Current Oncology

10 pages, 1726 KiB

Open AccessArticle

Impact of Multileaf Collimator Width and Normal Tissue Objective on Radiation Dose Distribution in Stereotactic Radiosurgery Using HyperArc for Single Brain Lesions

by Se An Oh, Jae Won Park, Ji Woon Yea, Jaehyeon Park and Yoon Young Jo

Curr. Oncol. 2025, 32(5), 272; https://doi.org/10.3390/curroncol32050272 - 7 May 2025

Abstract

This study retrospectively investigated the impact of stereotactic radiosurgery (SRS) normal tissue objective (NTO) and multileaf collimator (MLC) width on radiation dose distribution in patients with brain metastasis treated using HyperArc. In total, 21 patients who underwent SRS using the HyperArc of the [...] Read more.

This study retrospectively investigated the impact of stereotactic radiosurgery (SRS) normal tissue objective (NTO) and multileaf collimator (MLC) width on radiation dose distribution in patients with brain metastasis treated using HyperArc. In total, 21 patients who underwent SRS using the HyperArc of the TrueBeam linear accelerator from November 2022 to June 2024 were included. All patients received radiotherapy with HA_SH planned with SRS NTO and HD MLC. HyperArc(HA_AH) combined with the auto NTO and HD MLC and HyperArc(HA_AM) with auto NTO and millennium MLC were generated and compared. Monitor units (MU), conformity index (CI), radical dose homogeneity index (rDHI), moderate DHI (mDHI), and gradient index (GI) were evaluated as target factors, and V₂(Gy), V₁₀(Gy), V₁₂(Gy), V₁₈(Gy), V₁₀(cc), and V₁₂(cc) were evaluated as normal brain factors. Dosimetric comparisons were performed between HA_SH, HA_AH, and HA_AM and between target and normal brain tissues. Between HA_SH and HA_AH, average MU was 7206 and 5798, respectively; the difference was significant (p < 0.001). The MU of HA_AM was 5835. Among HA_SH, HA_AH, and HA_AM, CI and mDHI were not significantly different, but there were significant differences in rDHI, GI, and normal brain tissues. When treating a single lesion using HyperArc, SRS NTO influences MU and GI, and the MLC width influences rDHI and GI. In HyperArc for single metastatic brain lesions, SRS NTO and MLC width have a significant effect on the radiation dose delivered to the target and normal brain tissues. Full article

(This article belongs to the Special Issue Stereotactic Radiosurgery for Brain Tumors)

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10 pages, 1292 KiB

Open AccessCase Report

Drug Sensitivity Testing in Osteosarcoma: A Case Report

by Ines Lohse, Giselle Dutcher, Hassan Al-Ali, Warren Alperstein, Donald W. Coulter, Matteo Trucco, Jonathan C. Trent and Claes Wahlestedt

Curr. Oncol. 2025, 32(5), 271; https://doi.org/10.3390/curroncol32050271 - 7 May 2025

Abstract

Precision medicine approaches using ex-vivo drug sensitivity testing (DST) have received attention in the cancer research community as a means to improve treatment stratification in populations where multiple treatment attempts are not feasible, or no standard-of-care treatment exists, such as ultra-rare cancers with [...] Read more.

Precision medicine approaches using ex-vivo drug sensitivity testing (DST) have received attention in the cancer research community as a means to improve treatment stratification in populations where multiple treatment attempts are not feasible, or no standard-of-care treatment exists, such as ultra-rare cancers with a significant clinical need for effective treatment options, like osteosarcoma. DST has the potential to supplement existing patient stratification approaches by providing tumor-specific response data to aid in treatment selection at the time of treatment decision. We present the case of a pediatric osteosarcoma patient who was evaluated using DST at the time of standard-of-care treatment to evaluate treatment sensitivity. The DST screen indicated significant treatment sensitivity to anthracyclines and methotrexate, consistent with the first-line standard-of-care therapy (MAP). Clinical follow-up showed treatment sensitivity to standard-of-care MAP treatment and pathology results of 90% necrosis. The present case shows that DST screening is feasible from a technical standpoint, can be performed in a clinically relevant time frame that does not delay treatment start, and provides personalized drug sensitivity information on clinically available agents, and the DST results align with the clinical treatment response. Full article

(This article belongs to the Section Bone and Soft Tissue Oncology)

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Graphical abstract

7 pages, 3451 KiB

Open AccessCase Report

Combination of Osimertinib and Brigatinib in the Treatment of EGFR Triple-Mutated Lung Adenocarcinoma: A Case Report

by Daphnée Demers and Marie Florescu

Curr. Oncol. 2025, 32(5), 270; https://doi.org/10.3390/curroncol32050270 - 7 May 2025

Abstract

Osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), is widely used in treating patients with EGFR-mutated non-small-cell lung cancers (NSCLCs), especially in cases with secondary resistance mutations. However, tertiary resistance mutations often arise, and there is currently no established [...] Read more.

Osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), is widely used in treating patients with EGFR-mutated non-small-cell lung cancers (NSCLCs), especially in cases with secondary resistance mutations. However, tertiary resistance mutations often arise, and there is currently no established standard of care for NSCLC harboring triple EGFR mutations. In recent years, brigatinib, an anaplastic lymphoma kinase (ALK) TKI, has shown effectiveness in treating EGFR triple-mutated NSCLC. Despite this, the combined use of osimertinib and brigatinib remains largely unstudied. This case report describes a 51-year-old woman with EGFR-mutated NSCLC who was initially treated with first- and second-generation EGFR TKIs, then switched to osimertinib upon development of an exon 20 T790M mutation. When an exon 20 C797S mutation emerged, the decision was made to add brigatinib to the osimertinib regimen. The combined treatment of osimertinib and brigatinib offers a promising new approach. Nonetheless, it is important to consider the potential risk of off-target toxicities. Full article

(This article belongs to the Section Thoracic Oncology)

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13 pages, 1762 KiB

Open AccessArticle

Treatment Patterns, Clinical Outcomes and Quality of Life in BRCA1/2-Associated Breast Cancer Patients: A Retrospective Analysis

by Anna-Maria Parger, Paulina Gebhart, Daniela Muhr, Christian F. Singer and Yen Y. Tan

Curr. Oncol. 2025, 32(5), 269; https://doi.org/10.3390/curroncol32050269 - 2 May 2025

Viewed by 148

Abstract

Background: Breast cancer (BC) patients with germline BRCA1/2 pathogenic variants (PVs) often face unique challenges compared to non-carriers. However, the impact of PVs on treatment patterns, clinical outcomes, and quality of life (QoL) remains insufficiently explored. This study aims to assess these [...] Read more.

Background: Breast cancer (BC) patients with germline BRCA1/2 pathogenic variants (PVs) often face unique challenges compared to non-carriers. However, the impact of PVs on treatment patterns, clinical outcomes, and quality of life (QoL) remains insufficiently explored. This study aims to assess these factors in these individuals. Methods: A retrospective analysis was conducted using data from the Medical University of Vienna Center for Familial Breast and Ovarian Cancer between 2011 and 2021. Among 1285 individuals identified, 338 were included (120 BRCA1 PVs, 47 BRCA2 PVs, and 171 non-carriers). Clinical data including treatment patterns and outcomes were collected; QoL was assessed in BRCA1/2 PV carriers using the SF-12 questionnaire. Results: Among 338 BC patients, BRCA1 PV carriers were significantly younger at disease onset and more likely to present with triple-negative BC, with higher Ki-67 (>10%) than BRCA2 or non-carriers. Platinum-based chemotherapy was more frequently administered to BRCA PV carriers for neoadjuvant treatment (OR 7.7, p < 0.001), and therapeutic bilateral mastectomy was more common in BRCA1 carriers (44.7%) compared to BRCA2 (37.8%, p = 0.114) and non-carriers (25.2%, p = 0.003). Epirubicin was the primary agent for adjuvant chemotherapy across all groups compared to other chemotherapeutic agents. QoL assessments revealed significant physical health challenges, particularly among those who underwent neoadjuvant chemotherapy and surgery, while mental health scores remained relatively high. Conclusions: This study highlights the distinct treatment patterns and tumor characteristics associated with BRCA1/2 carriers, including the impact of treatments on quality of life. Nevertheless, our findings ought to be interpreted with caution due to the small sample size. Larger prospective studies with more complete treatment data, including PARP inhibitor use, and further research on supportive care strategies are needed for this high-risk population. Full article

(This article belongs to the Special Issue Advanced Research on Breast Cancer Genes in Cancers)

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13 pages, 1455 KiB

Open AccessArticle

Real-World Treatment Patterns and Survival Outcomes of Patients with Relapsed/Refractory Multiple Myeloma Treated with a Selinexor-Containing Triplet-Based Regimen

by Andrew Whiteley, Stephen C. Ijioma, David Ray, Spencer S. Langerman, Ellen Hu, Amy Pierre, Tomer Mark and Habte Yimer

Curr. Oncol. 2025, 32(5), 268; https://doi.org/10.3390/curroncol32050268 - 2 May 2025

Viewed by 208

Abstract

Treatment for relapsed/refractory multiple myeloma (RRMM) is complex, with several classes of drugs that can be combined into doublet, triplet, or quadruplet regimens. Real-world studies can help to determine the optimal treatment sequences and dosing through observed usage of drugs outside of clinical [...] Read more.

Treatment for relapsed/refractory multiple myeloma (RRMM) is complex, with several classes of drugs that can be combined into doublet, triplet, or quadruplet regimens. Real-world studies can help to determine the optimal treatment sequences and dosing through observed usage of drugs outside of clinical trials. Previous clinical trials have demonstrated high rates of durable responses in the treatment of patients with triple-class-exposed RRMM with regimens containing selinexor, a first-in-class, orally available selective exportin 1 inhibitor. This study analyzed real-world treatment patterns and survival outcomes using a nationwide electronic health record-derived, deidentified database of patients with RRMM treated with an eligible selinexor-containing, triplet-based regimen, including combinations with dexamethasone and pomalidomide, bortezomib, carfilzomib, or daratumumab. Patients had a real-world overall survival (rwOS) of 14.7 months (95% CI: 10.6, 20.9) and a derived progression-free survival (dPFS) of 4.7 months (95% CI: 3.4, 6.7). Patients with previous exposure to anti-CD38 monoclonal antibodies (mAbs) in the most recent regimen prior to the selinexor treatment had numerically higher survival outcomes (rwOS, 20.9; dPFS, 8.7 months). These data suggest that, in the real-world setting, the use of selinexor triplet regimens is effective in patients with RRMM, especially those with prior exposure to an anti-CD38 mAb in the immediate prior line of therapy. Full article

(This article belongs to the Special Issue Clinical Progression and Treatment Outcome of Multiple Myeloma)

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28 pages, 12877 KiB

Open AccessArticle

Burdens of Breast Cancer and Projections for 2030 Among Women in Asia: Findings from the 2021 Global Burden of Disease Study

by Feng Wang, Sixuan Liu, Jianwei Li, Yuzhen Shi, Zhaohui Geng, Yajie Ji and Jie Zheng

Curr. Oncol. 2025, 32(5), 267; https://doi.org/10.3390/curroncol32050267 - 1 May 2025

Viewed by 113

Abstract

Background: Employing the most recent dataset from the Global Burden of Disease (GBD) Study 2021, this report sought to delineate the current epidemiologic landscape of breast cancer in Asian women. Methods: We examined the evolving trends in disease prevalence and explored [...] Read more.

Background: Employing the most recent dataset from the Global Burden of Disease (GBD) Study 2021, this report sought to delineate the current epidemiologic landscape of breast cancer in Asian women. Methods: We examined the evolving trends in disease prevalence and explored the correlations between breast cancer and factors such as age, temporal periods, and generational cohorts. We utilized an autoregressive integrated moving average (ARIMA) model to predict the incidence and deaths of breast cancer in Asia. Results: From 1990 to 2021, the age-standardized incidence rate (ASIR), age-standardized DALYs rate (ASDR), and age-standardized mortality rate showed an overall upward trend for Asian women with breast cancer. In 2021, the high-income Asia Pacific region had the highest ASIR value, while South Asia had the lowest ASIR value. The highest age-standardized mortality rate and ASDR values in 2021 occurred in Southeast Asia, while the lowest values for these metrics were in East Asia. In 2021, breast cancer incidence and DALYs were highest in the 50–54 age group, with deaths peaking in the 55–59 age group. The leading risk factor attributed to breast cancer deaths in Asia in 1990 and 2021 was a “diet high in red meat”. Breast cancer incidence and mortality rates are expected to continue to rise in Asia over the next 10 years. Conclusions: The burden of breast cancer in Asian women is increasing, especially in low SDI countries. This study highlighted the differences between populations and regions and predicted the incidence and mortality rates of breast cancer in Asia over the next decade using an ARIMA model. An increased awareness of breast cancer risk factors and prevention strategies is necessary to reduce breast cancer burden in the future. Full article

(This article belongs to the Section Health Economics)

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25 pages, 1332 KiB

Open AccessArticle

Pilot Randomized Controlled Trial of iCanWork: Theory-Guided Return-to-Work Intervention for Individuals Touched by Cancer

by Christine Maheu, Maureen Parkinson, Kyla Johnson, Wing Lam Tock, Naomi Dolgoy, Simon-Pierre Dupuis and Mina Singh

Curr. Oncol. 2025, 32(5), 266; https://doi.org/10.3390/curroncol32050266 - 1 May 2025

Viewed by 175

Abstract

Background: Recent systematic reviews report a limited number of return-to-work (RTW) interventions for individuals touched by cancer (ITBC), with many falling short in effectiveness and lacking an integrated work-health approach. In response, iCanWork—a theoretically informed, multidisciplinary RTW intervention integrating vocational rehabilitation (VR) and [...] Read more.

Background: Recent systematic reviews report a limited number of return-to-work (RTW) interventions for individuals touched by cancer (ITBC), with many falling short in effectiveness and lacking an integrated work-health approach. In response, iCanWork—a theoretically informed, multidisciplinary RTW intervention integrating vocational rehabilitation (VR) and occupational therapy (OT)—was conceptualized and developed to address the gap identified in recent reviews for robust, work-health-focused RTW interventions. Methods: A pilot randomized controlled trial was conducted to explore the feasibility, acceptability, and preliminary work-related outcomes of the iCanWork intervention among 23 ITBC participants randomized to either the intervention or control group. Feasibility was assessed through recruitment, retention, and engagement benchmarks; acceptability was measured using a participant satisfaction survey. Preliminary work-health-related outcomes included RTW status, work ability index (WAI) scores, and health-related quality of life (QoL) domains. Results: Feasibility benchmarks were achieved, with 92% recruitment, 83% retention, and 100% completing at least one VR session. Adherence to the session delivery benchmarks was met by 75% of participants before RTW and 41.7% after RTW. Participants rated the intervention highly for its tailored and supportive approach. Compared to the control group, the iCanWork group showed modest improvements in RTW status, WAI scores (mean change: +2.54), and QoL domains, including fatigue, social roles, and pain interference. Given the small sample size, these exploratory findings should be interpreted as preliminary signals to inform outcome selection for a future trial. Conclusions: iCanWork is a feasible and acceptable RTW intervention for ITBC with early indications of benefit. These findings inform the design and outcome selection for a future, larger trial aimed at evaluating the intervention’s potential to improve RTW outcomes for ITBC. Full article

(This article belongs to the Special Issue Self-Management/Patient Activation and Self-Management Support Interventions for Cancer Survivors)

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16 pages, 243 KiB

Open AccessSystematic Review

Patient-Reported Outcome Measures (PROMS) in Lymphoma

by Neha Akkad and Christopher R. Flowers

Curr. Oncol. 2025, 32(5), 265; https://doi.org/10.3390/curroncol32050265 - 1 May 2025

Viewed by 148

Abstract

Patient-reported outcome measures (PROMs) are often used to evaluate the impact of treatment and clinical decisions on the patient experience for patients with lymphoma. Regulatory agencies have provided guidance on the use of PROMs for patient-focused drug development. Though PROMs are increasingly utilized, [...] Read more.

Patient-reported outcome measures (PROMs) are often used to evaluate the impact of treatment and clinical decisions on the patient experience for patients with lymphoma. Regulatory agencies have provided guidance on the use of PROMs for patient-focused drug development. Though PROMs are increasingly utilized, the way in which they are used, analyzed, and reported is heterogeneous. This systematic evidence-based review will focus on how PROMs are currently used for patients with lymphoma, what domains PROMs measure, their clinical significance, links to clinical outcomes, and what gaps need to be filled to better incorporate PROMs as endpoints in clinical trials and clinical decision-making. Full article

(This article belongs to the Section Hematology)

15 pages, 522 KiB

Open AccessReview

Role of Immunotherapy in the Treatment of Hepatocellular Carcinoma

by Irina Y. Dobrosotskaya, Rashmi Kumar and Timothy L. Frankel

Curr. Oncol. 2025, 32(5), 264; https://doi.org/10.3390/curroncol32050264 - 30 Apr 2025

Viewed by 126

Abstract

Hepatocellular carcinoma is the most common primary liver tumor and is strongly related to underlying liver cirrhosis. Common etiologies include viral hepatitis, elevated alcohol consumption and metabolic diseases, all of which result in liver inflammation and scarring. Previously, systemic therapies for locally advanced [...] Read more.

Hepatocellular carcinoma is the most common primary liver tumor and is strongly related to underlying liver cirrhosis. Common etiologies include viral hepatitis, elevated alcohol consumption and metabolic diseases, all of which result in liver inflammation and scarring. Previously, systemic therapies for locally advanced or metastatic disease were limited to tyrosine kinase inhibitors with poor efficacy and rare cures. Recent advances have harnessed the power of the immune system to combat disease, resulting in improved outcomes and occasional cures. Here, we describe the recent clinical trials in immunotherapies for the treatment of hepatocellular carcinoma as first- and second-line therapies and in combination with other drug classes. Full article

(This article belongs to the Special Issue Innovative Therapeutic Strategies, Biomarkers, and Molecular Pathways in Gastrointestinal and Hepatobiliary Cancers)

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20 pages, 3116 KiB

Open AccessArticle

Risk Factors for Recurrence in Serous Borderline Ovarian Tumors and Early-Stage Low-Grade Serous Ovarian Carcinoma

by Jingjing Zhang, Ming Wang and Yumei Wu

Curr. Oncol. 2025, 32(5), 263; https://doi.org/10.3390/curroncol32050263 - 30 Apr 2025

Viewed by 109

Abstract

Background: Tumor recurrence significantly impacts the quality of life and fertility of patients with serous borderline ovarian tumors (SBOT) and early-stage low-grade serous ovarian carcinoma (LGSOC). This study aims to characterize recurrence patterns, identify independent risk factors for recurrence, and develop a nomogram [...] Read more.

Background: Tumor recurrence significantly impacts the quality of life and fertility of patients with serous borderline ovarian tumors (SBOT) and early-stage low-grade serous ovarian carcinoma (LGSOC). This study aims to characterize recurrence patterns, identify independent risk factors for recurrence, and develop a nomogram to predict recurrence-free survival (RFS). Methods: We conducted a retrospective case-control study to investigate recurrence in patients undergoing fertility-sparing surgery (FSS) and radical surgery (RS). Logistic regression and Cox regression were used to identify risk factors. Kaplan–Meier analysis was applied to evaluate RFS. A nomogram was developed based on identified variables to predict RFS. Results: Tumor capsule disruption and micropapillary were associated with higher recurrence risk in the FSS group. Non-invasive implants were associated with higher recurrence risk in the RS group. The nomogram prediction model was developed based on identified risk factors. The area under the curve (AUC) for RFS predictions was 0.74 (95% CI: 0.62–0.85) at 3 years and 0.78 (95% CI: 0.67–0.89) at 5 years for the FSS group and 0.87 (95% CI: 0.76–0.98) at 3 years and 0.81 (95% CI: 0.65–0.97) at 5 years for the RS group. Conclusions: We identified the risk factors for recurrence of SBOT and early-stage LGSOC following FSS and RS procedures and developed a predictive model for forecasting RFS. This model provides valuable guidance for patients and clinicians in predicting recurrence risk for patients. Full article

(This article belongs to the Section Gynecologic Oncology)

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18 pages, 7056 KiB

Open AccessArticle

The Spatial Proximity of CD8⁺ FoxP3⁺PD-1⁺ Cells to Tumor Cells: A More Accurate Predictor of Immunotherapy Outcomes in Advanced Non-Small-Cell Lung Cancer

by Zijuan Hu, Zhihuang Hu, Keji Chen, Huixia Huang, Xinyang Zhong, Yaxian Wang, Jiayu Chen, Xuefeng He, Di Shi, Yupeng Zeng, Jiwei Li, Xiaoyan Zhou and Ping Wei

Curr. Oncol. 2025, 32(5), 262; https://doi.org/10.3390/curroncol32050262 - 30 Apr 2025

Viewed by 110

Abstract

Background: To optimize precision immunotherapy for advanced NSCLC, comprehensive tumor immune microenvironment (TIME) characterization is crucial for efficacy prediction. Methods: Pretreatment tumor samples from 46 advanced NSCLC patients treated with PD-1/PD-L1 inhibitors were analyzed. The subregional abundance and spatial proximity scores of TIME [...] Read more.

Background: To optimize precision immunotherapy for advanced NSCLC, comprehensive tumor immune microenvironment (TIME) characterization is crucial for efficacy prediction. Methods: Pretreatment tumor samples from 46 advanced NSCLC patients treated with PD-1/PD-L1 inhibitors were analyzed. The subregional abundance and spatial proximity scores of TIME cell subpopulations in 27 samples were assessed via multiplex immunohistochemistry (mIHC) targeting pan-CK, CD163, CD8, FoxP3, PD-1, and PD-L1. Correlations between the TIME features, clinicopathologic factors, treatment response, and prognosis were evaluated. Results: CD8⁺FoxP3⁺ cells were identified in NSCLC tissues, predominantly expressing PD-1/PD-L1. The PD-L1 TPS subgroups showed significant immune cell density/proximity differences, but CD8⁺FoxP3⁺PD-1⁺ infiltration was PD-L1 TPS-independent. Responders had higher CD8⁺FoxP3⁺PD-1^high density (p = 0.0497) and proximity scores (p = 0.0099) than non-responders. The CD8⁺FoxP3⁺PD-1⁺ presence and tumor proximity were essential for favorable outcomes. In low-PD-L1 TPS patients, the CD8⁺FoxP3⁺PD-1⁺ abundance and proximity scores strongly predicted the response (AUC: 0.79 and 0.75 vs. PD-L1 TPS AUC = 0.58). A survival analysis linked the presence and proximity score of CD8⁺FoxP3⁺PD-1⁺ cells to prolonged overall survival (OS) and progression-free survival (PFS). Notably, a low proximity score of CD8⁺FoxP3⁺PD-1⁺ cells emerged as an independent risk factor for a shorter PFS (HR = 6.16, 95% CI: 2.12–17.93, p = 0.001). Conclusion: The CD8⁺FoxP3⁺PD-1⁺ spatial proximity to tumor cells robustly predicts improved immunotherapy outcomes in advanced NSCLC. Full article

(This article belongs to the Section Thoracic Oncology)

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15 pages, 1197 KiB

Open AccessReview

ADCs and TCE in SCLC Therapy: The Beginning of a New Era?

by Paola Muscolino, Fausto Omero, Desirèe Speranza, Carla Infurna, Silvana Parisi, Vincenzo Cianci, Massimiliano Berretta, Alessandro Russo and Mariacarmela Santarpia

Curr. Oncol. 2025, 32(5), 261; https://doi.org/10.3390/curroncol32050261 - 30 Apr 2025

Viewed by 140

Abstract

The therapeutic landscape for small cell lung cancer (SCLC) has remained stationary for decades, with chemotherapy representing the sole treatment strategy, with a modest survival benefit. The addition of immune checkpoint inhibitors (ICIs) to standard first-line chemotherapy for SCLC was a considerable milestone. [...] Read more.

The therapeutic landscape for small cell lung cancer (SCLC) has remained stationary for decades, with chemotherapy representing the sole treatment strategy, with a modest survival benefit. The addition of immune checkpoint inhibitors (ICIs) to standard first-line chemotherapy for SCLC was a considerable milestone. However, despite high overall response rates, this strategy failed to deliver long-term benefits for most patients, who continue to face a poor prognosis. Over the last few years, a deeper knowledge of the molecular biology of SCLC and the impressive advancements in drug development, have led to the generation of novel classes of systemic therapies that promise to revolutionize the current therapeutic scenario. Among the various therapeutic approaches in development, T-cell Engagers (TCE) and antibody-drug conjugates (ADCs) stand out due to their unique structural characteristics and mechanisms of action. These therapies represent a paradigm shift from traditional monoclonal antibody (mAb) and chemotherapy regimens, allowing direct engagement of multiple targets associated with tumor progression. In this review, we provide an overview of current drug development in SCLC, specifically focusing on these new agents, summarizing available evidence, and tracking future directions. Full article

(This article belongs to the Special Issue Hype or Hope—Combination Therapies for Lung Cancer)

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10 pages, 1280 KiB

Open AccessCase Report

Spontaneous Dramatic Regression of Clear Cell Renal Cell Carcinoma After Pazopanib-Induced Severe Systemic Inflammatory Syndrome: A Case Report and Literature Review

by Chi Hyuk Oh and Hong Jun Kim

Curr. Oncol. 2025, 32(5), 260; https://doi.org/10.3390/curroncol32050260 - 30 Apr 2025

Viewed by 162

Abstract

Renal cell carcinoma (RCC) is the most common type of kidney cancer, accounting for a significant proportion of all cancer cases in Korea. This case report presents a unique instance of spontaneous dramatic tumor regression in a 42-year-old Korean male diagnosed with clear [...] Read more.

Renal cell carcinoma (RCC) is the most common type of kidney cancer, accounting for a significant proportion of all cancer cases in Korea. This case report presents a unique instance of spontaneous dramatic tumor regression in a 42-year-old Korean male diagnosed with clear cell RCC. The patient initially presented with right lower back pain, weight loss, and a loss of appetite. Following systemic immunotherapy with nivolumab and ipilimumab, and right radical nephrectomy, the patient was diagnosed with metastatic clear cell RCC, with new metastatic lesions detected in the liver, and on the chest wall on follow-up imaging. Second-line systemic treatment with pazopanib was initiated. Shortly thereafter, the patient developed severe systemic inflammatory syndrome, resulting in a mental stupor and acute kidney failure. Intensive care, including continuous renal replacement therapy and high-dose immunosuppressants, was administered. The patient’s condition improved significantly with the intensive care regimen, leading to unintended tumor regression. These potentially fatal side effects occurred without infection, as confirmed by negative blood and urine cultures, and were attributed to the recent introduction of pazopanib. Follow-up imaging showed a significant reduction in hepatic metastatic lesions and the disappearance of chest wall nodules. This is the first reported case of RCC tumor regression following the side effects of pazopanib, underscoring the need for further studies into the immune mechanisms involved in RCC treatment and highlighting potential therapeutic strategies that leverage innate immune responses. Full article

(This article belongs to the Section Genitourinary Oncology)

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8 pages, 209 KiB

Open AccessArticle

Does Pre-Existing Chronic Obstructive Pulmonary Disease Increase the Risk of Checkpoint Inhibitor Pneumonitis in Advanced/Metastatic Non-Small Cell Lung Cancer Treated with Immune Checkpoint Inhibitors?

by David Spillane, Carmela Pepe, Goulnar Kasymjanova, Diane Cruiziat, Sara Cohen, Jeremy Naimer and Jason Agulnik

Curr. Oncol. 2025, 32(5), 259; https://doi.org/10.3390/curroncol32050259 - 29 Apr 2025

Viewed by 165

Abstract

Objective: Immune checkpoint inhibitors (ICIs) are front-line treatment options for NSCLC. ICI therapy is associated with a risk of immune-related adverse events (irAEs). Checkpoint inhibitor pneumonitis (CIP) is a potentially life-threatening irAE. Previous studies have demonstrated that asthma and interstitial lung disease are [...] Read more.

Objective: Immune checkpoint inhibitors (ICIs) are front-line treatment options for NSCLC. ICI therapy is associated with a risk of immune-related adverse events (irAEs). Checkpoint inhibitor pneumonitis (CIP) is a potentially life-threatening irAE. Previous studies have demonstrated that asthma and interstitial lung disease are associated with an increased risk of CIP. We sought to determine whether chronic obstructive pulmonary disease (COPD) is associated with CIP. Methods: This retrospective study examines a cohort of ICI-treated NSCLC patients either with or without chemotherapy at the Anna and Peter Brojde Lung Cancer Centre, Jewish General Hospital in Montreal, Canada between 2014 and 2023. We explored associations between risk factors and CIP using the Mann–Whitney U test or Fisher’s exact test. Analysis of prognostic factors was performed using a logistic regression model. All statistical analyses were carried out using SPSS software, version 24.0 (SPSS, Chicago, IL, USA). p-values of 0.05 or less were considered significant. Results: Of the 327 selected patients on ICIs, 23 experienced an acute respiratory deterioration that was attributed to CIP, 87/327(26.6%) patients had a pre-existing diagnosis of COPD, and 11/87 (12.6%) COPD patients experienced CIP compared to 13/240 (5.5%) non-COPD patients (p = 0.061). There was no statistical or clinically meaningful correlation between COPD severity and CIP. The only variable significantly associated with CIP was a poor ECOG performance status. Among ECOG 1 patients, 18/91 (19.8%) experienced CIP compared to 5/226 (2.2%) of those with an ECOG of 0. A multivariate assessment involving all 327 patients revealed no significant factors affecting CIP development. Conclusions: Our single-institution study revealed that although there was a trend, the presence of COPD was not statistically associated with an increased risk of CIP. Additionally, neither FEV1 nor DLCO had a meaningful impact on the development of CIP in COPD patients. Given these findings, we emphasize the need for larger prospective studies to confirm these observations before drawing definitive clinical recommendations. Full article

(This article belongs to the Section Thoracic Oncology)

18 pages, 932 KiB

Open AccessArticle

A Population Survival Kinetics Assessment of Extensive Small Cell Lung Cancer and Rationale for Maintenance Therapy

by David J. Stewart, Katherine Cole and Stephanie Brule

Curr. Oncol. 2025, 32(5), 258; https://doi.org/10.3390/curroncol32050258 - 29 Apr 2025

Viewed by 156

Abstract

Progression-free survival (PFS) and overall survival (OS) curves generally approximate first-order kinetics. On log-linear plots, convex curves with downward inflection (indicating late acceleration of progression/death) might arise from stopping effective therapies. We digitized published PFS/OS curves for etoposide/platinum-treated extensive small-cell lung cancer (SCLC) [...] Read more.

Progression-free survival (PFS) and overall survival (OS) curves generally approximate first-order kinetics. On log-linear plots, convex curves with downward inflection (indicating late acceleration of progression/death) might arise from stopping effective therapies. We digitized published PFS/OS curves for etoposide/platinum-treated extensive small-cell lung cancer (SCLC) and other malignancies and replotted the curves log-linearly. Of 26 SCLC PFS curves, 21 (81%) were highly convex (with a marked late down-turn), and 26 (100%) were moderately or highly convex vs. 35/888 (4%) highly convex and 186 (21%) moderately/highly convex curves for other cancers (p < 0.0001). For SCLC, all 32 OS curves were moderately or highly convex vs. 87/363 (24%) that were moderately/highly convex for other cancers (p < 0.0001). The SCLC PFS curves had an initial downward inflection at a median of 3.1 months (around the completion of first-line chemotherapy), then a second inflection at 5.4 months, with further acceleration of progression. The median PFS half-life was 11.9 months while receiving treatment vs. 1.7 months after the second inflection point. Immunotherapy benefit appeared to be limited to 6–10% of the population. SCLC PFS/OS curves are more often convex than for other cancers, reflecting SCLC chemotherapy sensitivity but rapid progression following the completion of first-line chemotherapy. Effective maintenance strategies are needed. Full article

(This article belongs to the Section Thoracic Oncology)

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13 pages, 891 KiB

Open AccessArticle

The Role of [¹⁸F]FDG PET/CT Prior to and During Neoadjuvant Chemotherapy for Soft Tissue Sarcomas

by Stijn J.C. van der Burg, Bernies van der Hiel, Lotte Heimans, J. Martijn Kerst, Michel W.J.M. Wouters, Petur Snaebjornsson, Yvonne M. Schrage, Winette T.A. van der Graaf and Winan J. van Houdt

Curr. Oncol. 2025, 32(5), 257; https://doi.org/10.3390/curroncol32050257 - 28 Apr 2025

Viewed by 172

Abstract

This retrospective, single-center study investigates the association between PET parameters and pathological response or disease recurrence in patients with soft tissue sarcoma (STS) treated with neoadjuvant chemotherapy (NACT). The maximum standardized uptake value (SUVmax_BL), metabolic tumor volume (MTV_BL), and [...] Read more.

This retrospective, single-center study investigates the association between PET parameters and pathological response or disease recurrence in patients with soft tissue sarcoma (STS) treated with neoadjuvant chemotherapy (NACT). The maximum standardized uptake value (SUVmax_BL), metabolic tumor volume (MTV_BL), and total lesion glycolysis (TLG_BL) were measured at baseline [¹⁸F]FDG PET/CT and the change in percentage (ΔSUVmax, ΔMTV, ΔTLG) from baseline to early evaluation [¹⁸F]FDG PET/CT was calculated. The optimal cutoff values of the different PET parameters for pathological response, defined as <10% residual viable tumor (RVT) or >15% fibrosis/hyalinization, and recurrence-free survival were obtained for analysis. Forty-two patients who underwent baseline [¹⁸F]FDG PET/CT and NACT followed by surgery were included between January 2015 and January 2023. The primary diagnoses were angiosarcoma (n = 15), leiomyosarcoma (n = 15), sarcoma not otherwise specified (n = 9) and synovial sarcoma (n = 3). Twenty-eight (66.6%) patients underwent an early evaluation PET/CT. MTV_BL, TLG_BL, and ΔSUVmax (p = 0.024; p = 0.042, p = 0.009, respectively) values above the cutoff were associated with a pathological response based on RVT. ΔSUVmax, ΔMTV, and ΔTLG (p = 0.002; p = 0.019; p = 0.039, respectively) values above the cutoff were positively related to >15% fibrosis/hyalinization. MTV_BL, TLG_BL, and ΔMTV (p = 0.014; p = 0.022; p = 0.034, respectively) values above the cutoff were prognostic for the recurrence of disease. [¹⁸F]FDG PET/CT has a promising role in STS patients treated with NACT. Full article

(This article belongs to the Special Issue Sarcoma Surgeries: Oncological Outcomes and Prognostic Factors)

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26 pages, 6801 KiB

Open AccessSystematic Review

Minimally Invasive Surgical Techniques for Renal Cell Carcinoma with Intravenous Tumor Thrombus: A Systematic Review of Laparoscopic and Robotic-Assisted Approaches

by Yiting Wu, Shuyang Feng and Ping Fu

Curr. Oncol. 2025, 32(5), 256; https://doi.org/10.3390/curroncol32050256 - 28 Apr 2025

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Abstract

Introduction: Locally advanced renal cell carcinoma (RCC) with intravenous tumor thrombus (IVTT) represents 4–10% of renal tumors. This review assesses the safety and outcomes of minimally invasive techniques, specifically laparoscopic (LAP) and robotic-assisted (RA) methods, for treating RCC with IVTT. Methods: A literature [...] Read more.

Introduction: Locally advanced renal cell carcinoma (RCC) with intravenous tumor thrombus (IVTT) represents 4–10% of renal tumors. This review assesses the safety and outcomes of minimally invasive techniques, specifically laparoscopic (LAP) and robotic-assisted (RA) methods, for treating RCC with IVTT. Methods: A literature search across several databases identified 54 studies (42 case series, 12 cohort studies) for analysis. Perioperative outcomes, including operative time, blood loss, transfusion rates, length of stay, and complications, were compared based on IVTT levels. Results: LAP and RA techniques were feasible for low-level IVTT, showing similar perioperative results. RA outperformed LAP in high-level IVTT with shorter operative times and lower blood loss and transfusion rates, despite managing more complex cases. RA maintained stable cancer-specific mortality (CSM) and metastasis rates, whereas LAP exhibited higher rates in high-level cases. Both techniques had low local recurrence rates. Conclusion: RA may be a superior option for RCC with IVTT, especially in high-level cases, but the data come mainly from specialized centers, signaling a need for multicenter validation and standardized criteria. Long-term outcomes require further study to assess RA’s non-inferiority to LAP. Full article

(This article belongs to the Section Genitourinary Oncology)

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11 pages, 8363 KiB

Open AccessArticle

Molecular and Pathological Heterogeneity of Synchronous Small and Large Duct Intrahepatic Cholangiocarcinoma—A Case Series

by Savelina Popovska, Vladislav Nankov, Boriana Ilcheva and George Dimitrov

Curr. Oncol. 2025, 32(5), 255; https://doi.org/10.3390/curroncol32050255 - 27 Apr 2025

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Abstract

Background: Synchronous small- and large-duct intrahepatic cholangiocarcinoma (iCCA) represents a rare and heterogeneous entity, posing challenges for diagnosis, prognosis, and treatment selection. The pathological and molecular diversity between these subtypes influences tumor behavior and therapeutic response, necessitating a personalized approach. This study investigates [...] Read more.

Background: Synchronous small- and large-duct intrahepatic cholangiocarcinoma (iCCA) represents a rare and heterogeneous entity, posing challenges for diagnosis, prognosis, and treatment selection. The pathological and molecular diversity between these subtypes influences tumor behavior and therapeutic response, necessitating a personalized approach. This study investigates the molecular and pathological heterogeneity of synchronous iCCA and its clinical implications. Methods: This prospective case series included six patients diagnosed with synchronous small- and large-duct iCCA at the Military Medical Academy, Sofia, between January 2023 and January 2025, with a median follow-up of 15 months. Tumor classification was based on histopathological examination, immunohistochemical analysis, and next-generation sequencing (NGS)-based genomic profiling. Radiological and clinical data were analyzed to assess tumor growth patterns, treatment response, and progression-free survival (PFS). Results: Small-duct-predominant iCCA was associated with IDH1/2 mutations and FGFR2 fusions, a mass-forming growth pattern, and longer PFS. In contrast, large-duct-predominant iCCA exhibited KRAS, TP53, and NF1 mutations, an infiltrative periductal growth pattern, and a more aggressive clinical course with shorter PFS. Tumor mutational burden-high (TMB-H) and microsatellite instability-high (MSI-H) were observed in a subset of large-duct iCCA cases, suggesting potential benefit from immune checkpoint inhibitors (ICIs). Conclusions: Synchronous small- and large-duct iCCA demonstrates distinct molecular, histopathological, and clinical features, necessitating individualized treatment strategies. Targeted therapies for IDH1/2- and FGFR2-altered small-duct iCCA have shown efficacy, whereas large-duct iCCA remains more aggressive and treatment-resistant, requiring novel therapeutic approaches. Future research should focus on adaptive treatment strategies that account for tumor heterogeneity and dominant molecular drivers. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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19 pages, 4943 KiB

Open AccessArticle

Reassessing the Prognostic Value of Lymph Node Metastasis in Deficient Mismatch Repair Colorectal Cancer

by Zilan Ye, Dakui Luo, Fan Chen, Jiayu Chen, Zezhi Shan, Junyong Weng, Yu Zhang, Qingguo Li and Xinxiang Li

Curr. Oncol. 2025, 32(5), 254; https://doi.org/10.3390/curroncol32050254 - 27 Apr 2025

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Abstract

Background: In non-metastatic deficient mismatch repair (dMMR) colorectal cancer (CRC), traditional prognostic factors, such as pN staging, often fail to distinguish patient outcomes effectively. Methods: This retrospective study included a cohort of 792 dMMR CRC patients who underwent surgical treatment without neoadjuvant chemoradiotherapy [...] Read more.

Background: In non-metastatic deficient mismatch repair (dMMR) colorectal cancer (CRC), traditional prognostic factors, such as pN staging, often fail to distinguish patient outcomes effectively. Methods: This retrospective study included a cohort of 792 dMMR CRC patients who underwent surgical treatment without neoadjuvant chemoradiotherapy or immunotherapy. Traditional prognostic factors were compared with lymph node-based models (NLN, LNR, LOODS) for their ability to predict overall survival (OS) and disease-free survival (DFS). Results: The study demonstrated that traditional factors, such as histologic type, differentiation, and vascular invasion, had limited predictive value in dMMR CRC. Furthermore, the pN stage failed to effectively distinguish between pN1 and pN2 for both OS (p = 0.219) and DFS (p = 0.095). Conversely, LOODS demonstrated superior performance over traditional pN staging in predicting both OS and DFS (p < 0.001). A prognostic model combining LOODS with age exhibited superior predictive performance compared with the traditional TN staging system. Conclusions: LOODS was identified as a more effective independent prognostic factor compared with traditional pN staging, enabling more precise stratification of pN+ patients in non-metastatic dMMR CRC, highlighting its potential utility in guiding postoperative treatment and optimizing therapeutic strategies. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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23 pages, 317 KiB

Open AccessArticle

A Multi-Site Refinement Study of Taking Back Control Together, an Intervention to Support Parents Confronted with Childhood Cancer

by Nikita Guarascio, Ariane Levesque, David Ogez, Valérie Marcil, Daniel Curnier, Véronique Bélanger, Émélie Rondeau, Katherine Péloquin, Caroline Laverdière, Raoul Santiago, Josée Brossard, Stéphanie Vairy, Serge Sultan and The TBCT-Québec Team

Curr. Oncol. 2025, 32(5), 253; https://doi.org/10.3390/curroncol32050253 - 26 Apr 2025

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Abstract

A child’s cancer diagnosis profoundly impacts the psychological well-being of parents. To alleviate parental distress, researchers developed Taking Back Control Together (TBCT), a manualized six-session program targeting individual problem-solving skills and dyadic coping. The current study aimed to refine TBCT for future uptake [...] Read more.

A child’s cancer diagnosis profoundly impacts the psychological well-being of parents. To alleviate parental distress, researchers developed Taking Back Control Together (TBCT), a manualized six-session program targeting individual problem-solving skills and dyadic coping. The current study aimed to refine TBCT for future uptake across different sites. We invited potential interventionists and local stakeholders from three pediatric oncology centers (CHU Sainte-Justine, CHU de Sherbrooke, and CHU de Québec) to join the refinement team. The final working team comprised 26 professionals, including social workers, psychologists, researchers, coordinators, and parent-partners. The study included eight 50- to 90-min discussion sessions designed to stimulate conversation and facilitate the exchange of ideas and perspectives. We used framework analysis to identify and describe patterns within the qualitative data. The data were organized into three categories: (1) intervention description, which addresses changes in personnel, modes of delivery, and tailoring to accommodate different family structures; (2) content modifications, which include language simplification and visual enhancements; and (3) factors influencing TBCT’s future uptake, such as accessibility, participant satisfaction, clinician compensation, and flexibility in program delivery. The direct output of this research is a refined program with an updated manual, tools, and format adapted for use in different sites. Full article

(This article belongs to the Section Childhood, Adolescent and Young Adult Oncology)

10 pages, 196 KiB

Open AccessArticle

The Application Effect of Endoscopic Thyroidectomy via the Gasless Unilateral Axillary Approach in Thyroid Cancer and Its Impact on Postoperative Stress Response

by Jinliang Jia, Jihua Han, Rui Pang, Wen Bi, Bo Liu, Ruinan Sheng and Lingyu Kong

Curr. Oncol. 2025, 32(5), 252; https://doi.org/10.3390/curroncol32050252 - 26 Apr 2025

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Abstract

Objective: This study aims to evaluate the application effect of endoscopic thyroidectomy via the gasless unilateral axillary (GUA) approach in thyroid cancer and its impact on the postoperative stress response. Methods: Ninety-four thyroid cancer patients were enrolleod and assigned into the open group [...] Read more.

Objective: This study aims to evaluate the application effect of endoscopic thyroidectomy via the gasless unilateral axillary (GUA) approach in thyroid cancer and its impact on the postoperative stress response. Methods: Ninety-four thyroid cancer patients were enrolleod and assigned into the open group (underwent conventional-open-anterior-cervical-approach thyroidectomy) and the endoscopic group (underwent GUA endoscopic thyroidectomy) (n = 47). Perioperative indicators between the two groups were compared. Thyroid function parameters [total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH)] were measured preoperatively and on postoperative day 2. Inflammatory markers [interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)] and stress-related hormones [norepinephrine (NE) and cortisol (Cor)] were evaluated preoperatively and on postoperative day 1. The aesthetic appearance of the incision was evaluated at 1 and 3 months postoperatively using the Vancouver Scar Scale (VSS). Postoperative complications were also compared between the two groups. Results: The endoscopic group exhibited less intraoperative blood loss, reduced postoperative drainage, a lower pain degree on 1 day postoperatively, a shorter hospitalization time, and a longer surgical time versus the open group (p < 0.05). The serum levels of TT3, TT4, FT3, and FT4 were lower, while the TSH levels were higher in both groups on postoperative day 2 compared to preoperative values. Additionally, the serum levels of IL-6, TNF-α, NE, and Cor increased on day 1 postoperatively, with the endoscopic group showing lower levels of these markers compared to the open group (p < 0.05). The VSS scores at 1 and 3 months after surgery were lower in the endoscopic group compared to the open group, indicating better cosmetic outcomes (p < 0.05). The incidence of postoperative complications was comparable between the endoscopic and open groups (p > 0.05). Conclusions: Endoscopic thyroidectomy by a GUA offers notable advantages over the conventional-open-anterior-cervical-approach thyroidectomy, including reduced intraoperative blood loss, less postoperative drainage, and a lower postoperative stress response. This approach also results in improved cosmetic outcomes, making it a promising alternative for thyroid cancer surgery. Full article

(This article belongs to the Section Head and Neck Oncology)

23 pages, 693 KiB

Open AccessSystematic Review

Molecular Prognostic Factors in Uterine Serous Carcinomas: A Systematic Review

by Anna Svarna, Michalis Liontos, Alkistis Papatheodoridi, Aristea-Maria Papanota, Eleni Zografos, Maria Kaparelou, Flora Zagouri and Meletios-Athanasios Dimopoulos

Curr. Oncol. 2025, 32(5), 251; https://doi.org/10.3390/curroncol32050251 - 25 Apr 2025

Viewed by 198

Abstract

Uterine serous carcinomas are an aggressive minority of endometrial cancers. They are characterized by mutations in TP53 and extensive copy number alterations and are primarily classified in the copy number-high/p53abn molecular prognostic group, highlighting a unique molecular profile that is crucial for understanding [...] Read more.

Uterine serous carcinomas are an aggressive minority of endometrial cancers. They are characterized by mutations in TP53 and extensive copy number alterations and are primarily classified in the copy number-high/p53abn molecular prognostic group, highlighting a unique molecular profile that is crucial for understanding their behavior and treatment responses. Clinical studies have shown that molecular categorization via biomarkers can facilitate proper treatment selection, and this is now widely used. In this context, the scope of this systematic review is to identify molecular characteristics with prognostic significance for these neoplasms to further inform on their treatment needs. We performed a comprehensive literature search of all articles written in English using the PubMed/Medline and Cochrane databases through February 2025. Our review led to the inclusion of 95 studies, from which we identified a total of 66 distinct molecular characteristics along with new cancer signatures that may impact prognosis. These findings have the potential to inform clinical practice by aiding in the development of tailored treatment strategies for patients with uterine serous carcinoma, ultimately improving outcomes in this challenging malignancy. Full article

(This article belongs to the Section Gynecologic Oncology)

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9 pages, 5162 KiB

Open AccessCase Report

Delayed Bronchopleural Fistula Formation Following Salvage Surgery of Stage IV Anaplastic Lymphoma Kinase-Positive Non-Small-Cell Lung Cancer

by Lauren Barter, Stephanie Snow, Aneil Mujoomdar, Lara Best and Daniel French

Curr. Oncol. 2025, 32(5), 250; https://doi.org/10.3390/curroncol32050250 - 25 Apr 2025

Viewed by 200

Abstract

This case report highlights the management of a delayed bronchopleural fistula (BPF) following salvage pulmonary resection to achieve local control and no radiographic evidence of disease in a patient treated with serial tyrosine kinase inhibitors (TKIs) for stage IV anaplastic lymphoma kinase (ALK)-positive [...] Read more.

This case report highlights the management of a delayed bronchopleural fistula (BPF) following salvage pulmonary resection to achieve local control and no radiographic evidence of disease in a patient treated with serial tyrosine kinase inhibitors (TKIs) for stage IV anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer (NSCLC). The initial pulmonary resection was complicated by dense adhesions and an abnormally torturous pulmonary artery. Six weeks after the index surgery, the patient presented with a delayed BPF requiring decortication, repair of airway, and coverage of the bronchial stump with a serratus anterior muscle flap. Full article

(This article belongs to the Special Issue Clinical Management and Outcomes of Lung Cancer Patients)

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11 pages, 199 KiB

Open AccessCommentary

Current and Future Directions Using Virtual Avenues for Care Delivery Across the Cancer Continuum

by Charlotte T. Lee, Franco Ng and Elizabeth Borycki

Curr. Oncol. 2025, 32(5), 249; https://doi.org/10.3390/curroncol32050249 - 24 Apr 2025

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Abstract

Oncology nurses have long been at the forefront of virtual care, transitioning from telenursing to technology-driven delivery methods that address the evolving needs of cancer patients. Initially developed to overcome barriers to care for rural and underserved populations, virtual care has grown into [...] Read more.

Oncology nurses have long been at the forefront of virtual care, transitioning from telenursing to technology-driven delivery methods that address the evolving needs of cancer patients. Initially developed to overcome barriers to care for rural and underserved populations, virtual care has grown into a critical component of oncology practice. Oncology nurses play a central role in providing timely, personalized, and holistic care, leveraging tools such as remote monitoring, patient-reported outcomes, and mHealth platforms. However, the rapid adoption of virtual care demands a broader focus to sustain its impact. This commentary explores the need to clearly define the role of oncology nurses in virtual care, emphasizing leadership in digital health, the integration of hybrid care models, and workforce training. By addressing these priorities, virtual care can continue to enhance patient outcomes, strengthen nursing-led interventions, and expand the scope of oncology nursing, positioning it as an essential and enduring facet of cancer care delivery. Full article

(This article belongs to the Special Issue Feature Reviews in Section "Oncology Nursing")

14 pages, 548 KiB

Open AccessArticle

The Influence of Poverty and Rurality on Colorectal Cancer Survival by Race/Ethnicity: An Analysis of SEER Data with a Census Tract-Level Measure of Persistent Poverty

by Steven S. Coughlin, Meng-Han Tsai, Jorge Cortes, Malcolm Bevel and Marlo Vernon

Curr. Oncol. 2025, 32(5), 248; https://doi.org/10.3390/curroncol32050248 - 23 Apr 2025

Viewed by 253

Abstract

Purpose: Because of shared mechanisms such as decreased access to health care, rurality and poverty may act synergistically to decrease colorectal cancer (CRC) survival. Methods: We conducted a retrospective cohort analysis of SEER data (22 registries) with census tract-level measures of poverty/rurality for [...] Read more.

Purpose: Because of shared mechanisms such as decreased access to health care, rurality and poverty may act synergistically to decrease colorectal cancer (CRC) survival. Methods: We conducted a retrospective cohort analysis of SEER data (22 registries) with census tract-level measures of poverty/rurality for the period 2006–2015. Multivariable Cox proportional hazard regressions were applied to examine the independent and intersectional associations of persistent poverty and rurality on 5-year cause-specific CRC survival across five racial/ethnic groups. Results: Among 532,868 CRC patients, non-Hispanic Blacks (NHB) demonstrated lower 5-year survival probability (64.2% vs. 68.3% in non-Hispanic Whites [NHW], 66.5% in American Indian/Alaska Natives [AI/AN], 72.1% in Asian/Pacific Islanders, and 68.7% in Hispanic groups) (p-value < 0.001). In adjusted analysis, CRC patients living in rural areas with poverty were at a 1.2–1.6-fold increased risk of CRC death than those who did not live in these areas in five racial/ethnic groups. In particular, AI/AN patients living in rural areas with poverty were 66% more likely to die from CRC (95% CI, 1.32, 2.08). Conclusions: CRC patients who live in rural or poverty areas in SEER areas in the U.S. have a poorer survival compared with those who do not live in such areas regardless of race/ethnicity. Significantly greater risk of CRC death was observed in AI/ANs. Impact: Patient navigators, community education or screening, and other health care system interventions may be helpful to address these disparities by socioeconomic status, race, and geographic residence. Multi-level interventions aimed at institutional racism and medical mistrust may also be helpful. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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9 pages, 188 KiB

Open AccessArticle

COVID-19 Pandemic’s Effects on Breast Cancer Screening, Staging at Diagnosis at Presentation, Oncologic Management, and Immediate Reconstruction: A Canadian Perspective

by Adolfo Alejandro Lopez Rios, Alissa Dozois, Alexander T. Johnson, Toros Canturk and Jing Zhang

Curr. Oncol. 2025, 32(5), 247; https://doi.org/10.3390/curroncol32050247 - 23 Apr 2025

Viewed by 219

Abstract

Background: Did the COVID-19 pandemic lead to delays in breast cancer management, impacting treatment recommendations? The goal of this study was to assess the pandemic’s effect on breast cancer treatment and management practices. Methods: This study aimed to assess the pandemic’s effect on [...] Read more.

Background: Did the COVID-19 pandemic lead to delays in breast cancer management, impacting treatment recommendations? The goal of this study was to assess the pandemic’s effect on breast cancer treatment and management practices. Methods: This study aimed to assess the pandemic’s effect on breast cancer treatment from March 2018 to February 2020 (pre-pandemic) and March 2020 to February 2022 (during the pandemic) in Canada. A retrospective cohort study at The Ottawa Hospital, Ontario, Canada, compared breast cancer patients diagnosed in the two years before and after the pandemic’s onset. The study examined patient demographics, cancer stages, treatment timelines, and procedures, including neoadjuvant chemotherapy, endocrine therapy, and surgical treatment. Descriptive statistics and frequencies identified changes. The study is limited to a single institution, which may restrict generalizability. Inclusion criteria focused on female patients over 18 years with newly diagnosed breast cancer, excluding recurrent cases. Stage IV patients were included, but further details on their management are needed. Results: Breast cancer diagnoses decreased from 2577 before the pandemic to 2290 after its onset. Surgeries decreased from 1226 to 1013 (p < 0.020), while neoadjuvant endocrine therapy increased from 148 to 169, and adjuvant radiotherapy rose from 586 to 722 (p < 0.001). The study revealed a decrease in breast cancer diagnoses and surgeries during the pandemic, with a rise in non-surgical treatments. Conclusions: These changes indicate significant shifts in breast cancer management due to the pandemic. The decrease in surgical treatments and increase in non-surgical options such as endocrine therapy and radiotherapy suggest adaptations in clinical practices to cope with the challenges posed by the pandemic. Understanding these shifts is crucial for developing strategies to mitigate the impact of future disruptions on breast cancer care and ensuring optimal patient outcomes. Full article

(This article belongs to the Section Breast Cancer)

16 pages, 9566 KiB

Open AccessArticle

Use of Radiofrequency in Robot-Assisted Partial Nephrectomy for Small Tumors: A Novel Technique

by Matías Larrañaga, Helga Ibañez, Jessica Pfeifer, Cristobal Román, Rubén Olivares, José Antonio Salvadó, José Miguel Cabello, Sergio Moreno, Renato Cabello, Carmen Franco and Alfredo Velasco

Curr. Oncol. 2025, 32(5), 246; https://doi.org/10.3390/curroncol32050246 - 23 Apr 2025

Viewed by 281

Abstract

Introduction and Objectives: Radiofrequency is standardized for ablating small renal tumors, but evidence regarding its effects remains limited. Partial nephrectomy, the gold standard, often leads to hemorrhagic complications and irreversible renal damage due to hilum clamping. To mitigate these risks, we propose a [...] Read more.

Introduction and Objectives: Radiofrequency is standardized for ablating small renal tumors, but evidence regarding its effects remains limited. Partial nephrectomy, the gold standard, often leads to hemorrhagic complications and irreversible renal damage due to hilum clamping. To mitigate these risks, we propose a novel technique that replaces clamping with radiofrequency ablation of the tumor for hemostasis in robot-assisted partial nephrectomy. Methods: We report on 357 consecutive patients with T1a renal tumors treated with robot-assisted surgery between 2010 and July 2024. Radiofrequency was used peri-tumorally for hemostasis, followed by complete lesion enucleation. Follow-up included ultrasound and creatinine at 1 month, CT scans at months 3 and 9, and then annually for 5 years. Results: The median age was 60.2 years, with 251 men (70.3%). The median tumor size was 22 mm, and the median blood loss was 15 mL. Hemorrhagic complications occurred in eight patients (2.2%), with one requiring a blood transfusion (0.28%). A total of 30 patients experienced transient stage 1 acute kidney disease (8.4%), with no significant change in median 74.92 mL/min/1.77 m² vs. 78.77 mL/min/1.77 m² vs. (p-value 0.15). The median follow-up was 48.2 months, with no tumor recurrence at the treated site. Renal cell carcinoma was found in 83.7% of tumors. Conclusions: To our knowledge, this series represent the largest global undertaking of renal tumor treatment using peripheral radiofrequency ablation without clamping, demonstrating optimal surgical and oncological outcomes, lower morbidity, and fewer complications compared to those noted in the revised literature regarding traditional clamping techniques. Full article

(This article belongs to the Section Surgical Oncology)

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11 pages, 1477 KiB

Open AccessArticle

Prognosis of Cancer Patients with Severe Hyponatremia in the Emergency Department: A Retrospective Study from the National Cancer Center of China

by Qinglong Jiang, Xi Zhang, Chao Wang, Rong Qin, Rui Sun, Shengling Qin, Cong Zhao, Zhiyong Li, Wenjie Zhu and Minghua Cong

Curr. Oncol. 2025, 32(5), 245; https://doi.org/10.3390/curroncol32050245 - 23 Apr 2025

Viewed by 189

Abstract

Aim: The aim of this study was to analyze the clinical characteristics and prognostic factors of profound hyponatremia in solid cancer patients admitted to the oncologic emergency department. Methods: We gathered data retrospectively from cancer patients who visited the emergency department of the [...] Read more.

Aim: The aim of this study was to analyze the clinical characteristics and prognostic factors of profound hyponatremia in solid cancer patients admitted to the oncologic emergency department. Methods: We gathered data retrospectively from cancer patients who visited the emergency department of the National Cancer Center of China between October 2019 and February 2023 with a serum sodium (Na) level of less than 125 mmol/L. The demographic and clinical characteristics, medical history, admission symptoms, laboratory parameters, and outcomes of the patients were recorded. Results: This study comprised 307 patients with severe hyponatremia in total. With 39.4% of all tumors being lung cancer (n = 121), nausea and vomiting were the most common admission symptoms for patients with severe hyponatremia. The 30-day mortality rate of profound hyponatremia cancer patients in the emergency department was 13.4%. The albumin level (p < 0.001), the hemoglobin level (p = 0.033), the TNM stage (p = 0.004), the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) score (p < 0.001), hypocalcemia (p = 0.006), renal insufficiency (p = 0.035), and the efficacy of sodium supplementation (p = 0.006) were significantly associated with 30-day mortality. Binary logistic regression analysis showed that a lower albumin level (OR 0.924, 95% CI 0.861–0.991, p = 0.028) and higher ECOG score (OR 8.443, 95% CI 3.568–19.976, p < 0.001) were independent risk factors for 30-day mortality. The overall survival of emergency cancer patients with severe hyponatremia was also examined. The results of the COX regression analysis demonstrated that the efficacy of sodium supplementation (OR = 2.643, 95% CI 1.593–4.386, p < 0.001), a low albumin level (OR = 0.654, 95% CI 0.463–0.923, p = 0.016), the TNM stage (OR = 4.606, 95% CI 2.846–7.455), and a higher ECOG score (OR = 1.738, 95% CI 1.292–2.338, p < 0.001) were independent risk factors for overall survival. Conclusions: The clinical manifestations of severe hyponatremia in emergency cancer patients are varied. Hypoalbuminemia and a higher ECOG score are independent risk factors for 30-day mortality and overall survival. Severe hyponatremia patients with a high ECOG score and/or a low albumin level should be monitored and followed more closely. Full article

(This article belongs to the Section Palliative and Supportive Care)

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14 pages, 636 KiB

Open AccessReview

Technical Innovations and Complex Cases in Robotic Surgery for Lung Cancer: A Narrative Review

by Giacomo Cusumano, Giuseppe Calabrese, Filippo Tommaso Gallina, Francesco Facciolo, Pierluigi Novellis, Giulia Veronesi, Stefano Viscardi, Filippo Lococo, Elisa Meacci, Alberto Terminella, Gaetano Romano, Cristina Zirafa, Franca Melfi, Stefano Margaritora and Marco Chiappetta

Curr. Oncol. 2025, 32(5), 244; https://doi.org/10.3390/curroncol32050244 - 22 Apr 2025

Viewed by 258

Abstract

For over two decades, robotic-assisted thoracic surgery (RATS) has revolutionized thoracic oncology. With enhanced visualization, dexterity, and precision, RATS has reduced blood loss, shortened hospital stays, and sped up recovery compared to traditional surgery or video-assisted thoracoscopic surgery (VATS). The use of 3D [...] Read more.

For over two decades, robotic-assisted thoracic surgery (RATS) has revolutionized thoracic oncology. With enhanced visualization, dexterity, and precision, RATS has reduced blood loss, shortened hospital stays, and sped up recovery compared to traditional surgery or video-assisted thoracoscopic surgery (VATS). The use of 3D high-definition imaging and articulated instruments allows for complex resections and advanced lymph node assessment. RATS delivers oncological outcomes similar to open surgery and VATS, with high rates of complete (R0) resections and acceptable complication rates. Its minimally invasive nature promotes quicker recovery. Advances in imaging software and augmented reality further enhance surgical accuracy and reduce intraoperative risks. However, RATS has some limitations, including high costs and a lack of tactile feedback, and certain complex procedures, such as extended resections and intrapericardial interventions, remain challenging. With growing experience and technological advances, RATS shows promise in reducing morbidity, improving quality of life, and expanding access to advanced oncologic care. This article reviews the evolution, benefits, and limitations of RATS in NSCLC treatment, highlighting its emerging role in managing complex cases. Full article

(This article belongs to the Section Thoracic Oncology)

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14 pages, 222 KiB

Open AccessArticle

Predictors of Colon Cancer Screening Among the Saudi Population at Primary Healthcare Settings in Riyadh

by Amani Alharthy, Mamdouh M. Shubair, Badr F. Al-Khateeb, Lubna Alnaim, Emad Aljohani, Nada Kareem Alenazi, Maha Alamodi Alghamdi, Khadijah Angawi, Rawabi M. Alsayer, Naif M. Alhawiti and Ashraf El-Metwally

Curr. Oncol. 2025, 32(5), 243; https://doi.org/10.3390/curroncol32050243 - 22 Apr 2025

Viewed by 317

Abstract

(1) Background: This study aims to identify the sociodemographic, behavioural, and systemic predictors of colorectal cancer (CRC) screening among primary healthcare attendees in Riyadh, Saudi Arabia, to inform targeted interventions and policy strategies. (2) Methods: This cross-sectional study was conducted between March and [...] Read more.

(1) Background: This study aims to identify the sociodemographic, behavioural, and systemic predictors of colorectal cancer (CRC) screening among primary healthcare attendees in Riyadh, Saudi Arabia, to inform targeted interventions and policy strategies. (2) Methods: This cross-sectional study was conducted between March and July 2023 across 48 randomly selected primary healthcare centers in Riyadh, Saudi Arabia. The target population for this study was adults aged 18 and above attending primary healthcare centers in Riyadh. Multi-stage random sampling was used to recruit participants. Multivariate logistic regression was performed to identify independent predictors of CRC screening. (3) Results: CRC screening uptake was found to be only 4.2%. Age was a significant predictor, with individuals aged 50–75 years (adjusted odds ratio [AOR]: 1.90, 95% confidence interval [CI]: 1.50–2.42) and those aged 75 years or older (AOR: 1.37, 95% CI: 1.01–1.87) being more likely to undergo screening compared to younger individuals. Insurance coverage strongly influenced screening behaviour (AOR: 1.64, 95% CI: 1.37–1.96). Smokers were nearly four times more likely to participate in screening than non-smokers (AOR: 3.87, 95% CI: 3.21–4.69), and physical activity was positively associated with screening (AOR: 1.43, 95% CI: 1.11–1.82). (4) Conclusions: CRC screening uptake in Riyadh is critically low, highlighting the need for targeted public health interventions. Key predictors such as age, insurance coverage, smoking, and physical activity underscore the importance of addressing sociodemographic disparities and promoting health awareness. The findings emphasize the need for culturally tailored educational campaigns, improved healthcare access, and enhanced screening programs to increase uptake. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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Curr. Oncol., Volume 32, Issue 5 (May 2025) – 30 articles

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