Current Oncology

16 pages, 430 KB

Open AccessArticle

Participants’ Evolving Experiences, Hope, and Coping While Enrolled in a Community-Based Bereavement Support Program: A Pre–Post Mixed-Methods Pilot Study

by Yoojung Kim and Carmen G. Loiselle

Curr. Oncol. 2026, 33(6), 350; https://doi.org/10.3390/curroncol33060350 (registering DOI) - 10 Jun 2026

Abstract

Living with Loss, an eight-session community-based bereavement program, supports individuals who have lost a loved one to cancer within the past two years. This pilot study sought to document people’s experiences across program delivery and compare levels of hope and coping before [...] Read more.

Living with Loss, an eight-session community-based bereavement program, supports individuals who have lost a loved one to cancer within the past two years. This pilot study sought to document people’s experiences across program delivery and compare levels of hope and coping before and after program completion. Participants (N = 11) completed self-report e-questionnaires (Hope Herth Index and Brief Cope Scale) before and after program completion. Semi-structured individual interviews were conducted before program attendance, at the midpoint and after program completion. Levels of hope and coping were compared using paired-sample t-tests. Digitally recorded interview data were transcribed verbatim and thematically analyzed. Total hope scores significantly increased at program completion. There were no significant pre-post changes in coping subscales. Qualitative data revealed three themes: (1) tangible and intangible program contributions to bereavement processes (i.e., developing coping strategies, perspective changes), (2) an enhanced sense of community post-attendance (i.e., mutual understandings, group-related growth), and (3) distinct preferences for in-person vs. virtual delivery (i.e., depth of interpersonal connections, anticipated instrumental issues including parking restrictions). Preliminary findings suggest that Living with Loss is relevant and beneficial for bereaved participants. Documenting experiences across program delivery serves to further inform program adjustments to better meet participants’ needs and preferences. Full article

(This article belongs to the Section Psychosocial Oncology)

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13 pages, 882 KB

Open AccessArticle

Automated PROMISE V2 Scoring from PSMA PET/CT Reports Using Large Language Models: A Comparative Evaluation of Prompt Design and Model Performance

by Tilman Speicher, Isa Ethem Demirkol, Arne Blickle, Moritz B. Bastian, Stephan Maus, Andrea Schaefer-Schuler, Mark Bartholomä, Caroline Burgard, Samer Ezziddin and Florian Rosar

Curr. Oncol. 2026, 33(6), 349; https://doi.org/10.3390/curroncol33060349 (registering DOI) - 9 Jun 2026

Abstract

Large language models (LLMs) are increasingly explored for clinical use. However, the extent to which such models can reliably support physicians in reporting, staging, and the assessment of classification remains an active area of research. This study aimed to evaluate and compare multiple [...] Read more.

Large language models (LLMs) are increasingly explored for clinical use. However, the extent to which such models can reliably support physicians in reporting, staging, and the assessment of classification remains an active area of research. This study aimed to evaluate and compare multiple LLMs for automated PROMISE V2 classification for prostate cancer. A total of 126 unambiguous German-language PSMA PET/CT text reports were retrospectively analyzed, with reference standards established by expert consensus based on image interpretation and the original report text. Five LLMs (GPT-5.4, DeepSeek-V3.2, Claude Sonnet 4.6, Gemini 3 Flash and Grok 4) were assessed using two English-language prompting strategies of varying complexity. Agreement with the reference standard served as the primary endpoint. Performance varied in the short-prompt setting (36.5–79.4%) but improved consistently with the long prompt (74.6–86.5%), with Gemini 3 Flash achieving the highest agreement. Across PROMISE V2 subcategories, agreement rates were high (miT: 81.0–92.1%, miN: 92.9–96.0%, miM: 92.9–95.2%), despite inter-model differences. In conclusion, contemporary LLMs demonstrate promising performance in deriving PROMISE V2 scores from unambiguous original report texts, particularly when guided by detailed prompts. Full article

(This article belongs to the Special Issue AI-Powered Oncologic Nuclear Medicine in Clinical Translation: Advanced Assessment of Tumor Load and Microenvironment)

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13 pages, 719 KB

Open AccessArticle

Perspectives of Rectal Cancer Patients Undergoing Non-Operative Management (NOM): A Qualitative Study

by Armaghan Alam, Ameer Farooq, Farhad Udwadia, Manoj Raval, Ahmer Karimuddin, Terry Phang, Amandeep Ghuman and Carl Brown

Curr. Oncol. 2026, 33(6), 348; https://doi.org/10.3390/curroncol33060348 (registering DOI) - 9 Jun 2026

Abstract

There is growing interest in non-operative management (NOM) for rectal cancer patients who achieve a complete response to neoadjuvant therapy. The patients’ perspectives of these approaches are limited. Here, we describe a qualitative study where we conducted semi-structured interviews with fourteen rectal cancer [...] Read more.

There is growing interest in non-operative management (NOM) for rectal cancer patients who achieve a complete response to neoadjuvant therapy. The patients’ perspectives of these approaches are limited. Here, we describe a qualitative study where we conducted semi-structured interviews with fourteen rectal cancer patients, including seven men and seven women, who were successfully treated by NOM at our center between 2020 and 2022. The responses were analyzed using the constant comparative method. Four major thematic categories emerged: impact of rectal cancer diagnosis, treatment values, decision-making factors, and the impact of NOM surveillance. Avoidance of a stoma was a major theme in both determining patient treatment values as well as ultimately driving their decision-making. Trust in the treating physician was also found to be a major theme in decision-making. While the psychological burden of surveillance did emerge as a major theme, patients who did not have recurrence were still quite satisfied with their decision to pursue NOM. Limitations of this study include selection bias, the single-center design, and the lack of patients who ultimately experienced recurrence following NOM. As NOM of rectal cancer becomes more commonplace, understanding the patients’ perspectives will ensure appropriate counseling and shared decision-making. Full article

(This article belongs to the Special Issue Quality of Life in Surgical Oncology Patients)

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10 pages, 187 KB

Open AccessCommentary

Strengthening Biomarker Research in Canadian Cancer Clinical Trials: A Pathology-Focused White Paper

by David F. Schaeffer, Jennifer Chan, Jason Morin, Marie-Christine Guiot, George M. Yousef, Catherine J. Streutker, Harman Sekhon, Madeline Fitzpatrick, Shakeel Virk, Alexander Wyatt, Alan Spatz, Lois Shepherd, Jonathan M. Loree and Mary Kinloch

Curr. Oncol. 2026, 33(6), 347; https://doi.org/10.3390/curroncol33060347 (registering DOI) - 9 Jun 2026

Abstract

Pathology is foundational to biomarker-driven and translational oncology research, yet systemic barriers limit full pathology engagement in Canadian cancer clinical trials, compromising the tissue-based questions such trials are designed to answer. This commentary and white paper synthesizes the perspectives of a national pathology [...] Read more.

Pathology is foundational to biomarker-driven and translational oncology research, yet systemic barriers limit full pathology engagement in Canadian cancer clinical trials, compromising the tissue-based questions such trials are designed to answer. This commentary and white paper synthesizes the perspectives of a national pathology working group convened at the 2025 Canadian Cancer Trials Group (CCTG) Annual General Meeting with a descriptive internal audit of the CCTG Tumour Tissue Data Repository (TTDR), in which biospecimen attrition was tabulated at the patient level by disease site; no inferential testing was performed. The TTDR data revealed substantial attrition across disease sites, with no tissue submitted for 32–44% of patients and slides submitted in place of formalin-fixed paraffin-embedded blocks for up to 51% of cases, reflecting persistent misalignment between protocol expectations and laboratory capacity. From these observations, five interrelated gaps were identified—in trial design, funding and resourcing, digital pathology infrastructure, academic recognition, and knowledge translation around consent and ethics governance. Five corresponding strategies are proposed to align research demands with pathology capacity, reduce attrition, and strengthen biomarker-driven trials. As a consensus- and experience-driven analysis rather than a systematic review, these recommendations are intended to frame a national conversation and a starting point for prospective evaluation. Full article

17 pages, 1354 KB

Open AccessArticle

Social Progress Index as a Determinant of Healthcare Access and Treatment in Pancreatic Cancer

by Francisco Tustumi, Felipe Antonio Boff Maegawa, Victória Bulcão Caraciolo, Giovanna Mennitti Shimoda, Isabella Paes Leme Rufino, Bianca Aguiar Giacometti dos Santos, Lucas Cata Preta Stolzemburg, Daniel José Szor, Sergio Eduardo Alonso Araujo, Pedro Luiz Serrano Uson Junior and Nelson Wolosker

Curr. Oncol. 2026, 33(6), 346; https://doi.org/10.3390/curroncol33060346 (registering DOI) - 9 Jun 2026

Abstract

Background: Health accessibility is a key determinant of equitable cancer care. In many countries, specialized oncology services are concentrated in urban and socioeconomically advantaged regions, forcing many patients to travel long distances for treatment. Consequently, geographic and social characteristics may be impactful [...] Read more.

Background: Health accessibility is a key determinant of equitable cancer care. In many countries, specialized oncology services are concentrated in urban and socioeconomically advantaged regions, forcing many patients to travel long distances for treatment. Consequently, geographic and social characteristics may be impactful in determining cancer healthcare outcomes. Objective: The aim of this study was to evaluate the association between the municipal-level Social Progress Index (SPI) and geographic travel burden, stage at diagnosis, treatment, and survival in patients with pancreatic cancer in São Paulo state, Brazil. Methods: We conducted a population-based study using data from “Fundação Oncocentro” on adults with pancreatic adenocarcinoma (2005–2025). The SPI (0–100 scale), a composite measure of municipal social and environmental development, was the primary exposure. It is structured into 3 dimensions and 12 components: Basic Human Needs (nutrition, medical care, water and sanitation, housing, safety); Foundations of Well-being (education, information access, health, environmental quality); and Opportunity (rights, freedom of choice, social inclusion, higher education). Municipal residence and cancer center locations were geocoded, and travel distance (km) was estimated. Multivariable Cox, logistic, and linear regression models assessed associations between SPI and overall survival, stage IV at diagnosis, surgery, and travel distance. Results: A total of 13,478 patients were included (mean follow-up 15.1 ± 27.2 months; mean age 62.3 years; 50.4% male). Stage IV disease was frequent (46.3%), and surgery was performed in 33% of cases. Over half of patients (53.2%) traveled more than 10 km for treatment. Increasing SPI was strongly associated with shorter travel distance (β −62.6 km per SPI unit; p < 0.001) and higher odds of surgery (OR 1.04; p < 0.001) and remained independently associated with a higher likelihood of undergoing surgical treatment (adjusted OR 1.04; p < 0.001). The proportion of stage IV disease did not decrease with increasing SPI and was slightly higher in the highest quartile (49.3%). In survival analysis, SPI demonstrated a protective effect in univariate modeling (HR 0.987; p < 0.001), but lost significance in multivariable analysis (p = 0.125). Travel burden was not retained as an independent predictor of survival after adjustment. Conclusions: Municipal-level SPI was a strong determinant of healthcare access and the likelihood of receiving surgical treatment for pancreatic cancer. Social and geographic vulnerability directly influence care pathways, revealing structural inequities in access to treatment. SPI-based stratification may serve as a practical tool to identify priority regions for transport support and equitable allocation of oncology services. Full article

(This article belongs to the Special Issue Gastrointestinal Tumors: Prevention, Screening and Predictive Analytics)

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11 pages, 466 KB

Open AccessArticle

A Prognostic Model Incorporating Age and Systemic Inflammation Response Index for Primary CNS Lymphoma

by Ryosuke Matsuda, Takeshi Okuda, Hiromasa Yoshioka, Kengo Yamada, Takayuki Morimoto, Tsutomu Nakazawa, Hiromichi Hayami, Ryosuke Maeoka, Shohei Yokoyama and Ichiro Nakagawa

Curr. Oncol. 2026, 33(6), 345; https://doi.org/10.3390/curroncol33060345 (registering DOI) - 9 Jun 2026

Abstract

Background: Here, we propose a novel predictive scoring system incorporating age and the systemic inflammation response index (SIRI), which is calculated using neutrophil, monocyte, and lymphocyte counts, for patients with newly diagnosed primary central nervous system lymphoma (PCNSL). Methods: The study included 55 [...] Read more.

Background: Here, we propose a novel predictive scoring system incorporating age and the systemic inflammation response index (SIRI), which is calculated using neutrophil, monocyte, and lymphocyte counts, for patients with newly diagnosed primary central nervous system lymphoma (PCNSL). Methods: The study included 55 consecutive patients with sufficient blood test data and follow-up at our institution between November 2006 and May 2022. Age and SIRI were identified as prognostic factors and incorporated into a predictive multivariate Cox proportional hazards model. A scoring system of 0–2 points was created, with 1 point each assigned to age ≥ 65 years and high SIRI score (≥1.43 × 10⁹/L). We subsequently validated the predictive scoring system in an independent external validation cohort. Results: Patients with 0, 1, and 2 points were assigned to groups 1, 2, and 3, respectively. The median overall survival (OS) was 35.9 months in the entire training cohort and 57.8, 37.2, and 16.1 months in groups 1, 2, and 3, respectively. The three groups showed significant differences in median OS (p < 0.001), with lower scores corresponding to longer survival times. The performance of our new scoring system was significant in the training cohort and in the external validation cohort. Conclusion: Our new scoring system incorporating age and SIRI may serve as a preliminary prognostic model for predicting OS in patients with PCNSL. This score may be beneficial for disease risk stratification and clinical decision-making in the future. Full article

(This article belongs to the Section Neuro-Oncology)

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19 pages, 865 KB

Open AccessReview

The Evolving Role of Intralesional Therapy in In-Transit Melanoma

by Celine Jeun, Mackenzie M. Mayhew, Kate Joshua and Russell G. Witt

Curr. Oncol. 2026, 33(6), 344; https://doi.org/10.3390/curroncol33060344 (registering DOI) - 9 Jun 2026

Abstract

In-transit melanoma represents a biologically aggressive form of locoregional disease in which effective management requires integration of local tumor control with systemic immune engagement. Although traditional regional therapies achieve high response rates, they have not consistently translated into durable systemic survival. This review [...] Read more.

In-transit melanoma represents a biologically aggressive form of locoregional disease in which effective management requires integration of local tumor control with systemic immune engagement. Although traditional regional therapies achieve high response rates, they have not consistently translated into durable systemic survival. This review evaluates the clinical development and mechanistic rationale of intralesional therapies, including cytokine-based approaches, oncolytic viruses, immunocytokines, and energy-based delivery platforms, as immunologic intermediaries. Analysis of clinical trial data suggests that outcomes may heavily depend on an agent’s ability to induce immunogenic cell death and sustain antigen presentation. Platforms such as talimogene laherparepvec (T-VEC), vusolimogene oderparepvec (RP1), and tavokinogene telseplasmid with electroporation (Tavo-EP) demonstrate enhanced activity in combination with checkpoint blockade, whereas therapies limited to pattern-recognition receptor activation have shown inconsistent efficacy in randomized trials. Emerging noninvasive technologies, such as focused ultrasound, may further expand strategies for remodeling the immunosuppressive tumor microenvironment to enable immune sensitization. These findings support a shift toward mechanism-based treatment selection in which locoregional therapies function to overcome immune resistance rather than solely reduce tumor burden. Full article

(This article belongs to the Special Issue Immunotherapy for Melanoma: Systemic and Locoregional Approaches, Mechanisms, and Future Directions)

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15 pages, 3298 KB

Open AccessReview

Endobiliary Photodynamic Therapy in Cholangiocarcinoma: Clinical Outcomes, Patient Selection, and Procedural Context

by Xuewu Zhang and An Jiang

Curr. Oncol. 2026, 33(6), 343; https://doi.org/10.3390/curroncol33060343 (registering DOI) - 9 Jun 2026

Abstract

Endobiliary photodynamic therapy (PDT) in cholangiocarcinoma (CCA) is used mainly for local palliation of malignant biliary obstruction, particularly in extrahepatic and perihilar disease. This Review synthesizes the clinical evidence on endobiliary PDT while using drainage, infection control, stent strategy, light delivery, and systemic-therapy [...] Read more.

Endobiliary photodynamic therapy (PDT) in cholangiocarcinoma (CCA) is used mainly for local palliation of malignant biliary obstruction, particularly in extrahepatic and perihilar disease. This Review synthesizes the clinical evidence on endobiliary PDT while using drainage, infection control, stent strategy, light delivery, and systemic-therapy context as an interpretive framework rather than as practice recommendations. This narrative review was informed by targeted searching of PubMed/MEDLINE, Embase, and Web of Science from database inception through to 31 December 2025, supplemented by reference-list screening. We prioritized prospective studies, comparative cohorts, systematic reviews, and relevant guidance documents. Across the literature, the clearest support for PDT concerns selected local biliary palliation, including decompression, stent patency or delayed dysfunction, and symptom relief. Survival signals remain inconsistent: early positive studies contrast with the negative PHOTOSTENT-02 randomized trial and are highly confounded by drainage adequacy, infection control, retreatment strategy, and systemic-therapy access. We therefore interpret PDT as a context-dependent local biliary strategy rather than an established survival-prolonging treatment, and we highlight the clinical variables that make published outcome signals more or less interpretable. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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26 pages, 4720 KB

Open AccessReview

Radiobiotherapy in Osteosarcoma: A State-Based Educational Framework for Strategy Selection and Trial Design

by Srinivasan Vijayakumar, Shirley Lewis, Marc Matrana, Robert J. Vasquez, Anshul Singh, Nicholas Duesbery, Anderson B. Collier, Zoe Larned, Jennifer Barr, Wayne R. Orr, Mary R. Nittala and Vani Vijayakumar

Curr. Oncol. 2026, 33(6), 342; https://doi.org/10.3390/curroncol33060342 (registering DOI) - 8 Jun 2026

Abstract

Background: Osteosarcoma remains a biologically complex and clinically challenging malignancy, with survival gains plateauing despite decades of multimodal therapy incorporating surgery and cytotoxic chemotherapy. Unlike cancers in which mutation-centric precision oncology has yielded transformative advances, osteosarcoma is characterized by profound structural variation, [...] Read more.

Background: Osteosarcoma remains a biologically complex and clinically challenging malignancy, with survival gains plateauing despite decades of multimodal therapy incorporating surgery and cytotoxic chemotherapy. Unlike cancers in which mutation-centric precision oncology has yielded transformative advances, osteosarcoma is characterized by profound structural variation, copy number alteration dominance, and dynamic clonal evolution, limiting the effectiveness of single-target approaches. These realities motivate alternative strategy-level frameworks that better align treatment selection with evolving disease behavior. Methods: This narrative educational review synthesizes contemporary evidence from osteosarcoma biology, radiobiology, and translational oncology to propose a state-based framework for integrating radiotherapy—particularly stereotactic body radiotherapy (SBRT/SABR) and spatially fractionated radiotherapy (SFRT)—into osteosarcoma management and clinical trial design. Rather than relying solely on static anatomic stage, this framework emphasizes clinically actionable, time-varying state variables, including disease burden patterns (localized, oligometastatic, polymetastatic), tempo of progression, prior systemic response, and feasibility of complete local control. Results: Within this context, radiotherapy is presented not only as a local control modality but also as a hypothesis-generating biologic intervention, capable of perturbing tumor vasculature, inflammatory signaling, innate DNA-sensing pathways, and immune/myeloid programs in a dose-, fractionation-, and spatial-distribution-dependent manner. The review critically examines both the potential opportunities (e.g., local eradication, immune modulation) and limitations (e.g., rarity of abscopal responses, risk of unintended systemic signaling) of radiobiotherapy combinations, emphasizing the need for cautious interpretation and prospective validation. Conclusions: Finally, the article outlines practical implications for state-stratified, biomarker-embedded clinical trials, highlighting endpoints beyond conventional response criteria, including circulating tumor DNA dynamics, immune and myeloid signatures, and long-term patterns of disease progression. Overall, this review frames radiobiotherapy as an educational and investigational paradigm intended to support rational hypothesis generation, multidisciplinary decision-making, and learning-oriented trial designs in osteosarcoma, rather than as definitive clinical guidance. Full article

(This article belongs to the Special Issue Advances in the Orthopaedic Oncology)

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30 pages, 817 KB

Open AccessReview

Connecting Patients with Clinical Trials Using Patient Navigation: A Scoping Review

by Olla Hilal, Ria Patel, Pratham Gupta, Nicole Askin, Victoria Ivankovic, Carla Epp, Renee Nassar, Milica Paunic, Mahmoud Hossami, Rhonda Abdel-Nabi, Michael Touma, Govana Sadik, Anaam Jaet, Christina Trieu, Ibrahim Mohamed, Gregory Anagnostopoulos, Leonard Yoo, Mohammad El Hindawi, Caroline Hamm and Megan Delisle

Curr. Oncol. 2026, 33(6), 341; https://doi.org/10.3390/curroncol33060341 (registering DOI) - 8 Jun 2026

Abstract

Patient navigation is a promising intervention to address barriers and improve access to cancer clinical trials. Although navigation has been widely studied across the cancer continuum, its role in facilitating clinical trial participation has not been systematically evaluated. This scoping review aims to [...] Read more.

Patient navigation is a promising intervention to address barriers and improve access to cancer clinical trials. Although navigation has been widely studied across the cancer continuum, its role in facilitating clinical trial participation has not been systematically evaluated. This scoping review aims to identify, characterize, and synthesize evidence on patient navigation interventions designed to increase access to cancer clinical trials. Nine databases were searched for English peer-reviewed articles from inception through 5 March 2025. Two independent researchers screened titles, abstracts, and full texts and extracted data using standardized forms. The results were interpreted using descriptive statistics and collated using predetermined conceptual frameworks. Of 10,238 citations identified, 23 studies met inclusion criteria. All were conducted in North America, and five (21.7%) were randomized controlled trials. Thirteen studies (56.5%) evaluated enrollment outcomes, with mixed results. One randomized trial and two observational studies found no significant effect, while three observational studies and seven single-arm reports suggested improved enrollment. Navigation interventions most commonly included education/information provision (100%), care coordination (60.9%), and empowerment (47.8%). Navigators were primarily lay navigators (73.9%), often selected for community or lived experience; training varied widely, and only two programs reported certification. Fifteen studies (65.2%) targeted equity-deserving groups, most frequently racial and ethnic minorities, with reports of increased representation in trial enrollment. Patient navigation shows promise in improving access to cancer clinical trials, particularly for equity-deserving populations, but current evidence is limited, heterogeneous, and largely observational. Standardized definitions, rigorous trial designs, and reporting of navigator training and outcomes are needed to clarify effectiveness. Full article

(This article belongs to the Section Oncology Nursing)

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14 pages, 485 KB

Open AccessArticle

Real-World 30-Day Mortality After the Last Dose of Immune Checkpoint Inhibitors: A Multicenter Retrospective Cohort Study in Turkey

by Kadriye Başkurt, Orhun Akdoğan, Yasemin Sağdıç Karateke, İlknur Deliktaş Onur, Galip Can Uyar, Enes Yeşilbaş, Ozan Yazıcı, Bülent Yıldız, Cengiz Karaçin, Ömür Berna Çakmak Öksüzoğlu and Osman Sütçüoğlu

Curr. Oncol. 2026, 33(6), 340; https://doi.org/10.3390/curroncol33060340 - 6 Jun 2026

Abstract

Short-term mortality following the last dose of immune checkpoint inhibitors (ICIs) is an increasingly recognized real-world outcome measure, yet its clinical predictors remain poorly characterized. This multicenter retrospective study included 458 consecutive patients with advanced melanoma, non-small cell lung cancer, or renal cell [...] Read more.

Short-term mortality following the last dose of immune checkpoint inhibitors (ICIs) is an increasingly recognized real-world outcome measure, yet its clinical predictors remain poorly characterized. This multicenter retrospective study included 458 consecutive patients with advanced melanoma, non-small cell lung cancer, or renal cell carcinoma who received ICIs at four tertiary centers in Turkey between 2018 and 2023. The primary endpoint was 30-day mortality after the final ICI dose. Among 458 patients, 71 (15.5%) died within 30 days. Multivariable logistic regression identified ECOG performance status ≥ 2, number of metastatic sites ≥ 3, and log-transformed C-reactive protein-to-albumin ratio (log-CAR) as independent predictors of 30-day mortality in Model 1 (AUC 0.954), while ECOG PS ≥ 2, brain metastasis, metastatic sites ≥ 3, and log-NLR were independent predictors in Model 2 (AUC 0.912). In the lung cancer subgroup, log-CAR and NLR remained independent predictors while ECOG PS did not. Patients who died within 30 days had significantly shorter progression-free survival (1.18 vs. 4.63 months) and overall survival (2.30 vs. 14.39 months) compared with survivors. These findings suggest that routine assessment of inflammatory and nutritional biomarkers alongside tumor burden parameters may help identify patients at high risk of early mortality and inform the timing of supportive care in ICI-treated populations. Full article

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

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13 pages, 548 KB

Open AccessArticle

Identifying Factors Associated with the Acquisition of Multiple Indications for Anticancer Drugs

by Shutaro Takahashi and Hideki Maeda

Curr. Oncol. 2026, 33(6), 339; https://doi.org/10.3390/curroncol33060339 - 6 Jun 2026

Abstract

With the declining success rate of new drug development, lifecycle management strategies have become increasingly important. However, approximately 25–40% of approved drugs remain limited to a single indication. In this study, we compared drugs that obtained multiple indications with those confined to a [...] Read more.

With the declining success rate of new drug development, lifecycle management strategies have become increasingly important. However, approximately 25–40% of approved drugs remain limited to a single indication. In this study, we compared drugs that obtained multiple indications with those confined to a single indication, aiming to identify factors associated with the acquisition of multiple indications. We identified anticancer drugs initially approved by US Food and Drug administration (FDA) between 2015 and 2020. This retrospective observational study includes 48 anticancer drugs for solid tumors. For each drug, data were collected on approved indications, sponsoring company characteristics, and clinical efficacy outcomes, including objective response rate (ORR) and progression-free survival (PFS). The drugs were categorized based on the number of approved indications, and comparative analyses were conducted. No clear association was observed between multiple indication acquisition and factors such as mechanism of action (MoA) or company size at the initial approval. Since additional indications may be obtained through various approaches—including expansion to new tumor types or different lines of therapy—no consistent relationship was observed between specific strategies and the acquisition of multiple indications. In contrast, drugs demonstrating higher clinical efficacy and those initially approved for non-rare cancers were more likely to achieve multiple indications. The factors associated with additional indications varied depending on the approach, and only a limited set of factors consistently correlated with multiple indication acquisition. Notably, clinical efficacy and the tumor type at initial approval appeared to be associated with acquisition of multiple indications. These findings provide important insights into research and development strategies and may inform decision-making in pharmaceutical lifecycle management. Full article

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15 pages, 7286 KB

Open AccessSystematic Review

One Surgery, Two Solutions: A Systematic Review of Combined Autologous Breast Reconstruction and Lymphatic Surgery

by Ion Lingenheil, Lisa Radacher, Hans-Günther Machens, Michael Mayr-Riedler, Katrin Seidenstücker, Niclas Peter Broer and Lisanne Grünherz

Curr. Oncol. 2026, 33(6), 338; https://doi.org/10.3390/curroncol33060338 - 6 Jun 2026

Abstract

Simultaneous autologous breast reconstruction (ABR) and lymphatic surgery has emerged as a strategy to address breast cancer-related lymphedema (BCRL) while restoring breast contour within a single operative procedure. In light of the diversity of surgical strategies, we aimed to evaluate the current literature [...] Read more.

Simultaneous autologous breast reconstruction (ABR) and lymphatic surgery has emerged as a strategy to address breast cancer-related lymphedema (BCRL) while restoring breast contour within a single operative procedure. In light of the diversity of surgical strategies, we aimed to evaluate the current literature on combined ABR and lymphatic surgery, with particular focus on surgical techniques, clinical outcomes, complications, and patient-reported satisfaction. A systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251135446). Medline, Embase, CENTRAL, Web of Science, and PubMed were searched through 9 January 2026 Studies reporting outcomes of simultaneous ABR and lymphatic reconstruction were included. Data on surgical techniques, complications, changes in limb volume and cellulitis incidence, and patient-reported outcomes were extracted. Twenty-seven studies including 499 patients (mean follow-up 23 months) were analyzed. The most common approach was a chimeric deep inferior epigastric perforator (DIEP) flap with inguinal lymph nodes (459 patients), followed by ABR with a separate vascularized lymph node transfer and ABR with lymphovenous anastomosis. Most studies reported postoperative reductions in limb volume and cellulitis, with cellulitis reduction rates up to 100%. Patient-reported outcomes (LYMQOL, ULL-27, LYMPH-Q) showed improved quality of life. Complication rates were low, including 4% seroma and 1% flap loss after chimeric DIEP. Simultaneous ABR and lymphatic reconstruction is feasible and associated with improved clinical and patient-reported outcomes. However, heterogeneity limits comparison between the different surgical techniques, and prospective studies with standardized outcomes measurements are needed. Full article

(This article belongs to the Special Issue Microsurgical Management of Chronic Cancer-Related Lymphedema)

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12 pages, 553 KB

Open AccessArticle

Salvage Radiotherapy in Isolated Locoregional Recurrence of Pancreatic Adenocarcinoma Post-Radical Surgical Resection: Prudent or Pointless? A Retrospective Comparative Analysis

by Colin Faulkner, Ayah Erjan, Sara Mheid, Michael Yan, Chaya Ganor Shwaartz, Erica Tsang, Sangeetha Kalimuthu, Teodor Stanescu, Ali Hosni and Aruz Mesci

Curr. Oncol. 2026, 33(6), 337; https://doi.org/10.3390/curroncol33060337 - 6 Jun 2026

Abstract

Isolated Locoregionally Recurrent Pancreatic Adenocarcinoma (ILRPA) accounts for 25–30% of recurrences after radical resection, yet the role of salvage radiation (RT) in this setting remains controversial due to limited data. We aimed to evaluate the impact of salvage RT on survival outcomes compared [...] Read more.

Isolated Locoregionally Recurrent Pancreatic Adenocarcinoma (ILRPA) accounts for 25–30% of recurrences after radical resection, yet the role of salvage radiation (RT) in this setting remains controversial due to limited data. We aimed to evaluate the impact of salvage RT on survival outcomes compared with non-salvage RT in patients with ILRPA. We retrospectively analyzed data of patients with ILRPA post-radical resection treated at our centre between 2012 and 2021. Patients were categorized into two cohorts based on whether salvage RT was administered post-recurrence. Patients who received a minimum of 30 Gy in 10 fractions (BED₁₀ ≥ 39 Gy) were included for analysis. The clinical characteristics, treatments, and outcomes were analyzed. The chi-square or Fisher’s exact test for categorical variables and Student’s t-test or Wilcoxon rank sum test for continuous variables were utilized for comparisons. The Kaplan–Meier method and log-rank test were performed to compare overall survival (OS) and progression-free survival (PFS) between the two groups. OS and PFS were calculated from the time of locoregional recurrence until event or loss of follow-up. Thirty-two patients were identified, with sixteen patients in each group. The patients and tumour characteristics were balanced between the two cohorts, except for chemotherapy, where the salvage RT group tended to receive palliative chemotherapy more than the non-salvage group (p = 0.007). The median radiotherapy dose received for the salvage RT cohort was 50.4 Gy (BED₁₀ = 59.5 Gy). Chemotherapy was restarted in 75% either before, after, or during radiation, and only in 31.25% of patients in the non-salvage group (p = 0.013). Patients who received salvage RT had statistically significantly better median OS and PFS than those who did not (25.2 vs. 8.4 months, p = 0.0006, HR 0.25, 95% CI (0.11–0.59)), (15.6 vs. 7.2 months, p = 0.0006, HR 0.26, 95% CI (0.11–0.58), respectively). Ten patients (62.5%) developed distant metastases (DM) at least 3 months post-recurrence in the salvage RT cohort compared to five patients (31.25%) in the non-salvage RT cohort (p = 0.08). In the salvage RT group, 10/16 patients (62.5%) maintained locoregional disease control post-RT. Salvage RT was associated with better OS and PFS in patients with ILRPA, highlighting its potential as an essential treatment modality. While salvage RT appears beneficial, confounding factors like chemotherapy disparities between groups necessitate further investigation in prospective cohorts. Full article

(This article belongs to the Special Issue Radiation Therapy and Targeted Therapies for Pancreatic Cancer)

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20 pages, 1822 KB

Open AccessArticle

Predicting Postoperative Complications in Lung Cancer Spinal Metastases: A Nomogram Based on Nutritional, Low Psoas Muscle Index, and Functional Status

by Xinyao Lv, Ruizhao Zhao, Yuyu Fan, Zijian Wang, Xiutong Fang and Junjie Qiao

Curr. Oncol. 2026, 33(6), 336; https://doi.org/10.3390/curroncol33060336 - 5 Jun 2026

Abstract

Objective: This study seeks to investigate the association between nutritional, muscular, and functional status and moderate-to-severe postoperative complications (Clavien–Dindo ≥ grade II) in patients with lung cancer spinal metastases and to construct an individualized risk prediction nomogram. Methods: A total of [...] Read more.

Objective: This study seeks to investigate the association between nutritional, muscular, and functional status and moderate-to-severe postoperative complications (Clavien–Dindo ≥ grade II) in patients with lung cancer spinal metastases and to construct an individualized risk prediction nomogram. Methods: A total of 162 patients with histologically confirmed lung cancer spinal metastases who underwent surgery were retrospectively enrolled. Preoperative clinical data were collected. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for postoperative complications, with variable selection based on a combination of statistical significance and clinical judgment. A nomogram model was constructed and evaluated using receiver operating characteristic curve, calibration curve, and decision curve analysis. Internal validation was performed using the bootstrap method. For exploratory assessment of the model’s clinical stratification capability, patients were classified into low-, medium-, and high-risk groups based on tertiles of the predicted probability. Results: The incidence of Clavien–Dindo ≥ grade II complications during postoperative hospitalization or within 14 days was 57.4%. Multivariate analysis suggested that lower psoas muscle index (low PMI) (OR = 4.131, p = 0.034), lower body mass index (BMI) (continuous: OR = 0.539 per 1 kg/m² increase, p = 0.001, indicating that lower BMI was associated with higher risk), lower prognostic nutritional index (PNI) (OR = 0.456, p < 0.001), and lower Karnofsky Performance Status (KPS) score (OR = 0.890, p = 0.009) were identified as potential independent factors associated with postoperative complications. The nomogram achieved an Area Under the Curve of 0.907, showed acceptable calibration (Hosmer–Lemeshow test, p = 0.735), and demonstrated a favorable net clinical benefit in the decision curve analysis. In the exploratory risk stratification analysis, complication rates in the low-, medium-, and high-risk groups were 28.8%, 63.6%, and 78.2%, respectively (p < 0.001). Patients with complications had significantly longer hospital stays (median 20 vs. 13 days). Conclusions: In this cohort, low PMI, low BMI, low PNI, and low KPS were identified as potential independent factors associated with short-term moderate-to-severe postoperative complications. The nomogram may preliminarily predict the risk and might serve as a quantitative reference for individualized perioperative management, but its clinical utility requires further confirmation in external validation. The exploratory risk stratification suggests that the model has preliminary potential for clinical discrimination. Full article

(This article belongs to the Section Surgical Oncology)

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12 pages, 1606 KB

Open AccessCase Report

3D-Printed Bolus-Assisted Radiotherapy for Converting Unresectable Breast Cancer with a Breast Prosthesis into a Resectable Condition: A Case Report

by Shih-Kai Hung, Wei-Ta Tsai, Chun-Hung Lin, Moon-Sing Lee, Hon-Yi Lin, Liang-Cheng Chen, Chia-Hui Chew, Feng-Chun Hsu and Wen-Yen Chiou

Curr. Oncol. 2026, 33(6), 335; https://doi.org/10.3390/curroncol33060335 - 5 Jun 2026

Abstract

Background: The use of conventional boluses in recurrent breast cancer often fails to conform to irregular surfaces, leading to air gaps and suboptimal dose distribution. We present a clinical experience involving a 3D-printed conformal bolus for a patient with gross recurrence and [...] Read more.

Background: The use of conventional boluses in recurrent breast cancer often fails to conform to irregular surfaces, leading to air gaps and suboptimal dose distribution. We present a clinical experience involving a 3D-printed conformal bolus for a patient with gross recurrence and breast prosthesis invasion—a complex scenario where the treatment goal was surgical conversion. This report aims to generate hypotheses regarding the utility of customized boluses in facilitating the resection of initially unresectable tumors in the presence of reconstructive hardware. Case Presentation: A 58-year-old female with a history of breast cancer and prosthesis reconstruction presented with a rapid chest wall recurrence in 2018. The tumor invaded the overlying skin and the underlying prosthesis, rendering it unresectable. The patient received intensive salvage radiotherapy using Volumetric Modulated Arc Therapy (VMAT) with a dose-escalation regimen and a customized 1 cm 3D-printed bolus. While daily IGRT/CBCT and in vivo dosimetry were not available to definitively quantify the air gap reduction, the technical application of the bolus aimed to optimize surface dose coverage. Two months post-treatment, significant tumor regression was observed, allowing for the successful surgical removal of both the tumor and the prosthesis. Conclusions: To our knowledge, this case illustrates a specialized application of 3D-printed boluses in complex salvage scenarios. Following treatment, the patient experienced improved quality of life through pain reduction and reduced dressing frequency. Although the dramatic tumor response likely reflects the overall intensity of the radiotherapy regimen, our experience suggests that a 3D-printed bolus is a physically plausible tool to aid in achieving local control and facilitating surgical intervention. Further prospective studies are required to isolate the specific dosimetric advantages of this technology over conventional methods. Full article

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

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14 pages, 331 KB

Open AccessArticle

Readiness to Consider and Adopt Genetic and Genomic Tests in Canada—An Update to the State of Readiness Report

by Don Husereau, Filomena Servidio-Italiano, Monika Slovinec D’Angelo, Vivek Muthu, Michael Mengel, Craig Ivany, Lotte Steuten, Daryl S. Spinner, Brandon Sheffield, Stephen Yip, Philip Jacobs and Larry Arshoff

Curr. Oncol. 2026, 33(6), 334; https://doi.org/10.3390/curroncol33060334 - 4 Jun 2026

Abstract

(1) Background: Genomic medicine—i.e., the use of laboratory-based biomarkers that measure the expression, function and regulation of genes and gene products to aid healthcare decision making is a rapidly emerging technology. Readiness to consider and adopt new testing programs effectively and avoid critical [...] Read more.

(1) Background: Genomic medicine—i.e., the use of laboratory-based biomarkers that measure the expression, function and regulation of genes and gene products to aid healthcare decision making is a rapidly emerging technology. Readiness to consider and adopt new testing programs effectively and avoid critical challenges requires health systems to harbor a number of key conditions that address infrastructural, as well operational and other needs. This assessment re-examines Canada’s state of readiness since a previously published 2023 assessment. (2) Methods: A mixed-methods approach of a review of the literature and key informant interviews with a purposive sample of experts was used. Health system readiness was assessed using a previously published set of conditions. (3) Results: This updated analysis of Canada’s state of readiness for genetic and genomic testing reveals Canada is only partially ready for a future of genomic medicine, although some progress has been made since 2023. The most established conditions were the use of appropriate service models and the integration of innovation and healthcare delivery functions. They suggest that Canada’s major healthcare regions are moving closer to a state of readiness for the consideration and adoption of new testing required for genomic medicine, although using different approaches and at different rates. These findings should be seen as generalizable to other regions internationally—health systems need to have functions that promote responsiveness and resilience, i.e., are able to recognize valuable innovation and quickly shift priorities and create conditions necessary to enable it. Full article

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11 pages, 1626 KB

Open AccessCase Report

Time Is Key: Early Diagnosis of Post-Transplant Lymphoproliferative Disorder Presenting as Primary CNS Diffuse Large B-Cell Lymphoma

by Asli Altunbas, Aarti Desai, Andrea Muniz, Hussien Al Asi, Rajvi Chaudhary, Laxmi Raj Bangari, Surbhi Dadwal, Jose Ruiz, Juan Leoni, Julie Hammack, Harry Powers, James Foran and Rohan Goswami

Curr. Oncol. 2026, 33(6), 333; https://doi.org/10.3390/curroncol33060333 - 4 Jun 2026

Abstract

Post-transplant lymphoproliferative disorder (PTLD) involving the central nervous system (CNS) is a rare but serious life-threatening complication seen in recipients of solid organ transplant. Primary CNS encompasses 5–15% of all types of PTLD diagnoses, and heart transplant recipients represent 3–5% of those reported [...] Read more.

Post-transplant lymphoproliferative disorder (PTLD) involving the central nervous system (CNS) is a rare but serious life-threatening complication seen in recipients of solid organ transplant. Primary CNS encompasses 5–15% of all types of PTLD diagnoses, and heart transplant recipients represent 3–5% of those reported cases. Diagnosis is often delayed due to the highly variable presentation, with some cases remaining undiagnosed for years. Multidisciplinary collaboration is crucial for early diagnosis and management. A 53-year-old woman patient presented with altered mental status. MRI revealed nodular ventriculitis and bilateral periventricular hyperdense infiltrates. CSF studies demonstrated lymphocytic pleocytosis, elevated protein, and EBV-PCR-positive results. A stereotactic brain needle biopsy confirmed the presence of EBV-positive diffuse large B-cell lymphoma, consistent with primary CNS PTLD, 14 months after her heart transplant. Despite appropriate management, the patient experienced progressive neurological decline and ultimately suffered a fatal intracerebral hemorrhage. We demonstrate the importance of the early diagnosis and variable presentation of post-heart-transplant PTLD. The importance of surveillance regardless of EBV status and close monitoring of disease progression due to potential life-threatening complications, such as fatal hemorrhages. Therefore, primary CNS-PTLD remains a challenging disease and is being increasingly recognized with improved transplant recipient survival and prolonged exposure to chronic immunosuppression. Full article

(This article belongs to the Section Neuro-Oncology)

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11 pages, 814 KB

Open AccessArticle

Regional Variations in Guideline Concordance for Women with Triple-Negative and HER2+ Breast Cancer in Nova Scotia

by Andrea Mayo, Hanna Stewart, Tongtong Li, Cameron Penny, Rachel Hemsworth, Ashley Drohan, Katerina Neumann, Boris Gala-Lopez, Richard T. Spence and Gregory Knapp

Curr. Oncol. 2026, 33(6), 332; https://doi.org/10.3390/curroncol33060332 - 2 Jun 2026

Abstract

Background: Systematic neoadjuvant therapy (NAT) is recommended for triple-negative (TNBC) and HER2+ breast cancers when tumor size at diagnosis is ≥2 cm. This study aimed to determine the proportion of patients in Nova Scotia with non-metastatic, incident, ≥2 cm TNBC and HER2+ [...] Read more.

Background: Systematic neoadjuvant therapy (NAT) is recommended for triple-negative (TNBC) and HER2+ breast cancers when tumor size at diagnosis is ≥2 cm. This study aimed to determine the proportion of patients in Nova Scotia with non-metastatic, incident, ≥2 cm TNBC and HER2+ breast cancer who received guideline-concordant NAT, stratified by administrative zone. Methods: This retrospective analysis utilized data from the Nova Scotia Breast Screening Program. Adult patients (18–80 years) with an incident, non-metastatic, ≥T2 breast cancer diagnosis between 2021 and 2023 were considered theoretically eligible for NAT, defined by a wait time of ≥4 months between core biopsy and surgery. Guideline-concordant care was confirmed through chart review and compared across health system administrative zones and over time. Results: Of the 291 women theoretically eligible for NAT, 67.0% received it. Significant differences in NAT receipt were observed across administrative zones (Central 73.1%, Eastern 72.9%, Northern 57.4%, Western 54.2%, p = 0.030). Conclusions: This study identifies meaningful regional disparities in NAT receipt for TNBC and HER2+ breast cancer in Nova Scotia. Targeted strategies to improve guideline concordance are warranted and may lead to better patient outcomes. Full article

(This article belongs to the Section Breast Cancer)

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