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| 1 | Management of oligometastatic non-small cell lung cancer patients:Current controversies and future directions显示文摘Oligometastatic non-small cell lung cancer(NSCLC)describes an intermediate stage of NSCLC between localized and widely-disseminated disease.This stage of NSCLC is characterized by a limited number of metastases and a more indolent tumor biology.Currently,the management of oligometastatic NSCLC involves radical treatment(radiotherapy or surgery)that targets the metastatic lesions and the primary tumor to achieve disease control.This approach offers the potential to achieve prolonged survival in patients who,in the past,would have only received palliative measures.The optimal therapeutic strategies for the different scenarios of oligometastatic disease(intracranial vs extracranial disease,synchronous vs metachronous)remain undefined.Given the lack of head-to-head studies comparing radiotherapy to surgery in these patients,the decision to apply surgery or radiotherapy(with or without systemic treatment)must be based on prognostic factors that allow us to classify patients.This classification will allow us to select the most appropriate therapeutic strategy on an individualized basis.In the future,the molecular or microRNA profiles will likely improve the treatment selection process.The objective of the present article is to review the most relevant scientific evidence on the management of patients with oligometastatic NSCLC,focusing on the role of radiotherapy and surgery.We also discuss areas of controversy and future directions. | Felipe Counago Javier Luna Luis Leonardo Guerrero Blanca Vaquero María Cecilia Guillén-Sacoto Teresa González-Merino Begona Taboada Verónica Díaz Belén Rubio-Viqueira Ana Aurora Díaz-Gavela Francisco JoséMarcos Elia del Cerro | 2019 | World Journal of Clinical Oncology2019，10，10： | 5 |
| 2 | New horizons for uncommon mutations in non-small cell lung cancer: BRAF, KRAS, RET, MET, NTRK, HER2显示文摘The 2004 discovery of EGFR mutations,followed by ALK rearrangements,ushered in a targeted therapy era for advanced non-small cell lung cancer(NSCLC).Tyrosine kinase inhibitors targeting gene alterations have substantially improved survival and quality of life for patients with NSCLC.In the last decade,rearrangements of the ROS1 oncogene have been incorporated into healthcare practice that are applicable to another small subgroup of patients who benefit from similar targeted strategies.Recent genome studies of lung adenocarcinoma have identified other possible therapeutic targets,including RET,NTRK fusions,c-MET alterations,and activating mutations in KRAS,BRAF,and HER2,all with frequencies greater than 1%.Lung cancers harbouring these genome changes can potentially be treated with agents approved for other indications or under clinical development.This review updates the therapeutic arsenal that especially targets those genes. | Maria Eugenia Olmedo Raquel Cervera Luis Cabezon-Gutierrez Yolanda Lage Elena Corral de la Fuente Ana Gomez Rueda1,Xabier Mielgo-Rubio Juan Carlos Trujillo Felipe Counago | 2022 | World Journal of Clinical Oncology2022，13，4： | 3 |
| 3 | Clinical features and radiological manifestations of COVID-19 disease显示文摘Coronavirus disease 2019(COVID-19)was discovered after unusual cases of severe pneumonia emerged in December 2019 in Wuhan Province(China).Coronavirus is a family of single-stranded RNA viruses.Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is transmitted from person to person.Although asymptomatic individuals can transmit the virus,symptomatic patients are more contagious.The incubation period ranges from 3-7 d and symptoms are mainly respiratory,including pneumonia or pulmonary embolism in severe cases.Elevated serum levels of interleukins(IL)-2,IL-6,IL-7 indicate the presence of cytokine release syndrome,which is associated with disease severity.The disease has three main phases:Viral infection,pulmonary involvement,and hyperinflammation.To date,no treatment has proved to be safe or effective.Chest X-ray and computed tomography(CT)are the primary imaging tests for diagnosis of SARS-CoV-2 pneumonia,follow-up,and detection of complications.The main radiological findings are ground-glass opacification and areas of consolidation.The long-term clinical course is unknown,although some patients may develop pulmonary fibrosis.Positron emission tomography-computed tomography(PETCT)is useful to assess pulmonary involvement,to define the affected areas,and to assess treatment response.The pathophysiology and clinical course of COVID-19 infection remain poorly understood.However,patterns detected on CT and PETCT may help to diagnose and guide treatment.In this mini review,we analyze the clinical manifestations and radiological findings of COVID-19 infection. | Pedro Landete Carlos Andres Quezada Loaiza Beatriz Aldave-Orzaiz Susana Hernandez Muniz Antonio Maldonado Enrique Zamora Allan Charles Sam Cerna Elia del Cerro Raquel Cano Alonso Felipe Counago | 2020 | World Journal of Radiology2020，12，11： | 2 |
| 4 | GOECP/SEOR radiotheraphy guidelines for non-small-cell lung cancer显示文摘Non-small cell lung cancer(NSCLC) is a heterogeneous disease accounting for approximately 85% of all lung cancers. Only 17% of patients are diagnosed at an early stage. Treatment is multidisciplinary and radiotherapy plays a key role in all stages of the disease. More than 50% of patients with NSCLC are treated with radiotherapy(curative-intent or palliative). Technological advancesincluding highly conformal radiotherapy techniques, new immobilization and respiratory control systems, and precision image verification systems-allow clinicians to individualize treatment to maximize tumor control while minimizing treatment-related toxicity. Novel therapeutic regimens such as moderate hypofractionation and advanced techniques such as stereotactic body radiotherapy(SBRT) have reduced the number of radiotherapy sessions. The integration of SBRT into routine clinical practice has radically altered treatment of early-stage disease. SBRT also plays an increasingly important role in oligometastatic disease. The aim of the present guidelines is to review the role of radiotherapy in the treatment of localized, locally-advanced, and metastatic NSCLC. We review the main radiotherapy techniques and clarify the role of radiotherapy in routine clinical practice. These guidelines are based on the best available evidence. The level and grade of evidence supporting each recommendation is provided. | Nuria Rodriguez De Dios Arturo Navarro-Martin Cristina Cigarral Rodolfo Chicas-Sett Rafael Garcia Virginia Garcia Jose Antonio Gonzalez Susana Gonzalo Mauricio Murcia-Mejia Rogelio Robaina Amalia Sotoca Carmen Vallejo German Valtuena Felipe Counago | 2022 | World Journal of Clinical Oncology2022，13，4： | 2 |
| 5 | Is there a place for optimizing thoracic radiotherapy in limited-stage small cell lung cancer after twenty years?显示文摘Thoracic radiotherapy(TRT)is one of the main treatments in limited-stage small cell lung cancer(LS-SCLC).Hyperfractionated TRT(45 Gy,1.5 Gy twice daily)has been the standard of care(SOC)since Turrisi and colleagues published the results of their clinical trial in 1999.Two meta-analyses have demonstrated the benefits of concurrent chemotherapy and TRT in terms of intrathoracic disease control at 2 years and 3-year overall survival(OS).The phase 2 trial by Grønberg et al(2016)comparing once-daily hypofractionated TRT to twice-daily hyperfractionated TRT in LS-SCLC found similar outcomes in both groups in terms of response rate,progression-free survival(PFS),grade 3-4 adverse effects,and OS.The CONVERT trial,published in 2017,failed to demonstrate the superiority of the conventional scheme(once-daily TRT)vs twice-daily radiotherapy,despite the application of modern radiotherapy techniques and a quality assurance programme,thus confirming the twice-daily hyperfractionated regimen as the SOC.At the 2020 American Society of Clinical Oncology(ASCO)annual meeting,Grønberg et al reported preliminary findings from a phase 2 trial comparing two different TRT dose regimens(45 Gy vs 60 Gy),both administered twice daily.Those data demonstrated a marked improvement in 2-year survival rates in the high dose arm(70.2%vs 46.1%,P=0.002),despite similar objective response rates and PFS outcomes.Those findings provide a new treatment alternative to consider:Hyperfractionated,high-dose TRT.However,the results of that trial will need to be validated in a large,randomized phase 3 study.The results of the phase 2 CALCG 30610 trial will help to clarify the optimal dose and regimen.The potential role of upfront immunotherapy,which early data suggest may improve OS,also needs to be determined. | Jose Maximo Barros Manglio Miguel Rizzo Jorge Oscar Chiozza Felipe Counago | 2021 | World Journal of Clinical Oncology2021，12，1： | 2 |
| 6 | Update on the treatment of metastatic renal cell carcinoma显示文摘Metastatic renal cell cancer(mRCC)management has undergone a paradigm shift in recent decades.The first revolution came with the emergence of vascular endothelial growth factor inhibitors;there was a second wave with the unprecedented success of checkpoint inhibitors,and then the latest approach,which is becoming the new care standard in mRCC,of combining these two strategies in different ways.Updated results of Checkmate-214 after 42 mo of follow-up were consistent with previously published results showing the superiority of nivolumab/ipilimumab over sunitinib in progression free survival(PFS),overall survival(OS),and objective response rate(ORR)in intermediate and high-risk patients.However,several studies presented at the American Society of Clinical Oncology 2020 suggested that the best place,and so far,the only one for nivolumab/ipilimumab is the frontline setting.The update on Keynote-426 after 23 mo of follow-up showed no superiority of pembrolizumab/axitinib over sunitinib in favorable-risk mRCC,suggesting that it should no longer be the first line of choice in low-risk patients.Finally,the phase III Checkmate 9ER trial results revealed the superiority of nivolumab/cabozantinib vs sunitinib in PFS,OS,and ORR,providing a new first-line option among all International Metastatic RCC Database Consortium risk patients.Some phase II clinical trials also presented this year showed promising results with new combination therapies such as nivolumab/sitravatinib,cabozantinib/atezolizumab,and lenvatinib/pembrolizumab,providing promising grounds upon which to start phase III studies.In addition,other works are using novel therapeutic agents with different mechanisms of action,including telaglenastat(a glutaminase inhibitor),entinostat[an inhibitor of histone deacetylases(HDACs)],and olaparib and talazoparib,poly(ADP-ribose)polymerase inhibitors widely used in other tumors.However,some questions regarding mRCC management still need to be addressed,such as head-to-head comparisons between the current options,treatment sequencing,non-clear cell mRCC,and the role of biomarkers to ascertain the best treatment choice. | Rafael Antonio Medina Lopez Ines Rivero Belenchon Javier Mazuecos-Quiros Carmen Belen Congregado-Ruiz Felipe Counago | 2022 | World Journal of Clinical Oncology2022，13，1： | 1 |
| 7 | Neoadjuvant treatment in non-small cell lung cancer:New perspectives with the incorporation of immunotherapy显示文摘The aim of neoadjuvant treatment in non-small cell lung cancer(NSCLC)is to eliminate micrometastatic disease to facilitate surgical resection.Neoadjuvant chemotherapy(ChT)in localised NSCLC has numerous advantages over other therapeutic modalities and is considered standard treatment in resectable disease.Treatment with immune checkpoint inhibitors(ICI)improves long-term survival in advanced disease and has a better toxicity profile than conventional therapies.These immunotherapy agents(anti-PD1/PD-L1),administered with or without ChT,are currently being evaluated in the preoperative setting,with initial results showing better pathological response rates and more long-term benefits.Importantly,these drugs do not appear to increase the rate of severe adverse effects and/or postoperative complications.However,several questions still need to be resolved,including the identification of predictive biomarkers;comparative studies of immunotherapy alone vs combined treatment with ChT and/or radiotherapy;the optimal duration of treatment;the timing of surgery;the need for adjuvant treatment;appropriate radiologic evaluation and mediastinal staging;and the correlation between pathological response and survival outcomes.Here we review the current evidence for immunotherapy from a multidisciplinary perspective and discuss current and future controversies. | Carlos Aguado Luis Chara Mónica Antonanzas Jose Maria Matilla Gonzalez Unai Jiménez Raul Hernanz Xabier Mielgo-Rubio Juan Carlos Trujillo-Reyes Felipe Counago | 2022 | World Journal of Clinical Oncology2022，13，5： | 1 |
| 8 | Nonmetastatic castration-resistant prostate cancer: Novel agents to treat a lethal disease显示文摘Nonmetastatic castration-resistant prostate cancer(nmCRPC)-defined as prostate-specific antigen(PSA)>2 ng/mL,testosterone castration levels<1.7 nm/L,and the absence of metastatic lesions on conventional imaging(computed tomography or bone scan)-has been defined as a lethal disease by the Prostate Cancer Work Group.One-third of patients with prostate cancer who receive androgen deprivation therapy for biochemical recurrence after local treatment will develop CRPC,with death occurring an average of 2.5 years after diagnosis of castration resistance.Most patients diagnosed with nmCRPC are asymptomatic or minimally symptomatic at diagnosis due to local treatment.In patients with short PSA doubling times(<10 mo)and high baseline PSA levels,there is a high risk of bone metastases followed by prostate cancer-related mortality.These patients also present significant morbidity that negatively impacts quality of life(QoL).Recently,the results of three randomized trials(PROSPER,SPARTAN,and ARAMIS)were published.Those trials evaluated the efficacy of three different androgen receptor inhibitors-enzalutamide,apalutamide,and darolutamide-in patients with nmCRPC.In all three trials,the study drugs improved both metastasis-free survival and overall survival compared to placebo,plus on-going androgen deprivation therapy without a negative impact on QoL.In patients with nmCRPC,the most important clinical objective is early detection and treatment to maintain a low tumor burden and to prolong the symptom-free interval.For patients with nmCRPC,these novel drugs offer new hope for better QoL and survival outcomes. | Ivan Henriquez Daniel Spratt Alfonso Gomez-Iturriaga Oscar Abuchaibe Felipe Counago | 2021 | World Journal of Clinical Oncology2021，12，1： | 0 |
| 9 | COVID-19 pneumonia:A review of typical radiological characteristics显示文摘Coronavirus disease 2019(COVID-19)was first discovered after unusual cases of severe pneumonia emerged by the end of 2019 in Wuhan(China)and was declared a global public health emergency by the World Health Organization in January 2020.The new pathogen responsible for the infection,genetically similar to the beta-coronavirus family,is known as severe acute respiratory syndrome coronavirus-2(SARS-CoV-2),and the current gold standard diagnostic tool for its detection in respiratory samples is the reverse transcription-polymerase chain reaction test.Imaging findings on COVID-19 have been widely described in studies published throughout last year,2020.In general,ground-glass opacities and consolidations,with a bilateral and peripheral distribution,are the most typical patterns found in COVID-19 pneumonia.Even though much of the literature focuses on chest computed tomography(CT)and X-ray imaging and their findings,other imaging modalities have also been useful in the assessment of COVID-19 patients.Lung ultrasonography is an emerging technique with a high sensitivity,and thus useful in the initial evaluation of SARS-CoV-2 infection.In addition,combined positron emission tomography-CT enables the identification of affected areas and follow-up treatment responses.This review intends to clarify the role of the imaging modalities available and identify the most common radiological manifestations of COVID-19. | Maria Churruca Elisa Martinez-Besteiro Felipe Counago Pedro Landete | 2021 | World Journal of Radiology2021，13，10： | 0 |
| 10 | Single-fraction stereotactic ablative body radiation therapy for primary and metastasic lung tumor:A new paradigm?显示文摘Stereotactic ablative body radiotherapy(SABR)is an effective technique comparable to surgery in terms of local control and efficacy in early stages of non-small cell lung cancer(NSCLC)and pulmonary metastasis.Several fractionation schemes have proven to be safe and effective,including the single fraction(SF)scheme.SF is an option costeffectiveness,more convenience and comfortable for the patient and flexible in terms of its management combined with systemic treatments.The outbreak of the severe acute respiratory syndrome coronavirus 2 pandemic has driven this not new but underutilized paradigm,recommending this option to minimize patients’visits to hospital.SF SABR already has a long experience,strong evidence and sufficient maturity to reliably evaluate outcomes in peripheral primary NSCLC and there are promising outcomes in pulmonary metastases,making it a valid treatment option;although its use in central locations,synchronous and recurrencies tumors requires more prospective safety and efficacy studies.The SABR radiobiology study,together with the combination with systemic therapies,(targeted therapies and immunotherapy)is a direction of research in both advanced disease and early stages whose future includes SF. | Castalia Fernandez Arturo Navarro-Martin Andrea Bobo Joaquin Cabrera-Rodriguez Patricia Calvo Rodolfo Chicas-Sett Javier Luna Nuria Rodriguez de Dios Felipe Counago | 2022 | World Journal of Clinical Oncology2022，13，2： | 0 |
| 11 | Tsunami of immunotherapy reaches mesothelioma显示文摘Malignant pleural mesothelioma(MPM) is the most common type of malignant mesothelioma. It is a rare tumor linked to asbestos exposure and is associated with a poor prognosis. Until very recently, patients with advanced or unresectable disease had limited treatment options, primarily based on doublet chemotherapy with cisplatin and pemetrexed. In 2020 and 2021, after more than a decade with no major advances or new drugs, two phase Ⅲ clinical trials published results positioning immunotherapy as a promising option for the first-and second-line treatment of MPM. Immunotherapy has revolutionized the treatment of many cancers and is also showing encouraging results in malignant mesothelioma. Both immune checkpoint inhibition and dual cytotoxic T-lymphocyte–associated antigen 4 and programmed death-ligand 1 pathway blockade resulted in significantly improved overall survival in randomized phase Ⅲ trials. In the Check Mate 743 trial, first-line therapy with nivolumab plus ipilimumab outperformed standard chemotherapy, while in the CONFIRM trial, nivolumab outperformed placebo in patients previously treated with chemotherapy. These two trials represent a major milestone in the treatment of MPM and are set to position immunotherapy as a viable alternative for treatment-naive patients and patients with progressive disease after chemotherapy. | Xabier Mielgo-Rubio Ana Cardena Gutierrez Veronica Sotelo Pena Maria Virginia Sanchez Becerra Andrea Maria Gonzalez Lopez Adriana Rosero Juan Carlos Trujillo-Reyes Felipe Counago | 2022 | World Journal of Clinical Oncology2022，13，4： | 0 |
| 12 | Lung cancer screening, what has changed after the latest evidence?显示文摘Lung cancer(LC)is still one of the most frequent cancers with a high related mortality.Their prognosis is directly proportional to the stage at the time of diagnosis.Seventy percent are currently diagnosed in advanced or locally advanced stage(higher than stage III),making a cure unlikely for the majority of patients.Developments in LC treatment are significant however they do not seem to be enough to reverse the current situation,at least,in a short period of time.Despite recent advances in treatment,primary prevention and early diagnosis appear to be the key to reduce the incidence and mortality of this disease.Many countries have developed LC screening programs based on the results of clinical trials published in recent years.The aim of this paper is to review the latest results of the NEderlands Leuvens Longkanker Screenings Onderzoek and compare them with the findings of the National Lung Screening Trial.We address the question whether it is necessary to continue discussing the evidence regarding LC screening.In both trials,there is a clear impact on LC mortality but,with a modest reduction in over all mortality.Undoubtedly,the benefit of screening can be expected to grow as low-dose computed tomographys are performed over longer periods of time. | Juan Carlos Trujillo-Reyes Luis Seijo Elisabeth Martinez-Tellez Felipe Counago | 2020 | World Journal of Radiology2020，12，7： | 0 |
| 13 | Scientific evidence in the COVID-19 treatment: A comprehensive review显示文摘In December 2019,cases of unknown origin pneumonia appeared in Wuhan,China;the causal agent of this pneumonia was a new virus of the coronaviridae family called severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).According to the clinical severity,symptoms and response to the different treatments,the evolution of the disease is divided in three phases.We analysed the most used treatments for coronavirus disease 2019 and the phase in which they are supposed to be effective.In the viral phase,remdesivir has demonstrated reduction in recovery time but no mortality reduction.Other drugs proposed for viral phase such as convalescent plasma and lopinavir/ritonavir did not demonstrate to be effective.In the inflammatory phase,corticosteroids demonstrated reduction of 28-d mortality in patients who needed oxygen,establishing that a corticosteroid regimen should be part of the standard treatment of critically ill patients.There are other immunosuppressive and immunomodulatory treatments such as anakinra,sarilumab,tocilizumab,colchicine or baricitinib that are being studied.Other treatments that were proposed at the beginning,like hydroxichloroquine or azithromycin,demonstrated no efficacy and increased mortality when combined. | Gorane Iturricastillo Elena Avalos Perez-Urria Felipe Counago Pedro Landete | 2021 | World Journal of Virology2021，10，5： | 0 |
| 14 | Are all prostate cancer patients 'fit' for salvage radiotherapy?显示文摘The indication for salvage radiotherapy(RT)(SRT)in patients with biochemically-recurrent prostate cancer after surgery is based on prostate-specific antigen(PSA)levels at the time of biochemical recurrence.Although there are clear criteria(pT3-pT4 disease and/or positive margins)for the use of adjuvant radiotherapy,no specific clinical or tumour-related criteria have yet been defined for SRT.In retrospective series,5-year biochemical progression-free survival(PFS)ranges from 35%-85%,depending on the PSA level at the start of RT.Two phase 3 trials have compared SRT with and without androgen deprivation therapy(ADT),finding that combined treatment(SRT+ADT)improves both PFS and overall survival.Similar to adjuvant RT,the indication for ADT is based on tumour-related factors such as PSA levels,tumour stage,and surgical margins.The number of patients referred to radiation oncology departments for SRT continues to rise.In the present article,we define the clinical,therapeutic,and tumour-related factors that we believe should be evaluated before prescribing SRT.In addition,we propose a decision algorithm to determine whether the patient is fit for SRT.This algorithm will help to identify patients in whom radiotherapy is likely to improve survival without significantly worsening quality of life. | Carmen González-San Segundo Alfonso Gómez-Iturriaga Felipe Counago | 2020 | World Journal of Clinical Oncology2020，11，1： | 0 |
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