Current Oncology

16 pages, 1008 KiB

Open AccessReview

Glioblastoma in NF1: A Unique Entity—A Literature Review Focusing on Surgical Implication and Our Experience

by Elisa Garbin, Lorenzo Nicolè, Salima Magrini, Yuri Ceccaroni, Luca Denaro, Luca Basaldella and Marta Rossetto

Curr. Oncol. 2025, 32(4), 242; https://doi.org/10.3390/curroncol32040242 - 21 Apr 2025

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Abstract

Glioblastoma in patients affected by NF1 germline mutation (NF1-associated GBM) represents a unique heterogeneous clinical and pathological entity. We have reviewed the few cases reported in the literature and they seem to have a better response to standard therapy and overall survival than [...] Read more.

Glioblastoma in patients affected by NF1 germline mutation (NF1-associated GBM) represents a unique heterogeneous clinical and pathological entity. We have reviewed the few cases reported in the literature and they seem to have a better response to standard therapy and overall survival than GBM in the non-NF1 population. We present two cases of long-survival NF1 patients with GBM. Case 1 was a 38-year-old woman with cerebellar GBM who underwent surgical asportation and the Stupp protocol many times with an overall survival of 117 months. Case 2 was a 47-year-old woman with GBM in the eloquent area of the right frontal lobe; she underwent surgical asportation and the Stupp protocol with an overall survival of 25 months. The data analysis demonstrates that NF1-associated GBM patients could be considered long-term survivors. Full article

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

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169 pages, 909 KiB

Open AccessConference Report

40th Annual CAPO Conference—Responding to the Human Experience of Cancer and Caring for the Soul: Building on 40 Years of Global Leadership in Psychosocial Oncology

by Peter Traversa and Doris Howell

Curr. Oncol. 2025, 32(4), 241; https://doi.org/10.3390/curroncol32040241 - 20 Apr 2025

Viewed by 188

Abstract

On behalf of the Canadian Association of Psychosocial Oncology, we are pleased to present the Abstracts from the 2025 Annual Conference, titled “Responding to the Human Experience of Cancer and Caring for the Soul: Building on 40 years of global leadership in psychosocial [...] Read more.

On behalf of the Canadian Association of Psychosocial Oncology, we are pleased to present the Abstracts from the 2025 Annual Conference, titled “Responding to the Human Experience of Cancer and Caring for the Soul: Building on 40 years of global leadership in psychosocial oncology”. The 40th Annual CAPO Conference was held in Toronto from 23 April 2025 to 25 April 2025. In an era marked by the rapid advancement of biologically focused precision medicine, it is imperative to redirect our attention towards the human experience of illness and the soul of medicine. Biomedicine has conceptualized illness in ways that have proved profoundly productive from a curative and biological point of view. But it cannot—and it does not pretend to—illuminate the experience of living with it. (Hurwitz 2009). This conference aims to delve into the intricate interplay between cutting-edge biomedical technologies inclusive of artificial intelligence and big data and the deeply personal narratives of individuals navigating illness. By shifting the focus from mere disease pathology to encompassing the holistic human experience, we aspire to foster a more compassionate and patient-centered approach to healthcare with psychosocial support at the core of humanistic care that can improve survival and well-being in all aspects of a whole-person approach to illness. Through interdisciplinary dialogue and introspection, we endeavor to illuminate the profound connection between mind, body, and spirit in the practice of medicine, reaffirming the timeless significance of empathy, understanding, and human connection in healing and psychosocial aspects of care as fundamental to living well with cancer. This conference brought together key stakeholders including multidisciplinary professionals from nursing, psychology, psychiatry, social work, spiritual care, nutrition, medicine, rehabilitation medicine, occupational health and radiation therapy for both adult and pediatric populations. Participants included clinicians, researchers, educators in cancer care, community-based organizations and patient representatives. Patients, caregivers and family members presented abstracts that speak to their role in managing cancer experiences and care. Over two hundred (200) abstracts were submitted for presentation as symposia, 20-minute oral presentations, 10-minute oral presentations, 90-minute workshops and poster presentations. We congratulate all the presenters on their research work and contribution. Full article

(This article belongs to the Section Psychosocial Oncology)

18 pages, 1310 KiB

Open AccessArticle

Cost-Effectiveness Analysis of Contemporary Advanced Prostate Cancer Treatment Sequences

by Valentyn Litvin, Armen G. Aprikian and Alice Dragomir

Curr. Oncol. 2025, 32(4), 240; https://doi.org/10.3390/curroncol32040240 - 20 Apr 2025

Viewed by 144

Abstract

There has been a proliferation of novel treatments for the management of advanced prostate cancer (PCa), including androgen receptor pathway inhibitors (ARPI). Although there are health economic analyses of novel PCa treatments, such as ARPIs for specific health states, there is a lack [...] Read more.

There has been a proliferation of novel treatments for the management of advanced prostate cancer (PCa), including androgen receptor pathway inhibitors (ARPI). Although there are health economic analyses of novel PCa treatments, such as ARPIs for specific health states, there is a lack of sequential analyses. Our paper aims to fill this gap. We developed a Monte Carlo Markov model to simulate the management of advanced PCa to end-of-life. We modeled patients who begin in metastatic and nonmetastatic castration-sensitive PCa (mCSPC and nmCSPC), with risk stratification for mCSPC, progressing to metastatic castration-resistant PCa (mCRPC). Using current guidelines and recent literature, we simulated admissible treatment sequences over these states along a 15-year horizon. We report the best treatment sequences in terms of efficacy and cost-effectiveness. We find that the most cost-effective use of ARPIs is early in advanced PCa for a cost-effectiveness threshold (CET) of CAD 100K per QALY. For a CET of CAD 50K per QALY, early ARPI use is most cost-effective in mCSPC-starting patients but not nmCSPC-starting. We conclude that the most cost-effective way to use ARPIs is when patients first enter advanced PCa. The most cost-effective ARPI at current Canadian prices is abiraterone, mostly due to abiraterone’s lower price level. Full article

(This article belongs to the Section Health Economics)

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18 pages, 1554 KiB

Open AccessArticle

Real-World Treatment Patterns and Outcomes Among Patients with Early Non-Small Cell Lung Cancer

by Jennifer D. Deem, Zsolt Hepp and Joshua J. Carlson

Curr. Oncol. 2025, 32(4), 239; https://doi.org/10.3390/curroncol32040239 - 19 Apr 2025

Viewed by 171

Abstract

Worldwide, about two million people are diagnosed with lung cancer each year, 85% of whom have non-small cell lung cancer (NSCLC). Recent progress in treating advanced/metastatic NSCLC with targeted therapies has shifted attention to early NSCLC (Stages I–IIIA) and perioperative (neoadjuvant and adjuvant) [...] Read more.

Worldwide, about two million people are diagnosed with lung cancer each year, 85% of whom have non-small cell lung cancer (NSCLC). Recent progress in treating advanced/metastatic NSCLC with targeted therapies has shifted attention to early NSCLC (Stages I–IIIA) and perioperative (neoadjuvant and adjuvant) systemic therapies. However, our comprehension of how targeted therapeutics are incorporated into care and their impact on patient outcomes is just starting to unfold. Methods: This retrospective observational study used a US nationwide electronic health record-derived deidentified database spanning January 2019–March 2024 and aimed to describe (1) eNSCLC patient demographic and clinical characteristics, (2) real-world neoadjuvant and adjuvant use, and (3) patient outcomes. Results: The study population included 4841 Stage IB–IIIA NSCLC patients with a mean age of 70.9 ± 8.6 years. The majority (69.9%) received definitive treatment: surgery (n = 2280), definitive radiation (n = 320), or definitive chemoradiation (n = 783), while 30.1% (n = 1458) did not. Many definitive treatment patients received some perioperative systemic therapy (surgery: 52.6%, radiation: 52.2%, chemoradiation: 75.5%). Neoadjuvant use was limited in all groups (surgery: 8.2%, radiation: 6.1%, chemoradiation: 11.6%). Among the 54.6% receiving adjuvant, immune checkpoint inhibitors were the most common choice for definitive radiation (39.1%) and chemoradiation (73.7%) patients, while surgical patients predominantly received platinum-doublet therapy (37.0%). Surgical patient outcomes were similar across all groups, while definitive chemoradiation or radiation patients without systemic therapy had lower survival rates. Conclusions: In this study, we found that although the majority of patients underwent some form of definitive treatment, adjuvant use was limited, and neoadjuvant use was rarely included in care. A crucial initial step in improving patient outcomes is to understand and address the underutilization of neoadjuvant/adjuvant systemic therapy for eNSCLC patients. Full article

(This article belongs to the Section Thoracic Oncology)

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15 pages, 734 KiB

Open AccessReview

Perspectives on Outpatient Delivery of Bispecific T-Cell Engager Therapies for Multiple Myeloma

by Andrée-Anne Pelland, Mathilde Dumas, Émilie Lemieux-Blanchard, Richard LeBlanc, Julie Côté, Jean-Samuel Boudreault, Dominic Duquette, Rayan Kaedbey, Marc Lalancette, Frédéric Larose, Anna Nikonova, Michel Pavic, April Shamy, Jean Roy, Michael Sebag, Sabrina Trudel and Jean-Sébastien Claveau

Curr. Oncol. 2025, 32(4), 238; https://doi.org/10.3390/curroncol32040238 - 18 Apr 2025

Viewed by 242

Abstract

In the past few years, a new promising therapy, called bispecific T-cell engager (TCE), has been developed and is now available in many countries for patients with relapsed or refractory multiple myeloma. T-cell engagers are associated with sustained efficacy and progression-free survival benefits [...] Read more.

In the past few years, a new promising therapy, called bispecific T-cell engager (TCE), has been developed and is now available in many countries for patients with relapsed or refractory multiple myeloma. T-cell engagers are associated with sustained efficacy and progression-free survival benefits in patients with heavily treated myeloma. However, complications such as cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and infections complicate their administration, particularly in remote centers. This review discusses the key requirements for delivering TCEs therapies, focusing on outpatient delivery. We also outline the primary acute and chronic complications of TCE therapy and their management. Full article

(This article belongs to the Section Hematology)

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11 pages, 1465 KiB

Open AccessArticle

Trends in the Cost and Utilization of Publicly Reimbursed Cancer Medications Dispensed as Take-Home Treatments from 2017–2021

by Ria Garg, Tara Dumont, Daniel McCormack, Mina Tadrous, Tonya Campbell, Kelvin Chan and Tara Gomes

Curr. Oncol. 2025, 32(4), 237; https://doi.org/10.3390/curroncol32040237 - 18 Apr 2025

Viewed by 140

Abstract

Background: The cost and uptake of cancer medications dispensed as take-home treatments are not well understood. Therefore, in this study, we describe trends and the impact of SARS-CoV-2 on the utilization and cost of take-home cancer medications dispensed through the public payer system [...] Read more.

Background: The cost and uptake of cancer medications dispensed as take-home treatments are not well understood. Therefore, in this study, we describe trends and the impact of SARS-CoV-2 on the utilization and cost of take-home cancer medications dispensed through the public payer system in Ontario, Canada. Methods: We conducted a repeated cross-sectional time-series analysis examining monthly and fiscal-year trends in the utilization and cost of take-home cancer medications reimbursed by the public payer between 1 April 2017 and 31 March 2021, in Ontario, Canada. Our primary outcome was per-beneficiary spending. Total public payer spending and the number of unique beneficiaries who were dispensed take-home cancer medications were reported as secondary outcomes. All outcomes were reported overall and stratified by drug class. We used autoregressive integrated moving average (ARIMA) models to assess the impact of the SARS-CoV-2 pandemic on the aforementioned trends. Results: Annual per-beneficiary spending on take-home cancer medications increased by 32.8% (from CAD 4422 in 2017/18 to CAD 6579 in 2020/21) over the study period. The rise in per-beneficiary spending was driven by the cost of medications within the small-molecule targeted therapy and immunotherapy drug classes, which accounted for three-quarters of total public payer spending on take-home cancer medications in 2020/21 despite being dispensed to less than 8% of beneficiaries. Upon the declaration of emergency for SARS-CoV-2, a short-term decline in per-beneficiary spending (CAD −179 per month; p-value < 0.01) was observed between March and June 2020. This temporary decline was driven by an increase in the number of beneficiaries (5582 per month; p-value < 0.01) receiving low-cost take-home cancer medications within the cytotoxic chemotherapy and hormonal therapy drug class without a corresponding rise in public payer spending. Conclusion: Future research should investigate barriers to the widespread uptake of take-home cancer medications during periods of public emergencies, particularly for high-cost drugs. Full article

(This article belongs to the Section Health Economics)

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14 pages, 2886 KiB

Open AccessArticle

Crizotinib Inhibits Viability, Migration, and Invasion by Suppressing the c-Met/PI3K/Akt Pathway in the Three-Dimensional Bladder Cancer Spheroid Model

by Byeongdo Song, Danhyo Kim, Jin-Nyoung Ho, Van-Hung Le and Sangchul Lee

Curr. Oncol. 2025, 32(4), 236; https://doi.org/10.3390/curroncol32040236 - 17 Apr 2025

Viewed by 168

Abstract

We aimed to evaluate the therapeutic potential of crizotinib, a broad-spectrum tyrosine kinase inhibitor against bladder cancer (BC) cells, based on a three-dimensional (3D) cell culture system. After proliferating cell masses (spheroids) using T24 cisplatin-naïve and T24R2 cisplatin-resistant human BC cell lines, the [...] Read more.

We aimed to evaluate the therapeutic potential of crizotinib, a broad-spectrum tyrosine kinase inhibitor against bladder cancer (BC) cells, based on a three-dimensional (3D) cell culture system. After proliferating cell masses (spheroids) using T24 cisplatin-naïve and T24R2 cisplatin-resistant human BC cell lines, the spheroids were exposed to various crizotinib concentrations in order to derive an ideal crizotinib concentration to suppress cell survival, migration, and invasion. Crizotinib suppressed cell proliferation, migration, and invasion in both T24 and T24R2 BC cell lines under a 3D spheroid model, which was more appropriate than the conventional two-dimensional cell culture model. Real-time quantitative polymerase chain reaction analysis revealed a reduced expression of E-cadherin and an enhanced expression of vimentin, suggesting EMT suppression and the subsequent suppression of tumor aggressiveness following crizotinib administration. Meanwhile, the expressions of apoptosis-related genes increased. Western blot analysis revealed that the expression levels of phosphorylated mesenchymal–epithelial transition factor (c-Met) and phosphorylated Akt decreased following crizotinib administration, suggesting that the antitumor effect of crizotinib can be associated with the inhibition of the phosphorylated activation of the c-Met/PI3K/Akt pathway. Crizotinib showed a potential antitumor effect on both cisplatin-naïve and cisplatin-resistant human BC cells, likely through c-Met-induced PI3K/Akt pathway inhibition. Full article

(This article belongs to the Section Genitourinary Oncology)

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12 pages, 980 KiB

Open AccessBrief Report

Accelerating Oncology Drug Reimbursement in Canada: Impact of the CDA-AMC Time-Limited Recommendation and pCPA Temporary Access Process

by Catherine Y. Lau, Arif Mitha and Allison Wills

Curr. Oncol. 2025, 32(4), 235; https://doi.org/10.3390/curroncol32040235 - 17 Apr 2025

Viewed by 586

Abstract

The complex pathway for new drug reimbursement in Canada has been well documented. Drugs with promising early efficacy data may receive a Notice of Compliance with Conditions (NOC/c) from Health Canada. For oncology drugs that receive NOC/c, the pathway through positive review by [...] Read more.

The complex pathway for new drug reimbursement in Canada has been well documented. Drugs with promising early efficacy data may receive a Notice of Compliance with Conditions (NOC/c) from Health Canada. For oncology drugs that receive NOC/c, the pathway through positive review by Canada’s Drug Agency (CDA-AMC) and subsequent public reimbursement can take over 500 days. To address this challenge, in September 2023, CDA-AMC announced a new Time-Limited Recommendation (TLR) category, and in parallel, the pan-Canadian Pharmaceutical Alliance (pCPA) developed a set of principles and conditions for a Temporary Access Process (pTAP). This accelerated access pathway, the first of its kind in Canada, enables patients with advanced diseases to gain timely access to promising therapies while managing the uncertainties and risks associated with early approvals. This report provides a first assessment of the impact of the TLR-pTAP process on the reimbursement timelines for oncology drugs approved with NOC/c. Methods: The time from NOC/c approvals for oncology drugs between 1 January 2023 to 31 December 2024, to first provincial listings, and the timelines of the Health Canada, CDA-AMC, and pCPA review processes, were collected and evaluated. Results: Nine oncology NOC/c were granted during the selected period, of which three products, Columvi, Akeega, and Epkinly, received provincial listings, and the median time from regulatory approvals to provincial listings is 509 days (IQ range 306–544 days). One drug, Epkinly, has elected to adopt the TLR-pTAP pathway. Compared to the conventional reimbursement pathway—including for the drug Columvi, whose therapeutic profile is similar to that of Epkinly—the new pathway reduced the time to first provincial listing by over 200 days. A stepwise analysis indicates that the most significant accelerator within the TLR-pTAP pathway is the pCPA’s prioritization and processing of the file in parallel to the CDA-AMC’s health technology assessment (HTA) review process, rather than subsequently. Electing to file the HTA submission pre-NOC could have further accelerated timelines. No acceleration in each agency’s review time was observed. Conclusions: Participation in the TLR-pTAP pathway can help mitigate concerns over uncertainties associated with novel therapies while providing timelier access for patients with life-threatening diseases. Full article

(This article belongs to the Special Issue Cost Effectiveness vs. Affordability in the Age of Targeted Drug Therapies)

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31 pages, 691 KiB

Open AccessSystematic Review

Supervised Physical Activity Interventions in Children and Adolescents with Cancer Undergoing Treatment—A Systematic Review

by Nadja Battanta, Krystyna Lange, Sabine V. Kesting, Daniela Marx-Berger, Philip Heesen, Hannah Ober, Aron Onerup, Saskia M. F. Pluijm, Eva Scheler, Emma J. Verwaaijen, Katrin Scheinemann and Maria Otth

Curr. Oncol. 2025, 32(4), 234; https://doi.org/10.3390/curroncol32040234 - 17 Apr 2025

Viewed by 241

Abstract

Background: A cancer diagnosis and its treatment often disrupt a child’s and adolescent’s normal level of physical activity, which plays a vital role in their development and health. They are therefore often less physically active during treatment than before the diagnosis or compared [...] Read more.

Background: A cancer diagnosis and its treatment often disrupt a child’s and adolescent’s normal level of physical activity, which plays a vital role in their development and health. They are therefore often less physically active during treatment than before the diagnosis or compared to healthy peers. Today, there is no comprehensive overview of the safety, feasibility, clinical effectiveness, and potentially long-lasting impact of physical activity (PA) interventions in this population. Methods: We conducted a systematic review in PubMed according to PRISMA guidelines to evaluate studies on PA interventions during cancer treatment in children and adolescents up to 25 years of age. We used the Joanna Briggs Institute’s critical appraisal tools to assess the risk of bias. Due to the heterogeneity in interventions and outcomes, we used descriptive approaches only to present the results. Results: Half of the 21 included studies were randomized controlled trials (10/21). PA interventions were found to be safe and feasible when tailored to the patient’s age, treatment phase, and clinical condition. Most studies reported improvements in physical fitness, strength, and quality of life, with some reductions in fatigue. Variability in interventions and outcomes, along with small sample sizes and heterogeneous patient populations, made it difficult to draw clear conclusions. Conclusions: PA appears to be a feasible and, in terms of injuries, safe adjunct to cancer treatment in children and adolescents. Despite promising trends, further large-scale, multicenter trials with standardized protocols are needed to better establish the long-term benefits and optimal interventions. Full article

(This article belongs to the Special Issue Feature Advancements in Section "Childhood, Adolescent and Young Adult Oncology")

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14 pages, 1082 KiB

Open AccessArticle

Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in Head and Neck Cancer Patients with Late Radiation-Associated Dysphagia: Swallowing Safety, Efficacy, and Dysphagia Phenotype

by Marco Gitto, Francesco Mozzanica, Vincenzo Porpiglia, Luca Morelli, Aurora Ninfa, Alessandro Selvagio, Sara Rocca, Nicole Pizzorni and Antonio Schindler

Curr. Oncol. 2025, 32(4), 233; https://doi.org/10.3390/curroncol32040233 - 16 Apr 2025

Viewed by 187

Abstract

Late radiation-associated dysphagia (late-RAD) remains a challenge in head and neck cancer (HNC) survivorship, despite advancements in treatment methods. Although Fiberoptic Endoscopic Evaluation of Swallowing (FEES) stands as the preferred diagnostic approach for oropharyngeal dysphagia assessment in the HNC population, current studies lack [...] Read more.

Late radiation-associated dysphagia (late-RAD) remains a challenge in head and neck cancer (HNC) survivorship, despite advancements in treatment methods. Although Fiberoptic Endoscopic Evaluation of Swallowing (FEES) stands as the preferred diagnostic approach for oropharyngeal dysphagia assessment in the HNC population, current studies lack a FEES-derived swallowing parameter characterization and phenotypic classification within this specific cohort. This study sought to employ FEES-based assessment to characterize swallowing safety and efficacy profiles, identify distinct phenotypes in HNC patients suffering from late-RAD, and examine potential correlations between safety and efficacy parameters. A retrospective analysis included twenty-four post-radiotherapy HNC patients evaluated using standardized FEES protocols across three bolus consistencies (liquid, semisolid, and solid). Swallowing safety was quantified using the Penetration–Aspiration Scale (PAS), while efficacy was measured via the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). Additionally, six distinct dysphagia phenotypes were characterized within the cohort. Propulsion deficit was the predominant phenotype (92%), followed by delayed pharyngeal phase (37.5%) and protective deficit (25%), with 46% of patients exhibiting multiple phenotypes. Unsafe swallowing occurred most frequently with liquid consistency (62.5%), while residue was most prevalent with semisolid (82.6% valleculae, 52.2% pyriform sinuses) and solid consistencies (92.3% valleculae, 53.8% pyriform sinuses). Significant correlations were found between penetration–aspiration and pharyngeal residue scores across consistencies (p < 0.05). FEES examination revealed distinct phenotypes in late radiation-associated dysphagia, with a predominance of propulsion deficit and significant interdependence between safety and efficacy parameters. Full article

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

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25 pages, 1542 KiB

Open AccessReview

Advances in Targeted and Systemic Therapy for Salivary Gland Carcinomas: Current Options and Future Directions

by Sushanth Sreenivasan, Rahim A. Jiwani, Richard White, Veli Bakalov, Ryan Moll, Joseph Liput and Larisa Greenberg

Curr. Oncol. 2025, 32(4), 232; https://doi.org/10.3390/curroncol32040232 - 16 Apr 2025

Viewed by 235

Abstract

Salivary gland carcinomas (SGCs) represent a rare and heterogeneous group of malignancies accounting for 3–6% of all head and neck cancers. While surgical resection and radiotherapy remain the standard for locoregional control, systemic treatment is indicated for recurrent or metastatic disease. Advances in [...] Read more.

Salivary gland carcinomas (SGCs) represent a rare and heterogeneous group of malignancies accounting for 3–6% of all head and neck cancers. While surgical resection and radiotherapy remain the standard for locoregional control, systemic treatment is indicated for recurrent or metastatic disease. Advances in molecular profiling have identified actionable targets such as NTRK gene fusions, HER2, immune checkpoint regulators, androgen receptors, and RET receptors. These have facilitated the development of targeted therapies, including TRK inhibitors, HER2-directed agents, and androgen receptor modulators, as well as emerging combinations of immunotherapy and chemotherapy. Despite these advancements, challenges such as resistance mechanisms and limited therapeutic efficacy persist. Overall response rates remain relatively low across most systemic therapies, reflecting a persistent unmet clinical need. This review discusses the current landscape of treatment options and explores promising clinical trials and future directions to enhance outcomes for patients with SGCs. Full article

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

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63 pages, 2086 KiB

Open AccessSystematic Review

Postmastectomy Breast Reconstruction in Patients with Non-Metastatic Breast Cancer: A Systematic Review

by Toni Zhong, Glenn G. Fletcher, Muriel Brackstone, Simon G. Frank, Renee Hanrahan, Vivian Miragias, Christiaan Stevens, Danny Vesprini, Alyssa Vito and Frances C. Wright

Curr. Oncol. 2025, 32(4), 231; https://doi.org/10.3390/curroncol32040231 - 16 Apr 2025

Viewed by 339

Abstract

Breast reconstruction after mastectomy improves the quality of life for many patients with breast cancer. There is uncertainty regarding eligibility criteria for reconstruction, timing (immediate or delayed—with or without radiotherapy), outcomes of nipple-sparing compared to skin-sparing mastectomy, selection criteria and surgical factors influencing [...] Read more.

Breast reconstruction after mastectomy improves the quality of life for many patients with breast cancer. There is uncertainty regarding eligibility criteria for reconstruction, timing (immediate or delayed—with or without radiotherapy), outcomes of nipple-sparing compared to skin-sparing mastectomy, selection criteria and surgical factors influencing outcomes of nipple-sparing mastectomy, prepectoral versus subpectoral implants, use of acellular dermal matrix, and use of autologous fat grafting. We conducted a systematic review of these topics to be used as the evidence base for an updated clinical practice guideline on breast reconstruction for Ontario Health (Cancer Care Ontario). The protocol was registered on PROSPERO, CRD42023409083. Medline, Embase, and Cochrane databases were searched until August 2024, and 229 primary studies met the inclusion criteria. Most studies were retrospective non-randomized comparative studies; 5 randomized controlled trials were included. Results suggest nipple-sparing mastectomy is oncologically safe, provided there is no clinical, radiological, or pathological indication of nipple-areolar complex involvement. Surgical factors, including incision location, may affect rates of complications such as necrosis. Both immediate and delayed reconstruction have similar long-term outcomes; however, immediate reconstruction may result in better short to medium-term quality of life. Evidence on whether radiotherapy should modify the timing of initial reconstruction or expander-implant exchange was very limited; studies delayed reconstruction after radiotherapy by at least 3 months and, more commonly, at least 6 months to avoid the period of acute radiation injury. Radiation after immediate reconstruction is a reasonable option. Surgical complications are similar between prepectoral and dual-plane or subpectoral reconstruction; prepectoral placement may give a better quality of life due to lower rates of long-term complications such as pain and animation deformity. Autologous fat grafting was found to be oncologically safe; its use may improve quality of life and aesthetic results. Full article

(This article belongs to the Section Breast Cancer)

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8 pages, 209 KiB

Open AccessPerspective

LAG3, TIM3 and TIGIT: New Targets for Immunotherapy and Potential Associations with Radiotherapy

by Camil Ciprian Mireștean, Roxana Irina Iancu and Dragoș Petru Teodor Iancu

Curr. Oncol. 2025, 32(4), 230; https://doi.org/10.3390/curroncol32040230 - 15 Apr 2025

Viewed by 316

Abstract

The combination of immunotherapy and radiotherapy has demonstrated synergistic potential, especially when a combination of immune checkpoint inhibitors (ICIs) is administered. Cytotoxic T-Lymphocyte-Associated Protein-4 (CTLA-4) inhibitors and Programmed Death-Ligand 1 (PD-L1) inhibitors or Programmed Cell Death Protein 1 (PD-1) inhibitors have been assessed [...] Read more.

The combination of immunotherapy and radiotherapy has demonstrated synergistic potential, especially when a combination of immune checkpoint inhibitors (ICIs) is administered. Cytotoxic T-Lymphocyte-Associated Protein-4 (CTLA-4) inhibitors and Programmed Death-Ligand 1 (PD-L1) inhibitors or Programmed Cell Death Protein 1 (PD-1) inhibitors have been assessed in both clinical and preclinical studies; the addition of radiotherapy activates immunomodulatory mechanisms materialized by an effect similar to “in situ” vaccination or the “abscopal” distant response of lesions outside the irradiation field. The new therapeutic targets (T cell immune-receptor with Ig and ITIM domains (TIGIT), Lymphocyte activating gene 3 (LAG-3), and T cell Ig- and mucin-domain-containing molecule-3 (TIM-3)) associated with traditional ICIs and radiotherapy open new perspectives to the concept of immuno-radiotherapy. The dynamic evaluation of T lymphocyte expression involved in the antitumor immune response, both in the tumor microenvironment (TME) and in the tumor itself, could have biomarker value in assessing the response to combination therapy with traditional and new ICIs in association with irradiation. Preclinical data justify the initiation of clinical trials in various tumor pathologies to explore this concept. Full article

(This article belongs to the Special Issue The Evolving Landscape of Precision Medicine in Radiation Oncology)

9 pages, 486 KiB

Open AccessArticle

Long-Term Outcomes in Patients with Locally Advanced and Metastatic Non-Small Cell Lung Cancer with High PD-L1 Expression

by Vesna Ćeriman Krstić, Ivan Soldatović, Milija Gajić, Natalija Samardžić, Ruža Stević, Nikola Čolić, Katarina Lukić, Biljana Šeha, Damir Radončić, Slavko Stamenić, Milan Savić, Vladimir Milenković, Brankica Milošević Maračić and Dragana Jovanović

Curr. Oncol. 2025, 32(4), 229; https://doi.org/10.3390/curroncol32040229 - 15 Apr 2025

Viewed by 270

Abstract

Before the introduction of targeted therapy and immunotherapy, patients with metastatic non-small-cell lung cancer (NSCLC) had a 5-year overall survival (OS) rate of up to 10%. After the positive results of KEYNOTE-024, pembrolizumab was approved in a first-line setting for patients with metastatic [...] Read more.

Before the introduction of targeted therapy and immunotherapy, patients with metastatic non-small-cell lung cancer (NSCLC) had a 5-year overall survival (OS) rate of up to 10%. After the positive results of KEYNOTE-024, pembrolizumab was approved in a first-line setting for patients with metastatic NSCLC and PD-L1 ≥ 50%. A small number of patients had a durable response to immunotherapy, and so far it has not been discovered who will benefit. The aim of this study was to investigate the efficacy of first-line pembrolizumab in patients with locally advanced and metastatic NSCLC with high PD-L1 expression in a real-world setting. We enrolled 35 patients with locally advanced and metastatic NSCLC who had PD-L1 ≥ 50%. Progression-free survival was 9 months, 95% CI (2.6–15.4). Overall survival was 14 months, 95% CI (0–28.5). Five-year OS rate for the whole group of patients was 20%, and the six-year OS rate was 17.2%. Immunotherapy was a revolution in the treatment of NSCLC. We still do not know which patients will benefit from immunotherapy, but patients who do respond may experience long-term outcomes. Full article

(This article belongs to the Special Issue Current State of Immunotherapy for Lung Cancer: Focusing on Real-World Evidence)

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11 pages, 1231 KiB

Open AccessArticle

Gastric Cancer in the Countryside or in the City: Does the Prognosis Change? An Analysis from the German States of Brandenburg and Berlin

by Andreas Loew, Anne von Ruesten, Constanze Schneider, René Mantke, Karsten H. Weylandt and Stephan Gretschel

Curr. Oncol. 2025, 32(4), 228; https://doi.org/10.3390/curroncol32040228 - 14 Apr 2025

Viewed by 182

Abstract

Background: Medical care structures differ between urban and rural areas. Clinical cancer registries can depict real-world care through detailed data analysis, identifying potential regional disparities and contributing to improvements in healthcare. Methods: Data from the Brandenburg–Berlin Clinical-Epidemiological Cancer Registry for the years of [...] Read more.

Background: Medical care structures differ between urban and rural areas. Clinical cancer registries can depict real-world care through detailed data analysis, identifying potential regional disparities and contributing to improvements in healthcare. Methods: Data from the Brandenburg–Berlin Clinical-Epidemiological Cancer Registry for the years of diagnosis 2017–2022 were analyzed to assess the epidemiology and real-world care of gastric cancer, including cardia. Brandenburg was compared to Berlin regarding perioperative treatment regimens. The resulting survival benefits were assessed using Kaplan–Meier and Cox regression models. Results: For the years of diagnosis 2017 to 2022, 5805 cases of gastric carcinoma were documented in the cancer registry. Survival data showed no significant differences between Berlin and Brandenburg. Preoperative therapy for cT3/cT4N0 tumors was significantly more common in Berlin (72%) than in Brandenburg (68%). Perioperative therapy was associated with a survival benefit for stages T3-/T4N+ but not for stages T1N+ or T2. The lower proportion of pre-treated T3/T4N+ patients in rural Brandenburg did not result in a significant survival difference. Conclusions: The data provide a comprehensive representation of the current state of gastric cancer care in these two regions. Gastric cancer treatment outcomes, in terms of survival, are comparable between the rural region of Brandenburg and the urban center of Berlin. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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11 pages, 212 KiB

Open AccessArticle

Prognostic and Inflammatory Differences Between Upper and Mid–Lower Rectal Cancers in Non-Metastatic Stage II–II Disease

by Fırat Mülküt, Cem Batuhan Ofluoğlu, Mustafa Kağan Başdoğan, İsa Caner Aydın, Akif Doğan and İsmail Ege Subaşı

Curr. Oncol. 2025, 32(4), 227; https://doi.org/10.3390/curroncol32040227 - 12 Apr 2025

Viewed by 243

Abstract

Background: This study aimed to compare the clinical, pathological, and biochemical characteristics of upper rectal cancer (URC) and mid–lower rectal cancer (MLRC) in stage II and III non-metastatic rectal cancer and to identify distinct prognostic factors influencing survival and recurrence. Material and Methods: [...] Read more.

Background: This study aimed to compare the clinical, pathological, and biochemical characteristics of upper rectal cancer (URC) and mid–lower rectal cancer (MLRC) in stage II and III non-metastatic rectal cancer and to identify distinct prognostic factors influencing survival and recurrence. Material and Methods: This retrospective cohort study included 100 patients with stage II and III non-metastatic rectal adenocarcinoma who underwent neoadjuvant chemoradiotherapy (nCRT) followed by curative-intent surgery between 2021 and 2024. Patients were categorized into URC (n = 53) and MLRC (n = 47) groups. Parameters analyzed included demographic factors, ASA score, surgical characteristics, pathological features (tumor stage, lymph node involvement, lymphovascular invasion (LVI), perineural invasion (PNI), tumor budding, tumor regression grade (TRG)), and biochemical markers (carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), white blood cell (WBC) count, neutrophil count, platelet count (PLT), and C-reactive protein (CRP)). One-year overall survival (OS) and disease-free survival (DFS) were analyzed using Kaplan–Meier survival curves, and Cox regression models identified independent prognostic factors. Results: Preoperative CEA levels were higher in MLRC (p = 0.05), whereas WBC count (p = 0.01), neutrophil count (p = 0.02), PLT (p = 0.01), and CRP levels (p = 0.01) were higher in URC. Pathological analysis revealed higher LVI (p = 0.04), PNI (p = 0.04), and tumor budding (p = 0.03) in MLRC. At one-year follow-up, OS rates were 82.1% (URC) vs. 80.3% (MLRC) (p = 0.85), and DFS rates were 78.6% (URC) vs. 73.4% (MLRC) (p = 0.72). Multivariate Cox regression analysis identified age (HR: 1.04, p = 0.03), ASA score (HR: 1.22, p = 0.01), CRP (HR: 1.18, p < 0.001), preoperative CEA (HR: 1.12, p = 0.02), preoperative CA19-9 (HR: 1.09, p = 0.03), LVI (HR: 1.42, p < 0.001), PNI (HR: 1.35, p = 0.02), and tumor budding (HR: 1.28, p = 0.03) as independent prognostic factors for OS. Similar trends were observed for DFS, with T stage (HR: 1.35, p = 0.01) and tumor size (HR: 1.22, p = 0.01) also being found significant. Conclusions: Inflammatory markers, tumor burden indicators (LVI, PNI, budding, tumor size, T stage), and preoperative CEA/CA19-9 were identified as significant predictors, suggesting a risk-adapted approach to rectal cancer treatment. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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22 pages, 332 KiB

Open AccessReview

Modern Treatment of Skeletal Metastases: Multidisciplinarity and the Concept of Oligometastasis in the Recent Literature

by Giulia Trovarelli, Arianna Rizzo, Felicia Deborah Zinnarello, Mariachiara Cerchiaro, Andrea Angelini, Elisa Pala and Pietro Ruggieri

Curr. Oncol. 2025, 32(4), 226; https://doi.org/10.3390/curroncol32040226 - 11 Apr 2025

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Abstract

Bone metastases are a major concern in cancer management since they significantly contribute to morbidity and mortality. Metastatic lesions, commonly arising from breast, prostate, lung, and kidney cancers, affect approximately 25% of cancer patients, leading to severe complications such as pain, fractures, and [...] Read more.

Bone metastases are a major concern in cancer management since they significantly contribute to morbidity and mortality. Metastatic lesions, commonly arising from breast, prostate, lung, and kidney cancers, affect approximately 25% of cancer patients, leading to severe complications such as pain, fractures, and neurological deficits. This narrative review explores contemporary approaches to bone metastases, emphasizing a multidisciplinary strategy and the evolving concept of oligometastatic disease. Oligometastases, defined by limited metastatic spread (1–5 lesions), offer a potential window for curative treatment through aggressive interventions, including stereotactic ablative radiotherapy and resection surgery. Tumor boards, integrating systemic therapies with local interventions, are crucial to optimize treatment. Despite promising results, gaps remain in defining optimal treatment sequences and refining patient selection criteria. Future research should focus on personalized approaches, leveraging biomarkers and advanced imaging to enhance outcomes and the quality of life in patients with bone metastases. Full article

(This article belongs to the Special Issue 2nd Edition: Treatment of Bone Metastasis)

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Open AccessSystematic Review

A Systematic Review of Cost-Effectiveness Studies on Pancreatic Cancer Screening

by Diedron Lewis, Laura Jiménez, Kelvin K. Chan, Susan Horton and William W. L. Wong

Curr. Oncol. 2025, 32(4), 225; https://doi.org/10.3390/curroncol32040225 - 11 Apr 2025

Viewed by 239

Abstract

Background: Pancreatic cancer (PC) is among the deadliest types of cancer globally. While early detection helps avert adverse outcomes, screening is only recommended for individuals at high risk, specifically those with familial and/or genetic predispositions. The objectives of this study are to systematically [...] Read more.

Background: Pancreatic cancer (PC) is among the deadliest types of cancer globally. While early detection helps avert adverse outcomes, screening is only recommended for individuals at high risk, specifically those with familial and/or genetic predispositions. The objectives of this study are to systematically review primary studies on the cost-effectiveness of PC screening and to identify the critical factors that influence cost-effectiveness. Methods: This systematic review was performed using PRISMA guidelines. Economic evaluation studies on PC screening were identified from searches on the SCOPUS and PubMed databases. The quality of reporting of the selected articles was assessed according to CHEERS 2022. Using predefined inclusion and exclusion criteria, two reviewers conducted the title–abstract review, full-text review, and data extraction to select relevant articles. The authors’ consensus was used to settle disagreements. The primary outcome was the incremental cost-effectiveness ratio, measured by cost per quality-adjusted life year and cost per life year saved. Results: Nine studies were selected for the final review. Most studies demonstrated that one-time screening for PC among high-risk individuals was cost-effective compared with no screening, while others found annual screening to also be cost-effective. High-risk was generally defined as having a >5% lifetime risk of PC and included individuals with either familial pancreatic cancer (FPC) or genetic susceptibility syndromes such as Peutz–Jeghers Syndrome, hereditary pancreatitis, hereditary non-polypoid colorectal cancer syndrome, familial adenomatous polyposis, and BRCA2 mutations. Individuals with new-onset diabetes (NOD) were also considered high-risk. Screening using mainly endoscopic ultrasound was cost-effective among FPC individuals and those with genetic syndromes. Risk-based screening was also cost-effective among patients with NOD. Conclusion: Screening for PC is cost-effective among selected high-risk individuals. However, cost-effectiveness depends on epidemiological factors, cost, the diagnostic performance of screening tools, and the overall design of studies. Full article

(This article belongs to the Section Health Economics)

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Open AccessArticle

Folliculin (FLCN) in Thyroid Tumors: Incidence, Significance, and Role as a Driver Gene and Secondary Alteration

by Faisal A. Hassan, Camryn Slone, Robert J. McDonald, Julie C. Dueber, Adeel M. Ashraf, Melina J. Windon, Oliver J. Fackelmayer, Cortney Y. Lee, Therese J. Bocklage and Derek B. Allison

Curr. Oncol. 2025, 32(4), 224; https://doi.org/10.3390/curroncol32040224 - 11 Apr 2025

Viewed by 218

Abstract

Thyroid carcinomas are driven by diverse molecular alterations, but the tumor suppressor gene folliculin (FLCN), best known for its role in Birt–Hogg–Dubé (BHD) syndrome, has received limited attention in thyroid tumors. Here, we describe two thyroid tumors with pathogenic FLCN alterations—one [...] Read more.

Thyroid carcinomas are driven by diverse molecular alterations, but the tumor suppressor gene folliculin (FLCN), best known for its role in Birt–Hogg–Dubé (BHD) syndrome, has received limited attention in thyroid tumors. Here, we describe two thyroid tumors with pathogenic FLCN alterations—one germline and one somatic—and analyze the broader prevalence and significance of FLCN in thyroid carcinomas using multiple large sequencing datasets, including ORIEN-AVATAR. Patient 1, with a germline FLCN mutation and a history of BHD syndrome, presented with a well-circumscribed oncocytic adenoma. Molecular testing confirmed biallelic FLCN inactivation, but no additional mutations or aggressive features were observed, and the patient remained disease-free post-thyroidectomy. Patient 2 harbored a somatic FLCN mutation in an oncocytic poorly differentiated thyroid carcinoma, which exhibited extensive angioinvasion, high proliferative activity, and concurrent TP53 and RB1 mutations. The tumor progressed with metastatic disease despite multimodal treatment. Thyroid carcinomas revealed FLCN alterations in 1.1% of cases. Pathogenic mutations were rare but associated with oncocytic morphology, while homozygous deletions occurred more frequently in genomically unstable tumors, including anaplastic thyroid carcinoma. These findings suggest FLCN mutations may act as early oncogenic drivers in oncocytic thyroid neoplasms, while deletions represent secondary events in aggressive tumor evolution. The lack of FLCN coverage in standard thyroid molecular panels likely underestimates its clinical relevance. Including FLCN in genetic testing could improve tumor detection and characterization, particularly in BHD patients who may benefit from routine thyroid screening. Further studies are needed to clarify FLCN’s role in thyroid cancer pathogenesis. Full article

(This article belongs to the Special Issue 2nd Edition: Molecular Testing for Thyroid Nodules and Cancer)

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17 pages, 2725 KiB

Open AccessArticle

Computed Tomography-Based Radiomic Nomogram to Predict Occult Pleural Metastasis in Lung Cancer

by Xiaoyi Zhao, Heng Zhao, Kongxu Dai, Xiangyu Zeng, Yun Li, Feng Yang and Guanchao Jiang

Curr. Oncol. 2025, 32(4), 223; https://doi.org/10.3390/curroncol32040223 - 11 Apr 2025

Viewed by 205

Abstract

Objectives: The preoperative identification of occult pleural metastasis (OPM) in lung cancer remains a crucial clinical challenge. This study aimed to develop and validate a predictive model that integrates clinical information with chest CT radiomic features to preoperatively identify patients at risk of [...] Read more.

Objectives: The preoperative identification of occult pleural metastasis (OPM) in lung cancer remains a crucial clinical challenge. This study aimed to develop and validate a predictive model that integrates clinical information with chest CT radiomic features to preoperatively identify patients at risk of OPM. Methods: This study included 50 patients diagnosed with OPM during surgery as the positive training cohort and an equal number of nonmetastatic patients as the negative control cohort. Using least absolute shrinkage and selection operator (LASSO) logistic regression, we identified key radiomic features and calculated radiomic scores. A predictive nomogram was developed by combining clinical characteristics and radiomic scores, which was subsequently validated with data from an additional 545 patients across three medical centers. Results: Univariate and multivariate logistic regression analyses revealed that carcinoembryonic antigen (CEA), the neutrophil-to-lymphocyte ratio (NLR), the clinical T stage, and the tumor–pleural relationship were significant clinical predictors. The clinical model alone achieved an area under the curve (AUC) of 0.761. The optimal integrated model, which combined radiomic scores from the volume of interest (VOI) with the CEA and NLR, demonstrated an improved predictive performance, with AUCs of 0.890 in the training cohort and 0.855 in the validation cohort. Conclusions: Radiomic features derived from CT scans show significant promise in identifying patients with lung cancer at risk of OPM. The nomogram developed in this study, which integrates CEA, the NLR, and radiomic tumor area scores, enhances the precision of preoperative OPM prediction and provides a valuable tool for clinical decision-making. Full article

(This article belongs to the Section Thoracic Oncology)

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14 pages, 2479 KiB

Open AccessArticle

Primary Central Nervous System Tumors in Adolescents: A Population-Based Study on Epidemiology and Clinical Pathways in a Challenging Age Group

by Lucia De Martino, Patrizia Piga, Marcella Sessa, Camilla Calì, Camilla Russo, Stefania Picariello, Nicola Onorini, Pietro Spennato, Lucia Quaglietta, Maria Vittoria Donofrio, Giuseppe Cinalli, Francesco Vetrano and Fabio Savoia

Curr. Oncol. 2025, 32(4), 222; https://doi.org/10.3390/curroncol32040222 - 10 Apr 2025

Viewed by 212

Abstract

Background: Oncological care of adolescent patients is often inconsistent, as they frequently fall between pediatric and adult services. The Childhood Cancer Registry of Campania (CCRC) is the Italian largest population-based registry specializing in children 0–19 years old, with a target population of approximately [...] Read more.

Background: Oncological care of adolescent patients is often inconsistent, as they frequently fall between pediatric and adult services. The Childhood Cancer Registry of Campania (CCRC) is the Italian largest population-based registry specializing in children 0–19 years old, with a target population of approximately 1.1 million inhabitants. Material and Methods: This report presents epidemiological indicators and clinical pathways on primary brain tumors in adolescents (15–19 years) from the Campania region. Results: Over the study period (2008–2020), the cohort included 219 adolescents with newly diagnosed central nervous system (CNS) tumors with an annual average incidence rate (IR) of 48.9 cases per million/year. The 5-year observed survival rate after diagnosis of CNS tumor was 84.8%. Overall, the most common tumor site was the pituitary gland and craniopharyngeal duct, representing 22.4% of all tumors. The most frequently occurring malignant primary CNS tumor was germinoma, while the most common non-malignant tumor was pituitary adenoma. Most patients were referred to adult services and nearly half migrated outside the region to receive cancer care. Conclusions: Challenges in the care of adolescent oncology patients include limited access to specialized care, difficulties in transitioning from pediatric to adult institutions, distinct tumor biology, and the underrepresentation of adolescents in clinical trials. The care of adolescents with CNS tumors is fragmented across institutions and significant variations in practice exist between adult and pediatric practitioners. Full article

(This article belongs to the Special Issue Quality of Life and Follow-Up Care Among AYA Cancer Survivors)

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10 pages, 1674 KiB

Open AccessArticle

Developing the Understanding Palliative Care Module: A Quality Improvement Initiative Incorporating Public, Patient, and Family Caregiver Perspectives

by Patricia Biondo, Mary-Ann Shantz, Yuanjie (Bill) Zheng, Miranda Manning and Louise Kashuba

Curr. Oncol. 2025, 32(4), 221; https://doi.org/10.3390/curroncol32040221 - 10 Apr 2025

Viewed by 246

Abstract

Improving public awareness of palliative care is crucial for improving access to, and uptake of, palliative care, which has demonstrated benefits for patients and health systems. However, there is a lack of engaging, accessible educational palliative care resources designed for public audiences. As [...] Read more.

Improving public awareness of palliative care is crucial for improving access to, and uptake of, palliative care, which has demonstrated benefits for patients and health systems. However, there is a lack of engaging, accessible educational palliative care resources designed for public audiences. As part of a larger quality improvement initiative to strengthen awareness of palliative care, we developed “Understanding Palliative Care”—an innovative, online educational module incorporating best practices for defining and promoting palliative care to a public audience. An expert working group with representation from nursing, medicine, social work, instructional design, and care navigation advised on the development of the module. Incorporating the perspectives of Albertans with lived palliative care experience was deemed essential by the working group. We identified three Albertans (one patient and two family caregivers) of diverse ages and cultural backgrounds who had personally benefitted from palliative care and consented to record virtual interviews. We incorporated multiple interview segments into the module that highlight the physical, emotional, social, and spiritual support provided by palliative care. Finally, a panel of thirteen public volunteers provided feedback on the content, design, and navigation of the draft module. The Understanding Palliative Care module fills an important gap in Alberta, providing a free, online, evidence-based, and engaging educational tool to improve public awareness and understanding of palliative care. Full article

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

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Open AccessArticle

The Role of Dysphagia on Head and Neck Cancer Patients’ Quality of Life, Functional Disabilities and Psychological Distress: Outcomes of Cancer Rehabilitation from an Observational Single-Center Study

by Špela Matko, Christina Knauseder, David Riedl, Vincent Grote, Michael J. Fischer, Samuel Moritz Vorbach, Karin Pfaller-Frank, Wilhelm Frank and Thomas Licht

Curr. Oncol. 2025, 32(4), 220; https://doi.org/10.3390/curroncol32040220 - 10 Apr 2025

Viewed by 305

Abstract

Many patients with head-and-neck cancer (HNC) suffer from speech or swallowing disorders. We investigated the impact of dysphagia on health-related quality of life (HRQOL), functioning, and distress in HNC survivors, and whether cancer rehabilitation can alleviate these conditions. Before admission (T0) and at [...] Read more.

Many patients with head-and-neck cancer (HNC) suffer from speech or swallowing disorders. We investigated the impact of dysphagia on health-related quality of life (HRQOL), functioning, and distress in HNC survivors, and whether cancer rehabilitation can alleviate these conditions. Before admission (T0) and at discharge (T1) of three-week inpatient cancer rehabilitation, patient-reported outcomes were collected. HRQOL, symptoms, functioning, and psychological distress were assessed with EORTC QLQ-C30 and Hospital Anxiety and Depression Scale (HADS) questionnaires. Of 63 HNC patients, 22 had dysphagia, 23 needed no speech therapy (Control-1), and 18 needed speech therapy, but showed no symptoms of dysphagia (Control-2). Before rehabilitation, HRQOL, physical, social, and emotional functioning were significantly lower in dysphagia patients than in controls. Dysphagia patients reported more severe general symptoms including fatigue, pain, sleep disturbances, nausea/vomiting, diarrhea, and financial worries. Furthermore, the emotional and social functioning of Control-2 was significantly worse than Control-1. For all HNC patients, social, emotional, and role functioning, fatigue, nausea/vomiting, insomnia, and appetite loss significantly improved at T1. Improvements in HRQOL were most noticeable in dysphagia patients. Psychooncological counseling reduced depression in dysphagia and Control-2 patients to levels seen in the general population. In conclusion, dysphagia patients suffer severely from impaired functioning and systemic symptoms but benefit substantially from rehabilitation. Full article

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

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8 pages, 3532 KiB

Open AccessCase Report

A Rare Malignant Case of a Primary Pseudomyogenic Haemangioendothelioma of the Bone

by Annabella Di Mauro, Salvatore Tafuto, Lucia Cannella, Francesca Collina, Giovanni Neri, Ottavia Clemente, Imma D’Arbitrio, Francesca Ricci, Secondo Lastoria, Gerardo Ferrara and Annarosaria De Chiara

Curr. Oncol. 2025, 32(4), 219; https://doi.org/10.3390/curroncol32040219 - 10 Apr 2025

Viewed by 221

Abstract

Pseudomyogenic haemangioendotheliomas (PMH) are exceedingly rare, mostly occurring in soft tissue, with malignant cases even more uncommon. In this report, we present a case of a 28-year-old male initially suspected of having a fibroblastic osteosarcoma of the right femur, which was then correctly [...] Read more.

Pseudomyogenic haemangioendotheliomas (PMH) are exceedingly rare, mostly occurring in soft tissue, with malignant cases even more uncommon. In this report, we present a case of a 28-year-old male initially suspected of having a fibroblastic osteosarcoma of the right femur, which was then correctly diagnosed as a primary pseudomyogenic hemangioendothelioma of the bone with synchronous metastases to other skeletal segments. Molecular analysis through targeted RNA sequencing confirmed the correct diagnosis, revealing a fusion transcript ACTB::FOSB. To our knowledge, this is one of the few reported cases of suffering from multiple pathological fractures. The rapid skeletal progression and the onset of distant metastases in this case is highly unusual considering the typically indolent clinical course commonly reported in the literature for this tumor. Full article

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

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7 pages, 1015 KiB

Open AccessCase Report

A Rare Case of Non-Hodgkin B-Cell Lymphoma Following Invasive Lobular Carcinoma of the Breast: A Case Report

by Elisa Bertulla, Raquel Diaz, Matteo Mascherini, Marco Casaccia, Francesca Depaoli, Letizia Cuniolo, Chiara Cornacchia, Cecilia Margarino, Federica Murelli, Simonetta Franchelli, Marianna Pesce, Chiara Boccardo, Marco Gipponi, Franco De Cian and Piero Fregatti

Curr. Oncol. 2025, 32(4), 218; https://doi.org/10.3390/curroncol32040218 - 10 Apr 2025

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Abstract

The association between breast cancer and non-Hodgkin lymphoma of the spleen is extremely rare, with very few cases documented in the medical literature. We present the case of a 39-year-old woman in good health but with a family history of breast cancer, who, [...] Read more.

The association between breast cancer and non-Hodgkin lymphoma of the spleen is extremely rare, with very few cases documented in the medical literature. We present the case of a 39-year-old woman in good health but with a family history of breast cancer, who, in 2017, developed invasive lobular carcinoma in her right breast, which was treated with mastectomy followed by hormonal therapy. In 2024, she presented with a suspicious right axillary mass, suspected of recurrence, which was confirmed by fine-needle aspiration biopsy. The patient received neoadjuvant chemotherapy, followed by axillary lymph node dissection and bilateral adnexectomy. CT and PET scans showed suspicious splenic lesions suggestive of metastases. Infectious and hematological tests were negative, leading to the decision to perform laparoscopic splenectomy. Histological examination revealed follicular B-cell non-Hodgkin lymphoma. The patient is now in good general condition and is on a biannual follow-up. The case highlights the diagnostic complexity of tumor recurrences and the need to consider alternative diagnoses other than metastasis in oncological patients. Full article

(This article belongs to the Section Breast Cancer)

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11 pages, 579 KiB

Open AccessArticle

Low-Malignant-Potential Adenocarcinoma: A Histological Category with a Significantly Better Prognosis than Other Solid Adenocarcinomas at IA Stage

by Marco Chiappetta, Alessandra Cancellieri, Filippo Lococo, Elisa Meacci, Carolina Sassorossi, Maria Teresa Congedo, Qianqian Zhang, Diomira Tabacco, Isabella Sperduti and Stefano Margaritora

Curr. Oncol. 2025, 32(4), 217; https://doi.org/10.3390/curroncol32040217 - 9 Apr 2025

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Abstract

Introduction: Low-malignant-potential adenocarcinoma has been defined as a type of non-mucinous tumor, which has a total tumor size measuring ≤ 3 cm, exhibits ≥ 15% lepidic growth, lacks non-predominant high-grade patterns (≥10% cribriform, ≥5% micropapillary, ≥5% solid), has an absence of angiolymphatic or [...] Read more.

Introduction: Low-malignant-potential adenocarcinoma has been defined as a type of non-mucinous tumor, which has a total tumor size measuring ≤ 3 cm, exhibits ≥ 15% lepidic growth, lacks non-predominant high-grade patterns (≥10% cribriform, ≥5% micropapillary, ≥5% solid), has an absence of angiolymphatic or visceral pleural invasion, spread through air spaces (STAS), necrosis and >1 mitosis per 2 mm². The aim of this study is to validate, with regard to cancer-specific survival (CSS) and disease-free survival (DFS), the proposed definition of LMP adenocarcinoma in an independent external cohort of lung adenocarcinoma patients having undergone surgical resection, and having presented with a long follow-up period. Methods: Clinicopathological characteristics of patients who underwent lung resection for adenocarcinoma from 1 January 2005 to 31 December 2014 were retrospectively analyzed. Patients with ground-glass opacity (GGO) and part-solid tumors, minimally invasive adenocarcinoma (MIA), adenocarcinoma in situ (AIS), tumors ≥5 cm in size, nodal involvement and/or distant metastases, patients who underwent neoadjuvant treatment, and those who had an incomplete follow-up or a follow-up shorter than 60 months were excluded. The proposed criteria for low-malignant-potential adenocarcinoma (LMPA) were tumor size ≤ 3 cm, invasive size ≥ 0,5 cm, lepidic growth ≥ 15%, and absence of the following: mitosis (>1 per 2 mm²), mucinous subtype, angiolymphatic invasion, visceral pleural invasion, spread through air spaces (STAS) and tumor necrosis. End points were disease-free survival (DFS) and cancer-specific survival (CSS). The log-rank test was used to assess differences between subgroups. Results: Out of 80 patients meeting the proposed criteria, 14 (17.5%) had the LMPA characteristics defined. The mean follow-up time was 67 ± 39 months. A total of 19 patients died, all in the non-LMPA category, and 33 patients experienced recurrence: 4 (28.5%) with LMPA and 29 (43.9%) with non-LMPA. Log-rank analysis showed 100% 10-year CSS for patients with LMPA and 77.4% for patients without LMPA, with this difference being statistically significant (p-value = 0.047). Univariate analysis showed a significant association with the cStage (AJCC eighth edition), both for CSS (p value = 0.005) and DFS (p-value = 0.003). LMPA classification did not show a statistically significant impact on CSS and DFS, likely due to the limited number of events (CSS p-value = 0.232 and DFS p-value = 0.213). No statistical association was found for CSS and DFS with pT, the number of resected nodes (< or >10) or the number of resected N2 stations (< or >2). Conclusions: Our study confirmed the prognostic role of LMPA features, with a low risk of recurrence and a good CSS and DFS. The criteria for diagnosis are replicable and feasible for application. The clinical implications of these findings, such as pre-operative prediction and surveillance scheduling, may be the topic of future prospective studies. Full article

(This article belongs to the Special Issue The Current Status of Lung Cancer Surgery)

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11 pages, 787 KiB

Open AccessArticle

Using Invitation Letters to Increase HPV Vaccination Among Adult Women

by Kelly Bunzeluk, Laura Coulter, Donna Turner, Chaeyoon Jeong, Carla Krueger and Austin Hill

Curr. Oncol. 2025, 32(4), 216; https://doi.org/10.3390/curroncol32040216 - 9 Apr 2025

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Abstract

(1) Background: In Manitoba, most people get the HPV vaccine through a publicly funded school-based program. If they miss the school-based program, they remain eligible for the free HPV immunization program. This study explored whether invitation and reminder letters would increase HPV vaccine [...] Read more.

(1) Background: In Manitoba, most people get the HPV vaccine through a publicly funded school-based program. If they miss the school-based program, they remain eligible for the free HPV immunization program. This study explored whether invitation and reminder letters would increase HPV vaccine uptake among adult women who remained eligible for the publicly funded program. (2) Methods: Eligible individuals were randomized into three groups of 4650 women each. Intervention groups I and II were mailed an information package inviting them to be vaccinated. Six weeks later, intervention group II received a reminder letter if they remained unvaccinated. The control group received no correspondence related to HPV vaccination. Vaccination status, defined as at least one dose of an approved HPV vaccine, was calculated six months after the packages were mailed. (3) Results: Overall, 4.0% (3.4–4.6%, p < 0.0001) of individuals in intervention group II (invitation/reminder) and 2.5% (2.1–3.0%, p < 0.0001) of individuals in intervention group I (invitation) received one dose of the HPV vaccine. Compared to the control group, sending invitations/reminders and invitation packages increased the likelihood of getting at least one dose of the HPV vaccine by 4.9 times (3.4–6.9, p < 0.0001) and 3.0 times (2.1–4.4, p < 0.0001), respectively. (4) Conclusion: Sending invitation and reminder letters to unvaccinated women may be an effective and low-cost way to increase HPV vaccination coverage among adults who are eligible for the publicly funded immunization program. Full article

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

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15 pages, 640 KiB

Open AccessReview

Current Limitations of Sentinel Node Biopsy in Vulvar Cancer

by Myriam Gracia, Maria Alonso-Espías and Ignacio Zapardiel

Curr. Oncol. 2025, 32(4), 215; https://doi.org/10.3390/curroncol32040215 - 8 Apr 2025

Viewed by 263

Abstract

Background: Vulvar cancer is a rare gynecologic malignancy with increasing incidence. Lymph node status is the most critical prognostic factor, traditionally assessed through inguinofemoral lymphadenectomy, a procedure associated with significant morbidity. Sentinel lymph node biopsy (SLNB), in selected cases, has emerged as a [...] Read more.

Background: Vulvar cancer is a rare gynecologic malignancy with increasing incidence. Lymph node status is the most critical prognostic factor, traditionally assessed through inguinofemoral lymphadenectomy, a procedure associated with significant morbidity. Sentinel lymph node biopsy (SLNB), in selected cases, has emerged as a less invasive alternative with favorable oncologic outcomes. Objective: This review summarizes current evidence on the indications, technique, safety, and oncologic outcomes of SLNB in vulvar cancer, with a focus on controversial scenarios such as recurrent and larger tumors. Methods: A narrative review of PubMed-indexed studies published in English over the last 35 years was conducted. Eligible studies included original research, systematic reviews, meta-analyses, randomized controlled trials, and case-control studies. Results: SLNB is recommended for unifocal vulvar tumors < 4 cm with stromal invasion > 1 mm and clinically negative nodes. Landmark trials, including GROINSS-V-I and GOG-173, confirmed its accuracy and lower morbidity compared to lymphadenectomy. SLNB utilization has increased since its inclusion in guidelines, with a concurrent decline in lymphadenectomy rates. Combined detection techniques are mandatory, while indocyanine green (ICG) is an emerging option. Future studies should focus on refining patient selection criteria, improving detection techniques, and clarifying the implications of low-volume nodal disease to further optimize outcomes for patients with vulvar cancer. Conclusion: SLNB is a validated, minimally invasive staging approach in early-stage vulvar cancer. Further research is needed to refine its role in high-risk cases and optimize detection methods. Full article

(This article belongs to the Section Gynecologic Oncology)

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21 pages, 672 KiB

Open AccessReview

Survivorship Considerations and Management in the Adolescent and Young Adult Sarcoma Population: A Review

by Allison Gunderson, Miriam Yun, Babe Westlake, Madeline Hardacre, Nicholas Manguso and Alicia A. Gingrich

Curr. Oncol. 2025, 32(4), 214; https://doi.org/10.3390/curroncol32040214 - 3 Apr 2025

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Abstract

Soft tissue sarcoma (STS) has an 2–8% incidence for all malignant tumors in the adolescent and young adult (AYA) population, which are patients from ages 15 to 39. As most STS tumors are aggressive, they require multimodal management with surgery, radiation and chemotherapy. [...] Read more.

Soft tissue sarcoma (STS) has an 2–8% incidence for all malignant tumors in the adolescent and young adult (AYA) population, which are patients from ages 15 to 39. As most STS tumors are aggressive, they require multimodal management with surgery, radiation and chemotherapy. This article discusses the survivorship considerations in this young population of cancer patients who complete therapy. The lasting side effects include surgical and radiation-related morbidity, chemotherapy toxicity, early and late secondary effects on other organ systems, such as cardiac and endocrine dysfunction, and the development of secondary cancers. The long-term psychologic and practical impacts for those who have received a sarcoma diagnosis in the prime of their life include fertility, mental health, relationship, education and career implications. Although there is a paucity of data in some of these areas, we present existing management guidelines as available. This article serves as a comprehensive review of this wide array of treatment effects intended for all providers participating in the care of AYA sarcoma survivors, to include oncologists, primary care providers and therapists. Full article

(This article belongs to the Special Issue Quality of Life and Follow-Up Care Among AYA Cancer Survivors)

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11 pages, 436 KiB

Open AccessArticle

Incidence of Tumour Lysis Syndrome in Patients with Acute Myeloid Leukemia During Initiation of Therapy with Azacitidine and Venetoclax: A Retrospective Chart Review from a Canadian Single-Centre Perspective

by Tana Saiyin, Grace Christou, Mitchell Sabloff, Tina Crosbie, Kim-My Nguyen-Tham and Jill Fulcher

Curr. Oncol. 2025, 32(4), 213; https://doi.org/10.3390/curroncol32040213 - 2 Apr 2025

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Abstract

Azacitidine and venetoclax (Aza-Ven) are part of a new standard of care for elderly patients with Acute Myeloid Leukemia (AML) [In line with recommendations, patients with AML at our centre were routinely admitted during initiation of Aza-Ven for close monitoring for tumour lysis [...] Read more.

Azacitidine and venetoclax (Aza-Ven) are part of a new standard of care for elderly patients with Acute Myeloid Leukemia (AML) [In line with recommendations, patients with AML at our centre were routinely admitted during initiation of Aza-Ven for close monitoring for tumour lysis syndrome (TLS). However, hospitalization impacts patient experience and is a significant resource burden. The objectives of this study were to evaluate the incidence of TLS in this population and identify patients who could safely initiate therapy in our outpatient facility. Of the 48 patients who commenced Aza-Ven as inpatients, the incidence of TLS was 25% using Cairo–Bishop (CB) diagnostic criteria but was mostly due to transient increases in uric acid, phosphate or potassium that remained within the normal laboratory reference range. Using Howard diagnostic criteria, TLS incidence was only 2%. Patients who developed CB TLS had a significantly higher baseline white blood count (WBC; p = 0.01). Patients with WBC of less than 30 × 10⁹/L subsequently completed outpatient initiation of Aza-Ven (n = 15). Only one of these patients developed mild, transient TLS by CB criteria but not by Howard criteria. Our results demonstrate that a significant portion of patients could safely initiate Aza-Ven in our outpatient facility and avoid unnecessary hospitalization. Full article

(This article belongs to the Section Hematology)

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Curr. Oncol., Volume 32, Issue 4 (April 2025) – 58 articles

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