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The Proclarix-MRI model, integrating prostate volume, Proclarix, and mpMRI data, was trained using data from the UCL cohort (n=159) and its performance was subsequently validated with data from the Vall d’Hebron cohort (n=562). The diagnostic accuracy was evaluated in relation to biopsy findings and contrasted with current clinical markers and risk prediction models.

The Proclarix-MRI model’s performance in the validation cohort was consistent with its performance in the training cohort, yielding a sensitivity of 90% for csPCa, a negative predictive value of 90%, and a positive predictive value of 66%. The specificity of the Proclarix-MRI score, measured at 68%, was statistically superior (P<0.0001) to that of the MRI-European Randomized study of Screening for Prostate Cancer risk score (51%), and the individual scores of Proclarix (27%) and mpMRI (28%). When considering the MRI Prostate Imaging-Reporting and Data System (PI-RADS) score 3 group, Proclarix proved superior to prostate-specific antigen density in specificity (25% versus 13%, P=0.0004), maintaining a perfect 100% sensitivity.

Combining mpMRI, prostate volume, and Proclarix, the system effectively predicted csPCa and distinguished men with no cancer or indolent forms of the disease. Through substantial effort, the number of unneeded biopsies was reduced by two-thirds. Further use of Proclarix allows for high-confidence and reliable detection of csPCa in men presenting with an indeterminate PI-RADS score 3 mpMRI. These positive results notwithstanding, a more rigorous validation process is required.

Prostate volume, mpMRI, and Proclarix together accurately predicted csPCa while also identifying men without or with indolent cancer. The unnecessary biopsies were cut back by two-thirds, marking a substantial decrease. Proclarix’s high confidence in detecting csPCa extends to men with an indeterminate PI-RADS score 3 mpMRI. Despite the positive outcomes, further validation procedures are necessary.

Immunotherapy has dramatically altered the landscape of cancer care, but it also introduces a new spectrum of complications that closely resemble autoimmune diseases, designated as immune-related adverse events (irAEs). The prevalence of endocrine complications stems from their involvement in nearly all endocrine tissues. Definitive hormonal substitution is frequently mandated in endocrine irAEs, corticosteroids proving useless in such cases. The central nervous system, the peripheral nervous system, and the neuromuscular junction can all be targets of neurological irAEs. While not common, neurological irAEs are linked to a substantial rise in the burden of illness and a higher risk of death. Accordingly, prompt detection and appropriate intervention are vital. The incidence, presentation, diagnostic evaluation, management, and common pitfalls of endocrine and neurological irAEs are the focus of this article.

Oncology patients undergoing immune checkpoint inhibitor treatment often experience skin and joint issues as common adverse effects. Early recognition of these occurrences, along with appropriate referral to an oncologist or dermatologist, is essential in everyday medical practice; the resulting organ damage can be significant and sometimes even fatal. Skin lesions, specifically maculopapular rash and bullous dermatitis, necessitate a diagnosis and management strategy tailored to the affected body surface area. For individuals with moderate or severe conditions, corticosteroids represent a key therapeutic approach. The relatively uncommon and diverse forms of rheumatologic toxicities are frequently overlooked, despite their potential impact. interleukin receptor Autoantibodies are not always present when these events manifest, and myositis poses a risk to life.

Different cancers may receive immunotherapy with immune checkpoint inhibitors (ICIs), a treatment that can lead to a broad array of immune-related adverse effects, including the potential for toxicity to vital organs such as the lungs, kidneys, and heart. The overriding hypothesis implies an overstimulation of immune cells in different parts of the body. Rare but life-threatening immune-related cardiotoxicity contrasts with more frequent but generally less severe ICI-induced acute kidney injury and pneumonitis. Acute tubulo-interstitial nephritis accounts for over 90% of renal toxicity cases. The hallmark of checkpoint inhibitor-induced pneumonitis, which is diagnosed primarily through respiratory symptoms, frequently showcases novel radiological features, particularly in the context of cryptogenic organizing pneumonia. Cardiotoxicity manifests most often through myocarditis, with pericarditis and arrhythmias often presenting as additional symptoms. Multidisciplinary management within a specialized center is essential, revolving around the key components of early recognition, either temporary or permanent cessation of ICI therapy, and swift initiation of high-dose corticosteroids.

Patients undergoing immune checkpoint inhibitor therapy often experience frequent gastrointestinal toxicities. Since some instances of these events can be severely detrimental or even fatal, the prompt identification of immune-related adverse events is essential. Initiating systemic immunosuppression can lead to improved outcomes. To ascertain the diagnosis of immune-related adverse events, a biopsy is frequently required. Discontinuation of ICI is critical when moderate or severe irAEs occur. The re-challenge of immune checkpoint inhibitors, following the resolution of toxicities, requires a case-specific approach.

Cancers of the urinary, reproductive, and digestive systems are seeing immunotherapy become an increasingly vital aspect of their management. A standard treatment approach for patients with advanced renal and liver cancers, and a significant number of bladder, cervical, gastric, and esophageal cancer patients, now involves combinations of immune checkpoint inhibitors, supported by various biomarker-based strategies. The responsiveness of some tumor types to immunotherapy is lower, specifically in instances like prostate and colon cancer. Immunotherapy proves particularly effective for a subset of patients with microsatellite-instability-high/DNA-mismatch repair deficient tumors. Molecular characterization is thus indispensable for recognizing patients suitable for these treatments. The pursuit of novel predictive biomarkers and innovative combination therapies or strategies is paramount to improving patient outcomes.

Three novel approaches to cancer immunotherapy, BITE, TIL, and cancer vaccines, are discussed in this article. These therapies recognize specific cancer cell targets, eliciting a precise immune response. Currently, these strategies do not yield the best results for all tumor types; hematological malignancies, melanoma, and lung cancer have displayed the most promising outcomes. Switzerland’s cancer centers are currently evaluating novel biological products, necessitating physician familiarity with related procedures, as these therapies may soon treat some of their patients.

In cases of localized melanoma, the most aggressive skin cancer, surgery is the standard treatment. While surgical intervention may eradicate the primary tumor, the risk of local and distant tumor recurrence still exists, particularly in situations where the tumor is thick or ulcerated, or lymphatic nodes are implicated. Patients with stage III and high-risk stage II melanoma who underwent surgery followed by immunotherapy using immune checkpoint inhibitors (ICIs) against PD-1, PD-L1, or CTLA-4, achieved superior relapse-free and distant metastasis-free survival compared with patients who received placebo treatment. In cases of inoperable, localized, and disseminated malignancies, the dual administration of immunotherapy agents, particularly anti-PD-1 and anti-CTLA-4, contributes to long-term survival in more than fifty percent of the patient population. Efforts to develop novel immunotherapies, including anti-LAG-3 immune checkpoint inhibitors, adoptive cell therapies, intra-tumoral immunotherapies, and cancer vaccines, along with new combination strategies, are underway to defeat resistance and enhance the survival of patients. For every patient, the multidisciplinary team’s specialized input is essential to discuss the best therapeutic decisions.

The stage of non-small-cell lung cancer significantly influences treatment strategies, with immunotherapy potentially crucial at all stages. Locally advanced cancer patients receiving neoadjuvant chemotherapy augmented with an immune checkpoint inhibitor (ICI) experience improved pathological response and extended event-free survival. Disease-free survival is augmented by the addition of ICI therapy to adjuvant chemotherapy protocols for resectable cancers. For unresectable stage III cancers undergoing combined chemo-radiotherapy, incorporating ICI as a maintenance strategy improves both progression-free and overall survival. Patients with metastatic cancer who receive both chemotherapy and immunotherapy (ICI) experience improved overall survival, freedom from disease progression, and treatment responses, regardless of the PD-L1 expression status. ICI treatment might be considered a viable option in instances of PD-L1 expression levels equal to or above 50%.

New avenues in cancer treatment have sprung from a deeper understanding of the immune system’s proteins and regulatory mechanisms. Antibodies, functioning as immune checkpoint inhibitors, with the capability to block interactions that curb the activation of T cells or their effector activities directed at cancer cells, have influenced the prognosis for numerous cancers. Cellular immunotherapies, like CARs and TILs, coupled with bispecific antibodies, stand as innovative immunotherapy approaches, proven effective against particular oncohematological diseases. Sadly, a small percentage of patients undergoing these treatments show improvement. The future will demand a deeper understanding of the resistance mechanisms immunotherapies face, enabling the personalization of treatment for each unique patient.