The introduction of targeted therapy (TT) and immuno-oncology (IO) agents have revolutionized the treatment of metastatic renal cell carcinoma (mRCC). However, despite the significant improvements in survival and clinical response yielded by these agents, a significant percentage of patients still experience progressive disease. Evidence now suggests that microorganisms living in the gut (i.e., the gut microbiome) could be used as a biomarker for response and may also have utility in increasing response to these treatments. In this review, we present an overview of the role of the gut microbiome in cancer and its potential implications in the treatment of mRCC.

Prostate cancer liver metastasis (PCLM), seen in upwards of 25% of metastatic castration-resistant PC (mCRPC) patients, is the most lethal site of mCRPC with a median overall survival of 10–14 months. Despite its ominous prognosis and anticipated rise in incidence due to longer survival with contemporary therapy, PCLM is understudied. This review aims to summarize the existing literature regarding the risk factors associated with the development of PCLM, and to identify areas warranting further research. A literature search was conducted through Ovid MEDLINE from 2000 to March 2023. Relevant subject headings and text words were used to capture the following concepts: “Prostatic Neoplasms”, “Liver Neoplasms”, and “Neoplasm Metastasis”. Citation searching identified additional manuscripts. Forty-one studies were retained for detailed analysis. The clinical risk factors for visceral/liver metastasis included 20 ng/mL, and a Gleason score >8. Additional risk factors comprised elevated serum AST, LDH or ALP, decreased Hb, genetic markers like RB1 and PTEN loss, PIK3CB and MYC amplification, as well as numerous PC treatments either acting directly or indirectly through inducing liver injury. Further research regarding predictive factors, early detection strategies, and targeted therapies for PCLM are critical for improving patient outcomes.

Esophagogastric cancers are aggressive malignancies, with poor prognosis despite current standard-of-care therapies. PD-1 inhibitors are a newer class of antitumor agents with the potential to improve outcomes among appropriately selected patients. This review provides an overview of the key trials that have guided the use of PD-1 and PD-L1 inhibitors in the refractory and first-line settings. We highlight recent studies investigating the role of genomic classification in predicting therapeutic activity of PD-1 inhibitors. In addition, there is a discussion of the use of different scoring systems and criteria to determine PD-L1 positivity, the impact on the therapeutic use of immune checkpoint inhibition with anti-PD-1 agents, and the controversies in current methods of PD-L1 testing and their implications in patient selection for anti-PD-1 therapy.

Background: The weighted toxicity score (WTS) is a metric suitable for comparing the toxicity burden in experimental versus control arms of randomized controlled trials (RCTs). When paired with clinical endpoints, the WTS offers a framework to evaluate the toxicity-benefit profile of anti-cancer agents. This study applied the WTS to phase III advanced prostate cancer (PC) clinical trials. Methods: Select phase III PC RCTs with adverse event (AE) data were compiled. The WTS was calculated for each arm using two approaches: (1) all AEs (A-WTS) and (2) symptomatic AEs (S-WTS). Percent change in WTS between trial arms quantified the toxicity burden, while hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were used to assess efficacy. Results: Seventeen RCTs were analyzed (investigational agents: androgen-receptor signaling inhibitors [ARSi, n = 4], poly (ADP-ribose) polymerase inhibitor monotherapy [PARPi, n = 2], ARSi + PARPi [n = 3], ARSi + ARSi [n = 3], triplet therapy [n = 3], and docetaxel as well as Lutetium-177 (177Lu)–PSMA-617) [n = 1 each]). Overall, toxicity and efficacy were greater among experimental than control arms (median A-WTS 6.62 vs 4.10; median S-WTS 3.91 vs 3.08; median HR for OS 0.75, median HR for PFS 0.61). ARSi + PARPi studies observed the highest average A-WTS increase (78%), whereas ARSi + ARSi and triplet therapy trials noted the lowest average A-WTS increases (31% and 32%, respectively) with favorable clinical outcomes. Conclusions: RCTs demonstrated increased toxicity in experimental arms relative to controls, with both toxicity and survival outcomes varying across therapeutic strategies.