Will modern immunotherapies become the standard of care for advanced synchronous or metachronous cancers?

The detection of multiple primary cancers in the same patient has increased in frequency during the last decades. Those diagnosed cancers are either synchronous, detected at the same time or metachronous, occurring after a period of time following the first cancer. A review of the literature of nearly one million cancer patients concluded that the prevalence of multiple primary malignant cancers was between 0.73 and 11.7% [1]. Overall, cancer survivors had a 14% higher risk of developing a new malignancy than would have been expected in the general population [2]. The occurrence of multiple primary cancers can be attributed to different factors, including the facilities of imaging and biopsies of different sites of the disease, the increase of life expectancy either in general population or in cancer patients and finally the major advances in cancer treatment. Other factors can also be incriminated in the development of multiple primary cancers such as hereditary, immunology, environment and carcinogens including viruses, radiotherapy and chemotherapy [3].

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