Current Oncology

10 pages, 2482 KiB

Open AccessArticle

Trajectories of Cancer Antigen 125 (CA125) Within 3 and 6 Months After the Initiation of Chemotherapy Treatment for Advanced Ovarian Cancer and Clinical Outcomes: A Secondary Analysis of Data from a Phase III Clinical Trial

by Chang Yin, Josee-Lyne Ethier, Mark S. Carey, Dongsheng Tu and Xueying Zheng

Curr. Oncol. 2025, 32(7), 390; https://doi.org/10.3390/curroncol32070390 - 7 Jul 2025

Abstract

Background: A single measurement or a summary of a limited number of measurements of CA125 was considered in the prediction of clinical outcomes for patients with ovarian cancer. We aimed to identify the classes of patients with advanced ovarian cancer based on their [...] Read more.

Background: A single measurement or a summary of a limited number of measurements of CA125 was considered in the prediction of clinical outcomes for patients with ovarian cancer. We aimed to identify the classes of patients with advanced ovarian cancer based on their CA125 trajectory and to investigate the heterogeneity of clinical outcomes among the patients in the different classes. Methods: CA125 trajectory classes were identified by latent-class mixed models based on values collected within 3 and 6 months post-treatment for 819 women with advanced ovarian cancer enrolled in a randomized trial. Results: Based on their CA125 values during the first 6 months of treatment, the patients with low CA125 levels at baseline that remained low during treatment had the best clinical outcome (a median survival of 83 months and a progression-free survival of 34 months). In contrast, the patients with high CA125 values at baseline with a modest decrease during treatment had the highest risk of death and progression (hazard ratio [95% confidence interval]: 4.83 [3.56, 6.54] for overall survival and 5.15 [3.87, 6.87] for progression-free survival). Conclusions: Longitudinal trajectories of CA125 may provide more direct information for the prognoses of patients with advanced ovarian cancer undergoing chemotherapy treatment. Full article

(This article belongs to the Section Gynecologic Oncology)

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14 pages, 1870 KiB

Open AccessCase Report

HIV Integration into the PTEN Gene and Its Tumor Microenvironment Implications for Lung Cancer

by Davey M. Smith, Elizabeth F. Rowland, Sara Gianella, Sandip Pravin Patel, Stephanie Solso, Cheryl Dullano, Robert Deiss, Daria Wells, Caroline Ignacio, Gemma Caballero, Magali Porrachia, Collin Kieffer and Antoine Chaillon

Curr. Oncol. 2025, 32(7), 389; https://doi.org/10.3390/curroncol32070389 - 4 Jul 2025

Abstract

Health outcomes for people with HIV (PWH) have improved significantly with combination antiretroviral therapy (ART), yet the risk of lung cancer remains elevated. While a single case cannot establish causality, we describe here an investigation of a 74-year-old male PWH with de novo [...] Read more.

Health outcomes for people with HIV (PWH) have improved significantly with combination antiretroviral therapy (ART), yet the risk of lung cancer remains elevated. While a single case cannot establish causality, we describe here an investigation of a 74-year-old male PWH with de novo high-grade neuroendocrine small cell lung carcinoma. To investigate the potential contribution of HIV to cancer development, we performed HIV integration site sequencing on blood, tumor, and non-tumor tissue samples from the patient. We analyzed integration site distribution, clonal expansion, and associated gene disruption. Phosphatase and Tensin Homolog (PTEN) expression was evaluated using immunofluorescence and microscopy. A total of 174 unique HIV integration sites were identified, with 29.9% (52/174) located in clonally expanded cells. The most frequent integration site in clonally expanded cells was within the PTEN gene, representing 4.2% to 16.7% of all HIV-infected cells across samples. PTEN expression was markedly reduced in tumor regions relative to non-tumor tissue. Areas positive for HIV p24 antigen showed minimal PTEN expression. These findings suggest that HIV integration into the PTEN gene, coupled with clonal expansion of HIV-infected cells, may impair anti-tumor immune responses and promote cancer progression in PWH. Full article

(This article belongs to the Section Thoracic Oncology)

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14 pages, 524 KiB

Open AccessArticle

Associations Between Symptom Complexity and Acute Care Utilization Among Adult Advanced Cancer Patients Followed by a Palliative Care Service

by Philip Pranajaya, Vincent Ho, Mengzhu Jiang, Vance Tran and Aynharan Sinnarajah

Curr. Oncol. 2025, 32(7), 388; https://doi.org/10.3390/curroncol32070388 - 4 Jul 2025

Abstract

Among adult advanced cancer patients already accessing palliative care, symptoms can contribute to unplanned acute care utilizations, which can disrupt care and worsen patient outcomes. We examined how a novel symptom complexity algorithm, using patients’ ratings of the nine Edmonton Symptom Assessment System—Revised [...] Read more.

Among adult advanced cancer patients already accessing palliative care, symptoms can contribute to unplanned acute care utilizations, which can disrupt care and worsen patient outcomes. We examined how a novel symptom complexity algorithm, using patients’ ratings of the nine Edmonton Symptom Assessment System—Revised (ESAS-r) symptoms to assign “low”, “medium”, or “high” complexity, predicts acute care utilizations. This retrospective observational cohort study used electronic medical record data from the Durham Regional Cancer Centre in Ontario, Canada, comprising adult advanced cancer patients who completed at least one ESAS-r report between 1 January 2022 and 31 December 2023. We applied chi-squared tests, Kruskal–Wallis H tests, and multivariable binary logistic regressions to evaluate factors associated with higher odds of acute care utilization within seven and fourteen days of patients’ first ESAS-r reports after their first palliative care interaction. Of 559 included patients, 125 (22.4%) exhibited low complexity, 180 (32.2%) exhibited medium complexity, and 254 (45.4%) exhibited high complexity on their first ESAS-r report. In total, 61 (10.9%) patients accessed acute care within seven days and 108 (19.3%) patients accessed acute care within fourteen days of their first ESAS-r report. Controlling for sociodemographic and clinical covariates, compared to low-complexity patients, high-complexity patients had higher odds of acute care utilization within seven days (aOR = 2.83, 95% CI: 1.18–6.77), but not within fourteen days (aOR = 1.78, 95% CI: 0.97–3.28). Accordingly, as a clinical decision-making tool, ESAS-r symptom complexity may help identify patients who would benefit from more intensive follow-up and potentially reduce unnecessary acute care utilizations. Full article

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

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15 pages, 259 KiB

Open AccessReview

Predictive Factors of Response to Neoadjuvant Chemotherapy (NACT) and Immune Checkpoint Inhibitors in Early-Stage Triple-Negative Breast Cancer Patients (TNBC)

by Khashayar Yazdanpanah Ardakani, Francesca Fulvia Pepe, Serena Capici, Thoma Dario Clementi and Marina Elena Cazzaniga

Curr. Oncol. 2025, 32(7), 387; https://doi.org/10.3390/curroncol32070387 - 4 Jul 2025

Abstract

Triple-negative breast cancer (TNBC) is a heterogenous group of breast tumors. This type of breast tumor is relatively difficult to manage, due to the lack of expression of Hormone Receptors (HR) and human epidermal growth factor receptor (HER2). Efforts have been made to [...] Read more.

Triple-negative breast cancer (TNBC) is a heterogenous group of breast tumors. This type of breast tumor is relatively difficult to manage, due to the lack of expression of Hormone Receptors (HR) and human epidermal growth factor receptor (HER2). Efforts have been made to understand the factors involved in determining how a triple-negative breast tumor responds to therapy. The standard of treatment in most cases today is a combined modality of immune checkpoint inhibitors (ICIs) and chemotherapy with agents such as anti-mitotic (taxanes) or DNA-damaging agents (alkylating agents, cyclophosphamides, platin salts). In this study, we investigated the predictive and prognostic factors for TNBC, in the neoadjuvant setting; understanding each patient’s response before treatment initiation is crucial to guiding the subsequent approach and finally improving patient outcomes. We focused on tumor-infiltrating lymphocytes at the site of the primary tumor (TILs), circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), the mutational status of protein 53 (p53), and Ki-67, investigating the potential roles of these factors in predicting responses to anti-cancer agents. Full article

(This article belongs to the Special Issue Advances in Immunotherapy for Breast Cancer)

2 pages, 133 KiB

Open AccessCorrection

Correction: Niscola et al. Acute Myeloid Leukemia in Older Patients: From New Biological Insights to Targeted Therapies. Curr. Oncol. 2024, 31, 6632–6658

by Pasquale Niscola, Valentina Gianfelici, Gianfranco Catalano, Marco Giovannini, Carla Mazzone, Nelida Ines Noguera and Paolo de Fabritiis

Curr. Oncol. 2025, 32(7), 386; https://doi.org/10.3390/curroncol32070386 - 4 Jul 2025

Abstract

In the original publication [...] Full article

13 pages, 1039 KiB

Open AccessArticle

Patients with a Short Distance Between the Prostate and the Rectum Are Appropriate Candidates for Hydrogel Spacer Placement to Prevent Short-Term Rectal Hemorrhage After External-Beam Radiotherapy for Prostate Cancer

by Shunsuke Owa, Takeshi Sasaki, Akito Taniguchi, Kazuki Omori, Taketomo Nishikawa, Momoko Kato, Shinichiro Higashi, Yusuke Sugino, Yutaka Toyomasu, Akinori Takada, Kouhei Nishikawa, Yoshihito Nomoto and Takahiro Inoue

Curr. Oncol. 2025, 32(7), 385; https://doi.org/10.3390/curroncol32070385 - 3 Jul 2025

Abstract

Radiation therapy, including external-beam radiation therapy (EBRT) and brachytherapy, is curative for localized prostate cancer. Hydrogel spacer (HS) placement between the rectum and prostate is popular for reducing radiation-related complications. Criteria to identify patients who benefit from HS placement would be clinically valuable. [...] Read more.

Radiation therapy, including external-beam radiation therapy (EBRT) and brachytherapy, is curative for localized prostate cancer. Hydrogel spacer (HS) placement between the rectum and prostate is popular for reducing radiation-related complications. Criteria to identify patients who benefit from HS placement would be clinically valuable. In a retrospective analysis of 430 patients with localized prostate cancer treated between November 2010 and March 2023 with ≥2 years of follow-up, we evaluated the incidence of rectal hemorrhage and its association with the median distance at the midpoint between the prostate and the rectum (mDPR) on pretreatment MRI. Rectal hemorrhage occurred in 6% of HS cases and 18% of non-HS cases (p < 0.001). Among 268 patients who received EBRT (±brachytherapy), the incidence was 9% with HS and 30% without HS (p < 0.001). In non-HS cases, the rate in patients with mDPR ≤ 1.62 mm was higher than in those with mDPR > 1.62 mm (24% vs. 12%, respectively; p = 0.04). In patients with EBRT and mDPR ≤ 1.62 mm, HS significantly reduced hemorrhage (9% vs. 39%, respectively; p < 0.001). Multivariate analysis identified mDPR and HS as independent predictors of rectal hemorrhage (both p = 0.02). Thus, HS placement may be safely omitted in non-EBRT cases with mDPR ≥ 1.62 mm. Full article

(This article belongs to the Section Genitourinary Oncology)

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20 pages, 2585 KiB

Open AccessArticle

Real-World Retrospective Study of Clinical and Economic Outcomes Among Patients with Locally Advanced or Metastatic Urothelial Carcinoma Treated with First-Line Systemic Anti-Cancer Therapies in the United States: Results from the IMPACT UC-III Study

by Helen H. Moon, Chiemeka Ike, Ruth W. Dixon, Christopher L. Crowe, Malvika Venkataraman, Valerie Morris, Mairead Kearney, Ivy Tonnu-Mihara and John Barron

Curr. Oncol. 2025, 32(7), 384; https://doi.org/10.3390/curroncol32070384 - 2 Jul 2025

Abstract

This retrospective cohort study evaluated characteristics, treatment patterns, and clinical outcomes in adults with locally advanced/metastatic urothelial carcinoma (la/mUC) receiving first-line (1L) systemic treatment with or without avelumab 1L maintenance (1LM) between January 2020 and July 2023. The index date was the first [...] Read more.

This retrospective cohort study evaluated characteristics, treatment patterns, and clinical outcomes in adults with locally advanced/metastatic urothelial carcinoma (la/mUC) receiving first-line (1L) systemic treatment with or without avelumab 1L maintenance (1LM) between January 2020 and July 2023. The index date was the first date with a claim for 1L systemic therapy after a la/mUC diagnosis. Patients with continuous health plan enrollment for ≥6 months before and ≥1 month after the index date were identified from Carelon Research’s Healthcare Integrated Research Database. Of 2820 patients receiving 1L treatment, 37.0% received platinum-based chemotherapy (PBC); 39.0%, immuno-oncology (IO) monotherapy; and 24.0%, other therapies. Renal disease and other comorbidities influenced 1L regimen choice. Healthcare resource utilization (HCRU) and costs were reported for patients receiving second-line (2L) treatment. HCRU was high in 32.8% of patients (926 of 2820) who received 2L treatment. Median all-cause direct medical costs per patient per month were USD 15,859, USD 19,781, USD 11,346, and USD 9516 for 1L PBC, 1L PBC + avelumab 1LM, 1L IO monotherapy, and 1L other therapies, respectively. Most direct healthcare costs were attributed to all-cause outpatient visits. Full article

(This article belongs to the Section Genitourinary Oncology)

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13 pages, 2611 KiB

Open AccessCase Report

Atypical Cystic Primary Hepatic GIST: A Case Report of Rare Presentation and Long-Term Survival

by Mirela Claudia Rimbu, Florin Dan Ungureanu, Cosmin Moldovan, Madalina Elena Toba, Marinela Chirila, Elena Truta and Daniel Cord

Curr. Oncol. 2025, 32(7), 383; https://doi.org/10.3390/curroncol32070383 - 1 Jul 2025

Abstract

Primary hepatic gastrointestinal stromal tumours (PHGISTs) are rare and frequently misdiagnosed due to their atypical presentation and uncertain origin. The purpose of this article is to present the case of a 79-year-old female patient with a gigantic PHGIST characterized by a predominantly cystic [...] Read more.

Primary hepatic gastrointestinal stromal tumours (PHGISTs) are rare and frequently misdiagnosed due to their atypical presentation and uncertain origin. The purpose of this article is to present the case of a 79-year-old female patient with a gigantic PHGIST characterized by a predominantly cystic nature—an extremely rare presentation, as most cases of PHGIST are solid. Despite extensive imaging and exploratory laparotomy, the primary origin remained uncertain, leading to questioning about whether it was a true primary hepatic GIST or an atypical metastatic lesion. The initial therapeutic approach involved a surgical procedure aimed to confirm the diagnosis and achieve reductive tumourectomy. Following the surgery, the patient was administered imatinib with a favourable clinical response for four and a half years—an atypical pattern of resistance, as most patients typically develop therapeutic resistance within two to three years. A second surgical intervention was performed to address a cystic lesion localized in the left hepatic lobe, followed by an atypical segment III hepatectomy to achieve macroscopic resection. Subsequently, the patient received sunitinib for two and a half years, which resulted in temporary disease stabilization. However, the sunitinib treatment was associated with hypertension and leukopenia. The patient’s overall survival was 8 years, suggesting that individualized therapeutic strategies and close monitoring might be the key in such cases. Furthermore, this case confirms the role of surgical intervention even in advanced disease stages, with multiple major resections contributing significantly to prolonged survival. The interplay between surgical and oncologic therapies remains essential to guiding clinical decisions. Given the unusual cystic presentation, this case highlights the necessity to expand the pathological and molecular profiling of PHGISTs. Furthermore, the atypical timeline of resistance development and treatment-related toxicity emphasizes the importance of further research into the genetic and pharmacological determinants of PHGISTs. These findings advocate for the refinement of diagnostic, therapeutic, and surveillance protocols tailored to rare GIST subtypes. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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15 pages, 2646 KiB

Open AccessArticle

Radiation Quality-Dependent Progressive Increase in Oxidative DNA Damage and Intestinal Tumorigenesis in Apc^1638N/+ Mice

by Kamendra Kumar, Santosh Kumar, Jerry Angdisen, Kamal Datta, Albert J. Fornace, Jr. and Shubhankar Suman

Curr. Oncol. 2025, 32(7), 382; https://doi.org/10.3390/curroncol32070382 - 1 Jul 2025

Abstract

Exposure to high-linear energy transfer (LET) heavy ions, such as ²⁸Si, poses a significant cancer risk for astronauts. While previous studies have linked high-LET radiation exposure to persistent oxidative stress and dysregulated stress responses in intestinal crypt cells with an increased risk [...] Read more.

Exposure to high-linear energy transfer (LET) heavy ions, such as ²⁸Si, poses a significant cancer risk for astronauts. While previous studies have linked high-LET radiation exposure to persistent oxidative stress and dysregulated stress responses in intestinal crypt cells with an increased risk of tumorigenesis, the relationship between IR-induced oxidative DNA damage and intestinal cancer risk remains incompletely understood. Here, we investigated the time-dependent effects of ²⁸Si-ion radiation on intestinal tumorigenesis and oxidative DNA damage in Apc^1638N/+ mice, a model for human intestinal cancer predisposition. Male Apc^1638N/+ mice were exposed to 10 cGy of either γ-rays (low-LET) or ²⁸Si-ions (high-LET), and intestinal tumor burden was assessed at 60 and 150 days post-irradiation. While both radiation groups showed modest, non-significant tumor increases at 60 days, ²⁸Si-irradiated mice exhibited an approximately 2.5-fold increase in tumor incidence by 150 days, with a higher incidence of invasive carcinomas compared to γ and sham groups. Serum 8-OxodG levels, a marker of systemic oxidative stress, were significantly elevated in the ²⁸Si-ion group, correlating with increased intestinal 8-OxodG staining. Additionally, assessment of the proliferation marker Cyclin D1 and metaplasia marker Guanylyl Cyclase C (GUCY2C) also revealed significant crypt cell hyperproliferation accompanied by increased metaplasia in ²⁸Si-exposed mouse intestines. Positive correlations between serum 8-OxodG and tumor-associated endpoints provide compelling evidence that exposure to ²⁸Si-ions induces progressive intestinal tumorigenesis through sustained oxidative DNA damage, crypt cell hyperproliferation, and metaplastic transformation. This study provides evidence in support of the radiation quality-dependent progressive increase in systemic and intestinal levels of 8-OxodG during intestinal carcinogenesis. Moreover, the progressive increase in oxidative DNA damage and simultaneous increase in oncogenic events after ²⁸Si exposure also suggest that non-targeted effects might be a significant player in space radiation-induced intestinal cancer development. The correlation between serum 8-OxodG and oncogenic endpoints supports its potential utility as a predictive biomarker of high-LET IR-induced intestinal carcinogenesis, with implications for astronaut health risk monitoring during long-duration space missions. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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12 pages, 3008 KiB

Open AccessReview

A Comparison of Radiation and Alkylator-Based Conditioning Therapy Regimens for Allogeneic Stem Cell Transplantation in Acute Myeloid Leukemia: A Clinician’s Perspective

by Alejandro Marinos Velarde, Julio Alvarenga Thiebaud, Yazan Madanat and Amir Toor

Curr. Oncol. 2025, 32(7), 381; https://doi.org/10.3390/curroncol32070381 - 1 Jul 2025

Abstract

Despite significant advancements in the treatment of acute myeloid leukemia (AML), hematopoietic stem cell transplantation (HSCT) remains the only curative option for patients with primary refractory AML, those with relapsed disease and for patients who are in first complete remission where the disease [...] Read more.

Despite significant advancements in the treatment of acute myeloid leukemia (AML), hematopoietic stem cell transplantation (HSCT) remains the only curative option for patients with primary refractory AML, those with relapsed disease and for patients who are in first complete remission where the disease has high risk cytogenetic and/or molecular features that increase relapse risk [...] Full article

(This article belongs to the Special Issue Allogeneic Stem Cell Transplantation: Does the Conditioning Regimen Intensity Still Matter?)

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31 pages, 1058 KiB

Open AccessSystematic Review

Psychedelic-Assisted Therapies for Psychosocial Symptoms in Cancer: A Systematic Review and Meta-Analysis

by Haley D. M. Schuman, Chantal Savard, Raèf Mina, Sofia Barkova, Hanna S. W. Conradi, Julie M. Deleemans and Linda E. Carlson

Curr. Oncol. 2025, 32(7), 380; https://doi.org/10.3390/curroncol32070380 - 30 Jun 2025

Abstract

This systematic review and meta-analysis evaluates (1) the effectiveness of psychedelic-assisted therapy (PAT) using psilocybin and ketamine for psychosocial symptoms in adults with cancer, (2) contextualizes findings with non-randomized and exploratory studies of other psychedelics, and (3) examines the role of therapeutic frameworks [...] Read more.

This systematic review and meta-analysis evaluates (1) the effectiveness of psychedelic-assisted therapy (PAT) using psilocybin and ketamine for psychosocial symptoms in adults with cancer, (2) contextualizes findings with non-randomized and exploratory studies of other psychedelics, and (3) examines the role of therapeutic frameworks in shaping outcomes. We searched PubMed, Cochrane Library, PsycINFO, and EMBASE (2000–2024) for randomized controlled trials (RCTs) and non-randomized studies investigating psychedelic agents in cancer populations. Meta-analyses pooled RCTs of psilocybin or ketamine using random-effects models. Non-randomized studies were synthesized narratively. Risk of bias and evidence certainty were assessed via Cochrane ROB 2.0, NIH Before–After tool, and GRADE. Eleven placebo-controlled RCTs and four single open-label studies were included. Meta-analysis of four ketamine RCTs (n = 354) showed large, rapid effects on depression/anxiety (Hedges’ g = −1.37, 95% CI: −2.66 to −0.08; I² = 92%). Three psilocybin RCTs (n = 101) showed a large effect of psilocybin on alleviating depression (Hedges’ g = −3.13, 95% CI: −10.04 to 3.77; I² = 95%). MDMA and LSD trials suggested promise but lacked rigor. PAT may offer meaningful relief for cancer-related distress, though effects vary by therapeutic model and context. Oncology-specific trials are needed to standardize and scale for implementation. Full article

(This article belongs to the Section Psychosocial Oncology)

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33 pages, 519 KiB

Open AccessSystematic Review

Impact of Oncological Treatment on Quality of Life in Patients with Head and Neck Malignancies: A Systematic Literature Review (2020–2025)

by Raluca Grigore, Paula Luiza Bejenaru, Gloria Simona Berteșteanu, Ruxandra Ioana Nedelcu-Stancalie, Teodora Elena Schipor-Diaconu, Simona Andreea Rujan, Bianca Petra Taher, Șerban Vifor Gabriel Berteșteanu, Bogdan Popescu, Irina Doinița Popescu, Alexandru Nicolaescu, Anca Ionela Cîrstea and Catrinel Beatrice Simion-Antonie

Curr. Oncol. 2025, 32(7), 379; https://doi.org/10.3390/curroncol32070379 - 30 Jun 2025

Abstract

Background: Quality of life (QoL) is a critical indicator in assessing the success of oncological treatments for head and neck malignancies, reflecting their impact on physiological functions and psychosocial well-being beyond mere survival. Treatments (surgery, radiotherapy, chemotherapy) pose multiple functional and emotional [...] Read more.

Background: Quality of life (QoL) is a critical indicator in assessing the success of oncological treatments for head and neck malignancies, reflecting their impact on physiological functions and psychosocial well-being beyond mere survival. Treatments (surgery, radiotherapy, chemotherapy) pose multiple functional and emotional challenges, and recent advancements underscore the necessity of evaluating post-treatment QoL. Objective: This literature review investigates the impact of oncological treatment on the QoL of patients with malignant head and neck cancers (oral, oropharyngeal, hypopharyngeal, laryngeal) and identifies factors influencing their QoL index. Methodology: Using a PICO framework, studies from PubMed Central were analyzed, selected based on inclusion (English publications, full text, PROM results) and exclusion criteria. The last research was conducted on 6 April 2025. From 231 identified studies, 49 were included after applying filters (MeSH: “Quality of Life,” “laryngeal cancer,” “oral cavity cancer,” etc.). Data were organized in Excel, and the methodology adhered to PRISMA standards. Results: Treatment Impact: Oncological treatments significantly affect QoL, with acute post-treatment declines in functions such as speech, swallowing, and emotional well-being (anxiety, depression). Partial recovery depends on rehabilitative interventions. Influencing Factors: Treatment type, disease stage, socioeconomic, and demographic contexts influence QoL. De-escalated treatments and prompt rehabilitation improve recovery, while complications like trismus, dysphagia, or persistent hearing issues reduce long-term QoL. Assessment Tools: Standardized PROM questionnaires (EORTC QLQ-C30, QLQ-H&N35, MDADI, HADS) highlighted QoL variations. Studies from Europe, North America, and Asia indicate regional differences in outcomes. Limitations: Retrospective designs, small sample sizes, and PROM variability limit generalizability. Multicentric studies with extended follow-up are recommended. Conclusions: Oncological treatments for head and neck malignancies have a complex impact on QoL, necessitating personalized and multidisciplinary strategies. De-escalated therapies, early rehabilitation, and continuous monitoring are essential for optimizing functional and psychosocial outcomes. Methodological gaps highlight the need for standardized research. Full article

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

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13 pages, 3699 KiB

Open AccessArticle

PDL1 Gene Gain Predicts an Unfavorable Prognosis in HIV-Positive Primary Central Nervous System Lymphoma

by Jiamin Chen, Xiaoman Kang, Xinghuan Ding, Yuyang Dai, Lei Sun, Man Li, Ting Liu, Enshan Feng and Xingang Zhou

Curr. Oncol. 2025, 32(7), 378; https://doi.org/10.3390/curroncol32070378 - 29 Jun 2025

Abstract

Primary central nervous system lymphoma (PCNSL) refers to non-Hodgkin lymphoma (NHL) originating in the brain, eyes, spinal cord, and cerebrospinal fluid without the presence of lymphoma outside of the central nervous system [...] Full article

(This article belongs to the Section Oncology Biomarkers)

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11 pages, 1637 KiB

Open AccessArticle

Robot-Assisted Lymph Node-to-Vein Anastomosis: Lessons from the First 22 Cases at a High-Volume Lymphatic Supermicrosurgery Center

by Wei F. Chen, David C. F. Cheong, Erica Tedone Clemente and Melis Salman

Curr. Oncol. 2025, 32(7), 377; https://doi.org/10.3390/curroncol32070377 - 29 Jun 2025

Abstract

(1) Background: Lymphedema is a common but underrecognized sequela of cancer treatment. Supermicrosurgical procedures such as lymphaticovenular anastomosis (LVA) and, more recently, lymph node-to-vein anastomosis (LNVA) have emerged as effective options for fluid-predominant disease. In 2024, we began performing robot-assisted LNVA using a [...] Read more.

(1) Background: Lymphedema is a common but underrecognized sequela of cancer treatment. Supermicrosurgical procedures such as lymphaticovenular anastomosis (LVA) and, more recently, lymph node-to-vein anastomosis (LNVA) have emerged as effective options for fluid-predominant disease. In 2024, we began performing robot-assisted LNVA using a next-generation microsurgical robot. This study describes our initial experience, technical insights, and the potential for robotics to extend the boundaries of supermicrosurgery. (2) Methods: Twenty-two consecutive robotic LNVAs were performed by a high-volume supermicrosurgeon at a tertiary center. Preoperative imaging with standard and ultra-high frequency ultrasound was used to identify optimal lymph nodes and veins. Robotic LNVA was performed using the Symani Surgical System, with adaptations for motion scaling, ergonomics, and console control. Intraoperative patency was confirmed by direct washout and/or indocyanine green (ICG) transit. (3) Results: All 22 procedures were technically successful, with 100% intraoperative patency. Anastomosis time improved from 37 to 18 min. Robotic assistance enhanced precision, eliminated tremors, and reduced the technical burden of operating at extreme submillimeter scales. (4) Conclusions: Robotic LNVA is safe, feasible, and efficient. It optimizes current techniques, offering the potential to extend surgical access below the 0.1 mm threshold, with implications for future treatment of lymphatic and possibly intracranial disease. Full article

(This article belongs to the Section Surgical Oncology)

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10 pages, 474 KiB

Open AccessArticle

Surgical and Oncological Outcomes of Minimally Invasive Left Pancreatectomy for Pancreatic Cancer: Robotic vs. Laparoscopic Approach

by Matteo De Pastena, Gabriella Lionetto, Salvatore Paiella, Martina Maruccio, Federico Faustini, Elisa Venturini, Antonio Pea, Fabio Casciani, Giuseppe Malleo and Alessandro Esposito

Curr. Oncol. 2025, 32(7), 376; https://doi.org/10.3390/curroncol32070376 - 28 Jun 2025

Abstract

Objective: This study compares the surgical and oncological outcomes of minimally invasive robotic (RLP) and laparoscopic (LLP) left pancreatectomy in pancreatic cancer (PC) patients. Methods: Data from patients who underwent minimally invasive left pancreatectomy between 2013 and 2023 were analyzed. Two groups were [...] Read more.

Objective: This study compares the surgical and oncological outcomes of minimally invasive robotic (RLP) and laparoscopic (LLP) left pancreatectomy in pancreatic cancer (PC) patients. Methods: Data from patients who underwent minimally invasive left pancreatectomy between 2013 and 2023 were analyzed. Two groups were identified: RLP and LLP. Perioperative outcomes were compared, including operative time, blood loss, conversion rate, and postoperative complications. Oncological outcomes included margin status, lymph node retrieval, lymph node status, overall survival (OS), and disease-free survival (DFS). Results: Fifty-four patients were divided into the LLP (n = 39) and RLP (n = 15) groups. The median operative time was shorter for LLP than RLP [260 min vs. 366 min, p = 0.007]. Blood loss and conversion rates were comparable (p > 0.05). In the LLP group, significantly more lymph nodes were harvested (29 vs. 19, p = 0.05), and a higher percentage of positive lymph nodes was noted (72% vs. 40%, p = 0.033). No significant difference was found in the R0 resection status (82% vs. 73%, p = 0.358). After a median follow-up of 26 months, OS (23 months vs. 34 months, p = 0.812) and DFS (17 months vs. 16 months, p = 0.635) were similar. Conclusion: RLP provides outcomes identical to LLP in treating body–tail pancreatic cancer, with further studies needed to confirm its long-term oncological efficacy. Full article

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

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21 pages, 1422 KiB

Open AccessReview

Cannabidiol (CBD) and Colorectal Tumorigenesis: Potential Dual Modulatory Roles via the Serotonergic Pathway

by Zhenhua Liu

Curr. Oncol. 2025, 32(7), 375; https://doi.org/10.3390/curroncol32070375 - 26 Jun 2025

Abstract

The 2018 Farm Bill legalized hemp-derived cannabidiol (CBD) products containing less than 0.3% tetrahydrocannabinol (THC) in the United States. This legislative shift catalyzed both public and scientific interest in CBD’s potential health benefits. However, the rapid expansion of the CBD market has considerably [...] Read more.

The 2018 Farm Bill legalized hemp-derived cannabidiol (CBD) products containing less than 0.3% tetrahydrocannabinol (THC) in the United States. This legislative shift catalyzed both public and scientific interest in CBD’s potential health benefits. However, the rapid expansion of the CBD market has considerably outpaced rigorous scientific research, leaving many health claims largely unsubstantiated. While preclinical studies suggest that CBD may exert antitumorigenic effects in colorectal cancer (CRC) by modulating cell proliferation, apoptosis, and inflammation, clinical evidence supporting these effects remains limited. This review critically examines the current evidence on the role of CBD in colorectal tumorigenesis, with particular attention to its molecular mechanisms and interactions with the serotonergic system—a signaling pathway implicated in the development of CRC and possessing potential dual anti- and pro-tumorigenic properties. By influencing the serotonergic system, CBD may confer both protective and potentially deleterious effects during CRC development. This review underscores the need for further research to elucidate the complex mechanisms of CBD in colorectal tumorigenesis and to evaluate its therapeutic potential in clinical settings. Understanding these interactions could pave the way for novel prevention and treatment strategies, optimizing the anticancer efficacy of CBD while mitigating unintended risks. Full article

(This article belongs to the Special Issue Bridging Borders: A Global Perspective on Colorectal Cancer Research and Prevention)

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8 pages, 470 KiB

Open AccessArticle

Preoperative Chemoradiation (Modified Eilber Protocol) Versus Preoperative/Postoperative Radiotherapy for Soft Tissue Sarcomas: A Population-Based Analysis

by Greg M. Padmore, Elizabeth C. Kurien, Michael J. Monument, Lloyd Mack, Antoine Bouchard-Fortier and on behalf of the ISARP Group

Curr. Oncol. 2025, 32(7), 374; https://doi.org/10.3390/curroncol32070374 - 26 Jun 2025

Abstract

Background: Local recurrence for high-risk extremities/trunk soft tissue sarcoma (STS) after treatment can range from 15 to 30%. The modified Eilber protocol (MEP) using low-dose intravenous chemotherapy with a reduced dosage of radiation in the preoperative setting has demonstrated excellent local control and [...] Read more.

Background: Local recurrence for high-risk extremities/trunk soft tissue sarcoma (STS) after treatment can range from 15 to 30%. The modified Eilber protocol (MEP) using low-dose intravenous chemotherapy with a reduced dosage of radiation in the preoperative setting has demonstrated excellent local control and reduced wound complications in these patients. The aim of the current study was to assess long-term local control and overall survival in patients with STS treated with the MEP versus standard preoperative or postoperative radiotherapy. Methods: Patients diagnosed with STS from 2004 to 2016 were identified using the Alberta Cancer Registry. Patients with STS treated with the MEP, preoperative or postoperative radiotherapy, were included. Patient and tumor characteristics, treatments and outcomes were abstracted from the registry and primary chart review. Characteristics were compared using one-way ANOVA for continuous variable and chi-square test and Fisher test for the categorical outcomes. Local recurrence-free survival and overall survival were analyzed using Kaplan–Meier Analysis with Log-rank test. Results: A total of 242 patients with STS were included, among which 100 (41.3%) received the MEP prior to surgery, 91 (37.6%) had preoperative radiation, and 51 (21.1%) had postoperative radiation. After a median follow up of 4.9 years, there were no significant differences in local recurrence or local recurrence-free survival between patients treated with the MEP vs. preoperative or postoperative radiotherapy (10 vs. 6.6% and 7.8%, respectively, p-value NS). There were also no significant differences between groups for recurrence-free survival and overall survival. Conclusions: This study demonstrates that the use of the MEP has non-inferior oncologic outcomes compared to standard preoperative or postoperative radiation in a population-based analysis despite reducing the overall dosage of radiation administered. The modified Eilber preoperative chemoradiation protocol may be considered as an additional option for patients with STS. Full article

(This article belongs to the Special Issue Sarcoma Surgeries: Oncological Outcomes and Prognostic Factors)

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12 pages, 605 KiB

Open AccessReview

Role of Circulating Tumor DNA in Adapting Immunotherapy Approaches in Breast Cancer

by Sudhir Kumar and Rossanna C. Pezo

Curr. Oncol. 2025, 32(7), 373; https://doi.org/10.3390/curroncol32070373 - 26 Jun 2025

Abstract

Immunotherapy has a defined role in the treatment of both early- and late-stage triple-negative breast cancer (TNBC) and is under active exploration in human epidermal receptor 2-positive as well as high-risk hormone-receptor-positive subtypes. It is critical to balance the efficacy and toxicity of [...] Read more.

Immunotherapy has a defined role in the treatment of both early- and late-stage triple-negative breast cancer (TNBC) and is under active exploration in human epidermal receptor 2-positive as well as high-risk hormone-receptor-positive subtypes. It is critical to balance the efficacy and toxicity of immunotherapy while keeping the cost and duration of treatment in check. In addition to the immunohistochemistry testing of PD-L1 expression, which only predicts the efficacy of immunotherapy in metastatic TNBC, there is a lack of biomarkers that are better standardized to predict efficacy and treatment response, detect early relapse, and guide prognosis in breast cancer patients treated with immunotherapy. Circulating tumor DNA (ctDNA) is a minimally invasive, dynamic, real-time, blood-based biomarker that has shown promising value in the management of solid tumors, including breast cancer. This review discusses the emerging evidence for the potential application of ctDNA to further refine patient-centered care and personalize treatment based on a molecularly defined risk assessment for breast cancer patients treated with immunotherapy-based approaches. We further discuss the challenges and barriers to widespread adoption of this promising tool in the management of breast cancer patients requiring immunotherapy. Full article

(This article belongs to the Special Issue Advances in Immunotherapy for Breast Cancer)

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13 pages, 1625 KiB

Open AccessArticle

Insights into the Prognostic Efficacy of the Geriatric Nutritional Risk Index for Nasopharyngeal Carcinoma in the Era of Volumetric Modulated Arc Therapy: A Nomogram for Predicting Long-Term Survival Outcomes

by Xiang Lin, Wei Wang, Jianming Ding, Zhaodong Fei and Chuanben Chen

Curr. Oncol. 2025, 32(7), 372; https://doi.org/10.3390/curroncol32070372 - 26 Jun 2025

Abstract

Background: The geriatric nutritional risk index (GNRI), a composite metric of serum albumin and body weight, has emerged as a prognostic tool in various cancers. However, its relevance in nasopharyngeal carcinoma (NPC) patients treated with volumetric modulated arc therapy (VMAT) remains unexplored. The [...] Read more.

Background: The geriatric nutritional risk index (GNRI), a composite metric of serum albumin and body weight, has emerged as a prognostic tool in various cancers. However, its relevance in nasopharyngeal carcinoma (NPC) patients treated with volumetric modulated arc therapy (VMAT) remains unexplored. The aim of this study was to assess the effect of the GNRI in the prediction of the prognosis of nasopharyngeal carcinoma in the era of VMAT. Methods: This retrospective study analyzed 498 newly diagnosed, non-metastatic NPC patients treated with VMAT between 2010 and 2011. The GNRI was calculated using serum albumin and body weight ratios, with receiver operating characteristic (ROC) curve analysis determining its optimal prognostic cutoff. Patients were stratified into training (70%) and validation (30%) cohorts. Cox regression identified independent prognostic factors, which were integrated into a nomogram predicting 3- and 5-year overall survival (OS). Model performance was assessed via the concordance index (C-index), calibration curves, and decision curve analysis (DCA). Results: In the study, 348 patients were included in the training cohort and 150 patients were included in the validation cohort according to a ratio of 7:3. The median follow-up was 68 months, with 5-year OS rates of 79.3%. A GNRI > 102 independently predicted improved survival (HR = 0.64; p = 0.044), alongside tumor volume, age, and N-stage. The nomogram demonstrated strong discrimination (C-index: 0.757–0.762 for training; 0.737–0.744 for validation) and calibration, aligning closely with observed survival. DCA confirmed superior clinical utility over default strategies. NPC patients treated with VMAT with a high GNRI, female sex, and a lower N-stage exhibited significantly better OS (p < 0.05). Conclusions: The GNRI is a robust prognostic marker for NPC patients receiving VMAT, reflecting the interplay of nutrition, inflammation, and treatment response. The validated nomogram provides a practical tool for individualized risk stratification, enhancing clinical decision-making in the era of precision radiotherapy. Full article

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

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