Current Oncology

12 pages, 519 KB

Open AccessArticle

Liver Metastasectomy in Anal Squamous Cell Carcinoma: The Mayo Clinic Experience

by Noah Takacs, Conor D. J. O’Donnell, Nguyen Tran, Krishan Jethwa, Thomas Atwell, Patrick Starlinger and Zhaohui Jin

Curr. Oncol. 2026, 33(3), 157; https://doi.org/10.3390/curroncol33030157 - 10 Mar 2026

Abstract

Background: Metastatic squamous cell carcinoma of the anus (SCCA) carries a poor prognosis, with systemic therapy remaining the standard of care. While metastasis-directed therapy improves outcomes in select gastrointestinal malignancies, the role of liver-directed intervention in metastatic SCCA remains undefined. We evaluated clinicopathologic [...] Read more.

Background: Metastatic squamous cell carcinoma of the anus (SCCA) carries a poor prognosis, with systemic therapy remaining the standard of care. While metastasis-directed therapy improves outcomes in select gastrointestinal malignancies, the role of liver-directed intervention in metastatic SCCA remains undefined. We evaluated clinicopathologic features and oncologic outcomes of patients with liver-limited metastatic SCCA treated with curative-intent hepatic local therapy at a tertiary academic center. Methods: We conducted a retrospective cohort study of adults with histologically confirmed SCCA and liver-only metastatic disease who underwent curative-intent hepatic resection or ablation at Mayo Clinic between 1993 and 2023. Patients with extrahepatic disease or incomplete records were excluded. Demographic, tumor, treatment, and outcomes data were abstracted from electronic medical records. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan–Meier method. Prognostic factors were assessed using univariate Cox proportional hazards models. Results: Twenty-five patients met inclusion criteria. Median age was 56.7 years, and 92% were female. Most patients had metachronous metastases (76%), a single hepatic lesion (56%), and unilobar disease (76%). Pre-intervention systemic therapy was administered in 52% of patients, with radiographic complete or partial responses observed in all treated patients. Liver-directed therapy consisted of surgical resection in 80% and thermal ablation in 20%. Among surgical patients, 90% achieved microscopically negative margins. With a median follow-up of 22 months, disease recurrence occurred in 80% of patients, most commonly within the liver. Median DFS was 7.27 months. Median OS from the date of liver-directed therapy was 51.3 months. On univariate analysis, poorly differentiated tumor histology was associated with inferior OS (hazard ratio 4.67, p = 0.018). No other clinicopathologic variables were significantly associated with DFS or OS. Conclusions: In this single-institution experience, carefully selected patients with liver-limited metastatic SCCA undergoing curative-intent hepatic-directed therapy achieved prolonged overall survival, substantially exceeding historical outcomes with systemic therapy alone. Despite frequent recurrence, the observed median OS exceeding four years supports consideration of liver-directed therapy within a multidisciplinary framework for patients demonstrating favorable disease biology and response to systemic treatment. Prospective studies are needed to better define patient selection and optimal integration of local and systemic therapies in the modern treatment era. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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31 pages, 6680 KB

Open AccessReview

Neutrophil Extracellular Traps in Cancer Metastasis: From Mechanistic Understanding to Targeted Therapy

by Xiaorui Tian, Jintong Na, Xinyi Tan, Fengqiu Dang, Rui Zhu, Liping Zhong and Yongxiang Zhao

Curr. Oncol. 2026, 33(3), 156; https://doi.org/10.3390/curroncol33030156 - 9 Mar 2026

Abstract

Metastasis is the leading cause of cancer-related death, underscoring the need to elucidate the key mechanisms behind this process. Neutrophil extracellular traps (NETs) have emerged as critical regulators of tumor progression and metastasis. This review summarizes the primary stimuli and signaling pathways that [...] Read more.

Metastasis is the leading cause of cancer-related death, underscoring the need to elucidate the key mechanisms behind this process. Neutrophil extracellular traps (NETs) have emerged as critical regulators of tumor progression and metastasis. This review summarizes the primary stimuli and signaling pathways that govern NET formation and outlines the mechanistic roles of NET components in tumor growth and metastatic spread. We focus on environmental and tumor microenvironment-derived factors, including psychological stress, tumor-secreted cytokines, and treatment-related responses, that drive NET formation. The involvement of NETs in multiple stages of the metastatic cascade is discussed, including angiogenesis, tumor cell intravasation and extravasation, circulating tumor cell survival, metastatic colonization, and the reactivation of dormant tumor cells. Additionally, we examine how NETs contribute to the establishment of an immunosuppressive microenvironment. Finally, emerging therapeutic strategies targeting NETs are briefly reviewed, highlighting their potential relevance in metastatic cancer treatment. Full article

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16 pages, 607 KB

Open AccessArticle

Comparable Access, Different Outcomes: Breast Cancer Survival Among Syrian Refugees and Turkish Patients in Türkiye

by Ilker Nihat Ökten, Tuba Baydaş, Canan Karan, Oğuzhan Kesen, İbrahim Çil and Fatih Teker

Curr. Oncol. 2026, 33(3), 155; https://doi.org/10.3390/curroncol33030155 - 8 Mar 2026

Abstract

Background: Breast cancer outcomes are influenced by tumor biology, stage at diagnosis, and access to timely care. Refugee populations may experience disparities in cancer outcomes despite formal access to healthcare services. Türkiye hosts the largest population of Syrian refugees globally and provides universal [...] Read more.

Background: Breast cancer outcomes are influenced by tumor biology, stage at diagnosis, and access to timely care. Refugee populations may experience disparities in cancer outcomes despite formal access to healthcare services. Türkiye hosts the largest population of Syrian refugees globally and provides universal access to oncology care, offering a unique context to examine equity in breast cancer outcomes. Methods: We performed a retrospective cohort study of female patients diagnosed with invasive breast cancer between 2013 and 2022 at two tertiary oncology centers in Gaziantep, Türkiye. Patients were grouped as Syrian refugees or Turkish citizens based on recorded nationality. Baseline clinicopathologic features and stage at diagnosis were compared between groups. Overall survival (OS) was estimated by the Kaplan–Meier method and compared using log-rank tests. Survival analyses were performed overall and stratified by stage category (I–III vs. IV). Cox proportional hazards regression was used to evaluate the association between ethnicity and OS with adjustment for stage and molecular subtype (and other prespecified covariates as appropriate). Treatment delivery patterns (systemic therapy and radiotherapy) were descriptively compared to evaluate access after entry into care. Results: Among 499 patients (150 Syrian refugees; 349 Turkish citizens), Syrian patients were younger at diagnosis and more frequently presented with de novo metastatic disease. In the overall cohort with survival data (n = 430), unadjusted OS differed by ethnicity; however, survival differences were attenuated after stratification by stage. In stage I–III disease, OS did not significantly differ between groups, and in stage IV disease, median OS was comparable between ethnicities. In multivariable analysis adjusting for stage and molecular subtype, ethnicity was not independently associated with OS, whereas stage and molecular subtype remained prognostic. Treatment delivery patterns in both the non-metastatic and metastatic settings were broadly similar between groups. Conclusions: Within a universal healthcare system, the dominant disparity between Syrian refugees and Turkish citizens was more advanced stage at presentation. After accounting for stage and tumor biology, ethnicity itself was not independently associated with overall survival, suggesting that efforts to reduce outcome gaps should prioritize earlier diagnosis and linkage to care. Full article

(This article belongs to the Section Breast Cancer)

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12 pages, 652 KB

Open AccessArticle

Analyzing Real-World Infection Risk in Multiple Myeloma Patients Receiving Teclistamab

by Paddy Ssentongo, Emma G. Guare, Chen Song, Yoshitaka Inoue, Manpreet Sandhu, Charyguly Annageldiyev, Jeffrey Sivik, Kevin Rakszawski, Seema Naik, Kentaro Minagawa, Shin Mineishi and Catharine I. Paules

Curr. Oncol. 2026, 33(3), 154; https://doi.org/10.3390/curroncol33030154 - 8 Mar 2026

Abstract

Background: Teclistamab is an anti-B-cell maturation antigen bispecific antibody used in relapsed, refractory multiple myeloma that induces durable responses but is associated with infectious complications. Real-world data characterizing infection risk remain limited. Methods: We conducted a single-center retrospective cohort study of relapsed/re fractory [...] Read more.

Background: Teclistamab is an anti-B-cell maturation antigen bispecific antibody used in relapsed, refractory multiple myeloma that induces durable responses but is associated with infectious complications. Real-world data characterizing infection risk remain limited. Methods: We conducted a single-center retrospective cohort study of relapsed/re fractory multiple myeloma patients treated with teclistamab from 1 January 2023 to 20 November 2023. The primary objective was to establish the incidence of infections after initiation of teclistamab. Secondary objectives included infection-related outcomes and identifying potential risk factors for infection. Results: 19 patients received teclistamab with a median age of 72 [IQR: 62–74] years and 73.7% had Karnofsky performance score < 80. A total of 11 (57.9%) patients developed 19 infections, with seven patients having multiple infections. There were five bacteremias, five other bacterial infections, seven respiratory viral infections, and 2 CMV reactivation events. Median time to first infection was 20 days (IQR: 9–87) and median grade of all infections was three (range: 1–5). Of the 19 documented infections, 15 (78.9%) were Grade ≥ 3. A total of 10 patients in the infection group and three in the non-infection group discontinued therapy permanently (p = 0.013). Conclusion: In this real-world cohort, infectious complications emerged early and frequently during teclistamab therapy and were a major driver of treatment interruption and permanent discontinuation. The clinical impact of infection extended beyond acute morbidity, often limiting continued access to an otherwise effective therapy in a heavily pretreated population. These findings highlight the need for proactive, individualized infection risk assessment and for standardized, evidence-informed approaches to infection monitoring, prophylaxis, and treatment modification during teclistamab therapy. Larger, multicenter studies will be essential to define strategies that balance infection risk with treatment durability in patients with limited therapeutic alternatives. Full article

(This article belongs to the Special Issue BCMA-Directed CAR-T Therapy in Relapsed or Refractory Multiple Myeloma)

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12 pages, 1419 KB

Open AccessArticle

Urachal Signet Ring Cell Carcinoma: A Clinicopathological Analysis of 28 Cases

by Natalie South, Ioana Maria Mihai, Vickie Wang, Mehdi Agoumi, Charles Guo and Gang Wang

Curr. Oncol. 2026, 33(3), 153; https://doi.org/10.3390/curroncol33030153 - 7 Mar 2026

Abstract

Background: Urachal carcinoma is a rare malignancy comprising less than 1% of all bladder cancers. The signet-ring cell subtype is particularly aggressive and poses significant diagnostic and therapeutic challenges. Methods: A retrospective review of urachal carcinoma cases from 1989 to 2023 was [...] Read more.

Background: Urachal carcinoma is a rare malignancy comprising less than 1% of all bladder cancers. The signet-ring cell subtype is particularly aggressive and poses significant diagnostic and therapeutic challenges. Methods: A retrospective review of urachal carcinoma cases from 1989 to 2023 was conducted using data from BC Cancer and MD Anderson Cancer Center. The study analyzed 75 patients, including 28 signet-ring cell carcinoma (SRCC) cases and a control group of 47 non-SRCC cases, to compare survival patterns, treatment outcomes, and histopathological features. Results: Clinically, the SRCC subtype was associated with advanced stage at presentation (pT3/pT4) and a higher recurrence rate (82% vs. 53%; p = 0.01). Survival analysis demonstrated worse outcomes for the SRCC cohort, with a five-year cancer-specific survival (CSS) of 39% compared to 64% in the non-signet group (p = 0.053). Partial cystectomy remained the primary surgical approach for both cohorts. Adjuvant chemotherapy was administered more often in SRCC cases (86% vs. 47%). Conclusions: By providing a comprehensive multi-institutional analysis, this study establishes urachal SRCC as a distinct clinical entity with a strong independent prognostic significance. Despite aggressive multimodal management, it carries a poorer prognosis compared to urachal non-SRCC, emphasizing the need for subtype-specific therapeutic guidelines. Full article

(This article belongs to the Section Genitourinary Oncology)

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18 pages, 1888 KB

Open AccessArticle

Real-World Treatment Patterns and Survival in Patients with ROS1-Positive Advanced Non-Small Cell Lung Cancer in Canada and Europe

by Winson Y. Cheung, Adam Lee, Helena Bote de Cabo, Kathrin Burdenski, Petros Christopoulos, Bárbara Pinto-Correia, Simon Deshayes, Nicolas Girard, Pooja Hindocha, Áine Madden, Marta Mella, Joana Moreira, Silvia Rizzi, Delvys Rodríguez Abreu, Marta Soares, Joseph Thomas, Maria Han, Christophe Y. Calvet, Gabrielle Emanuel, Mrudula B. Glassberg, Hazel Jacobs, Caroline Rault, Yong Yuan and Christos Chouaid Show full author list Hide full author list

Curr. Oncol. 2026, 33(3), 152; https://doi.org/10.3390/curroncol33030152 - 6 Mar 2026

Abstract

Real-world data on patients with ROS1-positive advanced non-small cell lung cancer (NSCLC) remain scarce. In this descriptive observational retrospective cohort study, we describe characteristics, treatments, and real-world progression-free survival (rwPFS) and overall survival (OS) among patients with ROS1-positive advanced NSCLC (de [...] Read more.

Real-world data on patients with ROS1-positive advanced non-small cell lung cancer (NSCLC) remain scarce. In this descriptive observational retrospective cohort study, we describe characteristics, treatments, and real-world progression-free survival (rwPFS) and overall survival (OS) among patients with ROS1-positive advanced NSCLC (de novo or recurrent) using secondary data pooled from clinical sites in Canada, France, Germany, Portugal, and Spain as part of the Oncology Evidence Network. Site-specific patient inclusion periods occurred between 2009 and 2023, with follow-up to 2024, allowing ≥1 year of potential follow-up at each site. In total, 108 patients were included, with most (n = 105; 97.2%) having a de novo diagnosis of advanced NSCLC. 103 patients (95.4%) received ≥1 line of systemic anticancer therapy (SACT), of which 65 (63.1%) received first-line targeted therapy, mostly crizotinib monotherapy (n = 45) or crizotinib-based regimens (n = 10), with a median (95% CI) rwPFS and OS of 14.0 (8.3–19.8) and 47.9 (27.3–not estimable) months, respectively. Thirty-eight of the 103 SACT-treated patients (36.9%) received first-line non-targeted therapy, mostly platinum-based chemotherapy (n = 26); median (95% CI) rwPFS and OS were 9.0 (7.5–11.0) and 29.3 (17.7–65.7) months, respectively. Results from this study indicated a tendency for longer survival using currently available ROS1-targeted versus non-targeted therapy for patients with ROS1-positive advanced NSCLC. Nevertheless, survival outcomes were limited, highlighting the importance of more effective emerging treatments for ROS1-positive disease. Full article

(This article belongs to the Section Thoracic Oncology)

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15 pages, 4268 KB

Open AccessArticle

Artificial Intelligence in Prostate MRI: Comparison of an AI-Based Software and an Experienced Radiologist for Detecting Clinically Significant Prostate Cancer

by Roberto Castellana, Simona Marzi, Andrea Russo, Maria Consiglia Ferriero, Irene Terrenato, Eugenia Papaleo, Giuseppe Navanteri, Davide Vitale, Giuseppe Pizzi, Antonello Vidiri and Luca Bertini

Curr. Oncol. 2026, 33(3), 151; https://doi.org/10.3390/curroncol33030151 - 6 Mar 2026

Abstract

Background: Multiparametric MRI is central to detecting clinically significant prostate cancer (csPCa), but diagnostic accuracy depends on reader experience. Artificial intelligence (AI) tools may support prostate MRI interpretation and reduce inter-reader variability. This study compared the detection rate of a trial, non-commercial version [...] Read more.

Background: Multiparametric MRI is central to detecting clinically significant prostate cancer (csPCa), but diagnostic accuracy depends on reader experience. Artificial intelligence (AI) tools may support prostate MRI interpretation and reduce inter-reader variability. This study compared the detection rate of a trial, non-commercial version an AI-based software (PAROS) with that of an experienced radiologist. Methods: This retrospective single-center study included 150 patients who underwent prostate MRI followed by combined systematic and MRI-targeted transperineal biopsy. MRI examinations were interpreted by an experienced radiologist according to PI-RADS v2.1 and independently analyzed using a precommercial trial version of PAROS operating on biparametric MRI. Histopathology served as the reference standard. Detection rate was evaluated using sensitivity, specificity, and positive and negative likelihood ratios (PLR and NLR) at PI-RADS thresholds ≥3 and ≥4. Results: CsPCa was present in 63.3% of patients. At both PI-RADS thresholds, PAROS and the radiologist showed comparable sensitivity and specificity, wuth extremely low NLRs, indicating excellent rule-out capability. PLRs were modest and similar at PI-RADS ≥ 3 (1.26 vs. 1.42) and 1.88 for both at PI-RADS ≥ 4. PAROS detected more lesions, particularly in the transition zone. Conclusions: PAROS achieved csPCa detection comparable to an experienced radiologist, supporting its role as a decision-support tool in prostate MRI interpretation. Full article

(This article belongs to the Special Issue New and Emerging Trends in Prostate Cancer)

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16 pages, 1011 KB

Open AccessArticle

Scientific Meetings in Medical Oncology: Are We Facing a Time- and Resource-Consuming Plethora?

by Vittorio Gebbia, Dario Piazza, Fabrizio Scrima, Alessia Passanisi, Daniela Sambataro, Giuseppa Scandurra and Maria Rosaria Valerio

Curr. Oncol. 2026, 33(3), 150; https://doi.org/10.3390/curroncol33030150 - 5 Mar 2026

Abstract

Background: In recent years, the rapid advances in molecular biology and cancer pathophysiology, and the rapid availability of new therapeutic agents, have led to an exponential increase in the number of medical oncology conferences. This plethora may partly result from excessive duplication, [...] Read more.

Background: In recent years, the rapid advances in molecular biology and cancer pathophysiology, and the rapid availability of new therapeutic agents, have led to an exponential increase in the number of medical oncology conferences. This plethora may partly result from excessive duplication, undertaken without scientific or updating aims, under pressure from sponsors or other motivations unrelated to scientific advancement. The quality of meetings is therefore to be analyzed. Methods: A panel of medical oncologists, psychologists, and health-related data managers reviewed the characteristics of 99 out of 125 medical oncology conferences. The meetings were assessed for quality using a 0–5 score based on five parameters: attendees-to-speaker ratio, speaker quality, adequate time allocated for discussion, availability of feedback, and fairness of speeches. Results: The panelists identified 25 of 99 scientific events (25%; 95% CI 17–35%) at the 75th percentile and classified them as high-tier meetings, with a total score of 4–5. There were 5 national conferences, 6 regional conferences, and 14 local conferences. Forty-five meetings (56%; 95% Cl 35–56%) reached a score of 0–2 and twenty-nine (29%; 95% Cl 21–39%) a score of 3, and all were considered low tiers. This difference was statistically significant (p = 0.002709) in favor of high-titer national conferences. Conclusions: Although this paper has several limitations, the results indicate that many conferences were of moderate to poor quality, with a significant prevalence of low-tier events at regional and local levels and a higher concentration of low-tier events within this group. Scientific societies should implement adequate countermeasures. Full article

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12 pages, 561 KB

Open AccessArticle

Higher Dose Irradiation for Malignant Spinal Cord Compression: Long-Term Results of the RAMSES-01 Trial

by Dirk Rades, Darejan Lomidze, Natalia Jankarashvili, Fernando Lopez Campos, Arturo Navarro-Martin, Barbara Segedin, Blaz Groselj, Charlotte Kristiansen, Kristopher Dennis and Jon Cacicedo

Curr. Oncol. 2026, 33(3), 149; https://doi.org/10.3390/curroncol33030149 - 4 Mar 2026

Abstract

Despite the increasing popularity of upfront decompressive surgery, there are still patients with malignant spinal cord compression (MSCC) and expected longer-term survival receiving irradiation alone. In these patients, local progression-free survival (LPFS) may be improved with doses beyond the commonly applied regimen of [...] Read more.

Despite the increasing popularity of upfront decompressive surgery, there are still patients with malignant spinal cord compression (MSCC) and expected longer-term survival receiving irradiation alone. In these patients, local progression-free survival (LPFS) may be improved with doses beyond the commonly applied regimen of 10 × 3.0 Gy. A prospective phase 2 trial (RAMSES-01) investigated the benefit of two regimens, 15 × 2.633 and 18 × 2.333 Gy, compared with a 10 × 3.0 Gy (historical control). Patients in the phase 2 cohort had significantly better local progression-free survival (LPFS) after 1 year. Since recurrent MSCC-related motor weakness is a serious situation, it must be avoided as long as possible. In this respect, it is important to know whether the superiority of 15 × 2.633 and 18 × 2.333 Gy found in the RAMSES-01 trial still exists after 2 or 3 years. This led to the current study. In the phase 2 group, 2- and 3-year LPFS rates were 93.1% and 93.1%, respectively, and survival rates were 54.2% and 36.1%, respectively. According to propensity-adjusted Cox regression analyses, radiotherapy regimens in the phase 2 cohort resulted in significantly better LPFS at 2 (p = 0.017) and 3 (p = 0.013) years. In contrast, survival was not significantly different (p = 0.251 and p = 0.288, respectively). Radiation myelopathy and pathologic vertebral fractures were not observed in any group. Given the limitations of this study, irradiation 15 × 2.633 or 18 × 2.333 Gy may be an alternative option for patients with MSCC and longer expected survival treated with irradiation alone. Full article

(This article belongs to the Special Issue Innovations in Patient-Centred Palliative Radiotherapy in Oncology: From Clinical Trials to Real-World Practice)

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24 pages, 1572 KB

Open AccessReview

Unlocking KRAS: Navigating Its Molecular Biology and Treatment Landscape Among Gastrointestinal Malignancies

by Austin Frisch, Eric Martin, Timothy Cannon, Raymond Wadlow, Srivatsan Raghavan, Triparna Sen and Nagla Abdel Karim

Curr. Oncol. 2026, 33(3), 148; https://doi.org/10.3390/curroncol33030148 - 3 Mar 2026

Abstract

KRAS-targeted therapy has opened new doors in the world of oncology, and many trials are underway for KRAS specific treatments for gastrointestinal (GI) malignancies. Outlining the current state of KRAS therapy and the remaining research gaps pertaining to these deadly cancers is [...] Read more.

KRAS-targeted therapy has opened new doors in the world of oncology, and many trials are underway for KRAS specific treatments for gastrointestinal (GI) malignancies. Outlining the current state of KRAS therapy and the remaining research gaps pertaining to these deadly cancers is crucial for the development of future therapeutics. In this review, we focus on the relationship between KRAS and GI malignancies. Current therapies are discussed with an in-depth exploration of the KRAS gene and how it connects to pancreatic, colorectal and other GI malignancies. Promising clinical trials and future therapies are highlighted while discussing the molecular biology behind them. Specifically, trials focusing on upcoming KRAS on and off inhibitors in development as well as variant focused inhibitors targeting the more common mutations G12D and G12V. We discuss exciting new pan/multi KRAS inhibitors that have been successful in pre-clinical trials. More unique therapeutic options include KRAS T cell therapies, vaccines, and combination strategies with immunotherapy. Furthermore, we address the difficulties with KRAS therapy, and the potential future directions needed to overcome them. An in-depth current literature review was done along with a review of the active clinical trials for KRAS-targeted therapeutics involving GI malignancies. Full article

(This article belongs to the Special Issue Therapeutic Studies from Pre-Clinical to Clinical (Phase I–IV) for Gastrointestinal Cancers)

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19 pages, 1431 KB

Open AccessReview

Molecular Mechanisms of Juvenile Nasopharyngeal Angiofibroma: A Narrative Review

by Xingchen Liu, Junying Hu, Weigang Gan, Feng Liu and Bing Zhong

Curr. Oncol. 2026, 33(3), 147; https://doi.org/10.3390/curroncol33030147 - 3 Mar 2026

Abstract

Juvenile nasopharyngeal angiofibroma (JNA), a rare vascular tumor in adolescent males, involves dysregulated angiogenesis and hormonal interplay. Key molecular drivers include HIF-1α, VEGF, bFGF, and β-catenin, promoting tumor growth via pathways like Wnt/β-catenin and Ras signaling. Androgens and estrogen modulate progression, though mechanisms [...] Read more.

Juvenile nasopharyngeal angiofibroma (JNA), a rare vascular tumor in adolescent males, involves dysregulated angiogenesis and hormonal interplay. Key molecular drivers include HIF-1α, VEGF, bFGF, and β-catenin, promoting tumor growth via pathways like Wnt/β-catenin and Ras signaling. Androgens and estrogen modulate progression, though mechanisms remain debated. Targeted therapies reduce tumor proliferation and vascularity in preclinical studies, yet clinical translation is hindered by drug resistance and inconsistent biomarker expression. Hormonal and MMP-targeted approaches also show potential but require validation. This review consolidates JNA’s molecular landscape, emphasizing the need for personalized strategies, biomarker refinement, and combination therapies to improve therapeutic outcomes for this challenging tumor. Full article

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16 pages, 3412 KB

Open AccessArticle

CT Radiomics Models Did Not Outperform Experts in Predicting [⁶⁸Ga]Ga-PSMA-PET Positivity in Prostate Cancer Lymph Node Staging

by Thula Cannon Walter-Rittel, Boris Gorodetski, Alexander Hartenstein, Julian Rogasch, Imke Schatka, Holger Amthauer, Marcus Makowski, Charlie Alexander Hamm and Tobias Penzkofer

Curr. Oncol. 2026, 33(3), 146; https://doi.org/10.3390/curroncol33030146 - 2 Mar 2026

Abstract

Background: The use of [⁶⁸Ga]Ga-PSMA-PET/CT for prostate cancer (PCa) staging is limited by cost and availability. This study evaluates whether radiomic features from contrast-enhanced (CE) CT can predict PSMA-positive lymph nodes (LNs) as a surrogate for metastasis. Methods: A [...] Read more.

Background: The use of [⁶⁸Ga]Ga-PSMA-PET/CT for prostate cancer (PCa) staging is limited by cost and availability. This study evaluates whether radiomic features from contrast-enhanced (CE) CT can predict PSMA-positive lymph nodes (LNs) as a surrogate for metastasis. Methods: A retrospective study of 447 patients included 2537 segmented LNs (425 PET-positive, 2112 PET-negative). Two uroradiologists assessed 417 LNs on CE-CT using a four-point Likert scale. Radiomic features were extracted, selected using four algorithms, and analyzed with six model-building methods. Model performance was compared to radiologist ratings. Results: Radiomic models achieved an accuracy of 0.77–0.85, sensitivity of 0.85–0.91, and specificity of 0.74–0.85. Compared to radiologists, models had higher NPV (0.97–0.98 vs. 0.96) and sensitivity (0.85–0.91 vs. 0.76), but radiologists had superior accuracy (0.95 vs. 0.77–0.85) and specificity (0.97–0.98 vs. 0.74–0.85). In a subanalysis of LNs rated as probably benign or malignant, expert radiologists outperformed the algorithm with greater specificity and PPV (p < 0.005). A density threshold of >27 HU predicted PSMA-positive LNs with 0.79 accuracy, 0.87 sensitivity, and 0.78 specificity. Conclusions: While radiomics did not outperform expert radiologists, the single first-order parameter CT density >27 HU was predictive of PSMA-positive LNs. Clinical Relevance Statement: Radiomic models did not outperform expert uroradiologists. However, in high-volume or resource-limited settings lacking access to [⁶⁸Ga]Ga-PSMA-PET/CT, they may help improve LN assessment in PCa patients with CT alone. 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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9 pages, 1649 KB

Open AccessCase Report

Concurrent Mold, Mycobacterial, and Viral Infections in a Hematopoietic Stem Cell Transplant Recipient Undergoing Lung Transplantation for Graft-Versus-Host Disease

by Layan Akkielah, Wayne Leung, Serena Wang, Lili Ataie, Anargyros Xenocostas, Asma Syed, Ying-Han R. Hsu, Michael Silverman, Fatimah AlMutawa and MohammadReza Rahimi Shahmirzadi

Curr. Oncol. 2026, 33(3), 145; https://doi.org/10.3390/curroncol33030145 - 2 Mar 2026

Abstract

Hematopoietic stem cell transplant (HSCT) recipients are at high risk for opportunistic infections due to profound immunosuppression and graft-versus-host disease (GvHD). Molds and nontuberculous mycobacteria (NTM) pose diagnostic and therapeutic challenges, especially when infections overlap. A 42-year-old woman with prior allogeneic HSCT for [...] Read more.

Hematopoietic stem cell transplant (HSCT) recipients are at high risk for opportunistic infections due to profound immunosuppression and graft-versus-host disease (GvHD). Molds and nontuberculous mycobacteria (NTM) pose diagnostic and therapeutic challenges, especially when infections overlap. A 42-year-old woman with prior allogeneic HSCT for acute myeloid leukemia (AML) developed pulmonary infections with Microascus spp. and Mycobacterium chimaera, later complicated by Aspergillus calidoustus and RSV infection. Initial therapy included voriconazole, amphotericin B, and a macrolide-based multidrug regimen for NTM. Modifications were required for drug resistance and hepatotoxicity. Despite partial response, recurrent fungal infection necessitated prolonged antifungal therapy, including adjunctive inhaled amphotericin B and terbinafine. Ultimately, progressive bronchiolitis obliterans prompted bilateral lung transplantation. Explant pathology revealed necrotizing granulomas positive for NTM and Microascus spp. Post-transplant prophylaxis with voriconazole, rifabutin, azithromycin, and inhaled amikacin prevented recurrence, and the patient remained clinically stable at 6-month follow-up. This case illustrates the complexity of managing overlapping mold and NTM infections in HSCT recipients, highlighting the need for individualized, multidisciplinary care. Therapeutic drug monitoring, careful adjustment for drug–drug interactions, and the use of adjunctive inhaled antifungals were critical to achieving a favorable outcome. Full article

(This article belongs to the Section Hematology)

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13 pages, 675 KB

Open AccessArticle

PD-L1 Negative Advanced Non-Small Cell Lung Cancer: Practice Patterns and Real-World Outcomes

by Audrey-Ann Bégin, Maude Dubé-Pelletier, Catherine Labbé, Vicky Mai, Michaël Maranda-Robitaille and Marie-Hélène Denault

Curr. Oncol. 2026, 33(3), 144; https://doi.org/10.3390/curroncol33030144 - 28 Feb 2026

Abstract

The standard first-line treatment for metastatic non-small cell lung cancer (NSCLC) without oncogenic alterations and programmed death-ligand 1 (PD-L1) expression < 1% is a combination of chemotherapy (CT) and immunotherapy (IO). However, real-world overall survival (OS) appears more modest than in clinical trials, [...] Read more.

The standard first-line treatment for metastatic non-small cell lung cancer (NSCLC) without oncogenic alterations and programmed death-ligand 1 (PD-L1) expression < 1% is a combination of chemotherapy (CT) and immunotherapy (IO). However, real-world overall survival (OS) appears more modest than in clinical trials, averaging 10–13 months. This retrospective study aimed to assess treatment patterns and real-world outcomes at the Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ). Patients diagnosed between January 2019 and December 2023 with advanced PD-L1 <1% NSCLC and treated with palliative intent at IUCPQ were included and categorized by first-line treatment. Progression-free survival (PFS) and OS of the CT + IO and CT groups were compared using Kaplan–Meier curves and Cox regression analyses. Data regarding regimen selection, adverse events and subsequent treatment lines were collected. Among 217 eligible patients, 82 (37.8%) received CT + IO, 32 (14.7%) CT alone, 16 (7.4%) targeted therapy, and 87 (40.1%) supportive care. Median PFS was 5.3 vs. 4.7 months (p = 0.5) and OS 14.4 vs. 13.5 months (p = 0.2) for CT + IO and CT alone, respectively. In the CT + IO group, treatment discontinuation was mainly due to disease progression (59.4%) or adverse events (36.2%). Immune-related adverse events occurred in 29.3%, most frequently pneumonitis (8.5%). Therefore, in this cohort, no statistically significant survival difference was observed between CT + IO and CT alone. However, these findings should be interpreted cautiously given the non-randomized design, baseline imbalances between groups, and the limited sample size of the CT alone cohort. Tolerability of CT + IO was consistent with that observed in clinical trials. Full article

(This article belongs to the Section Thoracic Oncology)

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18 pages, 1110 KB

Open AccessReview

The Rising Power of Electrochemotherapy in Musculoskeletal Oncology

by Nicolas Papalexis, Giuliano Peta, Simone Quarchioni, Laura Campanacci, Alessandro Gasbarrini, Giuseppe Tedesco, Michela Carta, Maddalena Di Carlo, Marco Miceli and Giancarlo Facchini

Curr. Oncol. 2026, 33(3), 143; https://doi.org/10.3390/curroncol33030143 - 28 Feb 2026

Abstract

Electrochemotherapy is a minimally invasive treatment based on the principle of reversible electroporation of target cells in pathologic tissues in order to increase the local effect of chemotherapeutic agents. The mechanism of action relies on temporarily increasing cell permeability to increase the uptake [...] Read more.

Electrochemotherapy is a minimally invasive treatment based on the principle of reversible electroporation of target cells in pathologic tissues in order to increase the local effect of chemotherapeutic agents. The mechanism of action relies on temporarily increasing cell permeability to increase the uptake of cytotoxic drugs in the intracellular space. Originally developed for the treatment of cutaneous malignancies, electrochemotherapy has significantly evolved over the past few decades, thanks to advancements in electrode design and image guidance, finding fertile ground in musculoskeletal oncological pathologies, such as bone and soft tissue tumors and different kinds of vascular malformations. Moreover, initial experiences have reported on the treatment of other soft tissue tumors such as desmoid fibromatosis. The aim of this review is to summarize the literature on the role of electrochemotherapy across a variety of musculoskeletal conditions, starting from established oncologic indications, such as metastatic bone or soft tissue tumors, to emerging evidence on primary musculoskeletal pathology, with particular attention paid to the results of the leading studies relating to the efficacy, complications, and recurrence rate. Full article

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

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15 pages, 309 KB

Open AccessArticle

Exploring the Impact of Gender and Income on Concerns Reported by Cancer Survivors Aged ≥85 Years in Canada: A Secondary Analysis of the Canadian Transitions Survey

by Lorelei Newton, Irene Nicoll, Fay J. Strohschein and Margaret I. Fitch

Curr. Oncol. 2026, 33(3), 142; https://doi.org/10.3390/curroncol33030142 - 28 Feb 2026

Abstract

This study describes concerns, positive experiences and suggestions for improvement in survivorship care from the perspectives of cancer survivors aged ≥85 years based on gender and income levels. A national Canadian survey was conducted in 2016 focusing on cancer survivors’ needs and experiences [...] Read more.

This study describes concerns, positive experiences and suggestions for improvement in survivorship care from the perspectives of cancer survivors aged ≥85 years based on gender and income levels. A national Canadian survey was conducted in 2016 focusing on cancer survivors’ needs and experiences with follow-up care after treatment. This paper reports a secondary analysis drawn from the survey data reported qualitatively. In total, 581 respondents aged ≥85 years responded, of which 399 confirmed gender and annual household income. Within this group, 201 were male, and 198 were female. Two-thirds of the males (n = 134 males, 66.7%) and 80.8% of the females (n = 160) reported annual household income under $50K (CAD). Limited differences were noted between survivors’ responses according to sex and/or income levels. Concerns focused on physical challenges and body changes. Positive comments reflected appreciation of the care provided by attentive healthcare professionals. Suggestions for improvement addressed the need for improved person-centred care and availability of services for older adults. The survivors faced a range of physical, emotional and practical challenges following cancer treatment. The study highlights the importance of considering how living alone or with others, community connection, and the burden of co-morbidities compounding physical challenges after cancer intersect to create unique situations for this age group. Full article

(This article belongs to the Section Oncology Nursing)

20 pages, 1331 KB

Open AccessReview

Systemic Treatment for Hepatocellular Carcinoma Recurrence After Liver Transplantation

by Chiara Mazzarelli, Francesco Berardi, Alessandra Bonfichi, Marina Clemente, Michele Orlando, Marina Strollo and Luca Saverio Belli

Curr. Oncol. 2026, 33(3), 141; https://doi.org/10.3390/curroncol33030141 - 28 Feb 2026

Abstract

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, and liver transplantation (LT) remains the only curative treatment addressing both tumor burden and underlying liver disease. Despite an adequate candidate selection, HCC recurrence after LT occurs in 8–20% of cases and [...] Read more.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, and liver transplantation (LT) remains the only curative treatment addressing both tumor burden and underlying liver disease. Despite an adequate candidate selection, HCC recurrence after LT occurs in 8–20% of cases and is associated with a poor prognosis, particularly in patients who experience an early relapse. The management of HCC recurrence remains particularly challenging due to the lifelong immunosuppression required after LT, which may promote tumor progression and restrict therapeutic options. This review synthesizes the current evidence on systemic therapies for recurrent HCC after LT, focusing on tyrosine kinase inhibitors (TKIs), immunotherapy, and the current available immunosuppression strategies. Unfortunately, in this setting, robust prospective studies are lacking, and clinical decision-making remains based on retrospective data and expert consensus. Future research should prioritize the prospective evaluation of systemic regimens, integration of immunosuppression modulation, and careful exploration of immunotherapy or new target therapies in this special population. Full article

(This article belongs to the Special Issue Systemic Therapy in Hepatocellular Carcinoma: Current Challenges and Future Directions)

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12 pages, 831 KB

Open AccessReview

Salvage or Second Autologous SCT in Relapsed Multiple Myeloma (2016–2026): A Decade in Review

by Marwa Nassar, Nourah Alzaidy, Abdulrahman Nasiri, Amr Hanbali, Mahmoud A. Aljurf and Mostafa F. Mohammed Saleh

Curr. Oncol. 2026, 33(3), 140; https://doi.org/10.3390/curroncol33030140 - 28 Feb 2026

Abstract

Background: The role of second or salvage autologous stem cell transplantation (ASCT2) in relapsed multiple myeloma (MM) has evolved substantially over the past decade with the introduction of novel agents, maintenance strategies, and cellular immunotherapies. The clinical value of ASCT2 in the contemporary [...] Read more.

Background: The role of second or salvage autologous stem cell transplantation (ASCT2) in relapsed multiple myeloma (MM) has evolved substantially over the past decade with the introduction of novel agents, maintenance strategies, and cellular immunotherapies. The clinical value of ASCT2 in the contemporary era requires reappraisal based on modern real-world and prospective data. Methods: We conducted a targeted literature review of PubMed-indexed studies published between January 2016 and January 2026 evaluating second or salvage autologous transplantation in adult patients with relapsed or refractory multiple myeloma. Retrospective registry analyses, real-world cohorts, and prospective randomized trials were included, focusing on feasibility, toxicity, progression-free survival (PFS), overall survival (OS), and prognostic determinants. Fourteen key studies formed the core evidence base, supplemented by guideline statements and comparative immunotherapy data. Results: Across large registry and institutional series, ASCT2 was consistently feasible with low non-relapse mortality (≤5% at day 100–1 year). The median PFS ranged from 9.8 to 30.2 months and the median OS from approximately 30 to >80 months, with outcomes strongly influenced by duration of remission after first ASCT. Patients relapsing ≥24 months after ASCT1 derived the greatest benefit, achieving a median PFS of 17–45 months and OS exceeding 60 months in favorable-risk subgroups. Post-ASCT2 maintenance, particularly with lenalidomide or carfilzomib-based regimens, significantly prolonged disease control in randomized and real-world studies. Conversely, the phase III GMMG ReLApsE trial did not demonstrate a survival advantage for routine salvage ASCT over continuous lenalidomide-based therapy, highlighting the importance of patient selection. In heavily refractory or cytopenic populations, ASCT2 provided modest disease control but enabled hematopoietic recovery and access to subsequent therapies. Conclusions: In the modern treatment landscape, second or salvage autologous transplantation remains a valid, safe, and effective strategy for carefully selected patients with relapsed multiple myeloma, particularly those with chemosensitive disease and prolonged initial remissions. ASCT2 should be integrated in a risk-adapted manner alongside maintenance therapy and emerging immunotherapies, serving as a durable consolidation or bridging approach rather than routine therapy for all relapsed patients. Full article

(This article belongs to the Section Hematology)

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11 pages, 630 KB

Open AccessArticle

Associations Between Early Neurosurgical Workflow and Survival in Primary Central Nervous System Lymphoma: A Single-Center Retrospective Study

by Emre Ozkara, Eray Horoz, Zuhtu Ozbek, Deniz Arik, Funda Canaz, Suzan Saylisoy, Hava Uskudar Teke and Murat Vural

Curr. Oncol. 2026, 33(3), 139; https://doi.org/10.3390/curroncol33030139 - 27 Feb 2026

Abstract

Primary central nervous system lymphoma (PCNSL) is an aggressive malignancy for which early management decisions frequently occur within neurosurgical workflows prior to oncologic treatment. In this retrospective single-center study, we aimed to explore whether early neurosurgical workflow characteristics are associated with survival outcomes [...] Read more.

Primary central nervous system lymphoma (PCNSL) is an aggressive malignancy for which early management decisions frequently occur within neurosurgical workflows prior to oncologic treatment. In this retrospective single-center study, we aimed to explore whether early neurosurgical workflow characteristics are associated with survival outcomes in patients with PCNSL. Consecutive adult patients diagnosed with PCNSL between 2012 and 2022 were included, and the variables of interest comprised pre-biopsy corticosteroid exposure, the interval between diagnostic magnetic resonance imaging (MRI) and stereotactic biopsy, and the time from biopsy to initiation of high-dose methotrexate–based induction therapy. All patients were treated under a standardized hematology protocol to limit systemic treatment heterogeneity. Overall survival (OS) and progression-free survival (PFS) were calculated from the date of diagnostic biopsy, and survival analyses were performed using Kaplan–Meier methods and log-rank testing. Twenty-nine patients met the inclusion criteria. Median OS and PFS were not reached in steroid-naïve patients, whereas pre-biopsy corticosteroid exposure was associated with consistently shorter survival trajectories, with a clear separation of the survival curves, despite conventional statistical significance not being reached. Similarly, median OS and PFS were not reached in patients undergoing biopsy within 7 days of MRI, and an MRI-to-biopsy interval exceeding 7 days demonstrated an unfavorable survival trajectory compared with earlier biopsy; biopsy-to-induction timing did not show a measurable association with early survival outcomes. Established prognostic stratification using Memorial Sloan–Kettering Cancer Center classes showed expected survival discrimination within the cohort, supporting internal validity. Given the limited sample size and retrospective design, all findings should be interpreted as exploratory associations rather than evidence of causality. These results suggest that early neurosurgical workflow characteristics, particularly empiric pre-biopsy corticosteroids avoidance and diagnostic delay minimization, may be associated with early survival trajectories in PCNSL and warrant further evaluation in larger prospective studies. Full article

(This article belongs to the Section Neuro-Oncology)

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