Novel therapeutic strategies for rare mutations in non-small cell lung cancer.

Lung cancer is still the leading cause of cancer-related mortality. Over the past two decades, the management of non-small cell lung cancer (NSCLC) has undergone a significant revolution. Since the first identification of activating mutations in the epidermal growth factor receptor (EGFR) gene in 2004, several genetic aberrations, such as anaplastic lymphoma kinase rearrangements (ALK), neurotrophic tropomyosin receptor kinase (NTRK) and hepatocyte growth factor receptor (MET), have been found. With the development of gene sequencing technology, the development of targeted drugs for rare mutations, such as multikinase inhibitors, has provided new strategies for treating lung cancer patients with rare mutations. Patients who harbor this type of oncologic driver might acquire a greater survival benefit from the use of targeted therapy than from the use of chemotherapy and immunotherapy. To date, more new agents and regimens can achieve satisfactory results in patients with NSCLC. In this review, we focus on recent advances and highlight the new approval of molecular targeted therapy for NSCLC patients with rare oncologic drivers.

Nutrition impact symptoms in head and neck cancer during radiotherapy: a longitudinal study.

BACKGROUND: Patients with head and neck cancer (HNC) receiving radiotherapy (RT) are at a high risk of weight loss (WL) due to a variety of nutrition impact symptoms (NISs). OBJECTIVE: This prospective observational study aimed to investigate the consecutive changes of NIS during RT and analyzed its impact on body weight. MATERIALS AND METHODS: The Head and Neck patient Symptom Checklist was adopted to evaluate NIS. NIS, body weight, hemoglobin and lymphocyte of 94 participants were assessed at four time points during RT and the treatment outcomes were assessed at the time of 12 months after the completion of RT. Generalised estimation equations (GEEs) and Kendall's tau-b were used for statistical analysis. RESULTS: Our study found that pain, taste changes and dry mouth were the most common NIS, reported by >90% of patients and had higher interference scores (more than 85% >2) at the end of RT. The average WL was 4.22 ± 3.59 kg after treatment, and more than two-thirds of patients (67.02%, 64/94) experienced significant WL of >5%. Lack of energy, vomiting and taste changes impacted WL significantly (p < .05). Taste changes were also associated with hemoglobin and lymphocyte reduction (p = .018, p < .001). WL correlated negatively with tumor response (p = .031). CONCLUSIONS AND SIGNIFICANCE: In patients with HNC, taste changes, pain, dry mouth and vomiting were seen. Nutritional intervention applied as early as the first 10 days of RT could help to change the nutrition status and improve the clinical outcomes.

Dynamic change of the systemic immune inflammation index is a risk factor for patients with oropharyngeal cancer: a case control study and an additional HPV-status subgroup analysis.

BACKGROUND: The study aimed to analyze the relationship between the dynamic systemic immune inflammation index (SII), human papillomavirus (HPV) infection, and the prognosis of oropharyngeal cancer patients. METHOD: We retrospectively obtained the data for 131 patients treated with curative treatments and calculated their SII values based on results acquired approximately 9 months after the first treatment. The entire cohort was divided into groups according to dynamic SII and HPV infection, and their prognoses were compared. RESULTS: The high SII group, particularly the persistently high SII group, had a poor prognosis, and static SII levels cannot fully reflect the prognosis of patients with oropharyngeal cancer. In HPV- patients, unfavorable dynamic SII and the site of tumor locating at the tongue base were all significantly associated with decreased disease-free survival. In contrast, no characteristic was presented as a poor prognostic factor for disease-free or overall survival in HPV+ patients. CONCLUSION: Dynamic SII values are more comprehensive prognostic indicators for oropharyngeal cancer patients, particularly HPV- patients. It could imply that an HPV- oropharyngeal cancer patient who experienced unfavorable dynamic changes in SII should receive more frequent tests or more advanced therapies.

Precious Gene: The Application of RET-Altered Inhibitors.

The well-known proto-oncogene rearrangement during transfection (RET), also known as ret proto-oncogene Homo sapiens (human), is a rare gene that is involved in the physiological development of some organ systems and can activate various cancers, such as non-small cell lung cancer, thyroid cancer, and papillary thyroid cancer. In the past few years, cancers with RET alterations have been treated with multikinase inhibitors (MKIs). However, because of off-target effects, these MKIs have developed drug resistance and some unacceptable adverse effects. Therefore, these MKIs are limited in their clinical application. Thus, the novel highly potent and RET-specific inhibitors selpercatinib and pralsetinib have been accelerated for approval by the Food and Drug Administration (FDA), and clinical trials of TPX-0046 and zetletinib are underway. It is well tolerated and a potential therapeutic for RET-altered cancers. Thus, we will focus on current state-of-the-art therapeutics with these novel RET inhibitors and show their efficacy and safety in therapy.