Current Oncology

23 pages, 4385 KB

Open AccessArticle

Serum p-Cresol and 7-HOCA Levels and Fatty Acid and Purine Metabolism Are Associated with Survival, Progression, and Molecular Classification in GB—Serum Proteome and Metabolome Analysis Pre vs. Post Up-Front Chemoirradiation

by Andra V. Krauze, M. Li, Y. Zhao, E. Tasci, S. Chappidi, T. Cooley Zgela, M. Sproull, M. Mackey and K. Camphausen

Curr. Oncol. 2025, 32(11), 650; https://doi.org/10.3390/curroncol32110650 - 20 Nov 2025

Viewed by 248

Abstract

Background: Glioblastoma (GB) is the most common primary brain tumor, with poor prognosis, significant neurological symptoms, and near-universal recurrence. Biomarker development is often limited by the scarcity of tumor tissue available for study. Noninvasive serum-based profiling offers potential to improve outcomes. Purpose: This [...] Read more.

Background: Glioblastoma (GB) is the most common primary brain tumor, with poor prognosis, significant neurological symptoms, and near-universal recurrence. Biomarker development is often limited by the scarcity of tumor tissue available for study. Noninvasive serum-based profiling offers potential to improve outcomes. Purpose: This study examined serum proteomic and metabolomic profiles pre- and post-concurrent chemoirradiation (CRT) to identify associations with patient outcomes and molecular classification, and to explore relevant signaling and metabolic pathways. Methods: Serum samples from 109 GB patients, obtained prior to and following completion of CRT, were analyzed with each patient serving as their own control, using a SOMAScan^® proteomic assay (7289 proteins) and metabolomics (SECIM, 6015 compounds). Clinical data were obtained through chart review. Proteomic and metabolomic changes were examined at baseline (prior to CRT) and in alteration (pre- vs. post-CRT) for their association with overall survival (OS), progression-free survival (PFS), MGMT, and IDH status. Cox models, gene set enrichment analysis (Hallmark, GSEA), and Kaplan–Meier survival analysis were used. Results: Several hundred proteins and metabolites were associated with OS and PFS. MGMT status was known in 60% and IDH in 38% of patients. Pre-CRT DLST (HR 11.7, p < 0.001, adj p = 0.01) was the only protein significantly associated with OS. Pre-CRT, and higher 7-HOCA was linked to worse OS (HR 1.3) and PFS (HR 1.5), while increased p-cresol was associated with improved OS (HR 0.8) and PFS (HR 0.9). Kaplan–Meier analysis based on signal alteration post-CRT vs. pre-CRT, revealed superior OS with lower DLST and MSR1 and superior PFS with higher PGAM2 and ATG5, and lower 7-HOCA. Pathway analysis linked improved PFS to fatty acid metabolism, citric acid cycle, and purine biosynthesis. MGMT and IDH class comparisons revealed associations primarily with amino acid and fatty acid metabolism. Both MGMT methylation and IDH mutation correlated with increased PLAG12B expression, with significance only for MGMT (p < 0.001). IDH mutation was associated with decreased MSR1 (p = 0.047) and p-cresol (p < 0.001). Conclusions: Serum-based fatty acid and purine metabolism pathways are associated with OS and PFS in GB. 7-HOCA and p-cresol emerged as potential biomarkers linked to treatment response and molecular subtype. These findings support further investigation of noninvasive biospecimens for clinically actionable biomarkers in GB. Full article

(This article belongs to the Special Issue Advances in Radiation Treatment for Brain Tumors)

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50 pages, 2122 KB

Open AccessReview

Neurofibromatosis Type 1 and the Search for Effective Tumor Therapies Using High-Throughput Drug Screening

by Stephanie J. Bouley, Benjamin E. Housden and James A. Walker

Curr. Oncol. 2025, 32(11), 649; https://doi.org/10.3390/curroncol32110649 - 20 Nov 2025

Viewed by 640

Abstract

Neurofibromatosis type 1 (NF1) is a complex, multisystem, genetic disorder caused by germline NF1 variants that predispose affected individuals to tumors of the nervous system. With the identification of the NF1 gene in the late 1980s and the elucidation of the role of [...] Read more.

Neurofibromatosis type 1 (NF1) is a complex, multisystem, genetic disorder caused by germline NF1 variants that predispose affected individuals to tumors of the nervous system. With the identification of the NF1 gene in the late 1980s and the elucidation of the role of the encoded protein, neurofibromin, in regulating RAS signaling, considerable research effort has been invested to identify therapeutic treatments for NF1 tumors. Over the past two decades, high-throughput drug screening approaches have been a significant component of these endeavors. However, considerable variability exists among studies in terms of disease models, symptom targets, screening libraries, methods, and outcomes. In this review, we present an overall summary of efforts toward discovering new therapeutic strategies for NF1-related tumors using high-throughput screening and how such findings can be employed for prospective research in the NF1 field. Full article

(This article belongs to the Special Issue Neurofibromatosis Type 1 (NF1) Tumor Spectrum)

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Graphical abstract

12 pages, 995 KB

Open AccessOpinion

Zolbetuximab or Immunotherapy as the Initial Targeted Therapy in CLDN18.2-Positive, HER2-Negative Advanced Gastric Cancer: Weighing the Options

by Jacob C. Easaw, Howard J. Lim, Hatim Karachiwala, Sharlene Gill, Xiaofu Zhu and Justin Bateman

Curr. Oncol. 2025, 32(11), 648; https://doi.org/10.3390/curroncol32110648 - 20 Nov 2025

Viewed by 689

Abstract

Advanced gastric/gastroesophageal junction (G/GEJ) adenocarcinoma remains a common and deadly form of cancer. Advances in G/GEJ cancer treatment have improved survival outcomes with the claudin-18.2 (CLDN18.2)-targeted agent, zolbetuximab, and immune checkpoint inhibitors (ICIs) targeting the PD-1 receptor. This article offers an evidence-informed opinion [...] Read more.

Advanced gastric/gastroesophageal junction (G/GEJ) adenocarcinoma remains a common and deadly form of cancer. Advances in G/GEJ cancer treatment have improved survival outcomes with the claudin-18.2 (CLDN18.2)-targeted agent, zolbetuximab, and immune checkpoint inhibitors (ICIs) targeting the PD-1 receptor. This article offers an evidence-informed opinion on considerations when selecting between these first-line treatments for G/GEJ adenocarcinoma in patients with HER2-negative disease that expresses CLDN18.2 and/or PD-L1, including the reliability of biomarker scoring and interpretation, overall survival (OS) rates, toxicity profiles, and logistical practicalities. Evidence from Phase III trials for zolbetuximab and ICIs suggest similar OS benefits of 14–18 months compared to chemotherapy alone, but there appears to be a gradient of benefit for ICIs with increasing PD-L1 combined positive score (CPS). There is high inter-observer variability in CPS scoring, particularly at lower thresholds. Zolbetuximab is associated with high rates of nausea and vomiting during the initial infusion, whereas ICIs are associated with risk of later-onset immune-related toxicities that can be fatal in rare cases. In considering the available evidence, our opinion is that zolbetuximab is a reasonable option for initial targeted treatment in HER2-/CLDN18.2-positive advanced G/GEJ when PD-L1 CPS score is <10 based on the reliability of biomarker testing, comparable OS, and avoidance of potentially irreversible ICI-induced immune toxicity. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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20 pages, 5431 KB

Open AccessArticle

Predicting the Consistency of Vestibular Schwannoma and Its Implication in the Retrosigmoid Approach: A Single-Center Analysis

by Raffaele De Marco, Giovanni Morana, Silvia Sgambetterra, Federica Penner, Antonio Melcarne, Diego Garbossa, Michele Lanotte, Roberto Albera and Francesco Zenga

Curr. Oncol. 2025, 32(11), 647; https://doi.org/10.3390/curroncol32110647 - 19 Nov 2025

Viewed by 271

Abstract

To explore the relationship between magnetic resonance imaging (MRI) parameters, including T2-weighted intensity and apparent diffusion coefficient (ADC), and intraoperative tumor characteristics, particularly consistency, in vestibular schwannomas (VSs). The association between tumor consistency, facial nerve (FN) function, and postoperative outcomes was analyzed. A [...] Read more.

To explore the relationship between magnetic resonance imaging (MRI) parameters, including T2-weighted intensity and apparent diffusion coefficient (ADC), and intraoperative tumor characteristics, particularly consistency, in vestibular schwannomas (VSs). The association between tumor consistency, facial nerve (FN) function, and postoperative outcomes was analyzed. A single-center retrospective analysis included newly diagnosed VS cases (2020–2023) with cisternal involvement (Samii T3a; volume ≥ 0.7 cm³). T2 and ADC maps from the perimetral region of interest were normalized, and tumors were categorized into 3 classes by combining qualitative consistency (soft, fibrous, or fibrous/hard), ultrasonic aspirator power, and adherence to neurovascular structures. FN function was assessed using the House–Brackmann scale at the immediate postoperative period and 12-month follow-up. MRIs of 33 VSs (18 solid and 15 cystic) were analyzed. Normalized values of both T2 (N-T2_mean) and ADC (N-ADC_min) maps predicted the classical radiological differentiation. N-ADC_min may have some role in predicting consistency (value 1.361, p = 0.017, accuracy 0.48) and demonstrated a significant association (p = 0.04) with the FN outcome in the immediate postoperative period. An augmented consistency could impair FN function by increasing the intrameatal pressure related to greater transmission of shocks derived from the dissection maneuvers of the cisternal component of the tumor. The possibility of non-invasively exploring VS consistency with a parameter easily calculable on MRI might be beneficial in surgical planning, modifying the timing of the opening of the meatus with respect to what could be the surgical routine in some centers. Full article

(This article belongs to the Topic Innovations in Brain Tumor Surgery: Techniques and Outcomes)

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7 pages, 485 KB

Open AccessCase Report

Serial Functional and Genomic Analyses Illuminate Clonal Evolution in Metastatic NSCLC with 12-Year Survival

by Vikrant S. Bakaya, Sabina A. Schneider, Tracy Nguyen, Derrick C. Phu, Lucas A. Alvarez, Steven S. Evans, Paula J. Bernard, Federico R. Francisco, Adam J. Nagourney, Luisa Torres, John Henry, Jr., Paulo D’Amora and Robert A. Nagourney

Curr. Oncol. 2025, 32(11), 646; https://doi.org/10.3390/curroncol32110646 - 19 Nov 2025

Viewed by 345

Abstract

Background: Non-small cell lung cancer (NSCLC) is the most common form of lung cancer and a leading cause of cancer-related death. Despite therapeutic advances, long-term survival in stage IV disease is uncommon. Tumor analyses that combine genomic and functional platforms may provide the [...] Read more.

Background: Non-small cell lung cancer (NSCLC) is the most common form of lung cancer and a leading cause of cancer-related death. Despite therapeutic advances, long-term survival in stage IV disease is uncommon. Tumor analyses that combine genomic and functional platforms may provide the opportunity to monitor clonal dynamics and guide therapy selection. Case Presentation: We report a 67-year-old woman with metastatic poorly differentiated lung adenocarcinoma, who achieved four durable remissions and survived nearly 12 years. Serial studies using ex vivo analysis of programmed cell death (EVA/PCD) functional-profiling-guided therapeutic choices were correlated with next-generation sequencing (NGS). Molecular events included the emergence of a BRAF V600E mutation responsive to dabrafenib plus trametinib and the acquisition of an EGFR exon 19 deletion responsive to Osimertinib. EVA/PCD identified activity for targeted agents and revealed synergy for vinorelbine plus Osimertinib not predicted by genomic profiling, which provided additional response. Discussion: This case highlights clonal evolution in NSCLC and illustrates how serial tissue analyses correlating phenotypic and genomic events can offer therapeutic interventions to provide long-term survival. Conclusions: The integration of functional and genomic profiling may improve personalized treatment in NSCLC by interrogating tumor heterogeneity and clonal evolution to inform rational therapeutic selection. Full article

(This article belongs to the Section Thoracic Oncology)

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13 pages, 623 KB

Open AccessArticle

Examining the Association Between Equity-Related Factors and EQ-5D-3L Health Utilities of Patients with Cancer

by Teresa C. O. Tsui, Rebecca E. Mercer, Eleanor M. Pullenayegum and Kelvin K. W. Chan

Curr. Oncol. 2025, 32(11), 645; https://doi.org/10.3390/curroncol32110645 - 19 Nov 2025

Viewed by 257

Abstract

Background: EQ-5D-3L health utilities inform health technology assessments in oncology, often derived from clinical trials enrolling highly selected populations, which may over-estimate real-world health utilities. Little is known about the association between socioeconomic status (SES) and EQ-5D-3L health utilities. Our objective was to [...] Read more.

Background: EQ-5D-3L health utilities inform health technology assessments in oncology, often derived from clinical trials enrolling highly selected populations, which may over-estimate real-world health utilities. Little is known about the association between socioeconomic status (SES) and EQ-5D-3L health utilities. Our objective was to examine EQ-5D-3L health utilities across SES in a real-world sample of patients with cancer. Methods: We conducted a cross-sectional analysis of EQ-5D-3L responses from 170 adult patients with cancer accrued from an Ontario oncology centre. We fitted multivariable linear regression models to estimate associations between covariates and EQ-5D-3L health utilities. Results: Lower EQ-5D-3L health utilities were significantly associated with the lowest and undisclosed family income categories in models with and without birth sex (p < 0.05). In the model including birth sex, disutility estimates for lowest family income (<CAD 29K) and undisclosed income was −0.202, 95% CI (−0.371 to −0.033), and −0.123 (−0.235 to −0.012), respectively. For the model excluding birth sex, disutility estimates for lowest income and undisclosed income was −0.163 (−0.280 to −0.046) and −0.106 (−0.184 to −0.028). Conclusions: Lower EQ-5D-3L health utilities were significantly associated with low income and nondisclosure, highlighting the need to incorporate SES in analyzing health utilities in cancer care. Full article

(This article belongs to the Section Health Economics)

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16 pages, 726 KB

Open AccessArticle

Parenteral Nutrition in Patients with Incurable Cancer: Exploring the Heterogenous and Non-Randomised Clinical Landscape

by Marianne Erichsen, Tora S. Solheim, Inger Ottestad, Ingvild Paur, Rikka F. Sande, Astrid Nygaard, Emilie H. Markhus, Lene Thoresen, Morten Thronæs, Randi J. Tangvik, Kari Sygnestveit, Patrik Hansson, Cathrine Vestnor, Gunnhild Jakobsen, Ørnulf Paulsen, Erik Torbjørn Løhre and Trude R. Balstad

Curr. Oncol. 2025, 32(11), 644; https://doi.org/10.3390/curroncol32110644 - 18 Nov 2025

Viewed by 418

Abstract

Background: There is an insufficient knowledge base for optimal parenteral nutrition (PN) use for patients with incurable cancer, leading to vague guidelines and varied practices. The aim of the study is to describe the practices and actual outcomes of PN in patients [...] Read more.

Background: There is an insufficient knowledge base for optimal parenteral nutrition (PN) use for patients with incurable cancer, leading to vague guidelines and varied practices. The aim of the study is to describe the practices and actual outcomes of PN in patients with incurable cancer at Norwegian hospitals. Methods: This multicentre study retrospectively reviewed 507 deceased patients (>18 years) receiving PN between 2011 and 2017. Data were collected from PN initiation until death, and analyses were descriptive. Results: Fifty-one percent had upper and lower gastrointestinal cancers, and the main PN indications were insufficient intake (75%) and gastrointestinal malfunction (47%). Sixty-seven percent received no anticancer treatment. Forty-three (8%) received PN as temporary bridging to anticancer treatment, of whom fifteen (35%) resumed or initiated treatment. The median PN dose corresponded to 53% of estimated energy requirements, and 94% of the patients had complementary energy intake. The most common reason for discontinuation was expected imminent death (47%). While common symptoms during PN were nausea (52%), vomiting (46%), and oedema (37%), 15% reported improved wellbeing. Conclusions: In this real-world cohort, up to 80% of the patients would not meet the eligibility criteria of previous trials due to cancer diagnosis and treatment, gastrointestinal tract function, weight loss criteria or complications such as ascites. This study highlights the heterogeneity in how patients with incurable cancer receive PN, and emphasises the importance of individualised PN treatment, carefully and safely managed to meet the patients’ palliative care situation. Future real-world pragmatic patient-centred protocols bridging the gap between clinical trials and patients in clinical practice are warranted. Full article

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

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19 pages, 621 KB

Open AccessArticle

Diversity and Experiences of Radiation Oncologists in Canada: A Survey of Gender Identity, Sexual Orientation, Disability, Race, Ethnicity, Religion, and Workplace Discrimination—A National Cross-Sectional Electronic Survey

by Amanda F. Khan, Stefan Allen, Ian J. Gerard, Rhys Beaudry, Glen Bandiera, David Bowes, Jolie Ringash, Reshma Jagsi, Jennifer Croke and Shaun K. Loewen

Curr. Oncol. 2025, 32(11), 643; https://doi.org/10.3390/curroncol32110643 - 17 Nov 2025

Cited by 1 | Viewed by 195

Abstract

Background: This study’s objective was to be the first to explore the ethnicity/cultural origins, gender identity, ability/disability, sexual orientation, socioeconomic background, and harassment/discrimination experiences of Canadian radiation oncologists (ROs). Methods: Following a literature review and input from content experts, an ethics-approved national cross-sectional [...] Read more.

Background: This study’s objective was to be the first to explore the ethnicity/cultural origins, gender identity, ability/disability, sexual orientation, socioeconomic background, and harassment/discrimination experiences of Canadian radiation oncologists (ROs). Methods: Following a literature review and input from content experts, an ethics-approved national cross-sectional electronic survey was developed in English and French and electronically distributed to all ROs in Canada (n = 598). Descriptive statistics summarized responses. Comparisons between groups were performed using Chi-square tests, and content analysis was performed on open-ended responses. Results: The survey was completed in full by 42.5% of ROs (254/598). Most respondents were male (62.9%), 35–44 years old (39.2%), and heterosexual (94.3%). 41.2% identified as belonging to a racialized group, which is higher than the overall Canadian population (27%), but Black, Indigenous, and Southeast Asian ROs were underrepresented (1.9% vs. 4%, <1% vs. 5% and 1.6% compared to 4%, respectively). A significant subset analysis showed that only 20% (21/105) of racialized ROs were women, whereas Caucasian women comprised 49.3% (74/150) of Caucasian respondents (p < 0.001). While 75.4% of respondents reported job satisfaction, 42.1% reported experiencing workplace discrimination/harassment within the past 5 years; most commonly, this was perpetrated by fellow faculty (31.7%; 58/183) or patients or their family members (31.7%; 58/183). Respondents felt that gender, race/ethnicity, and age were the three top reasons for discrimination/harassment, with double the amount of racialized ROs reporting harassment compared to White ROs (p < 0.001). Nearly half (45.2%; 114/252) did not understand how to report, or felt uncomfortable reporting, workplace discrimination/harassment. Conclusions: This study highlights high harassment and discrimination rates amongst Canadian ROs, especially amongst racialized women, which may affect career satisfaction and attrition rates. Compared to census data, Black, Indigenous, and Southeast Asian ROs were underrepresented, and amongst racialized ROs, racialized women were significantly underrepresented. These findings underscore the need for targeted diversity initiatives, improved mentorship programs, and stronger institutional policies to address harassment and foster an inclusive work environment. Full article

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10 pages, 218 KB

Open AccessArticle

Complications of Robotic Pelvic Lymph Node Dissection for Prostate Cancer: An Analysis of the National Surgical Quality Improvement Program Targeted Prostatectomy Database

by Vatsala Mundra, Renil S. Titus, Eusebio Luna-Velasquez, Jiaqiong Xu, Carlos Riveros, Sanjana Ranganathan, Aamuktha Porika, Brian J. Miles, Dharam Kaushik, Christopher J. D. Wallis and Raj Satkunasivam

Curr. Oncol. 2025, 32(11), 642; https://doi.org/10.3390/curroncol32110642 - 16 Nov 2025

Viewed by 301

Abstract

Introduction/Background: Treatment of localized prostate cancer includes radical prostatectomy (RP) with or without pelvic lymph node dissection (PLND). While multiple guidelines recommend PLND for staging purposes, recent data has shown questionable therapeutic benefit. Thus, understanding the morbidity associated with PLND is important for [...] Read more.

Introduction/Background: Treatment of localized prostate cancer includes radical prostatectomy (RP) with or without pelvic lymph node dissection (PLND). While multiple guidelines recommend PLND for staging purposes, recent data has shown questionable therapeutic benefit. Thus, understanding the morbidity associated with PLND is important for counseling patients. We used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) targeted prostatectomy database to quantify real-world 30-day postoperative outcomes of patients undergoing contemporary robot-assisted PLND at the time of RP for prostate cancer to quantify the incremental morbidity. Methods: We conducted a retrospective cohort study using the NSQIP database of adult patients undergoing radical prostatectomy from 2019 to 2022. The primary outcomes were procedure-specific outcomes such as lymphocele and rectal injury. Secondary outcomes included a composite of any of the following 30-day major postoperative outcomes: mortality, reoperation, cardiac or neurologic event, as well as the individual components of this outcome, as well as infectious and other complications. We also analyzed yearly trends associated with PLND. Groups were balanced using propensity score matching (PSM) with a 1:1 ratio using demographic characteristics, prior medical history, and cancer staging data. Likelihood of complications was assessed by conditional logistic regression. Results: We identified 13,413 patients between 2019 and 2022 who underwent robotic prostatectomy: 11,341 (85%) had PLND while 2072 (15%) did not. After PSM, our cohort included 2071 matched pairs of patients with and without PLND. Patients who underwent PLND were more likely to be diagnosed with lymphocele (2.14% vs. 0.68%, OR 4.17; 95% CI 2.00, 8.68), have unplanned readmission (4.22% vs. 3.27%, OR 1.31; 95% CI 1.03, 1.65), and develop organ-site/space SSI (1.18% vs. 0.60%) (OR 1.97, 95% CI 1.20, 3.23). There was no significant association between the receipt of PLND and the likelihood of urinary leak or fistula, or ureteral obstruction. There were no significant differences between the two groups with respect to secondary outcomes of interest. Conclusion: Contemporary robotic PLND is associated with a 3-fold increased likelihood of lymphocele, as well as increased likelihood of unplanned readmission and organ-site SSI, though no significant differences in major postoperative complications were identified. We found that the odds of lymphoceles, readmission, and SSI in our study are lower than previously reported. These data provide real-world data to guide patient counseling and optimize patient selection for PLND at the time of RALP. Full article

(This article belongs to the Section Surgical Oncology)

17 pages, 790 KB

Open AccessArticle

Cancer Treatment Patterns Among Yukon Residents Referred to British Columbia for Care: A 13-Year Retrospective Study

by Kaylie Willemsma, Jonathan Simkin, Debon Lee, Emma Quinn, Kira Makuk, Emily B. Jackson, Andrew Bang, Manik Chahal, Ying Wang and Jessica Chan

Curr. Oncol. 2025, 32(11), 641; https://doi.org/10.3390/curroncol32110641 - 16 Nov 2025

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Abstract

Yukon residents often must travel long distances to access specialized cancer care, which may impact cancer treatment patterns. We conducted a retrospective study to characterize all adult breast, prostate, colorectal, and lung cancer cases from the Yukon, diagnosed from 2009 to 2021 and [...] Read more.

Yukon residents often must travel long distances to access specialized cancer care, which may impact cancer treatment patterns. We conducted a retrospective study to characterize all adult breast, prostate, colorectal, and lung cancer cases from the Yukon, diagnosed from 2009 to 2021 and seen in consultation at BC Cancer. We collected data on demographics, tumour characteristics and treatment, including timepoints for cancer care. A secondary analysis of non-referred cases was conducted. There were a total of 336 breast, 270 prostate, 279 colorectal and 266 lung cancer cases diagnosed in the Yukon from 2009 to 2021, of which 298 (88.7%), 120 (44.4%), 206 (73.8%) and 204 (76.7%) cases were referred to BC Cancer, and 266 (79.2%), 118 (43.7%), 204 (73.1%) and 183 (68.8%) were included in this study, respectively. Most cases were diagnosed at an early stage (breast: 92.9%, prostate: 82.2%, colorectal: 72.1%, lung: 45.9%). Nearly 70% of cases resided in Whitehorse (Yukon’s capital), where most Yukon residents live. Compared to available published Canadian timepoints, Yukon patients had similar or shorter wait times in 13 of 22 timepoints along the pathway to diagnosis and treatment. However, time from biopsy to surgery had the longest relative wait times across all tumour groups (range: 26–60% longer). Our study provides baseline data that can help inform cancer care provision for Yukon residents. Full article

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12 pages, 585 KB

Open AccessArticle

Acupuncture Improves Functional Limitations for Cancer Patients with Chronic Pain: A Secondary Analysis of PEACE Randomized Clinical Trial

by Lingyun Sun, Mothi Babu Ramalingam, Raymond Baser, Marco Santos Teles, Christina Seluzicki, Qing Susan Li and Jun J. Mao

Curr. Oncol. 2025, 32(11), 640; https://doi.org/10.3390/curroncol32110640 - 16 Nov 2025

Viewed by 632

Abstract

Chronic pain significantly impairs functional performance in patients with cancer. Although acupuncture is effective for cancer-related pain, its impact on pain-related functional interference remains unclear. This secondary analysis of the PEACE randomized clinical trial included patients with prior cancer diagnoses and musculoskeletal pain [...] Read more.

Chronic pain significantly impairs functional performance in patients with cancer. Although acupuncture is effective for cancer-related pain, its impact on pain-related functional interference remains unclear. This secondary analysis of the PEACE randomized clinical trial included patients with prior cancer diagnoses and musculoskeletal pain for ≥3 months. Participants were randomized to groups undergoing 10 weeks of electro-acupuncture, auricular acupuncture, or a waitlist control. Functional performance was assessed using the Quick-Disability Arm/Shoulder/Hand (Q-DASH) for upper limbs and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) subscale for lower limbs (higher scores = worse function). Linear mixed models compared changes over time between groups, with week 12 as the primary endpoint. Functional changes were also compared between pain responders and non-responders in the acupuncture arms. Among 360 patients (mean [SD] age, 62.1 [12.7] years; 69.7% women), mean baseline Q-DASH and WOMAC scores were 33.2 (19.8) and 33.3 (20.3). At week 12, both electro-acupuncture and auricular acupuncture significantly improved function versus waitlist: Q-DASH by −7.18 and −9.64 points, respectively, and WOMAC by −6.89 and −7.61 points (all p < 0.001). No differences were found between the two acupuncture groups. Treatment effects on Q-DASH diminished during follow-up, while improvements on WOMAC persisted. Within the acupuncture groups, pain responders achieved greater functional gains than non-responders (Q-DASH, −6.74; WOMAC, −6.16; both p < 0.001). Electro-acupuncture and auricular acupuncture improved upper and lower extremity function in cancer patients with chronic pain. These findings support acupuncture as a potential adjunct in functional rehabilitation for cancer survivors. Full article

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

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14 pages, 531 KB

Open AccessArticle

Efficacy of Anti-VEGF and Anti-EGFRs in Microsatellite Instable (MSI-H) Metastatic Colorectal Cancer in a Turkish Oncology Group (TOG) Cohort Study

by İlknur Deliktaş Onur, Mutlu Doğan, Mehmet Akif Öztürk, Taha Koray Sahin, Murat Kiracı, Ahmet Melih Arslan, Eda Karapelit, Bahar Beliz Karaoğlan, Nargiz Majidova, Elif Şahin, Sabin Göktaş, Abdullah Sakin, Ali Oğul, Emine Türkmen, Kadriye Başkurt, Zeynep Yüksel Yaşar, Yakup Ergün, Esma Türkmen Bekmez, Şafak Yıldırım Dişli, Sinem Akbaş, Sema Türker, Ömer Dizdar, Öznur Bal, Tuğba Yavuzşen, Melek Karakurt, Arzu Hatime Yaşar, Tuğba Başoğlu, Faysal Dane, Şuayip Yalçın and Öztürk Ateş Show full author list Hide full author list

Curr. Oncol. 2025, 32(11), 639; https://doi.org/10.3390/curroncol32110639 - 14 Nov 2025

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Abstract

Background: Mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) colorectal tumors constitute 5% of metastatic colorectal cancer(mCRC). Immunotherapy is a new standard, but it is difficult to provide for all patients. 5-Flurouracil-based treatment with anti-EGFRs (cetuximab and panitumumab) in RAS/BRAF-wild or anti-VEGF (bevacizumab) is used in [...] Read more.

Background: Mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) colorectal tumors constitute 5% of metastatic colorectal cancer(mCRC). Immunotherapy is a new standard, but it is difficult to provide for all patients. 5-Flurouracil-based treatment with anti-EGFRs (cetuximab and panitumumab) in RAS/BRAF-wild or anti-VEGF (bevacizumab) is used in mCRC. Data is limited for the efficacy of anti-VEGF or anti-EGFRs in dMMR/MSI-H mCRC due to the small number of cases in the colorectal cancer population in trials. Aims: To evaluate prognostic factors in dMMR/MSI-H mCRC and compare progression-free survival time of patients receiving anti-VEGF and anti-EGFR combined with first-line 5FU-based therapy. Methods: Patients with metastatic dMMR/MSI-H colorectal cancer diagnosed between January 2015 and January 2023 were included in this cohort study. Progression-free survival times of patients treated with first-line therapy were compared. Prognostic factors associated with overall survival were investigated. Results: A total of 132 patients were included. Mutation rates were 35.6% (n:47) for RAS and 12.1% (n: 16) for BRAF (. Median progression-free survival (PFS) was 10.9 (95% CI: 9.2–12.6) months. Median overall survival (OS) was 44 months (95% CI: 26.23–63.03). 82 (62.1%) patients had primary tumor resection (PTR), 26 (19.7%) had PTR and metastasectomy. A total of 17 (12.8%) de novo mCRC patients had maximal cytoreductive surgery (MCS). A total of 14 (10.6%) patients had subsequent immunotherapy (IO). In multivariate analysis, RAS/BRAF mutation status, MCS, and subsequent IO are defined as prognostic factors for OS (p < 0.01, p: 0.022, and p: 0.005, respectively). No statistically significant difference (PFS, OS) was found in patients receiving first-line anti-VEGF or anti-EGFR therapy. Conclusions: dMMR/MSI-H mCRC is an entity with different tumor biology. We consider that dMMR/MSI-H mCRC patients with BRAF wild, MCS and subsequent IO have better outcomes with 1st line 5FU-based treatment with anti-VEGF/anti-EGFRs. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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12 pages, 238 KB

Open AccessArticle

Confirmatory Clinical Validation of a Serum-Based Biomarker Signature for Detection of Early-Stage Pancreatic Ductal Adenocarcinoma

by Patricio M. Polanco, Tamas Gonda, Erkut Borazanci, Evan S. Glazer, Jose G. Trevino, George DeMuth, Lisa Ford, Thomas King, Norma A. Palma and Randall E. Brand

Curr. Oncol. 2025, 32(11), 638; https://doi.org/10.3390/curroncol32110638 - 13 Nov 2025

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Abstract

Early detection of pancreatic ductal adenocarcinoma (PDAC) could extend patient survival, and biomarkers to facilitate this are urgently needed. Here, we performed a second independent validation of PancreaSure, a 5-plex serum biomarker signature to detect early-stage PDAC in high-risk individuals. In contrast to [...] Read more.

Early detection of pancreatic ductal adenocarcinoma (PDAC) could extend patient survival, and biomarkers to facilitate this are urgently needed. Here, we performed a second independent validation of PancreaSure, a 5-plex serum biomarker signature to detect early-stage PDAC in high-risk individuals. In contrast to the first validation, this study’s cohort was preemptively balanced for age and sex and only included samples stored for fewer than 5 years. The primary endpoint was to measure test sensitivity against the performance target of 65%. Measuring specificity against the performance target of 90% and comparing test performance to that of carbohydrate antigen 19-9 (CA 19-9) alone were secondary endpoints. Signature analytes were retrospectively measured in serum from a blinded independent cohort of Stage I and II PDAC cases and high-risk controls. A predictive signal for PDAC was generated from a predefined cutoff established in a previous model development study. PancreaSure distinguished early-stage PDAC from controls with 76.5% sensitivity (95% CI, 67.7–83.9), significantly higher than the performance target (p = 0.005). PancreaSure achieved 87.8% specificity (95% CI, 83.9–91.4), similar to the performance goal, and significantly outperformed sensitivity of CA 19-9 alone (p = 0.02). These results confirm that PancreaSure performs well at detecting early-stage PDAC in high-risk individuals. Full article

(This article belongs to the Section Gastrointestinal Oncology)

12 pages, 635 KB

Open AccessArticle

Electronic Health Literacy, Psychological Distress, and Quality of Life in Urological Cancer Patients: A Longitudinal Study During Transition from Inpatient to Outpatient Care

by Dominik Fugmann, Steffen Holsteg, Ralf Schäfer, Günter Niegisch, Ulrike Dinger and André Karger

Curr. Oncol. 2025, 32(11), 637; https://doi.org/10.3390/curroncol32110637 - 13 Nov 2025

Viewed by 331

Abstract

Urological cancers are associated with reduced quality of life and high psychological burden, yet affected patients receive less psychosocial support than other cancer groups. Electronic health literacy (eHL) may facilitate independent access to resources, but its role for psychological outcomes and quality of [...] Read more.

Urological cancers are associated with reduced quality of life and high psychological burden, yet affected patients receive less psychosocial support than other cancer groups. Electronic health literacy (eHL) may facilitate independent access to resources, but its role for psychological outcomes and quality of life in this group is unclear. This study examined associations between eHL, psychological symptoms, and quality of life during transition from inpatient to outpatient care. A prospective, single-centre observational study was conducted. Eligible inpatients (urological cancer, Distress Thermometer ≥5 and/or request for psycho-oncological support) received an initial psycho-oncology consultation and completed surveys during inpatient treatment (T1) and three months later (T2). Measures included socio-demographics, PO-BADO, eHL (eHEALS), distress, depression (PHQ-2), anxiety (GAD-2), and quality of life (EORTC QLQ-C30). Of 108 patients completing T1, 71 completed T2. After controlling for age, eHL was not significantly associated with distress, depression, anxiety, or quality of life. Age did not moderate these relationships. In this sample, eHL showed no significant associations with psychological outcomes or quality of life. However, higher age was linked to lower eHL, suggesting that older patients may face barriers to digital health engagement. Age-related differences in eHL should be considered when designing digital support services for urological cancer patients. Full article

(This article belongs to the Special Issue Psychological Interventions for Cancer Survivors)

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13 pages, 465 KB

Open AccessArticle

Primary Anastomosis Versus Hartmann’s Procedure in Obstructing Colorectal Cancer: A Retrospective Cohort Study

by Abbas Aras

Curr. Oncol. 2025, 32(11), 636; https://doi.org/10.3390/curroncol32110636 - 13 Nov 2025

Viewed by 390

Abstract

Introduction: The objective of this study was to analyze and compare the outcomes of two surgical techniques in the emergency management of obstructed colorectal carcinoma. Methods: This is a retrospective analysis of patients’ data from a tertiary referral university hospital. The medical [...] Read more.

Introduction: The objective of this study was to analyze and compare the outcomes of two surgical techniques in the emergency management of obstructed colorectal carcinoma. Methods: This is a retrospective analysis of patients’ data from a tertiary referral university hospital. The medical records of patients who underwent emergency surgery for obstructed colorectal cancer between May 2014 and August 2019 were evaluated. The cases were divided primarily into two groups: Primary Resection and Anastomosis (PRA) and Hartmann’s Procedure (HP). The clinical characteristics, peri-operative outcomes and oncological results including early postoperative complications, morbidity and mortality (30-day, 1-year and 5-year survival) were compared between groups. Results: In this retrospective study, 110 patients with obstructing colorectal cancer undergoing emergency surgery were analyzed. Patients were divided into two groups: 65 cases of Primary Resection and Anastomosis (PRA) and 45 cases of Hartmann’s Procedure (HP). PRA patients had significantly shorter hospital stays (8.7 ± 4.1 vs. 11.2 ± 5.2 days, p = 0.02), lower complication rates (33% vs. 66%, p = 0.003), and superior survival outcomes, with a 5-year survival rate of 33.8% compared to 22.2% in the HP group (p = 0.003). Subgroup analysis revealed significant differences, including higher complication rates and repeat surgery requirements in patients with a diverting ostomy or undergoing resection without anastomosis. Conclusion: PRA demonstrated favorable perioperative and long-term outcomes compared to HP in the emergency management of obstructing colorectal cancer. These findings highlight the potential benefits of avoiding permanent stoma formation when appropriate patient selection criteria are met. Full article

(This article belongs to the Special Issue Surgical Advances in the Management of Gastrointestinal Cancers)

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18 pages, 1433 KB

Open AccessSystematic Review

Association Between Metabolic Syndrome and Risk of Laryngeal Cancer: A Systematic Review

by Faizan Bashir, Supriya Peshin, Moniza Rafiq, Sajida Zaiter, Naga Anvesh Kodali, Helia Bazroodi, Moiza Bashir, Lalith Vardhan Choudary and Sakshi Singal

Curr. Oncol. 2025, 32(11), 635; https://doi.org/10.3390/curroncol32110635 - 13 Nov 2025

Viewed by 373

Abstract

Background: Metabolic syndrome (MetS) is a significant global health burden and a known risk factor of cardiovascular disease and diabetes. Growing evidence also links MetS to cancer development, likely via chronic inflammation, insulin resistance, and hormone disruption. However, its association with laryngeal [...] Read more.

Background: Metabolic syndrome (MetS) is a significant global health burden and a known risk factor of cardiovascular disease and diabetes. Growing evidence also links MetS to cancer development, likely via chronic inflammation, insulin resistance, and hormone disruption. However, its association with laryngeal cancer remains largely unclear and underexplored. Methods: For this review, we thoroughly searched PubMed/MEDLINE, Scopus, and Web of Science for observational studies investigating associations of MetS with laryngeal or head and neck cancers (HNCs) until 1 August 2025. Five large population-based studies were found to meet inclusion criteria, and risk of bias was assessed using the Joanna Briggs Institute checklist (JBI). Results: Three Korean cohort studies consistently found that MetS increased the risk of laryngeal cancer (HR 1.13–1.32), independent of smoking and alcohol use. Hypertension and hyperglycemia were the most consistent components associated with increased risk, and chronic MetS conferred the highest hazard. In contrast, analyses from the UK Biobank (HNC) and SEER-Medicare (HNSCC) cohorts showed null and inverse associations, respectively. Additional findings included dose–response effects with increasing MetS components, U-shaped associations for HDL-C and waist circumference and increased risk associated with elevated C-reactive protein. Conclusions: Current evidence suggests a possible association between MetS and risk of laryngeal cancer, although the direction and strength of effect vary across populations. Findings from Korean cohorts provide consistent signals of increased risk, whereas Western datasets have not replicated this pattern. Overall, the certainty of evidence is low to moderate, warranting cautious interpretation and further validation in diverse populations before inferring causality. Full article

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12 pages, 1684 KB

Open AccessCase Report

Parotid Gland Mass as the First Manifestation of Recurrent Metastatic Breast Carcinoma: Diagnostic Pitfalls and Therapeutic Considerations in Oral-Maxillofacial Care

by Esteban Raúl Mar-Uribe, Miguel Angel Noyola-Frías, Oscar Arturo Benítez-Cárdenas, Elhi Manuel Torres-Hernández, Adalberto Mosqueda-Taylor, Raquel Sánchez-Gutiérrez, Sofía Bernal-Silva, Andreu Comas-García, Francisco Javier Aguilar-Zapata, Ricardo Martínez-Rider and Marlen Vitales-Noyola

Curr. Oncol. 2025, 32(11), 634; https://doi.org/10.3390/curroncol32110634 - 13 Nov 2025

Viewed by 333

Abstract

Breast cancer rarely metastasizes to the parotid gland. Early recognition in patients with a history of malignancy is critical for timely diagnosis and treatment. We report the case of a 60-year-old female who presented with a two-month history of a left periauricular mass, [...] Read more.

Breast cancer rarely metastasizes to the parotid gland. Early recognition in patients with a history of malignancy is critical for timely diagnosis and treatment. We report the case of a 60-year-old female who presented with a two-month history of a left periauricular mass, 18 months after completing treatment for breast carcinoma. Despite the patient’s oncologic history, initial evaluation by our maxillofacial surgery service showed no evidence of distant metastasis, and we initially ruled out metastatic disease. Clinical evaluation, contrast-enhanced computed tomography (CT), fine-needle aspiration cytology (FNAC), PET-CT, and histopathological analysis were performed. Given the persistent and progressive nature of the mass, surgical excision was undertaken to obtain a definitive diagnosis and provide local control. Immunohistochemical analysis of the resected mass and adjacent node confirmed metastatic breast carcinoma infiltrating the parotid parenchyma and an intra-parotid lymph node, with strong positivity for progesterone receptor (PR) and carcinoembryonic antigen (CEA). Unfortunately, several months later, the patient developed pulmonary metastases and subsequently died. Full article

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

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18 pages, 3514 KB

Open AccessArticle

Von Hippel–Lindau Disease-Associated Endolymphatic Sac Tumours: Seven Cases and Genotype–Phenotype Features

by Qin Wang, Junhui Huang, Zhikai Zhao, Yu Su, Nan Wu, Shiming Yang, Weidong Shen, Na Sai and Weiju Han

Curr. Oncol. 2025, 32(11), 633; https://doi.org/10.3390/curroncol32110633 - 12 Nov 2025

Viewed by 362

Abstract

Von Hippel–Lindau disease-associated endolymphatic sac tumors (VHL-associated ELSTs) present diagnostic challenges due to their rarity and nonspecific symptoms. This study describes clinical, pathological and genotypic features to guide treatment. We retrospectively analyzed seven patients with VHL-associated ELSTs. The mean age of otologic symptom [...] Read more.

Von Hippel–Lindau disease-associated endolymphatic sac tumors (VHL-associated ELSTs) present diagnostic challenges due to their rarity and nonspecific symptoms. This study describes clinical, pathological and genotypic features to guide treatment. We retrospectively analyzed seven patients with VHL-associated ELSTs. The mean age of otologic symptom [hearing loss (100%) and facial nerve paralysis (85.71%)] onset was 22.43 ± 8.68 years (range: 10–33). Surgical management included trans-labyrinthine and subtotal temporal bone resection approaches. Among three patients with severe preoperative facial nerve dysfunction, two underwent great auricular nerve grafting improved to House–Brackmann grade IV, while one receiving hypoglossal–facial nerve anastomosis reached grade V. Genetic testing identified pathogenic VHL gene missense mutations in three patients. Two female patients demonstrated disease progression during pregnancy. Literature analysis revealed exon-specific patterns: Exon 1 mutations correlated with cerebellar/spinal hemangioblastomas in female patients, while Exon 3 mutations were associated with multisystem tumors. These findings support that VHL-associated ELSTs manifest early with otologic symptoms and demonstrate exon-specific phenotypic patterns. Optimal management requires complete surgical resection, genetic diagnosis, and a multidisciplinary approach to address these complex tumors and achieve favorable outcomes. Full article

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

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20 pages, 345 KB

Open AccessArticle

Breathe with the Waves (BWW)—Creating and Assessing the Potential of a New Stress Management Intervention for Oncology Personnel

by Lauren Deckelbaum, Nikita Guarascio, Marie-Pierre Bastien, Anik Cloutier, Maria Kondyli, Marie-Paule Latour, Émélie Rondeau and Serge Sultan

Curr. Oncol. 2025, 32(11), 632; https://doi.org/10.3390/curroncol32110632 - 11 Nov 2025

Viewed by 1144

Abstract

Healthcare providers in oncology experience exceptionally high stress rates. Research emphasizes that stress management programs must be quick to implement, flexible to accommodate demanding schedules, cost-effective, accessible to all staff, and tailored to the needs of oncology personnel. Programs that fail to meet [...] Read more.

Healthcare providers in oncology experience exceptionally high stress rates. Research emphasizes that stress management programs must be quick to implement, flexible to accommodate demanding schedules, cost-effective, accessible to all staff, and tailored to the needs of oncology personnel. Programs that fail to meet these criteria often struggle with uptake and sustainability. This mixed-methods exploratory study aimed (1) to design an online stress management program, Breathe with the Waves (BWW), based on breathing techniques; (2) to evaluate its acceptability, satisfaction, and relevance; (3) to identify perceived benefits and challenges; and (4) to generate potential outcome measures for future studies. A team of Canadian researchers and end-users co-designed the intervention. Twenty oncology professionals completed BWW, which featured pre-recorded breathing videos, and provided feedback via questionnaires and semi-structured interviews. We used t-tests and Wilcoxon rank tests to analyze quantitative data, and template analysis for qualitative data. Participants found BWW highly acceptable, satisfactory, and relevant. Participants reported three categories of benefits: stress reduction, improved work performance, and increased mindfulness. Challenges included anticipated challenges and experienced challenges. Potential outcome measures fell into six categories: physical health, mental health, relational, work, mindfulness and personal practice. BWW, available in English and French, represents a promising and accessible approach to supporting the well-being of oncology personnel. Full article

18 pages, 430 KB

Open AccessArticle

Germline Mutations in DNA Repair Genes in Patients with Pancreatic Neuroendocrine Neoplasms: Diagnostic and Therapeutic Implications

by Beata Jurecka-Lubieniecka, Małgorzata Ros-Mazurczyk, Aleksandra Sygula, Alexander J. Cortez, Marcela Krzempek, Anna B. Tuleja, Agnieszka Kotecka-Blicharz, Marta Cieslicka, Malgorzata Oczko-Wojciechowska and Daria Handkiewicz-Junak

Curr. Oncol. 2025, 32(11), 631; https://doi.org/10.3390/curroncol32110631 - 10 Nov 2025

Viewed by 473

Abstract

Pancreatic neuroendocrine neoplasms (pNENs) are the second most common type of pancreatic cancer after pancreatic ductal adenocarcinoma. Germline mutations in DNA repair genes drive several hereditary and sporadic cancers; however, their role in pNENs remains poorly defined. This pilot study aimed to assess [...] Read more.

Pancreatic neuroendocrine neoplasms (pNENs) are the second most common type of pancreatic cancer after pancreatic ductal adenocarcinoma. Germline mutations in DNA repair genes drive several hereditary and sporadic cancers; however, their role in pNENs remains poorly defined. This pilot study aimed to assess the frequency and clinical relevance of germline DNA repair gene mutations in patients with pNENs, both with and without a family history of cancer. Germline DNA from 57 Polish patients with pNENs was analyzed using targeted next-generation sequencing to identify variants in a panel of DNA repair genes. Variant classification followed the American College of Medical Genetics and Genomics/Association for Molecular Pathology guidelines. Germline mutations were identified in 14 patients (24.6%), both with and without a family history of malignancy. Two patients carried pathogenic variants in BRCA2 and CHEK2, while seven carried variants of uncertain significance (VUS). The identified variants have been implicated in various cancer types, including breast, ovarian, prostate, gastric, colorectal, and pancreatic cancers. These findings indicate that germline mutations in DNA repair genes may contribute to the pathogenesis of pNENs, even in patients without a family history. Broader germline testing and population-specific studies are needed to clarify the genetic landscape and clinical implications of these alterations. Full article

(This article belongs to the Special Issue High-Grade Neuroendocrine Neoplasms)

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13 pages, 964 KB

Open AccessArticle

Antibiotic Exposure Does Not Impact Anti-BRAF/Anti-MEK Targeted Therapy Outcome in Patients with Advanced Melanoma

by Yu Shi Wang, Qing Yin Wang, Alexia Erika Moise, Hamida Claudia Syed, Julie Malo, Spencer Soberano, Wiam Belkaid, Meriem Messaoudene, Karl Bélanger, Antoine Desilets, Rahima Jamal, Bertrand Routy and Arielle Elkrief

Curr. Oncol. 2025, 32(11), 630; https://doi.org/10.3390/curroncol32110630 - 10 Nov 2025

Viewed by 369

Abstract

The gut microbiome is an established predictor of response to immune checkpoint inhibitors (ICI) in melanoma, and antibiotic exposure prior to ICI initiation is a validated negative prognostic factor. About half of melanoma patients harbor BRAF mutations and are treated with BRAF/MEK inhibitors [...] Read more.

The gut microbiome is an established predictor of response to immune checkpoint inhibitors (ICI) in melanoma, and antibiotic exposure prior to ICI initiation is a validated negative prognostic factor. About half of melanoma patients harbor BRAF mutations and are treated with BRAF/MEK inhibitors (BRAFi/MEKi). While the detrimental impact of antibiotics is well described in the ICI setting, their effect on BRAFi/MEKi efficacy remains unknown. We retrospectively analyzed 49 advanced BRAF-mutant melanoma patients treated with BRAFi/MEKi. Antibiotic-exposed patients were compared with non-exposed patients across three time windows: within 30, 60, or 90 days before and after therapy initiation. Outcomes included progression-free survival (PFS), overall survival (OS), and overall response rate (ORR). Among the cohort, 41% had antibiotic exposure within ±30 days, 53% within ±60 days, and 57% within ±90 days. Baseline characteristics were comparable between groups, except for worse ECOG scores in antibiotic-exposed patients. Across all windows, ORR, PFS, and OS were comparable between groups. Unlike what was observed in the ICI setting, antibiotic use did not negatively affect outcomes with BRAFi/MEKi. Despite small sample size, these findings suggest that the detrimental prognostic impact of antibiotics is specific to immunotherapy, highlighting the importance of evaluating the microbiome as a predictive biomarker across treatment contexts. Full article

(This article belongs to the Special Issue Advances in Melanoma: From Pathogenesis to Personalized Therapy)

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11 pages, 226 KB

Open AccessReview

A Narrative Review of the Strengths and Limitations of Real-World Evidence in Comparison to Randomized Clinical Trials: What Are the Opportunities in Thoracic Oncology for Real-World Evidence to Shine?

by Peter M. Ellis, Larissa Long, Courtney H. Coschi and Arani Sathiyapalan

Curr. Oncol. 2025, 32(11), 629; https://doi.org/10.3390/curroncol32110629 - 10 Nov 2025

Viewed by 733

Abstract

Randomized clinical trials are considered the gold standard for the evaluation of new interventions and therapies. The results from randomized clinical trials are highly influential in treatment decision-making and decisions about the implementation of new therapeutic options within the field of oncology. This [...] Read more.

Randomized clinical trials are considered the gold standard for the evaluation of new interventions and therapies. The results from randomized clinical trials are highly influential in treatment decision-making and decisions about the implementation of new therapeutic options within the field of oncology. This article describes a narrative review of the literature to further explore the strengths and limitations of real-world evidence in comparison to randomized clinical trials and provides a commentary on opportunities for real-world evidence in thoracic malignancies. However, randomized trials often exclude oncology patients with poorer functional status or comorbidities which are routinely considered for treatment in real-world practice. Real-world data may complement existing data from randomized clinical trials and play an important role in evaluating patterns and outcomes of care, informing everyday oncology practice. While real-world data is increasingly reported in the medical literature, strengths and limitations exist which can also limit their applicability. More work is needed to standardize methodologies for real-world studies. Full article

(This article belongs to the Special Issue The Role of Real-World Evidence (RWE) in Thoracic Malignancies)

11 pages, 2010 KB

Open AccessCase Report

Thoracic Spinal Sclerosing Epithelioid Fibrosarcoma Mimicking Schwannoma: Case Report and Literature Review

by Donato Creatura, Jad El Choueiri, Alberto Benato, Leonardo Anselmi, Ali Baram, Mario De Robertis, Carlo Brembilla, Federico Pessina, Maurizio Fornari and Gabriele Capo

Curr. Oncol. 2025, 32(11), 628; https://doi.org/10.3390/curroncol32110628 - 7 Nov 2025

Viewed by 341

Abstract

Background/Objectives: Sclerosing epithelioid fibrosarcoma (SEF) is a rare soft tissue sarcoma with high rates of local recurrence and distant metastasis. Primary spinal involvement is exceedingly uncommon and often misdiagnosed due to radiological and histopathological resemblance to more frequent spinal tumors. The objective of [...] Read more.

Background/Objectives: Sclerosing epithelioid fibrosarcoma (SEF) is a rare soft tissue sarcoma with high rates of local recurrence and distant metastasis. Primary spinal involvement is exceedingly uncommon and often misdiagnosed due to radiological and histopathological resemblance to more frequent spinal tumors. The objective of this study is to present a rare case of thoracic spinal SEF and to contextualize it within the available literature. Methods: We describe the case of a 37-year-old woman presenting with progressive back pain and dysesthesia. MRI demonstrated a heterogeneously enhancing mass at the left T10–T11 neural foramen, initially interpreted as a common nerve sheath tumor. Gross total resection (GTR) was achieved, and histopathological analysis revealed a SEF. Clinical course, adjuvant therapies, and outcomes were evaluated, together with a review of previously reported spinal SEF cases. Results: Despite GTR followed by adjuvant chemotherapy, local recurrence occurred 18 months later. The patient underwent subtotal resection (STR) with adjuvant proton therapy. At 18-month follow-up after the second procedure, she remained neurologically stable and disease-free. The literature review confirmed the rarity of spinal SEF, its frequent misdiagnosis, and the absence of standardized therapeutic protocols. Conclusions: Spinal SEF is a rare malignancy that can mimic benign spinal tumors, delaying diagnosis. Its management relies on multidisciplinary assessment, individualized therapy, and long-term follow-up. This report increases awareness of spinal SEF and provides additional evidence to support clinical decision-making in rare spinal tumors. Full article

(This article belongs to the Section Neuro-Oncology)

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35 pages, 1436 KB

Open AccessReview

Vesicular Stomatitis Virus-Based Oncolytic Virotherapy: Recent Progress and Emerging Trends

by Cassandra Catacalos-Goad, Charlotte Johnstone and Valery Z. Grdzelishvili

Curr. Oncol. 2025, 32(11), 627; https://doi.org/10.3390/curroncol32110627 - 7 Nov 2025

Viewed by 730

Abstract

Oncolytic virotherapy has emerged as a promising and innovative approach to cancer treatment, leveraging viruses that selectively replicate in tumor cells and cause their destruction (oncolysis), while simultaneously stimulating anti-tumor immune responses. Vesicular stomatitis virus (VSV), a prototypic rhabdovirus, is among the most [...] Read more.

Oncolytic virotherapy has emerged as a promising and innovative approach to cancer treatment, leveraging viruses that selectively replicate in tumor cells and cause their destruction (oncolysis), while simultaneously stimulating anti-tumor immune responses. Vesicular stomatitis virus (VSV), a prototypic rhabdovirus, is among the most versatile oncolytic virus platforms due to its favorable biological characteristics, including rapid replication and cell lysis, lack of pre-existing immunity in humans, and amenability to genetic engineering. Over the past decade, significant progress has been made in VSV-based oncolytic virotherapy. This review presents a comprehensive update on developments since our last review, emphasizing improvements in VSV safety, oncoselectivity, tumor-specific replication, direct oncolysis, and induction of antitumor immunity. By integrating recent applied discoveries with foundational knowledge, this review aims to guide ongoing efforts to advance VSV-based oncolytic virotherapy toward broader clinical translation and improved cancer patient outcomes. Additionally, we provide an overview of three closely related rhabdoviruses (Maraba, Morreton, and Jurona viruses) as emerging oncolytic platforms currently under preclinical and clinical investigation. Full article

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17 pages, 641 KB

Open AccessReview

Evolving Therapeutic Landscape of ROS1-Positive Non-Small Cell Lung Cancer: An Updated Review

by Hervé Bischoff, Sébastien Gendarme, Laura Somme, Christos Chouaid and Roland Schott

Curr. Oncol. 2025, 32(11), 626; https://doi.org/10.3390/curroncol32110626 - 6 Nov 2025

Viewed by 965

Abstract

ROS1 gene rearrangements define a distinct molecular subtype of non-small cell lung cancer (NSCLC), occurring in approximately 2% of cases and frequently associated with younger age, non-smoker status, and a high incidence of brain metastases. The discovery of ROS1 as an oncogenic driver [...] Read more.

ROS1 gene rearrangements define a distinct molecular subtype of non-small cell lung cancer (NSCLC), occurring in approximately 2% of cases and frequently associated with younger age, non-smoker status, and a high incidence of brain metastases. The discovery of ROS1 as an oncogenic driver has led to the development of targeted tyrosine kinase inhibitors (TKIs). Crizotinib first demonstrated substantial clinical benefit, but its limitations, including poor central nervous system (CNS) penetration and acquired resistance, highlighted the need for next-generation inhibitors. Several agents have since been developed, including entrectinib, lorlatinib, repotrectinib, taletrectinib, and zidesamtinib, each offering improved intracranial (IC) activity and efficacy against resistance mutations, notably ROS1^G2032R. Despite these advances, optimal sequencing strategies remain undefined, and resistance ultimately emerges in most patients. This review provides an updated overview of ROS1 biology, diagnostic approaches, clinical outcomes with currently available TKIs, mechanisms of resistance, and ongoing challenges, emphasizing the rapidly evolving therapeutic landscape. Full article

(This article belongs to the Topic Cancer Genomics: Emerging Trends and Technological Advances)

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20 pages, 877 KB

Open AccessArticle

Structural Validity and Reliability of a Tool for Clinical Rehabilitation Staff to Evaluate Life-Goal-Setting Practice for Cancer Survivors

by Katsuma Ikeuchi, Seiji Nishida, Mari Karikawa, Chiaki Sakamoto and Mutsuhide Tanaka

Curr. Oncol. 2025, 32(11), 625; https://doi.org/10.3390/curroncol32110625 - 6 Nov 2025

Viewed by 324

Abstract

Background: There is a need for an assessment tool for clinical rehabilitation staff to evaluate their life-goal-setting practice, especially in oncology rehabilitation. This study aimed to confirm the structural validity and reliability of the 21-item Reengagement life Goal Assessment Tool for Cancer [...] Read more.

Background: There is a need for an assessment tool for clinical rehabilitation staff to evaluate their life-goal-setting practice, especially in oncology rehabilitation. This study aimed to confirm the structural validity and reliability of the 21-item Reengagement life Goal Assessment Tool for Cancer survivors (ReGAT-C) with a five-category response scale. Methods: Participants were clinical rehabilitation staff who worked at designated cancer care hospitals in Japan and had experience in setting life-goals with cancer survivors hospitalized during the non-terminal phase. The ReGAT-C was mailed to participants twice, and Rasch analysis was repeated on the scores of the first ReGAT-C to test structural validity and reliability. The test–retest reliability was also examined using the scores of the first and second ReGAT-Cs after revising it according to the Rasch analysis results. Results: A total of 121 participants completed the first ReGAT-C, and 70 participants completed the second ReGAT-C. Following three Rasch analyses, the ReGAT-C was revised to contain 14 items with a three-category response scale. The revised scale showed satisfactory psychometric properties. Conclusions: The 14-item ReGAT-C with a three-category response scale could help staff to identify elements that are lacking in their practice and adjust their policies based on the items’ difficulty. Full article

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

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14 pages, 1205 KB

Open AccessSystematic Review

Defining the Prognostic Significance of BRAF V600E in Early-Stage Colon Cancer: A Systematic Review and Meta-Analysis

by Matthew Dankner, Laurie-Rose Dubé, Mark Sorin, Andrew J. B. Stein, Alexander Nowakowski, Changsu Lawrence Park, Jamie Magrill, Anna-Maria Lazaratos, Joan Miguel Romero, Gerald Batist, Petr Kavan, April A. N. Rose and Kim Ma

Curr. Oncol. 2025, 32(11), 624; https://doi.org/10.3390/curroncol32110624 - 6 Nov 2025

Viewed by 695

Abstract

Background: BRAF mutations are found in 10% of colon cancers (CCs) and are associated with poor prognosis in metastatic disease. BRAF V600E predicts sensitivity to cetuximab + encorafenib in the metastatic setting. With new trials testing encorafenib-containing regimens for early-stage CC, we sought [...] Read more.

Background: BRAF mutations are found in 10% of colon cancers (CCs) and are associated with poor prognosis in metastatic disease. BRAF V600E predicts sensitivity to cetuximab + encorafenib in the metastatic setting. With new trials testing encorafenib-containing regimens for early-stage CC, we sought to characterize the clinical outcomes of early-stage BRAF V600E CC. Methods: We performed a systematic review and meta-analysis. Key inclusion criteria were a diagnosis of stage 2/3 BRAF V600E CC. Co-primary endpoints were overall survival (OS) and recurrence/disease-free survival (DFS). Meta-analysis was performed with a random-effects model incorporating sample size, hazard ratio (HR), and 95% confidence intervals (CIs). Results: A total of 206 studies underwent full-text review. Of these, six randomized controlled trials were included, comprising 6836 and 843 patients with wild-type (WT) and BRAF V600E, respectively. BRAF V600E was associated with inferior OS (HR 1.49, CI 1.21–1.75) and DFS (HR 1.17, CI 1.03–1.33). This finding remains in patients with microsatellite instability—low/stable or proficient mismatch repair (OS: HR 1.66, CI 1.36–2.02, DFS: HR 1.45, CI 1.22–1.72). Conclusions: BRAF V600E is associated with inferior prognoses compared to BRAF WT in early-stage CC. This finding will help optimize trial design for this population. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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17 pages, 238 KB

Open AccessArticle

Understanding Equity, Diversity, and Inclusion Within Canadian Radiation Oncology Training Programs: A National Survey of Residents and Fellows

by Stefan Allen, Amanda Farah Khan, Jolie Ringash, David Bowes, Reshma Jagsi, Zhihui Amy Liu, Glen Bandiera, Ian J. Gerard, Shaun K. Loewen and Jennifer Croke

Curr. Oncol. 2025, 32(11), 623; https://doi.org/10.3390/curroncol32110623 - 6 Nov 2025

Cited by 1 | Viewed by 249

Abstract

Background: This study characterizes the current representation of sociodemographic groups within Canadian radiation oncology training programs and trainees’ lived experiences. Methods: A 59-item ethics-approved, bilingual survey assessed sociodemographics, training perceptions, mentorship, discrimination/harassment experienced, and open-ended questions. Electronic surveys were distributed to all Canadian [...] Read more.

Background: This study characterizes the current representation of sociodemographic groups within Canadian radiation oncology training programs and trainees’ lived experiences. Methods: A 59-item ethics-approved, bilingual survey assessed sociodemographics, training perceptions, mentorship, discrimination/harassment experienced, and open-ended questions. Electronic surveys were distributed to all Canadian radiation oncology residents/fellows. Descriptive statistics summarized survey responses. Categorical groups were compared using chi-squared/Fisher’s exact tests. Thematic analysis was performed on open-ended responses. Results: Between July and December 2023, 98 of 177 (56%) trainees participated: 70% were residents, 52% identified as male, 62% as a racialized minority, and 10% as a sexual minority. Most respondents reported training program satisfaction (83%) and a respectful workplace culture (69%); however, discrimination during training was reported by 38%. Less than half (45%) felt comfortable reporting discrimination/harassment within their workplace. Women were more likely to feel under-represented in-training (46% vs. 13%, p = 0.001) and perceived more discrimination events (64% vs. 19%, p < 0.001). Three themes emerged as follows: importance of offering EDI education, ensuring pathways for reporting learner mistreatment, and creating appropriately diverse selection committees. Conclusions: Although most Canadian radiation oncology trainees reported satisfaction and a respectful culture, key differences between groups were observed. Targeted strategies and stronger institutional policies to improve representation and reduce rates of discrimination/harassment are needed. Full article

13 pages, 5159 KB

Open AccessArticle

Efficacy of a Fully Implantable Pleural Device in the Management of Complex Pleural Effusions

by Marco Marcaccini, Simona Sobrero, Federico Vaisitti, Alessandra Russo, Stefano Rudella, Federica Mellone, Chiara Grispi, Luca Errico and Francesco Leo

Curr. Oncol. 2025, 32(11), 622; https://doi.org/10.3390/curroncol32110622 - 6 Nov 2025

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Abstract

VATS talc poudrage is the standard treatment for recurrent pleural effusion, but it is not feasible when the lung does not re-expand, or for fragile patients who are unfit for general anesthesia. In these situations, indwelling pleural catheters (IPC) are a valuable option [...] Read more.

VATS talc poudrage is the standard treatment for recurrent pleural effusion, but it is not feasible when the lung does not re-expand, or for fragile patients who are unfit for general anesthesia. In these situations, indwelling pleural catheters (IPC) are a valuable option to offer long-term symptom relief and reduce hospitalization, with the only limitation being that an external portion of the device is needed in the majority of available devices. This study evaluates the efficacy and safety of a fully implantable pleural catheter in managing recurrent pleural effusion in patients who are unfit for traditional treatments. A retrospective, single-center analysis was conducted from April 2018 to August 2024, involving 150 patients that underwent Celsite^® DRAINAPORT implantation. The study measured the percentage of procedures with complications, the type of follow up, six months survival rate, cause of death, and the number of oncological treatments administered after implantation. Results indicated a complication rate of 12%, of which most were mild and manageable. Over half of the patients were successfully managed by home nursing services. Nearly 50% of the patients survived after six months, whereas 28.7% received subsequent oncological treatments. This suggests that this type of device is a safe and effective alternative for managing recurrent pleural effusion in patients with limited treatment options. Full article

(This article belongs to the Special Issue Palliative Care in Oncology: Current Advances)

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14 pages, 916 KB

Open AccessArticle

Risk of Childhood Cancer in Children with Congenital Anomalies and Their Impact on Survival: A Population-Based Registry Approach

by Carmen Martos, Laura García-Villodre, Laia Barrachina-Bonet, Lucía Páramo-Rodríguez, Berta Arribas-Díaz, Anna Torró-Gómez, Noura Jeghalef El Karoui, Consol Sabater and Clara Cavero-Carbonell

Curr. Oncol. 2025, 32(11), 621; https://doi.org/10.3390/curroncol32110621 - 6 Nov 2025

Viewed by 326

Abstract

Despite advances in treatment, childhood cancer survivors continue to experience substantial comorbidities stemming from chronic health conditions and face an elevated risk of premature mortality compared to the general population [...] Full article

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

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Curr. Oncol., Volume 32, Issue 11 (November 2025) – 63 articles

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