Expert Review Of Anticancer Therapy[JOURNAL]
Sun
200 papers
Liposomal nanomedicine in cancer therapy: advances in drug delivery.
Zaragoza-Jiménez A, López-Lara LF, Álvarez-Velázquez ED … +6 more , Aceves-Enríquez RS, Muñoz-Valle JF, Hernández-Bello J, Salinas-Santander MA, Vallejo-Cardona AA, Ríos-Ibarra CP
Expert Rev Anticancer Ther · 2026 May · PMID 41396166 · Publisher ↗
INTRODUCTION: Nanomedicine offers innovative and less invasive therapies by targeting key biological pathways through specific ligands, enhancing precision and minimizing adverse effects. Among nanocarriers, liposomes st...
INTRODUCTION: Nanomedicine offers innovative and less invasive therapies by targeting key biological pathways through specific ligands, enhancing precision and minimizing adverse effects. Among nanocarriers, liposomes stand out for their dual aqueous-organic structure, which enables encapsulation of both hydrophilic and hydrophobic compounds, improving drug stability and bioavailability. AREAS COVERED: Cancer remains one of the leading causes of death worldwide, with about 9.6 million deaths annually, according to the World Health Organization (WHO). Despite advances in chemotherapy and radiotherapy, major challenges persist, including toxicity and multidrug resistance. Nanoparticles (NPs) have emerged as promising tools for cancer therapy, acting through direct tumor targeting, modulation of the tumor microenvironment, and activation of immune responses. This review summarizes recent preclinical and clinical findings on liposomal formulations used against breast, liver, pancreatic, and prostate cancers, focusing on their therapeutic potential and translational progress. EXPERT OPINION: Liposome performance depends on molecular surface modifications using carbohydrates, proteins, peptides, aptamers, or monoclonal antibodies. These functionalized liposomes enable ligand-receptor recognition, facilitating endocytosis and controlled intracellular drug release. Consequently, targeted liposomal systems achieve higher specificity and reduced systemic toxicity compared with passively delivered formulations.
De-escalating locoregional radiation therapy in breast cancer: balancing promises and prudence.
Marta GN, Kaidar-Person O, Meattini I … +1 more , Poortmans P
Expert Rev Anticancer Ther · 2026 May · PMID 41390975 · Publisher ↗
INTRODUCTION: The integration of primary systemic therapy (PST) into breast cancer management increasingly shapes locoregional treatment. Rising pathological complete response rates and improved survival have fueled inte...
INTRODUCTION: The integration of primary systemic therapy (PST) into breast cancer management increasingly shapes locoregional treatment. Rising pathological complete response rates and improved survival have fueled interest in radiation therapy (RT) de-escalation to limit late toxicity while preserving oncological control. Yet the risk of undertreatment and its delayed consequences remains a major concern. AREAS COVERED: This article appraises evidence supporting response-adapted RT de-escalation after PST. We review key prospective and retrospective studies, including RAPCHEM and NSABP/B-51, outlining their methodological strengths, limitations, and clinical relevance. Evidence was identified through a focused narrative review of major clinical trials, pooled analyses, and meta-analyses addressing locoregional management in the post-PST setting. We further discuss how contemporary systemic therapies, evolving surgery, molecular profiling, and technological advances in RT inform individualized decision-making. EXPERT OPINION: Early data suggest that RT de-escalation may be feasible for carefully selected patients, but current evidence does not justify unrestricted omission of RT in all pathological complete responders. Decisions should remain grounded in long-term outcomes, accurate pre-treatment staging, and robust validation of predictive biomarkers. Until such evidence matures, RT de-escalation should be undertaken cautiously - preferably within clinical trials or prospective registries and following multidisciplinary review - to minimize the risk of inadvertent locoregional undertreatment.
Integrating artificial intelligence across the bladder cancer continuum: progress, promise, and pitfalls.
Saran Manivasagam S, Raman JD, Aminsharifi A
Expert Rev Anticancer Ther · 2026 May · PMID 41390951 · Publisher ↗
INTRODUCTION: Bladder cancer is a prevalent and costly malignancy, with persistent challenges in early detection, accurate staging, and personalized treatment planning. Artificial intelligence (AI) has emerged as a trans...
INTRODUCTION: Bladder cancer is a prevalent and costly malignancy, with persistent challenges in early detection, accurate staging, and personalized treatment planning. Artificial intelligence (AI) has emerged as a transformative tool with the potential to address these limitations across the bladder cancer continuum. AREAS COVERED: This review synthesizes findings from 49 studies selected through a comprehensive literature search of PubMed, MEDLINE, Embase, Scopus, and Google Scholar spanning 2005 to 2025. The included studies explore AI applications in cystoscopic lesion detection, radiologic staging using CT and MRI, histopathologic grading, molecular biomarker profiling, treatment response prediction, and survival prognostication. EXPERT OPINION: AI has demonstrated significant promise in enhancing diagnostic precision, reducing interobserver variability, and enabling individualized treatment strategies. However, widespread clinical adoption remains limited due to challenges in data quality, lack of multicenter validation, integration into electronic health records, and regulatory hurdles. Future research should prioritize explainable AI models, prospective validation, and demonstration of cost-effectiveness and survival benefits. With continued innovation and standardization, AI is poised to become an integral component of precision oncology in bladder cancer care.
Pediatric acute myeloid leukemia in Uruguay: clinical outcomes and diagnostic challenges in a national cohort (2008-2024).
Dapueto G, Pereira I, D'Andrea L … +4 more , Schelotto M, Silveira A, Kaspers G, Castillo L
Expert Rev Anticancer Ther · 2026 May · PMID 41389189 · Publisher ↗
BACKGROUND: Outcomes for pediatric acute myeloid leukemia (AML) have improved substantially in high-income countries through advances in therapy, supportive care, and risk stratification. In Uruguay, results remain poore...
BACKGROUND: Outcomes for pediatric acute myeloid leukemia (AML) have improved substantially in high-income countries through advances in therapy, supportive care, and risk stratification. In Uruguay, results remain poorer despite adopting international protocols. This study evaluates clinical features and outcomes of pediatric AML in Uruguay, establishing a baseline before implementation of the CHIP-AML22 protocol in 2025. RESEARCH DESIGN AND METHODS: A retrospective analysis was conducted using data from the National Pediatric Cancer Registry. Patients under 18 years diagnosed with AML between January 2008 and December 2024 were included. Treatment followed St. Jude AML08 and CLCN-UK 2016 protocols. High-risk or relapsed patients received allogeneic stem cell transplantation. RESULTS: Ninety-two patients were diagnosed with AML, including 7 with Down syndrome and 19 with acute promyelocytic leukemia (APL). Among 66 AML patients, excluding DS and APL, induction failure occurred in 24% (12% early death, 12% refractory disease), relapse in 24%, and treatment-related mortality accounted for 73% of deaths. Five-year overall survival was 50% and event-free survival 38%. CONCLUSIONS: Pediatric AML survival in Uruguay remains below international benchmarks, mainly due to treatment-related mortality during induction. Implementation of CHIP-AML22, together with stronger induction management and supportive care, offers opportunities to improve survival and narrow this gap.
Overcoming toxicity challenges in immune checkpoint inhibitor treatment of high-risk metastatic cancers.
Nalabothu R, Johnson DB
Expert Rev Anticancer Ther · 2026 Apr · PMID 41368804 · Publisher ↗
INTRODUCTION: Immune checkpoint inhibitors (ICI) have become a cornerstone of cancer treatment and induce durable responses in many patients with advanced cancer. However, they cause immune-related adverse events (irAEs)...
INTRODUCTION: Immune checkpoint inhibitors (ICI) have become a cornerstone of cancer treatment and induce durable responses in many patients with advanced cancer. However, they cause immune-related adverse events (irAEs) which result in symptoms related to autoimmunity, chronic sequelae, and occasionally death. Balancing toxicity and efficacy considerations remains a major challenge in ICI treatment. AREAS COVERED: We provide an overview of the pathophysiology, risk factors, and clinical presentation of irAEs. Next, we discuss potential approaches to manage these events. Finally, we discuss novel strategies to detect, prevent, and mitigate severe irAEs and thus optimize the benefits of ICI therapy for patients with cancer. EXPERT OPINION: irAEs, along with lack of response, remain the major challenge in ICI therapy. These constraints are not unrelated, as more aggressive combinations result in higher response rates (at least in some tumors), but increase irAEs as well. Novel multidrug regimens with immune modulators may 'thread the needle' to optimize both response and toxicity concerns.
Do genetic polymorphisms influence imatinib trough concentrations in patients with chronic myeloid leukemia? A systematic review and meta-analysis.
de Moraes FCA, Matheus GTFU, Rego LHRM … +3 more , Sano VKT, Gazabón JB, Burbano RMR
Expert Rev Anticancer Ther · 2026 May · PMID 41367289 · Publisher ↗
INTRODUCTION: Chronic myeloid leukemia (CML) is effectively treated with tyrosine kinase inhibitors such as imatinib, though drug response varies among patients. Genetic polymorphisms in drug transporter genes ABCB1 and...
INTRODUCTION: Chronic myeloid leukemia (CML) is effectively treated with tyrosine kinase inhibitors such as imatinib, though drug response varies among patients. Genetic polymorphisms in drug transporter genes ABCB1 and ABCG2 influence imatinib plasma trough concentrations (Ctrough). METHODS: Statistical analyses were performed using fixed-effect models and heterogeneity was assessed using I² statistic. RESULTS: This meta-analysis evaluated nine studies including 1,098 heterozygous patients, 519 variant carriers, and 896 wild-type individuals. Results showed significantly higher Ctrough in patients with the ABCB1 c.3435C>T TT genotype compared with CC with data of 7 studies (MD = 299.84; 95% CI: 208.06-391.62; = 0.0097; I² = 77%). Similarly, ABCB1 c.2677G>T GT (MD = 327.62; 95% CI: 198.90-456.34; = 0.0008; I² = 52%) and TT (MD = 289.22; 95% CI: 135.63-442.81; < 0.001; I² = 12%) genotypes were associated with higher levels than GG, both assessed by 4 studies. Additionally, data from 5 studies observed that ABCG2 c.412C>A CA carriers had increased Ctrough versus CC (MD = 186.83; 95% CI: 67.11-306.56; = 0.022; I² = 32%). CONCLUSIONS: These findings support the role of pharmacogenetic screening in optimizing imatinib therapy, improving efficacy, and reducing risks of adverse outcomes. REGISTRATION: PROSPERO (CRD42024574179).
Pretreatment hyperferritinaemia as an independent prognostic marker in metastatic solid tumors treated with immune checkpoint inhibitors.
Açar FP, Acar C, Yüksel HÇ … +2 more , Şahin G, Karaca B
Expert Rev Anticancer Ther · 2026 May · PMID 41367247 · Publisher ↗
BACKGROUND: Hyperferritinaemia is common in cancer and may reflect tumor-associated macrophage activity and ferroptosis resistance, yet its prognostic value during immune checkpoint inhibitor (ICI) therapy is uncertain....
BACKGROUND: Hyperferritinaemia is common in cancer and may reflect tumor-associated macrophage activity and ferroptosis resistance, yet its prognostic value during immune checkpoint inhibitor (ICI) therapy is uncertain. METHODS: We retrospectively analyzed 262 patients with metastatic solid tumors treated with ICIs (January 2015-September 2024). An optimal serum ferritin (SF) cutoff stratified patients into low (<500 ng/mL) vs high (>500 ng/mL) groups. Outcomes were compared between SF groups, and SF was compared with other inflammatory markers - the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and C-reactive protein (CRP). RESULTS: Median overall survival (OS) was 6.0 months for high SF vs 23.9 months for low SF; median progression-free survival (PFS) was 2.7 vs 6.4 months (both < 0.001). High SF independently predicted worse OS (hazard ratio [HR] 2.17) and PFS (HR 1.73). Subgroup interactions were largely non-significant; only age >65 years moderated the OS association (interaction = 0.035). Across metrics, SF showed the highest C-indices and superior 12-, 24-, and 36-month OS area under the curve (AUC) values compared with NLR, PLR, LMR, and CRP. CONCLUSIONS: Pretreatment hyperferritinaemia is an inexpensive, readily available biomarker that outperforms conventional inflammatory indices in predicting poor survival and diminished ICI benefit across diverse metastatic solid tumors.
Impact of HPV vaccination after a diagnosis of cervical HSIL - a case-control study.
Vieira-Baptista P, Lima-Silva J, Freitas G … +5 more , Gonçalves M, Coelho C, Melo C, Pinto C, Preti M
Expert Rev Anticancer Ther · 2026 Apr · PMID 41363551 · Publisher ↗
BACKGROUND: This study aimed to evaluate the impact of HPV vaccination at the time of treatment of cervical intraepithelial neoplasia (CIN) 2 or 3 on recurrence/persistence. RESEARCH DESIGN AND METHODS: Unvaccinated wome...
BACKGROUND: This study aimed to evaluate the impact of HPV vaccination at the time of treatment of cervical intraepithelial neoplasia (CIN) 2 or 3 on recurrence/persistence. RESEARCH DESIGN AND METHODS: Unvaccinated women with genital high-grade lesion(s) were offered vaccination (Gardasil 9®) at the time of treatment. Those with CIN2 or 3 were compared with a historical control group of unvaccinated women. RESULTS: Vaccination was accepted by 99.6% of women (267/268); 170 satisfied the inclusion criteria. CIN2+ recurrence/persistence rate up to 24 months in the vaccine group was 3.0% (5/164) . 7.1% (21/295) in the control group, = 0.091. There were no differences in the time until diagnosis.Positive margins (HR [hazard ratio] 8.28; 95% CI 4.08 to 16.77, < 0.001) and age > 45 years (HR 2.99; 95% IC 1.56 to 5.74, < 0.001) were associated with increased risk of persistence/recurrence.There was no reduction in HPV detection at 6 months, but vaccinated women were more likely to become HPV negative (HR 0.689; CI 95% 0.54 to 0.89; = 0.003) and earlier. CONCLUSION: There was a non-significant trend toward lower risk of recurrence/persistence of CIN2+ after treatment in vaccinated women; vaccination did not impact the short-term HPV detection but increased the likelihood of becoming undetectable.
Genomic divergence between matched primary and metastatic tumors across cancer types: a pan-cancer analysis of 5,692 samples.
Ergun Y
Expert Rev Anticancer Ther · 2026 Apr · PMID 41354463 · Publisher ↗
BACKGROUND: Metastasis is the leading cause of cancer-related death and involves biological processes such as genomic instability and immune evasion. Although metastatic tumors generally retain major alterations present...
BACKGROUND: Metastasis is the leading cause of cancer-related death and involves biological processes such as genomic instability and immune evasion. Although metastatic tumors generally retain major alterations present in primary tumors, the extent of additional genomic divergence across cancer types remains insufficiently characterized. RESEARCH DESIGN AND METHODS: A pan-cancer analysis was performed using targeted sequencing data from 2846 patients with matched primary and metastatic tumors (5692 samples) from the AACR Project GENIE-v18.0 cohort. Comparisons between primary and metastatic samples included mutation count, fraction of genome altered (FGA), gene-level mutation frequencies, copy number alterations (CNA), and structural variants (SV). RESULTS: Metastatic tumors showed modest but statistically significant increases in mutation count (median 6 vs. 5) and FGA (0.186 vs. 0.140), with the largest differences observed in lung, breast, colorectal, pancreatic, and prostate cancers. Eleven genes, including , , and , were more frequently altered in metastases. Differences in CNA and SV patterns were also observed, particularly in genes involved in cell cycle control and DNA repair. CONCLUSIONS: Compared with primary tumors, metastatic tumors demonstrated small but consistent genomic differences. These findings varied across cancer types and may reflect changes associated with the evolutionary transition from primary to metastatic disease.
The prognostic significance of lymph node metastases characteristics in papillary thyroid carcinoma: a scoping review.
Dhutt GS, Ellis L, Wiseman SM
Expert Rev Anticancer Ther · 2026 Apr · PMID 41351545 · Publisher ↗
INTRODUCTION: Despite neck lymph node metastases occurring commonly in cases of papillary thyroid carcinoma (PTC), there has remained controversy regarding the thresholds that should be used for lymph node characteristic...
INTRODUCTION: Despite neck lymph node metastases occurring commonly in cases of papillary thyroid carcinoma (PTC), there has remained controversy regarding the thresholds that should be used for lymph node characteristics in predicting PTC recurrence risk. AREAS COVERED: This scoping review explored the prognostic significance of lymph node characteristics in predicting risk of PTC recurrence. Following the PRISMA guidelines, the PubMed, Embase, and Web of Science databases were searched and supplemented by hand searching reference lists to identify articles published from database inception until October 2024. A total of 172 studies were included. Most studies had a retrospective cohort design and were reported from South Korea, Japan, and China. In general, an increased number of metastatic lymph nodes (commonly >5), presence of extranodal cancer extension, larger size of metastatic lymph nodes (commonly >3 cm), higher lymph node ratio (commonly ≥0.3 or ≥0.4), and presence of lateral neck compartment nodal metastases were all associated with higher recurrence rates. EXPERT OPINION: The lack of standardized definitions and terminology make the interpretation of findings difficult and limit generalizability. Future studies must focus on exploring long-term recurrence risk, in an exclusively PTC patient population, while also incorporating standardized definitions and terminology for lymph node characteristics and recurrence.
Unveiling the power of PARP inhibitors: a meta-analysis on newly diagnosed advanced ovarian cancer maintenance therapy.
Zhang W, Zhang N, Li S … +3 more , Ge W, Qiu H, Wu Q
Expert Rev Anticancer Ther · 2026 Mar · PMID 41347401 · Publisher ↗
INTRODUCTION: This meta-analysis sought to assess the efficacy and safety of poly (adenosine diphosphate-ribose) polymerase inhibitors (PARPi) as maintenance therapy for patients with newly diagnosed advanced ovarian can...
INTRODUCTION: This meta-analysis sought to assess the efficacy and safety of poly (adenosine diphosphate-ribose) polymerase inhibitors (PARPi) as maintenance therapy for patients with newly diagnosed advanced ovarian cancer (OC). METHODS: A comprehensive search was conducted across the PubMed, Medline, EMBASE, Cochrane Library, and Web of Science databases, up to 30 January 2025. Both pairwise meta-analysis and Bayesian network meta-analysis were employed. The primary end points were progression-free survival (PFS) and adverse events (AEs). RESULTS: A total of seven randomized controlled trials, encompassing 11 studies and 3220 patients, were included. PARPi maintenance therapy significantly improved PFS in patients with newly diagnosed OC. Subgroup analysis revealed PFS benefits across BRCA mutations, BRCA wild-type (BRCAwt), homologous recombination deficiency (HRD), and homologous recombination proficiency patients. However, no overall survival (OS) benefit was observed with PARPi maintenance therapy in either the overall or HRD populations. Notably, senaparib showed superior PFS efficacy compared to veliparib and niraparib. Additionally, PARPi treatment was associated with a significantly higher incidence of grade ≥3 AEs. CONCLUSIONS: PARPi showed efficacy in improving PFS as maintenance therapy for newly diagnosed advanced OC, although no OS advantage was observed. REGISTRATION: PROSPERO (CRD420251020275).
From macroscopic clearance to molecular eradication: paradigm shift and future perspectives in the detecting of residual lesions after transurethral resection of bladder tumors.
Zhang Y, Yan R, Wang H … +2 more , Man J, Yang L
Expert Rev Anticancer Ther · 2026 Apr · PMID 41313232 · Publisher ↗
INTRODUCTION: Residual lesions after transurethral resection of bladder tumor (TURBT) are a major contributor to recurrence in bladder cancer. Advances in diagnostic technology are shifting postoperative management from...
INTRODUCTION: Residual lesions after transurethral resection of bladder tumor (TURBT) are a major contributor to recurrence in bladder cancer. Advances in diagnostic technology are shifting postoperative management from conventional macroscopic evaluation toward molecular-level assessment. AREAS COVERED: A systematic search of PubMed, Web of Science and Embase from January 2000 to September 2025 identified studies on postoperative residual disease detection in non-muscle invasive bladder cancer (NMIBC). At the macroscopic level, enhanced cystoscopic modalities and artificial intelligence have improved visualization and recognition of subtle urothelial abnormalities. At the microscopic level, liquid biopsy approaches such as urinary tumor DNA, plasma circulating tumor DNA and exosome-based biomarkers enable more sensitive detection of minimal residual disease and dynamic molecular risk stratification beyond traditional cystoscopy and cytology. Integration of imaging findings with molecular profiling provides a more comprehensive basis for individualized surveillance and early therapeutic intervention in NMIBC. EXPERT OPINION: Future priorities include standardizing diagnostic workflows, improving multi-omics integration and validating MRD-guided strategies in prospective studies. These developments may refine risk stratification, reduce recurrence, and support more personalized postoperative management in bladder cancer.
Chemotherapy-induced neutropenia as a prognostic factor in pancreatic cancer: a systematic review and meta-analysis.
de Oliveira Diogo PN, Doro Lerco A, Duenha Garanhani A … +3 more , de Tarso Coelho Jardim P, José Grande A, Reche Razente G
Expert Rev Anticancer Ther · 2026 Apr · PMID 41313082 · Publisher ↗
BACKGROUND: Chemotherapy-induced neutropenia (CIN) may reflect higher pharmacodynamic exposure and relate to improved outcomes, but its clinical relevance in pancreatic cancer remains uncertain. METHODS: PROSPERO-registe...
BACKGROUND: Chemotherapy-induced neutropenia (CIN) may reflect higher pharmacodynamic exposure and relate to improved outcomes, but its clinical relevance in pancreatic cancer remains uncertain. METHODS: PROSPERO-registered, PRISMA-compliant systematic review and meta-analysis. PubMed, Embase, and CENTRAL were searched to 18 August 2025. Eligible studies compared OS in CIN ≥G3 vs <G3. Quantitative synthesis was limited to advanced/unresectable/metastatic disease. Log(HR) and SEs were pooled with random effects (DerSimonian - Laird); heterogeneity by Q and I^2. Sensitivity analyses included 95% prediction interval, Hartung - Knapp - Sidik - Jonkman, and leave-one-out. Publication bias was not assessed (k = 5). RESULTS: Eight observational studies met inclusion; five (all advanced disease) were meta-analyzed. CIN ≥G3 was associated with better OS (grouped HR 0.50; 95% CI 0.40-0.62; I = 0%), with consistent direction across studies. Sensitivity analyses confirmed robustness. ROBINS-I rated four studies at serious and four at moderate risk of bias; GRADE certainty for the pooled OS effect was moderate. CONCLUSIONS: In advanced pancreatic cancer, CIN ≥G3 is associated with improved OS, supporting its role as a cohort-level prognostic/pharmacodynamic marker. Generalizability is limited by predominantly Japanese cohorts. Prospective multicenter studies with time-dependent modeling and control of relative dose intensity. REGISTRATION: www.crd.york.ac.uk/prospero, identifier CRD420251005347.
Economic and disease burden of prostate cancer in expanded BRICS nations: systematic analysis of global burden of disease study 1990 - 2021.
Satapathy P, Gaidhane AM, Puri D … +5 more , Lakhanpal S, Mishra R, Kumar S, Arcot R, Satapathy P
Expert Rev Anticancer Ther · 2026 Apr · PMID 41307503 · Publisher ↗
BACKGROUND: Prostate cancer is a leading malignancy among men worldwide and an increasing challenge for emerging economies. The expanded BRICS nations represent regions undergoing rapid demographic and epidemiological tr...
BACKGROUND: Prostate cancer is a leading malignancy among men worldwide and an increasing challenge for emerging economies. The expanded BRICS nations represent regions undergoing rapid demographic and epidemiological transitions, yet data on their comparative disease and economic burden remain limited. METHODS: We analyzed data from the GBD 2021 study to estimate prostate cancer incidence, mortality, DALYs, and mortality-to-incidence ratios (MIRs) from 1990 to 2021 across BRICS+. Temporal patterns were assessed through EAPC. Productivity losses due to premature mortality were calculated using the Human Capital Approach. RESULTS: Incidence and mortality rose sharply in Russia and Egypt, while China and India showed declining mortality despite increasing incidence. MIRs decreased overall, reflecting improved survival, though Ethiopia and Egypt remained high. In 2021, productivity losses were greatest in China (US$73.1 billion) and Russia (US$19.5 billion), with comparatively lower losses in Ethiopia, Saudi Arabia, Egypt, and the UAE. CONCLUSION: Prostate cancer imposes a heterogeneous but rising health and economic burden across BRICS+ nations. Effective strategies integrating prevention, early detection, equitable treatment-access, and recognition of economic impact are critical to reduce disparities and improve outcomes.
Safety and preliminary efficacy of intraoperative Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in 100 pediatric patients with solid tumors: a retrospective study.
Wang J, Zhang Y, Wang X … +4 more , Shi J, Ma X, Zhu Z, Meng D
Expert Rev Anticancer Ther · 2026 Apr · PMID 41292278 · Publisher ↗
BACKGROUND: Peritoneal recurrence challenges pediatric solid tumors. HIPEC is established in adults but pediatric evidence is limited. We assessed safety and preliminary efficacy of intraoperative HIPEC in children. RESE...
BACKGROUND: Peritoneal recurrence challenges pediatric solid tumors. HIPEC is established in adults but pediatric evidence is limited. We assessed safety and preliminary efficacy of intraoperative HIPEC in children. RESEARCH DESIGN AND METHODS: Retrospective study of 100 children (Aug 2020-Jan 2024) undergoing cytoreductive surgery (CRS) plus HIPEC (cisplatin, doxorubicin, or ifosfamide at 40.5-41.5°C for 60 min). Outcomes included complications, recurrence, and survival. RESULTS: The median peritoneal carcinomatosis index was 4.0 (IQR: 8.0), and complete cytoreduction (CC-0) was achieved in 96% of patients. Adverse events were primarily grade 1-2 gastrointestinal toxicity (90%) and myelosuppression (93%); grade 3 events occurred in 10% and 7%, respectively. No grade 4+ adverse events or 30-day mortality were observed. Transient liver enzyme elevation (49%) normalized within one month. At a median follow-up of 24.3 months, the median overall and progression-free survival were 25.2 and 24.6 months, respectively. Seven patients experienced recurrence recurred and ten died. CONCLUSIONS: HIPEC demonstrated low rates of severe complications and promising survival outcomes. The main limitations include the retrospective design and tumor heterogeneity. Therefore, Large-scale prospective studies are warranted to validate these findings.
Targeted therapy for biliary tract cancer: facts and fictions as well as demands and challenges.
Neureiter D, Ellinghaus P, Ocker M
Expert Rev Anticancer Ther · 2026 Apr · PMID 41287511 · Publisher ↗
INTRODUCTION: Targeted therapy is an established treatment strategy for biliary tract cancer (BTC), yet its clinical efficacy remains limited when compared to promising and findings. This highlights the translational...
INTRODUCTION: Targeted therapy is an established treatment strategy for biliary tract cancer (BTC), yet its clinical efficacy remains limited when compared to promising and findings. This highlights the translational gap between preclinical research and real-world patient outcomes, emphasizing the urgent need for improved strategies to bridge laboratory insights with clinical practice. AREAS COVERED: This report explores the heterogeneous landscape of targeted therapy in BTC. It reviews established facts, including molecular mechanisms, signaling pathways, and clinical trial data, while addressing uncertainties such as patient- and tumor-related variables and infectious comorbidities. In addition, it discusses current demands and future challenges, with emphasis on integrating novel technologies, biomarker-driven approaches, and multidisciplinary collaborations to enhance therapeutic precision. EXPERT OPINION: Early and accurate diagnosis remains the cornerstone of successful BTC treatment. Noninvasive biomarkers, particularly liquid biopsy platforms, hold promise for improving detection and monitoring. Clinically, the establishment of high-volume BTC centers with integrated scientific and medical expertise is essential to translate molecular analyses into personalized therapies. Moreover, systematic incorporation of BTC-related clinical and molecular data into international multicenter trials is imperative. Such integration will refine therapeutic paradigms, accelerate drug development, and foster innovation through strategic collaborations with pharmaceutical industry consortia.
Post-CDK4/6 inhibitor treatment landscape in metastatic hormone receptor-positive breast cancer: a narrative review.
Güren AK, Kircali MF, Köstek O … +1 more , Demircan NC
Expert Rev Anticancer Ther · 2026 Apr · PMID 41267635 · Publisher ↗
INTRODUCTION: Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy have markedly improved clinical outcomes and are the preferred first-line treatment for metastatic hormone receptor - positiv...
INTRODUCTION: Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy have markedly improved clinical outcomes and are the preferred first-line treatment for metastatic hormone receptor - positive breast cancer. However, acquired resistance is almost universal, leading to a critical need for effective strategies in the post-CDK4/6i setting. AREAS COVERED: This review summarizes therapeutic approaches investigated after progression on CDK4/6i plus endocrine therapy. Key therapeutic approaches in this setting focus on overcoming resistance by inhibiting pathways such as PI3K/AKT/mTOR, altering treatment class through switching CDK4/6 inhibitors or endocrine therapy agents, and incorporating selective estrogen receptor degraders (SERDs). In addition, several novel strategies are under investigation, including targeting CDK7, utilizing antibody - drug conjugates, and exploiting DNA repair vulnerabilities with poly (ADP-ribose) polymerase (PARP) inhibitors. We conducted a literature search in PubMed/MEDLINE, Embase, and Scopus for studies published between January 2018 and June 2025 to identify evidence on efficacy, safety, and patient selection in this setting. EXPERT OPINION: Therapeutic development for post-CDK4/6i metastatic HR+ breast cancer is evolving rapidly. Identifying molecular drivers of resistance and matching patients to targeted therapies will be essential to optimize outcomes. Continued efforts toward biomarker-based treatment selection and rational sequencing strategies are expected to refine post-CDK4/6i management.
Future directions for antibody-drug conjugates in urothelial cancer.
D'Agostino E, Pirola M, Callegari V … +12 more , Tonni E, Tchawa C, Matranga R, Ponzoni O, Oltrecolli M, Piombino C, Pipitone S, Baldessari C, Bacchelli F, Dominici M, Sabbatini R, Vitale MG
Expert Rev Anticancer Ther · 2026 Mar · PMID 41263045 · Publisher ↗
INTRODUCTION: Urothelial carcinoma (UC) is a highly aggressive malignancy that has traditionally been treated with platinum-based chemotherapy. In recent years, the therapeutic landscape has undergone substantial transfo...
INTRODUCTION: Urothelial carcinoma (UC) is a highly aggressive malignancy that has traditionally been treated with platinum-based chemotherapy. In recent years, the therapeutic landscape has undergone substantial transformation with the advent of precision oncology, particularly through the introduction of immune checkpoint inhibitors, targeted agents, and antibody-drug conjugates (ADCs). AREAS COVERED: We searched MEDLINE (via PubMed), Embase, and ClinicalTrials.gov and reviewed practice guidelines from ASCO, ESMO, AIOM, and EAU in order to describe the current landscape of ADC-based therapy in UC. EXPERT OPINION: ADCs are rising as a cornerstone in UC, but important challenges remain. Future perspectives point toward the development of combination strategies and next-generation ADCs, designed to overcome resistance, minimize toxicity, and enhance selectivity.
Ropeginterferon alfa-2b in polycythemia vera: redefining disease control through molecular targeting.
De Fazio L, Molica M, Rossi M
Expert Rev Anticancer Ther · 2026 Mar · PMID 41258741 · Publisher ↗
INTRODUCTION: This review critically appraises recent clinical and translational advances on ropeginterferon alfa-2b, a long-acting, mono-pegylated interferon that has become a key therapeutic option for polycythemia ver...
INTRODUCTION: This review critically appraises recent clinical and translational advances on ropeginterferon alfa-2b, a long-acting, mono-pegylated interferon that has become a key therapeutic option for polycythemia vera (PV). Beyond its cytoreductive efficacy, ropeginterferon exerts immunomodulatory and antiproliferative effects that may modify disease biology. The review outlines its therapeutic rationale, pharmacologic profile, and emerging role as a disease-modifying agent compared with conventional cytoreductive therapies. AREAS COVERED: This article summarizes the pharmacokinetic properties, clinical efficacy, molecular activity, and safety of ropeginterferon alfa-2b across pivotal trials and real-world studies. Particular attention is given to hematologic responses, reduction of JAK2 V617F allele burden, and long-term tolerability. Data were identified through a systematic search of PubMed, Embase, and ClinicalTrials.gov for English-language studies published up to 2025. EXPERT OPINION: Ropeginterferon alfa-2b has redefined PV management by combining durable hematologic control with progressive molecular remission. Its favorable efficacy-toxicity balance and convenient dosing support long-term use, particularly in younger or treatment-naïve patients. Future research should refine patient selection, explore predictive biomarkers, and define its role among disease-modifying agents capable of transforming PV into a chronic, potentially controllable disorder.
Prognostic value of the body composition parameters in patients with colorectal liver metastases undergoing intra-arterial treatment.
Ozbay Y, Eldem FG, Cay F … +6 more , Bozkurt MF, Salancı BV, Ormancı A, Aydıngoz U, Dizdar O, Peynircioglu B
Expert Rev Anticancer Ther · 2026 Mar · PMID 41255084 · Publisher ↗
BACKGROUND: To investigate the impact of baseline and temporal changes of the CT-body compositions on survival in patients with colorectal liver metastases (CLRM) undergoing intra-arterial treatment. RESEARCH DESIGN AND...
BACKGROUND: To investigate the impact of baseline and temporal changes of the CT-body compositions on survival in patients with colorectal liver metastases (CLRM) undergoing intra-arterial treatment. RESEARCH DESIGN AND METHODS: A total of 146 patients with CLRM (mean age:59.98 ± 11.94, M/F:90/56) who underwent intra-arterial procedures between January-2012 and December-2022 were included. We determined the patient CT-body compositions by measuring at the level of L3 vertebrae on CT scans. The relationship between body composition and survival was evaluated using Kaplan-Meier survival curves, while factors affecting survival were investigated through univariate and multivariate Cox-regression analyses. RESULTS: Patients with sarcopenia had significantly shorter PFS (median PFS: 2.37 vs. 5.67 months; < 0.001) and OS (median OS:6.20 vs. 13.47 months; < 0.001) compared with those without sarcopenia. Similarly, patients with myosteatosis showed shorter PFS (median PFS: 3.73 vs. 6.10 months; = 0.036) and OS (median OS: 8.80 vs. 15.37 months; < 0.001) compared to those without myosteatosis. However, there was no statistically significant association between subcutaneous/visceral adipose tissue and survival. Besides other clinical or laboratory parameters, sarcopenia (HR: 2.65, = 0.006), myosteatosis (HR: 2.74, = 0.001) and greater loss of skeletal muscle index (HR: 2.03, = 0.037) were independently associated with decreased overall survival. CONCLUSIONS: Baseline sarcopenia, myosteatosis, and greater loss of skeletal muscle index are independent predictors of poor survival in patients with CRLM undergoing intra-arterial treatment.
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