Expert Review Of Anticancer Therapy[JOURNAL]
Sun
200 papers
Complications following small-molecule inhibitors for non-small cell lung cancer.
Kamali C, Ekman S
Expert Rev Anticancer Ther · 2026 May · PMID 42107523 · Publisher ↗
INTRODUCTION: Targeted therapies for oncogene-driven non-small cell lung cancer (NSCLC) have transformed precision oncology by enabling treatment tailored to specific molecular alterations and substantially improving out...
INTRODUCTION: Targeted therapies for oncogene-driven non-small cell lung cancer (NSCLC) have transformed precision oncology by enabling treatment tailored to specific molecular alterations and substantially improving outcomes in advanced disease. However, these agents are associated with distinct patterns of treatment-related toxicities affecting multiple organ systems and may impact long-term treatment success. AREAS COVERED: This review summarizes the spectrum of toxicities associated with the treatment of EGFR, ALK, BRAF, ROS1, MET, RET, KRAS, HER2, and NTRK. Evidence from pivotal clinical trials and real-world studies is discussed to describe toxicity incidence, underlying mechanisms, and current management strategies. Emphasis is placed on hepatic, gastrointestinal, dermatologic, neurologic, cardiovascular, and pulmonary adverse events, as well as on structured monitoring and multidisciplinary toxicity management approaches. A structured literature search was conducted in PubMed/MEDLINE, Embase, and Web of Science, including peer-reviewed publications. EXPERT OPINION: Early recognition and proactive management of toxicity are essential to maintain treatment adherence, optimize safety, and preserve quality of life. Emerging biomarkers of toxicity and resistance are expected to refine individualized management and guide the development of next-generation inhibitors with improved tolerability. Integrating precision toxicity management into routine clinical practice will be critical to maximizing the therapeutic benefit of targeted therapies in oncogene-driven NSCLC.
Frailty is not ECOG: why performance status alone is no longer enough in anticancer therapy.
Jerjes W
Expert Rev Anticancer Ther · 2026 May · PMID 42104752 · Publisher ↗
Abstract loading — click title to view on PubMed.
Optic glioma in children: clinical presentation, diagnosis, and management.
Susam Sen H, Varan A
Expert Rev Anticancer Ther · 2026 May · PMID 42101910 · Publisher ↗
INTRODUCTION: Optic gliomas are slow-growing astrocytic tumors that frequently occur in children. The general treatment approach for optic gliomas should be based on tumor location, patient age, and NF1 status. Optic gli...
INTRODUCTION: Optic gliomas are slow-growing astrocytic tumors that frequently occur in children. The general treatment approach for optic gliomas should be based on tumor location, patient age, and NF1 status. Optic gliomas respond well to chemotherapy; it is generally preferred over radiotherapy, especially for children under five years and those with NF1. Chemotherapy primarily results in stabilization of tumor volume, and this effect is often temporary. In some cases, a second line treatment may be required. Radiotherapy may be an option for treating patients with sporadic optic gliomas. Targeted therapy is a promising strategy. AREAS COVERED: This review provides an overview of clinical findings, diagnosis, current standard practices, emerging targeted treatments, and ongoing clinical trials for optic gliomas in children. The literature reviewed herein was identified through a non-systematic search of published articles, clinical trial registries, and authoritative guidelines. Selection was based on relevance, clinical significance, and contribution to understanding current and emerging management strategies. EXPERT OPINION: Because BRAF alterations are observed in most pilocytic astrocytomas, treatments targeting the MAPK pathway play an important role in the management of optic gliomas. Inhibition of the MAPK signaling pathway represents a potential advance in the treatment of optic gliomas.
LUMINATE-101-Maccabi: a real-world study of treatment patterns and clinical outcomes in patients with non-squamous metastatic non-small cell lung cancer in an Israeli Health Maintenance Organization (HMO).
Moser SS, Zer A, Hejazi A … +7 more , Passwell N, Hoshen M, Virani A, Sharmokh S, Daaboul N, Gazit S, Bar J
Expert Rev Anticancer Ther · 2026 Jul · PMID 42096187 · Publisher ↗
BACKGROUND: Treatment options for non-small cell lung cancer (NSCLC) patients lacking actionable genetic alterations (non-AGA) remain limited, particularly after first-line (1L) therapy. This study evaluated real-world t...
BACKGROUND: Treatment options for non-small cell lung cancer (NSCLC) patients lacking actionable genetic alterations (non-AGA) remain limited, particularly after first-line (1L) therapy. This study evaluated real-world treatment patterns and outcomes among second or later-line (2L+) patients with non-AGA non-squamous (NSQ) metastatic NSCLC (mNSCLC) at a Health Maintenance Organization in Israel. METHODS: A retrospective cohort study used de-identified data from the Maccabi Healthcare Services database to identify 2L+ adult patients with non-AGA NSQ mNSCLC between January 2017 and December 2020. Outcomes included progression-free survival (PFS), overall survival (OS), and time-to-next-treatment or death (TTNTD), analyzed using descriptive statistics and Kaplan-Meier methodology. RESULTS: Among 176 2L+ patients, median age was 67 years, 66.5% were male, 51.7% had an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1, and 30.7% received third-line therapy. Anti-programmed death-receptor/ligand 1 (anti-PD-[L]1) was the most common 2L therapy ( = 74, 42.0%) following 1L chemotherapy. Median overall TTNTD from 2L initiation was 3.73 months (docetaxel: 1.78 months; anti-PD-[L]1 combination: 7.05 months). Median overall PFS was 2.56 months (docetaxel: 1.78 months; anti-PD-[L]1 combination: 9.48 months) and median overall OS was 5.51 months (docetaxel: 1.81 months; anti-PD-[L]1 combination: 9.48 months). CONCLUSIONS: These findings highlight the high unmet need among 2L+ non-AGA NSQ mNSCLC patients in Israel.
Lu-PSMA-617 radioligand therapy as an immune modulator in prostate cancer.
Sciortino C, Nuzzo A, Stellato M … +12 more , Claps M, Rametta A, Guadalupi V, Gusmaroli E, Rota S, Mascaro F, Giannatempo P, Zimatore M, Maccauro M, Huber V, Verzoni E, Procopio G
Expert Rev Anticancer Ther · 2026 May · PMID 42089687 · Publisher ↗
INTRODUCTION: Metastatic castration-resistant prostate cancer (mCRPC) remains a therapeutic challenge despite advances in systemic treatments. Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT)...
INTRODUCTION: Metastatic castration-resistant prostate cancer (mCRPC) remains a therapeutic challenge despite advances in systemic treatments. Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) with Lu-PSMA-617 has emerged as an effective strategy, and increasing evidence suggests that its activity may extend beyond direct cytotoxicity to the modulation of the tumor immune microenvironment. AREAS COVERED: A narrative literature review was conducted using the PubMed database to identify relevant studies published up to January 2026. This review summarizes preclinical and clinical evidence on the immunomodulatory effects of PSMA-targeted RLT. We discuss how Lu-PSMA-617 influences immune cell populations, induces immunogenic cell death, and interacts with key microenvironmental factors such as hypoxia, vascularization, and PSMA heterogeneity. The role of alternative radioligands, including alpha-emitters and fibroblast activation protein-targeted agents, is also examined. EXPERT OPINION: PSMA-targeted RLT represents a promising immune-priming modality in mCRPC, but its clinical impact is limited by tumor and microenvironmental heterogeneity. Biomarker-driven patient selection, optimized dosimetry, and rational combination strategies with immunotherapy will be essential to fully exploit its immunomodulatory potential and to achieve durable clinical benefit.
Artificial intelligence in retinoblastoma and uveal melanoma - a narrative review.
Gurnani B, Kaur K
Expert Rev Anticancer Ther · 2026 May · PMID 42089602 · Publisher ↗
INTRODUCTION: Artificial intelligence (AI) is reshaping diagnostic paradigms across oncology. In ophthalmic oncology encompassing conditions like retinoblastoma and uveal melanoma, AI has immense potential due to the spe...
INTRODUCTION: Artificial intelligence (AI) is reshaping diagnostic paradigms across oncology. In ophthalmic oncology encompassing conditions like retinoblastoma and uveal melanoma, AI has immense potential due to the specialty's reliance on advanced imaging and the importance of early and accurate diagnosis. AREAS COVERED: This review explores recent developments in AI applications for ophthalmic oncology, particularly in imaging-based detection, prognostication, and treatment planning. A structured search of PubMed and Web of Science from 2010-2025 identified key studies focusing on AI's use in diagnosing retinoblastoma from fundus photography and differentiating uveal melanoma from benign lesions. Additionally, AI models trained on multimodal inputs such as Optical Coherence Tomography, Ultrasound B scan, and histopathology have demonstrated promise in outcome prediction and therapy stratification. EXPERT OPINION: AI algorithms have achieved diagnostic performance comparable to ophthalmic oncology experts and, in some cases, outperformed them in detecting subtle malignancies. While promising, clinical adoption remains limited by the need for large, diverse datasets and prospective validation. Multicenter collaborations and integration of multimodal imaging are essential to move from proof-of-concept to real-world application. With continued development, AI can significantly enhance diagnostic precision, personalize care, and serve as a scalable model for cancer imaging in ophthalmology and beyond.
Expert consensus on the role of immunotherapy in nasopharyngeal carcinoma: clinical and economic perspectives from the GCC region.
Hamad A, El-Sheashaey A, Alanazi AS … +6 more , Khan F, Khan MA, Alfar M, Abu Tabar O, Aljaber R, Elazzazy S
Expert Rev Anticancer Ther · 2026 May · PMID 42089269 · Publisher ↗
INTRODUCTION: Nasopharyngeal carcinoma (NPC) is a rare malignancy globally but poses a disproportionate clinical and economic burden in endemic regions, including parts of the Gulf Cooperation Council (GCC). Patients wit...
INTRODUCTION: Nasopharyngeal carcinoma (NPC) is a rare malignancy globally but poses a disproportionate clinical and economic burden in endemic regions, including parts of the Gulf Cooperation Council (GCC). Patients with recurrent or metastatic NPC (RM-NPC) often present with advanced disease and limited therapeutic options, historically relying on platinum-based chemotherapy with modest survival benefit and substantial toxicity. Recent advances in immunotherapy have begun to reshape the treatment landscape. AREAS COVERED: This position paper reviews the evolving role of immunotherapy in RM-NPC, with a particular focus on toripalimab. An advisory board meeting was convened to review disease burden, unmet needs, clinical outcomes associated with immune checkpoint inhibitors, and economic considerations relevant to formulary decision-making. A literature review was conducted from January 2015 to October 2025, focusing on clinical trials, guidelines, and economic evaluations related to immunotherapy in NPC. EXPERT OPINION: Toripalimab in combination with chemotherapy should be adopted as the new standard of care for RM-NPC. Beyond efficacy, its potential value in the GCC extends to health system efficiency and resource allocation. Experts emphasized that value-based assessment frameworks, supported by local, real-world, and economic data, are essential to guide sustainable adoption and equitable patient access to immunotherapy in the region.
Quantitative and qualitative fecal immunochemical tests for colorectal cancer screening in Kazakhstan: a comparative study.
Jumanov A, Kaidarova D, Zhylkaidarova A … +3 more , Turkpenova I, Oshibayeva A, Myrzakulov Y
Expert Rev Anticancer Ther · 2026 May · PMID 42089262 · Publisher ↗
BACKGROUND: Late diagnosis of colorectal cancer (CRC) remains a public health challenge due to limitations in screening programs. This study evaluated the fecal immunochemical test (FIT) as an alternative screening metho...
BACKGROUND: Late diagnosis of colorectal cancer (CRC) remains a public health challenge due to limitations in screening programs. This study evaluated the fecal immunochemical test (FIT) as an alternative screening method for CRC detection. RESEARCH DESIGN AND METHODS: Colonoscopy and immunochemical analysis were used as standard diagnostics. A population-based survey in Kazakhstan assessed disease prevalence and screening outcomes. Diagnostic accuracy and prognostic value of haemoccult testing were analyzed, comparing quantitative and qualitative results. RESULTS: Among 6,000 participants, 9.76% ( = 586) had positive FIT results. Elevated fecal hemoglobin concentrations (≥100 µg Hb/g stool) were found in 3.6% ( = 217), while 96.4% ( = 5786) had lower values. Of 150 clinically significant positive cases, 55 were confirmed, including 5 CRC cases and precancerous conditions. FIT facilitated large-scale screening. The Positive Predictive Value (PPV) for qualitative FIT was 10.4%, and for quantitative FIT (≥100 µg Hb/g), it was 15.7%. The Negative Predictive Value (NPV) for qualitative FIT was 100%, and for quantitative FIT, 99.5%. CONCLUSION: FIT demonstrates practical value as an efficient screening tool for early CRC detection, with a weak but significant correlation to histological findings ( < 0.01).
An evaluation of avutometinib in combination with defactinib for -mutated recurrent low-grade serous ovarian cancer.
Podder V, Slomovitz BM, Coleman RL
Expert Rev Anticancer Ther · 2026 May · PMID 42059499 · Publisher ↗
INTRODUCTION: Low-grade serous ovarian cancer (LGSOC) is a rare, biologically distinct subtype of epithelial ovarian cancer characterized by relative genomic stability, frequent activation of the mitogen-activated protei...
INTRODUCTION: Low-grade serous ovarian cancer (LGSOC) is a rare, biologically distinct subtype of epithelial ovarian cancer characterized by relative genomic stability, frequent activation of the mitogen-activated protein kinase (MAPK) pathway, and limited sensitivity to cytotoxic chemotherapy. Activating alterations in , , and mutations occur in 70% of cases, with being the predominant driver in recurrent disease, for which effective and durable treatment options remain limited. AREAS COVERED: This article reviews the mechanistic rationale for combined RAF/MEK and focal adhesion kinase (FAK) inhibition in LGSOC, focusing on avutometinib (a first-in-class RAF/MEK clamp) and defactinib (a selective FAK inhibitor). A structured review of preclinical and clinical evidence was conducted, including key findings from phase I FRAME and phase II RAMP-201 trials. Efficacy outcomes, safety and tolerability profiles, and the current regulatory landscape, including accelerated approval in the United States and ongoing phase III evaluation, are discussed. EXPERT OPINION: Avutometinib plus defactinib represents a promising targeted therapeutic strategy for recurrent LGSOC, particularly in patients with -mutant tumors. If confirmed in phase III trials, this combination may establish a molecularly informed disease-specific treatment paradigm with the potential for more durable disease control than existing therapies.
From budget constraints to value-based payment: an incremental cost-effectiveness analysis of sacituzumab tirumotecan for advanced triple-negative breast cancer in China.
Luo S, Wang X, Yang L … +4 more , Lin S, Huang X, Weng X, Xu X
Expert Rev Anticancer Ther · 2026 May · PMID 42059343 · Publisher ↗
BACKGROUND: Robust pharmacoeconomic evidence regarding the long-term affordability of sacituzumab tirumotecan (sac-TMT) in treatment of metastatic triple-negative breast cancer (TNBC) remains lacking. We evaluated the co...
BACKGROUND: Robust pharmacoeconomic evidence regarding the long-term affordability of sacituzumab tirumotecan (sac-TMT) in treatment of metastatic triple-negative breast cancer (TNBC) remains lacking. We evaluated the cost-effectiveness of sac-TMT versus chemotherapy for previously treated metastatic TNBC from the perspective of Chinese payers. RESEARCH DESIGN AND METHODS: A partitioned survival model was developed using clinical efficacy and safety data from the OptiTROP-Breast01 trial. Key inputs included survival probability, incidence of adverse events, direct medical costs, and utility values. Total costs, quality adjusted life-year (QALY), and incremental cost-effectiveness ratio (ICER) were calculated as main outputs. Sensitivity analyses tested parameter uncertainty. RESULTS: Sac-TMT provided an incremental survival benefit of 0.40 QALY compared to chemotherapy but incurred extra costs of $33,029.53. The corresponding ICER was $82,573.83/QALY, substantially exceeding the willingness-to-pay (WTP) thresholds of $40,343.68/QALY. Drivers of unaffordability were utility value of progressive disease, price of sac-TMT, and body weight. Probabilistic sensitivity analysis showed that the probability of sac-TMT being cost-effective was 0.68%, and price simulation manifested that a 77.5% price reduction for sac-TMT could make it economical. CONCLUSION: Sac-TMT is not cost-effective for metastatic TNBC compared to chemotherapy at current pricing. Significant price reductions are essential to justify its economic value in resource-constrained settings.
Pembrolizumab trough concentration monitoring and association with outcomes in advanced non-small cell lung cancer.
Trontzas IP, Palaiologou A, Kamperi N … +9 more , Georganta A, Panagiotou E, Orfanou IM, Kyriakoulis KG, Vathiotis I, Kotteas EA, Grapsa D, Tamvakopoulos C, Syrigos KN
Expert Rev Anticancer Ther · 2026 May · PMID 42059336 · Publisher ↗
BACKGROUND: Therapeutic drug monitoring (TDM) of immune checkpoint inhibitors (ICIs) remains limited due to drug-related challenges; however, a better understanding of exposure-effect relationships may improve antitumor...
BACKGROUND: Therapeutic drug monitoring (TDM) of immune checkpoint inhibitors (ICIs) remains limited due to drug-related challenges; however, a better understanding of exposure-effect relationships may improve antitumor activity and reduce immune-related adverse events (irAEs). METHODS: We conducted a prospective TDM study measuring pembrolizumab trough concentrations (Cmin) using a commercial ELISA kit in 31 patients with advanced non-small cell lung cancer (NSCLC) receiving pembrolizumab monotherapy. Serial Cmin measurements were obtained at baseline (T0), before cycle 2 (T1), and at 3 (T2), 6 (T3), and 12 months (T4). Baseline clinicopathologic and serologic variables were recorded. Patients were followed for 2 years to assess treatment outcomes. RESULTS: Pembrolizumab Cmin increased significantly over time ( < 0.0001), with the greatest rise after T2 (T1 vs. T2, < 0.001) and stabilization thereafter (T3 vs. T4, = 0.25). Higher Cmin levels at later timepoints were associated with improved clinical outcomes. Elevated Cmin correlated with a greater number of organ systems affected by irAEs. High baseline albumin and fewer comorbidities were predictors of higher Cmin. CONCLUSIONS: Pembrolizumab TDM is a feasible approach in NSCLC. Higher late-treatment Cmin levels may be associated with favorable outcomes, supporting pembrolizumab exposure as a potential biomarker and highlighting TDM as a tool for dose-tailoring strategies.
Neoadjuvant treatment regimens associated with pathological complete response in triple-negative breast cancer: a systematic review and network meta-analysis.
Menegat BLRS, Menegat ALRS, Ferreira Piccoli MV … +3 more , Diniz Guerra Braz L, Rebelo TG, de Moraes FCA
Expert Rev Anticancer Ther · 2026 Apr · PMID 42030172 · Publisher ↗
INTRODUCTION: Triple-negative breast cancer (TNBC) lacks estrogen, progesterone, and HER2 receptors, limiting treatment options. Neoadjuvant anthracycline- and taxane-based chemotherapy remains standard, achieving pathol...
INTRODUCTION: Triple-negative breast cancer (TNBC) lacks estrogen, progesterone, and HER2 receptors, limiting treatment options. Neoadjuvant anthracycline- and taxane-based chemotherapy remains standard, achieving pathological complete response (pCR) rates of approximately 30%. We compared neoadjuvant treatments for early-stage TNBC using a systematic review and network meta-analysis (NMA). METHODS: PubMed, EMBASE, and Cochrane were searched for randomized and observational studies of neoadjuvant treatment in TNBC. Odds ratios (OR) with 95% confidence intervals were pooled using a random-effects model. Certainty of evidence was assessed with GRADE. Statistical analyses were performed using RStudio. RESULTS: Thirty-seven studies with 7683 patients were included. Twenty-five treatment nodes were formed, with paclitaxel (P) or docetaxel (D) + anthracycline-based (A) chemotherapy as the main comparator. Compared with PA-based + cyclophosphamide, higher pCR rates were observed with PA-based + carboplatin + pembrolizumab + cyclophosphamide (OR 3.04) and PA-based + carboplatin + veliparib + cyclophosphamide (OR 2.67). When DA-based + cyclophosphamide was the comparator, DA-based + cyclophosphamide + bevacizumab (OR 1.67) increased pCR. The SUCRA ranked PA-based + carboplatin + pembrolizumab, paclitaxel + carboplatin + atezolizumab, and DA-based + lobaplatin as most effective. CONCLUSIONS: Platinum agents, PARP inhibitors, and immune checkpoint inhibitors were associated with higher pCR rates in early-stage TNBC. PROTOCOL REGISTRATION: CRD42025640277.
Clinical management of oligoprogressive renal cell carcinoma.
Bernstein EA, Schoenhals J, Dason S … +3 more , Wang SJ, Singer EA, Runcie K
Expert Rev Anticancer Ther · 2026 Apr · PMID 41979231 · Publisher ↗
INTRODUCTION: Nearly 81,000 new cases of renal cell carcinoma are expected to be diagnosed in 2025, with more than one-third of patients presenting with or eventually developing metastatic disease. Some patients develop...
INTRODUCTION: Nearly 81,000 new cases of renal cell carcinoma are expected to be diagnosed in 2025, with more than one-third of patients presenting with or eventually developing metastatic disease. Some patients develop oligoprogressive disease, defined by limited metastatic progression. AREAS COVERED: We discuss current data evaluating the treatment approaches to patients with oligoprogressive disease. This includes active surveillance, systemic therapy, and metastasis-directed therapy such as surgical resection, stereotactic ablative radiotherapy, and percutaneous thermal ablation. We also describe the disease characteristics that we consider when deciding on the appropriate therapy for patients with oligoprogressive disease. We searched databases such as PubMed and ClinicalTrials.gov from 2000 to 2026 for trials related to these treatment options. EXPERT OPINION: Patients with oligoprogressive RCC with favorable or intermediate-risk disease and limited metastases may benefit from metastasis-directed therapy. Patients that progress on immunotherapy and require subsequent therapy should consider a tyrosine kinase inhibitor. Biomarkers are being explored to better risk-stratify patients for metastasis directed therapy.
Determinants of survival after neoadjuvant chemotherapy in resectable gastric cancer: adjuvant dose intensity, radiotherapy, and pathologic response.
Dülgar Kaya Ö, Bayramgil A, Bilici A … +12 more , Sünger E, Kaya T, Başoğlu Tüylü T, Baydaş T, Koca S, Ağyol Y, Işık S, Çakan Demirel B, Erol VB, Bulut N, Niğdelioğlu B, Özçelik M
Expert Rev Anticancer Ther · 2026 Apr · PMID 41950348 · Publisher ↗
BACKGROUND: Neoadjuvant chemotherapy (NACT) is the standard of care for locally advanced gastric cancer, but adjuvant therapy is not tailored to pathological response and outcomes are poor. This study evaluated the impac...
BACKGROUND: Neoadjuvant chemotherapy (NACT) is the standard of care for locally advanced gastric cancer, but adjuvant therapy is not tailored to pathological response and outcomes are poor. This study evaluated the impact of adjuvant chemotherapy (ACT) dose intensity, radiotherapy, and pathologic factors on disease-free survival (DFS) and overall survival (OS). METHODS: A total of 197 patients with locally-advanced gastric cancer treated with NACT followed by gastrectomy from seven cancer centers were analyzed. Clinical, surgical, and pathological data were extracted. ACT regimens, dose-reductions, and receiving radiotherapy were recorded. Primary outcomes were DFS and OS. Kaplan-Meier and Cox-models were used to identify predictors of survival. RESULTS: Most patients received FLOT (84.8%) as NACT and D2-lymphadenectomy. Full-dose ACT was delivered to 66.1%. At 24 months, DFS and OS were 77.1% and 84.1% with full-dose ACT versus 35.8% and 63.6% with reduced-dose ACT. Dose reduction independently increased recurrence risk (HR 4.73) and mortality (HR 2.84). Positive margins, higher ypT/ypNstage, <50% tumor-regression, lymphovascular and perineural invasion were associated with shorter DFS. Adjuvant radiotherapy did not significantly improve survival outcomes. CONCLUSIONS: Reduced-dose ACT after NACT and surgery was associated with inferior DFS and OS, indicating that maintaining full-dose adjuvant therapy is critical. These findings are limited by retrospective design; prospective response-adapted trials are needed.
A systematic review on clinical pharmacokinetics and pharmacodynamics of antiangiogenic tyrosine kinase inhibitors (TKIs) with high TDM scores.
Sherazi AW, Rasool MF, Jiao Z … +1 more , Alqahtani F
Expert Rev Anticancer Ther · 2026 Apr · PMID 41947705 · Publisher ↗
INTRODUCTION: Tyrosine kinase inhibitor (TKI) drugs are used to treat various cancer types. This systematic review evaluates the published pharmacokinetic (PK) and pharmacodynamic (PD) parameters of TKI drugs with high t...
INTRODUCTION: Tyrosine kinase inhibitor (TKI) drugs are used to treat various cancer types. This systematic review evaluates the published pharmacokinetic (PK) and pharmacodynamic (PD) parameters of TKI drugs with high therapeutic drug monitoring (TDM) scores in humans. METHODS: A comprehensive computerized literature search of four internet databases was carried out until July 2025 for sunitinib, pazopanib, sorafenib, axitinib, and cabozantinib, and it provided 3192 articles, of which 56 met the inclusion criteria by providing human PK and related PD information. RESULTS: The exposure of TKI drugs generally increases with the dose escalation, as reflected by higher area under the curve from zero to infinity (AUC) and maximum plasma concentration (C). In pediatric patients, sunitinib showed dose-dependent increases in exposure. Cabozantinib 140 mg showed higher exposure under fed versus fasted conditions, with AUC increasing from 60,700 to 95,200 ng·h/ml and C from 505 to 709 ng/ml. In pediatric gastrointestinal stromal tumor patients, sunitinib exhibited a large apparent volume of distribution (V/F) 3160 L, indicating extensive tissue distribution. CONCLUSION: This review summarizes clinical PK, drug-drug interaction studies, effects of dosage form on PK, and corresponding PD parameters of TKI drugs supporting PK models development for optimizing dosing regimens. PROTOCOL REGISTRATION: www.crd.york.ac.uk/prospero identifier is CRD420251110777.
National Delphi consensus on perioperative and locally advanced NSCLC management in Colombia.
Bruges Maya R, Lombana M, Carvajal-Fierro CA … +4 more , Zapata Gonzalez R, Ortiz Martinez JJ, Gonzalez-Motta A, Loaiz Salazar LM
Expert Rev Anticancer Ther · 2026 Apr · PMID 41921504 · Publisher ↗
OBJECTIVES: To develop Colombian, evidence-informed consensus recommendations for perioperative systemic therapy and unresectable stage III non-small cell lung cancer (NSCLC), considering local testing and access constra...
OBJECTIVES: To develop Colombian, evidence-informed consensus recommendations for perioperative systemic therapy and unresectable stage III non-small cell lung cancer (NSCLC), considering local testing and access constraints. METHODS: Three Colombian professional societies conducted a modified Delphi process. A multidisciplinary panel completed two anonymous rating rounds in September 2024 and a structured debate. A systematic literature search (2010-2024) informed 34 draft statements spanning diagnostic workup, neoadjuvant and adjuvant therapy, and unresectable stage III management. RESULTS: Consensus was reached for 33/34 statements (97.1%). The panel endorsed multidisciplinary tumor board review and pretreatment molecular profiling. For resectable stage II-III disease without sensitizing EGFR/ALK alterations, neoadjuvant chemo-immunotherapy was preferred. For unresectable stage III, chemoradiotherapy followed by durvalumab consolidation was endorsed for PD-L1-positive tumors; use in PD-L1 tumor proportion score < 1% should be individualized. In EGFR-mutated unresectable stage III disease, durvalumab was not endorsed; osimertinib consolidation was favored. The only non-consensus item was adjuvant atezolizumab for PD-L1 ≥1% after platinum chemotherapy in EGFR/ALK-negative stage II-IIIA disease (AJCC 7th), lacking INVIMA approval at the time. CONCLUSION: This Delphi consensus provides a practical national framework for perioperative and unresectable stage III NSCLC management in Colombia.
Can we consider stopping hepatocellular carcinoma surveillance in low-risk patients with hepatitis B?
Kim NJ, Kim HN, McMahon BJ … +2 more , Kowalski Frank L, Ioannou GN
Expert Rev Anticancer Ther · 2026 Mar · PMID 41911050 · Publisher ↗
INTRODUCTION: Chronic hepatitis B (CHB) can cause liver cirrhosis and hepatocellular carcinoma (HCC). HCC surveillance with an abdominal ultrasound and serum alpha-fetoprotein every six months is recommended for patients...
INTRODUCTION: Chronic hepatitis B (CHB) can cause liver cirrhosis and hepatocellular carcinoma (HCC). HCC surveillance with an abdominal ultrasound and serum alpha-fetoprotein every six months is recommended for patients with cirrhosis and in a subset of patients with non-cirrhotic CHB. However, it can be difficult to determine which patients are at high- vs. low-risk for HCC. AREAS COVERED: We review the key factors that contribute to HCC risk in CHB, the concept of risk-based HCC surveillance, and some of the existing clinical tools that can be used to estimate HCC risk in CHB. EXPERT OPINION: Individualized HCC risk estimates can help clinicians stratify patients into high- and low-risk groups, enabling tailored surveillance strategies. However, the practical use of existing tools remains limited by the lack of wide validation, variability in access to laboratory testing, and the inability to accurately predict dynamic changes in HCC risk over time. For most patients with CHB, HCC risk remains sufficiently high enough to justify ongoing HCC surveillance. However, in select low-risk patients, surveillance may be delayed or stopped with regular reassessment of HCC risk and shared decision-making, given the limitations of existing tools and the likelihood of changes in HCC risk over time.
Antibody-drug conjugates in oncology: a clinically focused review for nursing practice.
Tsatsou I, Panagou E, Govina O
Expert Rev Anticancer Ther · 2026 Jun · PMID 41902827 · Publisher ↗
INTRODUCTION: Antibody-drug conjugates (ADCs) are an expanding class of targeted cancer therapies that combine monoclonal antibody specificity with potent cytotoxic agents, offering improved precision and efficacy across...
INTRODUCTION: Antibody-drug conjugates (ADCs) are an expanding class of targeted cancer therapies that combine monoclonal antibody specificity with potent cytotoxic agents, offering improved precision and efficacy across multiple malignancies. As their clinical use increases, there is a growing need to address the critical role of oncology nursing in ensuring safe administration, toxicity management, and patient education. AREAS COVERED: This narrative review examines the current landscape of approved ADCs with a focus on nursing practice. It explores ADC mechanisms of action, administration considerations, and characteristic toxicity profiles, including hematologic, pulmonary, dermatologic, neurologic, and ocular adverse events. A literature search was conducted using PubMed, CINAHL, regulatory agency publications, clinical guidelines, and prescribing information, prioritizing sources published within the past decade and those relevant to clinical nursing care and patient safety. EXPERT OPINION: Oncology nurses are central to the successful delivery of ADC therapy through comprehensive assessment, vigilant monitoring, proactive toxicity management, and patient education. As ADC technologies evolve and indications expand, continued development of nursing-specific protocols and education is essential to optimize patient outcomes and maintain treatment safety.
ESMO 2025 and new therapies in breast cancer: does society always benefit?
Ismaili N
Expert Rev Anticancer Ther · 2026 Mar · PMID 41860458 · Publisher ↗
The ESMO 2025 Congress delivered practice-defining data across breast cancer. Key results included the first overall survival benefit for an adjuvant CDK4/6 inhibitor in high-risk HR+/HER2- early breast cancer and T-DXd...
The ESMO 2025 Congress delivered practice-defining data across breast cancer. Key results included the first overall survival benefit for an adjuvant CDK4/6 inhibitor in high-risk HR+/HER2- early breast cancer and T-DXd established as standard in high-risk HER2+ disease. Novel antibody-drug conjugates redefined first-line therapy for metastatic TNBC. Updated guidelines mandate broader NGS profiling for PALB2, AKT1, and PTEN alterations. A strong emphasis emerged on biomarker-driven de-escalation, strategic sequencing, and proactive endocrine resistance management. However, benefits must be balanced against cost, equity, and the need for academically derived biomarkers. This report summarizes pivotal presentations reshaping clinical decision-making while reflecting on societal impact.
Radiotheranostics in solid tumors: focus on radiopharmaceutical therapy and clinical challenges.
Lucente D, Bellino S, La Salvia A
Expert Rev Anticancer Ther · 2026 Mar · PMID 41852274 · Publisher ↗
INTRODUCTION: Theranostic radiopharmaceuticals represent a significant advancement in personalized medicine, particularly in oncology. By integrating diagnostic imaging and targeted radionuclide therapy within a single m...
INTRODUCTION: Theranostic radiopharmaceuticals represent a significant advancement in personalized medicine, particularly in oncology. By integrating diagnostic imaging and targeted radionuclide therapy within a single molecular platform, these agents enable selective delivery of cytotoxic radiation to tumor cells. This integrated 'diagnose-then-treat' paradigm enables precise patient selection, individualized treatment planning, and response assessment. AREAS COVERED: A comprehensive literature search was performed using major biomedical databases, including PubMed, Scopus, and Web of Science. Clinical successes such as peptide receptor radionuclide therapy for neuroendocrine tumors (NETs), and Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) for metastatic castration-resistant prostate cancer underline the promise of radiotheranostics. Rapid innovation is driving personalized dosimetry from research into clinical practice, improving the balance between efficacy and toxicity. Furthermore, improved target selection using PET imaging is becoming essential for optimal patient selection and clinical trial design. EXPERT OPINION: Despite these advances, critical challenges persist, including toxicity management and heterogeneous target expression; additionally, radionuclide production, supply logistics, and cold-chain requirements remain significant barriers to widespread adoption; finally, standardization issues, harmonized imaging protocols, and clear response criteria further complicate patient selection. The field's advancement will rely on robust randomized clinical trials and innovative combination strategies to address tumor heterogeneity and resistance.
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