Current Oncology

9 pages, 480 KB

Open AccessArticle

Skeletal Muscle Radiation Attenuation at C3 Predicts Survival in Head and Neck Cancer

by Felix Barajas Ordonez, Kunpeng Xie, André Ferreira, Robert Siepmann, Najiba Chargi, Sven Nebelung, Daniel Truhn, Stefaan Bergé, Philipp Bruners, Jan Egger, Frank Hölzle, Markus Wirth, Christiane Kuhl and Behrus Hinrichs-Puladi

Curr. Oncol. 2025, 32(10), 587; https://doi.org/10.3390/curroncol32100587 - 21 Oct 2025

Viewed by 425

Abstract

Background: Sarcopenia assessed by skeletal muscle area (SMA) at the third lumbar vertebra (L3) is an established prognostic marker in many malignancies, including head and neck cancer (HNC). However, in HNC, L3 is rarely assessed. The prognostic value of myosteatosis, measured by [...] Read more.

Background: Sarcopenia assessed by skeletal muscle area (SMA) at the third lumbar vertebra (L3) is an established prognostic marker in many malignancies, including head and neck cancer (HNC). However, in HNC, L3 is rarely assessed. The prognostic value of myosteatosis, measured by skeletal muscle radiation attenuation (SMRA) remains largely unexplored. This study evaluated both muscle metrics at the third cervical vertebra (C3) for locoregional control (LRC) and overall survival (OS) in HNC. Methods: SMA and SMRA at C3 were quantified in CT scans of 904 HNC cases by a deep learning-based segmentation pipeline with manual verification. Cox proportional hazards models assessed associations with LRC and OS. Results: Median SMA was 36.64 cm² (IQR: 30.12–42.44). Median SMRA was 50.77 HU (IQR: 43.04–57.39). In multivariable analysis, lower SMA (HR 1.85, 95% CI: 1.19–2.88, p ≤ 0.001) and lower SMRA (HR 1.76, 95% CI: 1.22–2.54, p < 0.001) were associated with lower LRC. For OS, lower SMA (HR 1.53, 95% CI:1.06–2.20, p = 0.02) and lower SMRA (HR 2.13, 95% CI: 1.58–2.88, p < 0.001) were associated with a worse outcome in multivariable analysis. Conclusions: Both SMRA and SMA assessed at C3 correlate with worse LRC and OS in HNC. Full article

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

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16 pages, 504 KB

Open AccessArticle

Integrating Structured Peer Support Pathways for Patients Undergoing Cellular Therapies: Insights from a Participatory Study

by Karine Bilodeau, Pegah Torabi, Ludovic Tamaro, Sandie Oberoi, Deborah Pascale, Kelley Kilpatrick, David Ogez, Marie-Pascale Pomey, Katia Dumont, Catherine Paquette-Gascon, Israel Fortin, Isabelle Fleury and Imran Ahmad

Curr. Oncol. 2025, 32(10), 586; https://doi.org/10.3390/curroncol32100586 - 21 Oct 2025

Viewed by 427

Abstract

Individuals diagnosed with hematological cancer often face an emotionally demanding journey, frequently reporting high levels of distress and unmet needs, including a lack of personalized and emotional support. Our research team co-developed structured support provided by trained Accompanying patients (APs) during key stages [...] Read more.

Individuals diagnosed with hematological cancer often face an emotionally demanding journey, frequently reporting high levels of distress and unmet needs, including a lack of personalized and emotional support. Our research team co-developed structured support provided by trained Accompanying patients (APs) during key stages of the care pathway for individuals with hematological cancers treated with cellular therapies. This paper presents findings on the anticipated needs that APs can address, their role within the care team, and the key facilitators, challenges, and strategies needed to implement structured peer support. Using a participatory action research approach, three working sessions were conducted with 16 key stakeholders to co-develop the structured support pathways. Data from group discussions (n = 3) underwent thematic analysis to identify essential components for adapting the support offered by APs, as well as the barriers and facilitators to its implementation. Findings show that APs can help address a wide range of practical, emotional, social, and psychological needs while enhancing patient understanding and continuity of care. Participants emphasized the importance of clear role definitions, adequate training, and supportive tools to ensure the safe and effective involvement of APs. Organizational and communication challenges were also identified, along with strategies to promote long-term sustainability. This initiative represents the first structured peer support program tailored to cellular therapies in Canada and offers a promising model to improve patient experience, foster relational continuity, and support cancer survivors across the care continuum. Full article

(This article belongs to the Section Cell Therapy)

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10 pages, 631 KB

Open AccessArticle

Dynamic Monitoring of Recurrent Ovarian Cancer Using Serial ctDNA: A Real-World Case Series

by Eric Rios-Doria, Jonathan B. Reichel, Marc R. Radke, Enna Manhardt, Mayumi Rubin-Saika, Christina Lockwood, Elizabeth M. Swisher and Kalyan Banda

Curr. Oncol. 2025, 32(10), 585; https://doi.org/10.3390/curroncol32100585 - 21 Oct 2025

Viewed by 554

Abstract

Recurrent ovarian cancer (OC) is challenging to detect early using current methods like CA-125 and imaging. Circulating tumor DNA (ctDNA) may improve disease monitoring. Here, we assess the real-world clinical utility of serial ctDNA analyses in patients with recurrent OC. We analyzed serial [...] Read more.

Recurrent ovarian cancer (OC) is challenging to detect early using current methods like CA-125 and imaging. Circulating tumor DNA (ctDNA) may improve disease monitoring. Here, we assess the real-world clinical utility of serial ctDNA analyses in patients with recurrent OC. We analyzed serial plasma samples (N = 23) from six patients with recurrent OC using a tumor-informed next-generation sequencing assay targeting 68 cancer-related genes developed at the University of Washington. ctDNA variant allele frequencies (VAFs) were correlated with CA-125 levels, radiographic findings, and clinical outcomes. ctDNA levels generally reflected clinical status, accurately mirroring disease progression and therapeutic response. In one patient, rising ctDNA preceded clinical recurrence by four months, despite normal CA-125 and imaging, highlighting its potential advantage. Conversely, some patients exhibited clinical progression with undetectable ctDNA, indicating limitations in assay sensitivity, biological factors, or metastatic sites (e.g., brain metastases). ctDNA and CA-125 showed complementary value in most cases, suggesting potential combined use in clinical monitoring. Our findings demonstrate that ctDNA is a promising biomarker to complement existing monitoring approaches for recurrent OC. In some cases, capable of predicting relapse and treatment response ahead of current clinical indicators. However, identified discordances underscore technical and biological challenges that warrant further investigation. Larger prospective studies are necessary to refine ctDNA’s clinical utility and integration into personalized OC care. Full article

(This article belongs to the Special Issue Exploring Rare Gynecologic Tumors: A Cutting-Edge Perspective on Modern Diagnostic and Therapeutic Strategies)

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14 pages, 978 KB

Open AccessReview

Neoadjuvant Strategies for Patients with Resectable Biliary Tract Cancers: A Review

by Chelsea R. Olson, Gabriela L. Aitken, Michael W. Spinrad and Evan S. Glazer

Curr. Oncol. 2025, 32(10), 584; https://doi.org/10.3390/curroncol32100584 - 20 Oct 2025

Viewed by 507

Abstract

Cholangiocarcinoma (CC) is a rare and aggressive malignancy that arises from the epithelial cells (cholangiocytes) of the biliary tree. Biliary tract cancers (BTC) include both CC and gall bladder cancer. Surgical resection is considered the only curative treatment. Recently, however, a fundamental shift [...] Read more.

Cholangiocarcinoma (CC) is a rare and aggressive malignancy that arises from the epithelial cells (cholangiocytes) of the biliary tree. Biliary tract cancers (BTC) include both CC and gall bladder cancer. Surgical resection is considered the only curative treatment. Recently, however, a fundamental shift in the understanding of the molecular profiles of these tumors has led to a molecular-targeted approach with improved survival rates in some patients with these tumors. In patients with local or limited regional disease, neoadjuvant therapies offer a way to downstage tumors, assess tumor biology, potentially achieve R0 resection, and potentially prevent both locoregional and distant recurrence by treating occult micrometastatic disease. Because BTC are rare and surgery is the standard of care for patients with non-metastatic disease, there is very little data evaluating neoadjuvant strategies in resectable disease. Immunotherapies and molecularly targeted agents originally developed for advanced disease in the adjuvant or palliative settings are now being considered for neoadjuvant use. This review aims to summarize the data and provide a rationale for the role of neoadjuvant treatment in patients with resectable BTC. While there is no high-level evidence, studies show that neoadjuvant therapy that incorporates targeted treatments and immunotherapies under multidisciplinary oversight benefits select patients and is a valuable tool in the treatment of BTC. We favor molecular testing to guide neoadjuvant therapy for patients with BTC, when feasible, to prevent unnecessary operations and minimize the risk of recurrence or metastasis. Full article

(This article belongs to the Special Issue Biliary Tract Cancer Updates: Advancements and Insights)

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17 pages, 665 KB

Open AccessReview

Chemokine Receptors in Peripheral Blood Mononuclear Cells as Predictive Biomarkers for Immunotherapy Efficacy in Non-Small Cell Lung Cancer

by Paloma Galera, Antía Iglesias-Beiroa, Berta Hernández-Marín, Dulce Bañón, Teresa Arangoa, Lucía Castillo, María Álvarez-Maldonado, Cristina Gil-Olarte, Rafael Borregón, María Iribarren, Ramon Colomer and Jacobo Rogado

Curr. Oncol. 2025, 32(10), 583; https://doi.org/10.3390/curroncol32100583 - 20 Oct 2025

Viewed by 490

Abstract

Non-small cell lung cancer (NSCLC) remains a leading cause of cancer-related mortality globally. The advent of immune checkpoint inhibitors (ICIs) has significantly improved outcomes for a subset of patients; however, predictive biomarkers to identify responders are still lacking. Peripheral blood mononuclear cells (PBMCs) [...] Read more.

Non-small cell lung cancer (NSCLC) remains a leading cause of cancer-related mortality globally. The advent of immune checkpoint inhibitors (ICIs) has significantly improved outcomes for a subset of patients; however, predictive biomarkers to identify responders are still lacking. Peripheral blood mononuclear cells (PBMCs) offer a minimally invasive means to assess systemic immune status and have emerged as a potential source of predictive biomarkers. Recent studies have highlighted the role of chemokines and their receptors in modulating immune responses against tumors. In particular, the expression levels of chemokine receptors such as CXCR4 on PBMCs have been associated with patient responses to ICIs. The differences in expression of these receptors correlates with enhanced T cell trafficking and infiltration into the tumor microenvironment, leading to improved antitumor activity. This review consolidates current evidence on the prognostic and predictive value of chemokine receptor expression in PBMCs, like T cells, for NSCLC patients treated with ICIs. Understanding these associations can aid in the development of non-invasive biomarkers to guide treatment decisions and improve patient stratification in immunotherapy. Full article

(This article belongs to the Section Thoracic Oncology)

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13 pages, 1394 KB

Open AccessArticle

Readability of Chatbot Responses in Prostate Cancer and Urological Care: Objective Metrics Versus Patient Perceptions

by Lasse Maywald, Lisa Nguyen, Jana Theres Winterstein, Martin Joachim Hetz, Maurin Helen Mangold, Luisa Vivienne Renner, Titus Josef Brinker, Frederik Wessels and Nicolas Carl

Curr. Oncol. 2025, 32(10), 582; https://doi.org/10.3390/curroncol32100582 - 19 Oct 2025

Viewed by 278

Abstract

Large language models (LLMs) are increasingly explored as chatbots for patient education, including applications in urooncology. Since only 12% of adults have proficient health literacy and most patient information materials exceed recommended reading levels, improving readability is crucial. Although LLMs could potentially increase [...] Read more.

Large language models (LLMs) are increasingly explored as chatbots for patient education, including applications in urooncology. Since only 12% of adults have proficient health literacy and most patient information materials exceed recommended reading levels, improving readability is crucial. Although LLMs could potentially increase the readability of medical information, evidence is mixed, underscoring the need to assess chatbot outputs in clinical settings. Therefore, this study evaluates the measured and perceived readability of chatbot responses in speech-based interactions with urological patients. Urological patients engaged in unscripted conversations with a GPT-4-based chatbot. Transcripts were analyzed using three readability indices: Flesch–Reading-Ease (FRE), Lesbarkeitsindex (LIX) and Wiener-Sachtextformel (WSF). Perceived readability was assessed using a survey covering technical language, clarity and explainability. Associations between measured and perceived readability were analyzed. Knowledge retention was not assessed in this study. A total of 231 conversations were evaluated. The most frequently addressed topics were prostate cancer (22.5%), robotic-assisted prostatectomy (19.9%) and follow-up (18.6%). Objectively, responses were classified as difficult to read (FRE 43.1 ± 9.1; LIX 52.8 ± 6.2; WSF 11.2 ± 1.6). In contrast, perceived readability was rated highly for technical language, clarity and explainability (83–90%). Correlation analyses revealed no association between objective and perceived readability. Chatbot responses were objectively written at a difficult reading level, exceeding recommendations for optimized health literacy. Nevertheless, most patients perceived the information as clear and understandable. This discrepancy suggests that perceived comprehensibility is influenced by factors beyond measurable linguistic complexity. Full article

(This article belongs to the Special Issue Shaping the Future of Oncology: The Role of Generative AI in Clinical and Research Environments)

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20 pages, 674 KB

Open AccessReview

Exercise Interventions to Address Sarcopenia in People with Multiple Myeloma: A Scoping Review

by Leslie P. Ternes, Graeme M. Purdy, Stéphanie Bernard and Margaret L. McNeely

Curr. Oncol. 2025, 32(10), 581; https://doi.org/10.3390/curroncol32100581 - 18 Oct 2025

Viewed by 396

Abstract

Background: The clinical characteristics of sarcopenia, including low muscular strength, are commonly seen among people with multiple myeloma. A scoping review was conducted to explore the role of exercise as a potential countermeasure for sarcopenia in this population. Our objectives were to [...] Read more.

Background: The clinical characteristics of sarcopenia, including low muscular strength, are commonly seen among people with multiple myeloma. A scoping review was conducted to explore the role of exercise as a potential countermeasure for sarcopenia in this population. Our objectives were to (1) describe the design and findings of the studies and (2) identify the outcomes used in exercise-related studies to characterize sarcopenia. Methods: A systematic search (to March 2025) was conducted for published studies involving exercise or physical activity for individuals with multiple myeloma using key databases (MEDLINE, Embase, CINAHL, Scopus). Results: Of 971 articles reviewed, 12 articles were included, involving 967 total participants and 624 with multiple myeloma. All 12 studies included a measure for muscle physical performance, 9 studies included measures for muscular strength, and 7 studies included measures for muscle quantity/quality. Five studies reported a significant improvement from exercise for measures of muscular strength, four studies reported a significant benefit for physical performance, and three studies reported a benefit in muscle quantity. Few studies included outcomes that met all the international criteria recommended to characterize sarcopenia. Conclusions: Further multicentre research trials are needed to better understand whether and how exercise may be helpful for people with multiple myeloma, especially in the context of sarcopenia. Full article

(This article belongs to the Special Issue Cancer Rehabilitation: Innovations in Practice & Enhancing Survivorship Care)

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24 pages, 1234 KB

Open AccessReview

Supportive Care Needs of Patients with Breast Cancer Who Self-Identify as Black: An Integrative Review

by Etienne Oshinowo, Emily Peterson, Michelle Audoin, Jennifer Ryan, June Buckle, Clare Cruickshank, Jennifer Jones, Lisa Malinowski Kamran, Aisha Lofters, Patricia Russell, Leila Springer, Danielle VandeZande, Ashanté Lakey, Laura Burnett and Melanie Powis

Curr. Oncol. 2025, 32(10), 580; https://doi.org/10.3390/curroncol32100580 - 18 Oct 2025

Viewed by 333

Abstract

Black-identifying patients face many barriers to the receipt of equitable breast cancer care; however, little is currently known about the unique needs of this patient population, particularly in Canada. To address this gap, we identified and thematically grouped constructs from the published literature [...] Read more.

Black-identifying patients face many barriers to the receipt of equitable breast cancer care; however, little is currently known about the unique needs of this patient population, particularly in Canada. To address this gap, we identified and thematically grouped constructs from the published literature reporting on the needs of Black-identifying patients with breast cancer and compared these findings to a list generated through a virtual nominal consensus group (NG) attended by Canadian patients with breast cancer who self-identified as Black (n = 3). A scoping review was undertaken, and relevant citations published from database inception until January 2025 were identified from MEDLINE, Embase, and CINAHL. The literature review yielded 34 articles from the United States and identified 15 constructs consistent with the NG, which spanned the cancer continuum from screening to survivorship. The NG identified four additional constructs that were not found in the literature: advocacy and outreach, communication and health literacy, comorbidities and personalized care, and end-of-life care. The final set of constructs was then validated and prioritized by an expert panel consisting of patients with lived experience and relevant community partner organizations (n = 9) to drive future research, advocacy, and policy work. Patient navigation was identified as the top need, with financial support, access to culturally tailored information and resources, culturally relevant care, racialized data for treatment decision-making, and emotional support identified as high-priority needs. Full article

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12 pages, 1118 KB

Open AccessCommentary

Podcasting and Blogging as Tools to Engage with the Public on the Topic of Cancer: Experience and Perspectives of the Public Interest Group on Cancer Research

by Sevtap Savas, Kayla Crichton, Jason Wiseman, Janine Taylor-Cutting and Tracy Slaney

Curr. Oncol. 2025, 32(10), 579; https://doi.org/10.3390/curroncol32100579 - 18 Oct 2025

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Abstract

We (Public Interest Group on Cancer Research) started a podcast and guest blog series on cancer in 2024. Our objective in this Commentary is to describe our experience with this series, insights gained, adjustments made to our approach, and our recommendations for future [...] Read more.

We (Public Interest Group on Cancer Research) started a podcast and guest blog series on cancer in 2024. Our objective in this Commentary is to describe our experience with this series, insights gained, adjustments made to our approach, and our recommendations for future series. Our group identified and invited guests to contribute a blog or podcast episode on cancer, lived experience of cancer, cancer care and research, or advocacy. The podcast episodes were recorded using the WebEx platform (version 45.9.0.33069) and edited using the Kdenlive software (version 23.08.4). The blogs and podcasts were edited, finalized, and posted online for public access. In this manuscript, we utilized descriptive statistics to define and summarize information about the podcast episodes, guest blogs, and categorical responses to guest feedback survey questions, while we presented the responses to open-ended survey questions as quotes and summaries. As a result, during the period of January 2024–July 2025, we aired 28 podcast episodes and 13 guest blogs involving 36 guests. Guests included people from various backgrounds (such as people with lived experience, advocates, scientists, and healthcare providers) and members of equity-deserving communities (such as women, Indigenous and 2SLGBTQIA+ communities). We contemplated and learned as we proceeded with this project and implemented changes to address the issues that arose. In most cases the guests had positive experiences; however, in rare cases, university practices or federal policies prevented guest compensation, creating an unusual barrier. In conclusion, podcasting and blogging are practical public engagement instruments that provide space for sharing messages and knowledge to communicate with members of the public. Systematic barriers, such as policies that hamper guest compensation, need to be fixed for equitable participation, compensation, and engagement. As there is an increased interest in public engagement and knowledge mobilization activities, our learnings shared in this commentary may help other groups initiate or improve their public engagement practices. Full article

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17 pages, 2473 KB

Open AccessArticle

Comparative Prognostic Roles of β-Catenin Expression and Tumor–Stroma Ratio in Pancreatic Cancer: Neoadjuvant Chemotherapy vs. Upfront Surgery

by Shu Oikawa, Hiroyuki Mitomi, So Murai, Akihiro Nakayama, Seiya Chiba, Shigetoshi Nishihara, Yu Ishii, Toshiko Yamochi and Hitoshi Yoshida

Curr. Oncol. 2025, 32(10), 578; https://doi.org/10.3390/curroncol32100578 - 17 Oct 2025

Viewed by 416

Abstract

The benefit of neoadjuvant chemotherapy (NAC) over upfront surgery (UFS) for resectable pancreatic ductal adenocarcinoma (PDAC) is increasingly recognized, yet prognostic biomarkers remain undefined. We evaluated tumor–stroma ratio (TSR), β-catenin (β-CTN) expression, and tumor budding (TB) in 84 resected PDACs (35 NAC, 49 [...] Read more.

The benefit of neoadjuvant chemotherapy (NAC) over upfront surgery (UFS) for resectable pancreatic ductal adenocarcinoma (PDAC) is increasingly recognized, yet prognostic biomarkers remain undefined. We evaluated tumor–stroma ratio (TSR), β-catenin (β-CTN) expression, and tumor budding (TB) in 84 resected PDACs (35 NAC, 49 UFS) using digital image analysis of multi-cytokeratin (m-CK) and β-CTN immunohistochemistry. TSR was defined as the proportion of malignant epithelial area within the tumor, and the β-CTN/m-CK index as the ratio of β-CTN to m-CK immunoreactivity in tumor tissue relative to intralobular ducts. TB was significantly less frequent in NAC than UFS (p = 0.003), suggesting that NAC may indirectly modulate epithelial–mesenchymal transition, with TB regarded as its morphological correlate. In the NAC cohort, low TSR was associated with more favorable histological response (Evans IIa/IIb, median 7%; Evans I, 16%; p = 0.009), likely reflecting NAC-induced tumor shrinkage with relative stromal predominance. In multivariable analysis, low β-CTN/m-CK index (<0.5) predicted shorter relapse-free survival in both NAC (HR = 2.516, p = 0.043) and UFS (HR = 2.230, p = 0.025) subgroups. High TSR (≥13%) was associated with shorter cancer-specific survival (HR = 2.414, p = 0.034) in the overall cohort, indicating prognostic value complementing its association with NAC response. These results identify the β-CTN/m-CK index and TSR as prognostic biomarkers in PDAC. Full article

(This article belongs to the Special Issue Histological and Molecular Subtype of Pancreatic Cancer)

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12 pages, 564 KB

Open AccessReview

Akkermansia muciniphila and HCC: A Gut Feeling

by Mario Capasso, Marco Sanduzzi-Zamparelli, Valentina Cossiga, Maria Guarino, Stefania Murzilli, Alessandra Pelagalli, Domenico Sorrentino, Alon Rutigliano and Filomena Morisco

Curr. Oncol. 2025, 32(10), 577; https://doi.org/10.3390/curroncol32100577 - 17 Oct 2025

Viewed by 427

Abstract

Immune checkpoint inhibitors (ICIs) have radically changed the landscape of systemic treatment for hepatocellular carcinoma (HCC). Recently, there has been increasing interest regarding the relationship between the gut microbiome and the response to immunotherapy in oncological treatments. Among the gut commensals, Akkermansia ( [...] Read more.

Immune checkpoint inhibitors (ICIs) have radically changed the landscape of systemic treatment for hepatocellular carcinoma (HCC). Recently, there has been increasing interest regarding the relationship between the gut microbiome and the response to immunotherapy in oncological treatments. Among the gut commensals, Akkermansia (A.) muciniphila has gained increasing attention in the literature. A. muciniphila may affect the tumor microenvironment and enhance the efficacy of systemic therapies, including ICIs and targeted agents, by shaping host immune responses and metabolic pathways. This narrative review summarizes the current knowledge on A. muciniphila and its potential interaction with systemic therapies for HCC, focusing on its immunostimulatory properties, including enhancement of cytotoxic CD8⁺ T-cell activity and reversal of immunosuppressive tumor microenvironments. The therapeutic role of A. muciniphila might represent a novel and promising weapon in the HCC field, although the road is still long and the scientific evidence still remains in an exploratory stage. Its integration into clinical practice, however, requires robust clinical trials and a deeper understanding of its interactions within the gut–liver axis and tumor ecosystem. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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17 pages, 2034 KB

Open AccessArticle

Regional and Temporal Variation in Receipt of Gabapentinoid and SSRI/SNRI Therapy Among Older Cancer Survivors in the United States

by Amber Nguyen, Yong-Fang Kuo, Daoqi Gao and Mukaila Raji

Curr. Oncol. 2025, 32(10), 576; https://doi.org/10.3390/curroncol32100576 - 17 Oct 2025

Viewed by 269

Abstract

Opioids and benzodiazepines (BZD) are commonly prescribed for older cancer survivors with co-occurring pain and anxiety. The prescribing rate of gabapentinoids (GABA), Selective Serotonin Reuptake Inhibitors (SSRIs), and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) in the general population has increased as opioid/BZD alternatives, but little [...] Read more.

Opioids and benzodiazepines (BZD) are commonly prescribed for older cancer survivors with co-occurring pain and anxiety. The prescribing rate of gabapentinoids (GABA), Selective Serotonin Reuptake Inhibitors (SSRIs), and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) in the general population has increased as opioid/BZD alternatives, but little is known on temporal/regional trends in use of these alternatives among older cancer survivors. A retrospective cohort study using SEER-Medicare data was conducted. Patients aged ≥ 66 years, diagnosed with breast, colorectal, prostate, or lung cancer as their first cancer diagnosis any time from 2000 to 2015 and who were alive more than 5 years after cancer diagnosis, were eligible for inclusion. Temporal trends varied by region (p < 0.0001) and opioid-naïve status (p < 0.0001). Compared to 2013, GABA and SNRI use increased, while BZD and opioid use decreased. All regions experienced declines in opioid use. From 2013 to 2018, all regions saw an increase in GABA use, with a decline in 2020. GABA prescriptions increased more in opioid-naïve groups compared to non-opioid-naïve patients. The yearly trends in GABA and SSRI/SNRI use varied by region among older cancer survivors. Clinical practice variation suggests needs for further research on improving consistency and quality of cancer care. Full article

(This article belongs to the Special Issue Advances in Geriatric Oncology: Toward Optimized Cancer Care)

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13 pages, 423 KB

Open AccessArticle

Trastuzumab Deruxtecan-Associated Interstitial Lung Disease: Real-World Insights from a Tertiary Care Center

by Ahmed S. Alanazi, Ahmed A. Alanazi, Abdalrhman Alanizi, Ranad Babalghaith, Reema Alotaibi, Mohammed Alnuhait and Hatoon Bakhribah

Curr. Oncol. 2025, 32(10), 575; https://doi.org/10.3390/curroncol32100575 - 16 Oct 2025

Viewed by 808

Abstract

Background: Trastuzumab deruxtecan (T-DXd), a HER2-directed antibody-drug conjugate, has significantly advanced the management of HER2-expressing malignancies. However, interstitial lung disease (ILD) remains a clinically significant adverse effect. Despite increasing clinical use of T-DXd, real-world data on ILD incidence, characteristics, and outcomes—particularly in Middle [...] Read more.

Background: Trastuzumab deruxtecan (T-DXd), a HER2-directed antibody-drug conjugate, has significantly advanced the management of HER2-expressing malignancies. However, interstitial lung disease (ILD) remains a clinically significant adverse effect. Despite increasing clinical use of T-DXd, real-world data on ILD incidence, characteristics, and outcomes—particularly in Middle Eastern populations remain limited. Methods: This retrospective study analyzed medical records of patients who received trastuzumab deruxtecan (T-DXd) at a tertiary care hospital. Data collected included demographics, tumor characteristics, prior treatments, and interstitial lung disease (ILD)-related outcomes. ILD events were identified and graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Descriptive statistics were used to summarize baseline characteristics and ILD features. Univariate logistic regression was performed to assess potential risk factors associated with ILD development. Kaplan–Meier survival analysis was used to evaluate time-to-event outcomes, including time to ILD onset and resolution. Results: Among 65 patients with advanced stage IV cancer (90.8% with breast cancer), 16 (24.6%) developed ILD following T-DXd therapy. The median time to ILD onset was 125.5 days. The most common presenting symptoms were dyspnea and cough (50%). A history of ground-glass opacities was associated with increased odds of ILD (OR 2.7; p = 0.236), though not statistically significant. Patients with Grade ≥ 3 ILD had significantly lower oxygen saturation levels compared to those with milder grades (88.3% vs. 97.7%, p = 0.049). Median time to clinical resolution was 297 days (95% CI: 77.5–516). No significant associations were observed with smoking history, pulmonary metastases, or prior thoracic radiation. Conclusions: In this real-world cohort, ILD occurred in nearly one-quarter of patients receiving T-DXd, predominantly within the first six months of treatment. The findings highlight the importance of early respiratory symptom monitoring and pulse oximetry—particularly in patients with pre-existing pulmonary abnormalities. These results underscore the need for vigilant ILD surveillance strategies and further prospective studies to validate predictive risk factors and optimize management protocols. Full article

(This article belongs to the Section Thoracic Oncology)

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17 pages, 545 KB

Open AccessArticle

Use of Irreversible Electroporation in Pancreatic Cancer Patients: A Multi-Center Experience

by Bart Hendrikx, Eline-Alice Brys, Alexandra Dili, Thomas Apers, Vera Hartman, Martin Brichard, Filip Gryspeerdt, Claude Bertrand, Geert Roeyen and Frederik Berrevoet

Curr. Oncol. 2025, 32(10), 574; https://doi.org/10.3390/curroncol32100574 - 16 Oct 2025

Viewed by 464

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with a 5-year survival rate of 10%. Irreversible electroporation (IRE), a non-thermal ablative technique, may improve outcomes in locally advanced (LAPC) and borderline resectable pancreatic cancer (BRPC). This multi-center retrospective study aims to evaluate [...] Read more.

Background: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with a 5-year survival rate of 10%. Irreversible electroporation (IRE), a non-thermal ablative technique, may improve outcomes in locally advanced (LAPC) and borderline resectable pancreatic cancer (BRPC). This multi-center retrospective study aims to evaluate postoperative complications, 90-day mortality, and survival following IRE. Methods: 35 pancreatic cancer patients were treated with IRE between 2015 and 2023 across three Belgian hospitals. IRE was performed for tumor destruction in unresectable LAPC (n = 13) (IRE-LAPC) and for margin accentuation during resection in BRPC (n = 22) (IRE-MA). Primary endpoints were 90-day mortality, complications, and survival (only 33 patients included); secondary endpoints included metastases, local recurrence, and R0-resection rates. Results: Postoperative complications occurred in 23.1% (IRE-LAPC) and 68.2% (IRE-MA) of patients. Overall survival at 24 months was 27.3% (IRE-LAPC) and 27.3% (IRE-MA). Median survival time was 12.7 months (IRE-LAPC) and 13.3 months (IRE-MA). Six patients (17.1%) died within 90 days. Metastasis occurred in 51.5% of patients after a median time of 9.8 months. Local recurrence was seen in 24.2% of patients after a median time of 7.5 months. R0 resection was achieved in 63.6% (IRE-MA). Discussion: IRE for margin accentuation in BRPC is associated with relatively high morbidity and mortality rates and cannot be considered beneficial. In unresectable LAPC, IRE appears relatively safe for local disease control. Further research should clarify patient selection and optimize its therapeutic role. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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14 pages, 275 KB

Open AccessReview

Bevacizumab in Pediatric Neuro-Oncology

by Jacob Silverman, Sayanthen Sathyakumar, Hallie Coltin, Sebastien Perreault, Nada Jabado, Eric Bouffet and Samuele Renzi

Curr. Oncol. 2025, 32(10), 573; https://doi.org/10.3390/curroncol32100573 - 16 Oct 2025

Viewed by 468

Abstract

Bevacizumab is often used off-label in pediatric neuro-oncology, and evidence for indications of bevacizumab use in pediatric neuro-oncology is often fragmented. Therefore, this review aims to provide an organized summary of efficacy across different types of tumors, highlight outcomes, and link findings to [...] Read more.

Bevacizumab is often used off-label in pediatric neuro-oncology, and evidence for indications of bevacizumab use in pediatric neuro-oncology is often fragmented. Therefore, this review aims to provide an organized summary of efficacy across different types of tumors, highlight outcomes, and link findings to the underlying biology. Gaps in the literature were also identified to guide future research. We narratively synthesized various pediatric studies, and the following tumor categories were identified for discussion: low-grade glioma, high-grade glioma, diffuse intrinsic pontine glioma, schwannoma, medulloblastoma, radiation necrosis, and cerebral edema. Key outcomes considered included overall survival, event-free survival, progression-free survival, vision and/or hearing improvements, steroid use, quality of life, and toxicity. The greatest benefits were observed in cases such as recurrent medulloblastoma in combination with temozolomide and irinotecan, optic pathway glioma visual function, and diminished steroid use in radiation necrosis. Results were poorer in cases of newly diagnosed high-grade gliomas and diffuse intrinsic pontine gliomas. The medication was overall well tolerated, with adverse events like hypertension, proteinuria, and epistaxis often being manageable with surveillance. In consideration of the results, bevacizumab should be considered based on the tumor profile, and its outcome measured along functional endpoints, besides radiological evolution. Continued investigations into outcome measures, as well as combination with targeted treatments and optimizing therapy, will contribute to improving outcomes in this vulnerable population. Full article

(This article belongs to the Section Neuro-Oncology)

30 pages, 554 KB

Open AccessReview

A Current Perspective of Two of the Most Aggressive Head and Neck Cancers: Pharyngeal and Laryngeal

by Mihaela Iuliana Ciortan (Sirbu), Maria Alina Marin, Doina Chioran, Iasmina-Alexandra Predescu, Nicolae Constantin Balica, Sergio Liga, Mircea Rivis, Ştefania Dinu and Şerban Talpoş

Curr. Oncol. 2025, 32(10), 572; https://doi.org/10.3390/curroncol32100572 - 15 Oct 2025

Viewed by 450

Abstract

Background: Head and neck cancers (HNCs) represent a substantial global health burden, with an estimated mortality rate exceeding 50% annually. Among the various subsites, pharyngeal and laryngeal carcinomas are recognized as two of the most aggressive and challenging forms, characterized by high incidence, [...] Read more.

Background: Head and neck cancers (HNCs) represent a substantial global health burden, with an estimated mortality rate exceeding 50% annually. Among the various subsites, pharyngeal and laryngeal carcinomas are recognized as two of the most aggressive and challenging forms, characterized by high incidence, poor prognosis, and a strong association with advanced-stage diagnosis. Methods: A systematic literature review was performed using electronic literature databases (e.g., PubMed, Google Scholar). Search terms included “head and neck cancer”, “laryngeal cancer”, and “pharyngeal cancer”. Selected studies are published within the last two decades. Results: Laryngeal cancer constitutes approximately 40% of head and neck malignancies, with a clear male predominance, and pharyngeal cancer shows increased incidence in male populations from the Americas and Africa. Despite therapeutic advancements in radiotherapy, chemotherapy, and immunotherapy, overall survival rates remain unsatisfactory. Moreover, patients are at increased risk for second primary malignancies, particularly within the lungs and esophagus, due to the widespread carcinogenic exposure along the aerodigestive tract. Conclusions: To mitigate the morbidity and mortality associated with pharyngeal and laryngeal cancers, early detection, risk factor mitigation, and public health education are imperative. Enhancing screening among high-risk populations and adopting personalized, multidisciplinary treatment strategies may significantly improve clinical outcomes and long-term survival. Full article

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

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16 pages, 838 KB

Open AccessReview

Automated Software Evaluation in Screening Mammography: A Scoping Review of Image Quality and Technique Assessment

by Kelly M. Spuur, Clare L. Singh, Dana Al Mousa and Minh T. Chau

Curr. Oncol. 2025, 32(10), 571; https://doi.org/10.3390/curroncol32100571 - 15 Oct 2025

Viewed by 395

Abstract

Background: Standardised breast positioning and optimal compression are critical components of effective breast cancer screening. This scoping review aims to report the current landscape of automated software tools developed for image quality assessment and mammographic technique evaluation, and to examine their reported impact. [...] Read more.

Background: Standardised breast positioning and optimal compression are critical components of effective breast cancer screening. This scoping review aims to report the current landscape of automated software tools developed for image quality assessment and mammographic technique evaluation, and to examine their reported impact. Methods: A scoping review was undertaken across PubMed (MEDLINE), Scopus, and Emcare. Eligible studies were published between January 2014 and March 2025 and investigated the use of automated software or artificial intelligence-based tools to assess image quality, breast positioning, or compression in mammography or digital breast tomosynthesis. Results: Automated software was predominantly utilised in high-resource settings, where it provided benchmarked feedback, reduced the subjectivity inherent in traditional visual grading systems, and supported radiographer learning and skill development with measurable improvements. However, radiographer training in these systems, the impact of software on clinical workflow, and barriers to implementation, particularly in low-resource settings, were insufficiently addressed in the literature. Furthermore, no studies reported on the relationship between software-generated metrics and breast cancer screening outcomes. Conclusions: Automated software for image quality evaluation represents a significant advancement in breast screening, illustrating the potential of technology to strengthen the screening-to-treatment continuum in breast cancer care. Nonetheless, widespread adoption requires evidence that these tools directly contribute to improved cancer detection outcomes to justify their uptake. Full article

(This article belongs to the Special Issue From Screening to Treatment: Technology’s Impact on Breast Cancer Care)

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15 pages, 248 KB

Open AccessArticle

Exploring the Experiences of Individuals Diagnosed with Metastatic Non-Small-Cell Lung Cancer: A Qualitative Study

by Sarah Scruton, Caroline Hovey, Cynthia Kendell and Robin Urquhart

Curr. Oncol. 2025, 32(10), 570; https://doi.org/10.3390/curroncol32100570 - 15 Oct 2025

Viewed by 387

Abstract

Advancements in targeted therapies and immunotherapies have improved survival for individuals with metastatic non-small-cell lung cancer (mNSCLC), creating a growing population of Canadians living long-term with the disease. These individuals face ongoing physical, emotional, and practical challenges, yet existing supportive care services are [...] Read more.

Advancements in targeted therapies and immunotherapies have improved survival for individuals with metastatic non-small-cell lung cancer (mNSCLC), creating a growing population of Canadians living long-term with the disease. These individuals face ongoing physical, emotional, and practical challenges, yet existing supportive care services are often designed for patients receiving curative intent treatment and may not adequately address the challenges of those undergoing continuous treatment. To explore these experiences and inform the development of supports tailored to their needs, eight participants with mNSCLC completed one-on-one virtual interviews. They described limited support for managing side effects and psychosocial concerns despite general satisfaction with oncology care. Fatigue and cognitive challenges impacted daily functioning, and emotional challenges (e.g., fear of progression, stigma, and difficulty finding meaning) impacted quality of life. Financial burden, including unexpected costs and loss of income, further affected their well-being. Existing supports, such as exercise programs, were viewed positively but were often difficult to access, were offered only short-term, and required patients to find them independently. Recommendations included improved coordination and communication across the healthcare system, alongside tailored interventions such as navigation services, resource directories, health promotion supports, and expanded peer support. Overall, people living long term with mNSCLC face distinct challenges and unmet supportive care needs, highlighting the importance of integrating supportive services into routine oncology care. Full article

13 pages, 3481 KB

Open AccessArticle

Small Extracellular Vesicles Derived from NF2-Associated Schwannoma Cells Modulate Tumor Progression and Immunity via HSP90

by Ying Wang, Yuan Ren, Qi Zhang, Chao Zhang, Minjun Yan, Xin Ma, Bo Wang, Peng Li and Pinan Liu

Curr. Oncol. 2025, 32(10), 569; https://doi.org/10.3390/curroncol32100569 - 13 Oct 2025

Viewed by 351

Abstract

In-depth exploration of tumor immune suppression mechanisms may provide new therapeutic options for NF2-associated tumors. In this study, we found that sEVs secreted by NF2-associated schwannomas (NF2-EVs) facilitate the conversion of CD14⁺ monocytes into an MDSC-like phenotype, showcasing MDSC-like inhibitory functions. Moreover, [...] Read more.

In-depth exploration of tumor immune suppression mechanisms may provide new therapeutic options for NF2-associated tumors. In this study, we found that sEVs secreted by NF2-associated schwannomas (NF2-EVs) facilitate the conversion of CD14⁺ monocytes into an MDSC-like phenotype, showcasing MDSC-like inhibitory functions. Moreover, these NF2-EVs are capable of enhancing tumor cell proliferation. Through proteomic analysis and subsequent validation of the NF2-EVs, we identified elevated levels of HSP90. When we knocked down HSP90 expression in tumor cells, the sEVs secreted showed diminished capacity to convert monocytes into MDSCs and a reduced ability to promote tumor cell proliferation. Conversely, sEVs secreted by tumor cells that overexpress HSP90 displayed the opposite effects. Further mechanistic studies revealed that HSP90 could influence the expression of AKT/p-AKT and ERK/p-ERK. Our results suggest that NF2 tumor cells could regulate the AKT/p-AKT and ERK/p-ERK pathways to promote tumor cell proliferation and the formation of an immunosuppressive microenvironment by secreting sEVs’ HSP90, offering valuable insights into the involvement of HSP90 in exosome-mediated communication within the context of NF2-related schwannomatosis (NF2-SWN). This information has the potential to inform the design of effective immunotherapeutic protocols and offer new treatment options for NF2-SWN patients. Full article

(This article belongs to the Section Neuro-Oncology)

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14 pages, 532 KB

Open AccessArticle

Retrospective Cohort Study of Intrapericardial Cisplatin for Risk Reduction of Malignant Pericardial Effusion Recurrence

by Francisco Javier Muñoz-Carrillo, Roxana Maribel Reyes, David Pesántez, Gemma Carrera, Enric Cascos, Pedro Castro, Sara Fernández-Méndez, Carme Font, Laura González-Aguado, Ignacio Grafiá, Lucía Llavata, Inés Monge-Escartín, Joan Padrosa, Noemí Reguart, Adrián Téllez, Albert Tuca, Margarita Viladot, Carles Zamora-Martínez, Patrícia Amorós-Reboredo and Javier Marco-Hernández

Curr. Oncol. 2025, 32(10), 568; https://doi.org/10.3390/curroncol32100568 - 11 Oct 2025

Viewed by 376

Abstract

Malignant pericardial effusion (MPE) is a life-threatening condition in patients with cancer, with common recurrences after simple pericardiocentesis. Consequently, the intrapericardial instillation of sclerosing or cytotoxic agents has been explored, with limited evidence from small studies with different methodologies. We undertook an observational, [...] Read more.

Malignant pericardial effusion (MPE) is a life-threatening condition in patients with cancer, with common recurrences after simple pericardiocentesis. Consequently, the intrapericardial instillation of sclerosing or cytotoxic agents has been explored, with limited evidence from small studies with different methodologies. We undertook an observational, retrospective, single-centre study, including all patients diagnosed with a solid neoplasm and clinically significant and/or recurrent, cytology-confirmed MPE, treated with Intrapericardial Instillation of Cisplatin (IPIC), between 2009 and 2022. Patients with hematological malignancies were excluded. The procedure followed a multidisciplinary approach and a standardized protocol. Variables collected included baseline patient characteristics, neoplasm details, MPE impact, adverse events (AEs) from procedures (pericardiocentesis and IPIC) and outcomes (time to MPE recurrence and survival). This study adhered to the STROBE guidelines. A total of 41 patients were included, 51% female, with a median age of 61 (51–69) years. Non-small cell lung cancer (NSCLC) was the predominant primary tumour (78%) and in 44% of the cohort, MPE was identified at cancer diagnosis. Most patients (90.2%) presented symptoms related to MPE at diagnosis, and 88% had cardiac tamponade on echocardiography. IPIC was administered a median of four times. IPIC-related AEs occurred in 10 patients (24.4%), with transient atrial fibrillation (AF) being the most frequent one. Two patients (4.9%) experienced MPE recurrence within 30 days after IPIC. The median survival time from MPE diagnosis was 161 days (5.4 months; IQR 73–455 days). IPIC appears to be a feasible, effective and safe option for reducing the risk of MPE recurrence, mainly in NSCLC. Full article

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12 pages, 408 KB

Open AccessArticle

Predictive Factors and Clinical Impact of Radioactive Seed Migration After Prostate Brachytherapy: A Retrospective Study

by Shota Kikuchi, Takashi Fukagai, Jin Yamatoya, Kazuhiko Oshinomi, Masakazu Nagata, Masashi Morita, Kosuke Toyofuku, Atsuhito Sekimoto, Masako Kato, Madoka Morota and Yoshinori Ito

Curr. Oncol. 2025, 32(10), 567; https://doi.org/10.3390/curroncol32100567 - 11 Oct 2025

Viewed by 308

Abstract

Radioactive seed migration after low-dose-rate brachytherapy (LDR-BT) for prostate cancer is a known phenomenon; however, its clinical impact remains unclear. We retrospectively analyzed 611 patients treated with LDR-BT using loose iodine-125 seeds. Post-treatment imaging was used to assess seed migration. Treatment efficacy was [...] Read more.

Radioactive seed migration after low-dose-rate brachytherapy (LDR-BT) for prostate cancer is a known phenomenon; however, its clinical impact remains unclear. We retrospectively analyzed 611 patients treated with LDR-BT using loose iodine-125 seeds. Post-treatment imaging was used to assess seed migration. Treatment efficacy was evaluated using post-plan dosimetry (V100 and D90) and biochemical recurrence-free survival (bRFS). Seed migration was observed in 150 patients (24.5%) within 1–3 months post-treatment, involving a total of 210 seeds. Migration sites included lungs, vasculature, and seminal vesicles. Hematogenous migration was significantly associated with higher seed counts. Seminal vesicle migration was linked to increased needle usage and absence of neoadjuvant hormone therapy. No significant differences were observed in V100, D90, or bRFS between patients with or without seed migration. However, migration of ≥3 seeds correlated with significantly lower V100 and with a trend toward decreased bRFS. Limited seed migration appears to have minimal clinical impact. However, ≥3 migrated seeds may reduce dosimetric quality and affect treatment efficacy. Risk factors include larger prostate volume as well as higher seed and needle counts. Improved planning and using linked seeds may reduce migration and improve outcomes in LDR-BT for prostate cancer. Full article

(This article belongs to the Section Genitourinary Oncology)

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17 pages, 808 KB

Open AccessArticle

SUVmax-IPI as a New Prognostic Index in Metastatic Non-Small Cell Lung Cancer Patients Receiving Nivolumab

by Nagihan Kolkıran, Atike Pınar Erdoğan, Mustafa Şahbazlar, Semra Taş, Gamze Gököz Doğu, Kübra Canaslan, İlkay Tuğba Ünek, Özge Demirkıran, Bilgin Demir, Güler Nur Teküstün, Özgür Tanrıverdi and Ferhat Ekinci

Curr. Oncol. 2025, 32(10), 566; https://doi.org/10.3390/curroncol32100566 - 9 Oct 2025

Viewed by 475

Abstract

Background/Objectives: Nivolumab has significantly improved outcomes in patients with metastatic non-small cell lung cancer (NSCLC); however, reliable prognostic biomarkers remain an unmet need. To address this gap, we developed the SUVmax-IPI, a novel prognostic index combining maximum standardized uptake value (SUVmax) from ¹⁸ [...] Read more.

Background/Objectives: Nivolumab has significantly improved outcomes in patients with metastatic non-small cell lung cancer (NSCLC); however, reliable prognostic biomarkers remain an unmet need. To address this gap, we developed the SUVmax-IPI, a novel prognostic index combining maximum standardized uptake value (SUVmax) from ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) with systemic inflammatory markers. This study aimed to evaluate the prognostic value of SUVmax-IPI in patients with NSCLC receiving nivolumab therapy. Methods: This multicenter retrospective analysis included 187 patients with metastatic NSCLC receiving nivolumab across 5 tertiary institutions. The SUVmax-IPI incorporated pretreatment SUVmax and laboratory-based inflammatory prognostic index (IPI) parameters. Survival outcomes were evaluated using Kaplan–Meier analysis with log-rank testing and multivariate cox regression. Results: Receiver operating characteristic (ROC) analysis established an optimal SUVmax-IPI cut-off of 241.9. Patients with SUVmax-IPI ≤ 241.9 had significantly better survival outcomes: median overall survival (OS) was 35 versus 15 months (p = 0.002). For progression-free survival (PFS), although a numerical difference favored patients with SUVmax-IPI ≤ 241.9 (median: 15 vs. 8 months), this did not reach statistical significance (log-rank p = 0.175). Multivariate analysis confirmed SUVmax-IPI as an independent predictor of survival (p = 0.002). Conclusions: The SUVmax-IPI represents a promising prognostic tool for patients with metastatic NSCLC who received at least 3 months of nivolumab, integrating metabolic and inflammatory parameters to predict survival outcomes. Full article

(This article belongs to the Section Thoracic Oncology)

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5 pages, 172 KB

Open AccessEditorial

Cervical Cancer Elimination Requires Systems, Trust, and Action

by Samara Perez

Curr. Oncol. 2025, 32(10), 565; https://doi.org/10.3390/curroncol32100565 - 8 Oct 2025

Viewed by 343

Abstract

Cervical cancer has a clear and achievable path to elimination [...] Full article

(This article belongs to the Special Issue Action and Impact: Prevention and Screening Strategies Contributing to the Elimination of Cervical Cancer)

18 pages, 440 KB

Open AccessArticle

Supporting Employment After Cancer: A Mixed-Methods Evaluation of a Vocational Integration Programme for Childhood, Adolescent, and Young Adult Cancer Survivors

by Margherita Dionisi-Vici, Anna Schneider-Kamp, Ilenia Giacoppo, Alessandro Godono, Eleonora Biasin, Antonella Varetto, Emanuela Arvat, Francesco Felicetti, Giulia Zucchetti and Franca Fagioli

Curr. Oncol. 2025, 32(10), 564; https://doi.org/10.3390/curroncol32100564 - 8 Oct 2025

Viewed by 402

Abstract

Childhood, adolescent, and young adult cancer (CAYAC) survivors often face challenges entering the workforce due to long-term physical, cognitive, and psychological late effects, defined as chronic health conditions resulting from cancer and its treatments. This study evaluated a vocational integration programme that addresses [...] Read more.

Childhood, adolescent, and young adult cancer (CAYAC) survivors often face challenges entering the workforce due to long-term physical, cognitive, and psychological late effects, defined as chronic health conditions resulting from cancer and its treatments. This study evaluated a vocational integration programme that addresses these barriers and promotes psychosocial well-being. The multidisciplinary intervention combined career guidance, soft-skills training, and a paid internship. Using a mixed-method design with questionnaires and semi-structured interviews, we assessed feasibility, satisfaction, and psychosocial outcomes. Thirteen participants (mean-age-at-diagnosis: 12.9 years, SD 5.2; mean-age-at-interview: 27.2 years, SD 5.3) reported over 40 late effects, mostly of moderate severity. Health-Related Quality of Life (HRQoL), measured by the SF-12, showed a Physical Component Score mean of 45.2 (SD 9.1) and a Mental Component Score mean of 43.5 (SD 11.2), indicating greater psychological impact. The programme received high satisfaction ratings (mean 8.3/10) and was described as motivating and valuable, enhancing self-confidence and career prospects. Social support emerged as a key facilitator, while participants noted the need for flexibility and individualised pacing. Despite a limited sample size and potential recruitment bias, this study provides preliminary insights into the feasibility and perceived value of tailored vocational programmes, emphasising the importance of adaptable, socially supportive interventions for CAYAC survivors. Full article

(This article belongs to the Special Issue Interventions to Prevent and Reduce Late Effects in Childhood, Adolescent, and Young Adult Cancer Survivors)

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23 pages, 1124 KB

Open AccessReview

Health Effects of Ergonomics and Personal Protective Equipment on Chemotherapy Professionals

by Ana Reis, Vítor Silva, João José Joaquim, Luís Valadares, Cristiano Matos, Carolina Valeiro, Ramona Mateos-Campos and Fernando Moreira

Curr. Oncol. 2025, 32(10), 563; https://doi.org/10.3390/curroncol32100563 - 8 Oct 2025

Viewed by 607

Abstract

(1) Background: With the increasing incidence of cancer, the need for handling cytotoxic drugs has also grown. However, manipulating these drugs exposes healthcare professionals to significant risks, including occupational exposure to hazardous chemicals. Therefore, it is important to adopt protective measures, including personal [...] Read more.

(1) Background: With the increasing incidence of cancer, the need for handling cytotoxic drugs has also grown. However, manipulating these drugs exposes healthcare professionals to significant risks, including occupational exposure to hazardous chemicals. Therefore, it is important to adopt protective measures, including personal protective equipment (PPE) and correct ergonomic practices, to ensure safe drug preparation and minimize health risks for the operators. However, while chemical exposure and PPE have been extensively addressed in the literature, the combined impact of ergonomic practices and protective measures remains insufficiently emphasized, representing a critical gap this review aims to address. Accordingly, the objective of this literature review was to analyze the ergonomic and individual protection practices during the handling of cytostatic drugs and all the implications that bad ergonomic practices and/or poor individual protection have on the operator’s health; (2) Methods: In order to perform this integrative review, a structured literature search was conducted using online databases (Web of Science^®, Google Scholar^®, and PubMed^®) from January 2005 to June 2025. (3) Results: A total of 19 articles were analyzed, with 17 focusing on PPE and 17 on ergonomics. The findings emphasize that PPE, such as gloves, masks, gowns, sleeves and safety glasses, plays a critical role in the safe handling of cytotoxic drugs, particularly when combined with other safety measures. Additionally, maintaining correct ergonomic posture is important in preventing musculoskeletal disorders; (4) Conclusions: This review emphasizes the significance of integrating appropriate PPE use with sound ergonomic procedures. Although PPE is still the secondary line of defense against occupational exposure, ergonomic issues must also be addressed to avoid chronic musculoskeletal problems. Continuous training, rigorous attention to safety procedures, and ergonomic enhancements should be prioritized by healthcare facilities as a key element of occupational safety programs to reduce the short-term and long-term health hazards for personnel handling dangerous drugs. Full article

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14 pages, 398 KB

Open AccessArticle

Feasibility of a Physiatry Assessment Clinic to Address Physical Impairment in Head and Neck Cancer Patients Following Neck Resection and Free Flap Reconstruction

by Lauren C. Capozzi, Chad Wagoner, Julia T. Daun, Lisa Murphy, Steven C. Nakoneshny, George J. Francis, Joseph C. Dort, Khara Sauro and S. Nicole Culos-Reed

Curr. Oncol. 2025, 32(10), 562; https://doi.org/10.3390/curroncol32100562 - 7 Oct 2025

Viewed by 373

Abstract

Individuals with head and neck cancers are living longer than ever before, yet many live with the long-term effects of their cancer and treatment. The purpose of this study was to assess the feasibility of a physiatry assessment clinic (PAC) following neck resection [...] Read more.

Individuals with head and neck cancers are living longer than ever before, yet many live with the long-term effects of their cancer and treatment. The purpose of this study was to assess the feasibility of a physiatry assessment clinic (PAC) following neck resection and free flap reconstruction, during which physical function was assessed. Methods: Adult patients participating in a larger prehabilitation study were included. Attendance and the ability to complete the physical function assessment were examined. Exploratory analyses were completed to describe physical function, fitness, shoulder, and neck function among PAC attenders. To further understand PAC feasibility, patient-reported outcomes among PAC attenders and non-attenders were examined over 12 months (QuickDASH, NDII, EAT-10). Results: A total of 36 eligible participants (78.2%) from the larger prehabilitation study were approached to participate in the PAC, and 19 of the 36 attended (52.8%). Participants attended on average 8.6 ± 3.6 weeks post surgery, and 100% were able to complete the functional measures. Exploratory data suggest that those who did not attend (17 of 36 approached) had more advanced disease compared to those who attended (p < 0.05). Patient-reported outcomes suggested better shoulder function and swallow function at 6 months among those who attended the clinic versus those who did not. Conclusions: While recruitment to the PAC and assessment completion demonstrated feasibility, attendance posed challenges for patients. These findings highlight the need for innovative approaches to screening patients and tailoring rehabilitation services based on physical impairment. Full article

(This article belongs to the Special Issue Cancer Rehabilitation: Innovations in Practice & Enhancing Survivorship Care)

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14 pages, 1397 KB

Open AccessReview

The Emerging Role of CKAP4 in GI Cancer: From Molecular Pathways to Clinical Applications

by Markos Despotidis, Orestis Lyros, Tatiana S. Driva, Panagiotis Sakarellos, René Thieme, Andreas Mamilos, Stratigoula Sakellariou and Dimitrios Schizas

Curr. Oncol. 2025, 32(10), 561; https://doi.org/10.3390/curroncol32100561 - 7 Oct 2025

Viewed by 492

Abstract

Cytoskeleton-associated protein 4 (CKAP4) has emerged as a critical player in gastrointestinal (GI) cancer progression, diagnosis, and therapy. This comprehensive review synthesizes current knowledge on CKAP4′s multifaceted roles across GI malignancies, providing novel insights into its mechanisms of action and clinical potential. Its [...] Read more.

Cytoskeleton-associated protein 4 (CKAP4) has emerged as a critical player in gastrointestinal (GI) cancer progression, diagnosis, and therapy. This comprehensive review synthesizes current knowledge on CKAP4′s multifaceted roles across GI malignancies, providing novel insights into its mechanisms of action and clinical potential. Its interaction with DKK1 and subsequent activation of the PI3K/AKT pathway underscores its role in promoting tumor growth. This review also highlights novel insights into CKAP4′s mechanisms of action beyond the well-established DKK1-CKAP4 axis, including its interaction with integrin β1 and involvement in angiogenesis through the FMNL2/EGFL6/CKAP4/ERK pathway. CKAP4′s impact on tumor microenvironment and immune evasion is elucidated, offering a new perspective on its contribution to cancer progression. In addition, CKAP4 arises as a promising serum biomarker for early detection and prognosis across multiple GI cancers, emphasizing its potential superiority over traditional markers. The therapeutic potential of targeting CKAP4 is extensively explored, including novel approaches like anti-CKAP4 antibodies and aptamers, and their synergistic effects with existing treatments. By integrating findings from esophageal, gastric, pancreatic, and colorectal cancers, this review provides a unique, comprehensive overview of CKAP4 in GI oncology, underscoring CKAP4′s potential to revolutionize GI cancer diagnosis and treatment and paving the way for future translational research. Full article

(This article belongs to the Topic Advances in Gastrointestinal and Liver Disease: From Physiological Mechanisms to Clinical Practice, 2nd Edition)

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20 pages, 934 KB

Open AccessArticle

Baseline Characteristics of Individuals with Metastatic Cancer Enrolled in the Alberta Cancer Exercise Study and 12-Week Findings for Symptom-Related and Physical Fitness Measures

by Shirin M. Shallwani, S. Nicole Culos-Reed, Kerry S. Courneya, Tanya Williamson, Christopher Sellar, Harold Lau, Anil Abraham Joy, Jacob C. Easaw, Michelle Audoin, Edith Pituskin and Margaret L. McNeely

Curr. Oncol. 2025, 32(10), 560; https://doi.org/10.3390/curroncol32100560 - 7 Oct 2025

Viewed by 515

Abstract

Exercise has been found to be safe and beneficial for people with advanced cancers, but more research is needed to understand how best to design and implement exercise programming. The Alberta Cancer Exercise (ACE) study examines the effectiveness and implementation of a 12-week [...] Read more.

Exercise has been found to be safe and beneficial for people with advanced cancers, but more research is needed to understand how best to design and implement exercise programming. The Alberta Cancer Exercise (ACE) study examines the effectiveness and implementation of a 12-week community-based exercise program in Alberta, Canada, for people diagnosed with cancer. Here, we describe the characteristics of individuals with metastatic cancer enrolled in the ACE program and report 12-week changes in self-reported and objective outcomes. Of 306 participants, 274 (89.5%) completed the 12-week study. Many participants were female (65.4%), with ≥1 comorbidity (71.9%), and on active cancer treatment (74.8%). Common cancer types included breast (33.7%), genitourinary (16.7%), and digestive (15.0%). Frequent sites of metastasis were bone (44.8%), liver (28.8%), and lung (25.8%). The mean exercise attendance rate was 73.6%. One exercise-related adverse event (0.3%) and one non-exercise-related adverse event (0.3%) occurred, both in individuals with brain metastases. Participants demonstrated strong interest and engagement in exercise, with significant improvements in weekly physical activity, symptoms, quality of life, and physical fitness. Greater benefits were found among subgroups of male participants, those not undergoing chemotherapy, and those receiving group personal training or virtual circuit training. A low rate of adverse events is anticipated. Full article

(This article belongs to the Special Issue Building Hope for the Next Decade of Psychosocial Oncology: Optimizing the Integration of Supportive Care into Oncology Care)

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12 pages, 601 KB

Open AccessArticle

Oncotype DX Recurrence Score Predicts Survival in Invasive Micropapillary Breast Carcinoma: A National Cancer Database Analysis

by Ali J. Haider, Mohummad Kazmi, Kyle Chang, Waqar M. Haque, Efstathia Polychronopoulou, Jonathon S. Cummock, Sandra S. Hatch, Andrew M. Farach, Upendra Parvathaneni, E. Brian Butler and Bin S. Teh

Curr. Oncol. 2025, 32(10), 559; https://doi.org/10.3390/curroncol32100559 - 5 Oct 2025

Viewed by 733

Abstract

(1) Background: Invasive micropapillary carcinoma (IMPC) is a rare, aggressive breast cancer subtype marked by high lymph node metastasis rates. While Oncotype DX recurrence score (RS) offers prognostic information for patients with hormone-receptor-positive (HR+) breast cancer, its utility in IMPC—a histology with distinct [...] Read more.

(1) Background: Invasive micropapillary carcinoma (IMPC) is a rare, aggressive breast cancer subtype marked by high lymph node metastasis rates. While Oncotype DX recurrence score (RS) offers prognostic information for patients with hormone-receptor-positive (HR+) breast cancer, its utility in IMPC—a histology with distinct biologic behavior—remains unvalidated. This study evaluates whether Oncotype DX offers prognostic information with respect to overall survival (OS) in non-metastatic, early-stage patients with IMPC of the breast. (2) Methods: The National Cancer Database (2004–2020) was queried to select for women with ER+/HER2−, T1-T2N0-N1 IMPC who underwent Oncotype DX testing and received no neoadjuvant therapy. Patients were stratified by RS: low (≤11), intermediate (12–25), and high (>25). Kaplan–Meier survival curves and log-rank tests compared 5-year OS between groups. Multivariable Cox proportional hazards models assessed RS as an independent predictor, adjusting for age, race, comorbidities, grade, radiation, and insurance status. (3) Results: A total of 1325 women met the selection criteria. The cohort demonstrated significant survival disparities by RS (log-rank p = 0.017). Five-year OS rates were 97.5%, 97.5%, and 93.7% for low, intermediate, and high-risk patients, respectively. Adjusted multivariate analysis confirmed RS as an independent prognosticator: low (HR = 0.31, 95% CI: 0.15–0.75) and intermediate (HR = 0.32, 95% CI: 0.15–0.75) scores correlated with reduced mortality versus high RS. Omission of radiation therapy (HR = 2.68, 95% CI: 1.05–6.86) and higher comorbidity burden (0 comorbidities vs. ≥2: HR = 0.25, 95% CI: 0.10–0.61) were significantly associated with worse survival. (4) Conclusions: Oncotype DX is predictive for OS in IMPC, with high RS (>25) portending poorer outcomes. The survival detriment associated with RT omission aligns with prior studies demonstrating RT benefit in higher-risk cohorts. These findings validate RS as a prognostic tool in IMPC and underscore its potential to refine adjuvant therapy, particularly RT utilization. Future studies should explore RS-driven treatment personalization in IMPC, including comorbidity management and adjuvant radiation to improve outcomes in this distinct patient population. Full article

(This article belongs to the Section Breast Cancer)

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11 pages, 1114 KB

Open AccessArticle

Incidence of Hypothyroidism and Thyroid Function Monitoring After Immune Checkpoint Inhibitor Therapy Completion for Lung Cancer: A Nationwide Analysis of a Japanese Claims Database

by Hiroaki Ohta, Hinako Tsugane and Takeo Yasu

Curr. Oncol. 2025, 32(10), 558; https://doi.org/10.3390/curroncol32100558 - 4 Oct 2025

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Abstract

Immune checkpoint inhibitors (ICIs) improve lung cancer prognosis but are associated with immune-related adverse events, most commonly thyroid dysfunction. While prior studies and guidelines have focused on thyroid dysfunction during ICI therapy, data on hypothyroidism and its monitoring after ICI therapy remain limited. [...] Read more.

Immune checkpoint inhibitors (ICIs) improve lung cancer prognosis but are associated with immune-related adverse events, most commonly thyroid dysfunction. While prior studies and guidelines have focused on thyroid dysfunction during ICI therapy, data on hypothyroidism and its monitoring after ICI therapy remain limited. We aimed to investigate hypothyroidism incidence and implementation of thyroid function monitoring after ICI therapy completion in patients with lung cancer. We conducted a retrospective observational study using the DeSC claims database of approximately 12 million individuals in Japan. Patients with lung cancer who received ICI therapy between April 2014 and August 2023 were included; those with a history of thyroid hormone replacement or insufficient follow-up were excluded. Among 6883 eligible patients, 277 (4.0%) developed hypothyroidism requiring hormone replacement post-ICI therapy completion (median onset, 67.0 d). Risk factors included ICI plus bevacizumab therapy and a history of myasthenia gravis, while steroid use for ≥28 d during ICI therapy lowered the risk. Post-ICI therapy completion thyroid monitoring was performed in 73.7% of patients, with test date distribution showing a median of 126.0 d and mode of 21.0 d. Hypothyroidism was frequently found to develop within 2 months post-ICI therapy completion, highlighting the need for continued thyroid monitoring and prospective studies to establish optimal surveillance strategies. Full article

(This article belongs to the Section Thoracic Oncology)

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Curr. Oncol., Volume 32, Issue 10 (October 2025) – 60 articles

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