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Topic Review
De-Escalation of (Chemo)Radiation for HNSCC
Oncological outcomes for head-and-neck squamous cell carcinoma (HNSCC) patients are still unsatisfactory, especially for advanced tumor stages. Besides the moderate survival rates, the prevalence of severe treatment-induced normal tissue toxicities is high after multimodal cancer treatments, both causing significant morbidity and decreasing quality of life of surviving patients. Therefore, risk-adapted and individualized treatment approaches are urgently needed for HNSCC patients to optimize the therapeutic gain. It has been a well-known fact that especially HPV-positive oropharyngeal squamous cell carcinoma (OSCC) patients exhibit an excellent prognosis and may therefore be subject to overtreatment, resulting in long-term treatment-related toxicities. Regarding the superior prognosis of HPV-positive OSCC patients, treatment de-escalation strategies are currently investigated in several clinical trials, and HPV-positive OSCC may potentially serve as a model for treatment de-escalation also for other types of HNSCC. We performed a literature search for both published and ongoing clinical trials and critically discussed the presented concepts and results. Radiotherapy dose or volume reduction, omission or modification of concomitant chemotherapy, and usage of induction chemotherapy are common treatment de-escalation strategies that are pursued in clinical trials for biologically selected subgroups of HNSCC patients.
  • 627
  • 10 May 2021
Topic Review
EGFR Mutation-Positive Lung Cancer
EGFR mutations are found in approximately 15% of lung adenocarcinomas cases in Europe and the United States, and 55% cases in East Asia. The exon 19 deletion mutation and L858R mutation account for more than 90% of EGFR mutations, making tumors highly sensitive to EGFR-TKIs. Other mutations are rather uncommon, and a few among them, such as G719X, L861Q, and S768I, turn tumors highly sensitive to EGFR-TKIs; in NSCLC patients harboring these mutations, EGFR-TKIs are considered as the main therapeutic agents. On the contrary, patients harboring exon 20 insertion mutations or T790M mutations as primary mutations are resistant to EGFR-TKI and are not indicated for treatment.
  • 627
  • 08 Dec 2021
Topic Review
Betulinic Acid in Cancer Chemoprevention
The pursual of novel anticancer molecules from natural sources has gained worthwhile appreciation, and a significant fraction of conceptual knowledge has revolutionized people's understanding about heterogeneous nature of cancer. Betulinic acid has fascinated interdisciplinary researchers due to its tremendous pharmacological properties. Ground-breaking discoveries have unraveled previously unprecedented empirical proof-of-concept about momentous chemopreventive role of betulinic acid against carcinogenesis and metastasis. Deregulation of cell signaling pathways has been reported to play a linchpin role in cancer progression and colonization of metastatically competent cancer cells to the distant organs for the development of secondary tumors. Importantly, betulinic acid has demonstrated unique properties to mechanistically modulate oncogenic transduction cascades.
  • 627
  • 03 Jan 2023
Topic Review
Prognostic Factors for Cardiotoxicity among Children with Cancer
Improvements in the treatment of childhood cancer have considerably enhanced survival rates over the last decades to over 80% as of today. However, this great achievement has been accompanied by the occurrence of several early and long-term treatment-related complications major of which is cardiotoxicity.
  • 627
  • 13 Jun 2023
Topic Review
Targeting the Tumor Microenvironment in Breast Cancer
Breast cancer is one of the most prevalent tumors among women. Its prognosis and treatment outcomes depend on factors related to tumor cell biology. Studies have revealed the critical role of the tumor microenvironment (TME) in the development, progression, and treatment response of breast cancer. 
  • 627
  • 27 Nov 2023
Topic Review
Immunotherapy in Pediatric Brain Tumors
Immunotherapy, including chimeric antigen receptor (CAR) T-cell therapy, immune checkpoint inhibitors, cancer vaccines, and dendritic cell therapy, has been incorporated as a fifth modality of modern cancer care, along with surgery, radiation, chemotherapy, and target therapy. Among them, CAR T-cell therapy emerges as one of the most promising treatments. In 2017, the first two CAR T-cell drugs, tisagenlecleucel and axicabtagene ciloleucel for B-cell acute lymphoblastic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL), respectively, were approved by the Food and Drug Administration (FDA). In addition to the successful applications to hematologi-cal malignancies, CAR T-cell therapy has been investigated to potentially treat solid tumors, in-cluding pediatric brain tumor, which serves as the leading cause of cancer-associated death for children and adolescents.
  • 626
  • 16 Mar 2021
Topic Review
Delta Radiomics in Head and Neck Oncology
The clinical management of head and neck carcinomas (HNC) involves a number of challenges, both regarding tumour control and normal tissue toxicity owing to the particularities of head and neck anatomy and radiobiology. Resistance to radio- and/or chemotherapy are common factors leading to treatment failure or loco-regional recurrence. There are some key tumour characteristics, including hypoxia, proliferative ability, the fraction of cancer stem cells, intrinsic radio-resistance, as well as the human papillomavirus (HPV) status, which should be considered when treating HNC patients. Biomarkers for the identification of the above tumour properties are available and can assist with patient stratification to increase tumour control. Medical images are fundamental tools for the establishment of diagnosis, response to therapy and patient monitoring during and post therapy. A powerful tool in the evaluation and interpretation of image features is the assessment of changes exhibited by these features over the course of therapy. The change in quantitative features extracted from longitudinal images acquired at different time points along the course of treatment and follow-up is known as delta-radiomics. Current applications of delta-radiomics in head and neck oncology show various trends that evolved along (1) treatment response monitoring, (2) prediction of normal tissue toxicity and also (3) treatment adaptation based on changing image features over time. 
  • 626
  • 16 Feb 2023
Topic Review
Irinotecan as an Anticancer Drug
Irinotecan (SN-38) is a potent and broad-spectrum anticancer drug that targets DNA topoisomerase I (Top1). It exerts its cytotoxic effects by binding to the Top1-DNA complex and preventing the re-ligation of the DNA strand, leading to the formation of lethal DNA breaks. Following the initial response to irinotecan, secondary resistance is acquired relatively rapidly, compromising its efficacy. There are several mechanisms contributing to the resistance, which affect the irinotecan metabolism or the target protein. 
  • 626
  • 29 May 2023
Topic Review
Radiofrequency Ablation in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is responsible for 90% of primary hepatic cancer cases, and its incidence with associated morbidity and mortality is growing worldwide. There are three main types of locoregional therapy: radiofrequency ablation, transarterial chemoembolisation, and transarterial radioembolisation.
  • 626
  • 17 Jul 2023
Topic Review
GLIS1 in Cancer-Associated Fibroblasts
A cancer-associated fibroblasts (CAFs) are the most important players that modulate tumor aggressiveness. In this entry, researchers aimed to identify CAF-related genes in ovarian serous carcinomas (OSC) that account for the high incidence and mortality of ovarian cancers (OCs) and to develop therapeutic targets for tumor microenvironment modulation. Here, researchers performed a microarray analysis of CAFs isolated from three metastatic and three nonmetastatic OSC tissues and compared their gene expression profiles. Among the genes increased in metastatic CAFs (mCAFs), GLIS1 (Glis Family Zinc Finger 1) showed a significant increase in both the gene mRNA and protein expression levels. Knockdown of GLIS1 in mCAFs significantly inhibited migration, invasion, and wound healing ability of OC cells. In addition, an in vivo study demonstrated that knockdown of GLIS1 in CAFs reduced peritoneal metastasis. Taken together, these results suggest that CAFs support migration and metastasis of OC cells by GLIS1 overexpression. It also indicates GLIS1 in CAFs might be a potential therapeutic target to inhibit OC metastasis.
  • 625
  • 07 Mar 2022
Topic Review
PARP Inhibitors and ICIs in Ovarian Cancer
Ovarian cancer (OC) has a high impact on morbidity and mortality in the female population. Survival is modest after platinum progression. Therefore, the search for new therapeutic strategies is of utmost importance. BRCA mutations and HR-deficiency occur in around 50% of OC, leading to increased response and survival after Poly (ADP-ribose) polymerase inhibitors (PARPis) administration. PARPis represent a breakthrough for OC therapy, with three different agents approved. On the contrary, immune checkpoint inhibitors (ICIs), another breakthrough therapy for many solid tumors, led to modest results in OC, without clinical approvals and even withdrawal of clinical trials. Therefore, combinations aiming to overcome resistance mechanisms have become of great interest.
  • 625
  • 12 May 2022
Topic Review
Inflammation in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC), the most prevalent form of primary liver cancer, is prototypically an inflammation-driven cancer developing after years of inflammatory insults.
  • 624
  • 22 Dec 2022
Topic Review
Combination Radiation and Immunotherapy for Genitourinary Cancers
As the indications for the use of immunotherapy in genitourinary malignancies expand, its role in combination with standard or conventional therapies has become the subject of contemporary studies. Radiotherapy has multiple immunomodulating effects on anti-tumor immune response, which highlights potential synergistic role with immunotherapy agents. 
  • 624
  • 03 Jan 2023
Topic Review
Management of Osteosarcoma
Osteosarcoma is a rare malignancy arising from mesenchymal tissue, and represents the most common bone sarcoma. The management of osteosarcoma is challenging, and requires a multidisciplinary approach. In daily clinical practice, surgery, radiotherapy, and conventional chemotherapy constitute the therapeutic armamentarium against the disease.
  • 624
  • 06 May 2023
Topic Review
Preclinical Models in Prostate Cancer
Prostate cancer is an androgen-driven tumor. Different prostate cancer therapies consequently focus on blocking the androgen receptor pathway. Clinical studies reported tumor resistance mechanisms by reactivating and bypassing the androgen pathway. Preclinical models allowed the identification, confirmation, and thorough study of these pathways. 
  • 624
  • 09 Mar 2021
Topic Review
Thyroid Cancers: Surgery and Therapies
Differentiated thyroid cancers (DTC) are commonly and successfully treated with total thyroidectomy plus/minus radioiodine therapy (RAI). Medullary thyroid cancer (MTC) is only treated with surgery but only intrathyroidal tumors are cured. The worst prognosis is for anaplastic (ATC) and poorly differentiated thyroid cancer (PDTC). Whenever a local or metastatic advanced disease is present, other treatments are required, varying from local to systemic therapies. In the last decade, the efficacy of the targeted therapies and, in particular, tyrosine kinase inhibitors (TKIs) has been demonstrated. 
  • 623
  • 08 Apr 2021
Topic Review
Immunotherapy for Lung Brain Metastases
Brain metastasis (BM) is a common and grave complication in non-small cell lung cancer (NSCLC). Almost a third of NSCLC patients develop brain metastasis at some point during their disease course, with higher rates reported in patients with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) mutations. BMs are associated with adverse neurocognitive function, poor quality of life, and dismal prognosis despite multidisciplinary treatment with surgery, radiation therapy (RT), and systemic agents.
  • 623
  • 02 Aug 2021
Topic Review
HRQOL and Cognition Evaluations for Brain Metastases Patients
Brain metastases (BMs) are the most common brain malignancy and are projected to increase in incidence. Historically, brain metastasis studies have focused on improving survival outcomes, but the importance of evaluating health-related quality of life (HRQOL) and cognitive function has gained recognition.
  • 623
  • 07 Sep 2022
Topic Review
Phytochemicals in Cancer Treatment and Cancer Prevention
Phytochemicals are a non-nutritive substances that are present in plants and contribute significantly to their flavor and color. These biologically active compounds are classified into five major groups, namely phenolics, carotenoids, organosulfur compounds, nitrogen-containing compounds, and alkaloids, and are known for their potential health benefits in the prevention of various diseases, including cancer.
  • 623
  • 02 Aug 2023
Topic Review
FDA Approved Antibody–Drug Conjugates
Antibody–drug conjugates (ADCs) are an innovative family of agents assembled through linking cytotoxic drugs (payloads) covalently to monoclonal antibodies (mAbs) to be delivered to tumor tissue that express their particular antigen, with the theoretical advantage of an augmented therapeutic ratio.
  • 623
  • 03 Aug 2023
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