaella Massafra ,&nbsp;Michelino De Laurentiis","doi":"10.1016/j.ctrv.2025.103023","DOIUrl":"10.1016/j.ctrv.2025.103023","url":null,"abstract":"<div><div>Antibody-drug conjugates have recently revolutionized the treatment scenario of several tumors, including breast cancer. Among these, Datopotamab deruxtecan (Dato-DXd) is an ADC composed of a humanized anti-TROP2 monoclonal antibody linked to a potent exatecan-derived topoisomerase I inhibitor payload, deruxtecan (DXd), via a plasma-stable, selectively cleavable linker. Dato-DXd has shown notable efficacy and an overall tolerable safety profile, according to available evidence. Herein, we provide an overview of the pharmacological features, mechanisms of action, clinical efficacy, and adverse events of Dato-DXd in breast cancer. Furthermore, the current review proposes strategies to optimize patient management and accelerate the clinical development of Dato-DXd in this setting.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"140 ","pages":"Article 103023"},"PeriodicalIF":10.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108683","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":"Immune checkpoint inhibitor-related neurotoxicity: Incidence and management. A systematic review and meta-analysis","authors":"Dorte Lisbet Nielsen ,&nbsp;Carsten Bogh Juhl ,&nbsp;Inna Markovna Chen ,&nbsp;Yinghong Wang ,&nbsp;Ole Haagen Nielsen ,&nbsp;Bianca Denise Santomasso","doi":"10.1016/j.ctrv.2025.103011","DOIUrl":"10.1016/j.ctrv.2025.103011","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) have improved outcomes for various malignancies. However, serious immune-related adverse events (irAEs), including neurologic complications (NAEs), may occur. The aim of this study was to examine the incidence and spectrum of NAEs and evaluate management strategies for reducing their impact.</div></div><div><h3>Methods</h3><div>Two studies were conducted: 1) A <em>meta</em>-analysis of phase I-IV clinical trials involving adults with malignancies treated with ICIs, either as monotherapy, in combination with other ICIs, or with chemotherapy. The primary outcome was the incidence of (ir)NAEs, summarized using a <em>meta</em>-analysis with a random-effects model. 2) A systematic review of the literature addressing the clinical manifestations and treatment of irNAEs.</div></div><div><h3>Results</h3><div>The <em>meta</em>-analysis included 657 unique trials with 91,340 participants. For all ICIs, the incidence of all-grade NAEs was 0.24% (95% CI, 0.15–0.32%). Cerebral events, cerebrovascular accidents, were increased post-treatment and accounted for 54% of all grade-5 events in clinical trials. Among 991 reported irNAE cases, 77% of patients improved with treatment; however, 42% experienced unresolved sequelae and the overall mortality rate was 17.1%. Among patients with overlapping myasthenia gravis, myositis, and myocarditis (“Triple M”), the mortality reached 38%; primarily due respiratory failure (50%) or cardiotoxicity (41%).</div></div><div><h3>Conclusions</h3><div>Although the incidence of ICI-related NAEs is low such side effects may lead to severe morbidity and mortality. In patients with Triple M syndrome intensive respiratory function monitoring and support are essential parameters to improve the outcome. PROSPERO Protocol # CRD42023463750.</div></div>","PeriodicalId":9537,"journal":{"name":"Cancer treatment reviews","volume":"140 ","pages":"Article 103011"},"PeriodicalIF":10.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810544","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}