Journal Description
Current Oncology
Current Oncology
is an international, peer-reviewed, open access journal published online by MDPI (from Volume 28 Issue 1-2021). Established in 1994, the journal represents a multidisciplinary medium for clinical oncologists to report and review progress in the management of this disease. The Canadian Association of Medical Oncologists (CAMO), the Canadian Association of Psychosocial Oncology (CAPO), the Canadian Association of General Practitioners in Oncology (CAGPO), the Cell Therapy Transplant Canada (CTTC), the Canadian Leukemia Study Group (CLSG) and others are affiliated with the journal and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, MEDLINE, PMC, Embase, and other databases.
- Journal Rank: JCR - Q2 (Oncology)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 17.6 days after submission; acceptance to publication is undertaken in 2.6 days (median values for papers published in this journal in the first half of 2024).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Impact Factor:
2.8 (2023);
5-Year Impact Factor:
2.9 (2023)
Latest Articles
Assessing Barriers to Cancer Screening and Early Detection in Older Adults in Saudi Arabia: A Mixed-Methods Approach to Oncology Nursing Practice Implications
Curr. Oncol. 2024, 31(12), 7872-7889; https://doi.org/10.3390/curroncol31120580 (registering DOI) - 8 Dec 2024
Abstract
Background: Access to cancer screening services is crucial for early detection and improved survival rates, yet older adults in Saudi Arabia face significant barriers. Recent data from the Saudi Health Ministry indicate that cancer incidence in this demographic is rising, underscoring the urgent
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Background: Access to cancer screening services is crucial for early detection and improved survival rates, yet older adults in Saudi Arabia face significant barriers. Recent data from the Saudi Health Ministry indicate that cancer incidence in this demographic is rising, underscoring the urgent need for enhanced screening efforts. This study explores the factors influencing cancer screening behaviors among older adults in Riyadh, using a mixed-methods approach to identify and address these barriers effectively. Methods: The study integrated quantitative data from 100 participants aged 60 and above who attended King Saud University-affiliated healthcare centers, and qualitative insights from 20 semi-structured interviews. The Barriers to Cancer Screening Scale (BCSS) quantitatively assessed barriers, while the thematic analysis of interview data helped identify key themes. Results: Findings revealed significant barriers, categorized into three primary themes: accessibility challenges, psychological barriers, and social influences. These include logistical difficulties related to transportation and service availability, fears and anxieties regarding cancer diagnoses, and a lack of family support and cultural stigma, all of which impact participants’ willingness to engage in screening. Conclusion: The study underscores the multifaceted barriers faced by older adults in accessing cancer screening in Saudi Arabia. Tailored interventions that address logistical, psychological, and social factors are essential to enhance screening uptake and ensure equitable access to preventive services. These findings contribute to the ongoing discussions on public health strategies and underscore the necessity for community and healthcare provider engagement to improve cancer screening rates in this population.
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(This article belongs to the Special Issue Feature Reviews in Section "Oncology Nursing")
Open AccessArticle
Assessment of the American College of Surgeons Surgical Risk Calculator (ACS-SRC) for Prediction of Early Postoperative Complications in Patients Undergoing Cytoreductive Surgery for Ovarian Peritoneal Carcinomatosis
by
Cedric Kabeya, Charif Khaled, Laura Polastro, Michel Moreau, Dario Bucella, Maxime Fastrez and Gabriel Liberale
Curr. Oncol. 2024, 31(12), 7863-7871; https://doi.org/10.3390/curroncol31120579 (registering DOI) - 7 Dec 2024
Abstract
Ovarian cancer (OC) is diagnosed at a locally advanced stage in two-thirds of cases. The first line of treatment consists of cytoreductive surgery (CRS) combined with neoadjuvant and/or adjuvant chemotherapy. However, CRS can be associated with high rates of postoperative complications (POCs), and
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Ovarian cancer (OC) is diagnosed at a locally advanced stage in two-thirds of cases. The first line of treatment consists of cytoreductive surgery (CRS) combined with neoadjuvant and/or adjuvant chemotherapy. However, CRS can be associated with high rates of postoperative complications (POCs), and detection of fragile patients at high risk of POCs is important. The American College of Surgeons Surgical Risk Calculator (ACS-SRC) provides a predictive model for early POCs (30 days) for any given surgical procedure. This study aimed to evaluate the performance of the ACS-SRC in predicting the occurrence of early POCs for patients undergoing CRS for OC. This was a retrospective study that included patients undergoing CRS for advanced OC between January 2010 and December 2022. Early POCs were reviewed, and the rate of POCs was compared with those predicted by the ACS-SRC to evaluate its accuracy (i.e., discrimination and calibration). A total of 218 patients were included, 112 of whom underwent extensive surgery/resection. A total of 94 complications were recorded. This cohort demonstrated correct calibration of the ACS-SRC for the prediction of surgical site infection, readmission, and the need for nursing care post-discharge (NCPD; transfer to revalidation center or need for nursing care at home). Using both the discrimination and calibration methods, the score only predicted NCPD. In this study, the ACS-SRC was shown to be of little value for patients undergoing cytoreductive surgery for ovarian peritoneal carcinomatosis, as it only accurately predicted NCPD.
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(This article belongs to the Special Issue Ovarian Cancer in the Age of Precision Medicine)
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Open AccessArticle
The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer
by
Efthymios Papadopoulos, Andy Kin On Wong, Sharon Hiu Ching Law, Sarah Costa, Angela M. Cheung, Dmitry Rozenberg and Shabbir M. H. Alibhai
Curr. Oncol. 2024, 31(12), 7852-7862; https://doi.org/10.3390/curroncol31120578 - 6 Dec 2024
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Frailty and myosteatosis are each prognostic of all-cause mortality (ACM) in patients with cancer. However, it is unclear whether myosteatosis adds value to frailty for predicting ACM. We assessed whether myosteatosis improves the predictive ability of frailty for ACM in older adults undergoing
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Frailty and myosteatosis are each prognostic of all-cause mortality (ACM) in patients with cancer. However, it is unclear whether myosteatosis adds value to frailty for predicting ACM. We assessed whether myosteatosis improves the predictive ability of frailty for ACM in older adults undergoing chemotherapy. This was a retrospective study of older adults (≥65 years) initiating chemotherapy between June 2015 and June 2022. Frailty was assessed using a 24-item frailty index (FI). Myosteatosis was evaluated via computed tomography scans at the third lumbar vertebra (L3).. Multivariable Cox regression and Uno’s c-statistic determined the predictive performance of the FI and myosteatosis. In total, 115 participants (mean age: 77.1 years) were included. Frailty alone (adjusted hazards ratio (aHR) = 1.68, 95% confidence intervals (CIs) = 1.03–2.72, p = 0.037) and myosteatosis alone (aHR = 2.14, 95%CI = 1.07–4.30, p = 0.032) exhibited similar performance (c-statistic = 0.66) in predicting ACM in multivariable analyses adjusted for age, sex, body mass index, and treatment intent. However, the highest predictive performance for ACM was observed after inclusion of both myosteatosis and frailty in the multivariable model (c-statistic = 0.70). Myosteatosis improves the performance of frailty for predicting ACM in older adults with cancer. Prospective studies to assess the effect of exercise on myosteatosis in older patients are warranted.
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Open AccessSystematic Review
Peripheral Neuropathy Instruments for Individuals with Cancer: A COSMIN-Based Systematic Review of Measurement Properties
by
Silvia Belloni, Arianna Magon, Chiara Giacon, Francesca Savioni, Gianluca Conte, Rosario Caruso and Cristina Arrigoni
Curr. Oncol. 2024, 31(12), 7828-7851; https://doi.org/10.3390/curroncol31120577 - 6 Dec 2024
Abstract
Although the literature on patient-reported outcomes (PROMs) continues to expand, challenges persist in selecting reliable and valid instruments for assessing peripheral neuropathy (PN) in patients with cancer. This systematic review aimed to identify all validated self-report PN scales and critically appraise their measurement
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Although the literature on patient-reported outcomes (PROMs) continues to expand, challenges persist in selecting reliable and valid instruments for assessing peripheral neuropathy (PN) in patients with cancer. This systematic review aimed to identify all validated self-report PN scales and critically appraise their measurement properties. This review was conducted using the COSMIN methodology for PROMs and the PRISMA statement. Five databases were searched from inception to August 2024, identifying 46 eligible studies and 16 PROMs. Evidence quality ranged from “very low” to “moderate”, with notable inconsistencies in the content and structural validity phases of most instruments. Instruments such as the Chemotherapy-induced peripheral neuropathy assessment tool and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity demonstrated moderate quality and potential utility in clinical practice, while others, including the Location-based assessment of sensory symptoms in cancer and the Measure of Ovarian Symptoms and Treatment, had insufficient evidence to support their use. Importantly, all PROMs focused on chemotherapy-induced peripheral neuropathy, highlighting a significant gap in instruments addressing other PN causes, such as radiotherapy or tumor-related nerve damage. Further research should prioritize developing and validating instruments for distinct cancer populations, ensuring robust psychometric properties and clinical applicability.
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Open AccessArticle
Oncologic and Operative Outcomes of Robotic Staging Surgery Using Low Pelvic Port Placement in High-Risk Endometrial Cancer
by
Jeeyeon Kim and Jiheum Paek
Curr. Oncol. 2024, 31(12), 7820-7827; https://doi.org/10.3390/curroncol31120576 - 5 Dec 2024
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Upper para-aortic lymph node dissection (PALND) is one of the most challenging gynecologic robotic procedures. This study aimed to evaluate the oncologic and operative outcomes of robotic staging surgery, including upper PALND, using low pelvic port placement (LP3) in 22 patients with high-risk
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Upper para-aortic lymph node dissection (PALND) is one of the most challenging gynecologic robotic procedures. This study aimed to evaluate the oncologic and operative outcomes of robotic staging surgery, including upper PALND, using low pelvic port placement (LP3) in 22 patients with high-risk endometrial cancer. High-risk was defined as patients who showed deep myometrial invasion with grade III, cervical involvement, or high-risk histology. The mean patient age and body mass index were 58 years and 24 kg/m2. The mean operative time was 263 min. The mean number of total LNs and upper PALNs obtained was 31 and 10. Two patients received lymphangiography to reduce the amount of drained lymphatic fluid after surgery. The recurrence rate was 13.6% (3/22). There were two LN recurrences and one at the peritoneum in the intra-abdominal cavity. Robotic staging surgery using LP3 was feasible for performing PALND as well as procedures in the pelvic cavity simultaneously. It provides important techniques for performing optimal surgical procedures when surgeons decide to perform comprehensive PALND in instances of isolated recurrence or unexpected LN enlargement as well as high-risk endometrial cancer. Consequently, surgeons can achieve surgical consistency and reproducibility for PALND, leading to improved operative and survival outcomes in high-risk endometrial cancer.
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Open AccessArticle
Implementation of an Oncogeriatric Unit for Frail Older Patients with Breast Cancer: Preliminary Results
by
Helena Hipólito-Reis, Joana Santos, Paulo Almeida, Luciana Teixeira, Fernando Rodrigues, Nuno Teixeira Tavares, Darlene Rodrigues, Jorge Almeida and Fernando Osório
Curr. Oncol. 2024, 31(12), 7809-7819; https://doi.org/10.3390/curroncol31120575 - 4 Dec 2024
Abstract
(1) Background: Breast cancer (BC) has a high incidence in Europe, particularly in older adults. Traditionally under-represented in clinical trials, this age group is often undertreated due to ageism. This study aims to characterize frail older adults (≥70 years) with BC based on
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(1) Background: Breast cancer (BC) has a high incidence in Europe, particularly in older adults. Traditionally under-represented in clinical trials, this age group is often undertreated due to ageism. This study aims to characterize frail older adults (≥70 years) with BC based on a comprehensive geriatric assessment, to guide individualized treatment decision-making. (2) Methods: A descriptive analysis of older adults with BC treated from January 2021 to December 2022 was performed. Data were analyzed based on anonymized electronic medical records. (3) Results: Of 123 patients (mean age 84.0 ± 5.6 years), 122 (99.2%) were women. The mean G8 screening score was 12.1 ± 2.5. Most had functional dependence (69.9% Barthel Index, 81.3% Lawton/Brody Scale) and a moderate-to-high risk of falling (76.4% Tinetti index). Cognitive impairment and malnutrition risk were present in 15.4% and 30.1%, respectively. Prehabilitation inclusive strategies led to adapted treatment in 55.3% of cases. Endocrine therapy, surgery, radiotherapy, and chemotherapy was used in 99.2%, 56.1%, 35.0%, and 8.9% of patients, respectively. (4) Conclusions: Our comprehensive oncogeriatric strategy promotes personalized oncologic treatment, improves outcomes by addressing frailty, and enhances treatment tolerability in older patients with BC, validating the expansion of this combined team approach to other cancer types and institutions.
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Open AccessArticle
Survival Outcomes with Regorafenib and/or Trifluridine/Tipiracil Sequencing to Rechallenge with Third-Line Regimens in Metastatic Colorectal Cancer: A Multicenter Retrospective Real-World Subgroup Comparison from the ReTrITA Study
by
Carlo Signorelli, Maria Alessandra Calegari, Annunziato Anghelone, Alessandro Passardi, Giovanni Luca Frassineti, Alessandro Bittoni, Jessica Lucchetti, Lorenzo Angotti, Emanuela Di Giacomo, Ina Valeria Zurlo, Cristina Morelli, Emanuela Dell’Aquila, Adele Artemi, Donatello Gemma, Domenico Cristiano Corsi, Alessandra Emiliani, Marta Ribelli, Federica Mazzuca, Giulia Arrivi, Federica Zoratto, Mario Giovanni Chilelli, Marta Schirripa, Maria Grazia Morandi, Fiorenza Santamaria, Manuela Dettori, Antonella Cosimati, Rosa Saltarelli, Alessandro Minelli, Emanuela Lucci-Cordisco and Michele Bassoadd
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Curr. Oncol. 2024, 31(12), 7793-7808; https://doi.org/10.3390/curroncol31120574 - 4 Dec 2024
Abstract
Background: There is ongoing discussion around the optimal course of treatment for metastatic colorectal cancer (mCRC) following the second line. Trifluridine/tipiracil (T) and regorafenib (R) have been the mainstay of therapy in this situation, as they both increased overall survival (OS) in comparison
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Background: There is ongoing discussion around the optimal course of treatment for metastatic colorectal cancer (mCRC) following the second line. Trifluridine/tipiracil (T) and regorafenib (R) have been the mainstay of therapy in this situation, as they both increased overall survival (OS) in comparison to a placebo. Despite the paucity of evidence, therapy rechallenge is also recognized as an option for practical use. In the third-line scenario of mCRC, we planned to investigate the survival outcomes using (T) and (R), both with and without prior rechallenge treatment. Materials and methods: Between 2012 and 2023, we examined the medical records of 1156 patients with refractory mCRC who were enrolled in the multicenter retrospective ReTrITA study. We then separated the patients into two cohorts based on the rechallenge therapy that was given before regorafenib and/or trifluridine/tipiracil at 17 Italian centres. Results: A total of 981 patients underwent T and/or R therapy, while 175 patients had therapy rechallenge before T and/or R. The median overall survival (mOS) for patients treated with T/R and R/T sequences in the rechallenge therapy cohort was 14.5 months and 17.6 months, respectively (p = 0.1955). A statistically significant survival benefit was observed in patients who received monotheraphy with R (mOS: 6 months) compared to the T group (mOS: 4.2 months) (p = 0.0332). In the same cohort, a median progression-free survival (mPFS) benefit was demonstrated in favour of the R/T group (11.3 months) vs. 9 months of the reverse sequence (p = 0.4004). In the no-rechallenge cohort, the mOS was statistically longer in the R/T sequence than in the T/R sequence (16.2 months vs. 12.3 months, respectively; p = 0.0014). In terms of the mPFS, we saw the same significant result for the adoption of R/T treatment (11.5 months vs. 8.4 months, respectively; p < 0.0001). The two monotherapy groups did not reveal any significant differences. Conclusions: This study suggests that rechallenge therapy may improve survival rates in the third-line treatment of mCRC, particularly if it is administered before sequential R/T treatment. This could allow for the extension of mCRC treatment choices until prospective studies are finished or randomised trials are performed.
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(This article belongs to the Section Gastrointestinal Oncology)
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Open AccessCase Report
Planned Abscopal Effect with Concurrent Pembrolizumab and Ablative Radiotherapy to Pulmonary Metastasis: A Case Report and Review of the Literature
by
Yu-Ting Lee, Chien-Chin Chen, Hsiya Chao, Chih-Chia Chang and Cheng-Yen Lee
Curr. Oncol. 2024, 31(12), 7787-7792; https://doi.org/10.3390/curroncol31120573 - 4 Dec 2024
Abstract
Most abscopal effects are reported as sporadic and unpredictable events following radiotherapy at symptomatic sites. Herein, we report a case in which a planned abscopal effect was induced following deliberate radiotherapy and concurrent systemic immunotherapy. A 53-year-old man with a combined positive score
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Most abscopal effects are reported as sporadic and unpredictable events following radiotherapy at symptomatic sites. Herein, we report a case in which a planned abscopal effect was induced following deliberate radiotherapy and concurrent systemic immunotherapy. A 53-year-old man with a combined positive score ≥10 developed extensive metastatic bladder cancer after progressing on conventional chemotherapy. Extensive metastases were identified in his liver, lungs, and bones. He later had four cycles of single-agent pembrolizumab and planned hypofractionated radiotherapy at an ablative dose to selected metastatic lung tumors and developed complete remission of disease even when pembrolizumab was discontinued. This is a clear demonstration that the abscopal effect could be harnessed in a systematic manner with a combined positive score and aggressive local radiotherapy.
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(This article belongs to the Section Genitourinary Oncology)
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Open AccessReview
Canadian Consensus Recommendations for Predictive Biomarker Testing in Gastric and Gastroesophageal Junction Adenocarcinoma
by
Christine Brezden-Masley, Pierre O. Fiset, Carol C. Cheung, Thomas Arnason, Justin Bateman, Martin Borduas, Gertruda Evaristo, Diana N. Ionescu, Howard J. Lim, Brandon S. Sheffield, Sara V. Soldera and Catherine J. Streutker
Curr. Oncol. 2024, 31(12), 7770-7786; https://doi.org/10.3390/curroncol31120572 - 4 Dec 2024
Abstract
Gastric cancer is common globally and has a generally poor prognosis with a low 5-year survival rate. Targeted therapies and immunotherapies have improved the treatment landscape, providing more options for efficacious treatment. The use of these therapies requires predictive biomarker testing to identify
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Gastric cancer is common globally and has a generally poor prognosis with a low 5-year survival rate. Targeted therapies and immunotherapies have improved the treatment landscape, providing more options for efficacious treatment. The use of these therapies requires predictive biomarker testing to identify patients who can benefit from their use. New therapies on the horizon, such as CLDN18.2 monoclonal antibody therapy, require laboratories to implement new biomarker tests. A multidisciplinary pan-Canadian expert working group was convened to develop guidance for pathologists and oncologists on the implementation of CLDN18.2 IHC testing for gastric and gastroesophageal junction (G/GEJ) adenocarcinoma in Canada, as well as general recommendations to optimize predictive biomarker testing in G/GEJ adenocarcinoma. The expert working group recommendations highlight the importance of reflex testing for HER2, MMR and/or MSI, CLDN18, and PD-L1 in all patients at first diagnosis of G/GEJ adenocarcinoma. Testing for NTRK fusions may also be included in reflex testing or requested by the treating clinician when third-line therapy is being considered. The expert working group also made recommendations for pre-analytic, analytic, and post-analytic considerations for predictive biomarker testing in G/GEJ adenocarcinoma. Implementation of these recommendations will provide medical oncologists with accurate, timely biomarker results to use for treatment decision-making.
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(This article belongs to the Section Gastrointestinal Oncology)
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Open AccessBrief Report
Brief Report: Trends in Incidence, Mortality, and Disability-Adjusted Life Years for Early-Onset Colorectal Cancer in Canada Between 1990 and 2019
by
Igor Stukalin, Mehul Gupta, Katherine Buhler, Nauzer Forbes, Steven J. Heitman and Christopher Ma
Curr. Oncol. 2024, 31(12), 7765-7769; https://doi.org/10.3390/curroncol31120571 - 4 Dec 2024
Abstract
Background: Colorectal cancer is the third most common malignancy globally. Early-onset colorectal cancer (EOCRC) is becoming a growing healthcare focus globally, particularly in North America. We estimated trends in incidence, mortality, and disability-adjusted life years (DALYs) for EOCRC in Canada between 1990 and
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Background: Colorectal cancer is the third most common malignancy globally. Early-onset colorectal cancer (EOCRC) is becoming a growing healthcare focus globally, particularly in North America. We estimated trends in incidence, mortality, and disability-adjusted life years (DALYs) for EOCRC in Canada between 1990 and 2019. Methods: We used the Global Burden of Diseases Study to evaluate trends in incidence, mortality, and DALYs for EOCRC in Canada between 1990 and 2019. Rates were estimated per 100,000 persons at risk with associated uncertainty intervals (UIs). Annual percentage changes (APC) were estimated using joinpoint regression with 95% confidence intervals (CIs). Results: In 2019, the incidence, mortality, and DALYs rates for EOCRC were 10.89 (95% UI 8.09, 14.34), 2.24 (95% UI 2.00, 2.51), and 111.37 (95% UI 99.34, 124.78) per 100,000 individuals, respectively. Incidence increased during the study period by 1.12%/year (95% CI 1.03%, 1.22%; p < 0.001). The largest increase in incidence in EOCRC occurred between 1990 and 2007, with an APC of 2.23% (95% CI 2.09%, 2.37%; p < 0.001). Mortality (APC 2.95%, 95% CI 1.89%, 4.02%; p < 0.001) and DALY (APC 2.96%, 95% CI 1.84%, 4.09%; p < 0.001) rates increased for males between 2001 and 2006. Conclusions: Our study reveals a substantial burden in EOCRC in Canada, with a significant increase in incidence.
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(This article belongs to the Section Gastrointestinal Oncology)
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Open AccessArticle
Vulnerability in Colorectal Cancer: Adjusted Gross Income and Geography as Factors in Determining Overall Survival in Colorectal Cancer: A Single-Center Study Across a Broad Income Inequality in an American Context
by
Cataldo Doria, Patrick G. De Deyne and Papachristou Charalampos
Curr. Oncol. 2024, 31(12), 7754-7764; https://doi.org/10.3390/curroncol31120570 - 3 Dec 2024
Abstract
Introduction: Regional differences in socioeconomic status (SES) are well known, and we believe that the use of geocoding (zip code) can facilitate the introduction of targeted interventions for underserved populations. This is a single-center, retrospective analysis of data extracted from the cancer
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Introduction: Regional differences in socioeconomic status (SES) are well known, and we believe that the use of geocoding (zip code) can facilitate the introduction of targeted interventions for underserved populations. This is a single-center, retrospective analysis of data extracted from the cancer registry at the Capital Health Cancer Center in Pennington, N. The Capital Health Cancer Center in central New Jersey primarily serves two counties, catering to a diverse patient population from a wide range of socioeconomic backgrounds. Methods: We abstracted 1269 consecutive cases of colorectal cancer (CRC) diagnosed and treated between 2000 and 2019 from the Cancer Registry of the Capital Health Cancer Center (CHCC). Using the definition of SES based on previously published work, and zip codes (geocoding), we created four SES levels. We stratified our subjects according to their stage at diagnosis, age at diagnosis, race, and ethnicity. The primary outcome variable was overall survival (OS). Results: There was a statistically significant difference in OS based on SES, with the highest overall survival (OS) in the high-SES group (47 months) and the shortest OS in the low and mid-low-SES groups (40.4 and 30 months, respectively). Subjects living in high-SES areas were predominantly white (88.2%) and diagnosed at a later age (mean of 68.9 years of age) compared to individuals who lived in a low-SES area, who were predominantly non-white (72.6%) and diagnosed somewhat earlier in life (65.1 years of age). White people were diagnosed later in life (70.9 years of age) compared to non-white populations, including Black (66.5), Asian (61.7), and Hispanic (58.5) (p = 0.001) populations, but this did not lead to a significant difference in OS (p = 0.56). Stage at diagnosis was a significant predictor of OS, but was unrelated to SES (p = 0.066). A Cox proportional hazard ratio (HR) model showed that the risk of dying from colorectal cancer decreases with a higher socioeconomic status (SES). Those from mid-high-SES backgrounds had a 19% lower risk (HR 0.81), and those from high-SES areas had a 45% lower risk (HR 0.55) compared to individuals from low-SES areas. Conclusions: The vulnerability of patients with CRC in central New Jersey is a complex issue, influenced by many different variables. Our results indicate that SES is the most critical factor affecting OS after being diagnosed with CRC.
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(This article belongs to the Section Gastrointestinal Oncology)
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Open AccessGuidelines
Management of Ductal Carcinoma In Situ: An Ontario Health (Cancer Care Ontario) Clinical Practice Guideline
by
Muriel Brackstone, Lisa Durocher-Allen, Nadia Califaretti, Andrea Eisen, Sarah Knowles, Abeer Salim, Taude Plexman and C. Anne Koch
Curr. Oncol. 2024, 31(12), 7738-7753; https://doi.org/10.3390/curroncol31120569 - 3 Dec 2024
Abstract
(1) Background: To make recommendations on the most effective therapy options for Ductal Carcinoma of the Breast (DCIS) patients; (2) Methods: MEDLINE, EMBASE, Cochrane Library, PROSPERO databases, and main relevant guideline websites were searched. Draft versions of the guideline went through formal internal
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(1) Background: To make recommendations on the most effective therapy options for Ductal Carcinoma of the Breast (DCIS) patients; (2) Methods: MEDLINE, EMBASE, Cochrane Library, PROSPERO databases, and main relevant guideline websites were searched. Draft versions of the guideline went through formal internal and external reviews, with a final approval by the Program in Evidence Based Care and the DCIS Expert Panel. The Grading of Recommendations, Assessment, Development, and Evaluation approach was followed; (3) Results: Based on the current evidence from the systematic review and this guideline authors’ clinical opinions, initial draft recommendations were developed to improve the management of patients with DCIS. After a comprehensive internal and external review process, ten recommendations and 27 qualifying statements were eventually made. This guideline includes recommendations for the primary treatment of DCIS with surgical treatment and/or radiation therapy and the management of DCIS after primary treatment for patients with DCIS, including DCIS with microinvasion (<1 mm through the duct); (4) Conclusions: The current guideline was created after a systematic review and a comprehensive internal and external review process. We believe this guideline provides valuable insights that will be useful in clinical decision making for health providers.
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Open AccessReview
Braf-Mutant Melanomas: Biology and Therapy
by
Elvira Pelosi, Germana Castelli and Ugo Testa
Curr. Oncol. 2024, 31(12), 7711-7737; https://doi.org/10.3390/curroncol31120568 - 3 Dec 2024
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The incidence of melanoma, the most lethal form of skin cancer, has increased mainly due to ultraviolet exposure. The molecular characterization of melanomas has shown a high mutational burden led to the identification of some recurrent genetic alterations. BRAF gene is mutated in
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The incidence of melanoma, the most lethal form of skin cancer, has increased mainly due to ultraviolet exposure. The molecular characterization of melanomas has shown a high mutational burden led to the identification of some recurrent genetic alterations. BRAF gene is mutated in 40–50% of melanomas and its role in melanoma development is paramount. BRAF mutations confer constitutive activation of MAPK signalling. The large majority (about 90%) of BRAF mutations occur at amino acid 600; the majority are BRAFV600E mutations and less frequently BRAFv600K, V600D and V600M. The introduction of drugs that directly target BRAF-mutant protein (BRAF inhibitors) and of agents that stimulate immune response through targeting of immune check inhibitor consistently improved the survival of melanoma BRAFV600-mutant patients with unresectable/metastatic disease. In parallel, studies in melanoma stage II-III patients with resectable disease have shown that adjuvant therapy with ICIs and/or targeted therapy improves PFS and RFS, but not OS compared to placebo; however, neoadjuvant therapy plus adjuvant therapy improved therapeutic response compared to adjuvant therapy alone.
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Open AccessSystematic Review
Features of the Nurse-Patient Relationship: Insights from a Qualitative Review Using Artificial Intelligence Interpretation
by
Elsa Vitale, Luana Conte, Roberto Lupo, Stefano Botti, Annarita Fanizzi, Raffaella Massafra and Giorgio De Nunzio
Curr. Oncol. 2024, 31(12), 7697-7710; https://doi.org/10.3390/curroncol31120567 - 2 Dec 2024
Abstract
Introduction: This qualitative literature review explored the intersection of art, creativity, and the nurse–patient relationship in the context of oncology nursing. It delved into the perceptions and reflections of nurses as captured by Generative Artificial Intelligence (GAI) analysis from two specialized nursing databases.
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Introduction: This qualitative literature review explored the intersection of art, creativity, and the nurse–patient relationship in the context of oncology nursing. It delved into the perceptions and reflections of nurses as captured by Generative Artificial Intelligence (GAI) analysis from two specialized nursing databases. Methods: The protocol was registered on the Open Science Framework (OSF) Platform. A comprehensive search was conducted in CINAHL, the British Nursing Database, and the Nursing & Allied Health Database, using keywords related to art, cancer, creativity, nursing, and relationships. The extracted qualitative research studies were then analyzed using GAI to identify key themes and insights. Results: The analysis revealed profound considerations regarding the role of nurses in oncology and palliative patient care. Nurses acknowledged the spiritual dimension through religious and spiritual practices, while emphasizing authentic presence and empathic communication. They actively addressed patient concerns, adapted to challenges, and engaged in continuous professional development. The insights from the GAI interpretation underscored the significance of empathy, creativity, and artistry in nurturing meaningful nurse–patient connections. Conclusions: The GAI-enabled exploration provided valuable insights into several dimensions of care, emphasizing the importance of spiritual sensitivity, empathic communication, and ongoing professional growth. As technology and human care converge, integrating artistry into the nurse–patient relationship could enhance patient experiences, improve outcomes, and enrich the oncology nursing practice.
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(This article belongs to the Special Issue Feature Reviews in Section "Oncology Nursing")
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Open AccessArticle
The Impact of Cancer Status on Anxiety in Prostate Cancer Patients: A Network Analysis
by
Christopher F. Sharpley, Kirstan A. Vessey, Vicki Bitsika, Wayne M. Arnold and David R. H. Christie
Curr. Oncol. 2024, 31(12), 7686-7696; https://doi.org/10.3390/curroncol31120566 - 1 Dec 2024
Abstract
Prostate cancer (PCa) patients often also suffer from comorbid anxiety, which can impede treatment efficacy as well as be intrinsically unpleasant. Identification of the associations between particular symptoms of anxiety that are most likely to occur at different points in the PCa diagnosis–treatment
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Prostate cancer (PCa) patients often also suffer from comorbid anxiety, which can impede treatment efficacy as well as be intrinsically unpleasant. Identification of the associations between particular symptoms of anxiety that are most likely to occur at different points in the PCa diagnosis–treatment journey can inform anxiety treatment choices and potentially influence their overall treatment outcomes. Although simple correlational analyses and ANOVA models of data analysis have been used to address this issue, the possibility of confounds due to the inter-relationships between other anxiety symptoms argues for the use of network analysis, which calculates each symptom–symptom connection while also taking into account the entire range of symptom relationships. Responses to the GAD-10 self-report scale for Generalised Anxiety Disorder were collected from 415 PCa patients who were grouped according to whether (1) their PCa was just diagnosed and undergoing initial treatment; (2) their cancer was in remission; or (3) their cancer was recurring after initial treatment. The results of the network analysis indicated several areas where clinically relevant differences were present between the three PCa groups, but caution was applied to the results of statistical tests due to unequal sample sizes. Individual GAD symptom–symptom association differences are discussed in terms of their implications for directed and individualised anxiety-management treatment models.
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(This article belongs to the Special Issue New and Emerging Trends in Prostate Cancer)
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Open AccessArticle
Symptom Burden and Dietary Changes Among Older Adults with Cancer: A Cross-Sectional Study
by
Lea Büthe, Gina Westhofen, Andrea Hille and Judith Büntzel
Curr. Oncol. 2024, 31(12), 7663-7685; https://doi.org/10.3390/curroncol31120565 - 1 Dec 2024
Abstract
Background: Malnutrition has a direct impact on both the toxicities of cancer therapy and the overall survival of oncological patients. However, its prevalence amongst vulnerable groups such as older patients (age ≥ 65 years) is often underestimated. Screening tools recognizing patients at risk
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Background: Malnutrition has a direct impact on both the toxicities of cancer therapy and the overall survival of oncological patients. However, its prevalence amongst vulnerable groups such as older patients (age ≥ 65 years) is often underestimated. Screening tools recognizing patients at risk are well established, yet they do not take into account that cancer therapy may lead to changes in dietary habits or that therapy’s side effects may negatively influence nutritional status. Methods: To close this gap, we combined the validated Nutritional Risk Score 2002 (NRS-2002) and G8 screening tools with short questionnaires addressing diet changes and symptom load and screened 300 cancer inpatients between 12/2022 and 12/2023. Descriptive statistics (Fisher’s exact, Student’s t-test) as well as heat mapping were applied for data analysis. Results: Overall, two in three inpatients ≥65 years were at risk for malnutrition, and the majority of patients (87.67%) scored ≤14 points on the G8 and were considered frail. Surprisingly, the symptom complex of oral discomfort was most often mentioned by patients (xerostomia—178/300 patients, loss of appetite: 122/300 patients, dysgeusia: 93/300 patients). Diet changes were also common, with patients mainly avoiding certain foods (122/300 patients) or using dietary supplements (106/300 patients). Conclusions: Taken together, older cancer inpatients are frail and have a high risk of malnutrition. Screening should not only consider energy intake but also symptom burden and dietary changes to optimize supportive care.
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(This article belongs to the Section Palliative and Supportive Care)
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Open AccessArticle
Longitudinal Assessment of FT3 to FT4 Conversion Ratio in Predicting the Efficacy of First-Line Pembrolizumab-Based Therapy in Advanced Non-Small Cell Lung Cancer: A Propensity-Score Matching Analysis of Data from the National Drug Monitoring Agency
by
Fabrizio Nelli, Enzo Maria Ruggeri, Marta Schirripa, Antonella Virtuoso, Diana Giannarelli, Armando Raso, Daniele Remotti and Agnese Fabbri
Curr. Oncol. 2024, 31(12), 7647-7662; https://doi.org/10.3390/curroncol31120564 - 1 Dec 2024
Abstract
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Baseline thyroid function, as measured by the fT3 to fT4 ratio, has been shown to influence the prognosis of advanced cancer patients receiving active treatments. Although immune checkpoint blockade can alter the balance of thyroid hormones, this interaction has not been thoroughly investigated.
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Baseline thyroid function, as measured by the fT3 to fT4 ratio, has been shown to influence the prognosis of advanced cancer patients receiving active treatments. Although immune checkpoint blockade can alter the balance of thyroid hormones, this interaction has not been thoroughly investigated. The present research sought to determine whether changes in the fT3/fT4 ratio could affect the survival outcomes of patients with advanced non-small cell lung cancer (NSCLC) who were undergoing pembrolizumab-based therapies. This study included patients with metastatic NSCLC who received pembrolizumab as upfront treatment, either alone or in combination with platinum-based chemotherapy. Relevant data were gathered before the start (time point 1) and after 12 weeks (time point 2) of treatment. From April 2018 to May 2023, we enrolled 258 eligible patients, 156 (60.5%) and 102 (39.5%) of whom were treated with single-agent or combination therapy, respectively. We stratified patients into two groups based on baseline fT3 and fT4 values [euthyroid cohort defined by fT3 and fT4 both within the normal range vs. euthyroid sick syndrome cohort defined by low fT3 and/or fT4 levels]. We examined the differences in progression-free survival (PFS) and overall survival (OS) by univariate and multivariate analyses. After applying propensity-score matching, we considered 88 relevant cases in each cohort. Longitudinal comparison of fT3/fT4 ratios showed a significant increase in the median value after pembrolizumab-based therapy (p < 0.001). We computed ROC curves to analyze the correlation between fT3/fT4 ratios and survival outcomes. The relative AUC values were not viable in predicting a positive outcome at the first time point. Conversely, assessment at the second time point revealed a significant association with PFS [AUC 0.82 (95% CI 0.75–0.89), p < 0.001] and OS [AUC 0.81 (95% CI 0.75–0.88), p < 0.001]. After a median follow-up of 20.2 (95% CI 16.2–24.2) months, the median PFS for the low and high fT3/fT4 ratio groups was 4.1 (95% CI 3.0–5.1) and 15.3 (95% CI 10.3–20.1) months, respectively (p < 0.001). The median OS for the low and high fT3/fT4 ratio groups was 6.7 (95% CI 4.9–8.5) and 19.6 (95% CI 16.4–22.8) months, respectively (p < 0.001). The multivariate analysis revealed that a low fT3/fT4 ratio was independently associated with shorter PFS [HR 2.51 (1.66–3.78); p < 0.001] and OS [HR 2.18 (1.43–3.34); p < 0.001]. After the optimal weighting of prognostic factors according to thyroid function impairment, the fT3/fT4 ratio at baseline did not affect the survival of patients receiving immune checkpoint blockade for advanced NSCLC. Patients with an increased fT3/fT4 ratio experienced a significantly decreased risk of disease progression and mortality. The longitudinal assessment of fT3/fT4 ratio may play a predictive role in this specific therapeutic setting.
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Open AccessReview
Potential Benefits from Physical Exercise in Advanced Cancer Patients Undergoing Systemic Therapy? A Narrative Review of the Randomized Clinical Trials
by
Federico Bozzetti
Curr. Oncol. 2024, 31(12), 7631-7646; https://doi.org/10.3390/curroncol31120563 - 1 Dec 2024
Abstract
Design. The purpose of this review is the analysis of the literature concerning the effects of physical exercise in cancer patients undergoing medical oncologic treatment. Papers were retrieved from the scrutiny of 15 reviews/meta-analyses published in the last 2 years, which, however, pooled
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Design. The purpose of this review is the analysis of the literature concerning the effects of physical exercise in cancer patients undergoing medical oncologic treatment. Papers were retrieved from the scrutiny of 15 reviews/meta-analyses published in the last 2 years, which, however, pooled different populations of patients (surgical and medical patients, receiving or not an oncologic therapy, harboring a cancer, or being survivors). Results. We reviewed the data of 35 RCTs on the use of physical exercise in cancer patients, distinguishing well-nourished from malnourished patients. The conclusions of our study are the following: No major difference between well-nourished and malnourished patients as regards compliance/adherence with physical exercise and outcomes. Compliance with physical exercise was reported in about 70% of the studies. Compared with a control group receiving the usual care, in patients who practiced physical exercise, a benefit in some parameters of physical function and quality of life and lean body mass (LBM) was reported in 61%, 47%, and 12%, respectively, of the studies in non-malnourished patients, and in 50%, 100%, and 36%, respectively, of the studies in malnourished patients. The benefit in LBM was more frequently reported in weight-losing patients. There was no strict association among the results of different outcomes (muscle function vs. quality of life vs. LBM). There are still some ill-defined issues, including the optimal physical regimen (with some authors favoring high-intensity interval training and resistance) and the place of exercising (patients usually preferring home exercises, which, however, have been proved less efficacious).
Full article
(This article belongs to the Special Issue Diet and Physical Activity Management during Cancer)
Open AccessCase Report
Personalized Ultra-Fractionated Stereotactic Adaptive Radiotherapy for Non-Small Cell Lung Cancer Using Varian Ethos Therapy System
by
Vanda Leipold, Blanka Jakšić, Asmir Avdičević, Domagoj Kosmina, Hrvoje Kaučić, Ivana Alerić, Karla Schwarz, Mihaela Mlinarić, Giovanni Ursi, Adlan Čehobašić and Dragan Schwarz
Curr. Oncol. 2024, 31(12), 7625-7630; https://doi.org/10.3390/curroncol31120562 - 1 Dec 2024
Abstract
We present a patient treated with personalized ultra-fractionated stereotactic adaptive radiotherapy (PULSAR) for non-small cell lung cancer (NSCLC) using the adaptive Varian Ethos™ system equipped with the novel HyperSight imaging platform. Three pulses of 12 Gy were separated by a pause of four
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We present a patient treated with personalized ultra-fractionated stereotactic adaptive radiotherapy (PULSAR) for non-small cell lung cancer (NSCLC) using the adaptive Varian Ethos™ system equipped with the novel HyperSight imaging platform. Three pulses of 12 Gy were separated by a pause of four weeks during which the tumor was given enough time to respond to treatment. Only initial planning computed tomography (CT) was acquired on a CT simulator (Siemens Somatom Definition Edge), whereas other pulses were adapted using online cone beam computed tomography (CBCT) images (iCBCT Acuros reconstruction) acquired while the patient was lying on the treatment couch and delivered immediately. Significant tumor reduction was achieved between pulses, resulting in improved organs-at-risk sparing. In addition, the on-couch plan optimization based on CBCT greatly reduced the patient’s stay at the clinic and the duration of treatment preparation.
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(This article belongs to the Topic Innovative Radiation Therapies)
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Methadone in Cancer-Related Neuropathic Pain: A Narrative Review
by
Faten Ragaban, Om Purohit and Egidio Del Fabbro
Curr. Oncol. 2024, 31(12), 7613-7624; https://doi.org/10.3390/curroncol31120561 - 1 Dec 2024
Abstract
Background and Objective: Cancer-related neuropathic pain (CRNP) is often a significant burden on patients’ quality of life. There are limited treatment guidelines for cancer-related neuropathic pain outside of CIPN. Although opioids are considered a third-line treatment option, no consensus exists on which opioid
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Background and Objective: Cancer-related neuropathic pain (CRNP) is often a significant burden on patients’ quality of life. There are limited treatment guidelines for cancer-related neuropathic pain outside of CIPN. Although opioids are considered a third-line treatment option, no consensus exists on which opioid is most effective, either as a single agent or in combination with other medications. Our aim is to review and update the literature for methadone use in CRNP, since the last review was conducted in 2006. Methods: A comprehensive literature search was performed to evaluate the use of methadone in cancer-related neuropathic pain. Articles were identified from PubMed, Google Scholar, and Cochrane Library using the following keywords: “methadone AND cancer pain AND neuropathic pain” and “cancer-related opioid treatment”. Results: Studies were included if they evaluated methadone’s efficacy or safety in neuropathic pain management for patients with cancer. This review focused on randomized controlled trials (RCTs), systematic reviews, meta-analyses, and observational studies published between 2000 and 2024. Studies were excluded if they lacked specific data on cancer-related neuropathic pain or were case reports. Conclusions: The unique mechanisms of action and preliminary clinical trials support methadone’s status as the first opioid to consider for CRNP when non-opioid first-line treatments have failed to alleviate patient symptoms. Methadone can also be considered as a first-line opioid in patients with mixed nociceptive–neuropathic pain and any of the following features: renal dysfunction; administration of opioids through a feeding tube; a lack of financial resources/insurance; and a switch from another high-dose opioid. More research is needed regarding methadone for CRNP and methadone’s preferential use in specific sub-groups of patients.
Full article
(This article belongs to the Section Palliative and Supportive Care)
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