Current Oncology

Personalized cancer treatment depends on the accurate and timely detection of the patient tumor variants. LBx enables minimally invasive tumor mutation profiling. We report results of a pan-Canadian LBx program for patients with advanced solid tumors. Plasma samples were tested at Imagia Canexia Health accredited laboratory using the clinically validated Follow It 38-gene panel. A proprietary platform was used to identify clinically relevant variants in the circulating tumor DNA and report results following accepted international guidelines on clinical significance. A total of 4229 eligible patients submitted samples for LBx testing, and reports for 97% of them were delivered within ~8 days. More than 80% of Canadian oncologists from >150 institutions across 12 provinces (11% from rural centers) participated in the project. The patient cohort consisted mostly of advanced or metastatic lung, breast, and colon cancers. ctDNA mutations were detected in >50% of cases, and clinical trials were recommended for 76% of all participants. Health economics modeling analysis found that Follow It^® in combination with tissue biopsy was cost-saving and resulted in an additional 0.1138 QALYs gained relative to tissue biopsy alone. The successful pan-Canadian implementation of a cost-effective, robust LBx testing program demonstrated its sustained demand and feasibility, and its potential economic and health benefits.

Advanced-stage epithelial ovarian cancer (EOC) is defined by biological heterogeneity and poor outcomes, and traditional survival metrics fail to reflect the evolving nature of prognosis as patients survive longer. This study aimed to evaluate conditional survival (CS) in advanced EOC using both overall survival (OS) and progression-free survival (PFS) metrics to provide a dynamic understanding of long-term outcomes. We retrospectively analyzed 808 patients with FIGO stage III–IV EOC who underwent surgery at Baskent University Ankara Hospital between 2004 and 2024. CS estimates were calculated for additional 1- and 5-year intervals among patients who had already survived 6 months, 1, 3, or 5 years after surgery. Median OS and PFS were 4.37 and 1.70 years, respectively. Peritoneal dissemination and platinum resistance were independent predictors of poor survival. Approximately 11% of patients achieved survival beyond ten years. The 1-year CS-OS increased from 87% at 6 months to 95% at 5 years, while the 5-year CS-OS rose from 49% to 66%; corresponding CS-PFS values increased from 89% to 95% and from 44% to 62%. Conditional survival analysis underscores that prognosis in advanced ovarian cancer is not static but continually improves with time survived and sustained disease control. These insights redefine long-term outcomes and provide a modern foundation for individualized patient counseling and survivorship planning.

As treatments for multiple myeloma (MM) evolve, there is a need for real-world insights into treatment patterns and outcomes. The treatment practices and clinical outcomes in patients with MM (TOTEMM) was a database study (2018–2024) of newly diagnosed transplant-ineligible patients with MM in Argentina (TOTEMM-A) and Brazil (TOTEMM-B) in a private healthcare setting. In TOTEMM-A (n = 72) and TOTEMM-B (n = 892), 37 and 92 different drug regimens were reported, respectively. In each country, treatment duration reduced across lines of therapy (LOT) (TOTEMM-A: range, 6.2–3.4 months; TOTEMM-B: range, 4.4–3.5 months); attrition rates increased across LOT (TOTEMM-A: range, 52.8–86.1%; TOTEMM-B: range, 41.9–88.0%); triplet regimens (mainly bortezomib based) were used most frequently in first-line (1L); >75% relapsed within 12 months, regardless of the drug prescribed; over 90% of relapses occurred between 1L and second-line, and up to half of patients were rechallenged with the same drug; >65% of patients experienced disease progression after 1L; and the 1- to 5-year adjusted cumulative risk of progression or death increased across LOT (TOTEMM-A: range, 47.1–88.5%; TOTEMM-B: range, 40.4–91.7%). The rapid and marked progression underscores the urgent need for novel treatments and regimens.