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Purpose of Review: In this review article we describe the cardiovascular adverse events associated with BRAF and MEK inhibitors as well as their pathophysiologic mechanisms and provide up to date guidance for risk stratified surveillance of patients on treatment and the optimal management of emergent cardiotoxicities., Recent Findings: Combination BRAF/MEK inhibition has become an established standard treatment option for patients with a wide variety of BRAF mutant haematological and solid organ cancers, its use is most commonly associated with stage three and metastatic melanoma. The introduction of these targeted drugs has significantly improved the prognosis of previously treatment resistant cancers. It is increasingly recognised that these drugs have a number of cardiovascular toxicities including left ventricular systolic dysfunction, hypertension and QTc interval prolongation. Whilst cardiotoxicity is largely reversible and manageable with medical therapy, it does limit the effective use of these highly active agents., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Cardiotoxicity is a common and under-reported side effect of tyrosine-kinase inhibitors (TKI) and immune checkpoint inhibitors (ICI). Baseline risk factors may help in risk-stratifying patients at increased risk of cardiotoxicity. This real-world study investigated the effects of baseline risk factors in cardiotoxicity on patients with non-small-cell lung cancer (NSCLC) treated with TKIs and ICIs., Methods: This is a retrospective study carried out at The Royal Marsden Hospital, UK. Newly diagnosed patients with localized or metastatic NSCLC who received anticancer therapy with TKIs and/or ICIs were eligible. Patients who received only chemotherapy were excluded. Patients were followed up from the time of diagnosis until death or discharge. The relationship between cardiotoxicity and risk factors were tested by logistic regression., Results: Of 88/451 (19.5%) patients developed cardiotoxicity. Risk factors hypothesized to have a causal relationship with anticancer treatment-induced cardiotoxicity were analyzed. Cardiotoxicity risk was increased with prior diabetes mellitus (OR = 1.93, 95% CI, 1.04-3.61, P = .038), history of smoking (OR = 1.91, 95% CI, 1.13-3.22, P = .016) and presence of baseline cardiovascular disease (OR = 2.03, 95% CI, 1.13-3.64, P = .018). The risk of developing cardiotoxicity increased in patients for smokers with diabetes mellitus (OR = 3.03, 95% CI, 1.40-6.55, P < .01) and for smokers with previous cardiovascular disease (OR = 1.99, 95% CI, 1.03-3.84, P = .041)., Conclusion: Diabetes mellitus, smoking and baseline cardiovascular disease may synergistically contribute to cardiotoxicity when a patient is exposed to potentially cardiotoxic anticancer agents. Risk stratification at baseline may improve cardio-oncology care., Competing Interests: Disclosure Hasan Kobat, Praveena Idaikkadar and Michael Davidson declared no conflict of interest. Islam Elkonaissi is licensed clinical pharmacist in the UK and UAE, received honoraria from Roche, AZ, BMS, Novartis, J&J, MSD for educational events/presentations and received support from Roche, AZ, J&J for attending meetings and/or travel. Emma Foreman is licenced clinical pharmacist in the UK and received honoraria from AZ, BMS and Ipsen for speaking at educational events. Mary O'Brien declares royalties or licenses: Fast Fact of non–small-cell lung cancer, edition 1 and 2. Sparger publisher, consulting fees: advisory boards for MSD, Amgen, Puma, Pierre Fabra, Iteos, AstraZeneca, Sanofi, received payment/honoraria for the lecture to Chinese oncologist sponsored by Lilly and by Roche, received support for attending ASCO 2022 supported by MSD and ESMO 2022 and she is PHarmamar Lurbinectinib IDMC for the Lagoon trial. Shereen Nabhani-Gebara received EU H2020 grant for AI in Oncology, received speaking fee from Pfizer in September 2021, received support for attending meetings and/or travel from British Oncology Pharmacy Association, and have a leadership or fiduciary role at British Oncology Pharmacy Association., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Malignant bowel obstruction is a common cause of morbidity and mortality in patients with advanced ovarian cancer. Many patients aren't suitable for, or decline, surgical decompression. The outcomes for this frail group of patients are not well characterized., Aim: To evaluate survival outcomes of ovarian cancer patients who undergo non-surgical management of malignant bowel obstruction., Design: Systematic review and meta-analysis., Data Sources: Online literature search of Pubmed, Embase and Medline libraries up until December 2020. Searching abstracts of scientific meetings, reference lists of included studies and contacting experts in the field., Selection Criteria: Studies that investigated non-surgical management of confirmed bowel obstruction in advanced ovarian cancer patients were included. All levels of evidence including RCTs, cohort studies and case-series if they included greater than 5 patients., Data Collection and Analysis: The studies were independently chosen by two reviewers who extracted and analyzed the data separately through OpenMeta Analyst software. Study quality was assessed using the JADAD score and the Newcastle Ottawa Score., Results: 24 studies met the eligibility criteria for the systematic review and 9 for the meta-analysis. Median survival of patients managed non-surgically for bowel obstruction was 44 days (95% CI 38-49 days, I  2 = 0%, P = 0.128)., Conclusion: The quality of studies was relatively low, however the evidence shows that non-surgical management of bowel obstruction results in a short life expectancy but with controlled symptoms. Where quality of life is the main concern, this may be a feasible and effective strategy.

HOX genes are highly conserved members of the homeobox superfamily that have a crucial role in determining cellular identity. High grade ovarian cancer is the most lethal gynaecological malignancy. Our understanding of the role of HOX genes in the oncogenesis of ovarian cancer is evolving, and here we review their dysregulated expression patterns, their function in cell survival and invasion, their potential uses as biomarkers, and ways in which HOX genes are being targeted with new and existing drugs.