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Metastatic breast cancer (MBC) is traditionally regarded as an incurable condition and patients receive treatment with a palliative intent. A small subset of patients with MBC survives beyond 10 years and these patients often have limited metastatic burden, also referred to as oligometastases [1-4]. Hellman and Weichselbaum first introduced the term oligometastatic cancer to describe patients with limited metastatic burden in 1995 [5]. They postulated that oligometastatic cancer represents an intermediate state between localized disease and widespread metastatic cancer.
Sarcomas are a heterogenous group of cancers stemming from mesenchymal tissues, and can be classified into soft-tissue and bone sarcomas [1]. These broad tumor categories are further divided based on distinct morphology and genetic changes into more than 100 subtypes as defined by the World Health Organization [1]. While most sarcomas are detected as local tumors and treated with excisional surgery and radiation, metastasis will occur in up to 50% within the first five years (depending on the site, grade and subtype) [2].
Availability of clinical practice guidelines can improve the delivery of healthcare[1]. The National Comprehensive Cancer Network (NCCN) is a non-profit alliance of 30 leading cancer centers. The NCCN publishes evidence-based, consensus-driven guidelines for cancer prevention, diagnosis, treatment and supportive care[2]. The NCCN Guidelines are recognized globally, with 11.3 million downloads in 2019 from over 180 countries, nearly half outside the U.S.[3] Additionally, NCCN Guidelines influence both private and public health coverage world-wide[4].
Breast cancer is the most frequently diagnosed cancer and the leading cause of death in women[1, 2]. Classifications for breast cancer vary significantly, ranging from histologic subtypes and growth patterns to molecular subtypes[3-6]. The World Health Organization (WHO) has classified breast cancer into at least 21 distinctive histologies based on cell morphology, growth, and architecture patterns[7]. Invasive ductal carcinoma (IDC) accounts for 75% of all breast cancers and constitutes a diagnosis by exclusion, while the remaining 25% comprise subtypes that display distinctive morphologic and prognostic profiles.
Surgical resection is the only potentially curative treatment for biliary tract cancer (BTC)[1]. Unfortunately, approximately 80% of the patients with BTC are considered to have locally advanced or metastatic disease at presentation [2, 3]. There is no widely implemented staging system nor criteria to assess resectability of perihilar (pCCA) and intrahepatic cholangiocarcinoma (iCCA) may be different across centers. The Memorial Sloan-Kettering Cancer staging system (MSKCC) made a pre-operative staging system who tries to incorporate resection but this system has not gained wide acceptance [4].
Recently, immune checkpoint inhibitors (ICIs) have been used to treat many types of cancer, including lung cancer. In addition to advanced-stage non-small cell lung cancer without driver gene mutations, combined chemotherapy and immunotherapy has been recommended in the initial treatment of advanced-stage small cell lung cancer. During treatment with ICIs, managing immune-related adverse events (irAE) can be problematic. Among these, ICI-related pneumonitis (ICI-P) is sometimes fatal, and caution is required [1].
‘Precision Medicine’ requires detailed knowledge of the molecular profile of a patient’s lymphoma. Currently, this information is typically obtained from a tissue biopsy; however, invasive biopsies have significant limitations. Tissue biopsies carry procedural risks and cannot account for spatial inter- and intra-tumor heterogeneity (1, 2) due to sampling from only one location in a single tumor lesion. ‘Liquid biopsies’ – an emerging class of methods to detect and characterize tumors through a blood draw – can potentially improve on these limitations.
Short course preoperative radiotherapy (SCPRT) reduced the 5-year local recurrence (LR) rate in patients with rectal cancer from 27% to 11%, from 11% to 5%, and from 12% to 5% in the Swedish [1], Dutch [2-4], and Medical Research Council (MRC) CR07 trial [5,6] respectively, compared to surgery alone or surgery and selective postoperative radiotherapy or chemoradiotherapy.
Ovarian cancer is the eighth leading cause of death from cancer in women worldwide, with an estimated 185,000 deaths in 2018, representing 4% of all cancer deaths in women [1]. The relapsing nature of the disease has a profound impact on patients and their quality of life (QoL).
Epidermal Growth Factor Receptor (EGFR) exon 20 insertion (ex20ins) mutations occur in ∼2-3% of all non-small cell lung cancer (NSCLC) cases, representing ∼10-12% of all cancers with documented EGFR mutation [1–4]. These mutations are the third most common EGFR mutation subtype after the common sensitizing EGFR mutations, i.e. the exon 19 deletions and exon 21 L858R mutation [4].
Coronavirus disease in 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a global pandemic1. COVID-19 was first reported in Wuhan, China, in December 2019, among a group of individuals presenting with atypical pneumonia of unknown etiology2. Published data suggests that patients with a history of or active malignancy are at increased risk of infection and developing COVID-19 related complications3,4. Data from China have shown that cancer patients infected with COVID-19 are at 3.5 times the risk of requiring mechanical ventilation or intensive care unit (ICU) admission, compared to the general population3.
BRCA1-Associated Protein 1 (BAP1), encoded by the BAP1 gene, was originally discovered in 1998 as a novel ubiquitin carboxy-terminal hydrolase, an enzyme responsible for removing ubiquitin from protein substrates.[1] BAP1 was initially shown to localize to the nucleus where its primary interaction was binding to BRCA1 and enhancing its tumor suppressive activity.[1] In subsequent years, numerous research groups have revealed that BAP1 acts independently as a tumor suppressor, utilizing its deubiquitinating activity to regulate proteins involved in DNA damage repair, cellular differentiation, chromatin modulation, cell cycle control, and cell proliferation.[2] Clinical reports have demonstrated that BAP1 is commonly lost or inactivated in a
The DNA damage response (DDR) is an integrated kinase-driven cellular network activated by both endogenous and exogenous DNA damage [1-3] and has a key role in maintaining genomic integrity. The main steps in DDR are DNA damage recognition and activation of intra-cellular signaling pathways, mainly through sequential phosphorylations, which lead to transient cell cycle arrest and activation of DNA repair pathways. The ultimate goal of the DDR is the survival of cells that have successfully repaired DNA lesions.
Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in combination with endocrine therapy are a standard of care in hormone receptor positive, HER2 negative metastatic breast cancer. Palbociclib(1-5), ribociclib(6-11) and abemaciclib(12-15) have all been approved by the US Food and Drug Administration (FDA) and the European Medicines Agency among other regulatory bodies. CDK4/6i can be used in combination with aromatase inhibitors (AI) or with fulvestrant. Multiple randomized trials(1-3, 9-12, 15) support the registration of CDK4/6i and both trial-level(16) and individual patient data(17) meta-analyses confirm the benefit from this group of drugs.
Use of immune checkpoint blockade has resulted in improved overall survival (OS) in patients with multiple solid cancers, including but not limited to, advanced melanoma, non-small cell lung cancer, urothelial cancer and renal cell carcinoma [1–4]. Not all patients experience benefit from immunotherapy (and may experience immunotherapy-associated toxicities needlessly), highlighting the need for better patient selection. Reports have suggested that programmed cell death ligand 1 (PD-L1) immunohistochemistry, T-cell infiltration levels, T-cell receptor clonality, gut microbiome composition [5], gene expression signatures and peripheral blood markers, including neutrophil/lymphocyte ratio [6], may be associated with clinical response to check.
The prognosis of patients with advanced unresectable or metastatic melanoma profoundly improved over the last decade. With the advent of the immune checkpoint and MAP-kinase pathway inhibitors on one hand, and with further improvements of radiotherapy and surgical techniques on the other hand, a rising number of advanced melanoma patients is experiencing long-term disease control [1].
The exploitation of the immune system’s anti-cancer roles and clinical actionability has opened a new chapter in cancer treatment [1]. Although breast cancer patients are now provided with a variety of therapies, still a fairly high proportion of them experiences resistance or non-responsiveness to pharmacotherapy, including immunotherapy [2–4]. In this respect, cellular immunotherapy (CI) is emerging as an intriguing field of active research both in translational and clinical settings [5,6]. Despite CI has been initially celebrated in hematologic malignancies and melanoma, several studies have been carried out and are currently ongoing in breast cancer patients.
Haplo-identical transplant activity has significantly increased recently, with highest increase seen in South East Asia/West Pacific region (48.6%), followed by Europe (29.9%) and the Americas (19.8%) [1]. The most common platforms to overcome HLA-mismatching are: 1) Anti-thymocytic globulin (ATG)-based and 2) Post-transplant cyclophosphamide-based (PTCy). The ATG-based platform is used extensively in China and involves use of G-CSF mobilised peripheral stem cells as well as G-CSF primed bone marrow.

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