Background and Objectives: ROS1 rearrangement is a rare but targetable alteration in non-small-cell lung cancer (NSCLC), occurring in 1–2% of cases. Crizotinib, a tyrosine kinase inhibitor, has demonstrated efficacy in clinical trials, but real-world data remain limited. This study evaluates the safety and efficacy of crizotinib in ROS1-rearranged NSCLC patients in a real-world setting. Materials and Methods: This multicenter, retrospective research included 43 individuals with advanced/metastatic NSCLC and confirmed ROS1 rearrangements. Patients were treated with crizotinib in first- or second-line settings. Efficacy endpoints included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and disease control rate (DCR). Safety was assessed using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Results: The median follow-up was 45.8 months. The ORR for first-line crizotinib was 72.1%, with a DCR of 79%. The median PFS was 20.9 months (95% CI: 6.02–35.69), and the median OS was 52.7 months (95% CI: 13.08–92.31). ECOG performance status was a significant prognostic factor for ORR (p = 0.02). The most common adverse events were fatigue (16.2%), elevated transaminases (13.9%), and vision disorders (11.6%). All reported adverse events were grade 1 or 2, with no grade ≥ 3 events observed. Conclusions:Crizotinib demonstrated significant efficacy and a favorable safety profile in real-world individuals with ROS1-rearranged NSCLC. These findings align with pivotal trials, underscoring crizotinib’s role as a standard treatment for this molecular subset. Further prospective studies are warranted to explore intracranial efficacy and long-term outcomes.

Introduction and Aim: Renal transplant recipients face significant long-term graft and patient loss due to post-transplant malignancies. This study aimed to characterize post-transplant malignancies, determine mortality risk factors, and evaluate patient outcomes. Materials and Methods: This retrospective study included 2052 kidney transplant recipients who underwent transplantation between 1976 and 2019 at our institution, other national centers, or international facilities, and who had at least six months of follow-up. Regardless of the transplant center, all patients were followed exclusively at our nephrology department for post-transplant care. A comprehensive review of patient files was conducted, encompassing demographic data, malignancy type and treatment, mortality rates, tissue compatibility assessments, viral serology results, immunosuppression protocols, acute rejection history, and pre-transplant malignancies. The relationships between these variables and mortality were examined. Results: A total of 167 malignant events were observed in 163 patients out of 2052 renal transplant patients (7.9%). The female patients comprised 34.4% (n = 56) of the participants. Ages at transplantation and malignancy diagnosis had medians of 40.0 (13–72) and 50.0 (23–78) years, respectively. The leading malignancy was skin cancer at 30.0%, with Kaposi sarcoma at 11.3% and post-transplant lymphoproliferative disease at 10.6% following. Of the patients followed up, 58.9% (93 patients) had mortality. In univariate analysis, older age at transplant, older age at malignancy diagnosis, and male sex were associated with mortality; however, no independent predictors were identified in the multivariate model (all p > 0.05), likely due to sample size limitations and inter-variable collinearity. Mortality showed statistically significant associations (p < 0.05) with increased age at transplantation, increased age at malignancy diagnosis, and male gender. Conclusions: Post-transplant malignancies significantly compromise both graft longevity and patient survival. Particularly aggressive skin cancers demand heightened clinical vigilance. Early detection through regular dermatological screening, patient education, and timely biopsies must become integral to long-term transplant care protocols.

The treatment of metastatic prostate cancer contains various options. Hormonal agents, chemotherapies, targeted therapies and bone modifying agents are used in different combination and sequence nowadays. In this chapter, the importance of sequencing these treatments is depicted. Because of the numerous factors affecting the clinician’s decision making process, there is a need to simplify the treatment algorithms. Our aim is to spotlight on current treatments thanks to the evidence based data. Since there is rapid progress in randomized clinical trials and increasing body of evidence, one should keep in mind that following the latest guidelines will be the best approach to this topic. We hope our effort may help clinicians in their everyday practice.

Objective: Metastatic urothelial carcinoma (mUC) demonstrates substantial clinical heterogeneity, and outcomes may vary despite similar treatment approaches. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has emerged as a potential prognostic biomarker reflecting nutritional, inflammatory, and immune status. This study evaluated the prognostic significance of HALP in patients with mUC treated with first-line platinum-based chemotherapy.Materials and Methods: We retrospectively evaluated patients with metastatic or unresectable urothelial carcinoma who received first-line platinum-based chemotherapy at a single center between january 2015 and december 2023. HALP scores were calculated using baseline laboratory parameters obtained before treatment initiation. Patients were stratified according to the median HALP value. Overall survival (OS) was the primary endpoint, and progression-free survival (PFS) was the secondary end point. Survival analyses were performed using the Kaplan – Meier and Cox regression methods.Results: A total of 118 patients were included. The median HALP value was 24; 64 patients were classified as low HALP and 54 as high HALP. Patients with low HALP had significantly poorer outcomes. Median PFS was 4.90 months in the low HALP group and 7.67 months in the high HALP group. Median OS was 5.82 and 20.33 months, respectively (p<0.001). In multivariable analysis, low HALP and age ≥ 65 years remained independently associated with worse OS.Conclusion: Low HALP score was associated with worse survival outcomes in patients with mUC receiving first-line platinum-based chemotherapy. As an easily obtainable laboratory-based index, HALP may provide additional prognostic information beyond conventional clinical factors.

Background/Objectives: Prostate cancer is a leading cause of cancer-related morbidity and mortality. While prostate-specific antigen (PSA) is crucial for monitoring, its static levels are limited in predicting outcomes precisely. The Kinetics of Elimination of PSA (KELIM PSA) has recently emerged as a dynamic biomarker of treatment response. This research sought to determine the predictive power of KELIM PSA in castration-resistant prostate cancer (CRPC) on androgen receptor pathway inhibitors (ARPI). Methods: This study retrospectively analyzed 98 CRPC patients treated with enzalutamide or abiraterone. The patients were categorized as either unfavorable (KELIM < 1) or favorable (KELIM ≥ 1). Demographic and clinical characteristics were compared, and survival outcomes were evaluated using Kaplan–Meier curves and Cox regression. Results: Of the cohort, 42 (42.9%) patients had favorable and 56 (57.1%) unfavorable KELIM values. The unfavorable group had a higher mortality rate (62.5% vs. 38.1%, p = 0.029). Univariate analysis showed that poor KELIM results increased mortality risk twofold (hazard ratio [HR]: 2.30, 95% confidence interval [CI]: 1.26–4.19, p = 0.006). In multivariable analysis, unfavorable KELIM remained independently associated with worse overall survival (HR: 2.09, 95% CI: 1.12–3.89, p = 0.020), together with second-line ARPI (HR: 3.19, 95% CI: 1.71–5.93, p < 0.001) and ADT + docetaxel during CSPC (HR: 2.14, 95% CI: 1.11–4.12, p = 0.022). Kaplan–Meier curves revealed that the unfavorable group had notably reduced overall survival and progression-free survival (log-rank p = 0.018). Conclusions: KELIM PSA is an independent predictor in ARPI-treated CRPC. By integrating PSA kinetics into prognostic models, risk stratification may be improved, and this may guide individualized treatment. Prospective multicenter validation is warranted.