SAFFRON-103: a phase Ib study of sitravatinib plus tislelizumab in anti-PD-(L)1 refractory/resistant advanced melanoma

A rare case of rectal malignant melanoma with long-term survival: case report and literature review

BACKGROUND

Although cutaneous melanoma is relatively common, rectal malignant melanoma is extremely rare. Due to its rarity, rectal malignant melanoma is often not considered in the initial differential diagnosis. In such clinical scenarios, avoiding misdiagnosis, achieving early detection, and providing appropriate treatment remain major challenges and require particular attention. This case report presents a detailed account of the diagnostic and therapeutic process in a patient with primary rectal malignant melanoma. By sharing this case, we aim to provide clinicians with practical experience and valuable insights, thereby enhancing awareness and understanding of this rare condition within the medical community.

CASE PRESENTATION

A 56-year-old female presented to the hospital with a 10-day history of a perianal mass and hematochezia. Physical examination revealed a soft, flat abdomen with no palpable masses and normal bowel sounds. Imaging findings showed localized thickening of the distal rectum, diffuse mild thickening of the mid-to-upper rectal wall, and multiple small lymph nodes in the sigmoid mesocolon.Postoperative histopathological analysis, supported by immunohistochemical staining, confirmed the diagnosis of malignant melanoma. The patient underwent laparoscopic Miles surgery, followed by adjuvant abdominopelvic radiotherapy (GTVtb 50 Gy, CTV45 Gy) and targeted therapy with tislelizumab. She had an uneventful recovery and remained free of disease progression during 48 months of follow-up.

CONCLUSIONS

This case of rectal malignant melanoma, incidentally diagnosed during hemorrhoidectomy, was successfully treated with laparoscopic Miles' procedure and targeted immunotherapy, resulting in long-term disease-free survival, thereby raising clinical awareness and providing valuable insights for managing similar cases.

AXL signaling in cancer: from molecular insights to targeted therapies

AXL, a member of the TAM receptor family, has emerged as a potential target for advanced-stage human malignancies. It is frequently overexpressed in different cancers and plays a significant role in various tumor-promoting pathways, including cancer cell proliferation, invasion, metastasis, epithelial-mesenchymal transition (EMT), angiogenesis, stemness, DNA damage response, acquired therapeutic resistance, immunosuppression, and inflammatory responses. Beyond oncology, AXL also facilitates viral infections, including SARS-CoV-2 and Zika highlighting its importance in both cancer and virology. In preclinical models, small-molecule kinase inhibitors targeting AXL have shown promising anti-tumorigenic potential. This review primarily focuses on the induction, regulation and biological functions of AXL in mediating these tumor-promoting pathways. We discuss a range of therapeutic strategies, including recently developed small-molecule tyrosine kinase inhibitors (TKIs), monoclonal antibodies, and antibody-drug conjugates (ADCs), anti-AXL-CAR, and combination therapies. These interventions are being examined in both preclinical and clinical studies, offering the potential for improved drug sensitivity and therapeutic efficacy. We further discuss the mechanisms of acquired therapeutic resistance, particularly the crosstalk between AXL and other critical receptor tyrosine kinases (RTKs) such as c-MET, EGFR, HER2/HER3, VEGFR, PDGFR, and FLT3. Finally, we highlight key research areas that require further exploration to enhance AXL-mediated therapeutic approaches for improved clinical outcomes.

Analysis of efficacy and safety for the combination of tislelizumab and regorafenib in advanced hepatocellular carcinoma: A prospective clinical study

BACKGROUNDS

Programmed death receptor 1 (PD-1) monoclonal antibody has been approved for the first and second-line treatments of hepatocellular carcinoma (HCC). This study aimed to evaluate the efficacy and safety of tislelizumab + regorafenib as a second-line treatment option for advanced HCC.

METHODS

Treatment-related adverse events (TRAEs) were the primary endpoints in this clinical trial comprising 28 patients with advanced HCC. The secondary endpoints included objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS).

RESULTS

According to the mRECIST 1.1 evaluation criteria, the ORR was 28.6%. Complete and partial response were observed in 3 and 5 patients, respectively; stable disease was observed in 12 patients (DCR, 71.4%). The median PFS was 6.4 months. The incidence of grade 1-2 and 3-4 TRAEs was 57.1% and 39.3%, respectively.

CONCLUSION

This study suggests that tislelizumab + regorafenib can be used as a second-line treatment for advanced HCC.