Current Oncology

12 pages, 920 KiB

Open AccessArticle

Outcomes of Allogeneic Stem Cell Transplant in Patients with Relapsed/Refractory Hodgkin Lymphoma

by Shiliang Ge, Kylie Lepic, Ravi Bhindi, Tobias Berg, Dina Khalaf, Brian Leber, Michael Radford, Irwin Walker, Gwynivere Davies and Alejandro Garcia-Horton

Curr. Oncol. 2025, 32(2), 118; https://doi.org/10.3390/curroncol32020118 - 18 Feb 2025

Viewed by 1061

Abstract

Background: The aim of this study was to evaluate real-world clinical outcomes and transplant-related complications of allogeneic stem cell transplantation (alloSCT) for Hodgkin lymphoma (HL). Methods: This was a single-centre, retrospective analysis of relapsed and refractory (R/R) HL patients who received an alloSCT [...] Read more.

Background: The aim of this study was to evaluate real-world clinical outcomes and transplant-related complications of allogeneic stem cell transplantation (alloSCT) for Hodgkin lymphoma (HL). Methods: This was a single-centre, retrospective analysis of relapsed and refractory (R/R) HL patients who received an alloSCT between 1 January 2016 and 29 February 2024 in Hamilton, Ontario. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS), non-relapse mortality (NRM), and graft-versus-host disease/relapse-free survival (GRFS). Results: Twenty-one patients were identified, with thirteen (62%) pre-treated with programmed death 1 (PD-1) blockade with either nivolumab or pembrolizumab. Seventeen (81%) patients underwent related haploidentical donor transplants, while four (19%) patients received a matched unrelated donor transplant. The 2-year OS and PFS rates were 79% (95% CI: 53–92%) and 63% (95% CI: 37–81%), respectively. Trends towards improved OS, PFS, NRM, and GRFS in PD-1-inhibitor-exposed patients were observed. All PD-1-inhibitor-exposed patients who were in complete remission proceeding to alloSCT remained alive at the last follow-up visit. Among the nine patients in partial remission at the time of alloSCT, three deaths were reported, with a 2-year OS of 61%. Conclusions: Our outcome data of a single-centre, heavily pre-treated cohort of Canadian patients confirm that alloSCT with post-transplant cyclophosphamide-based immunosuppression, which has been associated with improvements in PFS, remains a safe and feasible treatment option for patients with R/R HL in the era of checkpoint inhibitor use. Full article

(This article belongs to the Section Cell Therapy)

► Show Figures

Figure 1

14 pages, 4109 KiB

Open AccessArticle

Gamma-Glutamyl Transferase Plus Carcinoembryonic Antigen Ratio Index: A Promising Biomarker Associated with Treatment Response to Neoadjuvant Chemotherapy for Patients with Colorectal Cancer Liver Metastases

by Yanjiang Yin, Bowen Xu, Jianping Chang, Zhiyu Li, Xinyu Bi, Zhicheng Wei, Xu Che and Jianqiang Cai

Curr. Oncol. 2025, 32(2), 117; https://doi.org/10.3390/curroncol32020117 - 18 Feb 2025

Viewed by 662

Abstract

Background: Colorectal cancer liver metastasis (CRLM) is a significant contributor to cancer-related illness and death. Neoadjuvant chemotherapy (NAC) is an essential treatment approach; however, optimal patient selection remains a challenge. This study aimed to develop a machine learning-based predictive model using hematological biomarkers [...] Read more.

Background: Colorectal cancer liver metastasis (CRLM) is a significant contributor to cancer-related illness and death. Neoadjuvant chemotherapy (NAC) is an essential treatment approach; however, optimal patient selection remains a challenge. This study aimed to develop a machine learning-based predictive model using hematological biomarkers to assess the efficacy of NAC in patients with CRLM. Methods: We retrospectively analyzed the clinical data of 214 CRLM patients treated with the XELOX regimen. Blood characteristics before and after NAC, as well as the ratios of these biomarkers, were integrated into the machine learning models. Logistic regression, decision trees (DTs), random forest (RF), support vector machine (SVM), and AdaBoost were used for predictive modeling. The performance of the models was evaluated using the AUROC, F1-score, and external validation. Results: The DT (AUROC: 0.915, F1-score: 0.621) and RF (AUROC: 0.999, F1-score: 0.857) models demonstrated the best predictive performance in the training cohort. The model incorporating the ratio of post-treatment to pre-treatment gamma-glutamyl transferase (rGGT) and carcinoembryonic antigen (rCEA) formed the GCR index, which achieved an AUROC of 0.853 in the external validation. The GCR index showed strong clinical relevance, predicting better chemotherapy responses in patients with lower rCEA and higher rGGT levels. Conclusions: The GCR index serves as a predictive biomarker for the efficacy of NAC in CRLM, providing a valuable clinical reference for the prognostic assessment of these patients. Full article

(This article belongs to the Section Gastrointestinal Oncology)

► Show Figures

Figure 1

18 pages, 2505 KiB

Open AccessArticle

MRI in Oral Tongue Squamous Cell Carcinoma: A Radiomic Approach in the Local Recurrence Evaluation

by Antonello Vidiri, Vincenzo Dolcetti, Francesco Mazzola, Sonia Lucchese, Francesca Laganaro, Francesca Piludu, Raul Pellini, Renato Covello and Simona Marzi

Curr. Oncol. 2025, 32(2), 116; https://doi.org/10.3390/curroncol32020116 - 18 Feb 2025

Viewed by 776

Abstract

(1) Background: Oral tongue squamous cell carcinoma (OTSCC) is a prevalent malignancy with high loco-regional recurrence. Advanced imaging biomarkers are critical for stratifying patients at a high risk of recurrence. This study aimed to develop MRI-based radiomic models to predict loco-regional recurrence in [...] Read more.

(1) Background: Oral tongue squamous cell carcinoma (OTSCC) is a prevalent malignancy with high loco-regional recurrence. Advanced imaging biomarkers are critical for stratifying patients at a high risk of recurrence. This study aimed to develop MRI-based radiomic models to predict loco-regional recurrence in OTSCC patients undergoing surgery. (2) Methods: We retrospectively selected 92 patients with OTSCC who underwent MRI, followed by surgery and cervical lymphadenectomy. A total of 31 patients suffered from a loco-regional recurrence. Radiomic features were extracted from preoperative post-contrast high-resolution MRI and integrated with clinical and pathological data to develop predictive models, including radiomic-only and combined radiomic–clinical approaches, trained and validated with stratified data splitting. (3) Results: Textural features, such as those derived from the Gray-Level Size-Zone Matrix, Gray-Level Dependence Matrix, and Gray-Level Run-Length Matrix, showed significant associations with recurrence. The radiomic-only model achieved an accuracy of 0.79 (95% confidence interval: 0.69, 0.87) and 0.74 (95% CI: 0.54, 0.89) in the training and validation set, respectively. Combined radiomic and clinical models, incorporating features like the pathological depth of invasion and lymph node status, provided comparable diagnostic performances. (4) Conclusions: MRI-based radiomic models demonstrated the potential for predicting loco-regional recurrence, highlighting their increasingly important role in advancing precision oncology for OTSCC. Full article

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

► Show Figures

Figure 1

15 pages, 2086 KiB

Open AccessCase Report

Salvage Ultrasound-Guided Robot-Assisted Video-Endoscopic Inguinal Lymphadenectomy (RAVEIL) as a Metastasis-Directed Therapy (MDT) in Oligoprogressive Metastatic Castration-Resistant Prostate Cancer (mCRPC): A Case Report and Review of the Literature

by Rafał B. Drobot, Marcin Lipa and Artur A. Antoniewicz

Curr. Oncol. 2025, 32(2), 115; https://doi.org/10.3390/curroncol32020115 - 18 Feb 2025

Viewed by 1008

Abstract

Background: Metastatic castration-resistant prostate cancer (mCRPC) remains challenging due to progression despite androgen deprivation therapy (ADT). Current treatments, including androgen receptor-targeted agents, chemotherapy, bone-targeted agents, and PARP inhibitors, extend survival but face challenges, such as resistance, adverse effects, and limited durability. Metastasis-directed [...] Read more.

Background: Metastatic castration-resistant prostate cancer (mCRPC) remains challenging due to progression despite androgen deprivation therapy (ADT). Current treatments, including androgen receptor-targeted agents, chemotherapy, bone-targeted agents, and PARP inhibitors, extend survival but face challenges, such as resistance, adverse effects, and limited durability. Metastasis-directed therapies (MDTs), such as stereotactic ablative radiotherapy (SABR), show promise in oligometastatic disease, but their role in oligoprogressive mCRPC is unclear. Salvage lymphadenectomy is rarely pursued due to invasiveness and limited data. This is the first report of robotic surgery as an MDT in this setting, demonstrating the potential of salvage robot-assisted video-endoscopic inguinal lymphadenectomy (RAVEIL) to manage oligoprogressive mCRPC and delay systemic progression. Methods: A 47-year-old male with metastatic hormone-sensitive prostate cancer (Gleason 10) underwent ADT, docetaxel chemotherapy, and radical retropubic prostatectomy with super-extended pelvic and retroperitoneal lymphadenectomy. Upon progression to oligoprogressive mCRPC, 68Ga-PSMA PET/CT detected a single metastatic inguinal lymph node. Salvage RAVEIL was performed using the da Vinci X™ Surgical System, guided by preoperative ultrasound mapping. Results: Histopathology confirmed metastasis in one of the eight excised lymph nodes. The patient achieved undetectable PSA levels and prolonged biochemical progression-free survival. Minor complications (lymphorrhea, cellulitis) resolved without sequelae. No further progression was observed for over 14 months. Conclusions: This case highlights RAVEIL as a viable MDT option for oligoprogressive mCRPC, potentially extending progression-free intervals while minimizing systemic treatment. Full article

(This article belongs to the Section Genitourinary Oncology)

► Show Figures

Figure 1

13 pages, 3085 KiB

Open AccessArticle

TM7SF2 as a Potential Biomarker in Colorectal Cancer: Implications for Metastasis

by Inpyo Hong, Sooyoun Kim, Minho Lee, Seoin Han, Hak Chun Kim, Chong Woo Chu, Seong Geun Kim, Min Kyung Kim, Chang Jin Kim, Dong Hyun Kang, Tae Sung Ahn, Moo Jun Baek, Mudasir Hussain, Hyog Young Kwon and Dongjun Jeong

Curr. Oncol. 2025, 32(2), 114; https://doi.org/10.3390/curroncol32020114 - 17 Feb 2025

Viewed by 565

Abstract

Colorectal cancer (CRC) is a commonly fatal cancer and ranks as the fourth most prevalent in men and third in women worldwide. While early-stage survival rates are high, they significantly decrease with recurrence and metastasis. Thus, the early detection and treatment of metastasis-related [...] Read more.

Colorectal cancer (CRC) is a commonly fatal cancer and ranks as the fourth most prevalent in men and third in women worldwide. While early-stage survival rates are high, they significantly decrease with recurrence and metastasis. Thus, the early detection and treatment of metastasis-related factors can significantly improve survival rates. In this study, the transmembrane 7 superfamily member 2 (TM7SF2) gene was validated as a biomarker for predicting metastasis in CRC. Immunohistochemical staining was performed on 236 CRC tissues, and the clinicopathological factors of patients with CRC were analyzed. This evaluation revealed that TM7SF2 expression is associated with the clinical stage. Kaplan–Meier analysis confirmed the relationship between the survival rate of CRC patients and TM7SF2 expression, showing a decrease in survival rate with TM7SF2 overexpression (log-rank, p < 0.001). TM7SF2 expression was also confirmed in two pairs of primary and metastatic cell lines (SW480 and SW620). TM7SF2 knockdown was executed using siRNAs in SW480 and SW620 cells, which exhibit high expression levels. The knockdown was verified using RT-PCR and immunoblotting. Functional studies investigated the effects of TM7SF2 on cell proliferation, migration, invasion, and colony formation, revealing that all these functions were suppressed in the CRC cell lines following TM7SF2 knockdown. Therefore, TM7SF2 shows promise as a biomarker for the prevention of colorectal cancer. Full article

(This article belongs to the Section Gastrointestinal Oncology)

► Show Figures

Figure 1

12 pages, 730 KiB

Open AccessReview

Endoscopic Ultrasound-Guided Locoregional Treatments for Pancreatic Neuroendocrine Neoplasms

by Graziella Masciangelo, Davide Campana, Claudio Ricci, Elisa Andrini, Emilija Rakichevikj, Pietro Fusaroli and Andrea Lisotti

Curr. Oncol. 2025, 32(2), 113; https://doi.org/10.3390/curroncol32020113 - 16 Feb 2025

Viewed by 755

Abstract

Pancreatic neuroendocrine neoplasms (pNENs) represent approximately 2% of all solid pancreatic tumors. The incidence of pNENs has been increasing in the last decade. The clinical manifestations of pNENs range from hormone secretion syndromes in functioning neoplasms (F-pNENs) to local infiltration or distant metastases [...] Read more.

Pancreatic neuroendocrine neoplasms (pNENs) represent approximately 2% of all solid pancreatic tumors. The incidence of pNENs has been increasing in the last decade. The clinical manifestations of pNENs range from hormone secretion syndromes in functioning neoplasms (F-pNENs) to local infiltration or distant metastases in late-stage diagnoses or incidental findings in small non-functioning neoplasms (NF-pNENs). While surgery is the gold-standard treatment for larger and more aggressive tumors, small and low-grade tumors (G1) may be followed-up due to the indolent course of disease. Recently, endoscopic ultrasound (EUS)-guided ablative techniques, such as ethanol injection (EUS-EI) and radiofrequency ablation (EUS-RFA), have emerged as promising options for loco-regional ablations in selected cases. Despite promising safety profile and efficacy, high-quality evidence is needed to support their widespread adoption. This article reviews the current state of EUS-guided locoregional therapies, patient selection criteria, procedural details, and associated risks. Full article

(This article belongs to the Section Gastrointestinal Oncology)

► Show Figures

Figure 1

20 pages, 4140 KiB

Open AccessSystematic Review

Immunotherapy Combined with Chemotherapy in the First-Line Treatment of Advanced Gastric Cancer: Systematic Review and Bayesian Network Meta-Analysis Based on Specific PD-L1 CPS

by Wenwei Zhang, Kaibo Guo and Song Zheng

Curr. Oncol. 2025, 32(2), 112; https://doi.org/10.3390/curroncol32020112 - 16 Feb 2025

Viewed by 1042

Abstract

Objective: To compare the efficacy and safety of immunotherapy combined with chemotherapy as the first-line treatment for advanced gastric cancer. Data Sources: Phase III randomised controlled trials were searched from PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials databases, and several [...] Read more.

Objective: To compare the efficacy and safety of immunotherapy combined with chemotherapy as the first-line treatment for advanced gastric cancer. Data Sources: Phase III randomised controlled trials were searched from PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials databases, and several international conference databases, from inception to 15 November 2024. Results: A total of eight eligible trials involved 7898 patients and eight treatments. The network meta-analysis showed that cadonilimab plus chemotherapy was the most superior treatment in improving overall survival (versus conventional chemotherapy, hazard ratio 0.62, 95% credible interval 0.50 to 0.78) and progression-free survival (0.53, 0.43 to 0.65), and consistency of results were observed in specific PD-L1 combined positive score groups. All immune checkpoint inhibitors combined with chemotherapy improved patient prognosis, but nivolumab plus chemotherapy may lead to an increase in grade 3 or higher adverse events (odds ratio 1.68, 95% credible interval 1.04 to 2.54), and the toxicity of cadonilimab plus chemotherapy was more likely to force patients to discontinue treatment. Conclusions: These results showed that cadonilimab plus chemotherapy had the best overall survival and progression-free survival benefits for advanced gastric cancer patients with HER-2 negative, and was preferentially recommended to patients with positive PD-L1 CPS. Full article

(This article belongs to the Section Gastrointestinal Oncology)

► Show Figures

Figure 1

19 pages, 1173 KiB

Open AccessArticle

“I Got My Trophy”: The Story of Implementing a Neuro-Oncology Exercise Program from the Patient and Caregiver Lens—A Qualitative Study

by Julia T. Daun, Mannat Bansal, Randall L. Iversen, Meghan H. McDonough, Gloria Roldan Urgoiti, Tana Dhruva, Emma McLaughlin, Lauren C. Capozzi, Jacob C. Easaw, Margaret L. McNeely, George J. Francis and S. Nicole Culos-Reed

Curr. Oncol. 2025, 32(2), 111; https://doi.org/10.3390/curroncol32020111 - 16 Feb 2025

Viewed by 691

Abstract

The purpose of this study was to gather patient and caregiver perspectives of adult neuro-oncology patients participating in a 12-week exercise program (i.e., the Alberta Cancer Exercise-Neuro-Oncology; ACE-Neuro study). Patients and their caregivers were invited to participate in semi-structured interviews across study delivery. [...] Read more.

The purpose of this study was to gather patient and caregiver perspectives of adult neuro-oncology patients participating in a 12-week exercise program (i.e., the Alberta Cancer Exercise-Neuro-Oncology; ACE-Neuro study). Patients and their caregivers were invited to participate in semi-structured interviews across study delivery. A qualitative photo elicitation methodology within a patient-oriented research approach was used. Interpretive description and a constructivist philosophy guided the investigation, analysis, and dissemination of findings. A patient partner was included as a member of the research team. N = 51 patients completed the ACE-Neuro study, of which 28 patients and nine caregivers participated in interviews (n = 37). Working with the patient partner, five themes were created and are presented as a story of neuro-oncology patients on their journey to accessing and participating in ACE-Neuro: (1) The Exposition: I Have Cancer…Now What?; (2) The Rising Action: Trials and Triumphs of Participation; (3) The Pivotal Moment: It’s More Than Exercise; (4) The Resolution: Tailored Not Templated…The Ideal Program for Me; and (5) The Epilogue: Key Factors for Sustained Delivery. The findings from this work address the lack of qualitative exploration for understanding the neuro-oncology exercise experience and will inform the sustainable implementation of programming to meet patients’ needs. Full article

(This article belongs to the Section Neuro-Oncology)

► Show Figures

Graphical abstract

13 pages, 1095 KiB

Open AccessReview

Perioperative Chemo-Immunotherapy in Non-Oncogene-Addicted Resectable Non-Small Cell Lung Cancer (NSCLC): Italian Expert Panel Meeting

by Filippo de Marinis, Andrea Ardizzoni, Ilaria Attili, Laura Bonanno, Emilio Bria, Diego Luigi Cortinovis, Stefano Margaritora, Francesca Mazzoni, Edoardo Mercadante, Alessandro Morabito, Francesco Petrella, Federico Rea, Rosario Salvi, Piergiorgio Solli, Lorenzo Spaggiari, Luca Voltolini and Cesare Gridelli

Curr. Oncol. 2025, 32(2), 110; https://doi.org/10.3390/curroncol32020110 - 14 Feb 2025

Viewed by 1434

Abstract

Background: Immunotherapy (IO)-based strategies have been demonstrated to significantly prolong survival in the perioperative setting of non-oncogene-addicted non-small cell lung cancer (NSCLC). The adoption of such strategies in clinical practice depends on heterogeneous regulatory approvals and on the agreement between medical oncologists and [...] Read more.

Background: Immunotherapy (IO)-based strategies have been demonstrated to significantly prolong survival in the perioperative setting of non-oncogene-addicted non-small cell lung cancer (NSCLC). The adoption of such strategies in clinical practice depends on heterogeneous regulatory approvals and on the agreement between medical oncologists and thoracic surgeons on patients’ selection. Methods: An Expert Panel Meeting of medical oncologists and thoracic surgeons was held virtually by the Italian Association of Thoracic Oncology (AIOT) to discuss results of pivotal clinical trials with perioperative chemo-immunotherapy and reach agreement on open issues for the topic, formulating specific statements based on initially proposed discussion questions. Results: Overall, panelists found agreement on seven statements. With regard to tissue and biomarker analysis, the role of increasing PD-L1 expression in predicting IO efficacy was recognized, whereas ctDNA and pCR were mainly attributed a prognostic role, in the absence of dedicated studies. The panelists acknowledged direct relationship between the benefit of neoadjuvant chemo-immunotherapy approaches and the local burden of disease/mediastinal node involvement, supporting the inclusion of these factors, together with PD-L1, in selecting upfront surgery or induction treatment. The panelists agreed that the current literature data do not answer the issue of assessing the role of the adjuvant phase within a perioperative treatment strategy. Surgical considerations on the role of pneumonectomy and other approaches were also discussed. Conclusions: This experience highlights the importance of a synergistic approach between oncologists and surgeons to leverage the unmet needs in translating results of IO-perioperative clinical trials into clinical practice in patients with resectable NSCLC. Full article

(This article belongs to the Section Thoracic Oncology)

► Show Figures

Figure 1

15 pages, 398 KiB

Open AccessReview

Multimodal Prehabilitation for Gynecologic Cancer Surgery

by Jeongyun Kim, Chae Hyeong Lee and Ga Won Yim

Curr. Oncol. 2025, 32(2), 109; https://doi.org/10.3390/curroncol32020109 - 14 Feb 2025

Viewed by 751

Abstract

Surgical treatment is commonly employed to treat patients with gynecologic cancer, although surgery itself may function as a stressor, reducing the patients’ functional capacity and recovery. Prehabilitation programs attempt to improve patients’ overall health and baseline function prior to surgery, thereby enhancing recovery [...] Read more.

Surgical treatment is commonly employed to treat patients with gynecologic cancer, although surgery itself may function as a stressor, reducing the patients’ functional capacity and recovery. Prehabilitation programs attempt to improve patients’ overall health and baseline function prior to surgery, thereby enhancing recovery and lowering morbidity. In recent years, prehabilitation has come to primarily refer to multimodal programs that combine physical activity, nutritional support, psychological well-being, and other medical interventions. However, the specific methods of implementing prehabilitation and measuring its effectiveness are heterogeneous. Moreover, high-level evidence regarding prehabilitation in gynecologic cancer surgery is limited. This review provides a summary of multimodal prehabilitation studies in gynecologic oncologic surgery. Enhanced postoperative recovery, lower postoperative complications, lower rate of blood transfusions, and faster gastrointestinal functional recovery have been reported after multimodal prehabilitation interventions. Patients and healthcare professionals should recognize the importance of prehabilitation in the field of gynecologic oncologic treatment, based on the emerging evidence. In addition, there is a need to establish an appropriate target group and construct a well-designed and tailored prehabilitation program. Full article

(This article belongs to the Special Issue Optimizing Surgical Management for Gynecologic Cancers)

► Show Figures

Figure 1

20 pages, 315 KiB

Open AccessReview

Evidence-Based Recommendations on the Use of Immunotherapies and Monoclonal Antibodies in the Treatment of Male Reproductive Cancers

by Farhan Khalid, Zubair Hassan Bodla, Sai Rakshith Gaddameedi, Raymart Macasaet, Karan Yagnik, Zahra Niaz, Peter N. Fish, Doantrang Du and Shazia Shah

Curr. Oncol. 2025, 32(2), 108; https://doi.org/10.3390/curroncol32020108 - 14 Feb 2025

Viewed by 997

Abstract

The incidence of male reproductive cancers, including prostate, testicular, and penile cancers, has risen in recent years, raising important health concerns. Prostate cancer is the second leading cause of cancer-related mortality in men, while penile cancer, though rare, typically affects men over 60. [...] Read more.

The incidence of male reproductive cancers, including prostate, testicular, and penile cancers, has risen in recent years, raising important health concerns. Prostate cancer is the second leading cause of cancer-related mortality in men, while penile cancer, though rare, typically affects men over 60. Testicular cancer, with a lifetime risk of about 0.4% in men, is most common among adolescents and young adults, decreasing sharply after the age of 40. Traditional treatments include chemotherapy, radiation, surgery, and combinations thereof, but advancements in immunotherapy and monoclonal antibodies are showing promising results, particularly for genitourinary cancers. These therapies, targeting immune checkpoints and tumor-specific antigens, are gaining traction as effective alternatives for resistant cases. This review provides evidence-based recommendations on current and emerging immunotherapy and monoclonal antibody treatments for male reproductive cancers, highlighting future directions to optimize patient outcomes. Full article

(This article belongs to the Section Genitourinary Oncology)

27 pages, 7849 KiB

Open AccessArticle

Sexual Health of Patients in Treatment for Lung Cancer: An Undercover Concern for Patients and Oncologists

by Mafalda Costa, Catarina Lopes Fernandes, Joana Leite, Marta Vilaça, Fernanda Estevinho and Helena Magalhães

Curr. Oncol. 2025, 32(2), 107; https://doi.org/10.3390/curroncol32020107 - 13 Feb 2025

Viewed by 653

Abstract

Sexual dysfunction (SD) prevalence in lung cancer (LC) patients is largely unknown. This study aims to assess the prevalence of SD among LC patients at our center. We conducted a cross-sectional survey of 69 patients using a questionnaire on sexual activity and satisfaction. [...] Read more.

Sexual dysfunction (SD) prevalence in lung cancer (LC) patients is largely unknown. This study aims to assess the prevalence of SD among LC patients at our center. We conducted a cross-sectional survey of 69 patients using a questionnaire on sexual activity and satisfaction. Participants were recruited from 1 July 2023 to 30 September 2024 and had to be diagnosed with LC, age > 18 years, able to read, and with at least 1 month of treatment. A total of 61 patients completed the survey, predominantly male (67.2%) with stage IV LC (68.9%). Less than half (45.9%) reported recent sexual activity, while many expressed little to no interest (55.7%) and minimal satisfaction with their sex life (42.8%). The factors affecting sexual satisfaction included fatigue (37.7%) and feelings of anxiety/stress (24.6%). The reasons for decreased sexual activity included a lack of interest (36.4%), difficulties with erection (24.2%), and issues with partners (24.3%). A significant association was found between SD and the perceived impact of LC on sexual life, with higher dysfunction scores linked to more negative reports. SD is common among LC patients. Implementing assessment strategies and interventions may improve the sexual life of these patients. Full article

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

► Show Figures

Figure 1

17 pages, 3343 KiB

Open AccessReview

Exploring the Role of Hypoxia and HIF-1α in the Intersection of Type 2 Diabetes Mellitus and Endometrial Cancer

by Alagappan V. S. Geetha, Kannan Harithpriya, Kumar Ganesan and Kunka Mohanram Ramkumar

Curr. Oncol. 2025, 32(2), 106; https://doi.org/10.3390/curroncol32020106 - 13 Feb 2025

Viewed by 1299

Abstract

Diabetes and Cancer are the most complex chronic diseases, accounting for significant global mortality and morbidity. The association between Type 2 DM (T2DM) and endometrial cancer (EC) is multifaced, sharing numerous risk factors, including insulin resistance, obesity, hypoxia, and oxidative stress. Hypoxia plays [...] Read more.

Diabetes and Cancer are the most complex chronic diseases, accounting for significant global mortality and morbidity. The association between Type 2 DM (T2DM) and endometrial cancer (EC) is multifaced, sharing numerous risk factors, including insulin resistance, obesity, hypoxia, and oxidative stress. Hypoxia plays a vital role in T2DM pathogenesis by altering the insulin level and pancreatic β-cell failure through an imbalance between antioxidant enzymes and cellular oxidative levels, while chronic inflammation contributes to EC malignancy. HIF-1α is a potent transcription factor involved in modulating cellular responses to hypoxia within the disease environment. Targeting the HIF-1α signaling cascade, a major metabolic regulator may contribute to advanced therapeutic advances. This review focuses on the association between T2DM and EC, especially focusing on hypoxia and HIF signaling pathways. These intersect with key pathways involved in T2DM and EC pathology, such as insulin signaling, PI3K/AKT, mTOR pathway, MUC1/HIF-1α pathway, and hormonal imbalance. Understanding this complex relationship paves the way for future researchers to develop HIF-1α-targeted therapies that could lead to novel combination therapies to treat these comorbid conditions. Full article

(This article belongs to the Section Gynecologic Oncology)

► Show Figures

Figure 1

23 pages, 227 KiB

Open AccessConference Report

Abstracts of the 2024 Canadian Association of Medical Oncologists Annual Scientific Meeting

by Alexi Campbell, Sharlene Gill, Desirée Hao, Suneil Khanna, Erin Powell, Moira Rushton, Maryam Soleimani and Stephen Welch

Curr. Oncol. 2025, 32(2), 105; https://doi.org/10.3390/curroncol32020105 - 12 Feb 2025

Viewed by 745

Abstract

On behalf of the Canadian Association of Medical Oncologists, we are pleased to present the abstracts of the 2024 Annual Scientific Meeting. The CAMO Annual Scientific Meeting (ASM) took place from 24–26 October 2024 in an in-person event in Ottawa, ON. Twenty-four (24) [...] Read more.

On behalf of the Canadian Association of Medical Oncologists, we are pleased to present the abstracts of the 2024 Annual Scientific Meeting. The CAMO Annual Scientific Meeting (ASM) took place from 24–26 October 2024 in an in-person event in Ottawa, ON. Twenty-four (24) abstracts were selected for presentation as oral presentations and poster presentations. Awards for the top three (3) abstracts were presented during the ASM; they have been marked as “Award Recipient”. We congratulate all presenters on their research work and contribution. Full article

9 pages, 215 KiB

Open AccessPerspective

Toward an Understanding of Cancer as an Issue of Social Justice: Perspectives and Implications for Oncology Nursing

by Tara C. Horrill, Scott M. Beck and Allison Wiens

Curr. Oncol. 2025, 32(2), 104; https://doi.org/10.3390/curroncol32020104 - 12 Feb 2025

Viewed by 899

Abstract

Within the fields of oncology practice and research, cancer has historically been and continues to be understood as primarily biologically produced and physiologically driven. This understanding is rooted in biomedicine, the dominant model of health and illness in the Western world. Yet, there [...] Read more.

Within the fields of oncology practice and research, cancer has historically been and continues to be understood as primarily biologically produced and physiologically driven. This understanding is rooted in biomedicine, the dominant model of health and illness in the Western world. Yet, there is increasing evidence of inequities in cancer that are influenced by social and structural inequities. In this article, we propose that cancer-related inequities ought to be seen as issues of social justice, and, given nursing’s longstanding commitments to social justice, they ought to be a priority for oncology nurses. Using a social justice lens, we highlight potential social injustices in the form of inequities in cancer outcomes and access to cancer care across the cancer continuum. Our intention is not to provide an exhaustive review of evidence, but to provide our perspective, adding to the dialogue surrounding health equity and cancer while shifting the narrative away from an understanding of cancer inequities as stemming from “lifestyle” and “behavioural” choices. We conclude by exploring the implications of considering cancer inequities as social injustices for nursing practice. Full article

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

18 pages, 1887 KiB

Open AccessReview

Management of Peritoneal Metastasis in Patients with Pancreatic Ductal Adenocarcinoma

by Grace Wu, Oliver J. Standring, Daniel A. King, Sepideh Gholami, Craig E. Devoe, Cornelius A. Thiels, Travis E. Grotz, Matthew J. Weiss, Richard L. Whelan, Mustafa Raoof and Danielle K. DePeralta

Curr. Oncol. 2025, 32(2), 103; https://doi.org/10.3390/curroncol32020103 - 12 Feb 2025

Viewed by 1618

Abstract

The peritoneum is the second most common site of metastasis in patients with pancreatic ductal adenocarcinoma (PDAC). Up to half of all patients that undergo curative-intent resection eventually develop peritoneal metastasis (PM), which accounts for significant morbidity and drives mortality. Despite recent advances [...] Read more.

The peritoneum is the second most common site of metastasis in patients with pancreatic ductal adenocarcinoma (PDAC). Up to half of all patients that undergo curative-intent resection eventually develop peritoneal metastasis (PM), which accounts for significant morbidity and drives mortality. Despite recent advances in management, PM is associated with very poor prognosis, which is often measured in weeks to months. Clinical manifestations including bowel obstruction, ascites, and urinary obstruction have profound impact on quality of life. Even with relatively advanced disease, PM often remains occult on imaging and thus tend to be underdiagnosed and understudied. Many patients with peritoneal-only PM are excluded from clinical trials because response cannot be measured by standard radiographic criteria. Furthermore, as patients with PM are not eligible for surgical resection and low-volume peritoneal disease is often not amenable to percutaneous biopsy, tissue samples for peritoneal-specific translational studies are limited. Intraperitoneal therapeutics have been proposed as an attractive option for PM, as better penetration of tumor tissue can be achieved with less systemic toxicity compared with intravenous chemotherapy. Heated intraperitoneal chemotherapy (HIPEC), typically combined with cytoreductive surgery (CRS), is an option for select patients with PM from gynecologic or gastrointestinal primary, and for patients with primary peritoneal mesothelioma. However, the incorporation of locoregional therapy for PM in patients with PDAC has been poorly studied given the aggressive nature of pancreatic cancer and overall poor prognosis. With recent advances in existing treatment options, there may be a subset of patients who may derive benefits from locoregional control with cytoreduction and/or intraperitoneal chemotherapy. Critically, additional work is needed to determine PM-favorable clinical and tumoral predictive biomarkers to identify patients who may benefit from a more aggressive approach. We describe the current state of management of patients with peritoneal metastasis from PDAC and review the available data exploring peritoneal-directed therapy with cytoreductive surgery and/or intraperitoneal chemotherapy. Full article

(This article belongs to the Special Issue New Treatments in Pancreatic Ductal Adenocarcinoma)

► Show Figures

Graphical abstract

11 pages, 838 KiB

Open AccessArticle

Leveraging Large Language Models for High-Quality Lay Summaries: Efficacy of ChatGPT-4 with Custom Prompts in a Consecutive Series of Prostate Cancer Manuscripts

by Emily Rinderknecht, Anna Schmelzer, Anton Kravchuk, Christopher Goßler, Johannes Breyer, Christian Gilfrich, Maximilian Burger, Simon Engelmann, Veronika Saberi, Clemens Kirschner, Dominik von Winning, Roman Mayr, Christian Wülfing, Hendrik Borgmann, Stephan Buse, Maximilian Haas and Matthias May

Curr. Oncol. 2025, 32(2), 102; https://doi.org/10.3390/curroncol32020102 - 11 Feb 2025

Viewed by 910

Abstract

Clear and accessible lay summaries are essential for enhancing the public understanding of scientific knowledge. This study aimed to evaluate whether ChatGPT-4 can generate high-quality lay summaries that are both accurate and comprehensible for prostate cancer research in Current Oncology. To achieve [...] Read more.

Clear and accessible lay summaries are essential for enhancing the public understanding of scientific knowledge. This study aimed to evaluate whether ChatGPT-4 can generate high-quality lay summaries that are both accurate and comprehensible for prostate cancer research in Current Oncology. To achieve this, it systematically assessed ChatGPT-4’s ability to summarize 80 prostate cancer articles published in the journal between July 2022 and June 2024 using two distinct prompt designs: a basic “simple” prompt and an enhanced “extended” prompt. Readability was assessed using established metrics, including the Flesch–Kincaid Reading Ease (FKRE), while content quality was evaluated with a 5-point Likert scale for alignment with source material. The extended prompt demonstrated significantly higher readability (median FKRE: 40.9 vs. 29.1, p < 0.001), better alignment with quality thresholds (86.2% vs. 47.5%, p < 0.001), and reduced the required reading level, making content more accessible. Both prompt designs produced content with high comprehensiveness (median Likert score: 5). This study highlights the critical role of tailored prompt engineering in optimizing large language models (LLMs) for medical communication. Limitations include the exclusive focus on prostate cancer, the use of predefined prompts without iterative refinement, and the absence of a direct comparison with human-crafted summaries. These findings underscore the transformative potential of LLMs like ChatGPT-4 to streamline the creation of lay summaries, reduce researchers’ workload, and enhance public engagement. Future research should explore prompt variability, incorporate patient feedback, and extend applications across broader medical domains. Full article

(This article belongs to the Section Genitourinary Oncology)

► Show Figures

Figure 1

16 pages, 415 KiB

Open AccessSystematic Review

The Requirements for Setting Up a Dedicated Structure for Adolescents and Young Adults with Cancer—A Systematic Review

by Lukas Rudolf von Rohr, Nadja Battanta, Cornelia Vetter, Katrin Scheinemann and Maria Otth

Curr. Oncol. 2025, 32(2), 101; https://doi.org/10.3390/curroncol32020101 - 11 Feb 2025

Viewed by 744

Abstract

Adolescents and young adults (AYAs), often defined as those aged 15–39 years, face unique challenges in oncology that are often unmet by conventional care models. This systematic review examines evidence on establishing dedicated AYA oncology units, focusing on logistical, infrastructural, and personnel-related recommendations. [...] Read more.

Adolescents and young adults (AYAs), often defined as those aged 15–39 years, face unique challenges in oncology that are often unmet by conventional care models. This systematic review examines evidence on establishing dedicated AYA oncology units, focusing on logistical, infrastructural, and personnel-related recommendations. A PRISMA-guided search of PubMed (2000–2024) identified seven studies that emphasized early stakeholder involvement and collaboration between pediatric and adult oncology teams to ensure comprehensive care. Multidisciplinary teams (MDTs) of oncologists, nurses, and psychosocial support staff were highlighted as essential to address AYA patients’ diverse needs. Care models varied, with some advocating consultation-based services and others supporting dedicated units. Priorities included increasing clinical trial enrollment, fertility counseling, and creating environments attuned to AYA patients’ social and psychological needs. Key barriers included limited funding, institutional resistance, and inadequate pediatric/adult team collaboration. Despite progress, the lack of standardized guidelines and long-term data on AYA unit efficacy remains a challenge. Further research is required to develop outcome metrics, refine care models, and enhance survival and quality of life for AYA cancer patients. Full article

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

► Show Figures

Figure 1

14 pages, 2843 KiB

Open AccessArticle

Compartmentalization of High Infratemporal Fossa in Oral Cavity Squamous Cell Carcinomas and Its Impact on Clinical Outcome

by Abhishek Mahajan, Ujjwal Agarwal, Renuka M. Ashtekar, Nivedita Chakrabarty, Richa Vaish, Vijay Maruti Patil, Vanita Noronha, Nandini Menon, Vasundhara Smriti, Jai Prakash Agarwal, Sarbani Ghosh-Laskar, Anil K. D’Cruz, Pankaj Chaturvedi, Prathamesh Pai, Asawari Patil, Munita Bal, Swapnil Rane, Neha Mittal and Kumar Prabhash

Curr. Oncol. 2025, 32(2), 99; https://doi.org/10.3390/curroncol32020099 - 10 Feb 2025

Viewed by 1211

Abstract

Background: According to the 8th edition of the American Joint Committee on Cancer (AJCC), involvement of the masticator space and infratemporal fossa (ITF) in oral cancers indicates advanced disease (T4b), which is often considered unresectable. Previous studies have shown that the extent of [...] Read more.

Background: According to the 8th edition of the American Joint Committee on Cancer (AJCC), involvement of the masticator space and infratemporal fossa (ITF) in oral cancers indicates advanced disease (T4b), which is often considered unresectable. Previous studies have shown that the extent of ITF involvement influences management and outcomes. Therefore, to optimize management, T4b disease should be subclassified based on ITF involvement. Notably, infranotch disease has a more favorable prognosis compared to supranotch disease. Our study also observed that certain subsets of high anterior retroantral ITF involvement may be operable with favorable clinical outcomes. This study aims to derive a new image-based compartmentalization of high ITF involvement and assess its impact on the management and outcomes of oral head and neck squamous cell carcinoma (HNSCC) patients with high ITF involvement. Materials and Methods: This retrospective observational study included 154 non-metastatic, upfront unresectable locally advanced HNSCC patients who were fit for induction neoadjuvant chemotherapy (NACT). ITF involvement was classified into distinct compartments, and detailed staging of the primary tumor (T) and regional nodes (Ns) was performed. Clinical data, including patient demographics, treatment received, and follow-up notes, were documented. Prognosis was assessed using survival metrics: event-free survival (EFS), progression-free survival (PFS), and overall survival (OS). The ITF was categorized into the following compartments: compartment 1 (low ITF: medial pterygoid), compartment 2 (anterior high ITF: retroantral fat), compartment 3 (posterior high ITF), including 3a (paramandibular compartment: paramandibular fat/temporalis), 3b (muscle compartment: lateral pterygoid), and 3c (Perineural compartment: pterygopalatine fossa and pterygomaxillary fissure). Results: Of the 154 cases, 142 (92%) were classified as T4b, with 63 (40.9%) having high ITF involvement and 79 (55.6%) having low ITF involvement. Twelve cases had T4a disease, which was deemed unresectable due to extensive nodal involvement. Subcompartmentalization of the 63 high ITF cases revealed 26 (41.2%) with compartment 2 involvement, 17 (26.9%) with compartment 3a involvement, 11 (17.4%) with compartment 3b involvement, and 9 (14%) with compartment 3c involvement. Disease progression following NACT was significantly higher in compartment 3c, which showed a poor response (p = 0.007). Univariate analysis for PFS revealed similar outcomes for compartments 1 and 2 (p = 0.692), while compartment 3 demonstrated poorer outcomes (p = 0.033). Among thosehigh ITF involvement, compartment 3c had the worst PFS outcome (p = 0.03). Conclusions: Baseline imaging plays a critical role in guiding individualized treatment and predicting clinical outcomes. Low ITF involvement and disease limited to the high retroantral fat compartment exhibit similar clinical outcomes. Among the posterior high ITF compartments, involvement of the pterygopalatine fossa and pterygomaxillary fissure (compartment 3c) is associated with the worst prognosis and poor response to chemotherapy. Subcompartmentalization of ITF involvement provides valuable prognostic information to tailor treatment strategies. Full article

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

► Show Figures

Figure 1

13 pages, 1226 KiB

Open AccessArticle

Safety and Efficacy in the Transcortical and Transsylvian Approach in Insular High-Grade Gliomas: A Comparative Series of 58 Patients

by Alberto Morello, Francesca Rizzo, Andrea Gatto, Flavio Panico, Andrea Bianconi, Giulia Chiari, Daniele Armocida, Stefania Greco Crasto, Antonio Melcarne, Francesco Zenga, Roberta Rudà, Giovanni Morana, Diego Garbossa and Fabio Cofano

Curr. Oncol. 2025, 32(2), 98; https://doi.org/10.3390/curroncol32020098 - 10 Feb 2025

Viewed by 870

Abstract

Gliomas within the insular region represent one of the most challenging problems in neurosurgical oncology. There are two main surgical approaches to address the complex vascular network and functional areas around the insula: the transsylvian approach and the transcortical approach. In the literature, [...] Read more.

Gliomas within the insular region represent one of the most challenging problems in neurosurgical oncology. There are two main surgical approaches to address the complex vascular network and functional areas around the insula: the transsylvian approach and the transcortical approach. In the literature, there is not a clear consensus on the best approach in terms of safety and efficacy. The purpose of this study is to evaluate the effectiveness of these approaches and to analyze prognostic factors on the natural history of insular gliomas. Patients with newly diagnosed high-grade insular gliomas who underwent surgery between January 2019 and June 2024 were analyzed. The series was analyzed according to the classification of Berger–Sanai and Yaşargil. The Karnofsky performance score (KPS), extent of resection (EOR), progression-free survival (PFS), and overall survival (OS) were considered the outcome measures. A total of 58 primary high-grade insular glioma patients were enrolled in this study. The IDH mutation was found in 13/58 (22.4%); specifically, 3/13 (23.1%) were grade 4, and 10/13 (76.9%) were grade 3. Furthermore, 40/58 patients (69%) underwent gross total resection (GTR), 15 patients (26%) subtotal resection, and 3 patients (5%) partial resection. Middle cerebral artery encasement negatively affected the OS. GTR, radiotherapy, KPS, and autonomous deambulation at a month after surgery positively affected the OS. The surgical approach used was transsylvian and transcortical in 11 and 47 cases, respectively. The comparison between the two different approaches did not display differences in terms of neurological deficits and OS (p > 0.05). The transcortical approach was related to the greater achievement of GTR (p = 0.031). According to the Berger–Sanai classification, the transcortical approach has higher EOR and postoperative KPS when the lesion is in zone III-IV (p = 0.029). Greater resection of insular gliomas can be achieved with an acceptable morbidity profile and is predictive of improved OS. Both the transsylvian and transcortical corridors to the insula are associated with low morbidity profiles. The transcortical approach with intraoperative mapping is more favorable for achieving greater EOR, particularly in gliomas within the inferior border of the Sylvian fissure. Full article

(This article belongs to the Special Issue Treatment for Glioma: Retrospect and Prospect)

► Show Figures

Figure 1

15 pages, 1123 KiB

Open AccessArticle

Trends in Kampo Medicine Usage as Supportive Care During Anticancer Drug Treatment in Japanese Patients: A Nationwide Cohort Analysis from Fiscal Years 2015 to 2021

by Hiroaki Ohta and Takeo Yasu

Curr. Oncol. 2025, 32(2), 100; https://doi.org/10.3390/curroncol32020100 - 10 Feb 2025

Viewed by 939

Abstract

The adverse effects of anticancer drugs significantly impact the quality of life of patients undergoing chemotherapy, necessitating evidence-based supportive therapies. In Japan, Kampo medicines, traditional Japanese herbal therapies used for relief of various symptoms, have been widely used as complementary and alternative treatments [...] Read more.

The adverse effects of anticancer drugs significantly impact the quality of life of patients undergoing chemotherapy, necessitating evidence-based supportive therapies. In Japan, Kampo medicines, traditional Japanese herbal therapies used for relief of various symptoms, have been widely used as complementary and alternative treatments for cancer, despite limited evidence regarding their efficacy and safety. Thus, we investigated the actual use of Kampo medicines as supportive care in patients undergoing anticancer drug treatment and evaluated the trends in prescription according to year. We analyzed 89,141 cancer drug therapy cases registered in the Japan Medical Data Center database between April 2014 and July 2022, excluding those with a history of Kampo medicine prescriptions before the first prescription of antineoplastic drugs. We assessed the trends in prescription according to sex, age group (<50, 50–74, and ≥75 years), and cancer type subgroup using the Cochran–Armitage trend test. Approximately 23.7% of patients were prescribed Kampo medicines during anticancer drug treatment. Since 2014, a decrease in the prescription of Kampo medicines during anticancer treatment has been observed regardless of sex, age, or cancer type. These findings suggest that recent negative reports on the efficacy and safety of Kampo medicines in cancer care may have influenced this trend. Full article

(This article belongs to the Special Issue Palliative Care and Supportive Medicine in Cancer)

► Show Figures

Figure 1

5 pages, 245 KiB

Open AccessCase Report

Treatment-Emergent Resistance to Asciminib in Chronic Myeloid Leukemia Patients Due to Myristoyl-Binding Pocket-Mutant of BCR::ABL1/A337V Can Be Effectively Overcome with Dasatinib Treatment

by Peter Batar, Gabriella Mezei and Arpad Illes

Curr. Oncol. 2025, 32(2), 97; https://doi.org/10.3390/curroncol32020097 - 9 Feb 2025

Cited by 1 | Viewed by 979

Abstract

Despite the groundbreaking success of tyrosine kinase inhibitor therapy, the management of chronic myeloid leukemia patients is often impaired by resistance due to specific point mutations in the BCR::ABL1 oncogene. Upon classical ATP-competitive inhibitor treatment, these single nucleotide variants occur in the tyrosine [...] Read more.

Despite the groundbreaking success of tyrosine kinase inhibitor therapy, the management of chronic myeloid leukemia patients is often impaired by resistance due to specific point mutations in the BCR::ABL1 oncogene. Upon classical ATP-competitive inhibitor treatment, these single nucleotide variants occur in the tyrosine kinase domain of ABL1. The novel allosteric BCR::ABL1 inhibitor asciminib was developed to treat CML patients alone or in combination to overcome or potentially prevent these treatment-emergent TKD mutations. Here, we present a case of a patient undergoing first-line asciminib therapy, and subsequently develop a specific BCR::ABL1/A337V point mutation, which resulted in asciminib resistance. Switching to second-line dasatinib treatment successfully overcame asciminib resistance and helped to achieve a deep molecular response. In case of treatment failures caused by single asciminib-specific point mutations, dasatinib therapy is a feasible choice. Full article

(This article belongs to the Section Hematology)

► Show Figures

Figure 1

13 pages, 3662 KiB

Open AccessArticle

Understanding Diagnostic Costs Using Hospital-Based Encounters in the Year Before Diagnosis for Canadian Patients with Malignant Central Nervous System Tumours Compared to Common Cancers

by Linwan Xu, Keyun Zhou, Yan Yuan and Emily V. Walker

Curr. Oncol. 2025, 32(2), 96; https://doi.org/10.3390/curroncol32020096 - 9 Feb 2025

Viewed by 585

Abstract

Rare cancers pose significant diagnostic challenges, leading to more tests and higher healthcare expenditures (HEs). Understanding the financial implications of diagnosing rare cancers is crucial, particularly in Canada, where overall HEs are high (12% of the GDP in 2023). We investigated the pre-diagnostic [...] Read more.

Rare cancers pose significant diagnostic challenges, leading to more tests and higher healthcare expenditures (HEs). Understanding the financial implications of diagnosing rare cancers is crucial, particularly in Canada, where overall HEs are high (12% of the GDP in 2023). We investigated the pre-diagnostic hospital–based HE for patients with malignant central nervous system (CNS) tumours and compared it to patients with common cancers across Canadian provinces, using in-patient and ambulatory care data (2010–2014) from the Canadian Institute for Health Information. Pre-diagnostic HE was calculated as the change in total HE (in-patient and out-patient) during the 12 months before diagnosis, calculated as the HE within this period minus the average annual HE estimated over the two preceding years. Comparison groups included pediatric patients diagnosed with leukemia and patients aged over 15 diagnosed with colorectal cancer and lung cancer. We used quantile regression to estimate the adjusted effect of diagnosis with a CNS tumour on pre-diagnostic HE. The results indicated that HE for CNS patients was higher compared to those with common cancers. The top three factors contributing to HE variation were encounter type (in-patient/out-patient), province (Alberta/Ontario), and comorbidities (yes/no). Further investigation is warranted to understand the drivers of the cost differences. Full article

(This article belongs to the Section Health Economics)

► Show Figures

Figure 1

14 pages, 1889 KiB

Open AccessArticle

A Novel Deep Learning-Based (3D U-Net Model) Automated Pulmonary Nodule Detection Tool for CT Imaging

by Abhishek Mahajan, Rajat Agarwal, Ujjwal Agarwal, Renuka M. Ashtekar, Bharadwaj Komaravolu, Apparao Madiraju, Richa Vaish, Vivek Pawar, Vivek Punia, Vijay Maruti Patil, Vanita Noronha, Amit Joshi, Nandini Menon, Kumar Prabhash, Pankaj Chaturvedi, Swapnil Rane, Priya Banwar and Sudeep Gupta

Curr. Oncol. 2025, 32(2), 95; https://doi.org/10.3390/curroncol32020095 - 8 Feb 2025

Viewed by 906

Abstract

Background: Precise detection and characterization of pulmonary nodules on computed tomography (CT) is crucial for early diagnosis and management. Objectives: In this study, we propose the use of a deep learning-based algorithm to automatically detect pulmonary nodules in computed tomography (CT) scans. We [...] Read more.

Background: Precise detection and characterization of pulmonary nodules on computed tomography (CT) is crucial for early diagnosis and management. Objectives: In this study, we propose the use of a deep learning-based algorithm to automatically detect pulmonary nodules in computed tomography (CT) scans. We evaluated the performance of the algorithm against the interpretation of radiologists to analyze the effectiveness of the algorithm. Materials and Methods: The study was conducted in collaboration with a tertiary cancer center. We used a collection of public (LUNA) and private (tertiary cancer center) datasets to train our deep learning models. The sensitivity, the number of false positives per scan, and the FROC curve along with the CPM score were used to assess the performance of the deep learning algorithm by comparing the deep learning algorithm and the radiology predictions. Results: We evaluated 491 scans consisting of 5669 pulmonary nodules annotated by a radiologist from our hospital; our algorithm showed a sensitivity of 90% and with only 0.3 false positives per scan with a CPM score of 0.85. Apart from the nodule-wise performance, we also assessed the algorithm for the detection of patients containing true nodules where it achieved a sensitivity of 0.95 and specificity of 1.0 over 491 scans in the test cohort. Conclusions: Our multi-institutional validated deep learning-based algorithm can aid radiologists in confirming the detection of pulmonary nodules through computed tomography (CT) scans and identifying further abnormalities and can be used as an assistive tool. This will be helpful in national lung screening programs guiding early diagnosis and appropriate management. Full article

(This article belongs to the Special Issue Imaging-Based Early Diagnosis of Cancers Using Artificial Intelligence)

► Show Figures

Figure 1

9 pages, 920 KiB

Open AccessCase Report

Immune Checkpoint Blockade Response in Mucinous Tubular and Spindle Cell Carcinoma

by Simran Makker, Neil J. Shah, Maria I. Carlo, Fengshen Kuo, A. Ari Hakimi, Ying-Bei Chen, Gopa Iyer and Ritesh R. Kotecha

Curr. Oncol. 2025, 32(2), 94; https://doi.org/10.3390/curroncol32020094 - 8 Feb 2025

Viewed by 886

Abstract

Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare kidney tumor which is usually characterized by indolent disease physiology. While several high-grade and sarcomatoid MTSCC tumors have been reported, the clinical experience with contemporary immune checkpoint blockade (ICB) combination therapies extrapolated from [...] Read more.

Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare kidney tumor which is usually characterized by indolent disease physiology. While several high-grade and sarcomatoid MTSCC tumors have been reported, the clinical experience with contemporary immune checkpoint blockade (ICB) combination therapies extrapolated from treatment paradigms of conventional renal cell carcinoma (RCC) remains limited. Here, we report two patients with metastatic MTSCC treated with first-line ipilimumab plus nivolumab therapy who both achieved great clinical benefit. We subsequently performed immune deconvolution analysis on previously identified MTSCC-like kidney tumors from The Cancer Genome Atlas (TCGA) and discovered significantly higher PD-L1 transcriptomic expression compared to similar papillary RCC tumors, providing additional biomarker data supporting the observed ICB response. These data implicate ICB therapy as an effective treatment for patients with metastatic MTSCC. Full article

(This article belongs to the Section Genitourinary Oncology)

► Show Figures

Graphical abstract

14 pages, 1917 KiB

Open AccessArticle

Measurement of Intratumor Heterogeneity and Its Changing Pattern to Predict Response and Recurrence Risk After Neoadjuvant Chemotherapy in Breast Cancer

by Mingxi Zhu, Qiong Wu, Xiaochuan Geng, Huaying Xie, Yan Wang, Ziping Wu, Yanping Lin, Liheng Zhou, Shuguang Xu, Yumei Ye, Wenjin Yin, Jia Hua, Jingsong Lu and Yaohui Wang

Curr. Oncol. 2025, 32(2), 93; https://doi.org/10.3390/curroncol32020093 - 7 Feb 2025

Viewed by 996

Abstract

The heterogeneity of breast tumors might reflect biological complexity and provide prediction clues for the sensitivity of treatment. This study aimed to construct a model based on tumor heterogeneity in magnetic resonance imaging (MRI) for predicting the pathological complete response (pCR) to neoadjuvant [...] Read more.

The heterogeneity of breast tumors might reflect biological complexity and provide prediction clues for the sensitivity of treatment. This study aimed to construct a model based on tumor heterogeneity in magnetic resonance imaging (MRI) for predicting the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC). This retrospective study involved 217 patients with biopsy-confirmed invasive breast cancer who underwent MR before and after NAC. Patients were randomly divided into the training cohort and the validation cohort at a 1:1 ratio. MR images were processed by algorithms to quantify the heterogeneity of tumors. Models incorporating heterogeneity and clinical characteristics were constructed to predict pCR. The patterns of heterogeneity variation during NAC were classified into four categories abbreviated as the heterogeneity high-keep group (H_keep group), heterogeneity low-keep group (L_keep group), heterogeneity rising group, and decrease group. The average heterogeneity in patients achieving pCR was significantly lower than in those who did not (p = 0.029). Lower heterogeneity was independently associated with pCR (OR, 0.401 [95%CI: 0.21, 0.76]; p = 0.007). The model combining heterogeneity and clinical characteristics demonstrated improved specificity (True Negative Rate 0.857 vs. 0.698) and accuracy (Accuracy 0.828 vs. 0.753) compared to the clinical model. Survival outcomes were best for the L_keep group and worst for the rising group (Log-rank p = 0.031). Patients with increased heterogeneity exhibited a higher risk of recurrence approaching two years post-surgery, particularly within the non-pCR population. The quantified heterogeneity of breast cancer in MRI offers a non-invasive method for predicting pCR to NAC and evaluating the implementation of precision medicine. Full article

(This article belongs to the Section Breast Cancer)

► Show Figures

Figure 1

11 pages, 210 KiB

Open AccessReview

Radical Prostatectomy in Multimodal Setting: Current Role of Neoadjuvant and Adjuvant Hormonal or Chemotherapy-Based Treatments

by Marco Oderda, Giorgio Calleris, Giuseppe Carlo Iorio, Giuseppe Simone and Paolo Gontero

Curr. Oncol. 2025, 32(2), 92; https://doi.org/10.3390/curroncol32020092 - 7 Feb 2025

Viewed by 1100

Abstract

The role of neoadjuvant and adjuvant hormonal or chemotherapy-based treatments before or after radical prostatectomy in localized or locally advanced high-risk prostate cancer (PCa) is currently debatable. European guidelines recommend adjuvant androgen deprivation therapy (ADT) only in pN1 patients after extended pelvic lymph [...] Read more.

The role of neoadjuvant and adjuvant hormonal or chemotherapy-based treatments before or after radical prostatectomy in localized or locally advanced high-risk prostate cancer (PCa) is currently debatable. European guidelines recommend adjuvant androgen deprivation therapy (ADT) only in pN1 patients after extended pelvic lymph node dissection based on outdated evidence on standard hormonal agents. The introduction of new-generation androgen receptor targeting agents (ARTAs) has revolutionized the treatment of metastatic PCa and might also impact the perioperative management of patients with high-risk localized disease. In the last years, a renewed interest has also arisen in chemotherapy-based neoadjuvant or adjuvant treatments alone or in combination with ADT and/or ARTAs. In the present review, we gathered the current evidence on the oncological outcomes of neoadjuvant and adjuvant systemic treatments in surgically treated patients with localized or locally advanced PCa. Despite mild benefits in terms of pathologic responses or oncological outcomes reported in some studies investigating ADT and/or chemotherapy in this setting of patients, strong evidence to support their use in clinical practice is lacking. Promising data in favor of ARTAs have been gathered from phase II trials and prospective series, but definitive results from phase III trials are awaited to confirm these findings. Full article

(This article belongs to the Collection New Insights into Prostate Cancer Diagnosis and Treatment)

8 pages, 2654 KiB

Open AccessCase Report

Chemotherapy-Induced Unconjugated Hyperbilirubinemia Complicated by Other Trigger Factors in a Child with T-Cell Acute Lymphoblastic Leukaemia and UGT1A1 Mutation-Associated Gilbert Syndrome

by Mohammad Shukri Khoo, Sharifah Naiema Jamalullail, C-Khai Loh, Sie Chong Doris Lau and Hamidah Alias

Curr. Oncol. 2025, 32(2), 91; https://doi.org/10.3390/curroncol32020091 - 7 Feb 2025

Viewed by 1199

Abstract

Gilbert syndrome (GS) is an inherited disorder characterised by unconjugated hyperbilirubinemia due to a deficiency in hepatic UDP-glucuronosyltransferase 1A1 (UGT1A1) enzyme activity, responsible for bilirubin glucuronidation. This results in decreased bilirubin conjugation and excretion, leading to elevated serum unconjugated bilirubin levels. [...] Read more.

Gilbert syndrome (GS) is an inherited disorder characterised by unconjugated hyperbilirubinemia due to a deficiency in hepatic UDP-glucuronosyltransferase 1A1 (UGT1A1) enzyme activity, responsible for bilirubin glucuronidation. This results in decreased bilirubin conjugation and excretion, leading to elevated serum unconjugated bilirubin levels. In T-cell acute lymphoblastic leukaemia (T-ALL), treatment typically involves intensive chemotherapy regimens that include agents metabolised by the liver, requiring careful consideration of liver function and bilirubin metabolism in patients with concurrent GS. We present the case of a 15-year-old male who was diagnosed with T-ALL and treated with a chemotherapy regimen following the modified Dutch Child Oncology Group ALL-9 (High Risk) protocol. Concurrently, the patient was observed to have persistent unconjugated hyperbilirubinemia aggravated by infection and fasting despite normal to mildly deranged liver function, which was initially assumed to be attributed by 6-Mercaptopurine (6-MP). Further workup confirmed a diagnosis of GS based on clinical history, laboratory findings, and genetic testing. We recommend performing a genetic analysis of UGT1A1 in patients presenting with chemotherapy-induced hyperbilirubinemia with no signs of liver impairment. This aims to prevent unnecessary alterations in chemotherapy regimens that could potentially increase the risk of relapse. Full article

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

► Show Figures

Figure 1

13 pages, 804 KiB

Open AccessReview

Causative Genes of Homologous Recombination Deficiency (HRD)-Related Breast Cancer and Specific Strategies at Present

by Seigo Nakamura, Yasuyuki Kojima and Sayoko Takeuchi

Curr. Oncol. 2025, 32(2), 90; https://doi.org/10.3390/curroncol32020090 - 6 Feb 2025

Viewed by 1474

Abstract

Recently, homologous recombination deficiency (HRD) has become a new target for hereditary cancers. Molecular-based approaches for hereditary cancers in the clinical setting have been reviewed. In particular, the efficacy of the PARP inhibitor has been considered by several clinical trials for various kinds [...] Read more.

Recently, homologous recombination deficiency (HRD) has become a new target for hereditary cancers. Molecular-based approaches for hereditary cancers in the clinical setting have been reviewed. In particular, the efficacy of the PARP inhibitor has been considered by several clinical trials for various kinds of hereditary cancers. This indicates that the PARP inhibitor can be effective for any kind of BRCA mutated cancers, regardless of the organ-specific cancer. Homologous recombination deficiency (HRD) has become a new target for hereditary cancers, indicating the necessity to confirm the status of HRD-related genes. ARID1A, ATM, ATRX, PALB2, BARD1, RAD51C and CHEK2 are known as HRD-related genes for which simultaneous examination as part of panel testing is more suitable. Both surgical and medical oncologists should learn the basis of genetics including HRD. An understanding of the basic mechanism of homologous repair recombination (HRR) in BRCA-related breast cancer is mandatory for all surgical or medical oncologists because PARP inhibitors may be effective for these cancers and a specific strategy of screening for non-cancers exists. The clinical behavior of each gene should be clarified based on a large-scale database in the future, or, in other words, on real-world data. Firstly, HRD-related genes should be examined when the hereditary nature of a cancer is placed in doubt after an examination of the relevant family history. Alternatively, HRD score examination is a solution by which to identify HRD-related genes at the first step. If lifetime risk is estimated at over 20%, an annual breast MRI is necessary for high-risk screening. However, there are limited data to show its benefit compared with BRCA. Therefore, a large-scale database, including clinical information and a long-term follow-up should be established, after which a periodical assessment is mandatory. The clinical behavior of each gene should be clarified based on a large-scale database, or, in other words, real-world data. Full article

(This article belongs to the Section Breast Cancer)

► Show Figures

Figure 1

15 pages, 583 KiB

Open AccessArticle

Implementation of a Multi-Disciplinary Geriatric Oncology Clinic in Toronto, Canada

by Ines B. Menjak, Khloe Campos, Mark Pasetka, Arlene Budden, Elaine Curle, Leslie Gibson, Ewa Szumacher and Rajin Mehta

Curr. Oncol. 2025, 32(2), 89; https://doi.org/10.3390/curroncol32020089 - 6 Feb 2025

Viewed by 784

Abstract

Older adults with cancer tend to face more complex health needs than their younger counterparts. Patients > 65 years of age are recommended for comprehensive geriatric assessment (CGA) to capture and address age-related vulnerabilities. Access to geriatrics services is limited, and our baseline [...] Read more.

Older adults with cancer tend to face more complex health needs than their younger counterparts. Patients > 65 years of age are recommended for comprehensive geriatric assessment (CGA) to capture and address age-related vulnerabilities. Access to geriatrics services is limited, and our baseline audit of geriatric referrals in 2019 from the cancer program revealed that only 30% of patients referred received a CGA. The aim of this study was to assess the implementation of a geriatric oncology (GO) clinic that employs CGA and determine patient outcomes. We conducted a retrospective cohort study at a single institution. Data collection included baseline characteristics, GO clinic findings and characteristics, recommendations/referrals, and emergency room (ER) visits/hospitalizations within 6 months of CGA. Descriptive statistics were used for analysis. A total of 100 patients were included, with a median (range) age of 80 (63–97) years; 70% were female, and the most common cancer type was breast (31%). Through the GO clinic, patients were seen in a timely manner, with a median of 3 weeks, compared to our historical baseline of 11 weeks. Cognitive decline (32%) and pre-treatment CGA (22%) were the most common reasons for referral, and the most common new diagnosis was cognitive impairment (65%). For pre-treatment CGA, 16 (48%) patients were deemed suitable for treatment and 10 (30%) were recommended for modified treatment; 34 (94%) referring physicians followed the recommendation. In addition, most (68%) patients received an allied health referral. One third of patients visited the ER and 30 (30%) patients were hospitalized. Overall, the GO clinic resulted in greater access to CGA in a timely manner, enhanced access to allied health, and assisted in treatment decision-making. Full article

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

► Show Figures

Figure 1

Journal Menu

Journal Browser

Curr. Oncol., Volume 32, Issue 2 (February 2025) – 63 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI