Objective: Glioblastoma (WHO classification Grade IV) is a highly malignant brain tumor with a high propensity for recurrence even after standard treatments. Patient death is inevitable, as the available methods are largely ineffective for remediation and treatment once recurrence has occurred. This review presents recent advancements in boron neutron capture therapy (BNCT) that have allowed for its clinical use in treating glioblastoma. Data Sources: We retrospectively reviewed the results of clinical trials and articles published in the past 30 years worldwide. Study Selection: All included studies addressed the use of BNCT to treat high-grade gliomas, including glioblastoma. Results: The development of boron-containing agents exhibiting specificity and improvements in technologies that generate neutron sources have led to the clinical use of BNCT for treating tumors. BNCT involves the delivery of a boron-10-containing drug specifically to tumor cells, followed by irradiation with low-energy thermal neutrons to generate two biologically active particles (helium [α particle] and lithium nuclei). Although these particles are highly effective at destroying cells, their field of destruction is limited to the tumor cells. Therefore, BNCT serves as an excellent mode of targeted particle therapy for tumors, particularly those that are infiltrative. The published articles reviewed here demonstrate the gradual refinement of the BNCT technique and prolonged survival for glioma patients compared to conventional treatments. Conclusion: With continued improvements, BNCT may become the first-choice treatment for malignant infiltrative glioblastoma in the near future.

Background: Head-and-neck cancer (HNC) constitutes one-third of all cancers in developing countries, and the majority present in locally advanced stages. Poor nutritional status is invariably present which compromises treatment compliance, quality of life and survival outcome, posing a major treatment challenge. The aim of this study was to assess the role of pretreatment biomarkers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) in predicting treatment tolerance. Materials and Methods: This prospective observational study included 82 patients receiving definitive and adjuvant radiotherapy for HNC. Utilizing baseline blood investigations, the NLR, PLR, and PNI (10 × albumin + 0.005× lymphocyte count) were calculated for each patient. The cutoff values of NLR, PLR, and PNI were based on the median values. Treatment tolerance in terms of weight loss of more than 10% during treatment, the need for feeding procedure, treatment breaks, and not completing planned treatment as per the schedule were assessed. Associations of NLR, PLR, and PNI with the treatment tolerance factors were assessed using the Chi-square test and Fisher's exact test, and a P < 0.05 was considered statistically significant. Results: Low PNI significantly correlated with feeding procedure requirement and treatment breaks, thus compromising treatment completion. NLR and PLR did not show statistically significant correlations. Conclusion: Low PNI is a reliable predictive factor of poor treatment tolerance. It is an accessible screening tool to identify patients at risk of poor treatment tolerance in whom early interventions can be made to aid in uneventful treatment completion.

Background: The cornerstone of management of phyllodes tumor is surgery. No standard of care exists regarding adjuvant therapy; however, local recurrence is a predominant pattern of failure. The aims of this study were to evaluate the clinical characteristics and treatment patterns of phyllodes tumor and to compare local recurrence and disease-free survival rates of patients with borderline and malignant phyllodes tumor treated with or without adjuvant radiotherapy. Materials and Methods: We analyzed the demographic data, treatment details, and recurrence patterns of all patients with nonmetastatic phyllodes tumors of the breast (n = 34) treated with a multimodality approach who presented to our institute from January 2015 to December 2020. Results: The median age at presentation was 41.2 years, and the median tumor size was 12.5 cm. All patients underwent definitive surgical procedures in the form of wide local excision or mastectomy. No recurrence was noted in the patients with a benign histology. After a median follow-up period of 38 months, the local recurrence rate was 27% for the patients with borderline and malignant histology treated with adjuvant radiotherapy (n = 11) versus 47% for those (n = 17) who did not receive adjuvant radiotherapy. The 3-year local recurrence-free survival rate was 72% in the adjuvant radiotherapy group, versus 51% in the surgery only group. Conclusion: The results of the current study confirm the excellent prognosis of patients with benign phyllodes tumor undergoing surgery alone. Local recurrence was the predominant mode of failure in the patients with borderline and malignant histology. Locoregional control was improved with the addition of postoperative radiotherapy in the patients with borderline and malignant histology irrespective of margin status.

Gastric adenosquamous carcinoma (GASC) is an extremely rare malignancy of the stomach. It is generally diagnosed at an advanced stage and is associated with a poor prognosis. Notably, the standard treatments for GASC remain undetermined because of the condition's rarity. In this report, we present a patient diagnosed with advanced GASC with positive predictive biomarkers for immune checkpoint inhibitors (ICIs), who achieved a durable response through nivolumab monotherapy. We also review and discuss the management of GASC and possible roles of ICIs in gastric cancers.

Sorafenib was approved for the treatment of hepatocellular carcinoma more than 10 years ago; however, the efficacy is limited. The IMbrave150 trial demonstrated better overall survival and progression-free survival with atezolizumab plus bevacizumab combination therapy compared to sorafenib, and so it has become the choice of first-line treatment. However, the optimal choice of subsequent therapy after atezolizumab plus bevacizumab is unknown. We present a case with advanced hepatocellular carcinoma who achieved a complete response for more than 2 years under sorafenib treatment after progression with atezolizumab and bevacizumab combination therapy.

Immune checkpoint inhibitors, including anti-programmed death receptor-1/ligand-1 drugs and anticytotoxic T lymphocyte-associated antigens, are novel drugs for the treatment of many cancers. However, they may rarely cause neurological immune-related adverse effects, including immune-related myasthenia gravis (MG). This condition leads to poorer clinical outcomes, especially when coexisting with myositis or myocarditis. We report a case of a patient with advanced cholangiocarcinoma along with a history of thymoma in whom a triad of MG, myositis, and myocarditis developed after nivolumab administration. Early recognition of neuromuscular symptoms remains critical to successful management.

Lymphoepithelioma-like cholangiocarcinoma (LEL-CC) is a rare variant of intrahepatic cholangiocarcinoma. Only a few cases of LEL-CC have been reported, and the understanding of LEL-CC remains limited. Herein, we describe a case involving a 38-year-old Asian man with hepatitis B virus infection and LEL-CC. The patient's liver tumor was incidentally discovered during routine abdominal ultrasonography without obvious clinical signs or symptoms. Dynamic magnetic resonance imaging (MRI) revealed features of hepatocellular carcinoma and he underwent laparoscopic partial hepatectomy. Histologically, the liver tumor exhibited a lymphoepithelioma-like appearance and features of cholangiocarcinoma with Epstein–Barr virus infection.

A 67-year-old man had suffered from persistent abdominal cramping pain for six months, with radiation to the back. Adenocarcinoma of pancreatic body with celiac encasement was diagnosed. Neoadjuvant chemotherapy was given and regressive tumor size was noted. Further operation of distal pancreatectomy with celiac axis resection (DP-CAR), including transection of the left gastric artery (LGA), was performed. The middle colic artery (MCA) was utilized for reconstruction of LGA, with LGA-MCA anastomosis. Intraoperative indocyanine green (ICG) fluorescence was used to confirm the blood supply. DP-CAR is a complicated procedure for tumor involving celiac axis but would bring benefit if en bloc resection was achieved. Reconstruction of the transected vessels was important to reduce further complications. Intraoperative indocyanine green (ICG) fluorescence imaging is a feasible method of evaluating the blood supply to the stomach and liver after the DP-CAR procedure.

This is a case of cervical cancer stage IIB according to the International Federation of Obstetrics and Gynecology Staging who initially presented with abnormal vaginal bloody discharge noted in August 2018. A cervical biopsy showed poorly differentiated squamous cell carcinoma, and pelvic magnetic resonance imaging revealed a 4.3-cm cervical mass involving the anterior lip, upper third of the vagina, and right parametrium without nodal or distant lesions. Although she underwent concurrent chemoradiotherapy, a residual cervical tumor was noted in April 2019. She then underwent salvage radical hysterectomy, bilateral pelvic lymph node dissection, and hyperthermic intraperitoneal chemotherapy with cisplatin in May 2019, followed by immunotherapy (picibanil-based intraperitoneal imiquimod), immune checkpoint inhibitors (pembrolizumab, atezolizumab, ipilimumab, and nivolumab), and concurrent chemoradiotherapy until March 2020. The immune risk profile showed T cell proliferation and alteration of Th1/Th2 activation after immunotherapy and immune checkpoint inhibitor therapy. There was significant increase in natural killer (NK) T cells (3.9-fold) and CD4+CD25 (4.25-fold). CD3, CD4, CD8, CD19, CD8+CD28−, and CD4/CD8 cells were increased, while CD2+CD279+ and NK cells were decreased. She received eight cycles of adjuvant chemotherapy (cisplatin, paclitaxel) and bevacizumab in June 2020 for local tumor recurrence in the pelvis which was found in April 2020. Unfortunately, she died in November 2020 due to septic shock.