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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.
  • 631
  • 10 May 2021
Topic Review
Role of ctDNA in Breast Cancer
Breast cancer is a heterogeneous disease, while circulating tumor DNA (ctDNA) is DNA released by the tumor into the bloodstream and can accurately reflect this heterogeneity. In breast cancer, it is used mainly in research or in clinical trials, but it will likely be used in routine clinical practice once certain issues have been worked out and methods of analysis have been improved and standardized. Breast cancer classification and treatment selection are now based on analysis of the tumor but circulating tumor DNA carries many features of the original tumor and can be analyzed from a simple, non-invasive blood extraction.
  • 631
  • 20 Jan 2022
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.
  • 631
  • 06 May 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.
  • 631
  • 13 Jun 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.
  • 631
  • 17 Jul 2023
Topic Review
ROS1 for Advanced Non Small Cell Lung Cancer
ROS proto-oncogene 1 (ROS1) rearrangements occur in 0.9–2.6% of patients with non small cell lung cancer (NSCLC), conferring sensitivity to treatment with specific tyrosine-kinase inhibitors (TKI). Crizotinib, a first-generation TKI, was the first target-therapy approved for the first-line treatment of ROS1-positive NSCLC. Entrectinib, a multitarget inhibitor with an anti-ROS1 activity 40 times more potent than crizotinib and better activity on the central nervous system (CNS), received approval for treatment-naive patients. 
  • 631
  • 27 Jul 2023
Topic Review
Cardiotoxicity Associated with the Use of Anti-VEGF Therapy
The ability to undergo neoangiogenesis is a common feature with all cancers. Signaling related to vascular endothelial growth factors (VEGF) and their receptors (VEGFR) plays a key role in the process of tumor neoangiogenesis. A close relationship has been demonstrated between excessive VEGF levels and the induction of immunosuppression in the tumor microenvironment. The use of drugs blocking the VEGF function, apart from the anticancer effect, also result in adverse effects, in particular related to the circulatory system and kidneys. Cardiac toxicity associated with the use of such therapy manifests itself mainly in the form of hypertension, thromboembolic episodes and ischemic heart disease. 
  • 631
  • 08 Feb 2024
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.
  • 630
  • 08 Dec 2021
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.
  • 630
  • 07 Mar 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. 
  • 630
  • 03 Jan 2023
Topic Review
Targeting Breast Cancer
Breast cancer became the most diagnosed cancer in the world in 2020. Chemotherapy is still the leading clinical strategy in breast cancer treatment, followed by hormone therapy (mostly used in hormone receptor-positive types).
  • 629
  • 29 Aug 2023
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. 
  • 629
  • 08 Apr 2021
Topic Review
Oligoprogression in Patients Harboring ALK Rearrangements
The growing efficacy and availability of new targeted systemic therapies have markedly improved the prognosis of metastatic lung cancer patients harboring ALK rearrangements. The use of effective targeted therapies capable of maintaining a prolonged control of disease, for as long as possible, is paramount to ensure the best survival outcomes. In this regard, in cases of oligoprogression, “beyond progression” systemic treatment added to local ablative therapies is considered a feasible option in an attempt to improve the quality and quantity of patients’ lives, even if based on retrospective data. Certainly, treatment of ALK rearranged lung cancer patients with oligoprogressive disease must be individualized and based on multidisciplinary decisions. Above all, when further molecular targeted therapies are available, options must always be evaluated, especially in case of cerebral progression.
  • 628
  • 16 Mar 2022
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.
  • 627
  • 16 Mar 2021
Topic Review
Extracellular Vesicles in Glioblastoma
Glioblastoma (GB) is the most aggressive form of brain cancer in adults, characterized by poor survival rates and lack of effective therapies. MicroRNAs (miRNAs) are small, non‐coding RNAs that regulate gene expression post‐transcriptionally through specific pairing with target messenger RNAs (mRNAs). Extracellular vesicles (EVs) are cell‐derived vesicles which transport miRNAs, mRNAs and intracellular proteins, and have been shown to promote horizontal malignancy into adjacent tissue, as well as resistance to conventional therapies. Furthermore, GB-derived EVs have distinct miRNA contents and are able to penetrate the blood–brain barrier and could be used as biomarkers, while EVs carrying specific miRNAs or miRNA inhibitors have great potential as therapeutic nanotools in GB.
  • 627
  • 09 Jul 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.
  • 627
  • 02 Aug 2021
Topic Review
Systemic Treatment of Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the most common liver primary tumor with a high rate of mortality.
  • 627
  • 11 Feb 2022
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. 
  • 627
  • 16 Feb 2023
Topic Review
Genetic Causes of Ovarian Cancer
Ovarian cancer occupies a significant position within the landscape of oncological diseases, captivating researchers and medical professionals alike. Its prominence can be attributed to a combination of factors that contribute to its scientific complexity and societal relevance. One of the primary facets that renders ovarian cancer intriguing is its multifaceted etiology, which involves intricate interactions between genetic predispositions, hormonal influences, and environmental factors.
  • 627
  • 15 Nov 2023
Topic Review
Role of NGF in Inflammation and Tumor Growth
Nerve growth factor (NGF) plays a dual role both in inflammatory states and cancer, acting both as a pro-inflammatory and oncogenic factor and as an anti-inflammatory and pro-apoptotic mediator in a context-dependent way based on the signaling networks and its interaction with diverse cellular components within the microenvironment.
  • 627
  • 31 Jan 2024
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