paclitaxel

A New Era of Treatment Sequencing in Platinum-Resistant Ovarian Cancer: Integrating Immunotherapy, Antibody-Drug Conjugates, and Targeted Therapies.

Mabuchi Seiji S, Kusakabe Ai A, Takimoto Yumi Y

Platinum-resistant ovarian cancer (PROC) has historically been treated with sequential non-platinum chemotherapy, with bevacizumab added when appropriate. The therapeutic landscape has expanded with positive randomized phase III data for pembrolizumab plus weekly paclitaxel with or without bevacizumab (KEYNOTE-B96), mirvetuximab soravtansine (MIRV) in FRα-high disease (MIRASOL), and relacorilant plus nab-paclitaxel (ROSELLA). Trastuzumab deruxtecan (T-DXd) has also shown substantial activity in previously treated HER2-expressing ovarian cancer, although its ovarian cohort was small, nonrandomized, and not restricted to PROC. These trials enrolled different populations and do not establish a cross-trial efficacy hierarchy. We therefore review the development of immunotherapy leading to KEYNOTE-B96, compare newer strategies with established PROC treatments, distinguish phase III evidence from regulatory approval and routine availability, and propose an evidence-informed framework for treatment selection and sequencing. The framework prioritizes current treatment opportunity while accounting for biomarker eligibility, prior treatment, residual toxicity, treatment and financial burden, patient priorities, and the feasibility of later-line therapy.

Locally Advanced Primary Cervical Endometrial Stromal Sarcoma: A Case Report.

Bali Asmae A, Khater Kaouthar K, Jebrouni Fadoua F, Chibani Hind H et al.

Primary cervical endometrial stromal sarcoma (ESS) is a challenging mesenchymal neoplasm that may present with non-specific clinical manifestations and advanced local disease at diagnosis. We report the case of a 50-year-old diabetic woman presenting with metrorrhagia and pelvic pain. Clinical examination revealed a large ulcerative cervical mass infiltrating the vaginal walls. Histopathology with immunohistochemistry supported the diagnosis of ESS. Imaging demonstrated extensive loco-regional invasion of the bladder, lower vagina, and rectal wall, consistent with FIGO stage IVA disease. The patient was treated with systemic chemotherapy (carboplatin-paclitaxel). This case highlights the diagnostic challenges of cervical ESS, the importance of histopathological and immunohistochemical evaluation, and the therapeutic considerations in locally advanced disease.

Paclitaxel-induced scleroderma: A scoping review of reported cases with an illustrative case from our center.

Bogojevic Milan M, Medjedovic Rifat R, Janjic Nevenka Lukovac NL, Vukovic Ivana I et al.

Paclitaxel-induced scleroderma is a rare but increasingly recognized adverse effect of taxane chemotherapy. Most cases present with distal edema and cutaneous sclerosis, usually without disease-specific autoantibodies or visceral involvement. This study aimed to map all published cases of paclitaxel-induced scleroderma and present a unique case characterized by dual anticentromere (ACA) and anti-cyclic citrullinated peptide (ACPA) antibody positivity. A scoping review of English-language literature was performed in PubMed and Scopus up to May 2025 using the terms "paclitaxel" OR "taxane" AND "scleroderma" OR "systemic sclerosis. " Only human case reports or case series describing paclitaxel- or nab-paclitaxel-induced scleroderma were included. Data were extracted on demographics, cancer type, clinical features, serology, and outcomes, and summarized descriptively. Nineteen publications describing 21 patients were analyzed. Most patients were female (85.7%), with a mean age of 58.1 years. Cutaneous involvement was predominant, affecting both upper and lower extremities in 85.7% of cases. Raynaud's phenomenon occurred in 28.6%, and visceral involvement was uncommon (9.5% interstitial lung fibrosis; 9.5% scleroderma renal crisis). Autoantibody profiles were largely negative; antinuclear antibodies (ANA) positivity was seen in 33.3% and ACA in only one case. Nearly all patients improved after paclitaxel withdrawal, with corticosteroids and/or methotrexate used in refractory disease. The presented patient developed scleroderma-like changes with ACA and ACPA positivity-an unprecedented serologic finding-together with transient synovitis and Raynaud's phenomenon, confirming an immune-mediated overlap phenotype. Paclitaxel-induced scleroderma typically manifests as a reversible cutaneous fibrosing reaction distinct from idiopathic systemic sclerosis. However, rare cases with autoimmune serology suggest underlying immune activation in genetically predisposed individuals. The coexistence of ACA and ACPA positivity in the current case broadens the immunologic spectrum of taxane-induced scleroderma and highlights the need for further mechanistic and immunogenetic studies.

Reply: Paclitaxel- versus limus-coated balloons in the treatment of ISR.

Sagris Marios M