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Systematic review and network meta-analysis of the efficacy of existing treatments for patients with recurrent glioblastoma.

BackgroundDespite advances in the treatment of cancers over the last years, treatment options for patients with recurrent glioblastoma (rGBM) remain limited with poor outcomes. Many regimens have been investigated in clinical trials; however, there is a lack of knowledge on comparative effectiveness. The aim of this systematic review is to provide an overview of existing treatment strategies and to estimate the relative efficacy of these regimens in terms of progression-free survival (PFS) and overall survival (OS).MethodsWe conducted a systematic review to identify randomized controlled trial

CAR T-cell therapy and critical care : A survival guide for medical emergency teams.

Chimeric antigen receptor (CAR) T‑cells are genetically engineered to give T‑cells the ability to attack specific cancer cells, and to improve outcome of patients with refractory/relapsed aggressive B‑cell malignancies. To date, several CAR T‑cell products are approved and additional products with similar indication or extended to other malignancies are currently being evaluated. Side effects of CAR T‑cell treatment are potentially severe or even life-threatening immune-related toxicities, specifically cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (

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… In general, an early strong collaboration between MET, hemato-oncologists, neurologists and other organ specialists is crucial. Therefore, at our centr we adapted current CAR T-related toxicity guidelines and developed a concise algorithm to be used by our MET (Fig. 1 ). … An established multidisciplinary collaboration between dedicated hemato-oncologists, organ specialists and critical care physicians is crucial in the management of these patients. …

Renal replacement therapy in cancer patients with acute kidney injury (Review).

Cancer patients are at high risk for developing acute kidney injury (AKI), which is associated with increased morbidity and mortality in these patients. Despite the progress made in understanding the pathogenic mechanisms and etiology of AKI in these patients, the main prevention consists of avoiding medication and nephrotoxic agents such as non-steroidal anti-inflammatory drugs, contrast agents used in medical imaging and modulation of chemotherapy regimens; when prophylactic measures are overcome and renal impairment becomes unresponsive to treatment, renal replacement therapy (RRT) is requi

The impact of Pegylated liposomal doxorubicin in recurrent ovarian cancer: an updated meta-analysis of randomized clinical trials.

BackgroundPrevious meta-analysis studies suggested that pegylated liposomal doxorubicin (PLD) may improve the survival rate of patients with recurrent ovarian cancer. The aim of the present meta-analysis, then, was to further update the role of PLD in the treatment of recurrent ovarian cancer.MethodsWe performed a literature search using the electronic databases Medicine, EMBASE, Web of Science, and the Cochrane Library to 27 July 2020. We only restricted the randomized clinical trials. Study-specific hazard ratios and 95% confidence interval (HR/95% CI) and risk ratios and 95% confidence inte

Oral Surgical Management of Bone and Soft Tissues in MRONJ Treatment: A Decisional Tree.

BACKGROUND: The aim of the present work was to analyze a 10-year retrospective series of surgically treated medication-related osteonecrosis of the jaws (MRONJ) cases, reporting the clinical outcome and success rate for each adopted procedure in order to draw a treatment algorithm that is able to standardize clinical decision making and maximize the success of oral surgical treatment of MRONJ. METHODS: Different surgical approaches were categorized taking into consideration two variables a) hard tissue management (defined as debridement, saucerization or marginal resective surgery of maxillar

Combined Administration of Bisphosphonates, Chemotherapeutic Agents, and/or Targeted Drugs Increases the Risk for Stage 3 Medication-Related Osteonecrosis of the Jaw: A 4-Year Retrospective Study.

OBJECTIVES: Patients with stage 3 medication-related osteonecrosis of the jaw (MRONJ) suffer from severe complications. Chemotherapeutic agents and targeted drugs are considered to be associated with the development of MRONJ. However, little is known regarding the association of those agents with stage 3 MRONJ. The purpose of this study is to analyze the comprehensive medication history of patients with advanced-stage MRONJ (stage 2 and stage 3) and evaluate the possible risk factors for stage 3 MRONJ. Patients and Methods. Sixty patients with advanced-stage MRONJ were involved in this retrosp

Design and rationale of FOCUS (PX-171-011): a randomized, open-label, phase 3 study of carfilzomib versus best supportive care regimen in patients with relapsed and refractory multiple myeloma (R/R MM).

BACKGROUND: Carfilzomib is a next-generation proteasome inhibitor with single-agent activity in patients with relapsed and refractory multiple myeloma (R/R MM). In PX-171-003-A1, a single-arm phase 2 study of carfilzomib monotherapy in heavily pretreated patients, the overall response rate was 23.7%, 37% of patients achieved ≥ minimal response and median overall survival (OS) was 15.6 months. Based on this study, carfilzomib was recently approved by the US Food and Drug Administration for the treatment of R/R MM. Herein we describe the trial design and rationale for a phase 3 randomized study,

Balloon kyphoplasty in malignant spinal fractures: a systematic review and meta-analysis.

BACKGROUND: Spinal fractures are a common source of morbidity in cancer patients. Balloon Kyphoplasty (BKP) is a minimally invasive procedure designed to stabilize fractures and correct vertebral deformities. We performed a meta-analysis to determine the efficacy and safety of BKP for spinal fractures in cancer patients. METHODS: We searched several electronic databases up to September 2008 and the reference lists of relevant publications for studies reporting on BKP in patients with spinal fractures secondary to osteolytic metastasis and multiple myeloma. Outcomes sought included pain relief

Status Epilepticus and Blindness in a Patient with Carfilzomib-Associated Posterior Reversible Encephalopathy Syndrome.

Posterior reversible encephalopathy syndrome (PRES) is a neurological condition characterized by headaches, visual disturbances, and seizures. A magnetic resonance imaging (MRI) scan of an affected brain typically shows symmetrical white matter edema in the posterior cerebral hemispheres. The onset of PRES can constitute a medical emergency, especially when accompanied by status epilepticus. If promptly recognized and treated, the clinical syndrome and associated radiological findings are usually resolved in a matter of weeks or months. Carfilzomib is a proteasome inhibitor that is newly appro

Second primary cancers following hematologic malignancies: Epidemiology, pathobiology and clinical management.

Second primary cancers (SPCs) pose an increasingly significant clinical challenge for survivors of hematologic malignancies, attributed to improved therapeutic outcomes and prolonged survival. The development of SPCs is influenced by a complex interplay of treatment-related factors, genetic susceptibility, immune dysregulation, and microenvironmental remodeling. This narrative review summarizes the epidemiological patterns of SPCs in survivors of hematologic malignancies and discusses the underlying biological mechanisms, including therapy-induced genomic instability, clonal hematopoiesis, inf

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… An effective MDT typically comprises hematologists, medical oncologists, radiation oncologists, surgical oncologists (as dictated by the subtype of SPCs), pathologists, radiologists, and supportive care specialists. 111 , 112 The MDT integrates critical information, including the status of the primary …

Patient-reported outcomes in cancer survivorship: insights from two decades of population-based PROFILES registry research.

PurposeWhen the field of cancer survivorship research was in its infancy, the PROFILES registry was set up in 2004 to monitor patient-reported outcomes (PROs) in survivors and a normative population. This scoping review aims to summarize lessons learned from developing a population-based PRO registry, focusing on study methodologies, data collection shifts, data utilization, multidisciplinary collaboration, societal impact, and data sharing.MethodsA systematic computerized literature search through PubMed was performed to collect all publications using data from the PROFILES registry between J

Digital Health Portals for Individuals Living With or Beyond Cancer: Patient-Driven Scoping Review.

BackgroundDigital health portals are online platforms allowing individuals to access their personal information and communicate with health care providers. While digital health portals have been associated with improved health outcomes and more streamlined health care processes, their impact on individuals living with or beyond cancer remains underexplored.ObjectiveThis scoping review aimed to (1) identify the portal functionalities reported in studies involving individuals living with or beyond cancer, as well as the outcomes assessed, and (2) explore the diversity of participant characterist

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… Study; country | Study type, method, and data source | Participants (number and characteristics) Alpert et al [ 35 ], 2019; United States | Qualitative Interviews | 35 patients with cancer, 13 oncologists, and 12 informaticists Baun et al [ 36 ], 2020; Denmark | Mixed methods Questionnaires and interviews … Williamson et al [ 78 ], 2017; United States | A stand-alone ePHR that allows survivors to upload and store important medical records, such as Survivor Healthcare Plans, letters from oncologists, and hospital discharge notes | No e-messaging. …

Drug-Induced Periocular and Ocular Surface Disorders: An EAACI Position Paper.

Various systemic and topical medications can induce ocular and periocular cutaneous adverse effects (AEs), ranging from mild to severe. These AEs may lead to ocular surface (OS) damage and, in some cases, life-threatening complications. Drug-induced ocular adverse reactions are generally classified into two primary categories: toxic reactions and/or allergic hypersensitivity reactions, which can be IgE or non-IgE-mediated. Systemic antibiotics, antivirals, and anticonvulsants can trigger adverse reactions that may involve the OS. Drugs like antihistamines, beta-blockers, antipsychotics, antide

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… Early recognition and close collaboration between oncologists and ophthalmologists are crucial to managing these complications while maintaining effective cancer treatment. … J., “Ocular Adverse Events Associated With Antibody‐Drug Conjugates for Cancer: Evidence and Management Strategies,” Oncologist 29, no. 11 (2024): e1435–e1451. 125. …

Time to deterioration of patient-reported outcome endpoints in cancer clinical trials: targeted literature review and best practice recommendations.

BackgroundTime to deterioration (TTD) endpoints are often utilized in the analysis of patient-reported outcome (PRO) data in oncology clinical trials but different endpoint definitions and analysis frameworks exist that can impact result interpretation. This review examined the analysis, reporting and heterogeneity of TTD endpoints in the literature, the impact of analysis methods on results, and provides recommendations for future trials.MethodsA targeted literature review of articles published between 2017 and 2022 was performed to collate TTD endpoints reported in oncology randomized contro

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… Although the analysis of PRO TTD endpoints has challenges to address, the results can be used to help guide regulators when clinical benefit magnitude is small, and they could help facilitate decision making between patients and oncologists when more than one treatment option is available. … Oncologist 25(2):e243–e251 32043763 10.1634/theoncologist.2019-0551 PMC7011625 50. …

Rare central nervous system lymphomas.

Central nervous system (CNS) lymphomas are rare malignancies characterised by lymphoid infiltration into the brain, spinal cord, cranial nerves, meninges and/or eyes in the presence or absence of previous or concurrent systemic disease. Most CNS lymphomas are of the diffuse large B-cell lymphoma (DLBCL) subtype for which treatment strategies, particularly the use of high-dose methotrexate-based protocols and consolidation with autologous stem cell transplantation, are well established. Other histopathological subtypes of CNS lymphoma are comparatively less common with published data on these r

Validity of evidence-based recommendations by a large language model for interdisciplinary board decisions in neurooncology: An explorative study and critical evaluation.

ObjectivesThis study aims to evaluate the stylistic and structural equivalence of Artificial Intelligence (AI)-generated summaries, particularly those by Large Language Models (LLMs) like ChatGPT, compared to traditional human-generated case summaries in neuro-oncological board decisions. The primary goal is to explore the stylistic alignment between AI-generated and human-authored summaries from board meeting audio recordings.MethodsThe study compares 30 traditional human-generated case summaries with 30 AI-generated summaries based on board meeting audio recordings. Two expert raters, blinde

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… Oncologist. 2013;18(6):744–751. Patient #5 Eine Patientin präsentiert multifokale, intraxiale Raumforderungen, insbesondere links temporomesial und in weiteren Hirnarealen. … The role of artificial intelligence on tumor boards: perspectives from surgeons, medical oncologists and radiation oncologists. Current Oncology 2024; 31: 4984–5007. 8. Crawford M, Joseph S, Fernando S. The parallel between artificial intelligence and neurosurgery. …

Chemotherapy-Induced Peripheral Neuropathy (CIPN): A Narrative Review and Proposed Theoretical Model.

BackgroundChemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating symptom experienced by cancer survivors. Despite the burden of CIPN-related symptoms, interventions remain limited.ObjectivesThis narrative review seeks to propose a framework for CIPN predisposing, precipitating, and perpetuating factors (3Ps), which will provide a foundation for future research and clinical interventions aimed at mitigating CIPN-related symptoms and morbidity.MethodsA comprehensive literature search was performed using PubMed, guided by keywords related to "chemotherapy-induced periphera

The Role of Cannabinoids in Advancing Cancer Treatment: Insights from Evidence-Based Medicine.

Purpose of reviewThis document critically examines the role of cannabinoids in cancer care during an era marked by rapid advancements in oncology and changing perceptions on cannabis. It traces the historical context of cannabis in medicinal use, navigating its journey from widespread acceptance, subsequent criminalization, to its resurgence in modern therapeutic applications, particularly within the framework of Evidence-Based Medicine (EBM).Recent findingsAnchored in EBM principles, this study synthesizes current research from clinical trials, systematic reviews, and meta-analyses to evaluat

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… A 2018 study involving 400 oncologists revealed that 70% perceived significant gaps in the data concerning cannabinoid use in cancer patients, even though 80% had engaged in discussions with their patients about this topic. … Oncologist. 2019;24(4):549–54. 10.1634/theoncologist.2018-0383. 84. Waissengrin B, Leshem Y, Taya M, Meiri D, Merimsky O, Shamai S, et al. The use of medical cannabis concomitantly with immune checkpoint inhibitors in non-small cell lung cancer: A sigh of relief? …

Cancer treatment-induced bone loss.

Cancer treatment-induced bone loss (CTBL) is associated with anti-tumor treatments, including endocrine therapies, chemotherapeutic treatments, radiotherapy, glucocorticoids, and tyrosine kinase inhibitors. Osteoporosis, characterized by the loss of bone mass, can increase the risk of fractures, leading to mortality and long-term disability, even after cancer remission. Cancer and osteoporosis have marked clinical and pathogenetic similarities. Both have a multifactorial etiology, affect the geriatric population, and markedly influence quality of life. Lifestyle management, including calcium a

Evaluating a web-based computer-tailored physical activity intervention for those living with and beyond lung cancer (ExerciseGuide UK): protocol for a single group feasibility and acceptability study.

BackgroundLung cancer is the leading cause of cancer-related death globally. Physical activity and exercise provide unequivocal benefits to those living with and beyond lung cancer. However, few of those living with and beyond cancer meet the national physical activity guidelines. Various barriers exist for this population's engagement in physical activity and exercise, such as the lack of knowledge and lack of tailored information, little access to exercise specialists, fatigue, and mobility challenges. Digitally delivered programmes have the potential to address several of these barriers, wi

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… The primary investigator will disseminate the recruitment information with assistance from participating site oncologists to those who meet the inclusion criteria during routine appointments. … Oncologist 2019 25 3 e555 e569 10.1634/theoncologist.2019-0463 32162811 PMC7066706 15. …