Natalia Picheta

Introduction: Advanced gastric and gastroesophageal junction (G/GEJ) adenocarcinomas are characterized by an aggressive course and a very poor prognosis. Due to the limited benefit of immunotherapy in patients with HER2-negative tumors, new therapeutic targets are sought. Zolbetuximab is a chimeric monoclonal antibody targeting the CLDN18.2 protein, which is overexpressed in 50–80% of gastric cancers. Materials and methods: This review is based on phase I–III clinical trials, including the pivotal SPOTLIGHT, GLOW, FAST, and ILUSTRO trials. The efficacy and safety of zolbetuximab in combination with chemotherapy were assessed as first-line treatment for adults with locally advanced or metastatic G/GEJ adenocarcinoma, HER2-negative, and highly CLDN18.2-expressing. Results: Early phase studies confirmed the clinical activity and tolerability of zolbetuximab. A Japanese phase I study demonstrated the safety and pharmacokinetic profile of zolbetuximab as monotherapy, establishing the recommended dose in subsequent studies. The phase II FAST study demonstrated that the addition of zolbetuximab to EOX chemotherapy significantly improved both PFS (HR 0.44; p=0.0005) and OS (HR 0.55; p=0.0001). The phase II ILUSTRO study demonstrated activity of zolbetuximab both as monotherapy (ORR 9%) and in combination with mFOLFOX6 (ORR 39%), supporting its advancement to phase III. These results were confirmed in two pivotal randomized phase III studies. In the SPOTLIGHT study, the addition of zolbetuximab to mFOLFOX6 reduced the risk of death by 25% (median OS 18.23 vs. 15.54 months), and in the GLOW study, the addition of zolbetuximab to CAPOX reduced the risk of death by almost 23% (median OS 14.39 vs. 12.16 months). The most common adverse events were nausea and vomiting, occurring primarily in the first treatment cycle. Conclusions: Zolbetuximab represents a significant advancement in the treatment of patients with advanced G/GEJ adenocarcinoma overexpressing CLDN18.2, addressing an important unmet clinical need. However, optimizing the stringent threshold for CLDN18.2 positivity (requiring staining in ≥75% of cells) and establishing a treatment regimen for patients with concurrent CLDN18.2 and PD-L1 expression remains a significant challenge. The review protocol was prospectively registered in the PROSPERO database (International Prospective Register of Systematic Reviews) under registration number CRD420261383764. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420261383764.

Ovarian cancer is a major cause of gynecological cancer mortality, frequently associated with platinum-resistant recurrences. Given the limited efficacy of conventional chemotherapy in this setting, alternative targeted therapeutics are needed. Mirvetuximab soravtansine (MIRV) is an antibody–drug conjugate designed to deliver the cytotoxic maytansinoid DM4 to folate receptor alpha (FRα)-overexpressing cells. This systematic review of PubMed, ClinicalKey, and SpringerLink databases (2019–2026) evaluates five publications across three clinical trials (one phase II, two phase III) encompassing 925 patients with platinum-resistant disease. Notably, the phase III MIRASOL trial demonstrated improved survival outcomes with MIRV over standard chemotherapy, extending median overall survival (16.46 vs. 12.75 months; HR 0.67) and progression-free survival (5.62 vs. 3.98 months; HR 0.65), with an objective response rate (ORR) of 42.3% versus 15.9%. Furthermore, the single-arm phase II SORAYA trial reported an ORR of 32.4% in pretreated patients, including those with prior PARP inhibitor and bevacizumab exposure. Although the preceding FORWARD I trial missed its primary endpoint in the unselected population, its high-FRα subgroup analysis revealed a clinical benefit that influenced subsequent biomarker-driven enrollment strategies. From a safety perspective, MIRV exhibited lower rates of severe neutropenia and anemia than chemotherapy, with toxicities primarily consisting of manageable, reversible ocular events. Ultimately, MIRV serves as a therapeutic option for platinum-resistant, FRα-positive ovarian cancer, offering survival advantages; however, rigorous biomarker-based screening remains necessary to optimize therapeutic outcomes.

Introduction: Anorexia nervosa (AN) is a serious eating disorder. Globally, eating disorders affect 25% of the population over the course of a lifetime and occur significantly more often in women than in men. AN is associated with high mortality, complications. The comorbidity of AN and depression highlights the need for a holistic therapeutic approach. Material and methods: This literature review was conducted on the basis of scientific articles published from 2013 to 2025. As sources were used:PubMed, Scopus, Google Scholar using the following keywords: norexia nervosa, phytotherap, cannabinoids, Angelica archangelica, Artemisia absinthium. Results: Phytotherapy may support recovery and improve quality of life in patients with AN, which remains a therapeutic challenge despite the growing treatment options. This article explores phytotherapy as an adjunct to conventional therapy, offering clinicians guidance on natural supplements. Cannabinoids can stimulate appetite and mood, Angelica archangelica may help manage anemia and cognitive impairment, while Artemisia absinthium alleviates anorexia-related symptoms caused by zinc deficiency. These approaches highlight phytotherapy’s potential role in enhancing treatment effectiveness and supporting patient outcomes. Conclusions: Phytotherapy including cannabinoids, A. archangelica, and A. absinthium offers promising support in the treatment of AN. Cannabinoids may improve appetite and mood, A. archangelica supports the treatment of anemia and cognitive impairment, while A. absinthium helps alleviate symptoms of anorexia resulting from zinc deficiency.

Background: Immunosenescence, or the age-related weakening of the immune system, leads to greater susceptibility to chronic diseases, infections, and metabolic disorders. This process involves changes in the number and function of lymphocytes, increased levels of inflammatory markers, and modifications to the gut microbiome. In recent years, increasing importance has been placed on diet—both functional, rich in bioactive ingredients, and conventional, often pesticide-laden—as a factor modulating immune system aging. Methods: This paper provides a literature review on the effects of dietary components on immunosenescence. Results from 2010 to 2025 and from clinical and experimental studies on substances such as curcumin, butyrate, vitamin D3, omega-3 fatty acids, and conventional products containing pesticides were analyzed. Their impact on the microbiome, intestinal barrier integrity, inflammatory biomarkers, and the overall immune response was considered. Results: Numerous beneficial effects of functional foods were identified. Curcumin increases microbiota diversity and lowers C-Reactive Protein (CRP) and Tumor Necrosis Factor α (TNF-α) levels. Butyrate supports remission in inflammatory bowel disease by reducing Interleukin (IL) 6 and TNF-α levels. Vitamin D3 lowers inflammatory markers and reduces calprotectin in inflammatory bowel disease. Omega-3 fatty acids modulate microbiome composition and improve lipid profiles. In contrast, conventional foods high in pesticides lead to dysbiosis, intestinal barrier damage, and increased pro-inflammatory cytokines. Conclusions: Diet is a key factor in modulating immunosenescence. Functional foods can support the microbiome and reduce chronic inflammation, while conventional foods may exacerbate the aging process of the immune system. Further clinical research is needed to develop dietary recommendations to support immunity in older adults.

Endometriosis involves oestrogen-dependent chronic inflammation and the abnormal proliferation of ectopic endometrial tissue. Conventional hormonal therapies suppress systemic oestrogen, but do not fully address local oxidative and inflammatory signalling. This review provides a mechanistic synthesis of recent molecular evidence. This evidence is on four FDA-recognized (Food and Drug Administration) medicinal plants. These are Curcuma longa, Zingiber officinale, Glycyrrhiza glabra, and Silybum marianum. The review highlights their capacity to modulate key intracellular pathways. These pathways are implicated in endometriosis. The review covers the integration of phytochemical-specific actions within NF-κB- (nuclear factor kappa-light-chain-enhancer of activated B cells), COX-2-(Cyclooxygenase-2), PI3K/Akt-(PI3K/Akt signaling pathway), Nrf2/ARE-(Nuclear factor erythroid 2–related factor 2) and ERβ-(Estrogen receptor beta) mediated networks, which jointly regulate cytokine secretion, apoptosis, angiogenesis and redox balance in endometrial lesions. Curcumin downregulates COX-2 and aromatase while activating Nrf2 signalling, shogaol from ginger suppresses prostaglandin synthesis and induces caspase-dependent apoptosis, isoliquiritigenin from liquorice inhibits HMGB1-TLR4–NF-κB (High Mobility Group Box 1, Toll-like receptor 4) activation, and silymarin from milk thistle reduces IL-6 (Interleukin-6) and miR-155 (microRNA-155) expression while enhancing antioxidant capacity. Together, these phytochemicals demonstrate pharmacodynamic complementarity with hormonal agents by targeting local inflammatory and oxidative circuits rather than systemic endocrine axes. This mechanistic framework supports the rational integration of phytotherapy into endometriosis management and identifies redox-inflammatory signalling nodes as future translational targets.

The aim of this narrative review is to present the current state of knowledge regarding the use of chimeric antigen receptor T-cell (CAR-T) therapy in solid tumors. Phase I clinical trials and side effects are discussed. The review is based on an analysis of available scientific publications, primarily phase I trials, Food and Drug Administration (FDA) reports, and PubMed, Scopus, and Google Scholar sources. It includes clinical trials and review articles from 2016 to 2025. Accumulated data indicate promising efficacy of CAR-T therapy in the treatment of certain solid tumors, particularly those of the gastrointestinal tract, although clinical responses were often limited to disease stabilization. The therapy was generally well tolerated, with a low incidence of serious adverse events. Efficacy was found to depend on factors such as the type of target antigen, the presence of conditioning therapy, and the ability to overcome the immunosuppressive tumor microenvironment. CAR-T therapy remains experimental outside of hematological malignancies, but further development, refinement of receptor design, and the search for better molecular targets may make it an effective treatment option for solid tumors as well. Current studies are in early phase and require confirmation in larger-scale randomized trials.

Lung cancer (LC) is the leading cause of cancer-related mortality worldwide, with non-small-cell lung cancer (NSCLC) representing 85–90% of cases. Despite the efficacy of PD-1/PD-L1 immune checkpoint inhibitors, primary and acquired resistance highlight the need for novel immunotherapeutic strategies. A systematic review of the literature from 2020 to 2025 was conducted according to the PICO model. Six studies were included, encompassing phase I–III clinical trials. The analysis focused on efficacy, safety, and emerging therapeutic strategies targeting TIGIT in NSCLC. TIGIT blockade enhances cytotoxic T lymphocyte and natural killer (NK) cell activity, strengthening antitumor immunity. Clinical trials, particularly with the monoclonal antibody tiragolumab combined with PD-1/PD-L1 inhibitors, show promising synergistic effects. Emerging strategies, including bispecific antibodies (e.g., TIGIT/PD-1 and TIGIT/PD-L1) and experimental cell therapies, are under investigation to further improve the antitumor response. Anti-TIGIT therapies represent a highly promising approach in NSCLC. While phase III data remain limited, biomarker-driven, well-designed trials are essential. If validated, TIGIT blockade could become a key addition to immuno-oncology treatment strategies for NSCLC.

Endometrial cancer represents one of the most common gynecological cancers in women. In recent years, there has been increasing interest in immunotherapy, including the use of pembrolizumab, particularly for the treatment of cancers with deficient mismatch repair (dMMR) and microsatellite instability-high (MSI-H). A systematic review of the literature from 2020 to 2025 was conducted according to the PICO model. Six studies were included in this review, comprising four randomized clinical trials (RCTs) and two pre-specified subgroup analyses derived from previous RCTs involving a total of 3684 patients with early-stage or advanced disease or metastatic or recurrent endometrial cancer. Interventions included the use of pembrolizumab in monotherapy and in combination with chemotherapy or lenvatinib. Pembrolizumab showed a significant improvement in progression-free survival (PFS) and overall survival (OS) in the dMMR patient groups. Therapeutic benefit was limited in the proficient mismatch repair (pMMR) groups. The incidence of side effects was high but comparable to the control group. Pembrolizumab, especially in combination therapy with lenvatinib, is a promising therapeutic option for patients with dMMR/MSI-H endometrial cancer. The results suggest a potential long-term treatment effect, although the limitations of the RCT and the variability in the therapeutic regimens require further research.

Background: Depression is a complex mental disease whose incidence increases every year; 300 million people worldwide currently suffer from it. Women are more likely to suffer from depression, twice the rate as men. It is one of the few illnesses that can lead to suicide, which makes it very dangerous – currently, 700,000 people die from suicide and it is the 4th most common cause of death in people aged 15-29. The treatment strategies for depression is a big challenge for physicians, pharmacists, scientists and classic remedies cause many side effects. Therefore, natural phytotherapy with herbs can prove to be a good solution. Phytotherapy is a popular treatment method used for centuries in Chinese medicine or Ayurveda.Materials and methods: The study conducted a comprehensive database search PubMed, ClinicalKey and MedNar covered the years 2015 - 2024 to provide the most up-to-date data. 13 randomized controlled trials and 1 meta – analysis were included in the systematic review.Results: Many plants show anti-inflammatory, antioxidant and cognitive enhancing effects, which are particularly important in depression. In the treatment of depression, plants such as Crocus sativus L. stigma, Lavandula angustifolia, Hypericum perforatum L. and Curcuma longa L. have proven to be effective. They show good effectiveness in human studies and alleviate the symptoms of depression. Herbal products can support classical pharmacotherapy, but this requires further research. Non-commercial clinical trials in the future should provide answers to research questions: at what stage of treatment of patients with MDD will the use of phytochemicals be most appropriate in terms of therapy efficacy and safety for the patient.Conclusions: Crocus sativus L. stigma, Lavandula angustifolia, Hypericum perforatum L. and Curcuma longa L. in modern medicine can help improve the well-being of patients with depression. The use of herbs as an intervention was associated with a decrease in the concentration of proinflammatory cytokines and an overall improvement in the mood of patients. Further research should be undertaken into combining both therapies in order to improve patients’ quality of life and reduce treatment costs.

Introduction and objective: Spinal muscular atrophy (SMA) is an autosomal recessive inherited disease that leads to the atrophy or weakening of skeletal muscles and changes in the brainstem. It is the second most common cause of infant mortality worldwide, with a prevalence ranging from about 1...