Mahzad Motallebi, M. Bhia, Huda Fatima Rajani
et al.
Naringenin is an important phytochemical which belongs to the flavanone group of polyphenols, and is found mainly in citrus fruits like grapefruits and others such as tomatoes and cherries plus medicinal plants derived food. Available evidence demonstrates that naringenin, as herbal medicine, has important pharmacological properties, including anti-inflammatory, antioxidant, neuroprotective, hepatoprotective, and anti-cancer activities. Collected data from in vitro and in vivo studies show the inactivation of carcinogens after treatment with pure naringenin, naringenin-loaded nanoparticles, and also naringenin in combination with anticancer agents in various malignancies, such as colon cancer, lung neoplasms, breast cancer, leukemia and lymphoma, pancreatic cancer, prostate tumors, oral squamous cell carcinoma, liver cancer, brain tumors, skin cancer, cervical and ovarian cancer, bladder neoplasms, gastric cancer, and osteosarcoma. Naringenin inhibits cancer progression through multiple mechanisms, like apoptosis induction, cell cycle arrest, angiogenesis hindrance, and modification of various signaling pathways including Wnt/β-catenin, PI3K/Akt, NF-ĸB, and TGF-β pathways. In this review, we demonstrate that naringenin is a natural product with potential for the treatment of different types of cancer, whether it is used alone, in combination with other agents, or in the form of the naringenin-loaded nanocarrier, after proper technological encapsulation.
High-grade neuroendocrine neoplasms (NENs), including poorly differentiated neuroendocrine carcinomas (NECs) and well-differentiated grade 3 neuroendocrine tumors (NETs), are aggressive malignancies with limited effective treatment options. Immune checkpoint inhibitors (ICIs) have demonstrated limited clinical activity in these neoplasms. Seneca Valley Virus (SVV-001) is a novel oncolytic RNA virus that has shown synergistic activity with ICIs in preclinical cancer models. Additionally, SVV-001 has been observed to reverse ICI resistance in vivo, further supporting its evaluation in combination with nivolumab and ipilimumab. This is an investigator-initiated, phase 1, dose-escalation and cohort-expansion study evaluating intratumoral SVV-001 in combination with nivolumab and ipilimumab in patients with histologically confirmed poorly differentiated NEC or well-differentiated grade 3 NET. The trial was activated in March 2025, with patient enrollment currently ongoing. A standard 3+3 dose-escalation design is being employed to determine the recommended phase 2 dose (RP2D). Following dose escalation, an expansion cohort will further evaluate safety and preliminary signals of activity. Tumor endothelial marker 8 (TEM8), a potential biomarker of SVV-001 sensitivity, will be assessed as part of correlative studies. Hereby we present the interim safety and the first efficacy results from dose escalation cohorts. As of January 12, 2026, the trial has completed enrolling patients in first two cohorts – dose level 1 (DL1) and dose level 2, and 2 patients in dose level 3 (DL3) cohort. All 9 enrolled patients received one dose of SVV-001 in combination with ipilimumab and nivolumab per protocol. No DLTs were observed in DL1 and DL2. Overall two patients experienced Grade 3 serious adverse events (anorexia, weight loss; hyperbilirubinemia, increase of alanine amino transferase; and seizures) unrelated to SVV-001, and one patient reported Grade 3 adverse event (elevated creatinine, xerostomia) possibly related to SVV-001 injection. Two patients achieved a partial response, 2 had stable disease and 3 came off study due to disease progression. Updated safety and efficacy data will be presented at symposium. The interim data demonstrate an acceptable safety profile and encouraging signs of efficacy in a disease representing a significant unmet medical need. NCT06889493 Aman Chauhan, Isildinha M. Reis, Chinmay Jani, Rakhi Modak, Daniel Bilbao. Cortes, Stephanie Baboun, Alexander Rivera, Hung Trinh, Paul Hallenbeck, Jaime Merchan, Gilberto Lopes, Peter Hosein. A phase 1 trial of the oncolytic virus SVV-001 with Nivolumab and Ipilimumab in patients with high grade Neuroendocrine Neoplasms [abstract]. In: Proceedings of the AACR Immuno-Oncology Conference (AACR IO): Discovery and Innovation in Cancer Immunology: Revolutionizing Treatment through Immunotherapy; 2026 Feb 18-21; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Immunol Res 2026;14(2 Suppl):Abstract nr LB-B002.
Introduction. Malignant neoplasms of the female reproductive system (ovarian, endometrial, and cervical cancers) account for a significant proportion of female oncology morbidity and mortality. Standard treatment methods, including surgery, chemotherapy, and radiotherapy, show limited efficacy in recurrent and drug-resistant tumors. The development of immunotherapy, particularly immune checkpoint inhibitors (ICI), has opened new therapeutic avenues; however, their clinical effectiveness in gynecologic oncology remains suboptimal. In connection with this, it has increased an interest in novel targets, notably TIGIT (T-cell immunoglobulin and ITIM domain), a co-inhibitory receptor expressed on T-cells and natural killer cells (NK-cells), which plays a key role in establishing an immunosuppressive tumor microenvironment.Aim: to systematize current data on the biological function of TIGIT and relevant ligands, its role in immunosuppression in malignant neoplasms of the female reproductive system as well as evaluate a therapeutic potential of its blockade during a personalized immunotherapy.Materials and Methods. This review was conducted according to the PRISMA methodology. There was performed a systematic literature search for publications from 2013 to 2024 in the databases PubMed/MEDLINE, Scopus, Web of Science, Embase, Google Scholar, and ClinicalTrials.gov. A total of 91 scientific sources and 7 registered clinical trials were included. Original studies, meta-analyses, reviews, guidelines, and clinical trial reports were analyzed.Results. TIGIT interacts with several ligands (CD155, CD112, Nectin-4, Fap2), leading to suppression of NK-cells and CD8+ T-cells activity, macrophage polarization toward M2 phenotype, activation of regulatory T-cells (Treg), and impaired antigen presentation. TIGIT is co-expressed with PD-1 (programmed cell death protein 1) and CD96, forming a suppressive signaling network. Its elevated expression is associated with disease progression in ovarian, endometrial, and cervical cancers, reduced cytotoxicity of tumor-infiltrating lymphocytes (TIL), and poor prognosis. TIGIT blockade, especially in combination with PD-1/PD-L1 (programmed cell death ligand 1), restores effector cell function and enhances antitumor immunity in preclinical and clinical studies.Conclusion. TIGIT is a promising immunotherapeutic target in malignant neoplasms of the female reproductive system. Its blockade may improve treatment outcomes in patients with recurrent and resistant cancert ypes. Combined approaches involving anti-TIGIT agents require further clinical validation but even today they offer new directions in targeted therapy and personalized management in gynecologic oncology.
A. O. Sherbacheva, D. M. Sibirtsev, N. N. Savin
et al.
Malignant neoplasms of the female reproductive system remain a significant global health concern, ranking among the leading causes of cancer incidence and mortality in women. Despite advances in the field of gynecologic oncology, early diagnosis and prognosis of such diseases continue to pose substantial challenges. In recent years, extracellular vesicles (EVs), including exosomes, microvesicles, and apoptotic bodies, have been increasingly attracted attention as key mediators of intercellular communication and carriers of biologically active molecules. EVs transport microRNAs, long non-coding RNAs, proteins, and other molecules that influence critical carcinogenic processes such as proliferation, angiogenesis, metastasis, and the development of chemoresistance. This review summarizes current data on the EVs role in the pathogenesis and progression of cervical, endometrial, and ovarian cancers. The diagnostic and prognostic potential of EV-associated biomolecular components is examined, with evidence from preclinical and clinical studies highlighting their promise as biomarkers. The review also discusses the prospects for clinical application of EVs, emphasizing the challenges of methodological standardization and the need for multicenter studies to validate their clinical utility. Additionally, the importance of integrating omics technologies and bioinformatics approaches is underscored as essential for improving patient stratification and advancing personalized therapy.
E. G. Romanov, K. A. Kokurina, A. A. Fedotova
et al.
Introduction. Nectin-4, a cell adhesion molecule of the immunoglobulin superfamily (IgSF), has been extensively studied in oncological diseases. Nectin-4 is involved in the formation of intercellular connections and promotes tumor cell proliferation, migration and chemoresistance. Upregulated nectin-4 expression has been detected in various malignant neoplasms, including tumors of the female reproductive system – ovarian, endometrial, cervical cancer, as well as rare tumors of the vulva, vagina and fallopian tubes.Aim: to summarize current data on nectin-4 role in the pathogenesis, diagnostics, prognosis and therapy of malignant tumors of the female reproductive system, and to assess the prospects for its clinical use in personalized medicine.Materials and Methods. A search for relevant publications was conducted in the PubMed/MEDLINE, Scopus, Web of Science, Embase and eLibrary.ru databases beginning from January 2000 to December 2024. The inclusion criteria covered original and review articles devoted to nectin-4 in gynecological oncology. Key words in Russian and English, Boolean operators, and filtering by full-text, subject matter, and quality of research were used. From the 3955 identified publications, 65 were included in the review.Results. Nectin-4 expression is associated with enhanced tumor cell proliferation, migration, and chemoresistance, whereas its involvement in generating tight intercellular junctions promotes the development of chemoresistant spheroids. In ovarian cancer, upregulated levels of nectin-4 messenger RNA (mRNA) and serum protein demonstrated high diagnostic and prognostic significance, especially in combination with traditional markers such as cancer antigen 125 (CA-125). In endometrial cancer, nectin-4 expression correlates with a deficiency of the mismatch repair system (MMR genes) MSH2/MSH6 genes and lowered progression-free survival. In cervical carcinoma, nectin-4 is related to drug resistance, thereby positioning it as a promising target for novel treatment strategies. The latter using nanoquinacrine and antibody-drug conjugates (ADCs) such as 9MW2821 and ADRX-0706, are currently undergoing clinical trials. Additionally, nectin-4 has shown relevance in non-malignant reproductive disorders such as endometriosis and preeclampsia.Conclusion. Nectin-4 demonstrates high clinical significance as a diagnostic and prognostic marker in gynecological malignancies. Its expression is associated with aggressive disease progression and drug resistance, especially in ovarian, endometrial and cervical cancers. Clinical trials with nectin-4-targeted drugs, including ADCs, are underway. Thus, nectin-4 represents a promising target for the development of personalized diagnostic and therapeutic strategies in gynecological oncology.
Ahmed Refaat, N. M. Hussien, R. M. Farghaly
et al.
Background: Metastatic colorectal cancer (CRC) is considered one of the lethal neoplasms globally. The embryonic M2 isoform of pyruvate kinase (PKM2), a crucial enzyme regulating glycolysis, promotes tumor cell proliferation and metastasis, and is correlated with unfavourable outcomes among several cancers, including CRC. Methods: This prospective cohort study included 80 de novo metastatic CRC patients at the Medical Oncology Department, South Egypt Cancer Institute (SECI), Assiut University, from June 2022 to June 2024. We analyzed the impact of PKM2 expression, evaluated by immunohistochemistry (IHC), in metastatic CRC patients, and response to first-line oxaliplatin-based chemotherapy regimens and survival outcomes in the form of progression-free survival (PFS) and overall survival (OS). Result: The median age of the studied cases was 47 ys, 42 (52.5%) were male, and 54 (67.5%) were left-sided. Our results revealed a statistically significant association between high PKM2 IHC expression and lower overall response rate (ORR), P = 0.001. After a median follow-up time of 13 months(ms), this translated into a statistically significant association between the high PKM2 IHC expression group and lower PFS and OS (6ms vs 10ms; P = 0.008), (12ms vs. 17ms; P = 0.008), respectively. Conclusion: Our results concluded that PKM2 IHC expression was one of the independent prognostic factors for OS. This supports the consideration of PKM2 as a promising molecular target for therapeutic strategies in CRC management.
Background: Depression commonly occurs in patients with breast cancer (BC), affecting their quality of life. Objectives: The relationships between depression and different sociodemographic characteristics in patients with BC are under-researched. We conducted a multicenter study to determine the magnitude of depression and its association with different sociodemographic characteristics. Design: In this multi-institutional study, clinical data were collected, prospectively between October 2019 and January 2023 from 207 patients who were on active treatment for BC diagnosis in tertiary oncology hospitals in Georgia. Methods: Patients’ sociodemographic characteristics were analyzed and their association with depression was assessed, using Patient Health Questionnaire-9 (PHQ-9) for the identification of depressive symptoms. Patients were stratified using basic information. Results: The median age of participants was 53 years (ranging from 31 to 77). Of the participants, 63.2% were married, 44.5% were employed, and only 16.4% reported having adequate financial status. Based on pro-rated PHQ-9 scores, 42% of patients reported some level of depressive symptoms, and 14.5% met the criteria for probable depressive disorder. Women with very inadequate financial status (10/21, 47.6%) reported significantly more depressive symptoms than those with adequate financial support (3/34, 8.8%) ( P = .001). Unemployed women (12/42, 28.6%) were nearly 3 times more likely to experience moderate or severe depressive symptoms compared with employed patients (8/92, 8.7%) ( P = .002). A significant difference in depressive symptoms was also observed based on education level, with individuals with higher education (12/119, 10%) reporting fewer depressive symptoms compared with those with middle education (18/88, 20.4%) ( P = .036). No statistically significant difference in depressive symptoms was found based on marital status or social support. Conclusions: Our study found a significant relationship between depression and factors such as financial status, education level, and employment. Lower household income and education level were identified as predictors of clinical depression among patients with BC. These findings can help oncologists in Georgia recognize the importance of providing psychological support to cancer patients. Early detection and prompt referral to mental health specialists can play a key role in effectively managing depression.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Muthmainnah Muthmainnah, Galuh Mega Kurnia, Avinka Nugrahani
Introduction
With Indonesia ranking top in the Association of Southeast Asian
Nations for the number of smokers aged 13–15 years, this study aims to analyze
the factors associated with smoking prevention behavior among students of senior
high school.
Methods
This cross-sectional pilot study, conducted in 2022 with 90 samples of
grade 10–11 students at SMA Negeri 1 Taman Sidoarjo East Java Indonesia,
examined variables such as perceived vulnerability (the belief about the risk of
experiencing a health issue), severity (the belief about the seriousness of the
health issue), benefits (the belief in the benefit of taking preventive actions),
barriers (the perceived obstacles to performing preventive behaviors), self-efficacy
(the confidence in one's ability to perform preventive behaviors successfully), and
cues to action (factors that trigger the decision to engage) in relation to health
behaviors. Data were analyzed using the chi-squared test.
Results
The chi-squared analysis showed significant associations between several
factors and smoking prevention behavior. For perceived susceptibility, 34.4%
with high susceptibility had good behavior, and 13.3% had not good behavior
(p=0.000). For perceived severity, 33.3% with high severity exhibited good
behavior, and 21% had not good behavior (p=0.002). Regarding perceived
benefits, 28.9% with high benefits showed good behavior, while 22.6% had not
good behavior (p=0.018). Self-efficacy indicated 36.7% with high self-efficacy
demonstrated good behavior versus 25.8% with not good behavior (p=0.001).
Cues to action revealed that 28.9% with high cues had good behavior, and 18.9%
did not have good behavior (p=0.003). No association was found for perceived
barriers (p=0.386).
Conclusions
The level of smoking prevention behavior is influenced by perceived
susceptibility, severity, benefits, self-efficacy, and cues to action. Therefore, more
intensive and targeted efforts are needed to promote awareness of the dangers of
smoking and to enhance adolescents' self-efficacy in preventing smoking.
Diseases of the respiratory system, Neoplasms. Tumors. Oncology. Including cancer and carcinogens
A. P. Meléndez-Fernández, Alejandra Sánchez-Servín, D. García-Ortega
et al.
Introduction Malignant Adnexal Tumors of the Skin (MATS) are rare neoplasms that differentiate into adnexal structures, including hair follicles, sebaceous glands, and eccrine or apocrine glands. With an incidence of approximately 5 per 1 million person-years, there are no standardized guidelines for their diagnosis and treatment, leading to inconsistent outcomes. This study aims to describe the clinicopathological characteristics and outcomes in an oncology reference center over 15 years. Materials and methods We retrospective analyzed 40 patients diagnosed with MATS at the National Cancer Institute of Mexico from 2005 to 2020. We collected clinical variables (age, gender, histological subtype, tumor site, and treatment) and pathological features (tumor size, lymphovascular invasion, perineural invasion, depth, necrosis, and margin status). We analyzed disease-free survival (DFS) and overall survival (OS). Results The median age at diagnosis was 64 years, with a slight male predominance (55 %). Eccrine/apocrine tumors were the most common (57.5 %), followed by sebaceous (25 %) and follicular tumors (17.5 %). The head and neck were the most frequent sites (52.5 %). Surgical excision was performed in 95 % of patients, with adjuvant radiotherapy in 17.5 %. Lymph node metastases were present in 5 %, and no distant metastases were observed initially. Recurrence occurred in 17.5 % of patients. Median DFS was 45.3 months, and median OS was 48.9 months. Conclusions Radical excision remains the primary treatment for MATS, though adjuvant radiotherapy may be helpful in high-risk cases. Prospective studies are needed to establish treatment guidelines and to improve outcomes.
Relevance. In Russia about 750 (749 – 2023) new cases of malignant tumors are registered among adolescents (15–17 years old), in the Northwestern Federal District (75 – 2023). In Russia die about 150 (151 – 2023), in the Northwestern Federal District – 10–15 (11 – 2023).Malignant tumors among adolescents are extremely rare. An even bigger problem is the formation of a complete database of patient contingents, since special treatment is possible only in large federal centers, and extracts from medical histories in most cases do not arrive at oncology institutions at the place of residence of patients. For the first time in Russia, long-term data on the survival rate of adolescents at the level of the federal district, taking into account the main localizations of malignant neoplasms at the population level, are presented. In 2023, isolated cases of malignant tumors were registered in certain territories of the Northwestern Federal District.The purpose of the study – to study the prevalence and effectiveness of anti-cancer measures with calculations of cumulative indicators of 1.5and 10-year survival of patients with malignant tumors of adolescents at the level of the Northwestern Federal District of the Russian Federation, taking into account gender.Materials and methods. The research material was open sources and a database of the Population cancer registry of the Northwestern Federal District of the Russian Federation numbering 1,6 million observations, including 1435 adolescents, standard methods for calculating indicators recommended by the International Association of Cancer Registries were used.The level of morbidity and mortality of adolescents from malignant tumors has practically not changed, with the exception of the last 2023, which is associated with the coronavirus epidemic, there has been a decrease in morbidity and mortality, especially among girls.Results. From 2000–2004 to 2020–2022 the survival rate of adolescents in the first year of follow-up has increased from 77.5 to 92.4 %, or by 19.2 %; among boys this rate has increased from 74.9 to 89.9 %, or by 20 %; among girls from 79.8 to 94.6 %, or by 18.5 %.The five-year cumulative survival rate increased for both genders from 59.9 to 72.0 %, or by 20.2 %; for boys from 51.9 to 70.5 %, or by 35.8 %; for girls from 67.2 to 74 %, or by 10.1 %.Conclusions. Standards of care for the adolescent population need to be established.
Asrarova Guzal, M. Tillyashaykhov, S. Djanklich
et al.
e13897 Background: Breast cancer is the leading cancer pathology among the female population in terms of incidence and mortality in Uzbekistan. Breast cancer outcomes are driven by a complex interplay of biological factors which impact tumor aggressiveness, in combination with other considerations including access to screening and treatment, treatment adherence, socioeconomic status, and comorbidities. These factors can influence Breast cancer presentations with earlier age at onset, advanced stage at presentation, more aggressive histologies, and may ultimately lead to increased mortality at earlier ages. Methods: The statistical informations taken from the book of “Condition of oncological assistance to the population of the Republic Uzbekistan in 2023”. Results: For highly qualified reading of mammograms based on the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology has established a reading center, to which mammograms for the 2nd and 3rd expert readings received from regional mammography rooms are sent. To encourage women to undergo mammography screening, commercials and audio recordings were launched on local television and radio. During the installation of the equipment, engineers and specialists conducted training courses on the operation of the equipment and work in the information system for medical personnel (x-ray technicians). To implement the pilot project, the information system “screening.mammo.uz” is used, which is a modern technology that allows for continuous monitoring at each stage of screening, a high level of evaluation of mammographic images, operational management and resolution of organizational issues. Moreover, women can sign up for a screening study on their own through the call center (short number - 1303), however, the majority of women are invited by doctors of family clinics. In 2023, 83,576 women took part in mammographic screening throughout the republic, of which 660 (0.8%) were diagnosed with a malignant neoplasm of the mammary gland, of which 80.8% were diagnosed at the initial stage I-II . Conclusions: Analysis of the results of screening mammography with determination of indications for biopsy of microcalcifications depending on the form of their accumulation made it possible to reduce the number of unjustified biopsies and surgical interventions for diagnostic purposes.
Grzegorz Przywara, Oliwia Biegańska, Emilia Biczak
et al.
Introduction and purpose: Microplastics (MPs) are defined as particles smaller than 5 mm. They are ubiquitous environmental pollutants. They enter the human body primarily through food, water and inhaled air. This paper focuses on a collection of scientific studies concerning the accumulation of MPs in human tissues and their impact on cancer development, also considering the role of MPs as carriers of known carcinogens. Brief description of the state of knowledge: In recent years, MPs have attracted considerable scientific attention. Their effects on human health, including oncology, have begun to be investigated. This area remains poorly studied, although new publications are emerging rapidly. Systematic reviews specifically addressing the oncological consequences of MPs are also lacking. Therefore, we see the need to summarize the current state of knowledge in this aspect. Summary (conclusions): Increased levels of polyethylene (PE), polypropylene (PP), polystyrene (PS) and polyvinyl chloride (PVC) have been detected in tumor tissues such as breast, colorectal, pancreatic, prostate, lung and cervical cancers. In vitro and in vivo studies show that MPs stimulate tumorigenesis by enhancing cell proliferation, epithelial-mesenchymal transition, migration and activation on oncogenic PI3K/AKT and MAPK/ERK pathways. Moreover, MPs can serve as vectors for carcinogens (for example, polycyclic aromatic hydrocarbons and bisphenols). We hope this review will help guide future research directions.
Non-AIDS-defining cancers represent one of the leading causes of death among people living with HIV in developed economies due to successful antiretroviral therapy. Malignant neoplasms (MNs) of the lung occupy leading positions in prevalence and mortality, affecting younger people compared to the general population. Despite the fact that the role of HIV in the direct mechanism underlying the lung cancer carcinogenesis has not been proven, the immunodeficiency-mediated effect, including that on the anti-tumor immunity, contributes to the earlier neoplastic process development and to the features of the disease course and anti-tumor treatment. HIV often becomes an exclusion criterion for multiple oncology clinical trials, and this group of patients is overlooked. The study aimed to assess the impact of the CD4/CD8 ratio as one of the key markers of the state of cell-mediated immunity on the lung cancer course prognosis during anti-tumor treatment. The data of 17 HIV patients with MNs of the lung and 31 non-HIV patients of the control group, who underwent treatment in 2018–2023, were analyzed. The analysis determined the threshold CD4/CD8 ratio value (≤ 0.57) and the fact of its decrease by more than 0.01, which reflected a significant overall survival worsening (p 0.05).
Toxic metals such as mercury, lead, and cadmium have multiple carcinogenic capacities, including the ability to damage DNA and incite inflammation. Environmental toxic metals have long been suspected to play a role in the pathogenesis of cancer, but convincing evidence from epidemiological studies that toxic metals are risk factors for common neoplasms has been difficult to gain. Another approach is to map the location of potentially toxic elements in normal human cells where common cancers originate, as well as in the cancers themselves. In this Perspective, studies are summarized that have used elemental biomapping to detect toxic metals such as mercury in human cells. Two elemental biomapping techniques, autometallography and laser ablation-inductively coupled-mass spectrometry imaging, have shown that multiple toxic metals exist in normal human cells that are particularly prone to developing cancer, and are also seen in neoplastic cells of breast and pancreatic tumors. Biomapping studies of animals exposed to toxic metals show that these animals take up toxic metals in the same cells as humans. The finding of toxic metals such as mercury in human cells prone to cancer could explain the increasing global incidence of many cancers since toxic metals continue to accumulate in the environment. The role of toxic metals in cancer remains to be confirmed experimentally, but to decrease cancer risk a precautionary approach would be to reduce emissions of mercury and other toxic metals into the environment from industrial and mining activities and from the burning of fossil fuels.
Sitong Ju, Alexander C. Rokohl, Yongwei Guo
et al.
Background The periocular skin is neoplasms-prone to various benign and malignant. Periocular malignancies are more aggressive and challenging to cure and repair than those in other skin areas. In recent decades, immunotherapy has significantly advanced oncology, allowing the autoimmune system to target and destroy malignant cells. Skin malignancies, especially periocular tumors, are particularly sensitive to immunotherapy. This technique has dramatically impacted the successful treatment of challenging tumors. Main text Extraocular cancers, including eyelid (basal cell carcinoma, squamous cell carcinoma, melanoma, merkel cell carcinoma), conjunctival tumors (conjunctival melanoma, ocular surface squamous neoplasia) and other rare tumors, are unique and challenging clinical situations. Several genetic alterations associated with the pathogenesis of these diseases have been identified, and molecular mechanism are essential for the development of the immunotherapy agents, such as Hedgehog pathway inhibitors (vismodegib and sonidegib) for basal cell carcinoma, BRAF/MEK inhibitors (vemurafenib, dabrafenib, and encorafenib) for melanoma, and immune checkpoint inhibitors (Avelumab, pembrolizumab) for Merkel cell carcinoma. Conclusions The optimal treatment for periocular skin cancer depends on the type and size of the tumor and whether it involves orbital and adnexal structures. Adjuvant and neoadjuvant therapy with chemotherapy-targeted therapies and immune checkpoint inhibitors should be considered based on tumor type, tumor molecular profile, expected response rate, and candidacy for systemic treatment.
Berna Aygun, Asthik Biswas, Mohammed Blaaza
et al.
Background Central nervous system cancers are a leading cause of childhood cancer-related mortality. Accurate staging and assessment of leptomeningeal spread, particularly in aggressive neoplasms such as embryonal tumors, is crucial for treatment planning and prognosis. Conventional diagnostic methods, relying on magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) cytology, have limitations, including high false-negative rates and sensitivity issues. In this retrospective study, we aim to compare the diagnostic sensitivity of contrast-enhanced T2-weighted fluid-attenuated inversion recovery (CE-T2W-FLAIR) and 2D and 3D contrast-enhanced T1-weighted imaging (CE-T1WI) for detecting leptomeningeal disease. Methods We retrospectively reviewed 1372 MRI brain studies of 297 patients aged 1-19 years. We included only those MRI examinations adhering to our neuro-oncology protocol while excluding incomplete or suboptimal studies. A control group without leptomeningeal disease was matched for disease and age. Three groups of 2 neuroradiologists each, blinded to case status, reviewed the images using various sequences. The results were compared using the McNemar test and chi-squared test for P-values. Results The sensitivity of CE-T2W-FLAIR sequence was significantly higher compared with that of CE-T1WI (P = .025). There was no statistically significant difference between the sensitivity of 2D CE-T1WI and 3D CE-T1WI (P = .3173). The specificity of the 3D CE-T1WI was significantly lower compared with those of CE-T2W-FLAIR and 2D CE-T1WI (P = .014). The positive predictive values for CE-T2W-FLAIR, 2D CE-T1WI, and 3D CE-T1WI were 100%, 100%, and 68.4%, respectively, whereas the negative predictive values were 100%, 85.7%, and 85.71%, respectively. Conclusions The inclusion of CE-T2W-FLAIR in the MRI protocol improves sensitivity and specificity in diagnosing leptomeningeal spread in pediatric brain tumors.