Anti PD-L1 antibody: is there a histologic-oriented efficacy? Focus on atezolizumab in squamous cell non-small cell lung cancer.

Squamous cell lung cancer (SqCLC) is the second most common histotype of non-small cell lung cancer (NSCLC) and is characterized by severe prognosis and lack of specific target agents. Atezolizumab is the first anti Programmed Death Ligand-1 (PDL-1) inhibitor approved for NSCLC patients of both histology in case of disease progression after first or further lines of therapy. Numerous studies are investigating the potential role of atezolizumab in different therapeutic setting, including SqCLC subtype. We searched for published clinical trials in Pubmed database, using the terms "atezolizumab", "squamous cell lung cancer", "NSCLC" and "non-small cell lung cancer". We also searched for recently concluded and not yet published or ongoing trials in clinicaltrials.gov and in data from the latest international congresses. The aim of this review is to summarize current evidence on atezolizumab in SqCLC, from first line setting to novel potential indications from ongoing trials. Strengths and weaknesses of atezolizumab treatment were highlighted to speculate the role of this immune checkpoint inhibitor in novel future clinical scenarios.

Role of magnetic resonance imaging in breast cancer management.

Magnetic resonance imaging (MRI) of the breast is primarily used as a supplemental tool to breast screening with mammography or ultrasound. A breast MRI is mainly used for women who have been diagnosed with breast cancer, to help measure the size of the cancer, look for other tumors in the breast, and to check for tumors in the opposite breast. For certain women at high risk for breast cancer, a screening MRI is recommended along with a yearly mammogram. MRI is known to give some false positive results which mean more test and/or biopsies for the patient. Thus, although breast MRI is useful for women at high risk, it is rarely recommended as a screening test for women at average risk of breast cancer. Also, breast MRI does not show calcium deposits, known as micro-calcifications which can be a sign of breast cancer.

The Role of Gonadotropin-Releasing-Hormone Analogues in the Treatment of Breast Cancer.

The prognosis of premenopausal breast cancer patients with early disease has improved over the past decades, particularly in women expressing hormone receptors in their tumors. Tamoxifen, a selective estrogen receptor modulator, has dramatically changed outcomes in these patients and remains one of the standards of care. Ovarian function suppression by gonadotropin-releasing-hormone analogues (GnRHa) represents an additional treatment option. Long-term data are required before firm conclusions can be drawn, whereas recent clinical trials suggest that the use of GnRHa is effective in both adjuvant and metastatic settings, particularly in younger patients (<35 years old). The decision to select the optimal therapy should be individualized according to the biological characteristics of tumors, estimates of disease response, comorbidities, patient preference, and long-term toxicity.