The SWItch/Sucrose Non-Fermentable (SWI/SNF) chromatin-remodeling complex is one of the most remarkably altered epigenetic regulators in cancer. Pathogenic mutations in genes encoding SWI/SNF-related proteins have been recently described in many solid tumors, including rare and aggressive malignancies with rhabdoid features with no standard therapies in advanced or metastatic settings. In recent years, clinical trials with targeted drugs aimed at restoring its function have shown discouraging results. However, preclinical data have found an association between these epigenetic alterations and response to immune therapy. Thus, the rationale for immunotherapy strategies in SWI/SNF complex alteration-related tumors is strong. Here, we review the SWI/SNF complex and how its dysfunction drives the oncogenesis of rhabdoid tumors and the proposed strategies to revert this alteration and promising novel therapeutic approaches, including immune checkpoint inhibition and adoptive cell therapy.

Cutaneous immune-related adverse events (cirAEs) are the most common side effects of immune checkpoint inhibitor (ICI) therapy (30–50% for all grades). The vast majority of them are low or mild and can be treated without ICI interruption. Autoimmune blistering disorders, such as immune-mediated bullous pemphigoid (IBP), are rare (<1%) but potentially serious conditions that must be early detected. The onset generally occurs within the first months of the treatment, and it appears to be more common with antiprogrammed death-1 or antiprogrammed ligand 1 (anti-PD1/PDL1) than with anticytotoxic T-lymphocyte-associated protein 4 (anti-CTLA4). We present a case of a three-day severe IBP onset after receiving the first cycle of atezolizumab. This exceptional early presentation could suggest the presence of some predisposing condition and demonstrates the need to better understand predictive toxicity-related biomarkers in candidate patients for immunotherapy.

Autoimmune haemolytic anaemia (AIHA) is a rare immune-related adverse event and appears to be more common with anti-PD1/PDL1 than anti-CTLA4. Little is known about the safety of re-treating with anti-PD1/PDL1 or changing to anti-CTLA4. We present a case of grade 4 AIHA due to nivolumab (PD1-inhibitor) treatment in a patient with melanoma for adjuvant setting after surgery and the safeness of subsequent treatment with ipilimumab (anti-CTLA4). After the remission of AIHA with steroids, ipilimumab was started with the rationale of its different mechanism of action. Fortunately, AIHA did not recur. The mechanism by which checkpoint inhibitors cause AIHA is likely by augmenting or redirecting immune surveillance, especially by activating pre-existing red blood cell autoantibodies, but further studies must be done. To our knowledge, this is the first case published in the literature with the change of immunotherapy treatment to anti-CTLA4.

Background/Objectives: Few large cohorts with relatively uniform treatment approaches and long-term follow-up are available for assessing clinical outcomes for breast cancer (BC) patients. The Institut Català d’Oncologia (ICO) Breast Cancer Cohort was designed to well characterize treatment patterns and overall survival outcomes at 5 and 10 years, with a particular focus on patients < 40 and ≥70 years old, age groups often underrepresented in clinical trials. Methods: In this retrospective, observational study, we included all pathologically confirmed invasive BC patients diagnosed and treated between 2010 and 2014 at ICO, a Spanish reference cancer center, with a follow-up until November 2023. We collected comprehensive real-world data on clinicopathologic characteristics and treatment modalities. Overall survival (OS) was estimated using the Kaplan–Meier technique and was reported stratified by prognostic factors for the age groups of ≤40, 41–69 and ≥70. The Multivariate Cox model was used to estimate the risk of death for subgroups of age, adjusting for subtype, stage and grade. Results: Overall, 3451 patients with stage I to IV BC were diagnosed and treated, with a mean age of 58 years (range 19–98); 371 (10.8%) were diagnosed ≤40 years, and 756 (21.9%) were ≥70 years. With a mean follow-up of 9.9 years (SD = 3.5), the 5- and 10-year OS were 89% (95% CI: 86–92%) and 85% (95% CI: 81–88%) for patients ≤ 40, respectively; for those aged 41–69 years, 91% (95% CI: 90–92%) and 85% (95% CI: 83–86%), respectively; and 70% (95% CI: 66–73%) and 50% (95% CI: 47–54%) for those ≥70 years, respectively. The 5- and 10-year relative survival (RS) were 92% and 88% for patients < 70 years, respectively, and 82% and 77% for those ≥70 years, respectively. The Multivariate Cox model identified a HR of 4.90 (95% CI: 3.44–6.97, p < 0.001) for patients ≥ 70 years compared to those between 41 and 69 years. Conclusions: The ICO Breast Cancer Cohort, as far as we know, the largest in Spain with long-term follow-up, underscores the critical role of age and subtype in determining overall survival outcomes in patients with breast cancer.