Current Oncology

15 pages, 493 KB

Open AccessArticle

Assessing Training Practices and Gaps for Staff Involved in the Delivery of Oncology Financial Navigation: A Qualitative Study

by Gaby Cordero, Maria Pisu, Shu-Fan Chen, Elizabeth Ward and Margaret I. Liang

Curr. Oncol. 2026, 33(2), 130; https://doi.org/10.3390/curroncol33020130 - 23 Feb 2026

Viewed by 650

Abstract

Financial hardship affects 30–70% of cancer patients and is associated with worse quality-of-life outcomes and higher mortality. In response, many health systems have implemented financial navigation teams to mitigate financial hardship and provide financial guidance to cancer patients. Currently, there is a lack [...] Read more.

Financial hardship affects 30–70% of cancer patients and is associated with worse quality-of-life outcomes and higher mortality. In response, many health systems have implemented financial navigation teams to mitigate financial hardship and provide financial guidance to cancer patients. Currently, there is a lack of standardization in financial navigation training. Our primary objective was to assess current training practices and gaps that may exist in critical information and tools for day-to-day operations for individuals providing financial navigation services. Our secondary objective was to supplement findings from the interviews with a web-based search for training resources that would be helpful in these roles. Semi-structured qualitative interviews were conducted over a video-based conferencing platform in the United States of America with nine individuals in varying roles related to financial navigation. Thematic analysis was conducted by investigators to identify common themes using a constant comparative method. Current financial navigation training practices were found to be less structured and comprehensive than desired, largely relying on experiential “on the job” learning. Participants expressed the need for more multi-dimensional training that covers insurance, cancer treatment and associated costs, financial resources, and an emphasis on developing soft skills to navigate the sensitive topics of cancer and cancer costs. The findings contribute to the development of more standardized trainings that incorporate dissemination of crucial financial information in a compassionate manner. A web-based search was also performed to create a compilation of available financial navigation training resources. Full article

(This article belongs to the Special Issue Health Economics in Oncology: Addressing Financial Toxicity, Value-Based Care, and Equity)

► Show Figures

Figure 1

34 pages, 1527 KB

Open AccessReview

Metabolic Vulnerabilities as a Therapeutic Target in Breast Cancer

by Sabrina Guo and Christina L. Addison

Curr. Oncol. 2026, 33(2), 129; https://doi.org/10.3390/curroncol33020129 - 23 Feb 2026

Cited by 3 | Viewed by 2247

Abstract

Metabolic reprogramming is a defining feature of breast cancer, enabling tumor cells to sustain rapid proliferation, survive under stress, and resist therapy. Key pathways including glycolysis, glutaminolysis, lipid metabolism, and one-carbon metabolism, play central roles in meeting the energetic and biosynthetic demands of [...] Read more.

Metabolic reprogramming is a defining feature of breast cancer, enabling tumor cells to sustain rapid proliferation, survive under stress, and resist therapy. Key pathways including glycolysis, glutaminolysis, lipid metabolism, and one-carbon metabolism, play central roles in meeting the energetic and biosynthetic demands of malignant cells. Enhanced glycolytic flux supports ATP generation and lactate production, while glutamine metabolism fuels the tricarboxylic acid cycle and provides nitrogen for nucleotide synthesis. Lipid metabolic pathways, particularly fatty acid synthesis, contribute to membrane biogenesis and signaling, and one-carbon metabolism driven by serine and glycine supplies methyl groups for epigenetic regulation and nucleotide production. These metabolic adaptations not only promote tumor growth but also create vulnerabilities that can be exploited therapeutically. Inhibiting these pathways has shown promise in preclinical models; however, challenges such as metabolic plasticity, tumor heterogeneity, and potential toxicity in normal tissues underscore the need for biomarker-driven strategies and rational combination therapies. Herein, we describe current knowledge of the role of these pathways in breast cancer progression, highlighting the role of key enzymes in promoting breast cancer tumor cell growth and in breast cancer prognoses. Full article

(This article belongs to the Section Breast Cancer)

► Show Figures

Figure 1

15 pages, 485 KB

Open AccessArticle

BLOSSOM Dietary Habits and 1-Year Intravesical Recurrence in High-Risk Non-Muscle-Invasive Bladder Cancer Treated with BCG

by Carlo Buonerba, Raffaele Baio, Felice Crocetto, Dario Bruzzese, Francesco Del Giudice, Antonio Nacchia, Francesco Chiancone, Concetta Ingenito, Oriana Strianese, Antonio Verde, Ferdinando Costabile, Luca Scafuri, Roberto Sanseverino, Elena Sorrentino, Vittorio Riccio, Dalila Carino, Margherita Bertoni, Federica Monaco, Paolo Verze, Teresa Di Lauro, Sisto Perdonà, Celeste Manfredi, Antonio Ruffo, Gabriele Barbato, Serena Rizzano, Sara Rizzano, Armando Pisapia, Marina Pisapia, Rossella Di Trolio, Emanuela Sergianni, Giuseppe Romeo, Francesca Cappuccio, Gennaro Sosto and Giuseppe Di Lorenzo Show full author list Hide full author list

Curr. Oncol. 2026, 33(2), 128; https://doi.org/10.3390/curroncol33020128 - 22 Feb 2026

Cited by 1 | Viewed by 1089

Abstract

Evidence on modifiable post-diagnosis factors influencing outcomes after intravesical Bacillus Calmette–Guérin (BCG) therapy for high-risk non-muscle-invasive bladder cancer (NMIBC) is limited. In this exploratory, feasibility-focused prospective multicenter cohort (March 2023–November 2024), BCG-naïve patients completed repeated interviewer-administered 24 h dietary recalls; prespecified food groups, [...] Read more.

Evidence on modifiable post-diagnosis factors influencing outcomes after intravesical Bacillus Calmette–Guérin (BCG) therapy for high-risk non-muscle-invasive bladder cancer (NMIBC) is limited. In this exploratory, feasibility-focused prospective multicenter cohort (March 2023–November 2024), BCG-naïve patients completed repeated interviewer-administered 24 h dietary recalls; prespecified food groups, selected foods, and nutrients were screened for associations with 1-year intravesical recurrence using Firth’s penalized logistic regression adjusted a priori for age, sex, and total energy intake, with false discovery rate control within each exposure family. Forty-six patients were enrolled; 41 had evaluable recurrence status, including 8 recurrences (19.5%). Participants were predominantly overweight (mean body mass index (BMI) 28.4 kg/m²) and had low adherence to a Mediterranean dietary pattern (median Mediterranean Adequacy Index 2.25). No dietary exposure met the within-family false discovery rate threshold; the smallest q-value was 0.361. Nominal inverse associations were observed for leafy green vegetables (OR per 1 SD 0.385; 95% CI 0.101–0.972) and for energy-adjusted zinc (OR 0.280; 95% CI 0.069–0.802) and magnesium intakes (OR 0.260; 95% CI 0.045–0.872), but these did not remain significant after FDR adjustment. These exploratory signals warrant replication in larger, biomarker-informed cohorts incorporating dietary biomarkers and immune profiling during BCG. Given the limited sample size and low number of recurrence events, these findings are strictly hypothesis-generating and should not be interpreted as evidence of definitive protective or risk dietary factors. Full article

(This article belongs to the Section Genitourinary Oncology)

► Show Figures

Figure 1

13 pages, 1279 KB

Open AccessArticle

Adult Patients with Philadelphia-Positive B-Cell Acute Lymphoblastic Leukemia Treated with a Pediatric-Inspired Multiagent Chemotherapy Regimen, in Combination with a TKI, Do Not Require Routine alloSCT

by Donna Zhe Sian Eng, Fatima Khadadah, Maria Agustina Perusini, Eshrak Al-Shaibani, Eshetu G. Atenafu, Aniket Bankar, Marta Davidson, Guillaume Richard-Carpentier, Dawn Maze, Karen Yee, Aaron Schimmer, Vikas Gupta, Steven Chan, Dennis Dong Hwan Kim, Andre Schuh, Mark Minden and Hassan Sibai

Curr. Oncol. 2026, 33(2), 127; https://doi.org/10.3390/curroncol33020127 - 22 Feb 2026

Viewed by 1089

Abstract

Tyrosine kinase inhibitors (TKIs) added to chemotherapy have improved outcomes of adult patients with Philadelphia-positive B-cell acute lymphoblastic leukemia (Ph+ B-ALL). These improvements initially led to a larger proportion of patients realizing allogeneic stem cell transplantation (alloSCT), long considered essential for cure, but [...] Read more.

Tyrosine kinase inhibitors (TKIs) added to chemotherapy have improved outcomes of adult patients with Philadelphia-positive B-cell acute lymphoblastic leukemia (Ph+ B-ALL). These improvements initially led to a larger proportion of patients realizing allogeneic stem cell transplantation (alloSCT), long considered essential for cure, but there has been a re-evaluation of alloSCT. At Princess Margaret Hospital (PM), adult patients with Ph+ B-ALL have been treated with a pediatric-inspired chemotherapy protocol with mostly imatinib. In the last two decades, we have witnessed many iterative changes in our approach. Here, we examine the outcomes of all Ph+ B-ALL patients treated at our institution from 2001 to 2019. During this time, there were two major protocol changes—omission of asparaginase in 2009 and discontinuation of routine referral for first complete remission (CR1) alloSCT from the early 2010s. Median follow-up was 41.13 months (range, 0.46–228.79). In total, 141 patients (91.56%) achieved CR1. Patient outcomes improved iteratively, with the best results seen in the final (2016–2019) cohort: no asparaginase, no routine alloSCT referral in CR1; 4-year overall survival (OS) and relapse-free survival (RFS) were 87.0% and 69.3%, respectively. The long-term OS in this patient group retained statistical significance in the multivariable analysis (p = 0.0176) when BCR::ABL1 molecular measurable residual disease (MRD) was considered. Full article

(This article belongs to the Section Hematology)

► Show Figures

Figure 1

10 pages, 1795 KB

Open AccessCase Report

CDX2 Expression and Fluoropyrimidine Response in Rare Non-GI Tumors: A Three-Case Series

by Riham Suleiman, Andrea Dipp Garcia, Binav Baral, Thorvardur Halfdanarson and Harry Fuentes-Bayne

Curr. Oncol. 2026, 33(2), 126; https://doi.org/10.3390/curroncol33020126 - 21 Feb 2026

Viewed by 968

Abstract

Caudal type homeobox 2 (CDX2) is an intestine-specific transcription factor that serves as a diagnostic marker of enteric differentiation and may also reflect tumor behavior and therapeutic susceptibility. Emerging evidence suggests that CDX2 expression may predict sensitivity to fluoropyrimidine-based therapy independent of tissue [...] Read more.

Caudal type homeobox 2 (CDX2) is an intestine-specific transcription factor that serves as a diagnostic marker of enteric differentiation and may also reflect tumor behavior and therapeutic susceptibility. Emerging evidence suggests that CDX2 expression may predict sensitivity to fluoropyrimidine-based therapy independent of tissue of origin. We report a retrospective case series of three patients with metastatic adenocarcinoma (aggressive variant prostate, minor salivary gland, and intestinal-type sinonasal tract) exhibiting strong CDX2 nuclear expression. In all cases, tumors were refractory to or lacked established standard systemic therapy. Treatment decisions were informed by the CDX2-positive enteric phenotype, leading to the initiation of fluoropyrimidine-based regimens. Response was assessed using PET-CT and MRI. All three patients achieved marked metabolic and clinical responses, including a sustained complete metabolic response in the prostate cancer case and durable disease control in the salivary gland and sinonasal tumors. These findings highlight CDX2 as a potential biomarker requiring validation, which may identify tumors intrinsically susceptible to fluoropyrimidines regardless of anatomical origin. CDX2 immunohistochemistry is widely available and inexpensive, and may complement genomic profiling in rare malignancies or in settings where standard treatment algorithms are limited. This report is hypothesis-generating and not intended to estimate response rates or treatment efficacy. Full article

(This article belongs to the Section Oncology Biomarkers)

► Show Figures

Figure 1

12 pages, 4684 KB

Open AccessCase Report

A Perplexing Plexopathy After Pembrolizumab Therapy in Early-Stage Triple-Negative Breast Cancer

by Toluwalogo Baiyewun, Brian McNamara, Emily Aherne, Alex James Bryan, Julie Twomey, Sorcha NiLoingsigh, Bolanle Ofi, Derek Power and Seamus O’Reilly

Curr. Oncol. 2026, 33(2), 125; https://doi.org/10.3390/curroncol33020125 - 20 Feb 2026

Cited by 1 | Viewed by 1318

Abstract

Background: In triple-negative breast cancer (TNBC), the addition of immunotherapy has significantly improved outcomes. Immune-related adverse events (irAEs) can be accelerated in patients with pre-existing autoimmune (AI) conditions. The treatment-response standardized protocol used in clinical care raises concerns about the need for right-sizing [...] Read more.

Background: In triple-negative breast cancer (TNBC), the addition of immunotherapy has significantly improved outcomes. Immune-related adverse events (irAEs) can be accelerated in patients with pre-existing autoimmune (AI) conditions. The treatment-response standardized protocol used in clinical care raises concerns about the need for right-sizing strategies. As the use of immunotherapy expands, recognizing toxicity from recurrence and optimizing response-adapted approaches are essential to balance cure with quality of survival. Case Presentation: A 38-year-old pregnant woman with a distant history of uveitis and psoriasis was discovered to have pregnancy-associated TNBC. Postnatally, she was treated with neoadjuvant chemotherapy and pembrolizumab, followed by wire-guided left breast wide local excision and sentinel lymph node biopsy of the left axilla. After surgery, residual cancer was noted. She continued adjuvant pembrolizumab and adjuvant radiotherapy 40.05 Gy/15 fr to the breast and nodes, followed by a 13.35 Gy/5 fr boost to the tumour bed (breast). Despite a persistent residual tumour, pembrolizumab was continued as per protocol in a response-agnostic manner. At the end of one year of adjuvant pembrolizumab, she developed progressive numbness and weakness in the ipsilateral arm, initially raising suspicion for local recurrence. Comprehensive MRI and PET-CT imaging did not identify recurrent tumour or new metastatic disease. Electromyography confirmed a lower-trunk brachial plexopathy without a structural cause. An immune-mediated process was diagnosed by a process of elimination. Despite treatment with 1st-line high-dose corticosteroids and 2nd-line intravenous immunoglobulin (IVIG), improvement was limited. Therapeutic plasmapheresis led to marked functional recovery and symptom resolution 20 months later. Discussion: Four main challenges are identified: (1) the diagnostic difficulty in identifying local recurrence or radiation injury from immune-related neuropathy; (2) the emerging therapeutic role of plasmapheresis in steroid-refractory irAEs; (3) the possible inconsistencies between rare toxicities observed in clinical trials vs. clinical practice; and (4) the limitations in response in adjuvant therapy, particularly in patients with coexisting AI conditions. Conclusions: Early recognition and accurate distinction from tumour recurrence, as well as support for plasmapheresis as a potential option in steroid-refractory presentations, have been shown to improve patient survival and symptom reduction. With increasing use of immunotherapy, real-world toxicity data, predictive biomarkers, and personalized treatment strategies are urgently needed to balance cure with long-term functional outcomes. Full article

(This article belongs to the Section Breast Cancer)

► Show Figures

Figure 1

23 pages, 1752 KB

Open AccessReview

Endocrine Therapy for Endometrial Carcinoma: Current Evidence, Resistance Mechanisms, and Biomarker-Driven Patient Selection

by Taro Yamanaka, Hiroshi Yoshida, Tatsunori Shimoi, Kazuki Sudo and Kan Yonemori

Curr. Oncol. 2026, 33(2), 124; https://doi.org/10.3390/curroncol33020124 - 19 Feb 2026

Cited by 2 | Viewed by 2250

Abstract

The treatment landscape for endometrial carcinoma (EC) is undergoing a paradigm shift from traditional histopathological dualism to precision medicine grounded in the Cancer Genome Atlas (TCGA) molecular classification. The “No Specific Molecular Profile” (NSMP) subgroup, the largest molecular cohort, has emerged as a [...] Read more.

The treatment landscape for endometrial carcinoma (EC) is undergoing a paradigm shift from traditional histopathological dualism to precision medicine grounded in the Cancer Genome Atlas (TCGA) molecular classification. The “No Specific Molecular Profile” (NSMP) subgroup, the largest molecular cohort, has emerged as a particularly promising target for endocrine-based strategies. While endocrine therapy (ET) has been a mainstay for over 60 years due to its favorable safety profile, its efficacy as monotherapy remains modest. This review provides a comprehensive overview of current endocrine strategies, including traditional agents like progestins and aromatase inhibitors, and focuses on novel combination therapies designed to overcome resistance. Recent clinical trials have demonstrated that integrating molecularly targeted agents, such as CDK4/6 and mTOR inhibitors, significantly improves clinical outcomes. Specifically, patients with TP53 wild-type status and CTNNB1 mutations exhibit exceptional responses to these combinations. Furthermore, we discuss the potential of next-generation selective estrogen receptor degraders (SERDs) and the importance of refining patient selection through robust predictive biomarkers. Driven by molecular insights, endocrine therapy is transitioning from a secondary palliative option into a definitive cornerstone of precision oncology, offering a personalized and effective treatment for patients with advanced or recurrent endometrial carcinoma. Full article

(This article belongs to the Section Gynecologic Oncology)

► Show Figures

Figure 1

15 pages, 697 KB

Open AccessArticle

Prognostic Value of Baseline Systemic Immune-Inflammation Index in Advanced Intrahepatic Cholangiocarcinoma Treated with First-Line Gemcitabine–Cisplatin Plus PD-L1 Inhibitor: A Single-Center Retrospective Study

by Shuan Wu, Jiawei Xu, Yan Li and Decai Yu

Curr. Oncol. 2026, 33(2), 123; https://doi.org/10.3390/curroncol33020123 - 19 Feb 2026

Viewed by 835

Abstract

Background: Gemcitabine–cisplatin (GC) combined with a programmed death-ligand 1 (PD-L1) inhibitor has become an important first-line regimen for advanced intrahepatic cholangiocarcinoma (ICC). However, overall efficacy remains modest, and inter-patient heterogeneity in outcomes is substantial, highlighting the need for simple biomarkers for pretreatment risk [...] Read more.

Background: Gemcitabine–cisplatin (GC) combined with a programmed death-ligand 1 (PD-L1) inhibitor has become an important first-line regimen for advanced intrahepatic cholangiocarcinoma (ICC). However, overall efficacy remains modest, and inter-patient heterogeneity in outcomes is substantial, highlighting the need for simple biomarkers for pretreatment risk stratification. The systemic immune-inflammation index (SII), derived from peripheral neutrophil, lymphocyte, and platelet counts, has been associated with prognosis in various malignancies, but its clinical relevance in advanced ICC treated with first-line GC plus PD-L1 inhibitor remains unclear. Aims: To evaluate the association of baseline SII with objective response and survival outcomes in patients with advanced ICC receiving first-line GC plus PD-L1 inhibitor. Methods: We retrospectively analyzed 193 consecutive patients with advanced ICC who received first-line GC plus a PD-L1 inhibitor at our center. Baseline clinicopathologic characteristics and laboratory parameters were collected, and SII was calculated as platelet count (×10⁹/L) × neutrophil count (×10⁹/L)/lymphocyte count (×10⁹/L). Receiver operating characteristic (ROC) analysis was performed to assess the discriminative ability of baseline SII for objective response and to determine an internally derived cut-off value. Patients were categorized into low- and high-SII groups accordingly. Logistic regression was used to identify factors associated with objective response rate (ORR). Progression-free survival (PFS) and overall survival (OS) were estimated by the Kaplan–Meier method and compared using the log-rank test. Multivariable Cox proportional hazards models were constructed to evaluate the independent prognostic significance of SII for PFS and OS. Results: Among the 193 patients included, 55 achieved complete or partial response and 138 had stable or progressive disease, yielding an ORR of 28.5%. Baseline SII showed good discrimination for objective response (AUC = 0.91), and the optimal cut-off value was 495.75. Patients in the low-SII group had a significantly higher ORR than those in the high-SII group (p < 0.001). Kaplan–Meier analysis demonstrated that both PFS and OS were longer in the low-SII group than in the high-SII group (median OS: 13.0 vs. 8.0 months, log-rank p < 0.001; median PFS: 8.5 vs. 6.0 months, p = 0.025). In multivariable Cox models adjusting for differentiation, CA19-9, tumor multiplicity, and distant metastasis, SII grouping remained independently associated with PFS and OS, and distant metastasis was consistently associated with increased risks of progression and death. Conclusions: Baseline SII is a readily available prognostic biomarker associated with objective response and survival in patients with advanced ICC treated with first-line GC plus PD-L1 inhibitor. Given the retrospective single-center design, the absence of a non-immunotherapy comparator cohort, and internal cut-off derivation, these findings should be interpreted as hypothesis-generating and warrant external validation. Full article

(This article belongs to the Section Oncology Biomarkers)

► Show Figures

Figure 1

20 pages, 729 KB

Open AccessReview

Estrogen Receptor-Low Positive (ER-Low) Breast Cancer: A Unique Clinical and Pathological Entity

by Gavino Faa, Eleonora Lai, Pina Ziranu, Andrea Pretta, Ekta Tiwari, Mariele Dessì, Cinzia Solinas, Giorgio Saba, Francesco Loi, Claudia Codipietro, Simona Graziano, Laura Ottelio, Massimo Dessena, Ferdinando Coghe, Jasjit S. Suri, Luca Saba and Mario Scartozzi

Curr. Oncol. 2026, 33(2), 122; https://doi.org/10.3390/curroncol33020122 - 18 Feb 2026

Cited by 5 | Viewed by 2691

Abstract

ER-low breast cancer (1–9% ER expression) represents a biologically and clinically distinct entity at the interface between ER-positive and ER-negative disease. Although traditionally managed as hormone receptor-positive, mounting evidence indicates that ER-low tumors share molecular signatures, aggressive behavior, and chemotherapeutic responsiveness with triple-negative [...] Read more.

ER-low breast cancer (1–9% ER expression) represents a biologically and clinically distinct entity at the interface between ER-positive and ER-negative disease. Although traditionally managed as hormone receptor-positive, mounting evidence indicates that ER-low tumors share molecular signatures, aggressive behavior, and chemotherapeutic responsiveness with triple-negative breast cancer. Accurate ER assessment is hindered by methodological variability and interpretative challenges, leading to potential misclassification and suboptimal treatment choices. While the benefit of endocrine therapy remains uncertain, ER-low tumors consistently show sensitivity to chemotherapy and promising responses to neoadjuvant chemo-immunotherapy, paralleling outcomes observed in triple-negative breast cancer cohorts. Emerging artificial intelligence tools, including digital pathology and multimodal deep learning, may enhance ER quantification, reduce observer variability, and enable more precise patient stratification. This review synthesizes current pathological and clinical insights into ER-low breast cancer and highlights evolving therapeutic strategies, with a forward-looking perspective on AI-driven approaches to optimize personalized treatment for this challenging subtype. Full article

(This article belongs to the Special Issue Estrogen-Receptor Low Positive (ER-Low) Breast Cancer: A New (or Old?) World to Discover)

► Show Figures

Figure 1

19 pages, 639 KB

Open AccessReview

Multimodal Cancer Therapy and Accelerated Brain Aging: Mechanisms, Biomarkers, and Clinical Consequences

by Mark Voynov, Maria Pospelova, Alexandra Nikolaeva, Varvara Krasnikova, Albina Makhanova, Olga Fionik, Konstantin Samochernykh, Tatyana Alekseeva, Stephanie E. Combs and Maxim Shevtsov

Curr. Oncol. 2026, 33(2), 121; https://doi.org/10.3390/curroncol33020121 - 18 Feb 2026

Cited by 1 | Viewed by 2020

Abstract

Advances in cancer therapy have markedly improved survival rates; however, long-term neurological sequelae represent a significant clinical challenge. Cancer treatment-related cognitive impairment (CRCI), commonly referred to as “chemobrain”, affects a substantial proportion of cancer survivors and encompasses a broad spectrum of neuropsychiatric and [...] Read more.

Advances in cancer therapy have markedly improved survival rates; however, long-term neurological sequelae represent a significant clinical challenge. Cancer treatment-related cognitive impairment (CRCI), commonly referred to as “chemobrain”, affects a substantial proportion of cancer survivors and encompasses a broad spectrum of neuropsychiatric and cognitive symptoms, including anxiety, depression, fatigue, balance disturbances, and deficits in attention, memory, processing speed, and executive function. Increasing evidence suggests that these manifestations reflect accelerated biological aging of the brain, rather than merely transient toxic effects. This review synthesizes current clinical, molecular, and neuroimaging evidence supporting the concept of accelerated brain aging associated with multimodal cancer therapy. We summarize key molecular and cellular mechanisms including oxidative stress, neuroinflammation, blood–brain barrier dysfunction, mitochondrial impairment, cellular senescence with a senescence-associated secretory phenotype, and epigenetic remodeling that overlap with physiological brain aging hallmarks. Particular attention is given to circulating molecular biomarkers of accelerated aging, such as inflammatory mediators, senescence markers, endothelial and neuronal injury indicators, and epigenetic age acceleration, and their potential translational relevance. We discuss clinical and neuropsychological data alongside structural and functional magnetic resonance imaging findings demonstrating cortical thinning, altered gyrification, white matter microstructural changes, disrupted functional connectivity, and increased brain age estimates following cancer therapy. Framing CRCI within an accelerated brain aging paradigm may improve risk stratification, guide biomarker development, and inform personalized survivorship care. Full article

► Show Figures

Graphical abstract

25 pages, 1248 KB

Open AccessGuidelines

Romanian Consensus Statement for Hormone Receptor-Positive and Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer (HR+/HER2– mBC) and Triple-Negative Metastatic Breast Cancer (mTNBC)

by Mircea Dragoș Median, Nicoleta Zenovia Antone, Simona Volovăț, Laura Mazilu, Șerban Mircea Negru, Răzvan Ovidiu Curcă, Amedeia Niță, Raluca Ileana Pătru, Andrei Ungureanu, Vlad Lupu and Cristina Marinela Oprean

Curr. Oncol. 2026, 33(2), 120; https://doi.org/10.3390/curroncol33020120 - 17 Feb 2026

Cited by 1 | Viewed by 1990

Abstract

Breast cancer (BC) is the most common malignant disease in women in Romania, with incidence and mortality rates among the highest in Europe. This consensus statement aims to ensure equitable access to care for human epidermal growth factor receptor 2-negative metastatic BC (HR+/HER2– [...] Read more.

Breast cancer (BC) is the most common malignant disease in women in Romania, with incidence and mortality rates among the highest in Europe. This consensus statement aims to ensure equitable access to care for human epidermal growth factor receptor 2-negative metastatic BC (HR+/HER2– mBC) and triple-negative mBC (mTNBC) in Romania. Between December 2024 and June 2025, a scientific board of 11 oncologists, in collaboration with the Romanian National Society for Medical Oncology (SNOMR), developed national recommendations based on ESMO/NCCN/ABC guidelines, clinical expertise, and local conditions. A modified Delphi survey was conducted among medical oncologists to evaluate acceptance of recommendations with greatest clinical impact. Key recommendations included: mandatory biopsy at metastasis with ER/PgR/HER2 retesting, HER2-low assessment, and molecular profiling (BRCA, PIK3CA, AKT1/PTEN, ESR1, plus PD-L1 testing in mTNBC); for HR+/HER2– mBC, first-line endocrine therapy plus CDK4/6 inhibitor, followed by targeted agents, chemotherapy, or antibody–drug conjugates based on progression and visceral crisis; for mTNBC, first-line immune checkpoint inhibitor plus chemotherapy in PD-L1-positive, PARP inhibitors in BRCA-positive patients, and sacituzumab-govitecan or trastuzumab-deruxtecan later; systematic toxicity monitoring; and integrated supportive and palliative care. Sixty-one oncologists completed the survey, with >90% overall agreement, suggesting broad acceptance of recommendations as Romania’s national standard for mBC care. Full article

(This article belongs to the Section Breast Cancer)

► Show Figures

Figure 1

18 pages, 734 KB

Open AccessArticle

DXA-Derived Visceral and Subcutaneous Adipose Tissue and Postmenopausal Breast Cancer Mortality

by Jennifer W. Bea, Shelby G. Ziller, Dylan Decker, Denise J. Roe, Andrew O. Odegaard, Heather M. Ochs-Balcom, Sarah M. Lima, Bette Caan, Jean Wactawski-Wende, Margaret S. Pichardo, Holly Harris and Zhao Chen

Curr. Oncol. 2026, 33(2), 119; https://doi.org/10.3390/curroncol33020119 - 17 Feb 2026

Viewed by 1010

Abstract

Background: Elevated abdominal adipose tissue at time of diagnosis is associated with breast cancer mortality. We sought to understand the association between abdominal adipose tissue (subcutaneous, SAT and visceral, VAT) assessed via dual-energy X-ray absorptiometry (DXA) and breast cancer mortality in the prevention [...] Read more.

Background: Elevated abdominal adipose tissue at time of diagnosis is associated with breast cancer mortality. We sought to understand the association between abdominal adipose tissue (subcutaneous, SAT and visceral, VAT) assessed via dual-energy X-ray absorptiometry (DXA) and breast cancer mortality in the prevention setting. Methods: Women enrolled in the Women’s Health Initiative study with baseline whole-body DXA scans were included in the study (n = 9767). Causes of death were adjudicated up to 27 years of follow-up. Competing risk models were used to examine independent associations between baseline VAT, SAT, per 100 cm², and breast cancer-specific deaths; findings were reported as sub-hazard ratios (SHR) and confidence intervals (CI). Time-varying analyses additionally included DXA at years 3 and 6. Covariates included demographic, lifestyle, and tumor factors. Results: Baseline VAT and SAT ranged from undetectable to 616.25 cm² and 55.26–952.46 cm², respectively. There were 738 incident breast cancer cases post-enrollment, and 87 breast cancer-related deaths. Median age at diagnosis was 62 years. In adjusted models, higher baseline VAT and SAT were significantly associated with higher risk breast cancer mortality (49% and 40%, respectively); time-varying models were similar. Conclusions: Higher VAT and SAT were similarly associated with breast cancer mortality in this group of postmenopausal women. Full article

(This article belongs to the Section Breast Cancer)

► Show Figures

Figure 1

17 pages, 704 KB

Open AccessArticle

Preoperative Cognitive Function and Physical Frailty Predict Decision Satisfaction and Postoperative Adherence in Older Gynecologic Oncology Patients: A Prospective Observational Study

by Celal Akdemir, Merve Konal, Mücahit Furkan Balcı, Gülin Özuyar Şimşek, Zeliha Öcal, Fatih Yıldırım, Zeynep Gül Dağlar, Serkan Karaoğlu and Muzaffer Sancı

Curr. Oncol. 2026, 33(2), 118; https://doi.org/10.3390/curroncol33020118 - 17 Feb 2026

Viewed by 1065

Abstract

With increasing life expectancy, a growing proportion of patients undergoing surgery for gynecologic cancers are older adults, underscoring the need for reliable predictors of postoperative recovery and patient engagement. Cognitive function and physical frailty are recognized determinants of surgical outcomes, yet their relative [...] Read more.

With increasing life expectancy, a growing proportion of patients undergoing surgery for gynecologic cancers are older adults, underscoring the need for reliable predictors of postoperative recovery and patient engagement. Cognitive function and physical frailty are recognized determinants of surgical outcomes, yet their relative impact on patient centered outcomes remains insufficiently explored. This prospective observational study included 68 women aged 65 years and older who underwent abdominal surgery for gynecologic malignancies. Preoperative cognitive function was assessed using the Montreal Cognitive Assessment, and physical frailty was evaluated with the Clinical Frailty Scale. Postoperative outcomes included early recovery parameters, complications, surgical decision satisfaction, and home-based adherence. Higher cognitive scores were associated with earlier mobilization, shorter hospital stay, better postoperative adherence, and greater decision satisfaction, whereas higher frailty scores were associated with delayed recovery and increased complication risk. In regression analyses, preoperative cognitive function was significantly associated with both postoperative adherence and surgical decision satisfaction, whereas physical frailty was not. These findings indicate that preoperative cognitive screening may have predictive value for patient centered recovery behaviors and decision satisfaction in this setting; however, the prediction estimates should be considered exploratory and warrant validation in larger, multicenter cohorts. Full article

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

► Show Figures

Graphical abstract

10 pages, 1025 KB

Open AccessCase Report

Primary Malignant Melanoma of the Nasolacrimal Duct Presenting Without Hemolacria: A Case Report and Literature Review

by Won Gun Kwack and Hong Jun Kim

Curr. Oncol. 2026, 33(2), 117; https://doi.org/10.3390/curroncol33020117 - 17 Feb 2026

Viewed by 1098

Abstract

Primary malignant melanoma of the nasolacrimal duct is a rare and aggressive mucosal neoplasm. Its diagnosis is frequently delayed because early symptoms often mimic benign inflammatory conditions like chronic dacryocystitis. While hemolacria is considered a hallmark sign, it is not universally present. We [...] Read more.

Primary malignant melanoma of the nasolacrimal duct is a rare and aggressive mucosal neoplasm. Its diagnosis is frequently delayed because early symptoms often mimic benign inflammatory conditions like chronic dacryocystitis. While hemolacria is considered a hallmark sign, it is not universally present. We present a case of a 78-year-old woman with a 1-year history of persistent epiphora and discharge from the left eye, without hemolacria. Initial lacrimal irrigation suggested obstruction. Computed tomography (CT) revealed a soft tissue lesion with widening of the lacrimal bony canal but without gross destruction. An incisional biopsy confirmed malignant melanoma. The patient underwent wide surgical resection, including medial maxillectomy, followed by adjuvant intensity-modulated radiotherapy (50 Gy). The tumor was BRAF wild-type. At 24 months post-treatment, the patient remains disease-free with no evidence of recurrence or metastasis. This case highlights that the absence of hemolacria should not preclude the suspicion of malignancy in refractory lacrimal obstruction. Early cross-sectional imaging and biopsy are essential for accurate diagnosis. Furthermore, this case suggests that a multimodal approach combining wide surgical excision and adjuvant radiotherapy may contribute to durable local control in selected patients. Full article

(This article belongs to the Section Dermato-Oncology)

► Show Figures

Figure 1

10 pages, 390 KB

Open AccessArticle

Characteristics, Prognosis and Reasons for Opting-Out of Treatment in Patients with Untreated Pancreatic Cancer

by Morten Ladekarl and Mogens Tornby Stender

Curr. Oncol. 2026, 33(2), 116; https://doi.org/10.3390/curroncol33020116 - 16 Feb 2026

Cited by 1 | Viewed by 978

Abstract

Background: About 40% of patients with pancreatic cancer (PC) are left untreated. Identification of the modifiable factors for opting out could increase the number eligible for treatment. Methods: We first assessed the completeness of registration. Next, we identified patients residing in the North [...] Read more.

Background: About 40% of patients with pancreatic cancer (PC) are left untreated. Identification of the modifiable factors for opting out could increase the number eligible for treatment. Methods: We first assessed the completeness of registration. Next, we identified patients residing in the North Denmark Region, included 2023/24 in the Danish Pancreas Cancer Database (DPCD), registered as “no treatment”. We supplemented register data with health record data, including reasons for opting out of treatment. Results: Registration in DPCD was complete compared to the National Clinical Cancer Database, except for one patient. Six patients had other tumors. Of a total of 91 patients, 79% were >75 years old, 2/3 were in performance status (PS) > 2, more than half were socially or physically fragile, while 42% had significant comorbidity. Only 20% were referred to an oncologist. The median overall survival was 2 months, and the 1-year survival was 6%. Clinical stage and PS were prognostic in multivariable analysis. In 70%, poor PS was a reason for opting out of treatment, while 11% declined treatment without objective reasons. Conclusions: Poor PS, frailty, or patients’ wishes explained 89% opting out of treatment. On a patient level, modifiable factors seem limited in this population. Full article

(This article belongs to the Section Gastrointestinal Oncology)

► Show Figures

Figure 1

25 pages, 7763 KB

Open AccessReview

Beyond Chordoma: A Comprehensive Review of Sacral Lesions

by Leonor Garbin Savarese, Nicolas Papalexis, Mateus de Andrade Hernandes, Giancarlo Facchini, Marco Miceli and Marcello Henrique Nogueira-Barbosa

Curr. Oncol. 2026, 33(2), 115; https://doi.org/10.3390/curroncol33020115 - 15 Feb 2026

Viewed by 2912

Abstract

The sacrum is a common site for a wide range of pathological processes, including benign and malignant tumors as well as non-neoplastic conditions. Accurate diagnosis of sacral lesions remains challenging due to overlapping imaging features and the anatomical complexity of the region. This [...] Read more.

The sacrum is a common site for a wide range of pathological processes, including benign and malignant tumors as well as non-neoplastic conditions. Accurate diagnosis of sacral lesions remains challenging due to overlapping imaging features and the anatomical complexity of the region. This review provides a comprehensive overview of sacral lesions, with emphasis on imaging characteristics, diagnostic challenges, and clinical implications. Key imaging findings are highlighted to help narrow the differential diagnosis. While certain imaging patterns may suggest specific etiologies, image-guided biopsy is often necessary for definitive diagnosis. Familiarity with the spectrum of sacral pathologies is essential for radiologists to effectively contribute to diagnosis, patient management, and multidisciplinary care. Full article

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

► Show Figures

Figure 1

16 pages, 1178 KB

Open AccessSystematic Review

Risk Factors for Delayed Leptomeningeal Dissemination in Choroid Plexus Papillomas: A Systematic Review and Illustrative Case

by Orlando De Jesus, Ricardo J. Fernández-de Thomas, Cesar Carballo-Cuello and Bryan Clampitt

Curr. Oncol. 2026, 33(2), 114; https://doi.org/10.3390/curroncol33020114 - 13 Feb 2026

Viewed by 1079

Abstract

Purpose: Choroid plexus papilloma (CPP) is a rare, benign intraventricular tumor that typically has an excellent long-term survival rate after gross total resection. Nevertheless, some patients develop delayed leptomeningeal dissemination (LMD) years after the initial diagnosis, a phenomenon that remains poorly understood. The [...] Read more.

Purpose: Choroid plexus papilloma (CPP) is a rare, benign intraventricular tumor that typically has an excellent long-term survival rate after gross total resection. Nevertheless, some patients develop delayed leptomeningeal dissemination (LMD) years after the initial diagnosis, a phenomenon that remains poorly understood. The authors encountered a case of CPP with delayed LMD 14 years after resection, which prompted this systematic review to identify potential risk factors. Methods: A systematic review was conducted according to PRISMA guidelines to identify CPP reports with subsequent delayed LMD. Studies of atypical CPP, choroid plexus carcinoma, or concurrent LMD at diagnosis were excluded. Extracted variables included demographics, tumor location, extent of resection, recurrence, proliferative index, and latency to dissemination. Results: Thirty patients developed delayed LMD after initial diagnosis. Seventeen patients underwent gross total resection, ten underwent subtotal resection, and three were unreported. Delayed LMD occurred with tumor recurrence in 14 patients. Histological transformation was observed in nine patients: eight progressed to aCPP and one to CPC. The extent of resection, recurrence, and tumor transformation were not significantly associated with delayed LMD. Conclusions: The pathogenesis and optimal treatment strategy of this phenomenon remain unclear. No significant risk factors for delayed LMD development in CPP were identified. Future studies incorporating molecular characterization are needed to clarify the mechanisms of LMD in patients with CPP and to improve risk stratification, underscoring the importance of lifelong surveillance and the integration of molecular profiling in clinical management. Full article

(This article belongs to the Section Neuro-Oncology)

► Show Figures

Figure 1

17 pages, 233 KB

Open AccessArticle

Canada Cancer Clinicians’ Perceptions of Palliative Care in Pancreatic Cancer: A National Survey

by Kamesha Valoo, Brigitte N. Durieux, Kajamathy Subramaniam, Ting Du, Samara Perez, James Downar, Karin Fink and Justin J. Sanders

Curr. Oncol. 2026, 33(2), 113; https://doi.org/10.3390/curroncol33020113 - 13 Feb 2026

Viewed by 665

Abstract

(1) Background: Pancreatic cancer causes significant morbidity and mortality, and guidelines recommend early integration of palliative care alongside active treatment. As access to palliative care is often mediated by oncology clinicians, this survey sought to understand these clinicians’ perspectives on barriers and facilitators [...] Read more.

(1) Background: Pancreatic cancer causes significant morbidity and mortality, and guidelines recommend early integration of palliative care alongside active treatment. As access to palliative care is often mediated by oncology clinicians, this survey sought to understand these clinicians’ perspectives on barriers and facilitators to clinician palliative care referral and patient palliative care access. (2) Methods: An online survey was distributed via community and academic institutions across Canada to oncology clinicians who were able to refer a pancreatic cancer patient to palliative care (e.g., oncology nurses, medical oncologists). (3) Results: Of 134 clinicians from ten provinces, almost all (97%) believe that palliative care is ‘very important’ in pancreatic cancer care. The greatest perceived barriers to patient palliative care access included patient-family reluctance to accept palliative care (73%), lack of knowledge about services (50%), and lack of support from other healthcare professionals (40%). Perceived barriers to referring included patient-family reluctance to accept palliative care (57%) and lack of available specialist services (58%). Most providers suggested patient education as a strategy to overcome barriers (85%). (4) Conclusions: Perceptions about public acceptance may preclude oncology clinicians from referring to palliative care, despite nearly universal belief in its importance. The findings highlight service and education gaps for future intervention. Full article

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

38 pages, 2496 KB

Open AccessGuidelines

Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HR+/HER2− Early Breast Cancer 2025

by Sandeep Sehdev, Anil Abraham Joy, Jean-François Boileau, Nathaniel Bouganim, Christine Brezden-Masley, Jeffrey Q. Cao, David W. Cescon, Stephen Chia, Scott Edwards, Karen A. Gelmon, Katarzyna J. Jerzak, Aalok Kumar, Kara Laing, Nathalie LeVasseur, Christine Simmons, Marc Webster, Mita Manna and on behalf of Patient Advocacy, Breast Cancer Canada

Curr. Oncol. 2026, 33(2), 112; https://doi.org/10.3390/curroncol33020112 - 12 Feb 2026

Cited by 1 | Viewed by 3165

Abstract

Hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) early breast cancer (EBC) is the most common breast cancer subtype and encompasses a biologically heterogeneous group of tumours. Endocrine therapy (ET) remains the cornerstone of treatment, but decisions regarding chemotherapy, cyclin-dependent kinase 4 [...] Read more.

Hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) early breast cancer (EBC) is the most common breast cancer subtype and encompasses a biologically heterogeneous group of tumours. Endocrine therapy (ET) remains the cornerstone of treatment, but decisions regarding chemotherapy, cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, and bone-modifying agents must be tailored to tumour biology, clinical stage, and menopausal status. REAL Canadian Breast Cancer Alliance (REAL Alliance), a pan-Canadian group of breast cancer specialists, convened to develop national clinical consensus recommendations for the systemic management of HR+/HER2− EBC. Using a structured consensus process, 28 recommendations were endorsed, spanning neoadjuvant and adjuvant systemic therapy, surgical considerations, and use of bisphosphonates. Key recommendations include the selective use of neoadjuvant chemotherapy for high-risk or locally advanced disease; genomic testing to guide chemotherapy decisions, particularly in postmenopausal patients; ET as the foundation of adjuvant therapy with intensification using CDK4/6 inhibitors in higher-risk patients; and adjuvant bisphosphonates in postmenopausal women to reduce recurrence and improve survival. These consensus recommendations provide practical, evidence-based guidance to support individualized, patient-centred management of HR+/HER2− EBC in the Canadian context. Full article

(This article belongs to the Special Issue REAL Canadian Breast Cancer Alliance Collection)

► Show Figures

Figure 1

11 pages, 458 KB

Open AccessArticle

Primary Tumor Size and Tumor–Vessel Interface Following Capecitabine and Temozolomide for Pancreatic Neuroendocrine Tumor

by Jin Guo, Kever A. Lewis, Laura Prakash, Priya Bhosale, Ajaykumar Morani, Matthew H. G. Katz, Ching-Wei D. Tzeng, Naruhiko Ikoma, Rebecca Snyder, Michael P. Kim, Chandrikha Chandrasekharan, Arvind Dasari, James C. Yao, Jeffrey E. Lee, Jessica E. Maxwell and Daniel M. Halperin

Curr. Oncol. 2026, 33(2), 111; https://doi.org/10.3390/curroncol33020111 - 12 Feb 2026

Viewed by 954

Abstract

Capecitabine/temozolomide (CAPTEM) is an established regimen for patients with metastatic pancreatic neuroendocrine tumors (PanNET) that is being increasingly used for tumor volume reduction in patients with borderline anatomically resectable disease. We sought to understand the response of the primary tumor, defined as changes [...] Read more.

Capecitabine/temozolomide (CAPTEM) is an established regimen for patients with metastatic pancreatic neuroendocrine tumors (PanNET) that is being increasingly used for tumor volume reduction in patients with borderline anatomically resectable disease. We sought to understand the response of the primary tumor, defined as changes in the tumor–vascular interface (TVI). This is a retrospective, single-institution study of patients with locally advanced or metastatic PanNET treated with CAPTEM between 2010 and 2020. RECISTv1.1 measurements and TVI assessments of the primary tumor were performed on pre- and post-therapy images. Patients with locally advanced or metastatic PanNET at presentation (n = 47) were included. CAPTEM was given for a median of 11 cycles. The most common site of metastatic disease was the liver (n = 38). An objective radiographic response in the primary tumor was observed in 6.4% (95% CI 1.7–18.6%) with clinical benefit in 70.2% (95% CI 54.9–82.2%). TVI was modified from >180° to ≤180° in 16.2% (95% CI 6.0–45.5%). Paired analysis of patients pre- and post-CAPTEM did not demonstrate a statistically significant shift in TVI with treatment (p = 0.134). A total of four patients had a change from an unresectable primary tumor to an anatomically resectable tumor following CAPTEM. In patients with locally advanced or metastatic PanNET, treatment with CAPTEM is associated with low radiographic response rates and changes in TVI. The degree to which these changes may correlate with surgical resection rates or R0 resections is not known. Extending these investigations in a cohort of PanNET patients offered CAPTEM for neoadjuvant intent could be helpful to understand whether these phenomena persist in that context. Full article

(This article belongs to the Special Issue Surgical Management of Patients with Hepatobiliary and Pancreatic Malignancies)

► Show Figures

Figure 1

15 pages, 235 KB

Open AccessArticle

Understanding Patients’ Preferences for Discussing Sexuality After Surgery—A Qualitative Study of Sexuality and Body Image in Women with Ovarian Cancer

by Julia Rosa Stöckl, Marlene M. Lee, Jalid Sehouli and Adak Pirmorady-Sehouli

Curr. Oncol. 2026, 33(2), 110; https://doi.org/10.3390/curroncol33020110 - 12 Feb 2026

Viewed by 1209

Abstract

Background: Aspects of sexuality are often deprioritized or overlooked during the treatment of women with ovarian cancer, despite the profound physical and psychosocial impact of surgical and oncological therapies. This study aimed to explore experiences of sexuality and body image in women with [...] Read more.

Background: Aspects of sexuality are often deprioritized or overlooked during the treatment of women with ovarian cancer, despite the profound physical and psychosocial impact of surgical and oncological therapies. This study aimed to explore experiences of sexuality and body image in women with ovarian cancer during the peri- and postoperative period. Methods: This qualitative exploratory study was based on twelve semi-structured, in-depth interviews with women aged ≥18 years diagnosed with ovarian cancer. Interviews were conducted in person or by telephone, transcribed verbatim, and analyzed using qualitative content analysis according to Kuckartz with MAXQDA 24.11. Results: Participants described substantial changes in sexuality and body image throughout their disease trajectory. Participants emphasized a lack of attention to sexual health and well-being in ovarian cancer care and expressed a need for timely and sensitive dialogue with medical professionals, social support systems, and with themselves regarding sexuality and intimacy. Conclusions: Sexuality emerged as a key factor for overall well-being and empowerment in women with ovarian cancer, regardless of age or relationship status. The findings suggest that sexuality-related concerns are oftentimes overlooked in clinical care and may negatively influence recovery. Greater awareness and a holistic, patient-centered perspective may help support sexual health and well-being throughout the disease trajectory. Full article

13 pages, 588 KB

Open AccessArticle

by Filip Marković, Mihailo Stjepanović and Milica Kontić

Curr. Oncol. 2026, 33(2), 109; https://doi.org/10.3390/curroncol33020109 - 12 Feb 2026

Viewed by 899

Abstract

In metastatic NSCLC with high PD-L1 expression (TPS ≥ 50%), pembrolizumab monotherapy yields durable benefit in a subset of patients. Immune-related thyroid dysfunction (irTD) is common during PD-1/PD-L1 blockade, but its predictive value remains uncertain. We conducted a retrospective, single-center study including 363 [...] Read more.

In metastatic NSCLC with high PD-L1 expression (TPS ≥ 50%), pembrolizumab monotherapy yields durable benefit in a subset of patients. Immune-related thyroid dysfunction (irTD) is common during PD-1/PD-L1 blockade, but its predictive value remains uncertain. We conducted a retrospective, single-center study including 363 patients with metastatic NSCLC, PD-L1 TPS ≥ 50%, and no actionable oncogenic drivers treated with first-line pembrolizumab. Thyroid function tests were performed at baseline and every six weeks. irTD was defined based on laboratory abnormalities with or without clinical symptoms and classified as early onset (≤90 days) or late onset (>90 days). Progression-free survival (PFS) was estimated using Kaplan–Meier methods and compared using log-rank tests. Cox proportional hazards models included irTD as a time-varying covariate. Landmark analyses at 3 and 6 months reduced immortal-time bias. Events were graded according to CTCAE v5.0. Among 363 eligible patients, irTD occurred in 110 (30.3%); median onset was 114 days (range 21–550). Median cohort PFS was 9.8 months (95% CI 7.26–12.34). Patients with irTD had significantly longer PFS than those without irTD: 26.33 (95% CI 19.09–33.57) vs. 6.16 months (95% CI 4.70–7.63), with an HR of 0.378 (95% CI 0.280–0.511; p < 0.001). Landmark analyses confirmed benefit at 3 months (28.4 vs. 13.7 months; HR 0.490, p < 0.001) and 6 months (29.0 vs. 20.5 months; HR 0.587, p < 0.001). PFS did not differ by irTD timing (early vs. late; HR 0.926, p = 0.682). Poor ECOG PS (≥2) was associated with worse outcomes and a lower incidence of irTD. We found that irTD is common, clinically manageable, and strongly associated with improved PFS in PD-L1-high metastatic NSCLC treated with pembrolizumab. Thyroid dysfunction may serve as a feasible on-treatment biomarker of effective immune activation, warranting further prospective validation. Full article

(This article belongs to the Section Thoracic Oncology)

► Show Figures

Figure 1

9 pages, 1292 KB

Open AccessCase Report

A Novel Three-Dimension Printed Individualized Curved-Needle-Based Interstitial Brachytherapy for Re-Irradiation in Uterine Fundus-Involving Recurrent Cervical Cancer: A Case Report

by Yangyi Zhang, Jie Zhang, Meiling Zhong, Lang Yu, Chunli Luo, Junfang Yan and Ke Hu

Curr. Oncol. 2026, 33(2), 108; https://doi.org/10.3390/curroncol33020108 - 12 Feb 2026

Viewed by 695

Abstract

Background: Re-irradiation in recurrent cervical cancer presents significant therapeutic challenges, particularly in those with a short interval since prior treatment. Brachytherapy is an ideal re-irradiation method, but regular intracavitary brachytherapy combined with interstitial brachytherapy (ISBT) is restricted by some challenging tumor anatomical locations, [...] Read more.

Background: Re-irradiation in recurrent cervical cancer presents significant therapeutic challenges, particularly in those with a short interval since prior treatment. Brachytherapy is an ideal re-irradiation method, but regular intracavitary brachytherapy combined with interstitial brachytherapy (ISBT) is restricted by some challenging tumor anatomical locations, which can be optimized through a three-dimensional (3D)-printed curved-needle ISBT system. Case Presentation: A 41-year-old woman diagnosed with cervical mucinous adenocarcinoma developed central pelvic relapse, with tumor extension to the uterine fundus, within two years after completing standard concurrent chemoradiotherapy (CCRT). The patient subsequently received 3D-printed individualized curved-needle-based, MRI-guided adaptive ISBT, in combination with external beam radiotherapy (EBRT) and chemotherapy. This comprehensive treatment approach achieved 45 months of overall survival (OS), 37 months of local control (LC) and progression-free survival (PFS) with grade 3 proctitis and grade 3 cystitis and no fistulation or perforation. Conclusions: The 3D-printed individualized curved-needle ISBT is a re-irradiation option that provides satisfactory LC and prolonged survival with acceptable adverse effects for recurrent tumors located in the distal uterine fundus in cervical cancer. This technique is particularly valuable when intracavitary and traditional interstitial applicators are unsuitable due to the unique location of the tumor. Full article

(This article belongs to the Section Gynecologic Oncology)

► Show Figures

Figure 1

15 pages, 717 KB

Open AccessSystematic Review

SMARCA4-Deficient Carcinomas of the Small Intestine: A Systematic Review

by Aaqid Syed, Yanis Boumber and Midhun Malla

Curr. Oncol. 2026, 33(2), 107; https://doi.org/10.3390/curroncol33020107 - 10 Feb 2026

Cited by 1 | Viewed by 1557

Abstract

Purpose: SMARCA4-deficient carcinomas are rare, aggressive malignancies characterized by loss of BRG1, a core component of the SWI/SNF chromatin remodeling complex. These typically arise in the chest, but recent case reports suggest rare involvement of the gastrointestinal tract, particularly the small intestine. [...] Read more.

Purpose: SMARCA4-deficient carcinomas are rare, aggressive malignancies characterized by loss of BRG1, a core component of the SWI/SNF chromatin remodeling complex. These typically arise in the chest, but recent case reports suggest rare involvement of the gastrointestinal tract, particularly the small intestine. This review aims to consolidate the available literature on SMARCA4-deficient carcinomas of the small intestine, highlighting their clinical, histopathological, molecular, and therapeutic features. Design: A systematic review of PubMed was conducted through March 2025 to identify all published cases of primary SMARCA4-deficient carcinomas of the small intestine. Inclusion criteria required immunohistochemical or molecular confirmation of SMARCA4/BRG1 loss. Studies describing metastases, non-small intestine primaries, or lacking molecular data were excluded. Ten eligible cases were analyzed in detail. Results: Patients were predominantly male (9 out of 10) with a median age of 54 years. Most carcinomas arose in the duodenum and patients frequently presented with nonspecific symptoms and advanced-stage disease. Histologically, tumors demonstrated undifferentiated or rhabdoid features with high mitotic activity and extensive necrosis. Immunohistochemistry confirmed loss of SMARCA4, while several cases also showed SMARCA2 loss. Molecular profiling revealed congruent mutations in TP53 and CTNNB1, among oncogenic drivers. While some patients with localized disease achieved prolonged survival after surgery and adjuvant chemotherapy, those with metastatic disease had limited responses to immune checkpoint inhibitors, despite PD-L1 positivity in a subset. Overall survival ranged from 2 to 29 months. Conclusions: SMARCA4-deficient carcinomas of the small intestine represent a distinct, high-grade malignancy with poor prognosis and limited therapeutic options. Prompt recognition, SMARCA4 testing, and referral to specialized centers are essential. Prospective studies are needed to guide therapy and explore targeted approaches in this challenging carcinoma subtype. Full article

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

► Show Figures

Figure 1

36 pages, 1443 KB

Open AccessGuidelines

Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HR+/HER2− Metastatic Breast Cancer 2025

by Katarzyna J. Jerzak, Aalok Kumar, Jean-François Boileau, Nathaniel Bouganim, Christine Brezden-Masley, Jeffrey Q. Cao, David W. Cescon, Stephen Chia, Scott Edwards, Anil Abraham Joy, Kara Laing, Nathalie LeVasseur, Sasha Lupichuk, Sandeep Sehdev, Christine Simmons, Marc Webster, Karen A. Gelmon, Mita Manna and on behalf of patient advocacy, Breast Cancer Canada

Curr. Oncol. 2026, 33(2), 106; https://doi.org/10.3390/curroncol33020106 - 9 Feb 2026

Cited by 4 | Viewed by 4003

Abstract

Hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) breast cancer accounts for approximately two-thirds of all breast cancers. The treatment landscape for HR+/HER2− metastatic breast cancer has evolved in recent years, with multiple new therapies demonstrating clinical efficacy and improved [...] Read more.

Hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) breast cancer accounts for approximately two-thirds of all breast cancers. The treatment landscape for HR+/HER2− metastatic breast cancer has evolved in recent years, with multiple new therapies demonstrating clinical efficacy and improved patient outcomes. To provide evidence-informed guidance on best practices in the management of patients with HR+/HER2− metastatic breast cancer in Canada, consensus recommendations were developed by Research Excellence, Active Leadership Canadian Breast Cancer Alliance (REAL Alliance), a standing nucleus committee with both clinical–academic oncologists from across Canada and representatives from Breast Cancer Canada, a patient advocacy organization. Recommendations were generated using a modified Delphi approach involving up to three anonymous voting rounds, with a predefined consensus threshold of 75%. These consensus recommendations offer guidance on optimal therapeutic strategies for HR+/HER2− metastatic breast cancer within the Canadian landscape, including integration of precision oncology and targeted therapies, optimal sequencing of therapies, and the importance of balancing the benefits of treatments with patient quality of life and preferences. Full article

(This article belongs to the Special Issue REAL Canadian Breast Cancer Alliance Collection)

► Show Figures

Figure 1

8 pages, 945 KB

Open AccessCase Report

Primary Renal Neuroendocrine Tumor: Diagnostic Challenges in a Rare Entity—A Case Report

by Raphaela D. Lewetag, Katharina Kluthe, Nils F. Trautwein, Ulrich M. Lauer, Christian la Fougère, Bence Sipos, Lars Zender, Clemens Hinterleitner, Stephan Singer and Martina Hinterleitner

Curr. Oncol. 2026, 33(2), 105; https://doi.org/10.3390/curroncol33020105 - 6 Feb 2026

Viewed by 1865

Abstract

Neuroendocrine neoplasms (NENs) represent a rare, heterogeneous group of malignancies. Within this tumor entity, primary renal neuroendocrine tumors (PRNETs) are exceedingly rare, with only 160 cases reported worldwide. Due to the absence of native neuroendocrine cells in the renal parenchyma, their cellular origin [...] Read more.

Neuroendocrine neoplasms (NENs) represent a rare, heterogeneous group of malignancies. Within this tumor entity, primary renal neuroendocrine tumors (PRNETs) are exceedingly rare, with only 160 cases reported worldwide. Due to the absence of native neuroendocrine cells in the renal parenchyma, their cellular origin remains unclear. Clinical and diagnostic challenges are reflected by the low incidence, non-specific clinical presentation, resemblance to common renal neoplasms, and the need for specialized histopathological diagnostic examination. Here, we present the case of a 61-year-old female with an incidentally diagnosed left-sided PRNET in September 2024. This case highlights the diagnostic complexity of PRNET and, importantly, underscores its genomic heterogeneity. It demonstrates a lack of typical renal cell carcinoma (RCC) or common NEN-associated gene alterations, emphasizing their unique molecular landscape. Full article

(This article belongs to the Section Genitourinary Oncology)

► Show Figures

Figure 1

11 pages, 561 KB

Open AccessArticle

Brain Tumor Care in Relation to Patient Age—An Observational Study Between Years 2016 and 2022 in a Nationwide Cohort in Germany

by Frederic Bold, Gerardo Rico Gonzalez, Rüdiger Gerlach, Oliver Heese, Steffen K. Rosahl, Michael Stoffel, Juraj Kukolja, Frederick Palm, Emilia Machado Musri, Ali Allam, Ralf Kuhlen, Julius Dengler, Sven Hohenstein, Andreas Bollmann and Nora F. Dengler

Curr. Oncol. 2026, 33(2), 104; https://doi.org/10.3390/curroncol33020104 - 5 Feb 2026

Viewed by 875

Abstract

As societies continue to age, brain tumors increasingly affect older patients. Still, large-scale evidence on whether the relationship between age and brain tumor has been evolving over time is scarce. We examined longitudinal trends among different age groups of patients with brain tumors [...] Read more.

As societies continue to age, brain tumors increasingly affect older patients. Still, large-scale evidence on whether the relationship between age and brain tumor has been evolving over time is scarce. We examined longitudinal trends among different age groups of patients with brain tumors at 78 German hospitals. Two time periods were compared as follows: phase 1 (1 January 2016–31 December 2019; pre-pandemic) and phase 2 (1 January 2020–31 December 2022; pandemic). Patients were categorized as non-elderly (<65 years) or elderly (≥65 years), and according to 10-year age brackets. The clinical condition was quantified using the Elixhauser Comorbidity Index (ECI) and the Hospital Frailty Risk Score (HFRS). Among the 20,005 patients included, changes in characteristics of non-elderly/elderly patients over time behaved similarly, with improvements in ECI (19.3 to 18.4/15.2 to 14.3; each p < 0.01) and HFRS (2.1 to 1.6/4.7 to 4.1; each p < 0.01), and increases in rates of brain tumor resection (26.1% to 31.8%/22.7% to 27.8%; each p < 0.01). Only patients aged 75–84 years did not follow any of those trends. Over the examined 7-year period, general trends in brain tumor care in elderly subjects resembled those observed in non-elderly patients, except for those aged 75–84 years. Full article

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

► Show Figures

Figure 1

19 pages, 565 KB

Open AccessReview

Predictors of Response and Mechanisms of Resistance to Antibody Drug Conjugates in Urothelial Carcinoma

by Jing Huang, Ademola Ojo and Bobby Liaw

Curr. Oncol. 2026, 33(2), 103; https://doi.org/10.3390/curroncol33020103 - 5 Feb 2026

Cited by 2 | Viewed by 2568

Abstract

Antibody–drug conjugates (ADCs) have reshaped the treatment landscape of urothelial carcinoma (UC) by enabling selective delivery of highly potent cytotoxic agents to tumor cells. Enfortumab vedotin, sacituzumab govitecan, and HER2-directed ADCs have demonstrated meaningful clinical activity across metastatic and earlier disease settings, with [...] Read more.

Antibody–drug conjugates (ADCs) have reshaped the treatment landscape of urothelial carcinoma (UC) by enabling selective delivery of highly potent cytotoxic agents to tumor cells. Enfortumab vedotin, sacituzumab govitecan, and HER2-directed ADCs have demonstrated meaningful clinical activity across metastatic and earlier disease settings, with enfortumab vedotin plus pembrolizumab now established as a first-line standard of care. Despite these advances, therapeutic responses remain heterogeneous, and resistance frequently limits durability. This review summarizes current knowledge on predictors of response and mechanisms of resistance to ADCs in UC, highlighting the roles of target antigen expression and heterogeneity, genomic alterations, payload sensitivity, drug efflux transporters, and tumor microenvironmental factors. We discuss emerging biomarkers beyond antigen abundance, patterns of cross-resistance and treatment sequencing, and evolving strategies to overcome resistance, including next-generation ADC design and rational combination therapies. Advancing biomarker-driven patient selection and addressing mechanisms of resistance will be critical to maximizing the durability and clinical impact of ADCs in urothelial carcinoma. Full article

(This article belongs to the Special Issue Recent Advances in Immune Checkpoint Inhibition and Antibody Drug Conjugates in Urothelial Carcinoma)

► Show Figures

Graphical abstract

12 pages, 528 KB

Open AccessArticle

People Living with HIV Eligibility in Canadian Cancer Clinical Trials

by Maria F. Comelles, Santiago Perez-Patrigeon, Tessa Senneker, Anna Johnson, Lisa K. Hicks, Lynda Balneaves, Bingshu E. Chen and Annette E. Hay

Curr. Oncol. 2026, 33(2), 102; https://doi.org/10.3390/curroncol33020102 - 5 Feb 2026

Cited by 1 | Viewed by 1036

Abstract

Background: People living with HIV (PLWH) have historically been excluded from cancer clinical trials, prompting the 2017 ASCO–Friends of Cancer Research recommendations to limit unjustified exclusions and promote equitable access. This study evaluated how Canadian Cancer Trials Group (CCTG) protocols align with these [...] Read more.

Background: People living with HIV (PLWH) have historically been excluded from cancer clinical trials, prompting the 2017 ASCO–Friends of Cancer Research recommendations to limit unjustified exclusions and promote equitable access. This study evaluated how Canadian Cancer Trials Group (CCTG) protocols align with these recommendations. Methods: We conducted a cross-sectional review of CCTG active trial protocols, abstracting HIV eligibility language and trial characteristics, and assessing associations using Chi-square tests. Results: Of 136 trials activated between 1999 and 2025, 81.6% involved solid tumors, 63.2% systemic therapy interventions, and 61.5% phase III designs. PLWH were included, not mentioned or excluded in 49/136 (36%), 55/136 (40.4%) and 32/136 (23.5%) respectively, with justification in 7/32 (21.9%). In multivariable analyses, exclusion was more likely in trials of immune checkpoint blockade therapy (p = 0.039) and those with industry support (p = 0.014). Adjusted models showed that both industry sponsorship and immune checkpoint blockade independently reduced HIV trial inclusion. Conclusions: Most CCTG-associated trials were inclusive or neutral toward PLWH; however, a proportion still excluded them, often without justification. This first national assessment evaluating adoption of ASCO Friends of Cancer Research–HIV guidance establishes a Canadian benchmark for equitable trial design and future research as both cancer and HIV therapies continue to evolve. Full article

► Show Figures

Figure 1

16 pages, 1192 KB

Open AccessArticle

Role of HER2 in Response to Neoadjuvant Endocrine Therapy in Luminal Breast Cancer

by Celia del Monte, Covadonga Martí, Elena Rodríguez, Elisa Moreno-Palacios, Laura Frías, Marcos Meléndez, Adolfo Loayza, Laura Yébenes and José Ignacio Sánchez-Méndez

Curr. Oncol. 2026, 33(2), 99; https://doi.org/10.3390/curroncol33020099 - 4 Feb 2026

Cited by 1 | Viewed by 854

Abstract

Purpose: Recently, authors have shown increasing interest in the emerging HER2-low subtype in breast cancer. These tumors are currently classified and treated as HER2-negative tumors. Neoadjuvant endocrine therapy (NET) has been used to achieve tumor downstaging and assess treatment response in postmenopausal [...] Read more.

Purpose: Recently, authors have shown increasing interest in the emerging HER2-low subtype in breast cancer. These tumors are currently classified and treated as HER2-negative tumors. Neoadjuvant endocrine therapy (NET) has been used to achieve tumor downstaging and assess treatment response in postmenopausal women with low-grade luminal HER2-negative tumors. This study aimed to determine whether the response to NET was affected by low levels of HER2 expression in luminal tumors. Methods: The study was a single-centered retrospective investigation. Data were gathered from the medical records of patients from 2017 to 2023. All patients had luminal HER2-negative tumors and were treated with NET and subsequent surgery. Results: In total, 175 tumors were analyzed; 24.0% of the tumors were HER2-zero, 48.0% were HER2-low 1+, and 28.0% were HER2-low 2+. No significant differences were found when assessing NET response between the three groups, nor when evaluating tumor features. Response to NET was influenced by estrogen receptor levels, histological subtype and histological grade at diagnosis, Ki67 levels at interim biopsy, and NET duration. No differences were found for progression-free survival (PFS) or overall survival (OS) between HER2 groups. The group with Ki67 ≤ 10% at interim biopsy had longer PFS than the Ki67 > 10% group (p < 0.05). No differences for OS were found between these groups. Conclusions: Response to NET was not influenced by low levels of HER2 expression in luminal tumors when compared to HER2-zero tumors. PFS was longer for patients who had lower Ki67 levels at interim biopsy after NET. Full article

(This article belongs to the Section Breast Cancer)

► Show Figures

Graphical abstract

Journal Menu

Journal Browser

Curr. Oncol., Volume 33, Issue 2 (February 2026) – 65 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI