Current Oncology

19 pages, 4201 KB

Open AccessArticle

Real-World Outcomes of Frontline Multimodal Treatment Strategies for Localized Extranodal NK/T-Cell Lymphoma, Nasal Type: A Single-Center Vietnamese Cohort Study

by Huong Nguyen Thi Thu, Dang Nguyen Van, Yen Le Thi, Tung Nguyen Thanh, Manh Pham Duy, Nga Tran Thi Giang and Quang Le Van

Curr. Oncol. 2026, 33(7), 435; https://doi.org/10.3390/curroncol33070435 - 21 Jul 2026

Abstract

Introduction: Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL-NT), is a rare and aggressive lymphoma for which real-world data from resource-limited settings remain scarce. This study evaluated the efficacy and safety of frontline multimodal treatment strategies for localized ENKTL-NT. Methods: We retrospectively analyzed 62 [...] Read more.

Introduction: Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL-NT), is a rare and aggressive lymphoma for which real-world data from resource-limited settings remain scarce. This study evaluated the efficacy and safety of frontline multimodal treatment strategies for localized ENKTL-NT. Methods: We retrospectively analyzed 62 patients with localized ENKTL-NT treated at the Vietnam National Cancer Hospital between May 2019 and June 2025. Patients received concurrent chemoradiotherapy followed by VIPD or VIDL, or sequential chemoradiotherapy with GELOX/PGEMOX. Treatment responses, survival outcomes, and toxicities were assessed. Results: The median age was 44 years, and 67.7% of patients had stage I disease. Baseline EBV-DNA positivity was detected in 46.8%, while 54.8% had PINKE scores of 1–2. The overall response rate was 93.5%, including an 85.5% complete response rate. Grade 3–4 neutropenia was the most common adverse event (18.7%). The estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 76.3% and 79.5%, respectively. Multivariable Cox analysis identified PINKE risk stratification as an independent predictor of both PFS and OS. Conclusions: Frontline multimodal treatment strategies achieved high response rates, favorable survival outcomes, and manageable toxicities in localized ENKTL-NT. The PINKE score remained an important prognostic factor, supporting risk-adapted treatment selection in routine clinical practice. Full article

(This article belongs to the Section Hematology)

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23 pages, 7483 KB

Open AccessReview

Perineural Invasion, Pain and Immunosuppression Across Solid Tumours

by Przemysław Dybcio, Anna Kuraś, Mikołaj Dyrka, Michał Iwaszko, Joanna Pec, Jakub Kleinrok and Agnieszka Korolczuk

Curr. Oncol. 2026, 33(7), 434; https://doi.org/10.3390/curroncol33070434 - 20 Jul 2026

Abstract

Perineural invasion (PNI) is a distinct route of cancer spread associated with neuropathic pain, local recurrence, and poor survival across many solid tumours. Increasing evidence shows that PNI is not only a structural pattern of invasion but also a dynamic biological process involving [...] Read more.

Perineural invasion (PNI) is a distinct route of cancer spread associated with neuropathic pain, local recurrence, and poor survival across many solid tumours. Increasing evidence shows that PNI is not only a structural pattern of invasion but also a dynamic biological process involving neurodegeneration, nociceptor sensitisation, and marked local immunosuppression. This narrative review synthesises experimental, translational, and clinical data on the molecular, neurological, and immunological mechanisms of PNI in solid malignancies. PNI arises through complex crosstalk between tumour cells, Schwann cells, macrophages, fibroblasts, and neurotrophic pathways, leading to peripheral nerve remodelling, axonal degeneration, and abnormal regeneration. These changes promote neuropathic pain through ion-channel dysregulation, neurotrophin-driven sensitisation, and pathological neuroplasticity. At the same time, PNI creates an immunosuppressive microenvironment enriched in Tregs, M2 macrophages, and myeloid-derived suppressor cells, shaped by cholinergic, adrenergic, and neuropeptidergic signalling, which may contribute to immune exclusion and resistance to immunotherapy. We propose that PNI should be understood as a neuro-immuno-metabolic process and that recognising the PNI–pain–immunosuppression triad may support the development of targeted neuroprotective, analgesic, and immunomodulatory therapies. Full article

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15 pages, 3215 KB

Open AccessArticle

An Equity-Embedded, Protocol-Agnostic Pre-Trial Navigation Model for Canadian Blood Cancer Trials: Findings from the Myeloma Canada Phase 0 Workshop

by Gabriele Colasurdo, Alvina Nadeem, Nina Mason, Juliette Royer, Stephanie Soltys, Henry Chan, Richard K. Plante, Julie Stakiw, Joseph R. Mikhael and Michelle Oana

Curr. Oncol. 2026, 33(7), 433; https://doi.org/10.3390/curroncol33070433 - 20 Jul 2026

Abstract

Background: Inequitable access to clinical trials persists in blood cancers despite ongoing equity, diversity, and inclusion (EDI) efforts. Despite the critical role of clinical trials in improving survival and outcomes, recruitment remains suboptimal, limiting patient access to potentially life-saving therapies. Practical and scalable [...] Read more.

Background: Inequitable access to clinical trials persists in blood cancers despite ongoing equity, diversity, and inclusion (EDI) efforts. Despite the critical role of clinical trials in improving survival and outcomes, recruitment remains suboptimal, limiting patient access to potentially life-saving therapies. Practical and scalable approaches are therefore needed to address the non-medical barriers that hinder patient readiness upstream of enrolment. Methods: Myeloma Canada led a national, multi-phase initiative using human-centred design (HCD) to operationalize EDI in clinical trials. Following an initial systems level workshop, the two-day Phase 0 workshop used a HCD approach that convened a purposively selected multidisciplinary group of stakeholders to co-design operational solutions for non-medical barriers affecting trial participation for patients. Given the use of purposive sampling, the results should be interpreted as reflecting a balanced range of diverse, informed perspectives across the Canadian clinical trial ecosystem. Results: Participants identified persistent cultural, logistical, financial, and linguistic barriers, along with fragmented awareness of available supports. Across diverse personas and care settings, all groups independently converged on a human-centred, equity-focused pre-trial navigation model supported by simple digital tools, including AI-enabled infrastructure drawing on curated resources from validated sources with appropriate governance, privacy, and oversight. Digital tools were proposed to support, rather than replace, human support and to align with existing health system realities. Conclusions: This hypothesis-generating work proposes a feasible, sustainable, and scalable equity-embedded, protocol-agnostic navigation framework. Its external hub-and-spoke structure can reduce non-medical barriers, strengthen trial access and accrual, and enhance representativeness. Pilot implementation that assesses feasibility, uptake, workflow impact, equity effects, and implementation burden is warranted. Full article

(This article belongs to the Section Hematology)

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12 pages, 222 KB

Open AccessArticle

Early Adherence to Immunomodulators in Multiple Myeloma: Retrospective Observations from a Safety-Net Hospital

by Onyebuchi Ononogbu, Sydney Mohr, Javeria Khalid, Alyssa Glass, Jane Emovon, Hilary Ma, Yaser Alkhatib and Amit Correa

Curr. Oncol. 2026, 33(7), 432; https://doi.org/10.3390/curroncol33070432 - 19 Jul 2026

Abstract

Background/Objectives: Multiple myeloma (MM) disproportionately affects older adults and racial/ethnic minorities, many of whom face socioeconomic barriers to care. Immunomodulators (IMiDs) are central to MM therapy, but their benefit relies on timely initiation and sustained adherence. In safety-net settings, barriers such as insurance [...] Read more.

Background/Objectives: Multiple myeloma (MM) disproportionately affects older adults and racial/ethnic minorities, many of whom face socioeconomic barriers to care. Immunomodulators (IMiDs) are central to MM therapy, but their benefit relies on timely initiation and sustained adherence. In safety-net settings, barriers such as insurance approvals, Patient Medication Assistance Program (PMAP) enrollment, and Risk Evaluation and Mitigation Strategy (REMS) requirements may influence adherence. This study evaluated IMiD adherence during the first two years of therapy among socioeconomically vulnerable MM patients in a large safety-net hospital, with attention to PMAP enrollment and treatment delays. Methods: We conducted a retrospective cohort study of adults (≥18 years) with newly diagnosed MM between October 2010 and January 2022 who initiated lenalidomide or pomalidomide at a safety-net hospital. Adherence was measured using the proportion of days covered (PDC). Delays in initiation were defined as ≥1 month from diagnosis to first IMiD prescription fill. This threshold was selected a priori based on the REMS-mandated 28-day prescription supply limit for lenalidomide and pomalidomide, which establishes a natural monthly treatment cycle; a delay exceeding one full 28-day cycle before therapy initiation is operationally meaningful within the REMS framework. Results: Eighty patients met criteria (mean age 55.1 years; 56.3% Hispanic/Latino; 31.3% African American). Most were unemployed (63.8%), 42.5% uninsured, and 57.5% enrolled in PMAP. Only 12.5% achieved PDC ≥ 80%. Median PDC was higher among PMAP enrollees (0.40 vs. 0.31; p = 0.0293) and transplant-ineligible patients (0.46 vs. 0.27; p = 0.0218). Delays ≥ 1 month occurred in 65% of patients. Conclusions: Adherence to IMiDs was suboptimal in this younger safety-net cohort. Although PMAP improved adherence, program delays may reduce early treatment benefits, underscoring the need for streamlined access and targeted interventions to address both patient- and system-level barriers. Full article

(This article belongs to the Section Hematology)

32 pages, 424 KB

Open AccessReview

Controversies in the Management of AML in Older Patients: A Canadian Perspective

by Andre C. Schuh, Joseph Brandwein, Mahmoud Elsawy, David Sanford and Brian Leber

Curr. Oncol. 2026, 33(7), 431; https://doi.org/10.3390/curroncol33070431 - 18 Jul 2026

Abstract

In the companion article in this issue of Current Oncology, ‘Management of AML in Older Patients: An Updated Canadian Consensus’, the authors have presented the third iteration of Canadian consensus guidelines on AML treatment in the elderly. While many aspects of AML [...] Read more.

In the companion article in this issue of Current Oncology, ‘Management of AML in Older Patients: An Updated Canadian Consensus’, the authors have presented the third iteration of Canadian consensus guidelines on AML treatment in the elderly. While many aspects of AML treatment in the elderly have become better defined, some old questions remain and new questions and controversies have arisen. Here, we address three topics on which there is, at this time, no universal consensus. The first is the development and features of new risk-stratification systems specifically aimed at older, less-intensively treated patients. Several different systems now exist in parallel, potentially causing confusion amongst clinicians. The second topic is good-prognosis AML subtypes (IDH1- and NPM1-mutated AML). In the Canadian context, IDH1-mutated AML is of particular interest due to the new availability of ivosidenib in Canada. The third topic is adverse-risk AML subtypes (FLT3- and TP53-mutated AML). FLT3-mutated AML remains problematic, although it is anticipated that new drug approvals and measurable residual disease-based treatment approaches may alleviate this, at least in part. And in particular, TP53-mutated AML remains a major problem. Ongoing clinical trial enrollment is essential. Full article

(This article belongs to the Special Issue Future Perspectives for Treatment and Diagnosis of Acute Myeloid Leukemia (AML))

13 pages, 248 KB

Open AccessArticle

Substantial LVSI Is Independently Associated with Para-Aortic Nodal Metastasis in Patients Undergoing Laparoscopic Surgical Staging for Endometrial Cancer

by Candost Hanedan, Oğuz Kaan Köksal, Şahin Kaan Baydemir, Neslihan Öztürk, Hande Nur Öncü and Vakkas Korkmaz

Curr. Oncol. 2026, 33(7), 430; https://doi.org/10.3390/curroncol33070430 - 18 Jul 2026

Abstract

Lymphovascular space invasion (LVSI) is a well-established prognostic factor in endometrial cancer; however, its independent contribution to para-aortic nodal metastasis remains incompletely defined. Identifying factors associated with nodal dissemination is important for surgical staging and postoperative management. This retrospective, single-center cohort study included [...] Read more.

Lymphovascular space invasion (LVSI) is a well-established prognostic factor in endometrial cancer; however, its independent contribution to para-aortic nodal metastasis remains incompletely defined. Identifying factors associated with nodal dissemination is important for surgical staging and postoperative management. This retrospective, single-center cohort study included 121 patients with endometrial cancer who underwent laparoscopic pelvic and para-aortic lymphadenectomy. The cohort was predominantly obese (median BMI: 32 kg/m²). Clinicopathological variables were analyzed using univariable and multivariable logistic regression models to identify associations with lymph node metastasis and para-aortic lymph node metastasis. Lymph node metastasis was observed in 16.5% of patients, including para-aortic involvement in 9.9%. In univariable analysis, the LVSI category was significantly associated with lymph node metastasis (p = 0.002), with substantial LVSI being present in 50.0% of patients with nodal metastasis compared with 14.9% of those without. LVSI was categorized as negative, focal, or substantial. In multivariable logistic regression analyses using negative LVSI as the reference category, substantial LVSI remained independently associated with both overall nodal metastasis (OR 5.44, 95% CI 1.67–17.65, p = 0.005) and para-aortic nodal metastasis (OR 6.98, 95% CI 1.81–26.78, p = 0.005), whereas focal LVSI was not significantly associated with either outcome. These findings suggest that the extent of LVSI may be relevant to nodal metastasis, with substantial LVSI showing a stronger association than focal LVSI. Full article

(This article belongs to the Special Issue Innovation in Gynecologic Cancer Surgery)

24 pages, 352 KB

Open AccessGuidelines

Management of Acute Myeloid Leukemia in Older Patients: An Updated Canadian Consensus

by Andre C. Schuh, Nicholas Chornenki, Mohamed A. Elemary, Mahmoud Elsawy, Brett L. Houston, Brian Leber, Lee Mozessohn, Mitchell Sabloff, Brittany Salter, David Sanford and Joseph Brandwein

Curr. Oncol. 2026, 33(7), 429; https://doi.org/10.3390/curroncol33070429 - 18 Jul 2026

Abstract

These are the third Canadian consensus guidelines on the management of acute myeloid leukemia (AML) in older patients. The first was published in 2013, and the second in 2017. The management of AML in older patients changed significantly over this time span, with [...] Read more.

These are the third Canadian consensus guidelines on the management of acute myeloid leukemia (AML) in older patients. The first was published in 2013, and the second in 2017. The management of AML in older patients changed significantly over this time span, with decreasing emphasis on the use of intensive chemotherapy and the adoption of new standards of care based on less-intensive therapies: first azacitidine + venetoclax combinations, followed by azacitidine + ivosidenib. Increased use of these new therapies in older patients has raised questions about their use, including how to determine patient suitability, select the most effective therapy, and manage dosing and toxicity. In this third Canadian guideline, we address these questions to provide clarity around these new standards of care and improve clinician understanding and confidence in using them. As more new targeted agents become available and hypomethylating agent-based triplet combinations are used more widely, we fully anticipate that we will, in some years’ time, write a fourth guideline on the management of AML in older patients. Full article

(This article belongs to the Special Issue Future Perspectives for Treatment and Diagnosis of Acute Myeloid Leukemia (AML))

18 pages, 321 KB

Open AccessArticle

by Yolanda Andreu, Ana Soto-Rubio, Beatriz Gil-Juliá, Carmen Picazo, Inmaculada Maestu and Silvia Fernández

Curr. Oncol. 2026, 33(7), 428; https://doi.org/10.3390/curroncol33070428 - 17 Jul 2026

Abstract

The study aims to investigate the Health-Related Quality of Life (HRQOL) in lung cancer survivors, comparing it with the HRQOL of survivors of other types of cancer, analyzing its association with clinically significant distress, and exploring the modulating role of sociodemographic, clinical, and [...] Read more.

The study aims to investigate the Health-Related Quality of Life (HRQOL) in lung cancer survivors, comparing it with the HRQOL of survivors of other types of cancer, analyzing its association with clinically significant distress, and exploring the modulating role of sociodemographic, clinical, and psychosocial variables. A total of 141 lung cancer survivors who had completed treatment with curative intent and were disease-free completed the Quality of Life in Adult Cancer Survivors questionnaire (QLACS), the Brief Symptom Inventory-18 (BSI-18), the Medical Outcomes Study–Social Support Survey (MOS-SSS), and the Utrecht Proactive Coping Competence scale (UPCC). Several multivariate analyses of variance (MANOVA) were performed to address the study objectives. Statistical analysis was performed using IBM SPSS Statistics 22.0. The overall HRQOL of lung cancer survivors did not differ from the HRQOL of hematologic, breast, and gynaecologic cancer survivors and was lower than that of colorectal, head/neck, prostate, and melanoma cancer survivors. HRQOL was associated with clinically significant distress. Younger age, female sex, lower levels of proactive coping, and less positive social interaction were independently associated with worse HRQOL in lung cancer survivors. The overall HRQOL of lung cancer survivors is among those with the poorest HRQOL compared with other cancer survivors’ groups. The modifiable nature of the psychosocial variables that characterize the risk profile (with the exception of sociodemographic ones) allows for the establishment of more ambitious goals than the simple establishment of subgroups on which to prioritize care. The team of professionals involved in the care of lung cancer survivors should also provide intervention strategies that improve their well-being. Full article

(This article belongs to the Section Psychosocial Oncology)

19 pages, 15909 KB

Open AccessArticle

Patient Perspectives on Non-Hodgkin Lymphoma: A Qualitative Study to Guide Selection of Clinical Trial Endpoints

by Amy Clark, Sophie Van Tomme, Lucinda Hetherington, Carla Dias Barbosa and Paul Cordero

Curr. Oncol. 2026, 33(7), 427; https://doi.org/10.3390/curroncol33070427 - 17 Jul 2026

Abstract

The literature on the qualitative experiences of patients with non-Hodgkin lymphoma (NHL) is limited. Qualitative interviews were conducted to investigate participants’ experiences with two types of NHL (diffuse large B-cell lymphoma [n = 20] and mantle cell lymphoma [n = 10]) and evaluate [...] Read more.

The literature on the qualitative experiences of patients with non-Hodgkin lymphoma (NHL) is limited. Qualitative interviews were conducted to investigate participants’ experiences with two types of NHL (diffuse large B-cell lymphoma [n = 20] and mantle cell lymphoma [n = 10]) and evaluate the comprehensiveness of patient-reported outcome (PRO) measures. Fatigue, tiredness, body aches, night sweats, lethargy, headache, appetite loss, altered taste, and weakness were the most frequent and bothersome symptoms. Key impacts were decreased physical performance, restricted activity, sadness, distress, fear of recurrence, and worry about future. Most participants expressed positive opinions about the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 (EORTC QLQ-C30) (n = 22/28), EORTC QLQ-NHL-High Grade Module 29 (EORTC QLQ-NHL-HG29) (n = 12/16), EORTC QLQ-NHL-Low Grade Module 20 (EORTC QLQ-NHL-LG20) (n = 8/12), and Functional Assessment of Cancer Therapy–Lymphoma (FACT-Lym) (n = 10/14), considering them relevant to their experiences (22/27, 13/15, 9/13, and 10/12, respectively). All measures adequately captured their experiences with NHL (QLQ-C30: n = 26/26, NHL-HG29: n = 14/14, NHL-LG20: n = 11/11, and FACT-Lym: n = 12/13). These findings provide a valuable framework for informing the selection of appropriate PRO measures in NHL clinical trials and identifying potentially meaningful trial endpoints. Full article

(This article belongs to the Special Issue Patient-Reported Outcomes Including Health-Related Quality of Life in Cancer Clinical Trials)

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20 pages, 364 KB

Open AccessReview

First-Line Bruton’s Tyrosine Kinase Inhibitor-Based Regimens for Mantle Cell Lymphoma

by Robert Puckrin, Diego Villa, Isabelle Fleury, Jean-François Larouche and John Kuruvilla

Curr. Oncol. 2026, 33(7), 426; https://doi.org/10.3390/curroncol33070426 - 17 Jul 2026

Abstract

First-line (1L) therapy for mantle cell lymphoma (MCL) continues to evolve rapidly, with several recent phase II and phase III trials consistently showing the activity of novel covalent Bruton’s tyrosine kinase inhibitor (cBTKi) combinations. Historical treatment selection criteria such as patient age, fitness, [...] Read more.

First-line (1L) therapy for mantle cell lymphoma (MCL) continues to evolve rapidly, with several recent phase II and phase III trials consistently showing the activity of novel covalent Bruton’s tyrosine kinase inhibitor (cBTKi) combinations. Historical treatment selection criteria such as patient age, fitness, and eligibility for autologous stem cell transplantation generally remain applicable for some, but not all, of these novel regimens. This potential for flexibility necessitates the consideration of additional factors during decision-making, such as MCL biology, patient risk tolerance, logistical and resource implications, and the impact on use of later-line options. This paper presents three illustrative patient cases to explore 1L therapy selection among these new and emerging cBTKi options. The realized and anticipated benefits, limitations, and challenges and persisting evidence gaps associated with these regimens are discussed. Full article

(This article belongs to the Section Hematology)

24 pages, 4526 KB

Open AccessReview

Magnetic Resonance-Guided Radiotherapy for Unresectable Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Case Series and Review of Treatment Options

by Nam Kyu Kang, So Jung Lee, Hye Jin Kang, Hun-Joo Shin, Jung Hyun Kwon, Soon Kyu Lee and Myungsoo Kim

Curr. Oncol. 2026, 33(7), 425; https://doi.org/10.3390/curroncol33070425 - 16 Jul 2026

Abstract

Bile duct tumor thrombus (BDTT) is a rare manifestation of hepatocellular carcinoma (HCC) that causes obstructive jaundice and is associated with a poor prognosis, although a treatment algorithm has yet to be established. We review the treatment landscape for HCC with BDTT, including [...] Read more.

Bile duct tumor thrombus (BDTT) is a rare manifestation of hepatocellular carcinoma (HCC) that causes obstructive jaundice and is associated with a poor prognosis, although a treatment algorithm has yet to be established. We review the treatment landscape for HCC with BDTT, including surgical, transarterial, systemic, and radiotherapy options, and report, to our knowledge, the first case series of magnetic resonance-guided radiotherapy (MRgRT) for this condition. Four patients with unresectable HCC and BDTT were treated on a 0.35-T MR-linac with real-time cine-MRI gating (50 Gy in 5 fractions, n = 3; 40 Gy in 5 fractions, n = 1), with tumor response assessed by modified RECIST. All patients completed treatment without interruption. The best response was complete response in two patients and partial response in two, and obstructive jaundice resolved in both affected patients. The maximum radiation-attributed toxicity was a transient grade 3 bilirubin elevation that resolved without biliary intervention, and no treatment-related deaths occurred. Overall survival ranged from 5.5 to 29 months, with the two Child-Pugh class A patients without portal vein tumor thrombosis surviving 22 and 29 months. MRgRT for HCC with BDTT appears feasible with acceptable short-term safety and merits prospective evaluation. Full article

(This article belongs to the Special Issue Stereotactic Radiotherapy for Tumors: Clinical Innovation and Practice)

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12 pages, 316 KB

Open AccessArticle

The Efficacy of Transcutaneous Electrical Acupoint Stimulation as an Adjunct to Standard Bladder Training for Bladder Emptying After Radical Hysterectomy for Cervical Cancer: A Randomized Controlled Trial

by Ting Xu, Junya Ke, Yalin Yue, Zhiling Zhu, Mingzhi Zhao and Yun Wang

Curr. Oncol. 2026, 33(7), 424; https://doi.org/10.3390/curroncol33070424 - 16 Jul 2026

Abstract

After radical hysterectomy for cervical cancer, postoperative bladder dysfunction is common. This randomized controlled trial evaluated whether adjunctive transcutaneous electrical acupoint stimulation (TEAS) reduces urinary retention. A total of 108 patients were assigned to a control group (standard bladder training, n = 53) [...] Read more.

After radical hysterectomy for cervical cancer, postoperative bladder dysfunction is common. This randomized controlled trial evaluated whether adjunctive transcutaneous electrical acupoint stimulation (TEAS) reduces urinary retention. A total of 108 patients were assigned to a control group (standard bladder training, n = 53) or a TEAS group (standard training plus daily 30 min TEAS for 7 days from postoperative day 3, n = 55). The primary outcome was urinary retention (post-void residual > 100 mL on day 11). Secondary outcomes included residual volume, recovery time, recatheterization, urinary tract infection (UTI), treatment efficacy, and quality of life (SF-36). Urinary retention occurred in 35.8% of controls versus 23.6% of TEAS patients (p = 0.164). TEAS significantly reduced median residual volume (70 vs. 85 mL, p = 0.004), shortened median recovery time (2 vs. 4 h, p < 0.001), and lowered recatheterization (16.4% vs. 34.0%, p = 0.036). UTI rates were similar. Treatment efficacy favored TEAS (p = 0.009), and all eight SF-36 domains significantly improved (all p < 0.01). In conclusion, adjunctive TEAS did not significantly reduce the primary outcome of urinary retention but significantly improved multiple secondary bladder-emptying measures and quality of life after radical hysterectomy for cervical cancer. Full article

(This article belongs to the Section Gynecologic Oncology)

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23 pages, 1511 KB

Open AccessArticle

Middle Turbinectomy in Endoscopic Endonasal Skull Base Surgery: How Significant Is Its Impact on Quality of Life?

by Narin Nard Carmel Neiderman, Orr Raved, Harel Sofer, Idan Peled, Idan Ben Nachum, Ran Bilaus, Tomer Ziv Baran, Omer J. Ungar, Lior Gonen and Avraham Abergel

Curr. Oncol. 2026, 33(7), 423; https://doi.org/10.3390/curroncol33070423 - 15 Jul 2026

Abstract

Background: Endoscopic endonasal approaches for pituitary adenomas are associated with improved clinical and quality of life (QOL) outcomes. However, the necessity of middle turbinate resection to optimize surgical exposure remains controversial, particularly regarding its potential impact on postoperative nasal and tumor-related QOL. Methods: [...] Read more.

Background: Endoscopic endonasal approaches for pituitary adenomas are associated with improved clinical and quality of life (QOL) outcomes. However, the necessity of middle turbinate resection to optimize surgical exposure remains controversial, particularly regarding its potential impact on postoperative nasal and tumor-related QOL. Methods: This prospective cohort study included adult patients undergoing endoscopic endonasal transsphenoidal resection of pituitary adenomas between 2014 and 2021 at a tertiary center. Patients were divided into those undergoing bilateral middle turbinectomy and those with turbinate preservation. Tumor-related QOL was assessed using the Anterior Skull Base Disease-Specific Questionnaire (ASBS-Q), and nasal QOL using the Sinonasal Outcome Test-22 (SNOT-22), at baseline and multiple postoperative time points up to >6 months. Clinical and surgical variables were collected and compared between groups. Results: Our study included 73 patients, 51 (69.9.%) of whom underwent middle turbinate resection and 22 (30.1%) who did not. The difference in overall ASBS-Q scores did not alter significantly between both groups during the long-term postoperative course (>6 months). SNOT-22 score differences also did not alter significantly throughout the entire postoperative course. Conclusion: Middle turbinectomy during endoscopic endonasal resection of pituitary adenomas was not associated in our cohort to adversely affect long-term nasal or tumor-related QOL. Full article

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19 pages, 2495 KB

Open AccessArticle

Mapping Support-Seeking After Cancer Treatment: A Co-Designed Model of Triggers, Timing and Support Pathways in Young People with Lived Experience of Cancer

by Nicole Collaço, Anna Kennington, Natalie Greenberg, Tara Imber, Danae Warne and Samantha Sodergren

Curr. Oncol. 2026, 33(7), 422; https://doi.org/10.3390/curroncol33070422 - 15 Jul 2026

Abstract

Post cancer treatment, many young people often live with ongoing emotional, social, and physical difficulties, but support is not always accessed when it is needed. This study aimed to co-produce a conceptual model of support-seeking after cancer treatment with young people with lived [...] Read more.

Post cancer treatment, many young people often live with ongoing emotional, social, and physical difficulties, but support is not always accessed when it is needed. This study aimed to co-produce a conceptual model of support-seeking after cancer treatment with young people with lived experience of cancer, to better understand the triggers, timing, and pathways influencing engagement with support. This co-design work, informed by Bird et al.’s generative framework for co-production, built upon a prior study involving interviews and co-design workshops with young people and healthcare/allied health professionals, and informed a preliminary model of support-seeking. The current work involved two further co-production stages through an online survey and workshop to refine this model. Data were analysed using a thematic approach to support conceptual model development. Four interconnected themes shaped support-seeking: (1) readiness to engage: recognition, emotional readiness, and relational safety; (2) access and appraisal of support: visibility, fit, feasibility, and burden; (3) pathways to support: multi-modal, layered, and non-linear engagement; and (4) support trajectory: changing needs and recurrent engagement. Engagement in support-seeking depended on the alignment of readiness, recognition of need, and relational safety. This model offers a framework to improve how post-treatment support is designed and delivered in practice. Full article

(This article belongs to the Section Psychosocial Oncology)

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21 pages, 730 KB

Open AccessReview

Evolving First-Line Endocrine Therapy in HR+/HER2− Metastatic Breast Cancer: CDK4/6 Inhibition, Biomarker-Guided Strategies and Emerging Therapeutic Paradigms

by Hikmat Abdel-Razeq and Baha Sharaf

Curr. Oncol. 2026, 33(7), 421; https://doi.org/10.3390/curroncol33070421 - 14 Jul 2026

Abstract

Hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) metastatic breast cancer (MBC) is the most prevalent subtype of advanced breast cancer and is predominantly driven by estrogen receptor (ER) signaling. Endocrine therapy (ET) has become the backbone of first-line treatment; however, [...] Read more.

Hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) metastatic breast cancer (MBC) is the most prevalent subtype of advanced breast cancer and is predominantly driven by estrogen receptor (ER) signaling. Endocrine therapy (ET) has become the backbone of first-line treatment; however, both intrinsic and acquired resistance limit long-term disease control. The introduction of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors has fundamentally reshaped the therapeutic landscape even in subsets of patients with aggressive or symptomatic visceral metastatic disease. Advances in molecular profiling have also enabled more precise, adaptive therapy. Circulating tumor DNA (ctDNA)-based liquid biopsy now allows real-time detection of emerging resistance mutations, particularly in ESR1. Additionally, patients with PIK3CA-mutated tumors who had progressed on or within 12 months of completing adjuvant ET and had no prior systemic therapy for metastatic disease had better treatment outcomes when treated with the PI3K inhibitor inavolisib in combination with palbociclib and fulvestrant. Together, these developments mark a shift from fixed treatment sequencing toward a more dynamic, biomarker-driven approach in first-line HR+/HER2– MBC. Integration of CDK4/6 inhibitors with next-generation endocrine agents and liquid biopsy-guided therapy offers the potential to delay resistance, improve survival outcomes, and individualize treatment. Full article

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

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18 pages, 983 KB

Open AccessArticle

Renal Involvement in Indolent and Aggressive B-Cell Neoplasms: A Comparative Study of Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma and Diffuse Large B-Cell Lymphoma

by Yiming Zhao, Bingjie Wang, Huihui Liu, Xiaoying Yang, Zhizhen Lai, Bo Tang, Weiwei Xie, Hongtao Ling, Shuanglian Xie, Shujing Guo, Xiaojuan Yu and Yujun Dong

Curr. Oncol. 2026, 33(7), 420; https://doi.org/10.3390/curroncol33070420 - 14 Jul 2026

Abstract

Renal involvement is an uncommon but clinically important manifestation of B-cell neoplasms, and direct comparisons between indolent and aggressive entities remain limited. This single-center retrospective biopsy-confirmed and tissue-selected study compared 28 biopsy-confirmed patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) or diffuse large [...] Read more.

Renal involvement is an uncommon but clinically important manifestation of B-cell neoplasms, and direct comparisons between indolent and aggressive entities remain limited. This single-center retrospective biopsy-confirmed and tissue-selected study compared 28 biopsy-confirmed patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) or diffuse large B-cell lymphoma/high-grade B-cell lymphoma (DLBCL/HGBL), with 14 patients in each group, treated at Peking University First Hospital between June 2010 and June 2025. The aggressive comparator group included 13 DLBCL cases and one case annotated as HGBL with MYC and BCL2 rearrangements. Clinical features, timing of renal involvement recognition, dominant clinical entry points, pathological patterns, treatment strategies, and hematologic and renal responses were analyzed. CLL/SLL was associated with higher white blood cell and absolute lymphocyte counts, whereas DLBCL/HGBL showed higher lactate dehydrogenase and β2-microglobulin levels. The interval to renal involvement recognition was longer in CLL/SLL than in DLBCL (24.00 vs. 2.00 months, p = 0.007). At renal involvement recognition or biopsy, 24 h urinary protein excretion was nominally higher in the CLL/SLL group than in the DLBCL/HGBL group (3.90 vs. 1.58 g/24 h). CLL/SLL more often presented with proteinuria/edema, hematuria, or renal dysfunction and showed heterogeneous infiltrative lesions with concurrent glomerular or vascular involvement. DLBCL/HGBL more frequently presented with flank pain or renal mass-related manifestations and was dominated by direct infiltrative or mass-forming lesions. Treatment patterns differed markedly, whereas no significant difference in the distribution of renal responses was detected; however, this comparison was underpowered and should be interpreted descriptively. In this biopsy-confirmed, tissue-selected cohort, CLL/SLL and DLBCL/HGBL showed different observed patterns of renal involvement recognition, tissue acquisition, and renal pathological presentation. These findings support tissue-based evaluation of renal abnormalities in B-cell neoplasms but should be interpreted as descriptive and hypothesis-generating in view of the small sample size and the influence of diagnostic and biopsy pathways. Full article

(This article belongs to the Section Hematology)

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16 pages, 2445 KB

Open AccessArticle

Impact of High-Risk Mutations and Treatment Intensity in Accelerated-Phase Blast-Phase MPN Without Adverse-Risk Karyotype and TP53

by Verna Cheung, Marta Davidson, Eshetu G. Atenafu, Andrea Arruda, Jaime O. Claudio, Aniket Bankar, Dawn Maze, Vikas Gupta and Hassan Sibai

Curr. Oncol. 2026, 33(7), 419; https://doi.org/10.3390/curroncol33070419 - 12 Jul 2026

Abstract

The prognostic significance of myelodysplasia-related gene mutations (MDS-RGMs), defined by the ELN 2022 classification and Mutation-Enhanced International Prognostic Score System high-risk mutations (MIPSS70-HRM), in accelerated-phase (AP) and blast-phase (BP) myeloproliferative neoplasms (MPNs) remains unclear. We conducted a retrospective study of 101 AP/BP MPN [...] Read more.

The prognostic significance of myelodysplasia-related gene mutations (MDS-RGMs), defined by the ELN 2022 classification and Mutation-Enhanced International Prognostic Score System high-risk mutations (MIPSS70-HRM), in accelerated-phase (AP) and blast-phase (BP) myeloproliferative neoplasms (MPNs) remains unclear. We conducted a retrospective study of 101 AP/BP MPN patients with intermediate-risk cytogenetics, excluding TP53 mutations and adverse-risk karyotypes. We evaluated whether MDS-RGM or MIPSS70-HRM predicted treatment response, overall survival (OS), or disease-free survival (DFS) and whether treatment intensity affected OS. Patients included AP (29.7%) and BP (70.3%), with 55% receiving intensive therapy. Allogeneic stem cell transplant (ASCT) significantly improved OS (HR 0.31, 95% CI 0.19–0.50; p < 0.0001), as did AP versus BP at transformation (HR: 0.43, 95% CI 0.26–0.73; p = 0.0016). Among patients ≤ 70 years with ECOG 0–1 (N = 77), ASCT and reversion to chronic-phase MPN (cMPN) were associated with longer OS (p < 0.0001 and p = 0.0475). Treatment intensity alone did not significantly affect OS (p = 0.1991). Full article

(This article belongs to the Section Hematology)

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12 pages, 446 KB

Open AccessArticle

Establishing a Clinical Trial Quality Team in a Comprehensive Cancer Center: A Strategy to Navigate the New European Regulatory Landscape

by Francesco Callegarin, Elisa Masetto, Beatrice Basaldella, Paola Del Bianco, Giulia Doria, Denise Kilmartin, Giovanna Magni, Giacomo Moratello, Giorgia Pagan, Angela Paggio, Lisa Perilli, Paola Rescigno and Gian Luca De Salvo

Curr. Oncol. 2026, 33(7), 418; https://doi.org/10.3390/curroncol33070418 - 11 Jul 2026

Abstract

Background: Clinical research has evolved into a multidisciplinary field integrating Medical Devices (MD), In Vitro Diagnostics (IVD), and Artificial Intelligence (AI), governed by a modernized European regulatory framework including the Clinical Trial Regulation (CTR), the Medical Device Regulation (MDR), and the In Vitro [...] Read more.

Background: Clinical research has evolved into a multidisciplinary field integrating Medical Devices (MD), In Vitro Diagnostics (IVD), and Artificial Intelligence (AI), governed by a modernized European regulatory framework including the Clinical Trial Regulation (CTR), the Medical Device Regulation (MDR), and the In Vitro Diagnostics Regulation (IVDR). In 2021, the Istituto Oncologico Veneto (IOV) IRCCS established the Clinical Trial Quality Team (CTQT) to provide support for non-profit trials and ensure high-quality standards. Methods: A descriptive analysis of trials managed between 2021 and 2025 was conducted using the REDCap platform. A team of 15 professionals assessed performance via Key Performance Indicators (KPIs) categorized into: ethical–regulatory compliance, operational efficiency and data quality. Results: The CTQT manages 18 studies (83% interventional, 50% multicentre), primarily focused on brain (17%) and genitourinary (23%) tumours. The mean time from internal feasibility to Ethics Committee discussion is 13 days. Total approval time (ethical and administrative) is 107 days. Operational metrics are strong, with Site Initiation Time averaging 27 days and First Patient In (FPI) at 41 days. Conclusions: A centralized, multidisciplinary structure effectively supports non-profit research in a complex regulatory environment. While operational speed is high, challenges such as staff turnover and query management variability remain. Future efforts will focus on standardizing post-approval administrative phases and optimizing data management to further improve trial efficiency and integrity. Full article

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14 pages, 2580 KB

Open AccessArticle

Evaluation of Diagnostic Performance and Inter-Reader Agreement of Prostate Imaging After Focal Ablation (PI-FAB) on Post-Focal Therapy (FT) Magnetic Resonance Imaging (MRI)

by Guanqi Hang, Zhuyi Rebekah Lee, Anna Lois Lai, Jyothirmayi Velaga, Hua Thun Ho, Shelby Xuan Lin Lam, Yu Guang Tan, Nye Thane Ngo, John Shyi P. Yuen, Li Yan Khor, Melvin Lee Kiang Chua, Kae Jack Tay and Yan Mee Law

Curr. Oncol. 2026, 33(7), 417; https://doi.org/10.3390/curroncol33070417 - 11 Jul 2026

Abstract

Focal therapy (FT) for localized prostate cancer induces architectural changes that complicate post-treatment multiparametric magnetic resonance imaging (mpMRI) surveillance. The Prostate Imaging after Focal Ablation (PI-FAB) system was developed to standardize the evaluation of in-field recurrence on mpMRI. This study assessed the diagnostic [...] Read more.

Focal therapy (FT) for localized prostate cancer induces architectural changes that complicate post-treatment multiparametric magnetic resonance imaging (mpMRI) surveillance. The Prostate Imaging after Focal Ablation (PI-FAB) system was developed to standardize the evaluation of in-field recurrence on mpMRI. This study assessed the diagnostic performance and inter-reader agreement of PI-FAB following focal cryoablation for localized prostate cancer. In this retrospective study (October 2019 to January 2024), 85 patients (140 lesion sites) underwent post-FT mpMRI and biopsy. Two radiologists (11 and 4 years of experience) independently scored mpMRIs using the three-point PI-FAB scale. Metrics included sensitivity, specificity, PPV, NPV, and accuracy. Inter-reader agreement was measured via quadratic weighted Cohen’s kappa (κ). Reader 1 (more experienced) demonstrated 83.9% sensitivity, 84.4% specificity, 60.5% PPV, and 94.8% NPV. Reader 2 demonstrated 71.4% sensitivity, 87.5% specificity, 58.8% PPV, and 92.5% NPV. Both achieved 84.3% accuracy. Inter-reader agreement was moderate (κ = 0.60). PI-FAB provides good diagnostic performance for detecting in-field recurrence after cryoablation. While reader experience may impact sensitivity, moderate agreement across experience levels supports PI-FAB’s validity and potential clinical utility in standardizing post-FT surveillance. Full article

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

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