It is projected that there will be 1.9 million new cancer diagnoses and over 600,000 cancer deaths in 2022 in the United States alone.¹ Spine is the most common site for bone metastasis; up to 70% of cancer patients could experience spinal metastasis (SM) and about 20% of them become symptomatic, causing considerable pain and morbidity.² Most common regions for SM are dorsal (45%), lumbar (17%), cervical (14%), and dorsolumbar (10%).³ Vertebral fractures (VFs) are the common complications of SM, with an estimation of 30% of patients developing VFs that mostly require surgery.⁴ Tumor lesions and some treatments for cancer can lead to loss of bone tissue, thus increasing the risk of VFs.⁵ Hence, it is imperative to predict the VF risk in SM patients, so that well-informed interventions can be designed.⁵ Factors influencing VFs include both the macro- and micro-structure of the vertebra, especially of the trabecula.⁵ In-vitro methods are used to study the biomechanical forces that alter the vertebral shape, but they cannot accurately measure in-vivo stresses that damage its microstructure.⁵ The development of computational modeling has made it a compelling tool for measuring these in-vivo stressors.⁵ A recent study by Ahmadian et al was to assess the feasibility of the artificial intelligence (AI)-assisted framework to create ‘digital twins’ of the human vertebra, termed ReconGAN, to predict the VF risk in both osteolytic and osteoblastic metastatic tumors.⁵

Cancer is a leading cause of death globally, claiming almost 10 million deaths in 2020.¹ Breast cancer is one of the most common cancers in women, with nearly 2.3 million new breast cancer diagnoses in 2020 worldwide.¹ Gene-expression profiling has identified distinct subtypes of cancer, among which there are subpopulations expressing specific markers.² According to the National Institutes of Health (NIH), hormone receptor-positive/human epidermal growth factor 2-negative (HR+/HER2-) is the most prevalent breast cancer.³ Cyclin-dependent kinase 4 and 6 (CDK4/6) are good drug targets for cancer, owing to their role in cell cycle progression.⁴ Ribociclib is one of the 3 inhibitors of CDK4/6 approved in combination with fulvestrant for treating HR+/HER2- advanced breast cancers in adults, based on a series of phase 3 clinical trials called MONALEESA, which tested ribociclib along with different drug partners in HR+/HER2- cancer patients.^4-7 The MONALEESA-2 study showed that progression-free survival (PFS) was significantly longer with first-line ribociclib + letrozole than with placebo + letrozole.⁷ The MONALEESA-7 trial also showed significantly longer median overall survival (mOS) in ribociclib in combination with the endocrine therapy (ET) vs. the placebo arm in postmenopausal HR+/HER2- cancer patients.⁶ Similarly, the primary MONALEESA-3 trial and its subsequent analysis Demonstrated that ribociclib + fulvestrant had significant OS benefit as compared with placebo in HR+/HER2- patients advanced breast cancer patients.^5,6 In a recently held European Society of Medical Oncology (ESMO) Breast Cancer Congress, Neven, et al. presented an updated exploratory mOS analysis result with the longest follow-up of the MONALEESA 3 study to date.⁸

Hyponatremia, defined as serum sodium below 135mEq/L, is the most prevalent electrolyte disorder observed in the oncology setting.^1,2 It is associated with many different cancer types, from head and neck cancer to breast cancer.² Hyponatremia is particularly prevalent in small cell lung cancer (SCLC), affecting 25% to 44% of SCLC patients.² Hyponatremia in cancer patients is often caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH), a manifestation of paraneoplastic syndromes (PNS) which are commonly related with small cell carcinomas.^3,4 In an interview with Omnihealth Practice, Dr. Angus Leung shared his view on how to optimize the treatment of hyponatremia caused by cancer-induced SIADH with the aim of achieving a better clinical outcome for cancer patients.