OBJECTIVES
Head and neck paragangliomas (HNPGLs) are rare neuroendocrine tumors with heterogeneous behavior, making prognostic assessment challenging. Although generally indolent, a subset exhibits malignant potential, and robust prognostic determinants remain insufficiently defined. This study aimed to identify clinical and pathological factors independently associated with overall survival (OS) in patients with HNPGLs.
METHODS
We performed a retrospective Surveillance, Epidemiology, and End Results (SEER)-based cohort study (1975-2021). Demographic, clinicopathologic, and treatment variables were evaluated using Kaplan-Meier survival estimates, Cox regression models, and receiver operating characteristic (ROC)-derived cutoffs.
RESULTS
Among 280 patients, most tumors originated in the carotid body (77.5%). In univariable analyses, extra-carotid location, tumor size ≥ 34.5 mm, absence of surgery, advanced stage, and older age were associated with poorer OS. In multivariable analysis, older age, advanced stage, and lack of surgery remained independently associated with reduced OS.
CONCLUSIONS
Age at diagnosis, disease stage, and surgical resection status were independently associated with OS, with stage emerging as the strongest determinant in HNPGLs. Associations involving tumor size and extra-carotid location should be interpreted as exploratory findings.
A. Carlini, Mirea Berti, Giuseppe Lamberti et al.· Annals of Otology, Rhinology...· 0 citations
Despite recent therapeutic advances, durable disease control in small cell lung cancer (SCLC) remains challenging, particularly after relapse following platinum-based chemo-immunotherapy. Lurbinectedin, a selective inhibitor of oncogenic transcription, has emerged as a novel therapeutic agent with a distinct mechanism of action combining transcription-dependent DNA damage, modulation of the tumor microenvironment, and induction of immunogenic cell death, providing a biological rationale for combination strategies with immunotherapy and other cytotoxic agents. Initially developed as a second-line treatment, lurbinectedin demonstrated clinically meaningful activity in early studies of relapsed SCLC, leading to accelerated regulatory approval. However, subsequent studies have progressively refined its role across different treatment settings. While the phase III ATLANTIS trial did not demonstrate a survival benefit for the combination of lurbinectedin and doxorubicin, emerging data have confirmed its activity and manageable safety profile across heterogeneous patient populations. More recently, the phase III IMforte trial demonstrated improved survival outcomes with maintenance lurbinectedin plus atezolizumab following induction chemo-immunotherapy, expanding its potential role beyond the relapsed setting. Understanding which patients are most likely to benefit from lurbinectedin and how best to integrate this agent into modern treatment strategies represents a key challenge in the management of SCLC. In this review, we summarize the biological rationale, key clinical evidence, and safety profile of lurbinectedin, with particular focus on clinical and molecular predictive factors of response, patient selection and its evolving role within increasingly complex SCLC treatment algorithms.
Andrea Monte, Elisa Andrini, S. Stumpo et al.· Critical reviews in oncology...· 0 citations
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