Annalice Gandini

Background: Hepatic arterial infusion chemotherapy (HAIC) is a valuable option in patients with liver-dominant metastatic colorectal cancer (mCRC) but remains underutilized due to limited data. Methods: We conducted a retrospective study of mCRC patients treated with HAIC in an expert center between 2010 and 2024. Patients were grouped according to treatment setting: intensification (INT; 1st/2nd line) and salvage (SALV; ≥3rd line). Results: Among 213 patients, 99 received INT-HAIC and 114 SALV-HAIC. SALV patients had worse baseline features, including more ECOG ≥2 (16% vs 4%), RAS mutation (55% vs 45%), extra-hepatic disease (45% vs 23%), liver burden >50% (65% vs 40%), and prior IV oxaliplatin progression (41% vs 16%). Oxaliplatin was the main agent used (81% INT, 78% SALV). Objective response and disease control rate were 51%/77% (INT) and 32%/60% (SALV). Median PFS, hepatic PFS and OS were 7.6, 9, and 23 months (INT) and 3.7, 5.7, and 12 months (SALV). Prior IV oxaliplatin progression was associated with poorer outcomes of oxaliplatin-HAIC in the INT-setting. Radical liver treatment followed HAIC in 28% (INT) and 7% (SALV). Grade 3–4 adverse events occurred in 42.7% and catheter complications in 26.7%. Concomitant antiangiogenic therapy was associated with a higher rate of catheter-related complications (44% vs 22%) and remained associated after adjustment for clinical covariates. Conclusions: HAIC demonstrates promising efficacy and manageable toxicity in liver-dominant mCRC when delivered in expert multidisciplinary centers, although careful patient selection and caution with concomitant antiangiogenic therapy are warranted.

At the end of the past century, the introduction of Total Mesorectal Excision (TME), preceded by either short-course radiotherapy (SCRT) or chemoradiation (CRT), established the new standard of care for locally advanced rectal cancer (LARC). Recently, significant advancements were achieved for both dMMR/MSI and pMMR/MSS LARC patients. For the 2–3% of dMMR/MSI LARCs, ablative immunotherapy emerged as a curative approach, offering the possibility of avoiding chemotherapy (CT), radiotherapy, and surgery altogether. In pMMR/MSS LARCs, the intensification of preoperative treatments with Total Neoadjuvant Treatment (TNT) afforded three outcomes: (a) a reduction of distant metastases, positively impacting on survival endpoints, (b) a significant increase of complete clinical response (cCR) rate, paving the way for non-operative management (NOM), and (c) the selective omission of radiotherapy following induction CT. The choice of the most appropriate therapeutic strategy can only be made through the shared decision-making process between physician and patient based on risk stratification and patient preferences.

Prostate cancer still represents one of the most frequent cancers and causes of death worldwide, despite the huge therapeutic advances in the last decades. The introduction into clinical practice of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) has significantly improved diagnostic capacity, allowing for the identification of lesions previously undetectable. The case we are presenting is about a 90-year-old man affected by metastatic prostate cancer and treated with hormonal therapies. At the second progression, the restaging with PSMA PET/CT pointed out a millimetric cardiac intra-atrial metastasis, on which little/scarce literature data are still available. On one hand, this finding confirms the high sensitivity of this technique, which should be preferred over traditional imaging. On the other hand, it suggests that introducing next-generation imaging into clinical practice may provide novel insights about prostate cancer metastatic spread.

Basal cell carcinoma (BCC) of the prostate is a very rare histologic variant of prostate cancer, of difficult diagnosis and uncertain prognosis. In fact, despite the frequency of prostate cancer, only 100 cases have been described in the literature, and most of the data derived from case reports. Because of the rarity of this disease, therapeutic options for these patients are scarce and no randomized trials are available. Here, we report the case of a 63-year-old man treated for a prostatic BCC (pBCC) that was challenging in terms of both diagnosis and treatment. We also performed a review of the literature to provide an overview of the therapeutic options for this rare tumor type and to better understand the role of molecular characterization in rare prostate cancer histologies. Given the rarity of pBCC worldwide, further collection of real-world data is needed to better understand the optimal diagnostic and therapeutic strategies for this rare disease.

Immune checkpoint inhibitors have significantly improved the therapeutic scenario of many different advanced malignancies and could be an effective treatment strategy in synchronous or metachronous... Plain language summary Immunotherapy is an effective treatment strategy across different cancer types and could be a valid treatment strategy in patients with multiple malignant tumors. In this sce...