A multicenter retrospective analysis of recurrent/metastatic nasopharyngeal cancer from non-endemic areas: Results in the pre-immunotherapy era.

Aim Of The Study: The aim of the study is to describe clinical features, treatment approach and outcomes of recurrent/metastatic (R/M) NPC in non-endemic areas MATERIALS AND METHODS: This observational, retrospective and multicenter study was conducted within 36 referral hospital in non-endemic areas including Europe, Jordan, Kuwait, Turkey and United States of America. All NPC patients diagnosed between 2004 and 2016 and with a minimum 12 months of follow-up were included. Data entry started in January 2018 and closed in December 2023.

International, Multi-Institutional Evaluation of Practice Patterns and Outcomes for Recurrent and Metastatic Sinonasal Undifferentiated Carcinoma.

Objectives: The aims of this study were to analyze the clinical characteristics of patients with recurrent and metastatic sinonasal undifferentiated carcinoma (SNUC) and evaluate the current treatment strategies to help guide future management.

Design: This is a retrospective cohort study.

Setting: The study was conducted at six international tertiary treatment centers.

The Multifaceted Role of Growth Differentiation Factor 15 (GDF15): A Narrative Review from Cancer Cachexia to Target Therapy.

Growth Differentiation Factor 15 (GDF15) has emerged as a key biomarker and therapeutic target in oncology, with roles extending beyond cancer cachexia. Elevated GDF15 levels correlate with poor prognosis across several solid tumors, including colorectal, gastric, pancreatic, breast, lung, prostate, and head and neck cancers. GDF15 modulates tumor progression through PI3K/AKT, MAPK/ERK, and SMAD2/3 signaling, thereby promoting epithelial-to-mesenchymal transition, metastasis, immune evasion, and chemoresistance via Nrf2 stabilization and oxidative stress regulation.

Adverse event profiles and management of cisplatin-based chemoradiotherapy in locally advanced head and neck squamous cell carcinoma: a systematic review.

Background: Patients with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) are treated with curative intent. Treatment guidelines recommend tumor resection, followed by adjuvant radiotherapy or chemoradiotherapy in patients with high risk of disease recurrence, or definitive chemoradiotherapy in patients who do not undergo surgery. When indicated, concurrent cisplatin provides benefit over radiotherapy alone but is highly toxic.

Current practices and challenges in the management of cancer-associated thrombosis: a survey of Italian oncologists.

Purpose: This study investigates current practices and challenges in managing cancer-associated thrombosis (CAT) among Italian oncologists, with the objective of evaluating adherence to guidelines for primary thromboprophylaxis, treatment approaches, and safety considerations. Additionally, it aims to identify areas for potential improvement in clinical decision-making and standardization of CAT management.

Methods: A cross-sectional survey was conducted between February and June 2024 among Italian oncologists, facilitated by the Italian Network for Supportive Care in Oncology (NICSO).

PD-L1 Expression in head and neck squamous cell carcinoma: qualitative or quantitative assessment? Is that enough or we need something more?

The Combined Positive Score (CPS) currently represents the sole biomarker employed in clinical practice to predict the efficacy of immune checkpoint inhibitors (ICIs) and to guide optimal personalized treatment sequencing in head and neck squamous cell carcinoma (HNSCC). However, CPS alone is insufficient for accurate patient stratification and prediction of ICI response, necessitating integration with additional immune-related biomarkers. The spatial distribution of programmed death ligand-1 (PD-L1) expressing cells may offer a promising approach to more comprehensively characterize both the tumor microenvironment (TME) and malignant cells, elucidate their interactions, and enhance the predictive value regarding response to ICI therapy.

The interplay of hypoxia, inflammation, and microbiota as indicators of malignant transformation in oral potentially malignant disorders.

Oral Potentially Malignant Disorders (OPMDs), such as leukoplakia, erythroplakia, proliferative verrucous leukoplakia, and oral submucous fibrosis, carry a risk of malignant transformation, with reported rates ranging from 2.6 % to 7.9 %.

Longitudinal assessment of plasma EBV-DNA in non-endemic EBV-related nasopharyngeal cancer (NPC): the LEA study.

Background: Plasma Epstein Barr Virus (EBV)-DNA is an established biomarker for endemic EBV-related nasopharyngeal carcinoma (NPC). Its relevance in non-endemic regions is less understood. This study longitudinally assessed plasma EBV-DNA (LEA study) throughout the curative management of non-endemic EBV-related NPC to evaluate its prognostic value.

Non-cisplatin concurrent agents plus definitive radiotherapy for locally advanced head and neck cancer: A network meta-analysis of randomized studies.

Introduction: Head and neck squamous cell carcinoma (HNSCC) poses a significant clinical challenge, particularly in its locally advanced stages. Cisplatin-based, definitive, chemoradiotherapy (CRT) is recognized as the preferred treatment strategy, providing substantial survival benefits and currently achieving the best locoregional control (LRC). However, the toxicity profile of cisplatin, which includes nephrotoxicity, neurotoxicity, and ototoxicity, restricts its application in patients with comorbidities or those of advanced age.

Selected laryngeal squamous cell carcinomas with laryngeal mobility impairment are suitable for curative larynx-preservation treatment: A multi-institutional study on 406 patients from the ARYFIX collaborative group.

Introduction: Mobility impairment defines a specific subset of laryngeal squamous cell carcinoma (LSCC), with implications for prognosis and treatment. While total laryngectomy (TL) is often considered for mobility-impairing LSCC (MI-LSCC), the role of organ-preserving strategies such as open partial horizontal laryngectomy (OPHL) and non-surgical treatments (NST) remains debated. This study aims to evaluate the outcomes of different treatment strategies for patients with MI-LSCC.

Patient-reported outcomes (PROs) in clinical trials and in clinical practice: report from the XXI national conference of the Italian Association of Medical Oncology (AIOM).

Objective: Patient-reported outcomes (PROs) are considered the gold standard for the assessment of subjective symptoms, quality of life (QoL) and patient well-being in both clinical trials and clinical practice. Here, we report key discussions and findings from the 21st National Conference of the Italian Association of Medical Oncology, held in Bologna on 21-22 June 2024, with a focus on the integration and impact of PROs in oncology research and clinical practice.

Methods And Analysis: Leading national and international experts presented and analysed data regarding the use of PROs in clinical trials and routine oncology care.

Adjuvant Cemiplimab or Placebo in High-Risk Cutaneous Squamous-Cell Carcinoma.

Background: Patients who have cutaneous squamous-cell carcinoma with high-risk features are at risk for recurrence after definitive local therapy. The benefit of systemic adjuvant therapy options has not been well established in clinical trials.

Methods: In a phase 3, randomized trial, we enrolled patients with local or regional cutaneous squamous-cell carcinoma, after surgical resection and postoperative radiotherapy, at high risk for recurrence owing to nodal features (extracapsular extension with largest node ≥20 mm in diameter or at least three involved nodes) or nonnodal features (in-transit metastases, T4 lesion [with bone invasion], perineural invasion, or locally recurrent tumor with ≥1 additional risk feature).

The loop between inflammation and late systemic toxicity in head and neck cancer survivors.

Curative treatment for head and neck cancers (HNC) typically involves a multidisciplinary approach, combining surgery, chemotherapy, and radiotherapy. Although a curative outcome is achieved in approximately 50 % of cases, long-term survivors frequently experience significant treatment-related sequelae, which substantially diminish both quality of life and overall life expectancy. These toxicities commonly manifest in clusters and encompass both local and systemic symptoms, the latter including asthenia, fatigue, sleep disturbances, thermoregulatory dysfunction, pain, gastrointestinal and neurocognitive impairments, and mood disorders.

The role of volumetry in sinonasal cancer response assessment to induction chemotherapy, results from two phase II non-randomized controlled prospective multicentric trials: SINTART-1 and SINTART-2.

Objective: This study aims to identify the best response criteria in patients with sinonasal cancer undergoing induction chemotherapy (IC).

Material And Methods: Patients enrolled in SINTART-1 and SINTART-2 were included in this study. Unidimensional diameters (anteroposterior, AP; laterolateral, LL; craniocaudal, CC), maximum axial area (Amax), and volume (V) were performed on MRI by two radiologists.

International consensus on laryngeal preservation strategies in laryngeal and hypopharyngeal cancer.

This Policy Review summarises an expert Delphi consensus process on larynx-preservation treatments in patients affected by intermediate-to-advanced laryngeal or hypopharyngeal squamous cell carcinoma. The experts, who represented all perspectives involved in multidisciplinary management of these patients and included patient representatives, approved 137 consensus statements that cover several relevant areas in the field of larynx-preserving treatments. Statements are grouped in the following topics: granular indications for T2-T3 cancer, indications for T4a cancer, indications for salvage organ-preservation surgery after chemoradiation failure, laryngeal function at baseline, which comorbidities are contraindications and to what extent, organ preservation in older patients: selection criteria, post-treatment surveillance, prognostic and predictive factors, listening to the patient's preferences: tools and implementation, prehabilitation and rehabilitation protocols, and cost-effectiveness of different laryngeal preservation approaches.

INTERLINK-1: A Phase III, Randomized, Placebo-Controlled Study of Monalizumab plus Cetuximab in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma.

Purpose: Treatment options for recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) after failure of immune checkpoint inhibitor treatment and platinum-based chemotherapy are limited. Preliminary data suggested that monalizumab plus cetuximab had clinical activity in R/M HNSCC.

Patients And Methods: INTERLINK-1 (NCT04590963) was a double-blind, phase III study.

Clinical trials for patients with salivary gland cancers: A systematic review of worldwide registers and an evaluation of current challenges.

Background: Clinical trials (CT) are crucial for generating scientific evidence and improving clinical outcomes, but they can be challenging in the context of rare cancers. Salivary gland cancers (SGC) are rare and heterogeneous tumors, without standard-of-care approved systemic therapies. We analyzed completed and ongoing CTs to assess the current state of clinical research activity in the field.

Precision medicine in Salivary Gland Carcinoma: Insights from breast and prostate cancer.

Salivary Gland Carcinomas (SGC) are a heterogeneous group of diseases with varied histologies, biology, clinical behaviors, and therapeutic approaches. The World Health Organization classifies SGCs into Low Aggression and High Aggression categories. Due to their rarity and unique biology, managing SGCs is challenging, often requiring expert histological diagnosis and treatment based on low-level evidence.

Nodal status in major salivary gland cancer: External validation of a novel N- classification.

Background: Nodal status has been considered an important prognosticator when dealing with MSGC. Since current TNM N-categories do not accurately stratify patients, alternative nodal staging systems have been advocated. Our group has previously proposed 3 novel N-classification models according to number of metastatic nodes, largest diameter of metastatic nodes, and a combination of these two parameters.

Improving the multidisciplinary therapeutic management of head and neck squamous cell carcinoma: Consensus statements from an Italian expert panel.

Objective: The management of recurrent and/or metastatic (RM) head and neck squamous cell carcinoma (HNSCC) poses significant clinical challenges. This study aimed to develop expert consensus statements to improve the multidisciplinary management of RM HNSCC.

Methods: A multidisciplinary team of 39 Italian experts, including medical oncologists, surgeons, radiation oncologists, radiologists, and pathologists, employed the Delphi method to achieve consensus on critical aspects of RM HNSCC management.