Prediction of Response to FDA-Approved Targeted Therapy and Immunotherapy in Acute Lymphoblastic Leukemia (ALL).

OPINION STATEMENT: Acute lymphoblastic leukemia (ALL) represents the predominant cancer in pediatric populations, though its occurrence in adults is relatively rare. Pre-treatment risk stratification is crucial for predicting prognosis. Important factors for assessment include patient age, white blood cell (WBC) count at diagnosis, extramedullary involvement, immunophenotype, and cytogenetic aberrations. Minimal residual disease (MRD), primarily assessed by flow cytometry following remission, plays a substantial role in guiding management plans. Over the past decade, significant advancements in ALL outcomes have been witnessed. Conventional chemotherapy has remarkably reduced mortality rates; however, its intensive nature raises safety concerns and has led to the emergence of treatment-resistant cases with recurrence of relapses. Consequently, The U.S. Food and Drug Administration (FDA) has approved several novel treatments for relapsed/refractory ALL due to their demonstrated efficacy, as indicated by improved complete remission and survival rates. These treatments include tyrosine kinase inhibitors (TKIs), the anti-CD19 monoclonal antibody blinatumomab, anti-CD22 inotuzumab ozogamicin, anti-CD20 rituximab, and chimeric antigen receptor (CAR) T-cell therapy. Identifying the variables that influence treatment decisions is a pressing necessity for tailoring therapy based on heterogeneous patient characteristics. Key predictive factors identified in various observational studies and clinical trials include prelymphodepletion disease burden, complex genetic abnormalities, and MRD. Furthermore, the development of serious adverse events following treatment could be anticipated through predictive models, allowing for appropriate prophylactic measures to be considered. The ultimate aim is to incorporate the concept of precision medicine in the field of ALL through valid prediction platform to facilitate the selection of the most suitable treatment approach.

Rheumatoid arthritis-associated interstitial lung disease hotspots and future directions: A Web-of-Science based scientometric and visualization study.

OBJECTIVE: To identify new trends and potential hotspots in research on rheumatoid arthritis-associated interstitial lung disease (RA-ILD). MATERIALS AND METHODS: The Web of Science (WOS) database was used to search for RA-ILD-related literature published between August 31, 2002 and August 31, 2022. CiteSpace 6.1.R3, VOSviewer version 1.6.17, Scimago Graphica, and Pajek V2.0 visualization software were used to conduct a comprehensive analysis and network visualization mapping of the authors, countries, institutions, journals, cited references, and keywords. RESULTS: A total of 2412 articles were retrieved, and the number of articles published has grown annually since 2002. Eric L. Matteson was the most prolific author, and the Mayo Clinic and UNITED STATES have the highest publishing volume and influence. Clinical Rheumatology is the journal with the most papers published. Rheumatology was the most cited journal. The citation clusters and keywords concentrated on the mechanism, treatment, and predictive and prognostic factors. CONCLUSION: Pathogenesis, treatment, and predictive and prognostic factors were among the RA-ILD research directions and hotspots. Antirheumatoid drugs, especially biologics and small molecule inhibitors, were among the most actively researched treatment options. The results of this study provides an in-depth understanding of the development of RA-ILD publications, aids researchers in understanding hotspots and trends and provides a new perspective for future RA-ILD research.

Prognostic and predictive factors in pancreatic cancer.

Pancreatic cancer is one of the leading causes of cancer death worldwide. Its high mortality rate has remained unchanged for years. Radiotherapy and surgery are considered standard treatments in early and locally advanced stages. Chemotherapy is the only option for metastatic patients. Two treatment regimens, i. e. the association of 5-fluorouracil- irinotecan-oxaliplatin (FOLFIRINOX) and the association of nab-paclitaxel with gemcitabine, have been shown to improve outcomes for metastatic pancreatic adenocarcinoma patients. However, there are not standardized predictive biomarkers able to identify patients who benefit most from treatments. CA19-9 is the most studied prognostic biomarker, its predictive role remains unclear. Other clinical, histological and molecular biomarkers are emerging in prognostic and predictive settings. The aim of this review is to provide an overview of prognostic and predictive markers used in clinical practice and to explore the most promising fields of research in terms of treatment selection and tailored therapy in pancreatic cancer.

Clinicopathological characteristics and prognosis of patients according to recurrence time after radical nephrectomy for localized renal cell carcinoma: a multicenter study of Anatolian Society of Medical Oncology (ASMO).

AIM: We investigated the clinicopathological features in patients with recurrent RCC within 5 years or more than 5 years after nephrectomy and determined predictors of survival and response treatment after recurrence. MATERIALS AND METHODS: We retrospectively evaluated 144 patients with disease recurrence; 73 had recurrence more than 5 years after radical nephrectomy. We compared clinicopathological characteristics in patients with disease recurrence before vs. after 5 years. In addition, we investigated predictors of survival and response to treatment after recurrence. RESULTS: Seventy-one patients (49%) were diagnosed with recurrence within 5 years after radical nephrectomy (early recurrence) and 73 patients (51%) were diagnosed with recurrence more than 5 years after radical nephrectomy (late recurrence). Fuhrman grade, tumor necrosis and lymphovascular invasion were statistically significantly different between the two groups (p<0.001, p=0.013, p=0.026, respectively). The late recurrence patients were significantly associated with the Memorial Sloan Kettering Cancer Center (MSKCC) favorable risk group compared to patients with early recurrence (p=0.001). From the time of disease recurrence, median Overall Survival (OS) was 36.0 (95% Confidence Interval (CI) 30.7-41.2) months in the late recurrence group, and 19 (95% CI 15.4-22.5) months in the early recurrence group (p=0.01). The median Progression Free Survival (PFS) was 6 (95% CI 3.87-8.12) months in the early recurrence group, and 18 (95% CI 15.4-20.5) months for the late recurrence group (p<0.001). CONCLUSION: Early recurrence was significantly associated with Fuhrman grade 3-4, tumor necrosis, lymphovascular invasion, MSKCC poor-risk group compared to patients with late recurrence. The study also demonstrated a potential prognostic value of late recurrence in terms of PFS and OS.