To identify the impact of CT-defined emphysema on efficacy and immune checkpoint inhibitor-related pneumonitis (ICIP) risk among non-small cell lung cancer (NSCLC) patients who receive ICIs.

In proficient mismatch repair (pMMR) non metastatic rectal cancer, standard neoadjuvant chemoradiotherapy (nCRT) yields low pathological and clinical complete response rates. Early randomized trials suggest adding PD 1 inhibitors may increase response but randomized evidence has not been synthesized.

Hyponatremia is the most prevalent electrolyte imbalance in cancer patients. Symptoms potentially signaling hyponatremia include altered mental status, neurological condition, headache, nausea, dizziness, and balance loss. Its management is particularly challenging as it must account for prognosis, treatment-related factors, and quality of life, especially in individuals treated with immune checkpoint inhibitors (ICIs). This systematic review and meta-analysis assessed the incidence of hyponatremia in patients receiving ICIs or immune-based combinations compared with placebo or other anticancer treatments. The review was registered in PROSPERO (CRD420251137412). Eligible studies included randomized clinical trials, quasi-experimental, and observational studies reporting hyponatremia frequency in patients treated with ICIs. Risk of bias was assessed using the ROB 2 tool for randomized studies and ROBINS-I for observational studies. A meta-analysis for proportions was performed using generalized linear mixed models. Proportion was measured for any grade of hyponatremia, grade 1-2, and grade ≥ 3; and three separate subgroup meta-analyses were performed: one for any grade, one for grade 1 or 2, and one for grade ≥ 3. Thirteen studies were included in the quantitative analyses. Any-grade hyponatremia was reported in 7 studies (934 patients, 49 events), with a pooled prevalence of 5.0% (95% CI = [2.3%; 11.9%]; I2 = 81.8%). Grade 1-2 hyponatremia was assessed in 7 studies (314 patients, 36 events) with a pooled prevalence of 1.2% (95% CI = [0.03%; 37.8%]; I2 = 88.2%). Grade ≥ 3 hyponatremia was evaluated in 14 studies (652 patients, 35 events), yielding a pooled prevalence of 5.5% (95% CI = [3.1%; 9.6%]; I2 = 44.8%). No significant small-study effects were detected for grade ≥ 3 events (Egger's test P = 0.313). These findings support routine electrolyte surveillance in patients treated with ICIs and highlight the need for further studies to clarify mechanisms and risk factors and define optimal monitoring strategies to improve both safety and outcomes.

Elotuzumab, an anti-SLAMF7 monoclonal antibody for multiple myeloma (MM), lacks a comprehensive safety profile from meta-analysis.

Immune checkpoint inhibitors (ICIs) have transformed cancer therapy but are complicated by immune-related adverse events, including acute kidney injury (AKI). As clinical experience matures and treatment durations lengthen, initial estimates of ICI-AKI incidence and the perceived risks of resuming therapy may become outdated.

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal cancers, driven by KRAS mutations long deemed "undruggable". We conducted a meta-analysis of seven early phase cohorts (n = 695) that evaluated KRAS-targeted therapies in patients with PDAC. The pooled objective response rate was 29% (95% CI 24-35%), indicating promising activity in refractory PDAC, with consistent estimates across studies (I2 = 5.7%). Gastrointestinal toxicities were among the most common adverse events, with pooled incidences of 40% for diarrhea and 41% for nausea in all patients treated with KRAS-targeted agents. These findings validate direct KRAS inhibition as a breakthrough concept in PDAC but are tempered by modest durability, risk of bias, and limitations of early phase designs, underscoring the need for biomarker-guided, rigorously designed clinical trials.

Intravitreal Ziv-Aflibercept (ZA-IV) is a recombinant fusion protein used to treat macular diseases. Several studies have demonstrated its efficacy and safety. The objective was to evaluate the efficacy and safety of ZA-IV in the treatment of diabetic macular edema (DME) and macular edema secondary to retinal vein occlusion (RVO).

To investigate the association between pretreatment controlling nutritional status (CONUT) score and clinical outcomes for cancer patients treated with immune checkpoint inhibitors (ICIs).

Osimertinib, a third-generation epidermal growth factor receptor (EGFR) inhibitor, was developed to overcome resistance from EGFR-mutant non-small-cell lung cancer (NSCLC). While it offers significant therapeutic benefits, reports have linked Osimertinib to cardiotoxic effects. This study aims to clarify the direct cardiotoxicity of Osimertinib by reviewing clinical trials and cohort studies involving Osimertinib monotherapy compared to other EGFR inhibitors. A search was conducted in online databases. Measured outcomes included risk of heart failure (HF), myocardial infarction (MI), decline in left ventricular ejection fraction (LVEF), arrhythmias, and pericardial effusion. These outcomes were reported as risk ratio (RR) with a random effects model using 95% confidence intervals (CI). Five studies with 19,008 patients (age 68 ± 13, 65% female) were selected. Osimertinib therapy was associated with an increased risk of HF (RR = 1.45, 95% CI 1.19-1.76, p = 0.0002), decline in LVEF (RR = 3.10, 95% CI 1.72-5.59, p = 0.0002) and MI (RR = 1.40, 95% CI 1.09-1.79, p = 0.0078) compared to other EGFR inhibitors. There was no difference in the risk of arrhythmias and pericardial effusion. Osimertinib therapy is associated with an increased risk of HF and a decline in LVEF compared to other EGFR inhibitors, while associations with MI and arrhythmias were less consistent. Although these events are infrequent, their potential severity warrants proactive cardiac monitoring for patients receiving Osimertinib, particularly in patients with pre-existing risk factors.

Immune checkpoint inhibitors (ICIs) have transformed cancer therapy but may cause immune-related adverse events (irAEs), including dry eye disease (DED). This study aimed to quantify the incidence of ICI-associated DED and to evaluate factors contributing to variability across studies.

Bone metastases are a frequent and clinically consequential complication of advanced non-small cell lung cancer (NSCLC), associated with substantial morbidity and poor survival. Whether adding radiotherapy (RT) to immune checkpoint inhibitors (ICIs) improves outcomes remains uncertain.

The systematic review and meta-analysis aim to thoroughly assess the efficacy of manual interventions like massage therapy, reflexology, and acupressure techniques in relation to overall symptoms, pain, and quality of life (QOL) in patients suffering from CIPN.

Immune checkpoint inhibitors (ICIs) combined with chemotherapy have become an important area of clinical investigation in the gastric cancer (GC) and gastroesophageal junction cancer (GEJC). In recent years, bispecific antibody therapies have been increasingly explored, including cadonilimab, a programmed death-1/cytotoxic T-lymphocyte-associated antigen 4 (PD-1/CTLA-4) bispecific antibody. Several phase II studies have reported early signals of antitumor activity with cadonilimab, prompting clinical interest in this strategy. However, treatment outcomes vary across studies, and a systematic assessment of the efficacy and safety of cadonilimab plus chemotherapy remains limited. This study aimed to evaluate the efficacy and safety profile of cadonilimab in combination with chemotherapy for gastric adenocarcinoma and gastroesophageal junction adenocarcinoma (G/GEJ adenocarcinoma) through a single-arm meta-analysis.

BACKGROUND: Immune checkpoint inhibitors (ICIs) enhance survival rate in non-small-cell lung cancer (NSCLC), but lead to immune-related adverse events, among which checkpoint-inhibitor pneumonitis (CIP) is a leading cause of death. The utility of bronchoalveolar-lavage (BAL) lymphocytosis for diagnosing CIP and predicting its severity remains uncertain. METHODS: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. RESULTS: A total of ten studies were included in the meta-analysis, comprising a total of 168 CIP samples. The pooled estimate for BAL lymphocyte percentage was 56.43% (95% CI, 43.89–68.98, I2 = 99.1%) in CIP, 14.85% (95% CI, 12.04–17.66, I2 = 9.0%) in idiopathic pulmonary fibrosis (IPF), and 43.76% (95% CI, 24.43–63.09, I2 = 99.3%) in NSCLC patients with no ICP or IPF. Significant differences were observed between CIP and IPF (p < 0.0001), NSCLC patients with no ICP or IPF (p = 0.0024). Additionally, the BAL lymphocyte percentage varied between low-grade and high-grade CIP (SMD = -1.15, 95% CI, -2.26–-0.04, I2 = 82.4%). Similar results were also calculated on the BAL lymphocyte CD4:CD8 ratio. The included studies demonstrated significant heterogeneity. CONCLUSION: BAL lymphocyte percentage is elevated and CD4:CD8 ratio is reduced in NSCLC patients with CIP, with higher lymphocyte percentages associated with severe disease. A deeper understanding of the relationships between immunophenotyping, clinical factors and lymphocytosis will guide the use of BAL in the diagnose and evaluation of CIP.

Hand-foot syndrome (HFS) is a common dose-limiting toxic effect of several chemotherapy agents, particularly capecitabine. Despite its substantial impact on the patient's quality of life and potential to compromise therapeutic efficacy, effective preventive strategies remain limited.

This study aimed to evaluate the efficacy of angiotensin-converting enzyme inhibitors (ACEi) in preventing anthracycline-induced cardiotoxicity in patients undergoing anthracycline-based chemotherapy. PubMed, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) comparing ACEi with standard treatment/placebo for cardiotoxicity prevention in patients undergoing anthracycline-based chemotherapy. We pooled outcomes of echocardiographic and cardiac biomarker changes. A random-effects model was used for all outcomes. We included 7 RCTs with 686 patients, of whom 346 (50%) received prophylaxis with ACEi. The most common malignancy was breast cancer, and the follow-up ranged from 6 to 31 months. Prophylactic use of ACEi was associated with a significantly smaller reduction in left ventricular ejection fraction (LVEF) compared with the control group {mean difference (MD) -5% [95% confidence interval (CI) -8% to -2%]; P < 0.010}. Subgroup analysis limited to studies excluding trastuzumab from the chemotherapy regimens showed no significant difference [MD -7% (95% CI -16% to 2%); P = 0.110]. By contrast, in studies including trastuzumab-containing regimens, ACEi demonstrated a statistically significant effect in limiting LVEF reduction [MD -3%, (95% CI -4 to -1); P < 0.010]. Diastolic function (E/A ratio) changes [MD 0.0 (95% CI -0.1 to 0.09); I 2 = 36.3%] and relative risk of increased troponin I at follow-up [Risk-Ratios 0.58 (95% CI 0.17-1.94); I 2 = 69.6%] were not statistically significant. Prophylactic ACEi administration in patients undergoing anthracycline-based chemotherapy was associated with a smaller decline in LVEF. This protective role may be more relevant in patients also receiving trastuzumab. More powered and longer follow-up studies are needed to confirm these findings.

Clear cell ovarian carcinoma is a rare sub-type characterized by poor prognosis and intrinsic resistance to platinum-based chemotherapy. Unlike high-grade serous ovarian cancer, its distinct molecular profile suggests a potentially greater susceptibility to immunotherapy. However, available evidence remains limited and heterogeneous. This systematic review and meta-analysis evaluated the efficacy and safety of immune checkpoint inhibitors in this setting.

MET exon 14 skipping mutations (METex14) or amplification drives a subset of non-small cell lung cancer (NSCLC). Tepotinib, a selective MET tyrosine kinase inhibitor (TKI), has shown promise in early trials; however, comparative efficacy and safety data across MET-altered subpopulations remain limited. This systematic review of six studies (546 patients) assessed the clinical outcomes of Tepotinib in METex14 or MET-amplified NSCLC. The primary endpoint was objective response rate (ORR); secondary endpoints included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety. The pooled objective response rate (ORR) was 52% (95% CI: 48–56%) and a disease control rate (DCR) of 76% (95% CI: 72–80%). Median PFS was 10.16 months, and median OS was 14.67 months. Subgroup analyses revealed no significant differences in ORR between METex14 (52%) and MET amplification (53%, p = 0.905) or between monotherapy (51%) and combination therapy (56%, p = 0.242). Common treatment-related adverse events (TRAEs) were grade 1–2 peripheral edema (50%) and diarrhea (36%); grade ≥ 3 TRAEs were infrequent (8% for edema). In conclusion, Tepotinib demonstrated comparable efficacy in METex14 and MET-amplified NSCLC with a manageable safety profile. The PFS benefit of combination therapy warrants further randomized trials. These findings support Tepotinib as a valuable therapeutic option for MET-altered NSCLC.

Venetoclax (VEN) combined with hypomethylating agents (HMA) is a standard treatment for unfit acute myeloid leukemia (AML) patients, but the conventional 28-day cycle often leads to prolonged cytopenias and infection risks. Recent studies suggest shorter VEN regimens may improve safety without compromising efficacy, but this remains controversial. To this end, we performed a systematic review and meta-analysis to compare the impact of VEN duration in patients receiving VEN-HMA. A comprehensive literature search was conducted in PubMed and Embase up to May 28, 2025. The Cochran Q test and I-squared statistics were used to identify the heterogeneity among the included studies. The network meta-analysis was performed by employing The mtc.model and mtc.run functions of the gemtc R package. We performed all statistical analyses using R 4.0.3. Six studies with 728 patients were included. Meta-analysis showed no significant difference in remission rates between shorter (≤ 14 days) and longer (> 14 days) treatments (RR = 1.07, 95% CI: 0.95–1.20). Network meta-analysis of 14-day (VEN14), 21-day (VEN21), and 28-day (VEN28) regimens found no statistically significant differences in remission rates or overall survival (OS), with VEN14 ranking first for both remission efficacy and survival benefit. Although grade 3/4 granulocytopenia was similar across groups, VEN21 correlated with significantly lower febrile neutropenia versus VEN28 (RR = 0.56, 95% CI: 0.29–0.98). Shorter VEN courses (14–21 days) appear to maintain comparable efficacy to the standard 28-day course, with VEN21 potentially offering a better safety profile regarding febrile neutropenia, supporting the individualization of treatment duration to improve tolerability in unfit AML patients.

Acute myeloid leukemia (AML) is the most common acute leukemia in adults. Approximately 30% of patients present alterations in the FMS-like receptor tyrosine kinase 3 (FLT3) gene, which are associated with poor prognosis. FLT3 inhibitors - midostaurin (first-generation), gilteritinib and quizartinib (second-generation) - have been developed to block FLT3 activation. Given the need of optimizing treatment in FLT3-mutated AML, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the safety profiles of FLT3 inhibitors. Following the PRISMA statement, we searched Embase, MEDLINE and Cochrane Library. The Cochrane Risk of Bias Tool for RCTs was used for quality assessment. Of 2132 references, seven RCTs, involving 2409 adult patients, met inclusion criteria: quizartinib and midostaurin in two trials each and gilteritinib in three. The most frequently reported adverse events (AEs) were classified under the System Organ Class (SOC) Blood and lymphatic system disorders (N = 5474, 58.4% of them related to FLT3 inhibitors). The most frequently observed non-hematological AEs were gastrointestinal disorders, pyrexia, elevated ALT/AST and headache. FLT3 inhibitors are not associated with a significant increase in the risk of AEs compared to standard treatments. No meaningful differences in AE risk were observed among the three drugs. The only exception was an higher risk of ALT increased with gilteritinib (RR = 2.40, 95% CI: 1.16-4.95). Future studies should stratify safety outcomes by demographic and clinical characteristics and incorporate long-term follow-up for a more comprehensive safety assessment in clinical practice.