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Topic Review
Diagnostic and Therapeutic Indications for Endoscopic Ultrasound
There is growing evidence supporting the substantial, essential and indispensable role of endoscopic ultrasound (EUS) as a key diagnostic armamentarium for upper GI oncologic surgery.
  • 597
  • 26 Sep 2022
Topic Review
PARP Inhibition in Prostate Cancer Patients
The increasing diffusion of genetic analysis regarding the pathogenetic variants (PVs) of genes involved in DNA Damage Repair (DDR) mechanisms and the development of Poly ADP ribose polymerase (PARP) inhibitors (PARPis) led to the first valid precision medicine option tailored toward metastatic prostate cancer (mPC). The concept of anticipation in the systemic treatment of mPC was initially adopted for androgen receptor signaling inhibitors (ARSIs) to describe the expansion of their indications, from the setting of the late-stage second-line treatment of metastatic castration-resistant prostate cancer (mCRPC) to first-line therapy in selected cases. There is already mounting evidence in favor of the anticipation of PARPis in the first line of mCRPC therapy, and further evidence in favor of mHSPC is emerging. 
  • 597
  • 13 Sep 2023
Topic Review
Adjuvant Radiotherapy in the Treatment of Breast Cancer
The role of postmastectomy radiotherapy and regional nodal irradiation after radical mastectomy is defined in high-risk patients with locally advanced tumors, positive margins, and unfavorable biology. The benefit of postmastectomy radiotherapy in intermediate-risk patients (T3N0 tumors) remains a matter of controversy. It has been demonstrated that radiotherapy after breast-conserving surgery lowers the locoregional recurrence rate compared with surgery alone and improves the overall survival rate. In patients with four or more positive lymph nodes or extracapsular extension, regional lymph node irradiation is indicated regardless of the surgery type (breast-conserving surgery or mastectomy). Despite the consensus that patients with more than three positive lymph nodes should be treated with radiotherapy, there is controversy regarding the recommendations for patients with one to three involved lymph nodes. In patients with N0 disease with negative findings on axillary surgery, there is a trend to administer regional lymph node irradiation in patients with a high risk of recurrence. In patients treated with neoadjuvant systemic therapy and mastectomy, adjuvant radiotherapy should be administered in cases of clinical stage III and/or ≥ypN1. In patients treated with neoadjuvant systemic therapy and breast-conserving surgery, postoperative radiotherapy is indicated irrespective of pathological response.
  • 597
  • 05 Mar 2024
Topic Review
Precision Oncology via NMR-Based Metabolomics
Precision oncology is an emerging approach in cancer care. It aims at selecting the optimal therapy for the right patient by considering each patient’s unique disease and individual health status.
  • 596
  • 21 Jun 2021
Topic Review
Gender-Related Side Effects Induced by Platinum Compounds
Gender medicine in the field of oncology is an under-researched area, despite the existing evidence towards gender-dependent response to therapy and treatment-induced adverse effects. Oncological treatment aims to fulfil its main goal of achieving high tumour control by also protecting normal tissue from acute or chronic damage. Chemotherapy is an important component of cancer treatment, with a large number of drugs being currently in clinical use. Cisplatin is one of the most commonly employed chemotherapeutic agents, used either as a sole drug or in combination with other agents. Cisplatin-induced toxicities are well documented, and they include nephrotoxicity, neurotoxicity, gastrointestinal toxicity, ototoxicity, just to name the most frequent ones. Some of these toxicities have short-term sequelae, while others are irreversible. Furthermore, research showed that there is a strong gender-dependent aspect of side effects caused by the administration of cisplatin. While evidence towards sex differences in animal models is substantial, clinical studies considering sex/gender as a variable factor are limited. 
  • 596
  • 10 Mar 2022
Topic Review
Exosomes in Breast Cancer Diagnosis
Liquid biopsies have been studied for the early diagnosis of cancer, the monitoring of tumor burden, tumor heterogeneity and the emergence of molecular resistance, along with the detection of minimal residual disease. Interestingly, liquid biopsy consents the analysis of circulating tumor cells, circulating tumor DNA and extracellular vesicles (EVs). In particular, EVs play a crucial role in cell communication, carrying transmembrane and nonmembrane proteins, as well as metabolites, lipids and nucleic acids. Of all EVs, exosomes mirror the biological fingerprints of the parental cells from which they originate, and therefore, are considered one of the most promising predictors of early cancer diagnosis and treatment response.
  • 596
  • 19 Sep 2023
Topic Review
Tumour-Agnostic Therapy for Pancreatic Cancer
The prognosis of patients with solid tumours has remarkably improved with the development of molecular-targeted drugs and immune checkpoint inhibitors. However, the improvements in the prognosis of pancreatic cancer and biliary tract cancer is delayed compared to other carcinomas, and the 5-year survival rates of distal-stage disease are approximately 10 and 20%, respectively. However, a comprehensive analysis of tumour cells using The Cancer Genome Atlas (TCGA) project has led to the identification of various driver mutations. Evidently, few mutations exist across organs, and basket trials targeting driver mutations regardless of the primary organ are being actively conducted. Such basket trials not only focus on the gate keeper-type oncogene mu-tations, such as HER2 and BRAF, but also focus on the caretaker-type tumour suppressor genes, such as BRCA1/2, mismatch repair-related genes, which cause hereditary cancer syndrome.
  • 595
  • 26 Feb 2021
Topic Review
Hepatocellular Carcinoma, Alpha Fetoprotein, and Liver Transplantation
Hepatocellular carcinoma (HCC) is one of the leading indications for liver transplantation and has been the treatment of choice due to the oncologic benefit for patients with advanced chronic liver disease (AdvCLD) and small tumors. For HCC patients undergoing liver transplantation, alpha fetoprotein (AFP) has increasingly been applied as an independent predictor for overall survival, disease free recurrence, and waitlist drop out. In addition to static AFP, newer studies evaluating the AFP dynamic response to downstaging therapy show enhanced prognostication compared to static AFP alone.
  • 595
  • 28 Oct 2022
Topic Review
Colorectal Cancer Epidemiology
Early onset colorectal cancer (EOCRC) is defined as CRC diagnosed in individuals younger than 50, which is generally considered the ideal age to start screening programs in the average-risk population. Although the overall incidence of colorectal cancer (CRC) is declining, the number of new diagnoses in patients younger than 50 is alarmingly increasing.
  • 595
  • 20 Jul 2023
Topic Review
General Aspects of Immune-Related Adverse Events
Immune checkpoint inhibitors (ICI) have revolutionized the landscape of cancer treatment. Although several studies have shown that ICIs have a better safety profile than chemotherapy, some patients develop immune-related adverse events (irAEs), which require specialized and multidisciplinary management.
  • 594
  • 26 Sep 2022
Topic Review
Inactivation of the Fragile Histidine Triad Gene
Tumor development follows an evolutionary pattern of "mutation-selection-adaptation", characterized by exogenous oncogenic induction and endogenous replicative stress. The fragile histidine triad (FHIT) is a tumor suppressor. Tumor suppressor genes with regular expression inhibit cell proliferation and tumorigenesis. Decreased FHIT expression leads to the malignant transformation of affected cells and promotes the evolutionary development of cancer. Aberrant transcripts or decreases in the transcription and translation of the FHIT are present in at least 50% of preneoplastic lesions and human cancers, especially in esophageal, lung, liver, stomach, pancreatic, kidney, skin, breast, and cervical cancers. Abnormal expression of the FHIT is also evident in hyperplastic lesions, suggesting that the inactivation of the FHIT plays a vital role in inhibiting the formation of early preneoplastic and premalignant lesions. There are three basic pathways leading to the aberrant expression of the FHIT: replication stress, loss of heterozygous (LOH), and CpG methylation at the promoter region.
  • 594
  • 14 Feb 2023
Topic Review
Glutamine, a Versatile Precursor for Biosynthesis and Bioenergetics
Glutamine, one of the most abundant amino acids in the body, plays diverse roles in cellular metabolism, ranging from bioenergetics to the synthesis of nucleotides, glutathione (GSH), and various other non-essential amino acids.
  • 594
  • 21 Mar 2024
Topic Review
Mmunotherapy-Based Rational Combinations for RCC
Advanced imaging techniques for diagnosis have increased awareness on the benefits of brain screening, facilitated effective control of extracranial disease, and prolonged life expectancy of metastatic renal cell carcinoma (mRCC) patients. Brain metastasis (BM) in patients with mRCC (RCC-BM) is associated with grave prognoses, a high degree of morbidity, dedicated assessment, and unresponsiveness to conventional systemic therapeutics. The therapeutic landscape of RCC-BM is rapidly changing; however, survival outcomes remain poor despite standard surgery and radiation, highlighting the unmet medical needs and the requisite for advancement in systemic therapies. Immune checkpoint inhibitors (ICIs) are one of the most promising strategies to treat RCC-BM. 
  • 592
  • 23 Jun 2021
Topic Review
Neoadjuvant Chemo-Immunotherapy for Locally Advanced Non-Small-Cell Lung Cancer
There is great interest in immunotherapy in non-small cell lung cancer (NSCLC) and its combination with chemotherapy demonstrated to be beneficial. The introduction of such combination in the neoadjuvant treatment could change management strategy and outcomes of resectable NSCLC, especially in the locally advanced stage. In fact, following the results from the CHECKMATE-816 (NCT02998528) trial, the FDA recently approved nivolumab and platinum-based chemotherapy in the neoadjuvant setting for resectable NSCLC.
  • 592
  • 18 Jul 2022
Topic Review
Diagnostic Unmet Needs in Gynecological Malignancies
Gynecological malignancies currently affect about 3.5 million women all over the world. Imaging of uterine, cervical, vaginal, ovarian, and vulvar cancer still presents several unmet needs when using conventional modalities such as ultrasound, computed tomography (CT), magnetic resonance, and standard positron emission tomography (PET)/CT.
  • 592
  • 05 May 2023
Topic Review
Viral Encoded miRNAs in Tumorigenesis
About 15% of all human cancers have a viral etiology. Although progress has been made, understanding the viral oncogenesis and associated molecular mechanisms remain complex. The discovery of cellular miRNAs has led to major breakthroughs. Interestingly, viruses have also been discovered to encode their own miRNAs. These viral, small, non-coding miRNAs are also known as viral-miRNAs (v-miRNAs).
  • 592
  • 15 Sep 2023
Topic Review
Prognostic Models for Oral Squamous Cell Carcinoma
An accurate prediction of cancer survival is very important for counseling, treatment planning, follow-up, and postoperative risk assessment in patients with Oral Squamous Cell Carcinoma (OSCC). There has been an increased interest in the development of clinical prognostic models and nomograms which are their graphic representation.
  • 591
  • 22 Nov 2021
Topic Review
Long Non-Coding RNAs in Colorectal Cancer
Colorectal cancer (CRC) is the third most prevalent cancer worldwide, with nearly two million newly diagnosed cases each year. The survival of patients with CRC greatly depends on the cancer stage at the time of diagnosis, with worse prognosis for more advanced cases. Consequently, considerable effort has been directed towards improving population screening programs for early diagnosis and identifying prognostic markers that can better inform treatment strategies.
  • 591
  • 29 Aug 2022
Topic Review
Different Microenvironments in Neck Squamous Cell Carcinoma
Epidemiological studies have revealed a broad range of risk factors for head and neck squamous cell carcinoma (HNSCC) that can classify these tumors into two main groups: the first group, carcinogen-associated HNSCC, is related to tobacco consumption, alcohol consumption, and exposure to environmental pollutants, and the second group, virus-associated HNSCC, is related to human papillomavirus (HPV) and Epstein–Barr virus (EBV) infections. Interestingly, several risk factors display geographical or cultural and/or habitual prevalence. For instance, in regions such as Southeast Asia and Australia, HNSCC has a high prevalence associated with the consumption of specific carcinogen-containing products, such as betel-nut and tobacco chewing.
  • 591
  • 09 Nov 2022
Topic Review
Localized Small Bowel Adenocarcinoma Management
Small bowel adenocarcinoma is a rare but aggressive disease that requires peri-operative treatment. Due to its rarity, there is little data on small bowel adenocarcinoma treatment, and most recommendations come from expert agreements or analogies to the management of colon cancer.
  • 590
  • 21 Jun 2022
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