Angiogenesis plays a major role not only in the growth of the primary tumor, but also in metastasis. Due to the angiogenesis in granulation tissue, the tumor cells easily migrate to and locate in ...this region, thereby accelerating the pathological angiogenesis process and proliferation via presence of the angiogenesis-stimulating factors in this site.
In this case report, we present tumor homing to granulation tissue following tooth extraction in a 68-year-old male patient with metastatic lung adenocarcinoma. He applied to hospital due to delayed wound healing after tooth extraction for tooth decay approximately 5 months after the diagnosis. A superficially swollen mass of 6 × 6 cm was detected in the tooth extraction site. The histopathological examination suggested that it was a lung carcinoma metastasis. The presence of tooth extraction history together with the pulmonary adenocarcinoma metastasis in the extraction site was explained as “tumoral homing” to granulation tissue following tooth extraction.
This patient is of significance since it is the first case in the literature with “tumor homing” observed in the granulation tissue following tooth extraction.
Oligometastatic prostate cancer (PCa) can be defined as cancer with a limited number of metastases, typically fewer than 5 lesions, and involves lesions contained within the axial versus the ...appendicular skeleton. Patients can present with de novo oligometastatic, oligorecurrent, or oligoprogressive PCa. Oligometastatic PCa patients demonstrate considerable improvements in survival outcomes, with a better prognosis than patients with extensive metastatic disease. However, the management of patients that present with nonsymptomatic oligometastatic PCa remains difficult. In the oligometastatic setting, the benefit of local therapies such as prostatectomy and radiotherapy on survival outcomes is an intriguing topic; however, their impact on oncological outcomes is still unknown.
The impact of checkpoint inhibitors on gastroesophageal cancer treatment has been tremendous in the last 2 years. KEYNOTE-590, CHECKMATE 649 and CheckMate 648 are landmark trials that have introduced ...immunotherapy to the field as first-line therapy, leading to a paradigm change for advanced esophageal and gastric cancer. Chemotherapy in combination with immunotherapy is now the standard of care for first-line treatment of locally advanced or metastatic adenocarcinoma of the esophagus, esophagogastric junction and stomach. Several new targets and treatments are available for gastroesophageal cancer that are based on the characterization of cancer cells and the tumor microenvironment. Biomarker-based therapy selection is critical to optimize outcomes and minimize toxicities, as well as give insight into the optimal timing and sequence of a patient's treatment course.
Objective
The objective of this retrospective study is to investigate the association between survival and maximum standardized uptake values (SUV
max
) of liver metastases detected by pre-treatment ...positron emission tomography-computed tomography (PET-CT) in patients with adenocarcinoma of unknown primary origin (ACUP).
Methods
A total of 58 patients with ACUP and liver metastases confirmed histopathologically by liver biopsy and pre-treatment PET-CT were included in this study. SUV
max
values of the liver lesions were measured and their association with survival was investigated.
Results
The median age was 62 years; 63.8 % of the patients were males and 36.2 % were females. The median overall survival was calculated as 10.7 months (OS). The median SUV
max
of the liver metastases was 8.6. Accordingly, two groups were established: one with values <8.6 and the other with ones ≥8.6. No differences were detected between the two groups with respect to general characteristics. Median OS was 13.2 months in the group with SUV
max
<8.6 compared to 7.4 months in the group with SUV
max
≥8.6. This difference was statistically significant (
p
= 0.033). SUV
max
(HR 1.104, 95 % CI 1.013–1.204,
p
= 0.025), age (HR 1.033, 95 % CI 1.002–1.064,
p
= 0.034), presence of chemotherapy (HR 2.296, 95 % CI 1.136–4.641,
p
= 0.021) and LDH level (HR 1.002, 95 % CI 1.001–1.003,
p
= 0.007) were identified as independent prognostic factors affecting survival in the multivariable analysis. This is the first report evaluating the impact of SUV
max
for liver metastases on ACUP patient survival.
Conclusion
The SUV
max
of liver metastases evaluated by PET-CT is a prognostic factor influencing survival of patients with ACUP.
Opinion statement
The treatment of renal cell carcinoma (RCC) is one of the great success stories in the field of oncology, which was revolutionized with the development of therapies aimed at ...disrupting crucial pathways. Tumor biology of RCC has provided insight into the disease through elucidation of the role of vascular endothelial growth-factor (VEGF) and the mammalian target of rapamycin (mTOR). Targeted agents against VEGF and mTOR, as well as agents targeting relevant immunomodulatory pathways, have shown clinical benefit for advanced disease. The targeted agents are highly effective in achieving a response and survival, particularly in high-risk patients. These include the vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs) axitinib and cabozantinib, and programmed cell death 1 protein (PD-1) immune checkpoint inhibitors (ICI) nivolumab and pembrolizumab. There is a wealth of evidence investigating different therapeutic options and combinations for first-line treatment of advanced RCC including the CheckMate 214 study, KEYNOTE-426, JAVELIN Renal 101, and CheckMate 9ER. Dual ICI and combination agents targeting the programmed cell death protein 1/programmed cell death protein ligand 1 (PD1/PDL1) and VEGF, began to demonstrate superiority over previously accepted standards in advanced clear-cell RCC. Data from a number of clinical studies are available to help physicians with evidence-based decisions for the sequence of second-line and future treatments for patients with progressive RCC. In this review, we focus on essentials for clinicians treating patients with clear-cell RCC.
Purpose of Review
Triple negative breast cancer (TNBC) is an aggressive subtype with frequent chemotherapy resistance. In recent years, advances in immunotherapy have yielded promising new ...therapeutic strategies for the treatment of TNBC; studies evaluating immune check point inhibitors (ICIs) in combination with chemotherapy have shown encouraging results in both early and advanced stages of disease.
Recent Findings
Atezolizumab plus nab-paclitaxel resulted in improved progression-free survival (PFS) and overall survival (OS) compared to nab-paclitaxel alone in patients with programmed death-ligand 1-positive (PD-L1+) metastatic TNBC (mTNBC). However, atezolizumab plus paclitaxel did not improve outcomes. Pembrolizumab plus chemotherapy improved PFS compared to chemotherapy alone in patients with PD-L1+ mTNBC, and follow-up for OS is ongoing. The addition of pembrolizumab and atezolizumab to neoadjuvant chemotherapy increased pathologic complete response rates, regardless of PD-L1 status, and event-free survival is pending. Several other combinations of ICIs with targeted agents are under investigation to enhance the host immune response and are discussed in this review.
Summary
TNBC has a poor prognosis with limited treatment options. Recent studies have demonstrated encouraging results by adding ICIs to chemotherapy, although optimal combinations remain to be defined. In this review, we highlight advances in TNBC treatment including ICIs and targeted agents and also discuss future directions.
Background
Gastric cancer is the second most common cause of cancer-related death in the world, and its prognosis remains poor with a median overall survival of 12 months for advanced disease. ...Advances in the understanding of molecular genetics have led to the development of directed molecular targeted therapy in gastric cancer, leading to improve patient outcomes and quality of life.
Discussion
In the treatment of human epidermal growth factor receptor 2 (HER2)-positive gastric cancer, the addition of trastuzumab significantly improves survival in the first-line setting of therapy. Ramucirumab, an antibody directed against vascular endothelial growth factor receptor 2, significantly improved progression-free and overall survival and has been approved for second-line treatment of gastric cancer. Anti-mesenchymal-epithelial transition (c-MET), mammalian target of rapamycin inhibitors, and polo-like kinase 1 inhibitors are under investigation as a novel therapeutic option for the treatment of gastric cancer. The novel therapies target the key immune checkpoint interaction between a T cell co-inhibitory receptor called programmed death 1 (PD-1) and one of its immunosuppressive ligands, PD-L1. This article reviews molecular targeted therapies in gastric cancer, in light of recent advances.
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