Lung cancer represents the most common cause of cancer-related death. Patients with non-small cell lung cancer (NSCLC) and liver metastases have worse prognosis, with an overall survival (OS) from three to six months. The majority of them have a poor response to chemotherapy, and the data are controversial regarding the response to immunotherapy. This could be because the liver is considered to be an immune-tolerant organ, which is characterized by T-cell anergy and immunosuppressive signals. This review evaluates current treatment options for patients with NSCLC and liver metastases. Combination therapies might be a better treatment option for this subgroup of patients. The addition of radiotherapy to immunotherapy could also be an option in selected patients. The resection of single liver metastasis should also be considered.

Background/Objectives: A significant breakthrough in non-small-cell lung cancer (NSCLC) treatment has occurred with the introduction of targeted therapies and immunotherapy. However, not all patients treated with these therapies would respond to treatment, and patients who respond to treatment would acquire resistance at some time point. This is why we need new biomarkers that can predict response to therapy. The aim of this study was to investigate whether soluble programmed cell death-ligand 1 (sPD-L1) could be a predictive biomarker in patients with epidermal growth factor receptor (EGFR)-positive NSCLC. Materials and Methods: Blood samples from 35 patients with EGFR-mutated (EGFRmut) adenocarcinoma who achieved disease control with EGFR tyrosine kinase inhibitor (EGFR TKI) therapy were collected for sPD-L1 analysis. We analyzed sPD-L1 concentrations in 30 healthy middle-aged subjects, as a control population, to determine the reference range. Adenocarcinoma patients were divided into two groups, i.e., a group with low sPD-L1 (≤182.5 ng/L) and a group with high sPD-L1 (>182.5 ng/L). Results: We found that progression-free survival (PFS) was 18 months, 95% CI (11.1–24.9), for patients with low sPD-L1 and 25 months, 95% CI (8.3–41.7), for patients with high sPD-L1. There was no statistically significant difference in PFS between the groups (p = 0.100). Overall survival (OS) was 34.4 months, 95% CI (26.6–42.2), for patients with low sPD-L1 and 84.1 months, 95% CI (50.6–117.6), for patients with high sPD-L1; there was also no statistically significant difference between the groups (p = 0.114). Conclusion: In our study, we found that patients with high sPD-L1 had numerically better PFS and OS, but this has no statistical significance. Further studies with a larger number of patients are needed to evaluate the role of sPD-L1 as a predictive biomarker in patients with EGFRmut NSCLC.

Before the introduction of targeted therapy and immunotherapy, patients with metastatic non-small-cell lung cancer (NSCLC) had a 5-year overall survival (OS) rate of up to 10%. After the positive results of KEYNOTE-024, pembrolizumab was approved in a first-line setting for patients with metastatic NSCLC and PD-L1 ≥ 50%. A small number of patients had a durable response to immunotherapy, and so far it has not been discovered who will benefit. The aim of this study was to investigate the efficacy of first-line pembrolizumab in patients with locally advanced and metastatic NSCLC with high PD-L1 expression in a real-world setting. We enrolled 35 patients with locally advanced and metastatic NSCLC who had PD-L1 ≥ 50%. Progression-free survival was 9 months, 95% CI (2.6–15.4). Overall survival was 14 months, 95% CI (0–28.5). Five-year OS rate for the whole group of patients was 20%, and the six-year OS rate was 17.2%. Immunotherapy was a revolution in the treatment of NSCLC. We still do not know which patients will benefit from immunotherapy, but patients who do respond may experience long-term outcomes.

Background/Objectives: Patients with stage III non-small cell lung cancer represent a very heterogeneous group of patients. In the past, the standard of care for patients with inoperable stage III non-small cell lung cancer was concurrent or sequential radical radiotherapy and chemotherapy. But the progression-free survival was 8 months, and the 5-year overall survival rate was less than 20%. After the results of the PACIFIC study, the standard of care for this group of patients is chemoradiotherapy with durvalumab as consolidation therapy. The aim of our study was to evaluate the efficacy of consolidation durvalumab in a real-world setting after sequential CRT. Methods: We included 24 patients with unresectable stage III non-small cell lung cancer who did not progress after sequential chemoradiotherapy and who received durvalumab consolidation. Results: Median progression-free survival was 16 months, 95% CI (0.5–31.5), and median overall survival was 20 months, 95% CI (13.4–26.6 months). The twelve-month progression-free survival and overall survival rate were 55.1% and 68%, respectively, and the 18-month progression-free survival and overall survival rates were 44.1% and 56.5%, respectively. Conclusions: Durvalumab introduced a new era in the treatment of patients with unresectable stage III non-small cell lung cancer with a significantly prolonged 5-year overall survival rate. Our study is one of the few that investigated the efficacy of durvalumab in a real-world setting after sequential CRT. Our results showed that durvalumab is effective in patients who were treated with sequential CRT. However, the time between radiotherapy termination and the start of durvalumab should be shorter.

Background and Objectives: Melanoma is one of the most aggressive malignancies in humans and is associated with an unfavorable prognosis due to its high metastatic potential. In recent decades, increasing incidence and mortality rates have been reported worldwide among Caucasian populations. This study aimed to analyze melanoma incidence and mortality trends in the Republic of Serbia from 2008 to 2022, with a special regard to sex- and age-specific differences. Materials and Methods: A descriptive epidemiological study was conducted using data on all cases of primary cutaneous melanoma (ICD-10 code C43) reported to the Serbian Cancer Registry between 2008 and 2022. Data on newly diagnosed cases and melanoma-related deaths were analyzed by sex and 5-year age groups. Crude rates were calculated per 100,000 populations, whereas age-standardized rates were obtained using direct standardization. Temporal trends were evaluated using the Joinpoint regression analysis. Results: During the study period, 9600 new melanoma cases and 3882 melanoma-related deaths were reported in Serbia. Both incidence and mortality were higher in men (52.5% and 60.1%, respectively). Age-standardized incidence rates remained relatively stable in both sexes, with a slight increase in men (AAPC = 0.9%; 95% CI: −0.5 to 2.3) and a stable trend in women (AAPC = −0.1%; 95% CI: −1.5 to 1.3). Age-standardized mortality rates showed a mild, statistically insignificant decline overall (AAPC = −0.6% in men and −0.9% in women). The calculated mortality-to-incidence ratio (MIR) shows consistently higher values in men compared to women. A significant increase in incidence was observed among men aged 70–74 years (AAPC = 3.1%; p = 0.011), while mortality significantly decreased in women aged 40–44 years (APC = −7.0%; p = 0.017). Conclusions: Melanoma incidence in Serbia remained relatively stable between 2008 and 2022, with a modest increase primarily among older men. Mortality trends showed a slight decline, suggesting potential improvements in early detection and treatment outcomes.

Introduction: Brain metastases represent the most common intracranial malignancy in the adult population, while breast cancer represents the leading cause of brain metastases among women. Brain metastases have increased in recent years due to improved therapeutic control of systemic disease and better diagnostic tools. Stereotactic radiosurgery (SRS) is used in patients with brain tumors to achieve local disease control, preserve the quality of life, and extend patient survival. This study aimed to evaluate the effects of SRS in patients with brain metastases from breast cancer through analysis of magnetic resonance imaging (MRI) parameters of the brain. Methods: Brain MRI was conducted in 30 adult female patients before and 3-6 months after SRS treatment. Radiological analysis was used to estimate lesion volumes before and after SRS. Results: Patients were categorized into four groups based on therapeutic response: 1 - complete response (CR) with loss of the lesion, 2 - partial response (PR) with more than 50% reduction in lesion volume, 3 - disease progression (PD) with more than 25% increase in lesion volume, 4 - stable disease (SD) if the patient did not display PR or PD. Among all patients, it was found that CR was present in 0 (0%), PR in 15 (50%), PD in 1 (3%), and SD in 14 (47%) patients. Following the SRS treatment, a statistically significant reduction in tumor volume was observed (p<0.001). Conclusion: Radiological volumetric analysis of brain metastases after SRS showed a statistically significant reduction in lesion volume, demonstrating effective local disease control.