Current Oncology

26 pages, 1865 KB

Open AccessReview

Optimizing the Efficacy–Toxicity Paradigm in Pediatric Oncology: A Narrative Review of Immunotherapy and Survivorship Outcomes

by Zaure Dushimova, Timur Saliev, Aigul Bazarbayeva, Kymbat Karimova, Abay Kussainov and Ildar Fakhradiyev

Curr. Oncol. 2026, 33(5), 298; https://doi.org/10.3390/curroncol33050298 - 20 May 2026

Abstract

Background: Childhood cancer survival now approaches 80% in high-income countries, yet most survivors face lifelong toxicity. This review examines the interplay between treatment efficacy, relapse prevention, and therapy-related complications. Methods: Narrative synthesis of landmark pediatric oncology trials (2000–2026), including AALL1731 (blinatumomab), ELIANA/PLAT-02 (CAR [...] Read more.

Background: Childhood cancer survival now approaches 80% in high-income countries, yet most survivors face lifelong toxicity. This review examines the interplay between treatment efficacy, relapse prevention, and therapy-related complications. Methods: Narrative synthesis of landmark pediatric oncology trials (2000–2026), including AALL1731 (blinatumomab), ELIANA/PLAT-02 (CAR T-cell), and GD2-CART01 (neuroblastoma), with comparative analysis of efficacy and toxicity. Results: In AALL1731, adding blinatumomab to chemotherapy improved 3-year disease-free survival from 87.9% to 96.0% (HR = 0.39, 95% CI: 0.27–0.56, p < 0.001), but increased sepsis from 5.1% to 14.8%. Comparison between AALL1731 (front-line blinatumomab) and ELIANA (CAR T-cell in relapsed disease) reveals that earlier immunotherapy deployment yields better outcomes: 96% DFS vs. 48% 3-year EFS, respectively. In GD2-CART01, early use (after 1–2 prior lines) achieved 89% 5-year survival vs. 43% with delayed use (HR = 0.31). Approximately 95% of survivors experience ≥1 late effect, with 60–90% carrying chronic conditions into adulthood. Conclusions: Immunotherapy transforms outcomes, but timing is critical, as earlier deployment dramatically improves survival. Toxicity remains pervasive, requiring systematic mitigation strategies. Full article

(This article belongs to the Special Issue Quality of Life and Management of Pediatric Cancer)

13 pages, 230 KB

Open AccessArticle

Factors Associated with Autopsy Consent in Pediatric Oncology: A 10-Year Review

by Meaghann S. Weaver, Jia Liang, Rachel Jalfon, Yimei Li, Abagail D. Cohen and Liza-Marie Johnson

Curr. Oncol. 2026, 33(5), 297; https://doi.org/10.3390/curroncol33050297 - 20 May 2026

Abstract

Purpose: Autopsy remains an important diagnostic and research modality in pediatric oncology. This study examined demographic and clinical factors associated with parental acceptance or decline of autopsy in childhood cancer. Patients and Methods: This study was a retrospective chart review of autopsy consent [...] Read more.

Purpose: Autopsy remains an important diagnostic and research modality in pediatric oncology. This study examined demographic and clinical factors associated with parental acceptance or decline of autopsy in childhood cancer. Patients and Methods: This study was a retrospective chart review of autopsy consent acceptance or decline patterns between 2007 and 2017 for inpatient pediatric oncology deaths in a large single-site oncology hospital. Demographic factors (age, race, gender), diagnostic factors (primary cancer, transplant history, and neurologic status 24 h prior to death), interventions (intensive care unit location, dialysis, ventilator, chemotherapy, medically administered nutrition), and code status in the 24 h prior to death were obtained. Analysis included descriptive and statistical correlations. Results: Among 344 inpatient decedents, 34% of families consented to autopsy. There was a difference in consent rate according to race (p = 0.015). Diagnosis, transplant status, age, and neurologic status showed no association. Use of dialysis (p < 0.001), ventilation (p < 0.001), and intensive care unit (ICU) location (p < 0.001) correlated with higher consent rates. Chemotherapy and assisted nutrition were not associated with decisions. Presence of a Do Not Resuscitate (DNR) order predicted lower consent (p < 0.001), while receipt of cardiopulmonary resuscitation (CPR) at death predicted higher consent (p < 0.001). Conclusion: One-third of families of inpatient pediatric oncology decedents with cancer agreed to autopsy. Demographic and diagnostic factors were not universally strong predictors, underscoring the personal nature of autopsy decisions. Further research should include multisite prospective designs and direct engagement with bereaved families. Full article

(This article belongs to the Section Childhood, Adolescent and Young Adult Oncology)

18 pages, 312 KB

Open AccessPerspective

Cancer During Pregnancy: Navigating Clinical and Research Challenges

by Mackenzie K. Callaway, Lizelle Comfort, Dhivyaa Anandan, Ruby Sharma, Narjust Florez, Traci R. Lyons, Doris Germain, Kathleen R. Cho, Burton L. Rochelson, Clarissa Bonanno, Kutluk Oktay, Sudarshana Roychoudhury, Eileen O’donnell, Richard Barakat, Joanne Marquardt, Diana W. Bianchi, Elyce Cardonick, Larry Norton, Ann H. Partridge, Susan M. Domchek, Virginia F. Borges, Frédéric Amant and Camila O. Dos Santos Show full author list Hide full author list

Curr. Oncol. 2026, 33(5), 296; https://doi.org/10.3390/curroncol33050296 - 19 May 2026

Abstract

The incidence of cancer during pregnancy is rising, yet scientific understanding and clinical management remain underdeveloped. Delayed diagnoses, limited therapeutic options, and lack of safety data exacerbate the clinical challenges of treating cancer during pregnancy. Further, the biology of gestational cancers is poorly [...] Read more.

The incidence of cancer during pregnancy is rising, yet scientific understanding and clinical management remain underdeveloped. Delayed diagnoses, limited therapeutic options, and lack of safety data exacerbate the clinical challenges of treating cancer during pregnancy. Further, the biology of gestational cancers is poorly understood due to the scarcity of model systems and mechanistic studies. This manuscript presents a multidisciplinary perspective from a group of researchers and clinicians to evaluate the current state of pregnancy-associated cancers, identify unmet clinical and biological questions, and propose strategies to improve diagnosis, treatment, and maternal–fetal outcomes. Full article

17 pages, 6423 KB

Open AccessArticle

SHCBP1 Is Upregulated in Colon Adenocarcinoma and Promotes Tumor Cell Proliferation and Growth

by Yiren He, Qian Zhang, Xinyang He and Wenyong Wu

Curr. Oncol. 2026, 33(5), 295; https://doi.org/10.3390/curroncol33050295 - 19 May 2026

Abstract

Colon adenocarcinoma (COAD) is a common malignancy with substantial morbidity and mortality, and the identification of new therapeutic targets remains essential for improving patient outcomes. In this study, we investigated SHC SH2-domain binding protein 1 (SHCBP1) in COAD through two complementary components with [...] Read more.

Colon adenocarcinoma (COAD) is a common malignancy with substantial morbidity and mortality, and the identification of new therapeutic targets remains essential for improving patient outcomes. In this study, we investigated SHC SH2-domain binding protein 1 (SHCBP1) in COAD through two complementary components with distinct evidentiary scopes. The first component comprised expression profiling, prognostic and methylation analyzes, bioinformatic characterization, and functional validation in vitro and in vivo. The second component comprised exploratory computational analyses, including predicted interaction network analysis and structure-based virtual screening. Public databases were used to analyze SHCBP1 expression, prognosis, and promoter methylation status. Co-expression and functional enrichment analyses were performed to explore the biological context of SHCBP1. In vitro and in vivo experiments were then conducted to evaluate the effects of SHCBP1 knockdown on tumor growth. SHCBP1 was significantly upregulated in COAD and was associated with poor patient prognosis. Promoter hypomethylation may contribute to its increased expression. Bioinformatic analyses suggested that SHCBP1 is associated with DNA replication and cell-cycle-related pathways. Experimental studies demonstrated that SHCBP1 knockdown suppressed cell proliferation and tumor growth. In the exploratory computational component, predicted interaction network analysis and virtual screening prioritized several in silico candidate interactions and two compounds with favorable predicted binding scores. These computational findings require independent biochemical and cellular validation. Overall, our findings suggest that SHCBP1 may represent a candidate biomarker associated with COAD proliferation and unfavorable prognosis, as well as a putative molecular target that warrants further validation. Full article

(This article belongs to the Special Issue Innovative Therapeutic Strategies, Biomarkers, and Molecular Pathways in Gastrointestinal and Hepatobiliary Cancers)

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3 pages, 147 KB

Open AccessComment

Toward Individualized Management: A Commentary on Perioperative Systemic Therapy Guidelines in Breast Cancer Surgery and Reconstruction. Comment on Galuia et al. Perioperative Drug Management of Systemic Therapies in Breast Cancer: A Literature Review and Treatment Recommendations. Curr. Oncol. 2025, 32, 154

by Emily E. Zona and Jacqueline S. Israel

Curr. Oncol. 2026, 33(5), 294; https://doi.org/10.3390/curroncol33050294 - 19 May 2026

Abstract

The perioperative management of systemic breast cancer therapies is an increasingly important aspect of planning for breast cancer surgery and reconstruction. This commentary compares two recent sets of recommendations and explains why treatment decisions often need to be tailored to the individual patient. [...] Read more.

The perioperative management of systemic breast cancer therapies is an increasingly important aspect of planning for breast cancer surgery and reconstruction. This commentary compares two recent sets of recommendations and explains why treatment decisions often need to be tailored to the individual patient. By highlighting differences in methodology and clinical considerations, we emphasize the importance of individualized perioperative planning and close collaboration between surgeons and oncologists. Continued research will help refine these strategies and improve care for patients undergoing breast reconstruction. Full article

(This article belongs to the Section Breast Cancer)

12 pages, 459 KB

Open AccessArticle

Ruptured Wilms Tumor: Clinical Features, Diagnostic Challenges, and Survival Outcomes

by Hiba Emadeldeen, Khalil Ghandour, Tamador Al-Shamaileh, Ahmad Kh. Ibrahimi, Nasim Sarhan, Iyad Sultan and Hadeel Halalsheh

Curr. Oncol. 2026, 33(5), 293; https://doi.org/10.3390/curroncol33050293 - 19 May 2026

Abstract

Background: Wilms tumor (WT) rupture is a serious complication that upstages the disease and requires treatment intensification. This study evaluates clinical characteristics, radiological-pathological concordance, and survival outcomes of ruptured versus non-ruptured WT at a major Middle Eastern tertiary center. Methods: We conducted a [...] Read more.

Background: Wilms tumor (WT) rupture is a serious complication that upstages the disease and requires treatment intensification. This study evaluates clinical characteristics, radiological-pathological concordance, and survival outcomes of ruptured versus non-ruptured WT at a major Middle Eastern tertiary center. Methods: We conducted a retrospective cohort study of 111 pediatric patients with unilateral WT treated at King Hussein Cancer Center, Jordan, between October 2014 and December 2023 (follow-up to December 2025). Tumor rupture was defined by preoperative CT findings (peritumoral effusion, hemorrhage, or peritoneal nodules), intraoperative capsular breach/spillage, or pathological confirmation. Event-free survival (EFS) and overall survival (OS) were estimated using Kaplan–Meier methods and compared with the log-rank test. Multivariable Cox regression identified independent prognostic factors. Results: Tumor rupture occurred in 17 patients (15.3%). Ruptured cases were older (median 4.2 vs. 3.5 years, p = 0.03), had larger tumors (13.7 vs. 11.7 cm, p = 0.01), and presented with lower hemoglobin (7.9 vs. 10.4 g/dL, p < 0.001). All ruptured cases were stage III/IV, with 41% having distant metastases at diagnosis. Five-year EFS was 44.1% vs. 75.8% (p = 0.025) and OS was 58.2% vs. 81.4% (p = 0.002) for ruptured vs. non-ruptured groups. On multivariable analysis, rupture independently predicted death (HR 17.62, 95% CI 2.69–115.48, p = 0.003) and relapse (HR 8.1, 95% CI 1.66–39.57, p = 0.01). Conclusion: WT rupture is associated with advanced disease at presentation and significantly inferior survival. Substantial discordance between preoperative radiological/intraoperative findings and post-chemotherapy pathology highlights the “masking effect” of neoadjuvant chemotherapy. A multidisciplinary approach integrating initial imaging, surgical notes, and histology is essential to avoid undertreatment in SIOP-based protocols. Full article

(This article belongs to the Section Surgical Oncology)

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15 pages, 2391 KB

Open AccessArticle

SLC39A13 Defines Myofibroblastic Activation and Immunosuppressive Tumor Microenvironment in Head and Neck Squamous Cell Carcinoma

by Hideyuki Takahashi, Hiroyuki Hagiwara, Hiroe Tada, Miho Uchida, Toshiyuki Matsuyama and Kazuaki Chikamatsu

Curr. Oncol. 2026, 33(5), 292; https://doi.org/10.3390/curroncol33050292 - 18 May 2026

Abstract

Zinc transport plays a critical role in cellular signaling, but its function in the tumor microenvironment remains poorly understood. We aimed to investigate the role of zinc transporters in cancer-associated fibroblasts in head and neck squamous cell carcinoma. Single-cell RNA sequencing data were [...] Read more.

Zinc transport plays a critical role in cellular signaling, but its function in the tumor microenvironment remains poorly understood. We aimed to investigate the role of zinc transporters in cancer-associated fibroblasts in head and neck squamous cell carcinoma. Single-cell RNA sequencing data were analyzed to evaluate zinc transporter expression across tumor cell populations, and bulk RNA sequencing of primary fibroblast cultures was used for validation. Clinical relevance was assessed using transcriptomic and survival data from a large patient cohort. We found that zinc transporter expression, particularly SLC39A13, was enriched in fibroblasts and strongly associated with myofibroblastic activation signatures, including extracellular matrix remodeling and TGFβ signaling. Fibroblasts with high SLC39A13 expression were linked to immunosuppressive tumor environments characterized by reduced cytotoxic T-cell infiltration and increased immunosuppressive cells. Clinically, SLC39A13 expression was associated with poor progression-free survival and remained an independent prognostic factor. These findings suggest that zinc transporter-mediated pathways play a key role in stromal activation and immune regulation, highlighting SLC39A13 as a potential therapeutic target in head and neck squamous cell carcinoma. Full article

(This article belongs to the Section Head and Neck Oncology)

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17 pages, 1052 KB

Open AccessArticle

Incidence and Management Trends in Advanced Head and Neck Non-Melanoma Skin Cancer in Ontario

by Ka-Kit David Yeung, Gregory Pond, Isaac Kong, Han Zhang, Michael Gupta, Zejia Chen and Justin Lee

Curr. Oncol. 2026, 33(5), 291; https://doi.org/10.3390/curroncol33050291 - 17 May 2026

Abstract

Head and neck non-melanoma skin cancers (H&N NMSCs) account for most head and neck malignancies. While primary treatment comprises surgery, adjuvant radiation is recommended in advanced tumors. Radiation oncology practice patterns for resected locally advanced (rLA) and locoregional (rLR) H&N NMSCs have not [...] Read more.

Head and neck non-melanoma skin cancers (H&N NMSCs) account for most head and neck malignancies. While primary treatment comprises surgery, adjuvant radiation is recommended in advanced tumors. Radiation oncology practice patterns for resected locally advanced (rLA) and locoregional (rLR) H&N NMSCs have not been well characterized. Using data from the Institute for Clinical Evaluative Sciences (ICES) between 2003 and 2019, we conducted a longitudinal, population-based study characterizing disease incidence, survival outcomes, and radiation utilization patterns. Among 2962 rLA and 1055 rLR cases, rLA incidence rose more than tenfold compared to population growth; however rLR incidence remained stable. Radiation oncology consultations occurred in 29.6% of rLA and 50.7% of rLR patients. Increased age, multiple cancers at diagnosis, non-rural demographic, and higher SES were observed to be correlated to receipt of adjuvant radiation treatment. Only 19.4% of rLA and 37.95 of rLR disease received adjuvant RT, which is much lower than expected based on international guidelines. Five-year overall survival (OS) was 69% (95% confidence interval (CI): 67–71%) for rLA and 68% (95% CI: 65–71%) for rLR disease. These findings highlight the burden of advanced H&N NMSC, low rates of radiation utilization and the need for improving referral pathways and guideline adherence. Full article

(This article belongs to the Section Head and Neck Oncology)

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19 pages, 258 KB

Open AccessArticle

Forward Planning: A Staffing Framework and Ratios for Psychosocial Oncology and Supportive Care Hiring Practices as Cancer Care Models Evolve

by Carole Mayer, Marianne Arab, Kimberley Thibodeau and Celestina Martopullo

Curr. Oncol. 2026, 33(5), 290; https://doi.org/10.3390/curroncol33050290 - 14 May 2026

Abstract

Innovative models of cancer care have emerged in response to advances in cancer treatment, expanding technologies that bring care closer to home and address COVID-19-related challenges and concerns about a shrinking healthcare workforce. Despite the advancements made, the psychosocial impact on people affected [...] Read more.

Innovative models of cancer care have emerged in response to advances in cancer treatment, expanding technologies that bring care closer to home and address COVID-19-related challenges and concerns about a shrinking healthcare workforce. Despite the advancements made, the psychosocial impact on people affected by cancer persists. The psychosocial burden of cancer underlines the need for patient access to evidence-based psychosocial oncology (PSO) and supportive care (SC) interventions. As models of care evolve, hiring practices of PSO professionals must also evolve for cancer patients to access properly staffed PSO programs that deliver high-quality and efficient services. In 2019, the Canadian Association of Psychosocial Oncology (CAPO)–Clinical Advisory Committee consulted administrators and clinicians across Canada to understand caseload volumes of PSO professionals with a goal to set staffing ratios. The engagement process revealed that there is no consistency in staffing PSO programs across Canada, let alone staffing ratios for PSO disciplines. In 2022, CAPO introduced a 10-point staffing framework and formula to calculate staffing ratios for hiring PSO professionals, beginning with the social work discipline. The goal of this paper is to provide updates to the existing framework and demonstrate how the formula can be adapted to other PSO disciplines. To our knowledge, this is the first published paper in Canada outlining the calculations for a PSO staff framework and formula. The authors advocate for greater transparency when reporting PSO staffing ratios across Canada, using this framework as a reference point. Organizations reporting on the cancer system performance are encouraged to develop PSO indicators, starting with tracking patient access to PSO services. Full article

(This article belongs to the Special Issue Building Hope for the Next Decade of Psychosocial Oncology: Optimizing the Integration of Supportive Care into Oncology Care)

18 pages, 715 KB

Open AccessArticle

Real-World Effectiveness of Capecitabine and Temozolomide Across Endocrine and Neuroendocrine Neoplasm Subtypes (ENENs): A Population-Based Cohort Study from Alberta, Canada (2011–2021)

by Alda Aleksi, Kaiden D. Jobin, Malek B. Hannouf, Patrik Husi, Heather Halperin, Chris White-Gloria, Tasnima Abedin and Dean Ruether

Curr. Oncol. 2026, 33(5), 289; https://doi.org/10.3390/curroncol33050289 - 14 May 2026

Abstract

Capecitabine plus temozolomide (CAPTEM) improves progression-free survival (PFS) in pancreatic endocrine and neuroendocrine neoplasms (PNENs), yet its real-world effectiveness across other endocrine and neuroendocrine neoplasm (ENEN) subtypes remains uncertain. We conducted a retrospective population-based cohort study including 159 adults with ENENs treated with [...] Read more.

Capecitabine plus temozolomide (CAPTEM) improves progression-free survival (PFS) in pancreatic endocrine and neuroendocrine neoplasms (PNENs), yet its real-world effectiveness across other endocrine and neuroendocrine neoplasm (ENEN) subtypes remains uncertain. We conducted a retrospective population-based cohort study including 159 adults with ENENs treated with CAPTEM in Alberta, Canada (2011–2021). Patients were stratified by primary tumor site, treatment line, and number of CAPTEM cycles received. Kaplan–Meier methods and Cox proportional hazards models adjusted for age and sex were used to evaluate PFS and overall survival (OS). Compared with pancreatic neuroendocrine neoplasms PNENs, gastrointestinal neuroendocrine neoplasms (GINENs) demonstrated similar PFS and OS. In contrast, pulmonary neuroendocrine neoplasms (PuNENs) and other ENENs (OENENs) were associated with significantly shorter PFS and OS. Use of CAPTEM in the first-line setting was associated with improved PFS (HR 0.56, 95% CI 0.40–0.78, p < 0.001) and OS (HR 0.42, 95% CI 0.29–0.62, p < 0.001). Receipt of ≥6 treatment cycles was also strongly associated with superior PFS (HR 0.22, 95% CI 0.16–0.32, p < 0.001) and OS (HR 0.22, 95% CI 0.14–0.34, p < 0.001). CAPTEM shows comparable real-world effectiveness in GINENs and PNENs but appears less effective in PuNENs and other OENEN subtypes. Early initiation and adequate treatment duration are key factors associated with improved survival outcomes. Full article

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17 pages, 259 KB

Open AccessArticle

Supporting Advance Care Planning Among Mandarin and Cantonese Speaking Communities: A Qualitative Exploratory Study

by Upma Chitkara, Ashfaq Chauhan, Ramya Walsan, Mary Li, Eric Yeung, Ursula M. Sansom-Daly and Reema Harrison

Curr. Oncol. 2026, 33(5), 288; https://doi.org/10.3390/curroncol33050288 - 14 May 2026

Abstract

Whilst advance care planning (ACP) is important to ensure person-centred end of life care, there is sparse evidence about factors contributing towards engagement for people from Mandarin and Cantonese speaking backgrounds (MCSB) affected by cancer. This study aimed to establish barriers and facilitators [...] Read more.

Whilst advance care planning (ACP) is important to ensure person-centred end of life care, there is sparse evidence about factors contributing towards engagement for people from Mandarin and Cantonese speaking backgrounds (MCSB) affected by cancer. This study aimed to establish barriers and facilitators for quality ACP among people from MCSB with cancer and carers. A qualitative study utilising semi-structured interviews and focus groups was conducted. Participants included adult community members from MCSB in New South Wales who had accessed cancer care services in Australia as a support person or a patient in the last five years with recruitment done purposefully. Data collected from eligible consenting participants were audio/video recorded, transcribed verbatim and analysed using the Framework Method applying the Theoretical Domains Framework. Eighteen people participated (11 in two focus groups, seven individual interviews). Key barriers to engagement with ACP were unclear understanding of process and conduct, poor quality communication by healthcare staff, resource constraints and cultural misalignment of ACP concepts. The main facilitators were openness of participants to discussions, culturally informed community resources and dedicated ACP services. Co-design provides a useful approach to address varied identified factors. At the system and service level, co-design with these communities and healthcare providers could potentially develop resources to assist these communities in engaging with ACP, including preparing for ACP communication. Understanding and acknowledging cultural factors that impact ACP and integrating this knowledge in ACP communication may enhance engagement. Full article

(This article belongs to the Section Palliative and Supportive Care)

20 pages, 415 KB

Open AccessReview

Applications of Artificial Intelligence in Endobronchial Ultrasound for Lung Cancer Diagnosis and Staging: A Scoping Review

by Jacobo Echeverri-Hoyos, Jaime A. Echeverri-Franco, Nicole Bonilla, Gustavo Monsalve-Morales and Eduardo Tuta-Quintero

Curr. Oncol. 2026, 33(5), 287; https://doi.org/10.3390/curroncol33050287 - 13 May 2026

Abstract

Introduction: Lung cancer remains highly lethal. Endobronchial ultrasound (EBUS) enables minimally invasive diagnosis and staging. Artificial intelligence (AI) improves image analysis and diagnostic accuracy, though current evidence is limited by retrospective, small, single center studies. Methods: A scoping review following Arksey–O’Malley, [...] Read more.

Introduction: Lung cancer remains highly lethal. Endobronchial ultrasound (EBUS) enables minimally invasive diagnosis and staging. Artificial intelligence (AI) improves image analysis and diagnostic accuracy, though current evidence is limited by retrospective, small, single center studies. Methods: A scoping review following Arksey–O’Malley, Levac, and JBI frameworks, was reported as per PRISMA-ScR. Databases were searched for studies (2015–2026) on AI in EBUS. Two reviewers screened, extracted standardized data, and performed narrative synthesis grouped by algorithm type, application, and performance metrics. Results: A total of 26 studies were included. Of these, 73.1% (19/26) employed deep learning-based models, while 26.9% (7/26) used traditional or hybrid machine learning approaches. The most frequent clinical objective was diagnostic classification of malignancy (14/26; 53.8%), followed by segmentation or cytological analysis (5/26; 19.2%), anatomical navigation or lymph node station classification (3/26; 11.5%), and multimodal predictive or staging support models (4/26; 15.4%). Most studies were based on EBUS-derived images or videos (18/26; 69.2%), including both convex-probe and radial-probe applications. Studies were distributed among Convex Probe-EBUS for mediastinal staging, Radial Probe-EBUS for peripheral lesion assessment, and rapid on-site evaluation-based cytology analysis, reflecting diverse clinical contexts. Most models were developed using static images. Conclusions: AI applications in EBUS are predominantly based on deep learning and mainly focused on diagnostic classification, with growing but still limited exploration of segmentation, navigation, and multimodal approaches. The evidence reflects diverse clinical contexts and data sources, particularly image-based inputs, but remains unevenly distributed across applications. Full article

(This article belongs to the Topic Advanced Endoscopic Ultrasound (EUS) Techniques: Current and Future Directions)

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20 pages, 3816 KB

Open AccessArticle

Lenvatinib Combined with New FP Hepatic Arterial Infusion Chemotherapy for Unresectable Hepatocellular Carcinoma: Clinical Efficacy, Vascular Remodeling, and Implications for Immuno-Oncology–Systemic Combination Therapy

by Susumu Maruta, Yohei Koshima, Yuji Debari, Chihei Sugihara, Gou Takahata, Ryo Tamura, Tadashi Ohshima, Yuji Ono, Yuho Morita, Tomoki Chiba, Satoru Ishida, Hideto Imai, Keisuke Watanabe, Ryo Chinzei, Masanori Takahashi and Yoshihiko Ooka

Curr. Oncol. 2026, 33(5), 286; https://doi.org/10.3390/curroncol33050286 - 13 May 2026

Abstract

Background/Objectives: Patients with unresectable hepatocellular carcinoma (uHCC) refractory or intolerant to immune checkpoint inhibitor (ICI)-based regimens represent a growing yet therapeutically underserved population with limited treatment options. We investigated the efficacy, safety, and mechanistic underpinnings of lenvatinib combined with New FP hepatic arterial [...] Read more.

Background/Objectives: Patients with unresectable hepatocellular carcinoma (uHCC) refractory or intolerant to immune checkpoint inhibitor (ICI)-based regimens represent a growing yet therapeutically underserved population with limited treatment options. We investigated the efficacy, safety, and mechanistic underpinnings of lenvatinib combined with New FP hepatic arterial infusion chemotherapy (LEN–New FP) in this challenging clinical setting. Methods: We retrospectively analyzed 14 consecutive patients with uHCC treated with LEN–New FP between April 2022 and March 2025. Tumor response was assessed by the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Proper hepatic artery (PHA) diameter was serially measured on angiography as an exploratory assessment of vascular remodeling, and tumor vascularity was semi-quantitatively evaluated using a 4-point angiographic scoring system (Tumor Vascularity Score [TVS]). Results: The cohort comprised BCLC stage B/C (7/7), mALBI grade 1–2b, and 13 of 14 patients with prior ICI-containing therapy. The objective response rate and disease control rate were 85.7% and 100%, including two complete responses. Median overall survival was 22.8 months from LEN–New FP initiation (median follow-up: 15.1 months) and 36.2 months from first-line initiation; median intrahepatic progression-free survival was 10.4 months. A total of 11 of 14 patients (78.6%) transitioned to subsequent therapies, including four curative-intent conversions. PHA narrowing was observed in 10 of 13 evaluable patients (76.9%), with no clear association with hepatic function deterioration. TVS decreased in 10 of 12 evaluable patients (83.3%), with reduction observed in 90.0% of PR/CR cases. Conclusions: LEN–New FP achieved sustained intrahepatic tumor control and encouraging survival in aggressive uHCC, including ICI-refractory or -intolerant disease. The concordant reduction in PHA diameter and tumor vascularity score provides angiographic evidence of VEGFR inhibition-mediated vascular remodeling, offering mechanistic insight into the synergistic antitumor effects of this regimen and supporting LEN–New FP as a promising multimodal strategy within the evolving landscape of HCC treatment. Full article

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14 pages, 1733 KB

Open AccessArticle

Radioembolization Practice in North America Versus Europe: Results from a Global Survey

by Grace Keane, Marnix G. E. H. Lam, Arthur J. A. T. Braat, Rutger C. G. Bruijnen, Nathalie Kaufmann, Hugo W. A. M. de Jong, Riad Salem and Maarten L. J. Smits

Curr. Oncol. 2026, 33(5), 285; https://doi.org/10.3390/curroncol33050285 - 12 May 2026

Abstract

Purpose: The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) conducted an international survey on the real-life application of transarterial radioembolization (TARE). This sub-analysis of the complete survey evaluates intercontinental disparities in TARE practices. Materials and Methods: A survey of 32 multiple-choice questions [...] Read more.

Purpose: The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) conducted an international survey on the real-life application of transarterial radioembolization (TARE). This sub-analysis of the complete survey evaluates intercontinental disparities in TARE practices. Materials and Methods: A survey of 32 multiple-choice questions was distributed to CIRSE members between November and December 2022. The questions addressed steps of the TARE workflow, including treatment work-up, planning and dosimetry, intervention, follow-up and innovations. Responses were curated to remove duplicates and incomplete entries and categorised into continental groups. Analysis focused on variations between Europe and North America and impacting factors in the respective regions were identified. Data is presented using descriptive statistics. Results: Responses were obtained from 30 countries and 133 hospitals, including 87 European and 21 North American centres. Hepatocellular carcinoma was the most common indication, constituting 61% of treatments in North America and 51% in Europe. North America predominantly used ⁹⁰Y glass microspheres, whereas Europe used ⁹⁰Y resin. Procedural differences included the adoption of intra-procedural CT imaging, utilized by all North American sites, versus 89% of European sites. Outpatient treatments were favoured in North America (85%), while in Europe, most patients remained hospitalized for one night (51%). Both regions increasingly emphasized dosimetry-guided treatments, with personalized dosimetry planning in 71% and 84% of North American and European sites, respectively. Conclusions: This North America–Europe comparison highlights regional differences in radioembolization practice between the leading continents in procedure volume, based on results of the CIRSE TARE survey. Specific intercontinental differences identified in this survey included hospitalization, product utilization, and procedural techniques. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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14 pages, 242 KB

Open AccessArticle

Temporal Clustering of Endometrial Cancer and Hyperplasia in HRT Users with Unscheduled Bleeding: A Retrospective NHS Cohort Study

by Mohamed Abdelwanis Mohamed Abdelaziz, Ahmed Mohamed, Ayodele Olaleye, Nesma Hesham, Nazifa Tasnim, Oluwafemi Ogundiran, Lorna Sandison, Hazem Sayed and Anita Juliana

Curr. Oncol. 2026, 33(5), 284; https://doi.org/10.3390/curroncol33050284 - 12 May 2026

Abstract

Background: Unscheduled bleeding in postmenopausal women on hormone replacement therapy (HRT) represents a common but poorly characterised clinical challenge. Whilst endometrial cancer affects approximately 9% of women with unexplained postmenopausal bleeding, existing evidence in HRT users is largely restricted to women under 60 [...] Read more.

Background: Unscheduled bleeding in postmenopausal women on hormone replacement therapy (HRT) represents a common but poorly characterised clinical challenge. Whilst endometrial cancer affects approximately 9% of women with unexplained postmenopausal bleeding, existing evidence in HRT users is largely restricted to women under 60 years and short-duration regimens, leaving a critical evidence gap in contemporary all-age clinical practice. Whether the same investigative urgency is warranted for HRT users experiencing unscheduled bleeding as for women with unexplained postmenopausal haemorrhage remains unresolved. Objectives: To determine the diagnostic yield of endometrial cancer and hyperplasia amongst postmenopausal women presenting with unscheduled bleeding whilst on HRT, and to explore potential associations with HRT regimens and clinical risk factors. Methods: This retrospective observational study analysed 343 postmenopausal women presenting with unscheduled bleeding whilst on HRT at a single tertiary centre between September 2023 and February 2024. All patients underwent transvaginal ultrasound and endometrial sampling according to institutional protocol. Descriptive statistics were used to characterise outcomes, with exploratory analyses of potential risk factors. Given the symptomatic and selected nature of this cohort, all proportions represent the diagnostic yield within an investigated population rather than population-level incidence estimates. Results: Amongst 343 women (mean age 56.2 ± 7.4 years), nine cases (2.6%) of endometrial abnormalities were identified: four malignancies (1.2%), four endometrial hyperplasia without atypia (1.2%), and one complex atypical hyperplasia (0.3%). Only five cases (1.5%) required surgical intervention. All four endometrial cancers were Stage IA (FIGO 2009; three Grade 1, one Grade 2; no LVSI), corresponding to Stage IA2mNSMP under FIGO 2023. None required adjuvant therapy. Strikingly, 88.9% of all abnormal cases occurred within two years of HRT initiation, with no endometrial pathology identified amongst the 45 women using systemic HRT for more than five years—a temporal pattern not previously reported. Conclusions: In this retrospective all-age NHS cohort, the diagnostic yield of endometrial cancer was 1.2% in HRT users with unscheduled bleeding, with only 1.5% requiring surgical intervention. All cancers were early-stage (FIGO 2009 Stage IA; FIGO 2023 Stage IA2mNSMP) and required no adjuvant therapy. A previously unreported temporal clustering of pathology within the first two years of HRT initiation generates a hypothesis that early unscheduled bleeding may unmask pre-existing rather than HRT-induced endometrial abnormalities. These observations are hypothesis-generating and should not be interpreted as evidence of endometrial safety. These findings apply specifically to symptomatic women presenting for investigation and cannot be generalised to asymptomatic HRT users. Prospective validation in larger cohorts with baseline endometrial assessment is required before any clinical conclusions can be drawn. What This Study Adds: (1) A real-world cancer detection proportion of 1.2% in an all-age contemporary NHS cohort. (2) A previously undescribed temporal pattern with pathology clustering within two years of HRT initiation and no pathology in long-term users (n = 45), generating a testable hypothesis about pre-existing versus HRT-induced disease. (3) Dual FIGO 2009/2023 staging demonstrating that molecular classification added no treatment-discriminatory value in this early-detection context. Full article

(This article belongs to the Section Gynecologic Oncology)

7 pages, 8347 KB

Open AccessCase Report

High-Grade Glioma Tumoral Cells in a Case of Postoperative, Recurrent Subdural Hematoma… Where Did They Come From?

by Paul E. Constanthin, Arthur Durouchoux, Gianpaolo Jannelli, Mégane Le Quang, Guillaume Chotard and Julien Engelhardt

Curr. Oncol. 2026, 33(5), 283; https://doi.org/10.3390/curroncol33050283 - 10 May 2026

Abstract

Background: High-grade glioma (HGG), formerly known as Glioblastoma multiforme, can be complicated by hematomas, either at the initial presentation or after surgical removal. Rarely, postoperative bleeding can occur extra-axially, resulting in subdural hematomas (SDH) that might require surgical evacuation. Of note, little is [...] Read more.

Background: High-grade glioma (HGG), formerly known as Glioblastoma multiforme, can be complicated by hematomas, either at the initial presentation or after surgical removal. Rarely, postoperative bleeding can occur extra-axially, resulting in subdural hematomas (SDH) that might require surgical evacuation. Of note, little is known about the cellular composition of those hematomas. Observations: We present the case of a patient operated on for HGG who developed postoperative recurrent SDH that required multiple surgical evacuations. Histopathological analyses of the membranes comprising the SDH revealed the presence of HGG tumoral cells. Conclusions: Based on our observation, hematomas associated with HGG, either extra or intra-axial, should be suspected of being a sign of tumoral recurrence or spread and histopathological analyses might be considered as they could lead to further adaptation of the patient’s treatment. Full article

(This article belongs to the Section Neuro-Oncology)

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7 pages, 713 KB

Open AccessCase Report

Spontaneous Regression of Clear Cell Renal Cell Carcinoma Metastases or Immune Restoration?

by Clara Vacheret, Fabien Moinard-Butot, Lucile Reberol, Alexandre Ciccolini, Roberto Luigi Cazzato and Philippe Barthélémy

Curr. Oncol. 2026, 33(5), 282; https://doi.org/10.3390/curroncol33050282 - 10 May 2026

Abstract

Spontaneous regression of metastatic renal cell carcinoma is a rare and incompletely understood phenomenon. We report the case of a 61-year-old man with biopsy-proven pulmonary metastases from clear cell renal cell carcinoma who experienced durable tumor regression without receiving any systemic therapy. The [...] Read more.

Spontaneous regression of metastatic renal cell carcinoma is a rare and incompletely understood phenomenon. We report the case of a 61-year-old man with biopsy-proven pulmonary metastases from clear cell renal cell carcinoma who experienced durable tumor regression without receiving any systemic therapy. The patient underwent cryoablation of a symptomatic iliac bone metastasis and discontinued methotrexate, previously prescribed for inflammatory polyarthritis. Serial imaging demonstrated initial slow progression followed by significant shrinkage of pulmonary and mediastinal lesions, leading to a sustained partial response according to RECIST 1.1 criteria. No disease progression has been observed after extended follow-up. Two non-mutually exclusive mechanisms may explain this observation: restoration of antitumor immunity following withdrawal of immunosuppressive therapy, and a systemic immune response triggered by local tumor destruction (abscopal effect). Although such events are exceptional, this case highlights the potential interplay between immune modulation and local therapies in renal cell carcinoma. Further investigation is warranted to better understand these mechanisms and their potential therapeutic implications. Full article

(This article belongs to the Section Genitourinary Oncology)

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10 pages, 324 KB

Open AccessArticle

Recording Medical Errors in Brain Tumor Surgery Can Facilitate Their Avoidance: Single Institution Comparative Cohort Analysis over 19 Years

by Mohammed J. Asha, Patrick E. Steadman, Ashkan Samienezhad and Mark Bernstein

Curr. Oncol. 2026, 33(5), 281; https://doi.org/10.3390/curroncol33050281 - 9 May 2026

Abstract

Objectives: Error-tracking studies have become an invaluable tool for gaining deeper insights into the patterns, causes, and clinical consequences of errors. In this paper, we examine the long-term impact of analyzing errors at the level of an individual surgeon. Methods: We [...] Read more.

Objectives: Error-tracking studies have become an invaluable tool for gaining deeper insights into the patterns, causes, and clinical consequences of errors. In this paper, we examine the long-term impact of analyzing errors at the level of an individual surgeon. Methods: We performed a retrospective analysis of an internally maintained prospective database from September 2013 to April 2019 (Group C). These variables were compared with two earlier cohorts: Group A (2000–2006) and Group B (2006–2013). The key endpoints assessed included error incidence, type, severity, preventability, and clinical impact. The study also investigated the potential seasonal variations in error incidence, considering the rotation of trainees. Results: A persistent decrease in the mean errors/case (across all types) since records began in 2000 was noted; (1.8 for study group C versus 1.9 and 2.4 for group B and group A respectively, p = 0.048). We observed a drop in error severity score (major errors of 17.5% versus 29.5% and 22.6% respectively, p < 0.00001) and clinical impact (high impact in 0.4% versus 1.0% and 2.7% respectively, p < 0.00001). Conclusions: Ongoing and systematic error tracking and analysis seem to have a lasting impact on reducing both the incidence and severity of errors. These positive outcomes are thought to reflect the establishment of a culture of safety, fostering transparency and constructive feedback within the broader surgical team. Full article

(This article belongs to the Section Neuro-Oncology)

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20 pages, 917 KB

Open AccessReview

Prostate Cancer Biomarkers with a Focus on Galectin-3: Emerging Clinical and Therapeutic Implications

by Hiba Narvel, Mohammad Arfat Ganiyani, Adnan Gulam Nabi, Aman Goyal, Rohan Garje, Sanjay Srinivasan, Hafiz Ahmed and Deepak Kilari

Curr. Oncol. 2026, 33(5), 280; https://doi.org/10.3390/curroncol33050280 - 9 May 2026

Abstract

Prostate cancer (PCa) management has evolved with biomarker-driven strategies, yet biological heterogeneity, adaptive resistance, and an immunosuppressive microenvironment limit their efficacy. Galectin-3 (Gal-3) has emerged as a central node in PCa pathobiology, influencing tumor survival, metastasis, and immune escape. This review comprehensively reviews [...] Read more.

Prostate cancer (PCa) management has evolved with biomarker-driven strategies, yet biological heterogeneity, adaptive resistance, and an immunosuppressive microenvironment limit their efficacy. Galectin-3 (Gal-3) has emerged as a central node in PCa pathobiology, influencing tumor survival, metastasis, and immune escape. This review comprehensively reviews Gal-3’s dual role as a biomarker and a therapeutic target. We first delineate the limitations of the current diagnostic, prognostic, and predictive biomarkers in PCa, establishing the unmet need. We then elucidate the multifunctional biology of Gal-3, detailing its compartment-specific roles in anti-apoptosis, angiogenesis, epithelial-to-mesenchymal transition, and, notably, its function as a master regulator of immunosuppression. The interaction between Gal-3 and prostate-specific antigen (PSA) is explored as a key regulatory interface. Furthermore, we catalog and analyze emerging Gal-3-targeted therapies, emphasizing their rationale for combination with immune checkpoint blockade to reverse therapeutic resistance. Finally, we outline a translational roadmap, advocating for standardized Gal-3 biomarker assays and biomarker-enriched clinical trials. Integrating Gal-3 into the PCa precision medicine toolkit offers a novel strategy to address heterogeneity and improve therapeutic durability. Full article

(This article belongs to the Section Genitourinary Oncology)

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