Cancer-Therapy-Related Adverse Events

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 March 2025 | Viewed by 5592

Special Issue Editors


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Guest Editor
Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Interests: cancer immunotherapy related GI toxicity; colitis; inflammatory bowel disease; fecal microbiota transplantation

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Guest Editor
The Stanford Cancer Institute, Stanford University, Stanford, CA 94305, USA
Interests: cancer care; cancer therapy; toxicities

Special Issue Information

Dear Colleagues,

We invite you to contribute to this Special Issue on cancer-therapy-related adverse events in different organ systems. With new cancer treatment strategies emerging rapidly, we recognize the limitations and the need for expanding upon our knowledge of toxicity management. These hurdles frequently disrupt cancer treatments and compromise patients’ outcomes. There is a critical knowledge gap in current clinical practices that needs to be bridged by research data to help practitioners and patients improve their quality of care and outcome.

This Special Issue aims to cover the various organ toxicities related to cancer therapies in the current era. This Special Issue will help to facilitate optimization in the clinical management of cancer care and to reduce symptom burden due to adverse events for cancer populations.

Original research articles and reviews are welcome in this Special Issue. Research areas may include (but are not limited to) cancer-therapy-related adverse events in different organs from one or more of the following categories.

  • Toxicity topic
  • Cardiology
  • Dermatology
  • Endocrinology
  • Gastroenterology
  • Hematology
  • Hepatology
  • Nephrology
  • Neurology
  • Ophthalmology
  • Pancreatology
  • Pulmonology
  • Rheumatology

Dr. Yinghong Wang
Dr. Pauline Funchain
Guest Editors

Manuscript Submission Information

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Keywords

  • cancer
  • cancer therapy
  • toxicities
  • adverse events

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Published Papers (4 papers)

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Research

14 pages, 2641 KiB  
Article
Neurocognitive Adverse Events Related to Lorlatinib in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis
by Jonathan N. Priantti, Maysa Vilbert, Francisco Cezar Aquino de Moraes, Thiago Madeira, Evair Moisés de Lima Santiago, Natasha B. Leighl, Ludimila Cavalcante and Nagla F. Abdel Karim
Cancers 2024, 16(14), 2611; https://doi.org/10.3390/cancers16142611 - 22 Jul 2024
Cited by 1 | Viewed by 1128
Abstract
Lorlatinib has been FDA-approved as a systemic therapy for ALK/ROS1-positive non-small cell lung cancer (NSCLC) patients. However, it has been associated with an increased frequency of neurocognitive adverse events (NAEs). Therefore, we conducted a systematic review and meta-analysis to assess the NAEs related [...] Read more.
Lorlatinib has been FDA-approved as a systemic therapy for ALK/ROS1-positive non-small cell lung cancer (NSCLC) patients. However, it has been associated with an increased frequency of neurocognitive adverse events (NAEs). Therefore, we conducted a systematic review and meta-analysis to assess the NAEs related to lorlatinib therapy in NSCLC patients. PubMed, Scopus, the Cochrane Library, and prominent conference proceedings were searched for eligible studies of lorlatinib in NSCLC patients. NAEs included cognitive, mood, speech, and psychotic effects. A total of 1147 patients from 12 studies were included; 62% had brain metastases. A pooled analysis of NAEs showed frequencies of cognitive effects of 14.57% (95% CI, 8.37 to 24.14, I2 = 84%), mood effects of 11.17% (95% CI, 5.93 to 20.07, I2 = 84%), speech effects of 7.24% (95% CI, 3.39 to 15.20, I2 = 72%), and psychotic effects of 4.97% (95% CI, 3.27 to 7.49, I2 = 21%). Clinical trials reported a significantly higher frequency of mood effects than was indicated by real-world data. These results highlight the importance of educating patients and healthcare professionals about lorlatinib-related NAEs for early detection and management to improve NSCLC patients’ quality of life. Full article
(This article belongs to the Special Issue Cancer-Therapy-Related Adverse Events)
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12 pages, 1495 KiB  
Article
Outcomes and Adverse Events in Patients with Cancer after Diagnosis of Immunotherapy-Associated Diabetes Mellitus: A Retrospective Cohort Study
by Eva Duvalyan, Sam Brondfield, Robert J. Rushakoff, Mark S. Anderson and Zoe Quandt
Cancers 2024, 16(9), 1663; https://doi.org/10.3390/cancers16091663 - 25 Apr 2024
Viewed by 1018
Abstract
Immune checkpoint inhibitor (CPI)-induced diabetes mellitus (CPI-DM) is a rare immune-related adverse event (irAE). Patients and providers fear that continuing CPIs puts patients at risk for additional irAEs and thus may discontinue therapy. Currently, there are little data to inform this decision. Therefore, [...] Read more.
Immune checkpoint inhibitor (CPI)-induced diabetes mellitus (CPI-DM) is a rare immune-related adverse event (irAE). Patients and providers fear that continuing CPIs puts patients at risk for additional irAEs and thus may discontinue therapy. Currently, there are little data to inform this decision. Therefore, this study aims to elucidate whether discontinuing CPIs after diagnosis of CPI-DM impacts the development of future irAEs and cancer outcomes such as progression and death. Patients who developed CPI-DM during cancer treatment at UCSF from 1 July 2015 to 5 July 2023 were analyzed for cancer outcomes and irAE development. Fisher’s exact tests, Student t-tests, Kaplan–Meier methods, and Cox regression were used as appropriate. Of the 43 patients with CPI-DM, 20 (47%) resumed CPIs within 90 days of the irAE, 4 (9%) patients restarted after 90 days, and 19 (44%) patients never restarted. Subsequent irAEs were diagnosed in 9 of 24 (38%) who resumed CPIs and 3 of 19 (16%) who discontinued CPIs (p = 0.17). There was no significant difference in death (p = 0.74) or cancer progression (p = 0.55) between these two groups. While our single-institution study did not show worse cancer outcomes after discontinuing CPIs, many variables can impact outcomes, which our study was not adequately powered to evaluate. A nuanced approach is needed to decide whether to continue CPI treatment after a severe irAE like CPI-DM. Full article
(This article belongs to the Special Issue Cancer-Therapy-Related Adverse Events)
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20 pages, 4643 KiB  
Article
Comprehensive 3DCRT Hypofractionated Radiotherapy Schedule for Localized Prostate Adenocarcinoma in the Era of IMRT: Dosimetric and Endoscopic Analysis
by Andromachi Kougioumtzopoulou, Nick Syrigos, Anna Zygogianni, Ioannis Georgakopoulos, Kalliopi Platoni, George Patatoukas, Kimon Tzannis, Aristotelis Bamias, Nikolaos Kelekis and Vasileios Kouloulias
Cancers 2024, 16(6), 1192; https://doi.org/10.3390/cancers16061192 - 18 Mar 2024
Cited by 1 | Viewed by 1095
Abstract
Background: Moderate hypofractionated radiotherapy (MHRT) has emerged as the preferred treatment modality for localized prostate cancer based on randomized controlled studies regarding efficacy and toxicity using contemporary radiotherapy techniques. In the setting of MHRT, available data on dosimetric parameters and late rectal toxicity [...] Read more.
Background: Moderate hypofractionated radiotherapy (MHRT) has emerged as the preferred treatment modality for localized prostate cancer based on randomized controlled studies regarding efficacy and toxicity using contemporary radiotherapy techniques. In the setting of MHRT, available data on dosimetric parameters and late rectal toxicity are limited. Aim: To present the effects of MHRT on late rectal toxicity while conducting an extensive dosimetric analysis in conjunction with rectoscopy results. Methods: This is a prospective study including patients with intermediate-risk prostate adenocarcinoma. All patients were treated with MHRT 44 Gy in 16 fractions to the seminal vesicles and to the prostate, followed by a sequential boost to the prostate alone of 16.5 Gy in 6 fractions delivered with three-dimensional conformal radiation therapy (3DCRT). Acute and late toxicity were assessed. Endoscopy was performed at baseline, every 3 months post-therapy for the first year, and every 6 months for the year after. The Vienna Rectoscopy Score (VRS) was used to assess rectal mucosal injury related to radiotherapy. Dosimetric analysis for the rectum, rectal wall, and its subsegments (upper, mid, and low 1/3) was performed. Results: Between September 2015 and December 2019, 20 patients enrolled. Grade 1 late gastrointestinal toxicity occurred in 10% of the patients, whereas 5% had a grade ≥2. Twelve months post radiotherapy: 4 (20%) patients had VRS 1; 2 (10%) patients had VRS 2; 1(5%) patient had VRS 3. 24 months post radiotherapy, VRS 1 was observed in 4 patients (20%) and VRS 2 in 3 (15%) patients. The dosimetric analysis demonstrated noticeable variations between the rectum, rectal wall, and rectal wall subsegments. The dosimetric analysis of the rectum, rectal wall, and its mid and low segments with respect to rectoscopy findings showed that the higher dose endpoints V52.17Gy and V56.52Gy are associated with rectal mucosal injury. Conclusions: A thorough delineation of the rectal wall and its subsegments, together with the dosimetric analysis of these structures, may reduce late rectal toxicity. Dosimetric parameters such as V52.17Gy and V56.52Gy were identified to have a significant impact on rectal mucosal injury; additional dose endpoint validation and its relation to late GI toxicity is needed. Full article
(This article belongs to the Special Issue Cancer-Therapy-Related Adverse Events)
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14 pages, 701 KiB  
Article
Practice Changes in Checkpoint Inhibitor-Induced Immune-Related Adverse Event Management at a Tertiary Care Center
by Malek Shatila, Farzin Eshaghi, Austin R. Thomas, Andrew G. Kuang, Jay S. Shah, Brandon Zhao, Sidra Naz, Mianen Sun, Sarah Fayle, Jeff Jin, Ala Abudayyeh, Ajay Sheshadri, Nicolas L. Palaskas, Maria C. Franco-Vega, Maria S. Gaeta, Anusha S. Thomas, Hao Chi Zhang and Yinghong Wang
Cancers 2024, 16(2), 369; https://doi.org/10.3390/cancers16020369 - 15 Jan 2024
Viewed by 1351
Abstract
Understanding of immune-related adverse events (irAEs) has evolved rapidly, and management guidelines are continually updated. We explored temporal changes in checkpoint inhibitor-induced irAE management at a tertiary cancer care center to identify areas for improvement. We conducted a single-center retrospective study of patients [...] Read more.
Understanding of immune-related adverse events (irAEs) has evolved rapidly, and management guidelines are continually updated. We explored temporal changes in checkpoint inhibitor-induced irAE management at a tertiary cancer care center to identify areas for improvement. We conducted a single-center retrospective study of patients who developed a gastrointestinal, pulmonary, renal, or cardiac irAE between July and 1 October in 2019 or 2021. We collected patient demographic and clinical information up to 1 year after toxicity. Endoscopic evaluation and specialty follow-up after discharge for patients with gastrointestinal irAEs declined between the 2019 and 2021 periods. Symptom duration and steroid taper attempts also declined. For pulmonary irAEs, rates of specialty consultation, hospital admission and readmission, and mortality improved in 2021 compared with 2019. Follow-up rates after hospital discharge were consistently low (<50%) in both periods. For cardiac irAEs, consultation with a cardiologist was frequent and prompt in both periods. Outpatient treatment and earlier specialty consultation improved outcomes with gastrointestinal irAEs. Our study exploring irAE practice changes over time identified areas to improve management; specifically, timely specialty consultation was associated with better outcomes for gastrointestinal irAEs. These findings can help improve the quality of management algorithms at our institution and may inform policies in other institutions. Full article
(This article belongs to the Special Issue Cancer-Therapy-Related Adverse Events)
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