The administration of bevacizumab, ramucirumab, and aflibercept increases the incidence of hypertension; however, the risk of discontinuation of cancer therapy due to hypertension from these medications remains unclear. A systematic review and meta-analysis were conducted to assess the incidence and risk of hypertension associated with bevacizumab, ramucirumab, and aflibercept, as well as the risk of treatment discontinuation due to hypertension. Phase III randomized controlled trials (RCTs) of these therapies published through November 5, 2024, were identified through searches in PubMed, Cochrane Library, and Web of Science databases. The meta-analysis included 57 RCTs comprising 34,145 patients who received bevacizumab, ramucirumab, or aflibercept. The overall incidence of hypertension was 28% (95% confidence interval [CI]: 22-34%) for all-grade hypertension and 9% (95% CI: 7-11%) for grade ≥3 hypertension. Compared to control groups, treatment with these agents was associated with an increased risk of all-grade hypertension (odds ratio [OR]: 4.5; 95% CI: 3.7-5.5) and grade ≥3 hypertension (OR: 5.0; 95% CI: 4.0-6.3). The incidence of treatment discontinuation due to hypertension was 1% (95% CI: 1-2%), with a risk difference of 1.60% (95% CI: 0.76-2.38). VEGF inhibitor therapy-induced hypertension has been suggested to increase the risk of cancer treatment discontinuation. Therefore, careful monitoring and management of blood pressure in patients receiving these agents is essential.

Ovarian cancer is one of the most lethal malignancies affecting women, often diagnosed at advanced stages. Bevacizumab, a novel therapeutic agent, has recently demonstrated efficacy in the management of this disease. However, its use has been associated with various adverse effects reported in clinical trials. This systematic review and meta-analysis aimed to provide a comprehensive evaluation of urinary complications linked to bevacizumab therapy in ovarian cancer patients.

Leukemias are heterogenous hematologic malignancies broadly classified into myeloid and lymphoid lineages, each with distinct molecular and clinical features. Here we aime to identify lineage-specific molecular vulnerabilities in myeloid and lymphoid leukemias and use them to guide targeted therapy and rational drug repurposing.

Glioblastoma (GB) is the most common and aggressive malignant brain tumor in adults, with poor long-term survival despite standard treatment. Targeted therapies such as immune checkpoint inhibitors (ICIs) and mTOR inhibitors have been explored to improve outcomes, but their clinical benefit in GBM remains unclear. We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the efficacy and safety of ICIs and mTORi in adult patients with newly diagnosed or recurrent GB. Databases searched included PubMed, Cochrane Library, and Semantic Scholar through March 2025. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were extracted or estimated and pooled using a fixed-effect model. Risk of bias was assessed with the Cochrane tool. Twenty-one trials involving 2,130 patients were included (12 on ICIs, 9 on mTOR inhibitors). ICIs showed no significant OS benefit (HR: 1.10; 95% CI: 0.98-1.24; p = 0.10), but a modest improvement in PFS (HR: 1.17; 95% CI: 1.04-1.33; p = 0.01). Pembrolizumab in a neoadjuvant setting demonstrated the most favorable outcomes. In contrast, mTOR inhibitors were associated with significantly worse OS (HR: 1.43; 95% CI: 1.08-1.89; p = 0.01), and no PFS benefit (HR: 1.16; 95% CI: 0.89-1.51). ICIs were commonly associated with immune-related adverse events, while mTOR inhibitors showed hematologic and metabolic toxicities. Neither ICIs nor mTOR inhibitors consistently improved survival in unselected GB populations. However, tailored approaches based on molecular features or delivery methods may offer benefits and should be further investigated.

Immune checkpoint inhibitors (ICIs) combined with radiotherapy (RT) enhance antitumor efficacy; however, the optimal sequencing of these treatments remains undefined. We conducted a network meta-analysis (NMA) of randomized controlled trials to compare the efficacy and safety of ICIs administered after completion of RT versus those administered concurrently with RT.

Despite the established role of anti-vascular endothelial growth factor (anti-VEGF) agents as first-line therapy for diabetic macular edema (DME), their therapeutic effect may be incomplete or unsustained in a proportion of patients.

Intra-arterial chemotherapy (IAC) has emerged as a targeted alternative to intravenous chemotherapy (IVC) for retinoblastoma; however, the comparative effectiveness and safety of these approaches remain incompletely defined. We performed a systematic review and meta-analysis to evaluate whether IAC-based regimens are associated with improved clinical outcomes compared with IVC in pediatric retinoblastoma. Twelve studies were included. Comparative studies contributed to the quantitative synthesis, whereas selected non comparative IAC series were summarized qualitatively to provide contextual evidence. Overall survival demonstrated a consistent association favoring IAC across both early and advanced disease categories, with a pooled effect estimate of OR 4.72 (95% CI 2.69-8.28). In early-stage disease, the pooled OR was 12.61 (95% CI 3.82-41.58), while advanced-stage disease showed a pooled OR of 3.56 (95% CI 1.88-6.74). Heterogeneity was negligible within subgroups (I² = 0%). Event-free survival favored IAC-based treatment overall with a pooled RR of 1.36 (95% CI 1.13-1.62). When stratified by treatment approach, IAC alone showed a pooled RR of 1.30 (95% CI 1.01-1.66) with moderate heterogeneity (I² = 61%), whereas IAC combined with IVC sequencing demonstrated a pooled RR of 1.43 (95% CI 1.10-1.86) with no heterogeneity (I² = 0%). Globe salvage outcomes were improved with IAC, with a pooled RR of 1.33 (95% CI 1.23-1.42; I² = 9%). Avoidance of enucleation also favored IAC overall, with a pooled RR of 1.69 (95% CI 1.34-2.12). Subgroup analyses indicated a modest and non-significant effect in early-stage disease (RR 1.27, 95% CI 0.89-1.80) and a clearer effect in advanced-stage disease (RR 2.08, 95% CI 1.54-2.80), with minimal heterogeneity (I² = 0%). Metastatic events were rare across studies; nevertheless, pooled analysis suggested lower odds of metastasis in IAC-based regimens compared with IVC (OR 0.42, 95% CI 0.19-0.91; I² = 0%), with no evidence of subgroup differences between IAC alone and IAC plus IVC sequencing. In conclusion, IAC-based strategies were associated with favorable outcomes in survival, disease control, globe salvage, and avoidance of enucleation compared with IVC, with consistently low heterogeneity across major endpoints and metastatic events remaining uncommon in both arms. These findings support the role of IAC as an important component of contemporary retinoblastoma management, particularly in settings with appropriate technical expertise and multidisciplinary resources.

Intravesical bacillus Calmette-Guérin (BCG) therapy remains the cornerstone for high-risk non-muscle-invasive bladder cancer (NMIBC), but up to 40% of patients experience disease recurrence or progression within 2 yr. We conducted a systematic review and meta-analysis of three phase 3 randomized trials POTOMAC, CREST, and ALBAN; n = 2590) in BCG-naïve high-risk NMIBC disease treated with a combination of BCG and an immune checkpoint inhibitor (ICI). Overall risk of bias was low for all studies. Combination therapy with BCG maintenance was associated with better event-free survival (EFS) in comparison to BCG alone (pooled hazard ratio [HR] 0.77, 95% confidence interval [CI] 0.60-0.99; Q = 3.29, p = 0.2). Using the HR for high-grade recurrence from ALBAN, the pooled estimate was directionally consistent, but not statistically significant (HR 0.78, 95% CI 0.58-1.04; Q = 3.94, p = 0.1). Overall survival was comparable between groups (HR 0.92, 95% CI 0.67-1.26). Grade ≥3 treatment-related adverse events were more frequent with combination therapy (risk ratio [RR] 3.66, 95% CI 2.56-5.24 for BCG induction only; RR 3.97, 95% CI 2.54-6.21 for BCG induction + maintenance). There was a moderate decline in patient-reported quality of life in the ICI + BCG maintenance arms. These findings are supported by moderate-certainty evidence for EFS. BCG monotherapy remains the benchmark for BCG-naïve high-risk NMIBC. ICI addition improves EFS but increases high-grade toxicity, which should prompt cautious and individualized adoption pending mature survival data.

Personalized escalation and de-escalation of immune checkpoint inhibitor (ICI) regimens may help to overcome upfront resistance and mitigate the risk for immune-related adverse events (irAEs). Here, we examined the association between pathological response and irAEs per ICI regimen. Meta-analysis of neoadjuvant ICI trials in melanoma illustrated a pattern of increased toxicity and efficacy with the addition and/or higher dosing of anti-CTLA-4 to anti-PD-1. We subgrouped anti-PD-1, low-dose anti-CTLA-4 + anti-PD-1, high-dose anti-CTLA-4 + anti-PD-1, and anti-PD-1 + anti-LAG-3 cohorts according to the baseline interferon-gamma (IFN-γ) signature and analyzed these for response and toxicity rates. Whereas in IFN-γ high subgroups the addition of (high-dose) anti-CTLA-4 increased toxicity but not efficacy, the addition of high-dose anti-CTLA-4 to anti-PD-1 increased efficacy in the IFN-γ low subgroup, while toxicity remained low. Our findings suggest that baseline immune signatures may be used to separate risk for toxicity from risk for non-response, with implications for patient stratification and treatment regimens.

Pre-therapeutic UGT1A1 genotyping is increasingly performed in patients receiving irinotecan, as its active metabolite SN-38 is primarily cleared through UGT1A1-mediated glucuronidation. Patients with the UGT1A1*28/*28 genotype exhibit reduced UGT1A1 activity, leading to increased SN-38 exposure and a higher risk of adverse events such as neutropenia and diarrhea. Although sacituzumab govitecan contains the same active metabolite as irinotecan, routine UGT1A1 genotyping prior to treatment with this drug is not yet standard practice and is not included in its product information. The aim of this study was to assess whether pre-therapeutic UGT1A1 genotyping may also benefit patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative and triple-negative breast cancer who are treated with sacituzumab govitecan. A literature search was conducted to identify relevant studies assessing the impact of UGT1A1 genotyping on the safety and efficacy of sacituzumab govitecan treatment. A meta-analysis was performed on selected studies. Additionally, a pharmacological analysis was performed using public data comparing SN-38 levels in patients treated with sacituzumab govitecan to those receiving irinotecan. The meta-analysis shows that grade ≥ 3 adverse events, including neutropenia, febrile neutropenia, and diarrhea, occurred more frequently in patients with the *28/*28 genotype. Furthermore, a statistically significant increased risk was found for developing grade ≥ 3 diarrhea or febrile neutropenia in this group. Although the meta-analysis was underpowered due to small sample sizes, the pharmacological analysis demonstrated higher SN-38 levels in patients treated with sacituzumab govitecan, supporting the rationale for UGT1A1 genotyping in this context.

The cell surface protein TROP-2 is overexpressed in various solid tumors, making it an attractive therapeutic target. Datopotamab deruxtecan (Dato-DXd) is a novel antibody-drug conjugate (ADC) designed to selectively deliver cytotoxic agents to TROP-2-expressing cancer cells. It has recently been approved for treating unresectable or metastatic hormone receptor-positive, HER2-negative breast cancer. While preclinical and early phase clinical trials have shown promising efficacy, this meta-analysis aims to provide a comprehensive evaluation of the efficacy and safety of Dato-DXd in patients with advanced solid tumors by synthesizing the available clinical evidence.

This review aims to explore the potential of Indonesian medicinal plants as therapeutic agents for breast cancer in in vitro studies.

Bevacizumab and poly (ADP-ribose) polymerase inhibitors (PARPi) administered as maintenance therapies after platinum-based chemotherapy have shown a progression-free survival benefit in patients with ovarian cancer. However, there is no head-to-head trial comparing the quality of life (QOL) between bevacizumab and PARPi. We conducted a Bayesian network meta-analysis to compare the QOL between bevacizumab and PARPi.

Osteosarcoma is an aggressive bone cancer primarily affecting children and adolescents, with low survival rates in advanced stages. A systematic review and meta-analysis were conducted following PRISMA guidelines to evaluate the impact of ICIs on survival and toxicity in advanced osteosarcoma. ICIs show potential in treating advanced osteosarcoma but are associated with significant toxicity and uncertain survival benefits. Further research is needed to define their role and identify biomarkers for predicting response. Close monitoring for adverse events is essential.

In premenopausal women with breast cancer, chemotherapy often leads to amenorrhea that could be temporary or permanent. Anti-Müllerian hormone (AMH) is a potential biomarker predicting resumption of ovarian function, an outcome that aids in the decision making for endocrine therapy. This study aimed to determine the predictive value of pre-chemotherapy AMH levels for resumption of ovarian function.

Lenvatinib, an effective targeted drug for various cancers, has clinical medication safety concerns due to its toxicities and side effects.

Combined modality treatment with chemotherapy, radiotherapy, and immunotherapy is a crucial therapeutic approach for lung cancer. However, controversies still exist regarding radiation doses, treatment regimens, and the risk of pneumonitis. This study aimed to conduct a comprehensive meta-analysis and in-depth subgroup analyses based on randomized controlled trials (RCTs) involving lung cancer patients undergoing radiotherapy to assess whether its combination with immunotherapy is effective and safe.

BACKGROUND: The adoption of immune checkpoint inhibitors in combination with tyrosine kinase inhibitors (TKIs) and/or local therapy, including transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC), has been utilized as neoadjuvant or conversion therapy for hepatocellular carcinoma. However, the efficacy of different combinations in terms of conversion or neoadjuvant therapy varies. METHODS: We conducted a single-group rate meta-analysis to determine the conversion rate or resection rate, tumor response, and corresponding 95% confidence intervals (CI) for the therapeutic combinations. The tumor response and adverse events were also evaluated. The prognosis of patients receiving neoadjuvant therapy followed by surgery and surgery alone was also compared by evaluating HR and its 95%CI. RESULTS: Forty-nine studies were included, with thirty-six studies involving 3497 patients focusing on conversion therapy and the remaining thirteen involving 569 patients focusing on neoadjuvant therapy. The meta-analysis revealed a conversion rate of 0.23 (95% CI: 0.18–0.29). Subgroup analyses based on different treatments revealed a conversion rate of patients receiving is the combination of ICIs, TKIs, and TACE or HAIC about 30%, while the conversion rate of patients receiving T + A is about 4%. When evaluated by modified Response Evaluation Criteria In Solid Tumors (mRECIST), the objective response rate (ORR) is 0.62 (95% CI: 0.56–0.67), the disease control rate is 0.87 (95% CI: 0.84–0.90). The incidence of adverse events (AEs) and severe AEs is 0.95 (95% CI: 0.92–0.98) and 0.39 (95% CI: 0.32–0.46), respectively. The meta-analysis revealed a resection rate of 0.87 (95% CI: 0.85–0.90). The OS and RFS of patients receiving neoadjuvant therapy followed by surgery is similar to those receiving surgery alone. CONCLUSION: Our study provides a comprehensive summary of the current evidence regarding the success rates of conversion therapy, including comparisons between different treatment regimens and associated adverse effects. Additionally, we present findings on the role and side effects of neoadjuvant therapy in resectable HCC.

To investigate the incidence of Infusion-Related Reactions (IRRs) among cancer patients receiving Immune Checkpoint Inhibitors (ICIs) and immune-based combinations.

Previous meta-analyses have assessed the benefits and safety profile of immune checkpoint inhibitors in hepatocellular carcinoma patients. This meta-analysis provides an updated synthesis by incorporating the newly published studies and previous studies with the revised data.