Major clinical research advances in gynecologic cancer 2009

In this review, we summarized nine major clinical advances in gynecology which occurred in 2009. For cervical cancer, the role of human papillomavirus (HPV) test as a screening test, the efficacy of HPV vaccine for middle-aged women, randomized controlled trial (RCT) regarding concurrent chemoradiation using gemcitabine plus cisplatin, and the efficacy of pazopanib for metastatic or recurrent disease were chosen. For endometrial cancer, the necessity of systematic pelvic lymphadenectomy in early endometrial cancer was reviewed. For ovarian cancer, the timing of treatment initiation for recurrent ovarian cancer, dose-dense chemotherapy as postoperative adjuvant treatment, the best chemotherapy regimen for platinum-sensitive recurrent ovarian cancer, and the efficacy of target agents were selected. In addition, the results of RCT testing the benefit of ginger in preventing post-chemotherapy nausea were examined.     

Major clinical research advances in gynecologic cancer 2008

In this review, we summarized 14 major clinical advances in gynecology which occurred in 2008. For cervical cancer, clinical impact of HPV vaccine, prognostic value of imaging during radiotherapy, and oncologic/obstetric outcomes of fertility-sparing surgery were chosen. For uterine cancer, optimal method of adjuvant radiotherapy in intermediate-risk patients, extent of lymph node dissection, outcome of robot-assisted staging surgery, new standard chemotherapy regimen for leiomyosarcoma were selected. For ovarian cancer, recent changes in adjuvant therapy, feasibility of neoadjuvant chemotherapy, prediction of optimal secondary cytoreduction, studies on new biomarkers, advances in screening and treatment of women with BRCA mutations were included. For other cancers, the safety of sentinel lymph node dissection in vulvar cancer and chemotherapy regimens for low-risk gestational trophoblastic tumors were reviewed.     

Major clinical research advances in gynecologic cancer in 2020

In 2020 series, we summarized the major clinical research advances in gynecologic oncology with providing representative figures of the most influential study for 1 of each 3 gynecologic cancers: cervix, ovary, and uterine corpus. Review for cervical cancer covered targeted agents and immune checkpoint inhibitors, adjuvant radiation therapy or concurrent/sequential chemoradiation therapy after radical hysterectomy in early cervical cancer, radical surgery in early cervical cancer; and prevention and screening. Ovarian cancer research included studies of various combinations of poly (ADP-ribose) polymerase inhibitors with chemotherapy, immune checkpoint inhibitors, and/or vascular endothelial growth factor inhibitors according to the clinical setting. For uterine corpus cancer, molecular classification upon which the decision of adjuvant treatments might be based, World Health Organization recommendation of 2-tier grading system (low grade vs. high grade), sentinel lymph node assessment and ovarian preservation in clinically early-stage endometrial cancer were reviewed. Molecular targeted agents including immune checkpoint inhibitors which showed promising anti-tumor activities in advanced/recurrent endometrial cancer were also included in this review.     

Major clinical research advances in gynecologic cancer in 2013

In 2013, 10 topics were selected for major clinical research advances in gynecologic oncology; these included three topics regarding cervical cancer, three regarding ovarian cancer, two regarding endometrial cancer, and one each regarding breast cancer and radiation oncology. For cervical cancer, bevacizumab was first demonstrated to exhibit outstanding clinical efficacy in a recurrent, metastatic setting. Regarding cervical cancer screening, visual inspections with acetic acid in low-resource settings, p16/Ki-67 double staining, and the follow-up results of four randomized controlled trials of human papillomavirus-based screening methods were reviewed. Laparoscopic para-aortic lymphadenectomy before chemoradiation for locally advanced cervical cancer was the final topic for cervical cancer. Regarding front-line ovarian cancer therapies, dose-dense paclitaxel and carboplatin, intraperitoneal chemotherapy, and other targeted agents administered according to combination or maintenance schedules were discussed. Regarding recurrent ovarian cancer treatment, cediranib, olaparib, and farletuzumab were discussed for platinum-sensitive disease. The final overall survival data associated with a combination of bevacizumab and chemotherapy for platinum-resistant disease were briefly summarized. For endometrial cancer, the potential clinical efficacy of metformin, an antidiabetic drug, in obese patients was followed by integrated genomic analyses from the Cancer Genome Atlas Research Network. For breast cancer, three remarkable advances were reviewed: the long-term effects of continued adjuvant tamoxifen for 10 years, the effects of 2-year versus 1-year adjuvant trastuzumab for human epidermal growth factor receptor 2-positive disease, and the approval of pertuzumab in a neoadjuvant setting with a pathologic complete response as the surrogate endpoint. Finally, the recent large studies of intensity-modulated radiotherapy for gynecologic cancer were briefly summarized.     

Major clinical research advances in gynecologic cancer in 2021

In the 2021 series, we not only summarized the major clinical research advances in gynecologic oncology but also added discussions to every part, based on communications at the conference. A review of cervical cancer included adjuvant treatments such as radiation and chemoradiation (concurrent or sequential) after radical hysterectomy in early cervical cancer, and immune checkpoint inhibitors in advanced, recurrent, and metastatic disease. Ovarian cancer research included studies of secondary cytoreductive surgery in platinum-sensitive recurrent ovarian cancer, and various trials of immune checkpoint inhibitors with or without vascular endothelial growth factor inhibitors and conventional chemotherapy. The rechallenge of poly (ADP-ribose) polymerase inhibitor maintenance in heavily pretreated ovarian cancer were also addressed. For uterine corpus cancer, dostarlimab (anti-programmed cell death protein 1 antibody) alone, or a tyrosine kinase inhibitor in combination with pembrolizumab for advanced, metastatic, or recurrent endometrial cancer were reviewed. The survival differences between the intensive and minimalist follow-up protocols were also described. In this review, we compared salpingectomy with delayed oophorectomy and salpingo-oophorectomy in terms of quality of life in BRCA 1 and 2 pathogenic variant carriers.     

Major clinical research advances in gynecologic cancer in 2011

The annual review of 2011 comprised 11 themes of major research achievements in gynecologic oncology including breast cancer. A potential paradigm shift in the management of ovarian cancer was reviewed through comprehensive genomic analyses and a tumor-specific new intraoperative fluorescence imaging technique using folate receptor-α targeted agent, which is expected to improve intraoperative staging and more radical cytoreduction. In addition, updates of bevacizumab and poly (ADP-ribose) polymerase inhibitors, risk-reducing salpingo-oophorectomy, and risk evaluation of pelvic mass were discussed. Regarding cervical cancer, this review covered new findings on human papillomavirus vaccines and human papillomavirus tests as well as the current status of clinical trials on locally advanced cervical cancer. The promising role of sentinel lymph node biopsy in the management of early stage endometrial cancer was followed by two notable clinical researches on: exemestane, an aromatase inhibitor, for the prevention of breast cancer and eribulin, a non-taxane microtubule dynamics inhibitor for the treatment of metastatic breast cancer. Lastly, in premenopausal women with breast cancer, the effect of gonadotropin-releasing hormone analogue on the occurrence of chemotherapy-induced early menopause was discussed.     

Major clinical research advances in gynecologic cancer in 2014

In 2014, 9 topics were selected as major advances in clinical research for gynecologic oncology: 2 each in cervical and corpus cancer, 4 in ovarian cancer, and 1 in breast cancer. For cervical cancer, several therapeutic agents showed viable antitumor clinical response in recurrent and metastatic disease: bevacizumab, cediranib, and immunotherapies including human papillomavirus (HPV)-tumor infiltrating lymphocytes and Z-100. The HPV test received FDA approval as the primary screening tool of cervical cancer in women aged 25 and older, based on the results of the ATHENA trial, which suggested that the HPV test was a more sensitive and efficient strategy for cervical cancer screening than methods based solely on cytology. For corpus cancers, results of a phase III Gynecologic Oncology Group (GOG) 249 study of early-stage endometrial cancer with high-intermediate risk factors are followed by the controversial topic of uterine power morcellation in minimally invasive gynecologic surgery. Promising results of phase II studies regarding the effectiveness of olaparib in various ovarian cancer settings are summarized. After a brief review of results from a phase III study on pazopanib maintenance therapy in advanced ovarian cancer, 2 outstanding 2014 ASCO presentations cover the topic of using molecular subtypes in predicting response to bevacizumab. A review of the use of opportunistic bilateral salpingectomy as an ovarian cancer preventive strategy in the general population is presented. Two remarkable studies that discussed the effectiveness of adjuvant ovarian suppression in premenopausal early breast cancer have been selected as the last topics covered in this review.     

Major clinical research advances in gynecologic cancer in 2010

This review summarizes 11 major clinical research advances in gynecologic oncology in 2010. For ovarian cancer, bevacizumab as a leading molecular targeted agent, pegylated liposomal doxorubicin in recurrent disease, the role of neoadjuvant chemotherapy in an advanced setting, an effective screening method, and ARID1A mutations as a clue to the origin of clear cell carcinoma are mentioned. For cervical cancer, confirmation of the efficacy and the introduction of a self collection method of the human papillomavirus (HPV) test, and the association between the HPV vaccine and miscarriage are examined. For endometrial cancer, the superiority of laparoscopy in staging operation, the role of vaginal brachytherapy in an adjuvant setting, and the effect of para-aortic lymph node dissection are reviewed. In addition, the trend of geriatric oncology and chemotherapy in carcinosarcomas is also assessed.     

Major clinical research advances in gynecologic cancer in 2015

In 2015, fourteen topics were selected as major research advances in gynecologic oncology. For ovarian cancer, high-level evidence for annual screening with multimodal strategy which could reduce ovarian cancer deaths was reported. The best preventive strategies with current status of evidence level were also summarized. Final report of chemotherapy or upfront surgery (CHORUS) trial of neoadjuvant chemotherapy in advanced stage ovarian cancer and individualized therapy based on gene characteristics followed. There was no sign of abating in great interest in immunotherapy as well as targeted therapies in various gynecologic cancers. The fifth Ovarian Cancer Consensus Conference which was held in November 7–9 in Tokyo was briefly introduced. For cervical cancer, update of human papillomavirus vaccines regarding two-dose regimen, 9-valent vaccine, and therapeutic vaccine was reviewed. For corpus cancer, the safety concern of power morcellation in presumed fibroids was explored again with regard to age and prevalence of corpus malignancy. Hormone therapy and endometrial cancer risk, trabectedin as an option for leiomyosarcoma, endometrial cancer and Lynch syndrome, and the radiation therapy guidelines were also discussed. In addition, adjuvant therapy in vulvar cancer and the updated of targeted therapy in gynecologic cancer were addressed. For breast cancer, palbociclib in hormone-receptor-positive advanced disease, oncotype DX Recurrence Score in low-risk patients, regional nodal irradiation to internal mammary, supraclavicular, and axillary lymph nodes, and cavity shave margins were summarized as the last topics covered in this review.     

Major clinical research advances in gynecologic cancer in 2022: highlight on late-line PARP inhibitor withdrawal in ovarian cancer,the impact of ARIEL-4, and SOLO-3

In the 2022 series, we summarized the major clinical research advances in gynecologic oncology based on communications at the conference of Asian Society of Gynecologic Oncology Review Course. The review consisted of 1) Ovarian cancer: long-term follow-up data, new poly (ADP-ribose) polymerase (PARP) inhibitors, overall survival (OS) issues with PARP inhibitor monotherapy, hyperthermic intraperitoneal chemotherapy, immunotherapy, and antibody-drug conjugate; 2) Cervical cancer: surgery in early stage disease, therapy for locally advanced stage and advanced, metastatic, or recurrent setting; and 3) Corpus cancer: follow-up regimen, immune checkpoint inhibitor, WEE1 inhibitor, selective inhibitor of nuclear export. A special note was made on the withdrawal of PARP inhibitor from the market for heavily pretreated ovarian cancer patients based on the final OS results of ARIEL-4 and SOLO-3 due to concerns of increased risk of death.     

索拉非尼治疗非小细胞肺癌的临床研究进展

目前晚期非小细胞肺癌患者的治疗效果还不理想,一线化疗的有效率为20%～40%,中位生存期为8～10个月,现有的化疗方案已达到"化疗疗效的平台".一系列靶向治疗药物的出现,将非小细胞肺癌的治疗引向分子水平.然而,目前用于治疗非小细胞肺癌的酪氨酸激酶抑制剂的疗效维持时间尚无法令人满意,中位疾病进展时间为6～8个月.对于复发和进展的非小细胞肺癌,在三线治疗之后,多采用以最佳支持疗法为主的治疗方案.索拉非尼是一种多靶点的酪氨酸激酶抑制剂,能够同时作用于肿瘤细胞的多个分子靶点,产生多种药理活性,且患者的依从性也更好,目前已被应用于肾癌、肝癌、胃肠间质瘤、乳腺癌和慢性粒细胞白血病的治疗,开创了靶向治疗的新时代.本文综述了多靶点酪氨酸激酶抑制剂索拉非尼治疗非小细胞肺癌的临床研究进展.     

维生素D及其受体在妇科癌症中的研究进展

在过去的二十几年中,国内外大量的研究是关于维生素D及维生素D受体(vitamin D receptor,VDR)在癌症发生、发展中所起的作用.维生素D的活性代谢产物1,25(OH)2 D3除了维持体内矿物质的稳态和骨骼的功能外,还具有抑制细胞增殖、诱导细胞分化、凋亡及免疫调节的作用.近些年,越来越多的研究证据表明,维生...     

Nanoparticle delivery systems for cancer therapy: advances in clinical and preclinical research

Conventional anticancer drugs display significant shortcomings which limit their use in cancer therapy. For this reason, important progress has been achieved in the field of nanotechnology to solve these problems and offer a promising and effective alternative for cancer treatment. Nanoparticle drug delivery systems exploit the abnormal characteristics of tumour tissues to selectively target their payloads to cancer cells, either by passive, active or triggered targeting. Additionally, nanoparticles can be easily tuned to improve their properties, thereby increasing the therapeutic index of the drug. Liposomes, polymeric nanoparticles, polymeric micelles and polymer- or lipid-drug conjugate nanoparticles incorporating cytotoxic therapeutics have been developed; some of them are already on the market and others are under clinical and preclinical research. However, there is still much research to be done to be able to defeat the limitations of traditional anticancer therapy. This review focuses on the potential of nanoparticle delivery systems in cancer treatment and the current advances achieved.     

Molecular advances in gynecologic oncology.

Cancer is a genetic disease, and inherited or acquired genetic defects contribute to the initiation and progression of cancer. Improved molecular techniques have lead to the identification of many of these genetic mutations in gynecologic malignancies. The molecular characterization of cancer has provided a better understanding of tumor formation and the clinical behavior of different tumor types, with important implications for developing screening tests and prognostic markers. Applications of these findings have led to novel targeted gene therapies that correct the critical genetic defects seen in gynecologic cancers. Future research will focus on the clinical translation of these genetic alterations as targets of cancer prevention, screening, and treatment.     

Recent advances in personalized colorectal cancer research

Colorectal cancer is one of the most prevalent cancers and a leading cause of cancer-related death. It is also curable if detected early. The prognosis for metastatic colorectal cancer remains poor and resistance to chemotherapy is still a major obstacle in effective treatment. While many patients do not clinically benefit from chemotherapy, others experience adverse reactions resulting in dose modifications or treatment withdrawal, thereby reducing treatment efficacy. Research efforts attempt to identify reliable biomarkers which will guide clinicians in decision making, while matching suitable therapeutic regimens. We here review currently known molecular biomarkers used for the personalized treatment of colorectal cancer.     

2016年胰腺癌研究及诊疗进展

胰腺癌是消化系统恶性程度最高的肿瘤之一,病情进展快,预后极差.近年来,发病率亦明显升高.胰腺癌的治疗模式已由单纯的手术优先,走向包括外科手术、化学治疗和放射治疗等在内的多学科综合治疗,其临床疗效有了明显提高.近年来,随着对胰腺癌发生、发展机制研究的不断深入,研究者对疾病本身有了更加清晰的认识,也为基础临床的转化提供了线索.该研究参考2016年国内外发表的胰腺癌基础和临床研究相关文献,针对胰腺癌发病因素、基础研究热点、外科手术相关进展及化学治疗进展等方面进行综述.     

2015年胰腺癌研究及诊疗前沿进展

随着发病率和死亡率的增加,癌症不仅成为中国疾病致死的重要原因,也同样是困扰世界的一个重大公共卫生问题。尤其令人担忧的是,全世界每年新发胰腺癌病例数呈现逐年上升的趋势。胰腺癌患者的预后较差,其5年生存率仅约6%,其主要原因包括：①在疾病的早期缺乏典型的临床症状,早期诊断困难;②高侵袭转移特性导致难以控制的复发和转移;③缺乏有效的化疗及靶向治疗药物;④容易对现有化疗药物产生耐药。手术根治性切除仍是目前最有效的治疗方式,但是根治术后早期转移复发仍是造成手术预后不良的主要问题。本文将就2015年全球范围内针对胰腺癌发病因素、流行病学调查、基础研究热点、外科手术相关进展、内科治疗和精准医学等方面的研究及诊疗前沿进展进行回顾性分析。     

2017年胰腺癌基础研究及诊疗新进展

胰腺癌是恶性程度极高的消化道肿瘤,疾病进展快,患者预后差,早期病情隐匿;同时手术切除率及化疗有效率低。近年来胰腺癌发病率逐年升高,成为危害人类健康的重大公共卫生问题。随着人们对胰腺癌生物学行为认识的不断加深,基础研究为临床治疗提供了理论依据,并丰富了临床治疗手段。胰腺癌的治疗模式已由单纯的外科治疗过渡到多学科综合诊治的模式。该文参考2017年胰腺癌研究领域发表的最新文献,对胰腺癌流行病学、发病因素、基础热点研究及临床研究新进展进行综述。     

肝癌干细胞研究进展

近几年,肿瘤起源于干细胞的假说正在人类各种肿瘤中得到证实,包括肝癌。目前认为肿瘤干细胞对肿瘤发生、转移和预后起了关键作用,因此如何分离和鉴定肝癌干细胞对于改善预防方法、促进早期检测以及研发新的治疗方法都是一个非常紧迫的课题。本文就有关肝癌干细胞存在的依据、来源、表面标志物分选等研究进展作一综述。