Cancers最新文献

{"title":"Impact of Surgical Resection After Induction Gemcitabine Plus S-1-Based Chemoradiotherapy in Patients with Locally Advanced Pancreatic Ductal Adenocarcinoma: A Focus on UR-LA Cases.","authors":"Masashi Kishiwada, Shugo Mizuno, Aoi Hayasaki, Benson Kaluba, Takehiro Fujii, Daisuke Noguchi, Takahiro Ito, Yusuke Iizawa, Akihiro Tanemura, Yasuhiro Murata, Naohisa Kuriyama","doi":"10.3390/cancers17061048","DOIUrl":"10.3390/cancers17061048","url":null,"abstract":"<p><p><b>Background:</b> This study aimed to assess the safety and efficacy of gemcitabine plus S-1-based chemoradiotherapy (GS-CRT) among patients with locally advanced pancreatic ductal adenocarcinoma (PDAC), especially among those with unresectable locally advanced (UR-LA) cases. <b>Methods</b>: A total of 351 consecutive PDAC patients were enrolled and prognostic predictors of disease-specific survival (DSS) were identified. <b>Results:</b> The treatment completion rate was 98.9% and Grade 3 or higher adverse events occurred in 181 cases (51.6%). Among 319 re-evaluated patients, pancreatectomy was performed in 184 (57.7%). Based on resectability, the 5-year DSS rates for the entire cohort were 39.6% (R), 43.8% (BR-PV), 21.2% (BR-A) and 13.3% (UR-LA), while the predictors of DSS were performance status (PS), hemoglobin (Hb) level, celiac artery (CA) involvement of ≥180 degrees and JPS 8th T category. In the resected cases, the predictors of DSS were preoperative PS, preoperative CA19-9 level, preoperative JPS-T factor, degree of histological response and adjuvant chemotherapy. In UR-LA resected patients, preoperative prognostic nutritional index (PNI), absence of pathological venous invasion and adjuvant chemotherapy were predictors of DSS. <b>Conclusions:</b> Even though Grade 3 or higher adverse events were encountered in about half of the cases, they were uneventfully managed. Therefore, GS-CRT is safe and highly tolerable with potential to improve patients' prognosis. Preoperative PS, CA19-9 levels and histological response are important prognostic factors, as well as adjuvant therapy. In UR-LA patients, prognostic nutritional index (PNI) and adjuvant chemotherapy were important for curative intent surgery.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Validation of an FDG-PET-Radiomic Model for Distant-Relapse-Free-Survival After Radio-Chemotherapy for Pancreatic Adenocarcinoma.","authors":"Monica Maria Vincenzi, Martina Mori, Paolo Passoni, Roberta Tummineri, Najla Slim, Martina Midulla, Gabriele Palazzo, Alfonso Belardo, Emiliano Spezi, Maria Picchio, Michele Reni, Arturo Chiti, Antonella Del Vecchio, Claudio Fiorino, Nadia Gisella Di Muzio","doi":"10.3390/cancers17061036","DOIUrl":"10.3390/cancers17061036","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Pancreatic cancer is a very aggressive disease with a poor prognosis, even when diagnosed at an early stage. This study aimed to validate and refine a radiomic-based [¹⁸F]FDG-PET model to predict distant relapse-free survival (DRFS) in patients with unresectable locally advanced pancreatic cancer (LAPC). <b>Methods</b>: A Cox regression model incorporating two radiomic features (RFs) and cancer stage (III vs. IV) was temporally validated using a larger cohort (215 patients treated between 2005-2022). Patients received concurrent chemoradiotherapy with capecitabine and hypo-fractionated Intensity Modulated Radiotherapy (IMRT). Data were split into training (145 patients, 2005-2017) and validation (70 patients, 2017-2022) groups. Seventy-eight RFs were extracted, harmonized, and analyzed using machine learning to develop refined models. <b>Results</b>: The model incorporating Statistical-Percentile10, Morphological-ComShift, and stage demonstrated moderate predictive accuracy (training: C-index = 0.632; validation: C-index = 0.590). When simplified to include only Statistical-Percentile10, performance improved slightly in the validation group (C-index = 0.601). Adding GLSZM3D-grayLevelVariance to Statistical-Percentile10, while excluding Morphological-ComShift, further enhanced accuracy (training: C-index = 0.654; validation: C-index = 0.623). Despite these refinements, all versions showed similar moderate ability to stratify patients into risk classes. <b>Conclusions</b>: [¹⁸F]FDG-PET radiomic features are robust predictors of DRFS after chemoradiotherapy in LAPC. Despite moderate performance, these models hold promise for patient risk stratification. Further validation with external cohorts is ongoing.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Endometrial Cancer Incidence Among Premenopausal and Postmenopausal Women in the United States Between 2001 and 2021.","authors":"Fangjian Guo, Victor Adekanmbi, Christine D Hsu, Thao N Hoang, Pamela T Soliman, Jacques G Baillargeon, Abbey B Berenson","doi":"10.3390/cancers17061035","DOIUrl":"10.3390/cancers17061035","url":null,"abstract":"<p><strong>Background: </strong>Endometrial cancer incidence has been rising in the United States. We assessed trends in endometrial cancer incidence among both premenopausal and postmenopausal women in the US from 2001 to 2021. We also compared the incidence during 2019-2021 to assess the impact of the COVID-19 pandemic.</p><p><strong>Methods: </strong>We used data from the United States Cancer Statistics 2001-2021 database to assess the incidence trends among adult females. Endometrial cancer incidence was corrected for hysterectomy prevalence and age, adjusted to the 2000 US standard population.</p><p><strong>Results: </strong>From 2001 to 2021, the incidence of endometrial cancer rose from 86.8 cases to 113.8 cases per 1,000,000 persons among women aged 20-49 years (APC 1.5, 95% CI 1.2-1.8), while in women 70 and older, it increased from 1326.4 cases to 1339.4 cases per 1,000,000 persons (APC 0.3, 95% CI 0.1-0.6). The incidence has recently decreased among women aged 50-69 years (APC from 2001 to 2016 0.3, 95% CI 0.1-0.9; APC from 2016 to 2021 -1.3, 95% CI -2.2--0.3). Endometrial cancer incidence sharply increased from 2001 to 2021 among non-Hispanic Blacks, non-Hispanic Asians or Pacific Islanders, and women in the South. Endometrial cancer incidence sharply decreased from 2019 to 2020, and the proportion of metastatic cancer at diagnosis increased across all age groups. In 2021, the incidence returned to 2019 levels.</p><p><strong>Conclusions: </strong>Endometrial cancer incidence rates are rising, particularly among premenopausal women. During the beginning of the COVID-19 pandemic, the incidence rates decreased, but the proportion of metastatic cancer increased.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of Combined Conventional CT Imaging Features and Radiomics Signature in Differentiating Grade 1 Tumors from Higher-Grade Pancreatic Neuroendocrine Neoplasms.","authors":"Florent Tixier, Felipe Lopez-Ramirez, Alejandra Blanco, Ammar A Javed, Linda C Chu, Ralph H Hruban, Mohammad Yasrab, Daniel Fadaei Fouladi, Shahab Shayesteh, Saeed Ghandili, Elliot K Fishman, Satomi Kawamoto","doi":"10.3390/cancers17061047","DOIUrl":"10.3390/cancers17061047","url":null,"abstract":"<p><strong>Background/objectives: </strong>Accurate identification of grade 1 (G1) pancreatic neuroendocrine tumors (PanNETs) is crucial due to their rising incidence and emerging nonsurgical management strategies. This study evaluated whether combining conventional CT imaging features, CT radiomics features, and clinical data improves differentiation of G1 PanNETs from higher-grade tumors (G2/G3 PanNETs and pancreatic neuroendocrine carcinomas [PanNECs]) compared to using these features individually.</p><p><strong>Methods: </strong>A retrospective analysis included 133 patients with pathologically confirmed PanNETs or PanNECs (70 males, 63 females; mean age, 58.5 years) who underwent pancreas protocol CT. A total of 28 conventional imaging features, 4892 radiomics features, and clinical data (age, gender, and tumor location) were analyzed using a support vector machine (SVM) model. Data were divided into 70% training and 30% testing sets.</p><p><strong>Results: </strong>The SVM model using the top 10 conventional imaging features (e.g., suspicious lymph nodes and hypoattenuating tumors) achieved 75% sensitivity, 81% specificity, and 79% accuracy for identifying higher-grade tumors (G2/G3 PanNETs and PanNECs). The top 10 radiomics features yielded 94% sensitivity, 46% specificity, and 69% accuracy. Combining all features (imaging, radiomics, and clinical data) improved performance, with 94% sensitivity, 69% specificity, 79% accuracy, and an F1-score of 0.77. The radiomics score demonstrated an AUC of 0.85 in the training and 0.83 in the testing set.</p><p><strong>Conclusions: </strong>Conventional imaging features provided higher specificity, while radiomics offered greater sensitivity for identifying higher-grade tumors. Integrating all three features improved diagnostic accuracy, highlighting their complementary roles. This combined model may serve as a valuable tool for distinguishing higher-grade tumors from G1 PanNETs and potentially guiding patient management.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Current Role of Circulating Cell-Free DNA in the Management of Hepatocellular Carcinoma.","authors":"Alkistis Papatheodoridi, Vasileios Lekakis, Antonios Chatzigeorgiou, George Papatheodoridis","doi":"10.3390/cancers17061042","DOIUrl":"10.3390/cancers17061042","url":null,"abstract":"<p><p>Circulating cell-free DNA (cfDNA) has emerged as a compelling candidate of liquid biopsy markers for the diagnosis and prognosis of several cancers. We systematically reviewed data on the role of cfDNA markers in the diagnosis, prognosis and treatment of hepatocellular carcinoma (HCC). Early studies suggested that levels of circulating cfDNA, mitochondrial DNA and cfDNA integrity are higher in patients with HCC than chronic liver diseases. In subsequent studies, methylation changes in circulating tumor DNA (ctDNA) as well as cfDNA fragmentation patterns and circulating nucleosomes were found to offer high sensitivity (>60%) and excellent specificity (>90%) for HCC diagnosis. The predictive role of cfDNA markers and ctDNA has been assessed in a few studies including untreated patients with HCC providing promising results for prediction of survival. However, port-hepatectomy detection of cfDNA/ctDNA markers or copy number variation indicators of cfDNA seem to reflect minimum residual disease and thus a high risk for HCC recurrence. The same markers can be useful for prediction after transarterial chemoembolization, radiofrequency ablation, radiotherapy and even systemic therapies. In conclusion, cfDNA markers can be useful in HCC surveillance, improving early diagnosis rates, as well as for monitoring treatment effectiveness and minimal residual disease post-treatment.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss of ING3 in the Prostate Leads to Activation of DNA Damage Repair Markers.","authors":"Viktor Lang, Lisa Barones, ShiTing Misaki Hu, Fatemeh Hashemi, Karen Blote, Karl Riabowol, Dieter Fink","doi":"10.3390/cancers17061037","DOIUrl":"10.3390/cancers17061037","url":null,"abstract":"<p><strong>Background/objectives: </strong>The inhibitor of growth family member 3 (ING3) acts as an epigenetic reader through physical interactions with histone-modifying enzymes and subsequent chromatin remodelling processes. It is involved in various cellular functions, such as cell cycle control, cell growth, and apoptosis. Although ING3 was assigned tumour suppressor candidate status in some types of cancers, including prostate cancer, some studies suggest it acts to promote growth. To address these contradictory reports regarding its role in the initiation and progression of prostate cancer, we specifically addressed the question of whether ablation of ING3 in the mouse prostate is sufficient to initiate malignant transformation of the prostate and support its (candidate) tumour suppressor status.</p><p><strong>Methods: </strong>To generate the prostate-specific <i>Ing3</i> knockout mouse, paternal inheritance of the PB-Cre4 transgene was used, while for the generation of a global knockout control, a female mouse harbouring the PB-Cre4 transgene was utilized. To determine the recombination efficiency of the Cre-LoxP system in the prostate at the <i>Ing3</i> locus, a duplex probe-based digital PCR assay capable of counting undisrupted <i>Ing3</i> copies was designed. The impact of DNA recombination on the protein level was investigated by immunohistochemical staining of prostate tissue samples.</p><p><strong>Results: </strong>In the prostate-specific knockout, digital PCR analysis revealed mosaic gene deletion. We found recombination efficiencies in the anterior, dorsolateral, and ventral prostate lobes ranging from approximately 15 to 30%. ING3 staining in the prostate was faint with no detectable differences in signal intensity between the knockout specimen and wild-type controls. This low ING3 expression in the prostate is consistent with observations of X-gal staining of an <i>Ing3</i>-LacZ reporter allele. Immunohistochemistry showed increased expression of DNA-damage-associated markers γH2AX and 53BP1. However, no gross anatomical abnormalities or prostate intraepithelial neoplasia (PIN) lesions in the prostate of tissue-specific knockout animals compared to wild-type controls were observed.</p><p><strong>Conclusions: </strong>Altogether, our data provide evidence that disruption of ING3 expression in prostate cells does not lead to malignant transformation and challenges the idea that ING3 acts primarily in a tumour-suppressive manner. Furthermore, this work supports the crucial role of ING3 in maintaining genomic stability, and we confirmed the embryonic lethal phenotype of homozygous <i>Ing3</i> null mice that is rescued by ectopic expression of ING3.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton Craniospinal Irradiation for Patients with Solid Tumor Leptomeningeal Disease: Real-World Feasibility, Toxicity, and Outcome Analysis.","authors":"Omer Gal, Alonso La Rosa, Matthew D Hall, Robert H Press, Zachary Fellows, Andrew J Wroe, Alonso N Gutierrez, Yazmin Odia, Minesh P Mehta, Rupesh Kotecha","doi":"10.3390/cancers17061046","DOIUrl":"10.3390/cancers17061046","url":null,"abstract":"<p><p>Leptomeningeal disease (LMD) is a devastating clinical scenario in patients with metastatic cancer [...].</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role and Potential of Modern Radiotherapy in the Treatment of Metastatic Prostate Cancer.","authors":"Robert Kwiatkowski, Anna M Kłeczek, Jadwiga Gabor, Natalia Brzezińska, Andrzej S Swinarew","doi":"10.3390/cancers17061045","DOIUrl":"10.3390/cancers17061045","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Prostate cancer is one of the most prevalent cancers among men, with a significant proportion progressing to metastatic disease. Traditional treatments for metastatic prostate cancer have primarily been palliative, focusing on symptom relief. However, recent advances in radiotherapy have shown promise in improving outcomes for these patients. <b>Methods</b>: This study presents a modern treatment plan for extensive metastatic prostate cancer. Pre-treatment imaging revealed extensive lymph node metastases and high metabolic activity in the prostate. The treatment regimen included bicalutamide, androgen deprivation therapy with leuprorelin, and six cycles of docetaxel chemotherapy, followed by a targeted radiotherapy regimen aimed at both the primary tumor and metastatic lymph nodes. <b>Results</b>: Following the comprehensive radiotherapy regimen, the patient's PSA level dropped below the edge of detection, indicating complete biochemical remission. Follow-up imaging and clinical assessments confirmed the absence of active metastatic sites. <b>Conclusions</b>: The findings support the integration of radiotherapy into comprehensive treatment plans for metastatic prostate cancer, demonstrating that radiotherapy can achieve complete remission even in patients with extensive metastatic disease. This suggests a need for re-evaluating traditional approaches and exploring more personalized, multimodal treatment strategies. Enhanced imaging techniques, such as PET/PSMA scans, play a crucial role in accurately targeting metastatic sites, enabling more effective and individualized treatment.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the Potential of ctDNA in Sarcomas: A Review of Recent Advances.","authors":"Sahana Aiyer, Tae-Hee Kim, Katharine Collier, Raphael Pollock, Claire Verschraegen, Daniel G Stover, Gabriel Tinoco","doi":"10.3390/cancers17061040","DOIUrl":"10.3390/cancers17061040","url":null,"abstract":"<p><p>Soft tissue sarcomas (STSs) constitute a group of tumors with heterogeneous alterations and different biological behavior. Genetic profiling techniques have immense potential to revolutionize sarcoma classification, detection, and treatment. Cell-free DNA (cfDNA) analysis offers a minimally invasive approach to profiling tumor alterations, including tracking specific mutations or targeted panels of cancer-related genes via DNA sequencing methods. Circulating tumor DNA (ctDNA) platforms have gained popularity as a noninvasive alternative to tissue biopsies, offering a less invasive approach to tumor profiling. Nonetheless, ctDNA profiling in concordance with standard solid tumor comprehensive genomic profiling (CGP) is poorly characterized for STSs. Ultra-low-pass whole-genome sequencing and whole exome sequencing of cfDNA have yet to be fully leveraged in patients with sarcomas. This comprehensive review provides an overview of the application of ctDNA in STSs.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Camptothein-Based Anti-Cancer Therapies and Strategies to Improve Their Therapeutic Index.","authors":"Jue Gong, Wenqiu Zhang, Joseph P Balthasar","doi":"10.3390/cancers17061032","DOIUrl":"10.3390/cancers17061032","url":null,"abstract":"<p><p>Camptothecin and its derivatives (CPTs) are potent antineoplastic agents that exert their effects by inhibiting DNA topoisomerase I, leading to apoptosis during cell proliferation. Since their discovery in the 1960s, CPTs have faced challenges such as low water solubility, pH-dependent lactone ring instability, and severe off-target toxicities. Despite extensive research, only two CPTs, irinotecan and topotecan, have received health authority approval. Ongoing clinical trials continue to explore the use of CPTs in combination with targeted therapies and immunotherapies to expand their clinical use. Drug delivery systems, including liposomes and antibody-drug conjugates (ADCs), have significantly enhanced the therapeutic index of CPTs. Liposomal irinotecan (Onivyde^®, Ipsen, Paris, France) and two ADCs delivering CPT payloads, trastuzumab deruxtecan (Enhertu^®, Daiichi Sankyo, Tokyo, Japan) and sacituzumab govitecan (Trodelvy^®, Gilead Sciences, Inc., Foster City, CA, USA), have demonstrated substantial efficacy and safety. There is promise that novel strategies such as inverse targeting and co-dosing with anti-idiotypic distribution enhancers may expand the utility of CPT ADCs. This review highlights CPT therapies in clinical use and discusses approaches to further enhance their therapeutic selectivity.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}