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Combining External Beam Radiotherapy and Immunotherapy for the Treatment of Hepatocellular Carcinoma -
The Yield of Staging Investigations in Patients with Breast Cancer Planned for Neoadjuvant Chemotherapy -
Will We Need a Novel Heuristic in Resectable Lung Cancer?: A Narrative Review -
Tumor-Agnostic Landscape with HER2 Amplification in Japan: Real-World Prevalence and Implications for Targeting HER2
Journal Description
Current Oncology
Current Oncology
is an international, peer-reviewed, open access journal that since 1994 represents a multidisciplinary medium for clinical oncologists to report and review progress in the management of this disease, and published monthly online by MDPI (from Volume 28, Issue 1 - 2021). The Canadian Association of Medical Oncologists (CAMO), Canadian Association of Psychosocial Oncology (CAPO), Canadian Association of General Practitioners in Oncology (CAGPO), Cell Therapy Transplant Canada (CTTC) and others are affiliated with Current Oncology and their members receive discounts 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) / CiteScore - Q1 (Oncology)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 22.6 days after submission; acceptance to publication is undertaken in 2.9 days (median values for papers published in this journal in the first half of 2026).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
- Journal Clusters of Oncology: Cancers, Current Oncology, Onco and Targets.
Impact Factor:
3.6 (2025);
5-Year Impact Factor:
3.6 (2025)
Latest Articles
Patients’ Perspectives on Changes in Cancer Care During the COVID-19 Pandemic: Results of a Survey Among Patients with Gynecological Malignancies and Breast Cancer in Germany (NOGGO-S25/Expression XIII)
Curr. Oncol. 2026, 33(8), 484; https://doi.org/10.3390/curroncol33080484 (registering DOI) - 17 Aug 2026
Abstract
Background/Objectives: The COVID-19 pandemic was a major challenge for healthcare systems and social life worldwide. During the pandemic, studies focused on examining structural changes in patient care and establishing new guidelines to manage COVID-19, but very few of them addressed patients’ perceptions and
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Background/Objectives: The COVID-19 pandemic was a major challenge for healthcare systems and social life worldwide. During the pandemic, studies focused on examining structural changes in patient care and establishing new guidelines to manage COVID-19, but very few of them addressed patients’ perceptions and concerns regarding changes in cancer treatment during the pandemic. This study aimed to assess the changes in their therapy situation during three waves of the pandemic and the impact on their social life. Methods: This exploratory cross-sectional multicenter survey was conducted among patients with gynecological malignancies and breast cancer at gynecological oncology centers in Germany between October 2020 and February 2022. An anonymous paper-based 50-item questionnaire, available in German, assessed medical care, treatment modifications, mental health, and socioeconomic burden during the COVID-19 pandemic. Data were analyzed descriptively. Two subgroup analyses were conducted, comparing age groups ≤70 and >70 years, as well as patients with and without a migrant background. Results: Overall, 778 patients met the inclusion criteria of the survey (median age: 59; range: 24–93). In the majority of the patients (77.1%), the treatment schedules remained unchanged during COVID-19 pandemic. Treatment appointments were modified in a small number of patients (9.0%). Changes in therapy schedules were slightly more common among the second- and third-generation migrants and among patients ≤70 years. Despite the uncertainty of the COVID-19 pandemic, most patients (83.4%) kept their trust in the healthcare system. Acceptance of preventive measures was high, and 85.9% were willing to be vaccinated against COVID-19. Psychological symptoms such as worries and fear were reported by more than half of the participants during the last 2 weeks previous to the survey and more common among patients ≤70 years. Only 8.6% were more afraid of a COVID-19 infection than their cancer disease. Conclusions: Despite major challenges in cancer care due to the COVID-19 pandemic, access to cancer treatment and adequate management at gynecological oncology centers in Germany remained stable. The increased psychological burden in crises requires new infrastructure and should be addressed to improve patient care in future crises. The acceptance of taking preventive measures against COVID-19 was high among cancer patients.
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(This article belongs to the Section Palliative and Supportive Care)
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Open AccessReview
Systemic Inflammatory Biomarkers and Cancer-Associated Cachexia: A Narrative Review
by
Shawna Landon, Jaclyn M. Hall and Saunjoo L. Yoon
Curr. Oncol. 2026, 33(8), 483; https://doi.org/10.3390/curroncol33080483 (registering DOI) - 15 Aug 2026
Abstract
Cancer-associated cachexia (CAC) is a multifactorial syndrome characterized by systemic inflammation, muscle wasting, and progressive functional decline, affecting up to 80% of patients with advanced cancer. The inconsistent diagnostic criteria limit comparability across studies and hinder translation into clinical practice. Inflammatory biomarkers, including
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Cancer-associated cachexia (CAC) is a multifactorial syndrome characterized by systemic inflammation, muscle wasting, and progressive functional decline, affecting up to 80% of patients with advanced cancer. The inconsistent diagnostic criteria limit comparability across studies and hinder translation into clinical practice. Inflammatory biomarkers, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and serum albumin, have been studied as markers of the presence, severity, and progression of CAC. This review synthesizes evidence linking these five biomarkers to key manifestations of CAC, including weight- loss, muscle depletion, fatigue, quality of life, and survival. A structured search of PubMed, Embase, and Web of Science studies published between 2000 and 2025, yielding 20 articles for final synthesis to evaluate biomarker patterns and their potential utility for early detection and risk stratification. IL-6 and CRP show consistent associations with muscle wasting and systemic inflammatory burden. Albumin and NLR demonstrate enhanced prognostic value when incorporated into composite indices such as the Cachexia index. TNF-α remains mechanistically relevant but shows limited predictive utility when assessed independently. CRP, Albumin, and NLR are derived from routine, low-cost tests, whereas IL-6 and TNF-α require specialized cytokine assays. Future research is warranted to standardize diagnostic criteria and validate biomarker thresholds to develop an accessible, multi-biomarker panel for improved detection and monitoring of CAC.
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(This article belongs to the Special Issue Role of Inflammation in Cancer)
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Symptom Burden, Depressive Symptoms, Resilient Coping, and Pretreatment Health-Related Quality of Life with Breast, Gynecological and Genitourinary Cancer
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Caterina Calderon, Patricia Cruz-Castellanos, Asia Ferrandez-Arias, Lucía Roncero-Sánchez, Valle Rodríguez-Morón, Rocío Galán-Moral, David Gómez-Sánchez, María Nevado-Rodríguez, Marina Gustems and Paula Jiménez-Fonseca
Curr. Oncol. 2026, 33(8), 482; https://doi.org/10.3390/curroncol33080482 (registering DOI) - 15 Aug 2026
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Pretreatment health-related quality of life (HRQoL) may identify supportive care needs, but the joint contribution of symptom burden, depressive symptoms, and resilient coping remains insufficiently characterized. This multicenter baseline analysis included 194 adults with breast (n = 86), gynecological (n =
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Pretreatment health-related quality of life (HRQoL) may identify supportive care needs, but the joint contribution of symptom burden, depressive symptoms, and resilient coping remains insufficiently characterized. This multicenter baseline analysis included 194 adults with breast (n = 86), gynecological (n = 77), or genitourinary (n = 31) cancer from six Spanish hospitals before systemic therapy. Global HRQoL was assessed with the EuroQol visual analogue scale EQ-VAS; symptom burden with EORTC QLQ-C30 symptom scales/items; depressive symptoms with the Brief Symptom Inventory-18 depression subscale; and resilient coping with the Brief Resilient Coping Scale. EQ-VAS scores did not differ by tumor site (p = 0.369). Symptom burden was strongly inversely associated with HRQoL (r = −0.827, p < 0.001). In the moderated mediation model, higher symptom burden was associated with higher depressive symptoms (B = 0.275, 95% CI 0.118 to 0.431); symptom burden (B = −0.642, 95% CI −0.715 to −0.569) and depressive symptoms (B = −0.529, 95% CI −0.743 to −0.316) were associated with lower HRQoL scores. Indirect effects through depressive symptoms were statistically different from zero, but resilient coping did not significantly moderate this indirect association. These cross-sectional findings support pretreatment screening for symptoms and depressive symptoms to guide early supportive oncology care.
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Open AccessArticle
Intraoperative Neurophysiological Monitoring During Adult Brainstem Glioma Resection: Association Between Electrophysiological Changes and Early Neurological Outcome
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Giada Pauletto, Benjamin Skrap, Barbara Tomasino, Christian Lettieri, Elisa Ecoretti, Miran Skrap, Andrea Landi, Luca Denaro, Marco Vindigni, Massimo Robiony, Mariarosaria Valente, Tamara Ius and Lorenzo Verriello
Curr. Oncol. 2026, 33(8), 481; https://doi.org/10.3390/curroncol33080481 (registering DOI) - 15 Aug 2026
Abstract
Intraoperative neurophysiological monitoring (IONM) is widely used during brainstem surgery to reduce the risk of neurological injury, although its prognostic value in adult brainstem glioma (BSG) surgery remains unclear. We retrospectively analyzed 22 consecutive adults who underwent surgery for BSGs with multimodal IONM
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Intraoperative neurophysiological monitoring (IONM) is widely used during brainstem surgery to reduce the risk of neurological injury, although its prognostic value in adult brainstem glioma (BSG) surgery remains unclear. We retrospectively analyzed 22 consecutive adults who underwent surgery for BSGs with multimodal IONM between 2010 and 2023. Monitoring included somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), brainstem auditory evoked potentials (BAEPs), corticobulbar MEPs (CoMEPs), and cranial nerves electromyography. The primary endpoint was the association between intraoperative neurophysiological changes and postoperative neurological functional status at hospital discharge, assessed with the modified McCormick Scale (mMCS). Secondary endpoints included postoperative complications and length of hospital stay. SSEP warning criteria were met in 10 patients (45.5%), while 10 patients (45.5%) experienced a ≥50% reduction in MEP amplitude in at least one monitored muscle. Despite these findings, neither SSEP nor MEP amplitude changes were significantly associated with postoperative neurological status. Transcranial MEP stimulation thresholds increased significantly during surgery (p = 0.007), and threshold elevation was associated with postoperative complications (Kendall’s τ = 0.498, p = 0.007). BAEP recordings remained stable throughout all procedures. Conventional amplitude-based IONM changes were not associated with early neurological outcome after adult BSG resection. In contrast, increases in MEP stimulation threshold may represent a sensitive indicator of postoperative complications. Further prospective studies are warranted.
Full article
(This article belongs to the Special Issue Surgery and Beyond: The Evolving Landscape of Glioma Management)
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Open AccessArticle
Prognostic Value of Immunonutritional Status and Radiologic Muscle Mass in Older Patients Receiving Immune Checkpoint Inhibitors: A Real-World Study
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Hülya Ertaş, Burcu Caner, Sibel Oyucu Orhan, Buket Şahin Çelik, Işıl Yüceışık and Yasemin Koç
Curr. Oncol. 2026, 33(8), 480; https://doi.org/10.3390/curroncol33080480 - 14 Aug 2026
Abstract
Background: Identifying biomarkers for biological vulnerability in older patients with cancer remains challenging. We evaluated psoas muscle index (PMI) and immunonutritional indices’ association with toxicity and overall survival (OS) in patients ≥ 65 years receiving immune checkpoint inhibitors (ICIs). Methods: This retrospective study
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Background: Identifying biomarkers for biological vulnerability in older patients with cancer remains challenging. We evaluated psoas muscle index (PMI) and immunonutritional indices’ association with toxicity and overall survival (OS) in patients ≥ 65 years receiving immune checkpoint inhibitors (ICIs). Methods: This retrospective study included 104 patients. Baseline sarcopenia was assessed via CT-derived PMI at the L3 level. Immunonutritional status was evaluated using the Prognostic Nutritional Index (PNI). Primary endpoint was immune-related adverse event (irAE) development; secondary endpoint was OS. Results: Median age was 71 years. Patients developing irAEs had significantly higher baseline PNI than those without (49.0 vs. 46.0, p = 0.042). OS did not differ significantly by irAE status (p = 0.859) or PMI group (p = 0.664). However, low PNI was strongly associated with poorer OS (17.0 months vs. not reached, p < 0.001). In a multivariable Cox model stratified by ICI treatment type, higher PNI remained independently associated with better OS (adjusted HR: 0.86, 95% CI: 0.81–0.93, p < 0.001). PNI correlated negatively with inflammatory markers NLR and SII. Conclusions: Baseline PNI was independently associated with OS, whereas PMI was not significantly associated with survival in this cohort. These findings support the potential prognostic utility of PNI in older patients receiving immunotherapy but should not be interpreted as demonstrating superiority over comprehensive sarcopenia assessment.
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(This article belongs to the Special Issue Advances in Geriatric Oncology: Toward Optimized Cancer Care)
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Routine Inflammatory and Hematological Markers and Acute Radiation Toxicity in Patients with Prostate Cancer
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Jolanta Łuniewska-Bury, Piotr Leśniak, Adam Majchrzak, Kamil Obel, Tomasz W. Kaminski, Tomasz Ząbkowski and Tomasz Syryło
Curr. Oncol. 2026, 33(8), 479; https://doi.org/10.3390/curroncol33080479 - 14 Aug 2026
Abstract
Background: Modern radiotherapy techniques have improved the safety of prostate cancer treatment, but acute gastrointestinal and genitourinary toxicity remains a common clinical problem. Early identification of patients who are likely to develop treatment-related adverse effects may help optimize supportive care. This study evaluated
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Background: Modern radiotherapy techniques have improved the safety of prostate cancer treatment, but acute gastrointestinal and genitourinary toxicity remains a common clinical problem. Early identification of patients who are likely to develop treatment-related adverse effects may help optimize supportive care. This study evaluated the relationships between clinical characteristics, radiotherapy planning parameters, systemic inflammatory biomarkers, and acute pelvic toxicity during hypofractionated radiotherapy. Materials and Methods: We retrospectively analyzed 142 patients with histologically confirmed prostate cancer who underwent external beam radiotherapy at the Provincial Integrated Hospital in Płock, Poland, between October 2024 and March 2026. Clinical, laboratory, and radiotherapy planning data were obtained from institutional electronic records. Laboratory analyses included CRP, creatinine, total leukocyte, neutrophil, lymphocyte, erythrocyte and platelet counts, hemoglobin, and hematocrit. Rectal and bladder toxicity was prospectively graded according to the RTOG/EORTC criteria at 2 and 4 weeks after treatment initiation. Correlation and multivariable regression analyses were performed to identify factors associated with acute treatment-related toxicity. Results: Radiotherapy significantly reduced leukocyte and lymphocyte counts (both p < 0.001) and produced smaller reductions in erythrocyte count, hemoglobin, hematocrit, and absolute neutrophil count (all p < 0.05). Patients who reported rectal or urinary symptoms early during treatment generally continued to experience toxicity later in the treatment course. Rectal and bladder toxicities were positively correlated, indicating that patients with toxicity affecting one pelvic organ frequently developed symptoms in the other. Routine inflammatory biomarkers and most dosimetric parameters showed limited independent value for predicting clinically relevant acute toxicity. Conclusions: Early gastrointestinal and genitourinary toxicity appears to be a useful clinical indicator of persistent treatment-related symptoms during hypofractionated prostate radiotherapy. Early rectal and bladder toxicity was associated with toxicity later during treatment, whereas routine laboratory markers and most dosimetric parameters showed limited independent associations with acute pelvic toxicity.
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(This article belongs to the Section Oncology Biomarkers)
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Impact of Lebanon’s Economic Crisis on Cancer Care Delivery: A Multicenter Cross-Sectional Study of Treatment Initiation Delays and Incomplete Therapy
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Mohamad Ali Hachem, Nadeen Zayour, Elie Daibess, Jacqueline Najjar, Elie Jean Karam, Solay Farhat, Zeinab Hammoud, Ghadir M. Nasreddine, Mohamad Abbass, Zeinab Sleiman, Maroun Sadek, Ahmad Ibrahim, Issam Chehade and Bassam Matar
Curr. Oncol. 2026, 33(8), 478; https://doi.org/10.3390/curroncol33080478 - 14 Aug 2026
Abstract
Background/Objectives: In Lebanon, the economic crisis since 2019 has severely strained healthcare infrastructure, yet its impact on cancer treatment adherence remains incompletely characterized. This study assessed factors associated with treatment delay and regimen modification to identify barriers to optimal cancer care among
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Background/Objectives: In Lebanon, the economic crisis since 2019 has severely strained healthcare infrastructure, yet its impact on cancer treatment adherence remains incompletely characterized. This study assessed factors associated with treatment delay and regimen modification to identify barriers to optimal cancer care among Lebanese patients. Methods: This multicenter, cross-sectional study was conducted in five tertiary hospitals in Beirut, Lebanon, between 13 June 2024, and 27 June 2025. Demographic, clinical and treatment data were collected via a structured questionnaire. Bivariate and multivariable binary logistic regression analyses were performed to identify independent predictors of treatment delay (>2 weeks) and incomplete treatment regimens. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) are reported. Results: A total of 244 patients were enrolled in the study. The study population was predominantly female (59.0%) and aged ≥60 years (60.2%). Advanced disease was common, with 50.4% of patients presenting with stage IV disease. Financial vulnerability was widespread: 72.6% reported monthly household incomes below USD 1000, 88.1% reported a decline in income due to the economic crisis, and 39.3% relied on unstable income sources. Overall, 52.5% of patients experienced treatment initiation delays, and 9.0% received incomplete or dose-reduced regimens. On multivariable analysis, reliance on unfixed income independently predicted treatment delay (aOR 2.55, 95% CI 1.42–4.59; p = 0.002), lack of health insurance (aOR 1.91, 95% CI 1.08–3.39; p = 0.026) and pre-treatment surgical costs also increased the odds of delay (aOR 9.03, 95% CI 2.57–31.7; p = 0.001). For incomplete treatment, unfixed income remained an independent predictor (aOR 2.09, 95% CI 1.16–5.79; p = 0.015). A lack of insurance (aOR 5.62, 95% CI 1.22–25.9; p = 0.027) and high laboratory costs (>USD 150 per session) were also associated with incomplete regimens (aOR 1.62, 95% CI 1.02–2.57; p = 0.041). Conclusions: In Lebanon’s crisis context, financial instability was a key factor associated with deviations in cancer treatment. These findings highlight the need for strengthened insurance coverage and subsidization of diagnostic and treatment-related costs to ensure timely and continuous oncologic care.
Full article
(This article belongs to the Special Issue Unveiling the Economic Impact of Cancer Treatment)
Open AccessArticle
Real-World Evidence of Disproportionate Financial Toxicity and Health-Related Social Needs Among Adolescents and Young Adults Receiving Care at an NCI-Designated Cancer Center
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Brittany C. Kimball, Minji K. Lee, Kimberly O. Steinert, Jordan A. Mason, Wendy A. Hanson, Wendy A. Allen-Rhoades, Allison C. Rosenthal, Nandita Khera and Robert R. McWilliams
Curr. Oncol. 2026, 33(8), 477; https://doi.org/10.3390/curroncol33080477 - 13 Aug 2026
Abstract
Financial toxicity is a significant but often overlooked consequence of cancer for adolescents and young adults (AYAs, 15–39 years old), who face limited savings, unstable employment, and insurance gaps that heighten financial stress. As part of a larger initiative to determine whether our
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Financial toxicity is a significant but often overlooked consequence of cancer for adolescents and young adults (AYAs, 15–39 years old), who face limited savings, unstable employment, and insurance gaps that heighten financial stress. As part of a larger initiative to determine whether our cancer center can use an existing social drivers of health (SDOH) screening process to identify patients who may benefit from targeted supportive interventions, we sought to characterize financial strain, toxicity, and SDOH needs in AYAs treated in our cancer center and compare them to both younger and older cancer patients. This is a cross-sectional observational study at Mayo Clinic of patients with an oncology-related department visit between 8 September 2023–4 June 2024 (N = 81,731) who completed routine institutional electronic screenings for financial strain and SDOH. Survey items assessed financial strain, transportation barriers, and food insecurity; institutional billing data captured financial toxicity (unresolved balances, collection referrals, write-offs). AYAs (n = 5655) were more likely than non-AYAs to report medium/high financial strain, have unpaid debt, or have an unresolved balance, referral to a collection agency, or bad debt write-off, with nearly double the odds of medium/high financial strain compared to patients over 40 (OR 2.02, 95% CI 1.84–2.23, p < 0.001). Within AYAs, ages 26–32 bore the greatest burden: 24.2% in the medium/high-risk category, 9.4% with unresolved billing issues or collections, and 11.6% reporting food insecurity. These findings identify AYAs—particularly those 26–32—as a distinct high-risk group for financial toxicity and health-related social needs, underscoring the need for targeted interventions, tailored financial navigation, and policy efforts to reduce economic barriers to care. Future research should evaluate the effectiveness of these interventions in mitigating financial toxicity, addressing health-related social needs, and improving patient outcomes in this population.
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(This article belongs to the Special Issue Unveiling the Economic Impact of Cancer Treatment)
Open AccessCase Report
Durable Hematologic Response in Therapy-Related Myelodysplastic Syndrome During Nivolumab Treatment for Metastatic Melanoma: A Case Report
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Fathima Nashfa M. Hamza, Fatima Eltayeb, Mohammed Al Katari and Mohammed F. K. Ibrahim
Curr. Oncol. 2026, 33(8), 476; https://doi.org/10.3390/curroncol33080476 - 13 Aug 2026
Abstract
Immunotherapy is the standard first-line palliative treatment for metastatic melanoma; however, its role in myelodysplastic syndrome (MDS) remains uncertain. We report a case in which nivolumab, administered for metastatic melanoma, was associated with a marked improvement in concurrent treatment-related MDS. A 67-year-old man
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Immunotherapy is the standard first-line palliative treatment for metastatic melanoma; however, its role in myelodysplastic syndrome (MDS) remains uncertain. We report a case in which nivolumab, administered for metastatic melanoma, was associated with a marked improvement in concurrent treatment-related MDS. A 67-year-old man with a history of oligosecretory multiple myeloma developed transfusion-dependent MDS following autologous stem cell transplantation, requiring twice-weekly blood transfusions. He subsequently developed metastatic melanoma and was treated with single agent nivolumab to minimize treatment-related toxicity. Nivolumab effectively controlled the melanoma, and during treatment the patient experienced a durable hematologic response with sustained transfusion independence. At approximately two years of follow up, he remained transfusion-independent with stable peripheral blood counts, supporting the durability of the hematologic response. Although checkpoint inhibitors are not established therapies for therapy-related MDS and a causal relationship cannot be confirmed from a single case, the timing and sustained nature of the response are noteworthy. The patient experienced a significant improvement in quality of life with minimal adverse effects. This case adds to the limited literature on checkpoint inhibition in MDS and supports further investigation of its potential effects on hematologic recovery.
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(This article belongs to the Section Dermato-Oncology)
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Overcoming Trial Exclusion: A Multicenter Analysis of Hemodialysis Multiple Myeloma Patients Who Underwent BCMA-Directed CAR-T Therapy
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Eli Zolotov, Reema Mody, Kimberley Doucette, Aimee Chappell, Chantal Accolatse-Mati, Harsh Parmar, James Di Palma-Grisi, Noa Biran, Pooja Phull, Joseph Franz, David S. Siegel and David H. Vesole
Curr. Oncol. 2026, 33(8), 475; https://doi.org/10.3390/curroncol33080475 - 13 Aug 2026
Abstract
Multiple myeloma (MM) patients with end-stage renal disease (ESRD) requiring hemodialysis (HD), who are disproportionately Black, have been excluded from all pivotal trials of BCMA-directed chimeric antigen receptor T-cell (CAR-T) therapy, leaving a critical evidence gap in a population. We conducted a multicenter
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Multiple myeloma (MM) patients with end-stage renal disease (ESRD) requiring hemodialysis (HD), who are disproportionately Black, have been excluded from all pivotal trials of BCMA-directed chimeric antigen receptor T-cell (CAR-T) therapy, leaving a critical evidence gap in a population. We conducted a multicenter retrospective analysis of all MM patients who received CAR-T therapy while on HD at two U.S. centers between June 2021 and December 2025. Of 284 CAR-T recipients, 8 (2.8%) were HD-dependent. Median age was 63 years; 62.5% were female and 75% were Black; patients had received a median of 6 prior lines. Five received ciltacabtagene autoleucel and three received idecabtagene vicleucel; lymphodepletion was bendamustine (n = 4) or dose-reduced fludarabine/cyclophosphamide (n = 4). Cytokine release syndrome occurred in 37.5% (all Grade 1), with no grade ≥ 3 events—substantially lower than pivotal trials (76–95%). All 7 evaluable patients achieved neutrophil recovery by Day 30. One patient with prolonged pre-existing cytopenia pre-CAR-T therapy developed ICAN grade 4 and died from fungal pneumonia. Median progression-free survival was 17.5 months and median overall survival was not reached. Treatment-related mortality was 12.5%. CAR-T therapy is feasible, relatively safe, and effective in carefully selected HD-dependent MM patients, supporting expanded eligibility with appropriate dose modification.
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(This article belongs to the Special Issue Clinical Progression and Treatment Outcome of Multiple Myeloma)
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Impact of Chronic Kidney Disease Stages 3–5 on Mortality and Morbidity Outcomes in Patients with Esophageal Cancer: A Propensity-Score-Matched Cohort Study
by
Tsai-Lung Yang, Cheng-Hao Chang and Chung-Kuan Wu
Curr. Oncol. 2026, 33(8), 474; https://doi.org/10.3390/curroncol33080474 - 12 Aug 2026
Abstract
Chronic kidney disease (CKD) may reduce physiologic reserve among patients with esophageal cancer, but evidence beyond postoperative cohorts is limited. Using the TriNetX Global Collaborative Network, we studied adults with esophageal cancer diagnosed during 2010–2023. CKD stages 3–5 were defined by diagnostic codes
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Chronic kidney disease (CKD) may reduce physiologic reserve among patients with esophageal cancer, but evidence beyond postoperative cohorts is limited. Using the TriNetX Global Collaborative Network, we studied adults with esophageal cancer diagnosed during 2010–2023. CKD stages 3–5 were defined by diagnostic codes plus estimated glomerular filtration rate < 60 mL/min/1.73 m2 within 6 months before or on the index date; dialysis-dependent patients were excluded. Non-CKD patients served as comparators. Prespecified outcomes from day 1 to up to 3 years included all-cause mortality, subsequent recorded metastatic diagnosis, pneumonia, sepsis, blood transfusion, and major adverse cardiovascular events. Propensity score matching produced 832 pairs. All-cause mortality was not significantly higher in the overall cohort with CKD stages 3–5 than in the non-CKD cohort (HR, 1.13; 95% CI, 0.98–1.31; p = 0.099), whereas CKD stages 4–5 were associated with higher mortality in the stage-specific analysis (HR, 1.46; 95% CI, 1.03–2.06; p = 0.031). CKD stages 3–5 were also associated with higher risks of blood transfusion (HR, 1.45; 95% CI, 1.04–2.01; p = 0.025) and MACEs (HR, 1.22; 95% CI, 1.02–1.47; p = 0.027), and with a lower risk of subsequent recorded metastatic diagnosis (HR, 0.80; 95% CI, 0.65–0.99; p = 0.036). These findings suggest that the associations of CKD with post-diagnostic outcomes varied by outcome type, with higher mortality observed in the separate CKD stages 4–5 analysis.
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(This article belongs to the Section Gastrointestinal Oncology)
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Open AccessCase Report
Multiple Myeloma Complicating Breast Cancer During Treatment: A Case Report
by
Lijing Guo, Zhengshuo Jin and Yuehua Huang
Curr. Oncol. 2026, 33(8), 473; https://doi.org/10.3390/curroncol33080473 - 10 Aug 2026
Abstract
Research Background: Breast cancer is a malignant tumor that threatens women’s health. Among breast cancer patients, about 4.2% to 17% may suffer from multiple primary malignant neoplasms. Cases of patients suffering from both breast cancer and multiple myeloma are relatively rare in clinical
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Research Background: Breast cancer is a malignant tumor that threatens women’s health. Among breast cancer patients, about 4.2% to 17% may suffer from multiple primary malignant neoplasms. Cases of patients suffering from both breast cancer and multiple myeloma are relatively rare in clinical practice. This paper reports one case of a patient who developed multiple myeloma during the treatment of breast cancer. Clinical Data: The patient was a 56-year-old female, admitted to hospital due to “fever for 4 days, one year after the treatment of left breast cancer”. The patient was diagnosed with left breast cancer (ypT1N1M0, HER2-overexpressing subtype) approximately one year prior to presentation. Following diagnosis, the patient was treated sequentially with TcbHP and THP chemotherapy regimens, and subsequently received local radiotherapy. The patient developed fever four days prior to admission. Further laboratory examinations revealed pancytopenia, positive IgA-λ-type monoclonal immunoglobulin by immunofixation electrophoresis, and myeloma cells accounting for 11% in bone marrow smears. Bone marrow immunophenotyping indicated abnormal plasma cells, and pathological results of bone marrow biopsy were consistent with multiple myeloma. The final diagnosis was breast cancer complicated with multiple myeloma. After confirmed diagnosis, the patient was transferred to another hospital for targeted treatment of multiple myeloma and has been receiving continuous treatment there up to the time of follow-up. Conclusions: For patients with breast cancer, if they develop bone pain, anemia, hypercalcemia or renal dysfunction that cannot be explained by tumor metastasis or conventional complications after surgery or during follow-up, clinicians should be alert to the possibility of second primary tumors.
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(This article belongs to the Section Breast Cancer)
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Revisiting Platinum Sensitivity in Relapsed Small-Cell Lung Cancer: Outcomes of Platinum-Containing Doublet Chemotherapy in the 3–6 Month Relapse Window
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İbrahim Çil, Maral Martin Mıldanoğlu, Yasin Kutlu, Ali Kaan Güren, Murat Sarı, İlker Nihat Ökten, Fatih Atalah, Tuba Baydaş, Cevat İlteriş Kıkılı, Deniz Tural, Ayberk Bayramgil, Gözde Balkaya Aykut, Pembegül Yumuştutan, Eda Erçin, Bekir Doğan, Mesut Yılmaz, Özgür Han, Bünyamin Güney, Sercan Olcar, Hatice Odabaş, Ahmet Bilici and Melike Özçelikadd
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Curr. Oncol. 2026, 33(8), 472; https://doi.org/10.3390/curroncol33080472 - 8 Aug 2026
Abstract
Background: Second-line treatment selection in relapsed extensive-stage small-cell lung cancer (ES-SCLC) is commonly guided by the platinum-free interval, but the optimal approach for patients progressing 3–6 months after first-line platinum-based therapy remains uncertain. We compared platinum-containing doublet chemotherapy with single-agent chemotherapy in this
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Background: Second-line treatment selection in relapsed extensive-stage small-cell lung cancer (ES-SCLC) is commonly guided by the platinum-free interval, but the optimal approach for patients progressing 3–6 months after first-line platinum-based therapy remains uncertain. We compared platinum-containing doublet chemotherapy with single-agent chemotherapy in this clinically ambiguous subgroup. Methods: This multicenter retrospective real-world cohort study included patients with ES-SCLC or recurrent metastatic SCLC after prior limited-stage disease who received first-line platinum-based chemotherapy, achieved disease control, and progressed within a platinum-free interval of 90–180 days. Treatment allocation was at the discretion of the treating physician and was not randomized. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety. Because of the non-randomized design, the treatment effect was examined across multiple analytic approaches, including multivariable Cox regression, propensity score adjustment, and stabilized inverse probability of treatment weighting (IPTW). Results: Of 105 patients, 54 received single-agent chemotherapy and 51 received platinum-containing doublet therapy; 39 (37.1%) had received first-line atezolizumab. Baseline characteristics were imbalanced in favor of the doublet group, which had a longer platinum-free interval, fewer pleural metastases, and a higher rate of objective response to first-line therapy. ORR was higher with doublet therapy (31.4% vs. 11.1%, p = 0.016), as was DCR (62.7% vs. 33.3%, p = 0.003). Median PFS was 4.4 months (95% CI 3.4–5.8) with doublet therapy versus 3.1 months (95% CI 2.7–3.7) with single-agent chemotherapy (unadjusted HR 0.53, 95% CI 0.36–0.80; p = 0.002). Median OS was 6.5 months (95% CI 5.4–8.0) versus 5.4 months (95% CI 4.1–6.0), a difference that was not statistically significant (HR 0.68, 95% CI 0.46–1.01; p = 0.054). The PFS estimate favored doublet therapy in all sensitivity analyses but was attenuated with increasingly complete adjustment for treatment selection (multivariable HR 0.46, 95% CI 0.29–0.72; propensity-adjusted HR 0.58, 95% CI 0.38–0.88; IPTW HR 0.68, 95% CI 0.38–1.20, p = 0.184). No OS estimate reached statistical significance in any model. Grade ≥ 3 adverse events were similar between groups (66.7% vs. 64.8%, p = 0.842). Conclusions: In this non-randomized cohort of patients relapsing within a 90–180-day platinum-free interval, platinum-containing doublet chemotherapy was associated with higher response rates and longer PFS, without an increase in severe toxicity, but no overall survival benefit was demonstrated. Because baseline prognostic factors consistently favored the doublet group and the PFS advantage was attenuated after propensity-based adjustment, these findings should be regarded as hypothesis-generating. They are nonetheless consistent with randomized data showing improved PFS but not OS with platinum rechallenge, and support platinum-containing rechallenge as a reasonable option in carefully selected patients rather than as a demonstrated survival-prolonging strategy.
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(This article belongs to the Section Thoracic Oncology)
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Open AccessArticle
Incidence and Associated Risk Factors in the Development of Carfilzomib-Induced Cardiovascular Toxicity
by
Noor Lad, Jayda Esplund, Dennis Grauer, Shebli Atrash, Prerna Mewawalla, Tejaswi Gadela, Charles Porter, Muhammad Mushtaq, Jeries Kort, Donald C. Moore, Al-Ola Abdallah, Zahra Mahmoudjafari and Jordan Snyder
Curr. Oncol. 2026, 33(8), 471; https://doi.org/10.3390/curroncol33080471 - 8 Aug 2026
Abstract
Background: Carfilzomib, a second-generation proteasome inhibitor, is widely used in multiple myeloma (MM) treatment but has been associated with cardiovascular adverse events (CVAEs). Real-world data evaluating the incidence and risk factors are limited. Methods: We conducted a multicenter retrospective cohort study of 385
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Background: Carfilzomib, a second-generation proteasome inhibitor, is widely used in multiple myeloma (MM) treatment but has been associated with cardiovascular adverse events (CVAEs). Real-world data evaluating the incidence and risk factors are limited. Methods: We conducted a multicenter retrospective cohort study of 385 adult MM patients treated with carfilzomib between January 2020 and August 2024 at three U.S. institutions. The primary objective of this study was to determine the incidence of carfilzomib-associated CVAEs. The secondary objectives included the identification of risk factors, characterization of cardiovascular events, and time-to-onset analysis. Results: Carfilzomib-associated CVAEs occurred in 25 patients (6.5%). The median time to event was 114 days. Heart failure was the most common manifestation (86%), followed by arrhythmias (32%) and acute coronary syndromes (8%). Patients with baseline heart failure had a significantly increased risk of CVAEs (HR 1.61, p = 0.042), whereas arrhythmias showed a trend toward significance. Traditional cardiovascular risk factors were not independently associated with an increased risk. CVAEs were associated with numerically inferior overall survival (45.7 vs. 97.3 months; HR 1.316, 95% CI 0.728–2.377, p = 0.361). Partial recovery of the left ventricular ejection fraction was observed following treatment discontinuation. Conclusion: Carfilzomib-associated CVAEs were infrequent but clinically meaningful in this multicenter cohort. These findings support consideration of a risk-adapted cardio-oncology approach, particularly in patients with pre-existing cardiac dysfunction, where closer surveillance and early intervention may help mitigate clinically significant cardiotoxicity.
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(This article belongs to the Special Issue U.S. Myeloma Innovations Research Collaborative (USMIRC) Collection)
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Open AccessArticle
Socioeconomic Inequalities in the Mortality of Hodgkin and Non-Hodgkin Lymphoma: A Two-Decade Trend Analysis
by
Kelly Zhang, Ali Kiadaliri and Mohammad Hajizadeh
Curr. Oncol. 2026, 33(8), 470; https://doi.org/10.3390/curroncol33080470 - 7 Aug 2026
Abstract
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Lymphomas are broadly categorized into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Despite treatment advances, they remain a major cause of cancer-related morbidity and mortality in Canada. This study examined temporal trends in socioeconomic inequalities in lymphoma mortality in Canada from 2000 to
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Lymphomas are broadly categorized into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Despite treatment advances, they remain a major cause of cancer-related morbidity and mortality in Canada. This study examined temporal trends in socioeconomic inequalities in lymphoma mortality in Canada from 2000 to 2019. Using a unique census division level dataset (n = 280) constructed by pooling information from the Canadian Vital Statistics Death Database, the Canadian Census of Population and the National Household Survey, we measured mortality in HL and NHL in Canada. The age-standardized Concentration index (C) was used to quantify income and education inequalities in lymphoma. Time trend analyses were conducted to examine the changes in the observed socioeconomic inequalities. Crude HL mortality declined significantly over the study period. Crude NHL mortality remained largely unchanged in Canada overall, although modest declines were observed in the Prairies. The age-standardized C indicated persistent income and education inequalities for both lymphoma types. For NHL, mortality became increasingly concentrated among lower-income and lower-education populations over time. The persistent and widening socioeconomic inequalities observed in HL and NHL mortality, respectively, in Canada underscore the need for targeted public health interventions and more equitable distribution of resources to address systematic and avoidable differences in cancer outcomes associated with socioeconomic disadvantage.
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Open AccessArticle
Safety of Immune Checkpoint Inhibitors in Hepatitis B Virus-Positive Cancer Patients: A Multicenter Retrospective Cohort Study
by
Meshail Baswaid, Alaa Shahbar, Afnan Noor, Danyah Ahmed Katlan, Abdulfattah Alhazmi, Mohammed Alnuhait, Aryaf Alsulami, Baker Saemaldaher and Hussam Magliah
Curr. Oncol. 2026, 33(8), 469; https://doi.org/10.3390/curroncol33080469 - 6 Aug 2026
Abstract
Background: Immune checkpoint inhibitors (ICIs) are widely used in cancer treatment, but their safety in patients with pre-existing hepatitis B virus (HBV) infection remains uncertain. HBV reactivation is a recognized complication of immunosuppressive cancer therapy, yet evidence supporting routine antiviral prophylaxis during ICI
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Background: Immune checkpoint inhibitors (ICIs) are widely used in cancer treatment, but their safety in patients with pre-existing hepatitis B virus (HBV) infection remains uncertain. HBV reactivation is a recognized complication of immunosuppressive cancer therapy, yet evidence supporting routine antiviral prophylaxis during ICI treatment is limited. This study evaluated HBV reactivation and HBV-related outcomes among HBV-positive cancer patients receiving ICIs. Methods: This multicenter retrospective cohort study included adult patients treated with ICIs between January 2017 and December 2022. Patients were grouped according to receipt of antiviral prophylaxis. The primary outcome was HBV reactivation during ICI therapy. Secondary outcomes included hepatic flare, severity, and timing of reactivation, response to antiviral therapy, and factors associated with HBV-related outcomes. Results: A total of 160 patients were included; 68 received antiviral prophylaxis and 92 did not. HBV reactivation occurred in 3 patients (1.9%) and the odd ratio between antiviral prophylaxis and HBV reactivation was wide and imprecise (2.76; 95% CI 0.25–31.05). Hepatic flare occurred in 16 patients (10.0%) and was more frequent in the prophylaxis group than in the no-prophylaxis group (19.1% vs. 3.3%; p = 0.001). Conclusion: In this multicenter retrospective cohort study, the HBV reactivation rate was low and could not determine whether antiviral prophylaxis reduced the risk of reactivation. Hepatic flares were significantly more common among patients who received antiviral prophylaxis, likely reflecting a higher baseline risk of HBV-related complications in this group. A future randomized controlled trial is warranted to guide risk-adapted antiviral prophylaxis and monitoring.
Full article
(This article belongs to the Section Gastrointestinal Oncology)
Open AccessArticle
Completion Nephrectomy Outcomes Following Prior Partial Nephrectomy in Hereditary Kidney Cancer Syndromes
by
Patrick D. Michael, Lauren Loebach, Ruben Blachman-Braun, Hangcheng Fu, Braden Millan, Jaskirat Saini, Sandeep Gurram, W. Marston Linehan and Mark W. Ball
Curr. Oncol. 2026, 33(8), 468; https://doi.org/10.3390/curroncol33080468 - 6 Aug 2026
Abstract
Hereditary kidney cancer syndromes predispose patients to multifocal, bilateral and/or recurrent renal tumors, requiring repeated interventions over a lifetime. Despite nephron-sparing surgery being the preferred management strategy, some patients ultimately require completion nephrectomy—radical nephrectomy following prior ipsilateral partial nephrectomy—when tumor burden, declining renal
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Hereditary kidney cancer syndromes predispose patients to multifocal, bilateral and/or recurrent renal tumors, requiring repeated interventions over a lifetime. Despite nephron-sparing surgery being the preferred management strategy, some patients ultimately require completion nephrectomy—radical nephrectomy following prior ipsilateral partial nephrectomy—when tumor burden, declining renal function, surgical complications, or pre-transplant indications necessitate definitive kidney removal. Data on outcomes in this population remain limited. We evaluated a prospectively maintained cohort of 58 patients who underwent completion nephrectomy at the National Institutes of Health between 2000 and 2024, following at least one prior ipsilateral partial nephrectomy. Perioperative complication rates and renal functional change were the primary outcomes of interest. Von Hippel–Lindau disease was the most common hereditary diagnosis (62.1%). Open surgery was performed in 56.9% of cases. Overall complications occurred in 43.1% of patients, with 24.1% experiencing a Clavien–Dindo grade ≥ 3 event; perioperative mortality was 6.9%. The median preoperative estimated glomerular filtration rate was 72 mL/min/1.73 m2, declining to 50 mL/min/1.73 m2 at the first postoperative clinic visit. Completion nephrectomy in hereditary kidney cancer syndrome patients is associated with substantial perioperative morbidity, mortality, and expected renal functional decline. These findings inform patient counseling and surgical decision-making in this high-risk population.
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(This article belongs to the Section Genitourinary Oncology)
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Open AccessArticle
Association of Primary Tumor Resection with Survival in De Novo Stage IV Colorectal Cancer: A Retrospective Cohort Study with Propensity Score Matching
by
Hatice Ayyıldız Sevim, Galip Can Uyar and Hayriye Şahinli
Curr. Oncol. 2026, 33(8), 467; https://doi.org/10.3390/curroncol33080467 - 5 Aug 2026
Abstract
Background: The role of primary tumor resection (PTR) in patients with de novo stage IV colorectal cancer remains controversial, particularly in the context of patient selection and tumor biology. This study aimed to evaluate the association between PTR and survival outcomes and to
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Background: The role of primary tumor resection (PTR) in patients with de novo stage IV colorectal cancer remains controversial, particularly in the context of patient selection and tumor biology. This study aimed to evaluate the association between PTR and survival outcomes and to identify clinical, molecular, and inflammatory-nutritional prognostic factors in patients with de novo stage IV colorectal cancer. Methods: Medical records of 204 patients with de novo stage IV colorectal adenocarcinoma treated at Ankara Etlik City Hospital from December 2022 to December 2025 were reviewed retrospectively. Patients were grouped according to PTR status. Baseline clinicopathological features, molecular tumor profile, metastatic disease extent, treatment characteristics, and inflammatory-nutritional markers were recorded. Survival outcomes were assessed in terms of progression-free survival (PFS) and overall survival (OS) using the Kaplan–Meier method and Cox proportional hazards regression models, as well as 1:1 propensity score matching and sensitivity analyses. Results: PTR was performed in 114 patients (55.9%), while 90 patients (44.1%) did not undergo PTR. Patients who underwent PTR were younger, had better Eastern Cooperative Oncology Group (ECOG) performance status, and more frequently had single-organ metastatic disease. In the unmatched cohort, patients who underwent PTR had longer median PFS and OS than those without PTR (15.88 vs. 11.03 months and 16.14 vs. 11.54 months, respectively; both log-rank p < 0.001). In the adjusted Cox models, PTR corresponded to lower risks of progression (hazard ratio [HR]: 0.50; 95% confidence interval [CI]: 0.34–0.74; p < 0.001) and death (HR: 0.48; 95% CI: 0.30–0.77; p = 0.002), whereas BRAF mutation showed higher risks of progression (HR: 3.00; 95% CI: 1.70–5.29; p < 0.001) and death (HR: 3.42; 95% CI: 1.83–6.38; p < 0.001). In the propensity score–matched cohort comprising 50 matched pairs, PTR remained associated with a lower risk of progression or death (HR: 0.59; 95% CI: 0.40–0.87; p = 0.007), whereas its association with OS was not statistically significant (HR: 0.69; 95% CI: 0.42–1.13; p = 0.141). Sensitivity analyses generally yielded estimates favoring PTR, although the statistical significance of the association with OS varied across analyses. Patients with higher prognostic nutritional index (PNI) values showed more favorable survival outcomes. Conclusions: In this retrospective cohort, PTR was consistently associated with longer PFS, whereas its association with OS was less robust across the adjusted analyses. Because these patients had a more favorable baseline profile, these associations should be viewed with caution and in relation to patient selection. BRAF mutation and PNI emerged as important prognostic factors, supporting a multidimensional approach to survival assessment that incorporates metastatic disease burden, tumor biology, and inflammatory-nutritional status.
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(This article belongs to the Section Gastrointestinal Oncology)
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Open AccessArticle
Clinical Characteristics and Prognostic Analysis of EBV-Positive HIV-Associated Diffuse Large B-Cell Lymphoma in China: A Retrospective Single-Center Study
by
Lizhi Feng, Haolan He, Han Zhao, Bo Liu, Zhimin Chen, Xinhua Liu, Haisheng Yu, Fengyu Hu, Xiaoping Tang and Linghua Li
Curr. Oncol. 2026, 33(8), 466; https://doi.org/10.3390/curroncol33080466 - 5 Aug 2026
Abstract
Epstein–Barr virus (EBV) contributes to human immunodeficiency virus (HIV)-associated diffuse large B-cell lymphoma (DLBCL) pathogenesis. We retrospectively analyzed clinical features and outcomes of EBV-positive (n = 32) and -negative (n = 71) cases. EBV status was determined using in situ hybridization.
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Epstein–Barr virus (EBV) contributes to human immunodeficiency virus (HIV)-associated diffuse large B-cell lymphoma (DLBCL) pathogenesis. We retrospectively analyzed clinical features and outcomes of EBV-positive (n = 32) and -negative (n = 71) cases. EBV status was determined using in situ hybridization. Immunological parameters, histological subtype, systemic B symptoms, plasma EBV DNA, and response to therapy were examined. Survival was compared using Kaplan–Meier analysis. Factors associated with overall survival (OS) and progression-free survival (PFS) in EBV-positive patients were examined using Cox regression models. EBV-positive cases showed a higher proportion of non-germinal center B cell subtypes and B symptoms, higher circulating EBV viral loads, and lower CD4+ T-cell counts at diagnosis than EBV-negative cases. OS did not differ significantly within the full cohort but was shorter in EBV-positive cases with high International Prognostic Index scores or CD4+ T-cell counts ≥ 50 cells/ L. Concurrent infections and elevated plasma EBV DNA levels remained associated with unfavorable survival outcomes. EBV-positivity in HIV-associated DLBCL is related to more aggressive clinical and immunological features and independently predicts poorer survival outcomes in high-risk subgroups. Plasma EBV DNA may reliably indicate EBV status and serve as a prognostic biomarker. Integrating these features into clinical decision-making may enhance risk stratification and inform individualized treatments.
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(This article belongs to the Section Hematology)
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Open AccessReview
Pragmatic Management of EGFR-Mutant NSCLC After Progression on Osimertinib: Canadian Expert Perspectives
by
Nathalie Daaboul, Jason S. Agulnik, Houda Bahig, Normand Blais, Marie-Ève Boucher, Nicole Bouchard, Marie-Hélène Denault, Patrice Desmeules, Pierre Olivier Fiset, Marie Florescu, Kevin Jao, Catherine Labbé, Magali Lecavalier-Barsoum, Carmela Pepe, Benjamin Shieh, Sophie Stock-Martineau and Nicolas Marcoux
Curr. Oncol. 2026, 33(8), 465; https://doi.org/10.3390/curroncol33080465 - 5 Aug 2026
Abstract
The management of epidermal growth factor receptor-mutated (EGFRm) non-small cell lung cancer (NSCLC) after progression on osimertinib is becoming increasingly complex, particularly in Canada, where access to diagnostic testing and newer therapies remains uneven. Although treatment is evolving with regimens such as amivantamab−lazertinib
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The management of epidermal growth factor receptor-mutated (EGFRm) non-small cell lung cancer (NSCLC) after progression on osimertinib is becoming increasingly complex, particularly in Canada, where access to diagnostic testing and newer therapies remains uneven. Although treatment is evolving with regimens such as amivantamab−lazertinib (MARIPOSA/MARIPOSA-2) and osimertinib plus chemotherapy (FLAURA2), access to such treatments in first and second lines varies across provinces. This article provides a pragmatic Canadian perspective on post-osimertinib management informed by expert roundtable discussions, a focused clinician survey, and the contemporary literature. Key challenges identified include delays and barriers related to tissue biopsy, next-generation sequencing, timely immunohistochemistry in time to influence treatment decisions and access to novel therapies. These gaps reduce the ability to individualize care and often force clinicians to rely on platinum-pemetrexed therapy as the default systemic backbone, even when biologically relevant resistance mechanisms exist, highlighting that post-osimertinib care in Canada remains shaped as much by access and system constraints as by emerging evidence.
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(This article belongs to the Section Thoracic Oncology)
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