Current Oncology

[¹⁷⁷Lu]Lu-PSMA-617 improves outcomes in patients with PSMA-positive metastatic Androgen Pathway Modulation-Resistant prostate cancer (mAPMR) previously treated with androgen deprivation therapy, androgen receptor pathway inhibitors and taxane chemotherapy; however, Canadian real-world data following public reimbursement remain limited. We evaluated the implementation and outcomes of a multidisciplinary theranostic program and the initial real-world experience with [¹⁷⁷Lu]Lu-PSMA-617 at Princess Margaret Cancer Centre, University Health Network. In total, 77 consecutive patients with mAPMR treated between December 2024 and May 2026 were retrospectively reviewed. Median age was 72 years, 22% had visceral metastases, and median baseline PSA was 146 µg/L. Patients received a median of four treatment cycles. Median follow-up was 7.2 months. PSA, PSA50 response, and radiographic response rates were 66%, 40%, and 19%, respectively. Median radiographic progression-free survival was 6.7 months (95% CI 4.7–9.1), and median overall survival was 12.3 months (95% CI 9.8—not reached). Grade 3–4 adverse events occurred in 16% of patients, and treatment discontinuation rate due to toxicity was only 1%. Despite less favourable baseline characteristics than the pivotal VISION trial, [¹⁷⁷Lu]Lu-PSMA-617 demonstrated clinically meaningful activity and a manageable safety profile. These findings support the feasibility and effectiveness of delivering PSMA-targeted radioligand therapy within a publicly funded healthcare system.

Background and Objectives: Pancreatic ductal adenocarcinoma (PDAC) is spatially heterogeneous and may extend beyond the tumour margin visible on CT. We compared intratumoral habitat radiomics with whole-tumour and 1-, 3-, and 5-mm peritumoral radiomics for overall survival after resection. Materials and Methods: This single-centre retrospective study included 315 patients assigned to training (n = 221) and internal test (n = 94) cohorts. Feature selection, model fitting, and cutoff definition were confined to training data. Clinicopathological, imaging, and integrated Cox models were evaluated with C-indices, censoring-weighted time-dependent AUCs, Kaplan–Meier analysis, and calibration. Additional analyses examined geometric partitions, reader repeatability, and scanner subgroups. Results: Habitat C-indices were 0.781 (95% CI 0.744–0.812) in training and 0.744 (0.700–0.784) in testing, compared with 0.647 and 0.619 for whole-tumour radiomics. Test AUCs at 1, 2, and 3 years were 0.828, 0.854, and 0.867 for habitat and 0.813, 0.852, and 0.890 for the integrated model; all paired difference intervals included zero. Habitat C-indices were 0.760 and 0.757 in the two scanner subgroups. Time-varying effects did not consistently improve test calibration. Conclusions: Habitat radiomics showed the strongest discrimination among the original imaging models, without evidence of improvement from integration. The results support further evaluation of postoperative risk stratification; external validation is needed before clinical application.

Background: Colorectal cancer (CRC) incidence is rising in China. Although obesity is a risk factor, body mass index (BMI) does not capture fat distribution. Central obesity indicators, particularly waist-to-hip ratio (WHR) and waist-to-hip ratio adjusted for BMI (WHRadjBMI), may better reflect visceral adiposity implicated in colorectal carcinogenesis. Methods: We conducted a prospective cohort study among 120,348 Chinese adults from the Nanjing Chronic Disease Cohort (NCDC). Baseline measures included BMI, waist circumference (WC), WHR, and WHRadjBMI. Incident CRC cases were ascertained via linkage to disease surveillance and health insurance databases. Cox regression estimated HRs and 95% CIs. Mutual adjustment and population attributable fraction (PAF) analyses were performed. Results: During 3.0 years of follow-up, 175 CRC cases occurred. Elevated WHR showed the strongest association (HR 1.90, 95% CI 1.33–2.73), followed by WHRadjBMI (HR 1.65) and WC (HR 1.60). BMI ≥ 24 kg/m² was not significant (HR 1.33, p = 0.076). In mutual adjustment, BMI’s association was attenuated, whereas WHR remained significant (HR 1.66, p = 0.015). WHR had the highest PAF (24.6%). The association was comparable in men and women. Conclusions: Central obesity measures, particularly WHR, demonstrated stronger associations with CRC risk than BMI in Chinese adults. Assessing central fat distribution may provide additional value for CRC risk stratification.