Current Oncology

11 pages, 436 KiB

Open AccessArticle

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

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

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

Abstract

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

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

(This article belongs to the Section Hematology)

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11 pages, 202 KiB

Open AccessArticle

Long-Term Patient-Reported Bowel and Urinary Quality of Life in Patients Treated with Intensity-Modulated Radiotherapy Versus Intensity-Modulated Proton Therapy for Localized Prostate Cancer

by Kimberly R. Gergelis, Miao Bai, Jiasen Ma, David M. Routman, Bradley J. Stish, Brian J. Davis, Thomas M. Pisansky, Thomas J. Whitaker and Richard Choo

Curr. Oncol. 2025, 32(4), 212; https://doi.org/10.3390/curroncol32040212 - 2 Apr 2025

Abstract

Purpose: This study aimed to compare long-term patient-reported outcomes in bowel and urinary domains between intensity-modulated radiotherapy (IMRT) and intensity-modulated proton therapy (IMPT) for localized prostate cancer. Methods and Materials: Patients with clinical T1–T2 prostate cancer receiving IMRT or IMPT at a tertiary [...] Read more.

Purpose: This study aimed to compare long-term patient-reported outcomes in bowel and urinary domains between intensity-modulated radiotherapy (IMRT) and intensity-modulated proton therapy (IMPT) for localized prostate cancer. Methods and Materials: Patients with clinical T1–T2 prostate cancer receiving IMRT or IMPT at a tertiary cancer center from 2015–2018 were analyzed to determine the changes in the prospectively collected bowel function (BF), urinary irritative/obstructive symptoms (UO), and urinary incontinence (UI) domains of EPIC-26. The mean changes in EPIC-26 scores were evaluated from pretreatment to 24 months post-radiotherapy for each modality. A score change >50% of the baseline standard deviation was considered a clinically meaningful change. Results: A total of 82 patients treated with IMRT (52.2%) and 56 patients treated with IMPT (53.3%) completed the questionnaire at baseline and 24 months post-RT. There were no baseline differences in domain scores between treatment modalities. At 24 months post-radiotherapy, there was a significant and clinically meaningful decline in the BF mean score in the IMRT cohort (−4.52 (range −50, 29.17), p = 0.003), whereas the decline in BF score did not reach clinical relevance or significance (−1.88 (range −37.5, 50), p = 0.046) when accounting for the Bonferroni adjustment in the IMPT cohort. A higher proportion of patients treated with IMRT had a clinically relevant reduction in BF when compared with IMPT (47.37% vs. 25.93%, p = 0.017). The mean changes in the UI and UO scores of the IMRT and IMPT cohorts were neither statically significant nor clinically relevant. Conclusions: IMPT leads to a smaller decrease in BF than IMRT at 24 months post-RT, while there was no differential effect on UO and UI. Full article

(This article belongs to the Special Issue Evolution of Treatments of Prostate Cancer: From Biology to Current Advanced Technologies)

13 pages, 965 KiB

Open AccessArticle

Merkel Cell Carcinoma of the Skin: Deducing the Pattern of Spread from an International Aggregated Database of 949 Patients

by Patricia Tai, Kurian Joseph, Vimal H. Prajapati, Aoife Jones Thachuthara, Jidong Lian, Avi Assouline, Edward Yu and Michael Veness

Curr. Oncol. 2025, 32(4), 211; https://doi.org/10.3390/curroncol32040211 - 2 Apr 2025

Abstract

(1) Background: It is controversial if Merkel cell carcinomas (MCCs) spread to lymph nodes or distant metastases (LNM/DM) first. (2) Methods: A total of 303 patients from six institutions (March 1982–February 2015) were combined with individual patient data from a PubMed search, totaling [...] Read more.

(1) Background: It is controversial if Merkel cell carcinomas (MCCs) spread to lymph nodes or distant metastases (LNM/DM) first. (2) Methods: A total of 303 patients from six institutions (March 1982–February 2015) were combined with individual patient data from a PubMed search, totaling 949 patients. The primary outcome was recurrence patterns. (3) Results: (a) More patients presented with lymph node metastases (LNMs) than DMs at diagnosis: 17.9% (166 among the 929 patients with known staging) vs. 1.9% (18/929); (b) 310/929 (33.4%) developed lifetime DM, of whom 220/310 also developed LNM. The majority (133 patients) of patients were documented to have developed LNM before DM. (c) A shorter median time of 1.5 months (range: 0–47.0) from initial diagnosis to LNM, versus 8 months (range: 0–107.8) to DM, was also found. Another observation was that 2.4% (23/949) of patients with primary tumors ≤1 cm developed lifetime DM, with the smallest being 0.2 cm. (4) Conclusions: Three observations support the idea that prior LNM gives rise to subsequent DM as the main pathway of dissemination in MCC. This implies that patients with nodal metastases should be considered for adjuvant systemic therapy studies as an enriched population. Participation in clinical trials is strongly encouraged. Full article

(This article belongs to the Section Dermato-Oncology)

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1 pages, 131 KiB

Open AccessCorrection

Correction: Dukaczewska et al. Necrosis in Preoperative Cross-Sectional Imaging and Postoperative Histology Is a Diagnostic Marker for Malignancy of Adrenocortical Tumors. Curr. Oncol. 2025, 32, 25

by Agata Dukaczewska, Stephan R. Marticorena Garcia, Simon Ponsel, Alexandra Webster, Frederike Butz, Eva M. Dobrindt, Johann Pratschke, Peter E. Goretzki, David Horst, Martina T. Mogl and Catarina A. Kunze

Curr. Oncol. 2025, 32(4), 210; https://doi.org/10.3390/curroncol32040210 - 2 Apr 2025

Abstract

Peter E [...] Full article

12 pages, 229 KiB

Open AccessArticle

The Relational Experience of Fear of Cancer Recurrence in Family Caregivers: A Reflexive Thematic Analysis Study

by Jani Lamarche, Faye Ajmera, Jonathan Avery, Ghizlène Sehabi, Sophie Lebel and Rinat Nissim

Curr. Oncol. 2025, 32(4), 209; https://doi.org/10.3390/curroncol32040209 - 1 Apr 2025

Abstract

Fear of cancer recurrence (FCR) affects approximately 50% of family caregivers. While FCR in cancer patients has been well-documented, less is known about the experience of FCR in family caregivers. This study aimed to qualitatively explore the distinct characteristics of FCR in family [...] Read more.

Fear of cancer recurrence (FCR) affects approximately 50% of family caregivers. While FCR in cancer patients has been well-documented, less is known about the experience of FCR in family caregivers. This study aimed to qualitatively explore the distinct characteristics of FCR in family caregivers. A focus group and semi-structured interviews were conducted via videoconferencing with family caregivers of cancer survivors (stages I–III, finished treatment, no recurrence). Participants were recruited through Canadian hospitals, community partners, and social media. The focus group and qualitative interviews explored family caregivers’ experiences of FCR, including its content, frequency, impact, and management. A reflexive thematic analysis was used. In total, twenty family caregivers participated. Six participated in the focus group. Sixteen participated in the interviews. Two participated in both. Family caregivers described their experience of FCR as all-consuming, constant, and marked by a sense of helplessness. Qualitative analysis revealed a major theme of relational aspects of FCR in family caregivers, with the following four inter-related themes: patient-centric hypervigilance, self-silencing, FCR as isolating, and finding support. This qualitative study examined the experiences of family caregivers living with FCR. Our findings highlight that relational factors shape how family caregivers experience and manage their FCR. High-quality survivorship care should be redefined to include FCR interventions tailored to family caregivers. Full article

(This article belongs to the Section Psychosocial Oncology)

21 pages, 2175 KiB

Open AccessArticle

Cancer Recurrence in Operated Primary Oral Squamous Cell Carcinoma Patients Seems to Be Independent of the Currently Available Postoperative Therapeutic Approach: A Retrospective Clinical Study

by Shahram Ghanaati, Samuel Ebele Udeabor, Anne Winter, Robert Sader and Anja Heselich

Curr. Oncol. 2025, 32(4), 208; https://doi.org/10.3390/curroncol32040208 - 1 Apr 2025

Abstract

Despite advances in treatment, recurrence rates in oral squamous cell carcinoma (OSCC) remain high. Prognostic outcomes vary in terms of local recurrence, metastasis, and overall survival. A retrospective cohort analysis was conducted on OSCC patients who underwent primary surgery at the Department of [...] Read more.

Despite advances in treatment, recurrence rates in oral squamous cell carcinoma (OSCC) remain high. Prognostic outcomes vary in terms of local recurrence, metastasis, and overall survival. A retrospective cohort analysis was conducted on OSCC patients who underwent primary surgery at the Department of Craniomaxillofacial and Facial Plastic Surgery, University Medical Center Frankfurt, between January 2014 and December 2020. Demographic data, tumor characteristics, surgical details, intraoperative frozen section results, and recurrence patterns were first assessed for availability. Subsequently, the available data relevant to each endpoint were analyzed. A total of 169 patients were analyzed (mean age: 64 years). The tongue was the most affected site and had the highest recurrence rate, followed by the floor of the mouth. Overall, 24.3% of patients experienced recurrence, with most cases occurring within the first year. T2 tumors had the highest recurrence rates. Between patients with and without adjuvant therapy, recurrence rates were comparable. Positive surgical margins were more common in recurrence cases, but no significant correlation was found between margin status and recurrence in patients without adjuvant therapy. Based on the analyzed data, achieving recurrence-free survival in OSCC does not solely depend on surgical technique or adjuvant therapy. Instead, early recognition of individual tumor characteristics and even tumor biology should guide personalized treatment planning. Notably, tumors of the tongue and floor of the mouth exhibited high recurrence rates regardless of disease stage, raising the question of whether primary chemoradiotherapy (CRT) could achieve better outcomes than surgery. Further studies are needed to evaluate the role of CRT as a first-line treatment for OSCC in these locations. Full article

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

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25 pages, 4340 KiB

Open AccessGuidelines

Canadian Expert Consensus Recommendations for the Diagnosis and Management of Glioblastoma: Results of a Delphi Study

by Warren P. Mason, Rebecca A. Harrison, Sarah Lapointe, Mary Jane Lim-Fat, Mary V. MacNeil, David Mathieu, James R. Perry, Marshall W. Pitz, David Roberge, Derek S. Tsang, Christina Tsien, Frank K. H. van Landeghem, Gelareh Zadeh and Jacob Easaw

Curr. Oncol. 2025, 32(4), 207; https://doi.org/10.3390/curroncol32040207 - 1 Apr 2025

Abstract

Glioblastoma is the most common and aggressive malignant brain tumor in adults, with an increasing incidence and a poor prognosis. Current challenges in glioblastoma management include rapid tumor growth, limited treatment effectiveness, high recurrence rates, and a significant impact on patients’ quality of [...] Read more.

Glioblastoma is the most common and aggressive malignant brain tumor in adults, with an increasing incidence and a poor prognosis. Current challenges in glioblastoma management include rapid tumor growth, limited treatment effectiveness, high recurrence rates, and a significant impact on patients’ quality of life. Given the complexity of glioblastoma care and recent advancements in diagnostic and treatment modalities, updated guidelines are needed in Canada. This Delphi study aimed to develop Canadian consensus recommendations for the diagnosis, classification, and management of newly diagnosed and recurrent glioblastoma. A multidisciplinary panel of 14 Canadian experts in glioblastoma care was convened, and a comprehensive literature review was conducted to synthesize evidence and formulate initial recommendations. Consensus was achieved through three Delphi rounds, in which panelists rated their agreement with recommendation statements on a five-point Likert scale. Statements with ≥75% agreement were accepted, and others were revised for re-voting. Final recommendations were formulated based on the consensus level, strength of evidence, clinical expertise, and consideration of the Canadian healthcare context. These recommendations aim to standardize glioblastoma diagnosis and classification across Canada, provide evidence-based guidance for optimal treatment selection, integrate novel therapies, and enhance the overall quality of care for glioblastoma patients. Full article

(This article belongs to the Section Neuro-Oncology)

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26 pages, 1932 KiB

Open AccessReview

Unveiling the Synergistic Potential: Bispecific Antibodies in Conjunction with Chemotherapy for Advanced Non-Small-Cell Lung Cancer Treatment

by Saqib Raza Khan and Daniel Breadner

Curr. Oncol. 2025, 32(4), 206; https://doi.org/10.3390/curroncol32040206 - 31 Mar 2025

Abstract

Lung cancer remains the leading cause of cancer-related mortality worldwide, with non-small-cell lung cancer (NSCLC) accounting for the majority of the cases. Despite advancements in targeted therapies and immunotherapies, many patients still rely on chemotherapy, highlighting the need for innovative treatment strategies. Bispecific [...] Read more.

Lung cancer remains the leading cause of cancer-related mortality worldwide, with non-small-cell lung cancer (NSCLC) accounting for the majority of the cases. Despite advancements in targeted therapies and immunotherapies, many patients still rely on chemotherapy, highlighting the need for innovative treatment strategies. Bispecific antibodies (bsAbs), which feature two distinct binding sites capable of targeting different antigens, have emerged as a promising therapeutic approach, particularly in combination with chemotherapy. This review explores the scientific evolution and clinical application of bsAbs in NSCLC, focusing on their synergistic potential with chemotherapy. BsAbs, such as amivantamab, which targets EGFR and MET, have demonstrated significant efficacy in clinical trials, particularly in patients with EGFR mutations. The combination of bsAbs with chemotherapy enhances immune-mediated tumor destruction by modulating the tumor microenvironment and overcoming resistance mechanisms. Recent clinical trials have shown improved progression-free survival and overall survival when bsAbs such as amivantamab are combined with chemotherapy, underscoring their potential to transform NSCLC treatment. Many other clinical trials are underway that are evaluating newer bsAbs, such as ivonescimab, which targets PD1 and VEGF. This review also discusses ongoing clinical trials investigating various bsAbs targeting EGFR, PD-1, PD-L1, HER2, and other pathways, highlighting the future directions of bsAb-based therapies. As the field evolves, bsAbs are poised to become a cornerstone of multimodal NSCLC treatment, offering more effective and personalized therapeutic options for patients with advanced disease. Full article

(This article belongs to the Special Issue Hype or Hope—Combination Therapies for Lung Cancer)

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14 pages, 5066 KiB

Open AccessCase Report

Neuroendocrine Breast Cancer-Associated Ectopic Adrenocorticotropic Hormone Syndrome Requiring Bilateral Adrenalectomy

by Kala Hickey, Hannah Yaremko, Christine Orr and David Pace

Curr. Oncol. 2025, 32(4), 205; https://doi.org/10.3390/curroncol32040205 - 31 Mar 2025

Abstract

Ectopic adrenocorticotropic hormone syndrome (EAS) occurs when a tumor develops neuroendocrine differentiation with the secretion of ACTH resulting in hypercortisolism and possibly Cushing’s syndrome (CS). Only 5–10% of CS cases are attributed to EAS; of these, breast tumors comprise less than 1%. Two [...] Read more.

Ectopic adrenocorticotropic hormone syndrome (EAS) occurs when a tumor develops neuroendocrine differentiation with the secretion of ACTH resulting in hypercortisolism and possibly Cushing’s syndrome (CS). Only 5–10% of CS cases are attributed to EAS; of these, breast tumors comprise less than 1%. Two known variants of breast neuroendocrine tumors include neuroendocrine-differentiated carcinoma and ductal carcinoma with neuroendocrine features. Currently, guidelines for treatment are limited and EAS is associated with significant morbidity and mortality. A 39-year-old female presented with a rapidly enlarging breast mass. Biopsy demonstrated invasive poorly differentiated breast carcinoma with high-grade neuroendocrine features and necrosis. Staging at diagnosis confirmed metastatic disease of the liver and bone. First-line chemotherapy (Cisplatin/Etoposide/Durvalumab) was initiated with evidence of disease progression after four cycles. Given a poor response to therapy, a simple mastectomy was performed for local control and complete pathologic analysis, demonstrating high-grade neuroendocrine carcinoma with large-cell features. Second-line therapy (Adriamycin/Cyclophosphamide) was initiated for three cycles after which the patient required admission for severe and refractory hypokalemia. Workup confirmed elevated ACTH consistent with paraneoplastic EAS and further evidence of disease progression. Third-line therapy (Nab-Paclitaxel) was initiated, and genetic testing was completed, confirming the PIK3 mutation, for which access to Alpelisib therapy was requested. Given symptoms of progressive severe CS with significant liver disease limiting medical therapies, the patient underwent urgent bilateral laparoscopic adrenalectomy after which she was able to be discharged home while awaiting additional systemic therapy. EAS resulting in CS secondary to breast neuroendocrine carcinoma is a rare and challenging diagnosis. Further research is needed to inform treatment guidelines to improve outcomes. While patient survival is dependent upon the underlying disease process, laparoscopic bilateral adrenalectomy is an accepted, definitive treatment option. Full article

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

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18 pages, 1087 KiB

Open AccessReview

Sex and Gender in Myeloid and Lymphoblastic Leukemias and Multiple Myeloma: From Molecular Mechanisms to Clinical Outcomes

by Mohammad Amin Ansarian, Mahsa Fatahichegeni, Juan Ren and Xiaoning Wang

Curr. Oncol. 2025, 32(4), 204; https://doi.org/10.3390/curroncol32040204 - 31 Mar 2025

Abstract

Biological sex and gender factors significantly influence the pathogenesis, progression, and treatment response in hematologic malignancies. This comprehensive review examines sex-specific differences in acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, and multiple myeloma through systematic analysis of the peer-reviewed literature published [...] Read more.

Biological sex and gender factors significantly influence the pathogenesis, progression, and treatment response in hematologic malignancies. This comprehensive review examines sex-specific differences in acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, and multiple myeloma through systematic analysis of the peer-reviewed literature published between 2014–2024 and identified through structured searches of PubMed, Web of Science, and MEDLINE databases. Epidemiological data demonstrate higher disease incidence (57% male vs. 43% female in MM, 63% male vs. 37% female in AML hospitalizations for ages 18–39) and inferior outcomes in male patients across malignancy types (5-year relative survival rates of 48.8% vs. 60.4% in females with AML), while female patients exhibit superior survival despite experiencing greater treatment-related toxicities. Our analysis reveals consistent sex-specific patterns in molecular mechanisms, including distinct mutational profiles, differences in immune system function, and sex-based pharmacokinetic variations that collectively suggest the necessity for sex-differentiated treatment approaches. The review identifies reproducible patterns across diseases, particularly in cytogenetic and molecular characteristics, with females demonstrating favorable prognostic mutations in leukemias and higher rates of chromosomal abnormalities in multiple myeloma. Despite these identifiable patterns, significant knowledge gaps persist regarding the underlying mechanisms of sex-based outcome differences. Incorporating sex and gender considerations into precision medicine frameworks represents a critical advancement toward optimizing treatment strategies and improving clinical outcomes for patients with hematologic malignancies. Full article

(This article belongs to the Section Hematology)

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35 pages, 4916 KiB

Open AccessReview

Neuropilin-1: A Multifaceted Target for Cancer Therapy

by Sai Manasa Varanasi, Yash Gulani, Hari Krishnareddy Rachamala, Debabrata Mukhopadhyay and Ramcharan Singh Angom

Curr. Oncol. 2025, 32(4), 203; https://doi.org/10.3390/curroncol32040203 - 31 Mar 2025

Abstract

Neuropilin-1 (NRP1), initially identified as a neuronal guidance protein, has emerged as a multifaceted regulator in cancer biology. Beyond its role in axonal guidance and angiogenesis, NRP1 is increasingly recognized for its significant impact on tumor progression and therapeutic outcomes. This review explores [...] Read more.

Neuropilin-1 (NRP1), initially identified as a neuronal guidance protein, has emerged as a multifaceted regulator in cancer biology. Beyond its role in axonal guidance and angiogenesis, NRP1 is increasingly recognized for its significant impact on tumor progression and therapeutic outcomes. This review explores the diverse functions of NRP1 in cancer, encompassing its influence on tumor cell proliferation, migration, invasion, and metastasis. NRP1 interacts with several key signaling pathways, including vascular endothelial growth factor (VEGF), semaphorins, and transforming growth factor-beta (TGF-β), modulating the tumor microenvironment and promoting angiogenesis. Moreover, NRP1 expression correlates with poor prognosis in various malignancies, underscoring its potential as a prognostic biomarker. Therapeutically, targeting NRP1 holds promise as a novel strategy to inhibit tumor growth and enhance the efficacy of regular treatments such as chemotherapy and radiotherapy. Strategies involving NRP1-targeted therapies, including monoclonal antibodies, small molecule inhibitors, and gene silencing techniques, are being actively investigated in preclinical and clinical settings. Despite challenges in specificity and delivery, advances in understanding NRP1 biology offer new avenues for personalized cancer therapy. Although several types of cancer cells can express NRPs, the role of NRPs in tumor pathogenesis is largely unknown. Future investigations are needed to enhance our understanding of the effects and mechanisms of NRPs on the proliferation, apoptosis, and migration of neuronal, endothelial, and cancer cells. The novel frameworks or multi-omics approaches integrate data from multiple databases to better understand cancer’s molecular and clinical features, develop personalized therapies, and help identify biomarkers. This review highlights the pivotal role of NRP1 in cancer pathogenesis and discusses its implications for developing targeted therapeutic approaches to improve patient outcomes, highlighting the role of OMICS in targeting cancer patients for personalized therapy. Full article

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10 pages, 235 KiB

Open AccessArticle

Merkel-Cell Carcinoma: Local Recurrence Rate Versus Radiation Dose Study from a 949-Patient Database

by Patricia Tai, Michael Veness, Vimal H. Prajapati, Aoife Jones Thachuthara, Jidong Lian, Avi Assouline, Edward Yu and Kurian Joseph

Curr. Oncol. 2025, 32(4), 202; https://doi.org/10.3390/curroncol32040202 - 28 Mar 2025

Abstract

(1) Background: Knowledge regarding the optimal radiotherapy dose for Merkel-cell carcinoma (MCC) remains limited. (2) Methods: Following a PubMed search, equivalent doses in 2 Gy fractions (Gy2) were compared. (3) Results: Of the 949 patients, 939 were evaluable, with 728 (77.5%) cases localized [...] Read more.

(1) Background: Knowledge regarding the optimal radiotherapy dose for Merkel-cell carcinoma (MCC) remains limited. (2) Methods: Following a PubMed search, equivalent doses in 2 Gy fractions (Gy2) were compared. (3) Results: Of the 949 patients, 939 were evaluable, with 728 (77.5%) cases localized to the primary site and 171 irradiated without chemotherapy. The overall local recurrence rate (LRR) was 23% (40/171). After definitive radiotherapy with EQD2 < 50 Gy2 versus ≥50 Gy2, the LRRs were 23.1% (3/13) and 12.5% a(1/8), respectively (p = 0.0004). (4) Conclusions: For definitive radiotherapy, EQD2 < 50 Gy2 demonstrates a significantly higher LRR than ≥50 Gy2 (p = 0.0004). This study is clinically useful and unique with stratification by definitive/adjuvant settings and positive/negative resection margins. A future prospective multicenter study is needed to determine the optimal radiotherapy doses. Full article

(This article belongs to the Section Dermato-Oncology)

9 pages, 993 KiB

Open AccessCase Report

Combined Use of Gefitinib and Bevacizumab in Advanced Non-Small-Cell Lung Cancer with EGFR G719S/S768I Mutations and Acquired C797S Without T790M After Osimertinib: A Case Report and Literature Review

by Wenting Lu, Jiayi Sun, Yawan Jing, Jing Xu, Chengming Huang, Yi Deng, Panwen Tian and Yalun Li

Curr. Oncol. 2025, 32(4), 201; https://doi.org/10.3390/curroncol32040201 - 28 Mar 2025

Abstract

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are effective in non-small-cell lung cancer (NSCLC) with sensitizing mutations. However, patients with uncommon EGFR mutations show variable responses, and resistance often develops. The C797S mutation is a common resistance mechanism after [...] Read more.

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are effective in non-small-cell lung cancer (NSCLC) with sensitizing mutations. However, patients with uncommon EGFR mutations show variable responses, and resistance often develops. The C797S mutation is a common resistance mechanism after third-generation EGFR-TKI osimertinib therapy, with no standard treatment established. A 37-year-old Chinese woman with advanced NSCLC harboring EGFR G719S/S768I mutations developed an acquired C797S mutation without T790M after second- and third-generation EGFR-TKI therapy. She was treated with a combination of gefitinib and bevacizumab, achieving a partial response, particularly in liver metastases. Her overall survival exceeded 60 months. Gefitinib combined with bevacizumab demonstrates efficacy in managing NSCLC with uncommon EGFR mutations and overcoming acquired C797S resistance. This combination therapy offers a promising treatment strategy for patients with limited options after resistance to second- and third-generation EGFR-TKIs. Full article

(This article belongs to the Section Thoracic Oncology)

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13 pages, 1122 KiB

Open AccessArticle

A New Prognostic Indicator for Biliary Tract Cancers: The ABIC Score

by Doğan Bayram, Öznur Bal, Kemal Karaman, Murat Bardakçı, Derya Demirtaş Esmer, İsmet Seven, Serhat Sekmek, Perihan Perkin, Fahriye Tuğba Köş, Efnan Algın and Doğan Uncu

Curr. Oncol. 2025, 32(4), 200; https://doi.org/10.3390/curroncol32040200 - 28 Mar 2025

Abstract

Introduction: Biliary tract cancers (BTC) comprise a heterogeneous group of malignancies, including gallbladder cancer, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma. The main determinants of prognosis in BTC are the stage of the disease and the eligibility for curative treatment. Additionally, liver functional capacity is [...] Read more.

Introduction: Biliary tract cancers (BTC) comprise a heterogeneous group of malignancies, including gallbladder cancer, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma. The main determinants of prognosis in BTC are the stage of the disease and the eligibility for curative treatment. Additionally, liver functional capacity is also one of the factors influencing survival in biliary tract cancers. The age–bilirubin–INR–creatinine (ABIC) score has been previously shown to predict prognosis in hepatic diseases. The aim of our study is to demonstrate the relationship between the ABIC score and prognosis in BTC. Materials and Methods: In this study, a retrospective analysis was performed on 41 patients with non-metastatic BTC and 73 patients with metastatic BTC who were followed up in our clinic between 2003 and 2025. All patients were ≥18 years old at the time of diagnosis, and BTC was pathologically confirmed. The ABIC score was calculated separately for each group. A threshold value for the ABIC score was determined using Receiver Operating Characteristic (ROC) analysis, and based on this threshold, patients were divided into low and high ABIC score groups. Both the relationship between the ABIC score and prognosis and the other factors affecting prognosis were investigated. Results: In the non-metastatic BTC group, the cutoff value for the ABIC score was 6.89. The median survival time of patients with a high ABIC score was significantly shorter. In the metastatic BTC group, the cutoff value for the ABIC score was 7.41. Similarly, in this group, patients with a high ABIC score had a significantly shorter median survival time. Additionally, in the non-metastatic BTC group, tumor localization and stage were prognostic factors affecting survival, while in the metastatic BTC group, CEA and first-line chemotherapy were the prognostic factors influencing overall survival. Conclusions: We demonstrate that the ABIC score is a prognostic factor determining median survival in both non-metastatic and metastatic BTC patients. Full article

(This article belongs to the Special Issue Biliary Tract Cancer Updates: Advancements and Insights)

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10 pages, 374 KiB

Open AccessArticle

Equivalent Disease-Specific Survival Between Rural and Urban Osteosarcoma Patients: A Retrospective Analysis of the SEER Database

by Kate S. Woods, Mitchell A. Taylor and Peter T. Silberstein

Curr. Oncol. 2025, 32(4), 199; https://doi.org/10.3390/curroncol32040199 - 28 Mar 2025

Abstract

Osteosarcoma is the most common primary malignancy of bone. Previous studies have demonstrated rural-urban disparities in metastatic disease incidence and overall survival in high-grade osteosarcoma patients. However, there is a paucity of literature investigating disease-specific survival (DSS) disparities between rural and urban patients, [...] Read more.

Osteosarcoma is the most common primary malignancy of bone. Previous studies have demonstrated rural-urban disparities in metastatic disease incidence and overall survival in high-grade osteosarcoma patients. However, there is a paucity of literature investigating disease-specific survival (DSS) disparities between rural and urban patients, which is explored herein using the SEER database. Patients with biopsy-proven cases of osteosarcoma were identified from 2000–2021. Statistical analysis was completed using SPSS version 29.0.2 and included chi-squared, Kaplan–Meier and log-rank, and stepwise Cox regressions. Statistical significance was considered at p < 0.05. Kaplan–Meier analysis revealed no significant differences in 5- and 10-year DSS between rural (55.0% and 47.0%) and urban patients (56.0% and 51.0%) (p = 0.107). Multivariable analysis further revealed no significant DSS difference between rural and urban patients (aHR: 1.03; 95% CI: 0.86–1.24; p = 0.757). This study expands upon prior research by investigating DSS between rural and urban osteosarcoma patients and finding no significant differences. While rural living is often associated with worse outcomes, important prognostic factors for osteosarcoma, including metastatic disease at presentation and tumor grade, were not significantly different between rural and urban patients in our study, possibly explaining our DSS-related findings. Factors other than geographical location likely impact outcomes, and future research should examine other ways that rural living may influence cancer care. Full article

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

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20 pages, 2163 KiB

Open AccessReview

Pathogenesis, Diagnosis, and Management of Cytokine Release Syndrome in Patients with Cancer: Focus on Infectious Disease Considerations

by Panos Arvanitis, Andreas Tziotis, Spyridon Papadimatos and Dimitrios Farmakiotis

Curr. Oncol. 2025, 32(4), 198; https://doi.org/10.3390/curroncol32040198 - 28 Mar 2025

Abstract

Background: Cytokine Release Syndrome (CRS) is a hyperinflammatory state triggered by immune therapies like CAR T-cell therapy and bispecific T-cell engagers (BiTEs). Characterized by excessive cytokine release, CRS often mimics infectious and inflammatory conditions, complicating diagnosis and treatment. Immunosuppressive therapies used for CRS [...] Read more.

Background: Cytokine Release Syndrome (CRS) is a hyperinflammatory state triggered by immune therapies like CAR T-cell therapy and bispecific T-cell engagers (BiTEs). Characterized by excessive cytokine release, CRS often mimics infectious and inflammatory conditions, complicating diagnosis and treatment. Immunosuppressive therapies used for CRS further elevate the risk of secondary infections. Methods: A systematic search of PubMed and EMBASE was conducted using terms related to “cytokine release syndrome”, “cytokine storm”, “infections”, and “management”. Studies were included if they described infectious complications, diagnostic mimics, or therapeutic approaches related to CRS. Results: Of 19,634 studies, 2572 abstracts were reviewed. Infections occurred in up to 23% of patients post-CAR T therapy and 24% post-BiTE therapy. Pathogens included gram-positive and gram-negative bacteria, herpesviruses (e.g., CMV, HSV), fungi (e.g., Candida, Aspergillus), and parasites (e.g., Toxoplasma gondii). CRS mimics also included non-infectious inflammatory syndromes. Differentiation remains challenging, but cytokine profiling and biomarkers (e.g., ferritin, CRP, sIL-2Rα) may aid in diagnosis. Treatments included tocilizumab, corticosteroids, and empiric antimicrobials. Prophylactic strategies were inconsistently reported. Conclusions: Effective CRS management requires early recognition, differentiation from infectious mimics, and collaboration between oncology and infectious disease (ID) specialists. A multidisciplinary, collaborative, and structured approach, including dedicated ID input and pre-treatment evaluation, is essential for optimizing CRS management and patient outcomes. Full article

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19 pages, 248 KiB

Open AccessArticle

How Can We Engage Oncology Care Providers and Glioblastoma Patients in Conversations About Physical Activity: A Qualitative Descriptive Study Using the Theoretical Domains Framework

by Jodi E. Langley, Grace Warner, Christine Cassidy, Robin Urquhart, Mary MacNeil and Melanie R. Keats

Curr. Oncol. 2025, 32(4), 197; https://doi.org/10.3390/curroncol32040197 - 27 Mar 2025

Abstract

Glioblastoma (GB) is the most common primary malignant brain tumour in adults. Physical activity (PA) has value as a supportive service for individuals living with a GB diagnosis to help maintain quality of life and physical functioning. The objective of this study is [...] Read more.

Glioblastoma (GB) is the most common primary malignant brain tumour in adults. Physical activity (PA) has value as a supportive service for individuals living with a GB diagnosis to help maintain quality of life and physical functioning. The objective of this study is to understand how oncology care providers (OCPs), family/friend caregivers, and health system decision makers can include conversations of PA into care for those living with a GB. We conducted 19 semi-structured interviews guided by the Capability, Opportunity, Motivation–Behaviour (COM-B) model and further refined them by the theoretical domains framework (TDF). The data were then analyzed using a directed content analysis using a codebook generated using the TDF. Patients and family/friend caregivers appreciated hearing about PA from their OCPs, from initial diagnosis into follow-up appointments, and they saw PA as a way to take a break from cancer/medically focused care, and historical PA behaviours did not mean patients were more or less likely to be open about PA discussions. This study further emphasises the inclusion of PA discussions in clinical care. OCPs in GB care feel they have the knowledge to partake in PA conversations, and GB patients are open to having these conversations. However, specific barriers are in place that do not lead to widespread implementation of PA discussions for all patients. Full article

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

17 pages, 276 KiB

Open AccessReview

Is There (Still) a Place for Sequential Conditioning?

by Boris Bours and Stavroula Masouridi-Levrat

Curr. Oncol. 2025, 32(4), 196; https://doi.org/10.3390/curroncol32040196 - 27 Mar 2025

Abstract

There is still an unmet need for the treatment of high-risk hematological malignancies. To date, allogeneic stem cell transplantation remains the only chance of cure. Most patients suffering from high-risk hematological malignancies are of an older age and often present with comorbidities. Moreover, [...] Read more.

There is still an unmet need for the treatment of high-risk hematological malignancies. To date, allogeneic stem cell transplantation remains the only chance of cure. Most patients suffering from high-risk hematological malignancies are of an older age and often present with comorbidities. Moreover, patients achieving remission often suffer from early relapse. Amongst the different treatment options, sequential conditioning has yet to prove its value against other conditioning regimens. Sequential conditioning relies on a short course of intensive chemotherapy that is quickly followed by immunosuppressive conditioning before allogeneic stem cell transplantation. Here, we will try to determine which patients can benefit from sequential conditioning. Amongst the different sequential regimens, we will also try to assess if one regimen is better than all the others. Despite the several studies conducted on sequential conditioning, very few are prospective work and head-to-head comparisons are almost inexistant. Sequential conditioning also relies on the use of prophylactic donor lymphocyte infusion post-transplantation. Hence, limiting non-relapse complications is of primary importance to the allow administration of post-transplant treatment. In the era of new targeting therapies, is there still a place for sequential conditioning? Can patients benefit from an association of new therapeutic agents and sequential conditioning? Full article

(This article belongs to the Section Hematology)

23 pages, 7837 KiB

Open AccessSystematic Review

Incidence Rates of Cutaneous Immune-Related Adverse Events in Patients with Lung Cancer: A Systematic Review and Meta-Analysis

by Zhihui Yang, Yuanyuan Luo, Ruiqi Lu, Xinqi Liu, Hanyu Liu, Suting Liu, Chen Huang, Jinhui Tian and Lili Zhang

Curr. Oncol. 2025, 32(4), 195; https://doi.org/10.3390/curroncol32040195 - 27 Mar 2025

Abstract

Objective: Cutaneous immune-related adverse events (cirAEs) represent a prevalent manifestation of adverse reactions linked to immune checkpoint inhibitors (ICIs) therapy, substantially affecting patients’ quality of life. This systematic review and meta-analysis aimed to quantify the pooled incidence of cirAEs in this population and [...] Read more.

Objective: Cutaneous immune-related adverse events (cirAEs) represent a prevalent manifestation of adverse reactions linked to immune checkpoint inhibitors (ICIs) therapy, substantially affecting patients’ quality of life. This systematic review and meta-analysis aimed to quantify the pooled incidence of cirAEs in this population and strengthen clinical awareness for early recognition and management. Methods: A comprehensive search of PubMed, Embase, CINAHL, Cochrane Library, CBM, CNKI, and Wanfang databases was conducted from inception to December 2022. Literature that reported the incidence of cirAEs in patients with lung cancer receiving ICIs therapy was included. A meta-analysis was conducted using R software, version 4.4.1 to estimate the pooled incidence of cirAEs, and a random-effects model was used for data synthesis. Begg’s rank correlation and funnel plots were used to assess publication bias. Results: A total of 99 articles involving 23,814 patients with lung cancer receiving ICIs therapy were included, with publication dates ranging from 2012 to 2022. The meta-analysis results reveal that the incidence of cirAEs in patients with lung cancer was 20.26% (95% confidence interval [CI (17.12–23.81)]. Significant differences were observed between all subgroups, including continent, study type, combination therapy, dual ICIs therapy, and diagnostic criteria for cirAEs for Grade 1–2 and Grade 3–4 incidences. Conclusions: The incidence of cirAEs in patients with lung cancer is relatively high, particularly undergoing combined or dual ICIs therapy. To comprehensively characterize cirAEs in patients with lung cancer, large-scale multicenter studies integrating real-world pharmacovigilance data are warranted to establish precise incidence estimates and identify clinically significant risk factors. Implications for clinical practice: This review’s insights aroused clinical staff’s attention and concern about cirAEs, potentially enhancing the quality of life of patients with cancer. Full article

(This article belongs to the Section Oncology Nursing)

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