Current Oncology

10 pages, 1354 KB

Open AccessBrief Report

Assessing Disparities in Who Accepts an Early Palliative Care Consultation

by Heather Halperin, Philip Akude, Seema King, Patricia Biondo, Aynharan Sinnarajah, Desiree Hao and Jessica Simon

Curr. Oncol. 2025, 32(9), 485; https://doi.org/10.3390/curroncol32090485 (registering DOI) - 30 Aug 2025

Abstract

Early palliative care improves quality of life for patients with life-limiting illnesses, but access is often inequitable. The goal of this study was to assess disparities in early specialist palliative care (SPC) consultation among newly diagnosed stage IV lung cancer patients. All newly [...] Read more.

Early palliative care improves quality of life for patients with life-limiting illnesses, but access is often inequitable. The goal of this study was to assess disparities in early specialist palliative care (SPC) consultation among newly diagnosed stage IV lung cancer patients. All newly diagnosed stage IV lung cancer patients in southern Alberta, Canada (June 2021–March 2022) were offered SPC consultations from a multidisciplinary team, post-oncology visit. A retrospective chart review analyzed demographic factors and consultation outcomes (accepted, ineligible, declined/unreachable), using the Pampalon Deprivation Index and NamSor surname analysis as proxies for equity-related variables. Of 113 patients, 76.2% were eligible for consultation, and 67.4% of those accepted consultation. Older age (>65 years), male sex, and high deprivation were linked to declining SPC (p < 0.05–0.01). Conversely, living alone or with a non-partner increased acceptance (p < 0.05). Age, sex, deprivation, and living situation influenced SPC acceptance. Identifying disparities can guide interventions to improve equitable access. Full article

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

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16 pages, 1199 KB

Open AccessReview

The Rethinking Clinical Trials (REaCT) Program: A Pragmatic Research Strategy to Improve Cancer Care for Patients, Caregivers, and Healthcare Systems

by Marie-France Savard, Mark Clemons and Sharon F. McGee

Curr. Oncol. 2025, 32(9), 484; https://doi.org/10.3390/curroncol32090484 - 29 Aug 2025

Abstract

Cancer care has become increasingly complex, expensive, and inaccessible, with patients often exposed to increased treatment-related harms for marginal benefits. Pragmatic clinical trials offer a solution by conducting real-world studies that evaluate dose optimization, toxicity, quality of life, and resource utilization. Pragmatic trials [...] Read more.

Cancer care has become increasingly complex, expensive, and inaccessible, with patients often exposed to increased treatment-related harms for marginal benefits. Pragmatic clinical trials offer a solution by conducting real-world studies that evaluate dose optimization, toxicity, quality of life, and resource utilization. Pragmatic trials can also address the efficacy–effectiveness gap: the poorer outcomes and greater toxicity observed in everyday practice compared to those reported in many clinical trials. The Rethinking Clinical Trials (REaCT) program was designed to conduct patient-centered practice-changing research by involving patients, their families, and healthcare providers in the design of inclusive, real-world clinical trials. The REaCT process starts with surveys and systematic reviews to identify knowledge gaps and uses this information to design pragmatic clinical trials that address these deficits. Since 2014, the program has conducted 17 patient and 17 healthcare provider surveys with 2298 and 1033 responses, respectively. With these results, the program has performed 22 systematic reviews. These surveys and systematic reviews have resulted in 19 completed and 8 ongoing REaCT clinical trials that have recruited over 5000 patients from across Canada. Here, we present some of the practice-changing research conducted by the REaCT program and address challenges facing the growth of pragmatic research. Full article

9 pages, 205 KB

Open AccessArticle

Real-World Selection of Patients for Allogeneic HCT at a Single Centre: Lack of a Suitable Donor and Other Reasons for Not Proceeding

by Madeline Monaghan, An Duong, Kalina Abrol, Trang Doan, Carolina Cieniak, Harold Atkins, Natasha Kekre, Ashish Masurekar, Ram Vasudevan Nampoothiri, Santhosh Thyagu, Christopher N. Bredeson, Michael Kennah and David S. Allan

Curr. Oncol. 2025, 32(9), 483; https://doi.org/10.3390/curroncol32090483 - 29 Aug 2025

Abstract

The reasons why patients cannot proceed with HCT, including cases where no suitable donor is identified, remain poorly described. We reviewed all referrals for allogeneic HCT to our programme between 1 January 2019 and 31 December 2023. Of 880 patients referred for allogeneic [...] Read more.

The reasons why patients cannot proceed with HCT, including cases where no suitable donor is identified, remain poorly described. We reviewed all referrals for allogeneic HCT to our programme between 1 January 2019 and 31 December 2023. Of 880 patients referred for allogeneic HCT, 494 (61.8%) proceeded to transplant (mean 52 ± 14.8 years, 61.5% male) using HLA-matched unrelated (64.2%) or related (19.4%) donors and HLA-mismatched (13%) or haploidentical (3%) donors. Of patients that did not proceed with HCT (386, 38.2%), disease-related causes (54.2%), patient preference (15.8%), and significant patient comorbidity (11.4%) were the most common reasons. Eleven patients (2.9% of transplants that did not proceed; 1.3% of all referrals) lacked a suitable donor and had HLA phenotypes most associated with Caucasian (six patients, 55%), First Nations, Inuit or Metis (two patients, 18%), Black African, Caribbean or African American (one patient, 9%), Asian or Pacific Islander (9%), or unknown ethnicity (one patient, 9%). Very few patients were unable to proceed with transplant due to lack of a suitable donor; however, those cases are overrepresented by non-Caucasian ethnicity relative to the population. Full article

(This article belongs to the Section Cell Therapy)

13 pages, 554 KB

Open AccessArticle

De-Escalation of Treatment in Women Aged ≥80 Years with Breast Cancer: A Retrospective Analysis from Two Breast Centers

by Gianmarco Piccolino, Giulia Cardelli, Francesca Arienzo, Emanuele Zarba Meli, Elena Del Giudice, Leopoldo Costarelli, Rosalinda Rossi, Claudia Scaringi, Tiziana Mastropietro, Laura Broglia, Valeria Vitale, Federica Bergamo, Elena Manna, Massimo La Pinta, Lorenzo Palleschi, Andrea Loreti, Augusto Lombardi and Lucio Fortunato

Curr. Oncol. 2025, 32(9), 482; https://doi.org/10.3390/curroncol32090482 - 28 Aug 2025

Abstract

Background: Breast cancer is frequently diagnosed in older women. However, the impact of surgery on survival is not well studied and prognosis for women ≥ 80 years of age is progressively depending on comorbidities. Methods: Medical records of consecutive women aged ≥ 80 [...] Read more.

Background: Breast cancer is frequently diagnosed in older women. However, the impact of surgery on survival is not well studied and prognosis for women ≥ 80 years of age is progressively depending on comorbidities. Methods: Medical records of consecutive women aged ≥ 80 years diagnosed with primary breast cancer treated with upfront surgery at two Breast Centers from 2011 to 2021 were retrospectively analyzed. Results: A total of 553 consecutive women with a median age of 83 years and a median tumor diameter of 21 mm were analyzed (574 lesions). Clinical Stages II or III were found in 263/574 (46%) and 101/574 cases (18%), respectively. Axillary staging was completely omitted for 94/542 invasive lesions (17%), and this increased over time from 2% to 33% (p < 0.001). Adjuvant hormone therapy and radiotherapy were omitted in 134/490 (27%) and in 122/420 patients (29%), respectively, while only 26/195 (13%) of patients with a clear clinical indication received adjuvant chemotherapy. At a median follow-up of 61 months (6–147) the 5- and 10-years overall survival (OS) were 64% and 21%, while breast cancer-specific survival (BCSS) at 5 and 10 years were 94% and 78%, respectively. Adjuvant therapies were not associated with a significant improvement in BCSS, while worse OS was associated with older age or more comorbidities as measured by the Charlson Comorbidity Index (CCI) (p < 0.001 and p = 0.012, respectively). Conclusions: Breast surgery, when possible, has a primary role even for women > 80 years of age, and it is associated with a reasonable BCSS. De-escalation of adjuvant therapies should be considered in this setting because survival is largely determined by age and co-morbidities. Full article

(This article belongs to the Section Breast Cancer)

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13 pages, 234 KB

Open AccessReview

Liver Transplantation for Unresectable Colorectal Liver Metastases: A Scoping Review on Redefining Boundaries in Transplant Oncology

by Berkay Demirors, Vrishketan Sethi, Abiha Abdullah, Charbel Elias, Francis Spitz, Jason Mial-Anthony, Godwin Packiaraj, Sabin Subedi, Shwe Han, Timothy Fokken and Michele Molinari

Curr. Oncol. 2025, 32(9), 481; https://doi.org/10.3390/curroncol32090481 - 28 Aug 2025

Abstract

Historically, colorectal liver metastases (CRLMs) have been considered a contraindication for liver transplantation (LT), primarily due to limited organ availability and concerns about oncologic efficacy. However, emerging evidence indicates that highly selected patients with unresectable CRLM can achieve long-term survival following LT—often with [...] Read more.

Historically, colorectal liver metastases (CRLMs) have been considered a contraindication for liver transplantation (LT), primarily due to limited organ availability and concerns about oncologic efficacy. However, emerging evidence indicates that highly selected patients with unresectable CRLM can achieve long-term survival following LT—often with outcomes superior to those obtained through conventional systemic therapies. To evaluate the evolving role of LT in this setting, we conducted a scoping review of the literature. A comprehensive search was performed across PubMed, Embase, Web of Science, Scopus, and ClinicalTrials.gov, as well as ProQuest Dissertations & Theses and Google Scholar to capture gray literature. The search included English-language articles published between January 2015 and April 2025. Eligible studies included those reporting on the application of LT for patients with unresectable CRLM. This scoping review synthesizes current evidence on patient selection criteria, overall and disease-free survival, recurrence patterns, and emerging biomarkers that may guide transplant eligibility. In addition, we explore innovations in organ utilization—including living donor LT and machine perfusion technologies—that aim to expand access while addressing ethical concerns related to organ allocation. As LT for CRLM transitions from investigational use to clinical implementation, this review outlines the key challenges and future opportunities that will shape its role in the landscape of transplant oncology. Full article

(This article belongs to the Special Issue Recent Advances in Surgical Strategies for Managing Metastatic Colorectal Cancer)

13 pages, 2991 KB

Open AccessArticle

Age-Stratified Clinicopathological Features and Efficacy of Adjuvant Chemotherapy in Resectable Gastric Cancer: An East-West Population-Based Study

by Zijian Deng, Jianping Guo, Zhizhong Xiong, Bin Zhong, Dayin Huang, Haoyang Xu, Shi Chen and Lei Lian

Curr. Oncol. 2025, 32(9), 480; https://doi.org/10.3390/curroncol32090480 - 26 Aug 2025

Abstract

Background: The incidence of early-onset gastric cancer (EOGC) has been steadily increasing in recent years. However, the efficacy of adjuvant chemotherapy (AC) in this population remains unclear. This study aimed to investigate the clinicopathological characteristics, survival outcomes, and efficacy of AC between EOGC [...] Read more.

Background: The incidence of early-onset gastric cancer (EOGC) has been steadily increasing in recent years. However, the efficacy of adjuvant chemotherapy (AC) in this population remains unclear. This study aimed to investigate the clinicopathological characteristics, survival outcomes, and efficacy of AC between EOGC and average-onset gastric cancer (AOGC) patients. Methods: Patients with stage II–III gastric adenocarcinomas who underwent curative D2 gastrectomy at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2014 to December 2021 were enrolled and classified into two groups: EOGC (≤45 years) and AOGC (>45 years) groups. Clinicopathological characteristics, overall survival (OS), and efficacy of AC were compared between the two groups. Western and East Asian cohorts were included as external validation sets to compare the efficacy of AC between different age groups. Results: Compared to AOGC, EOGC patients exhibited a higher proportion of females, poor differentiation, diffuse Lauren type, middle-third GC, perineural invasion (PNI), and receipt of AC. Univariate and multivariate analyses identified that T stage, N stage, PNI, and AC were independent prognostic factors for OS. After balancing the baseline characteristics between patients who received AC and those who did not, the Kaplan–Meier survival curves indicated that AC significantly improved OS across all patients. Further subgroup analysis revealed a survival benefit of AC in AOGC patients, whereas no significant survival difference was observed in the EOGC subgroup. Consistently, external validation in both Western and East Asian cohorts confirmed that AC did not confer a survival advantage in EOGC patients. Conclusions: EOGC exhibits aggressive pathological characteristics, and chemotherapy does not consistently improve survival in EOGC patients. Full article

(This article belongs to the Topic Recent Advances in Anticancer Strategies, 2nd Edition)

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21 pages, 6603 KB

Open AccessReview

Novel Therapeutic Development for Nasopharyngeal Carcinoma

by Jongwoo Kim, Yunjoo Lee, Seoin Kim and Jong Chul Park

Curr. Oncol. 2025, 32(9), 479; https://doi.org/10.3390/curroncol32090479 - 26 Aug 2025

Abstract

Nasopharyngeal carcinoma (NPC) is a rare malignancy with a distinct epidemiological pattern and is most often associated with Epstein–Barr virus (EBV). EBV plays a critical role in NPC pathogenesis, with viral proteins driving oncogenesis by altering immune regulation, apoptosis, and tumor progression. The [...] Read more.

Nasopharyngeal carcinoma (NPC) is a rare malignancy with a distinct epidemiological pattern and is most often associated with Epstein–Barr virus (EBV). EBV plays a critical role in NPC pathogenesis, with viral proteins driving oncogenesis by altering immune regulation, apoptosis, and tumor progression. The unique molecular landscape of NPC presents both challenges and opportunities for therapeutic development, particularly in the recurrent and metastatic (R/M) setting, where treatment resistance remains a major hurdle. While platinum-based chemotherapy has traditionally been the standard of care for R/M NPC, immune checkpoint inhibitors (ICIs) have emerged as a key component of treatment. However, both intrinsic and acquired resistance to PD-1/PD-L1 blockade underscore the need for alternative strategies, including modulation of alternative immune checkpoints and simultaneous engagement of non-redundant pathways to enhance responses and durability. Leveraging EBV-driven biology, emerging immunotherapeutic approaches, such as EBV-specific adoptive cellular therapies and therapeutic vaccines, aim to induce durable immunity to viral proteins. Additionally, targeted therapies including receptor tyrosine kinase inhibitors, epigenetic modulators, and antibody–drug conjugates are redefining precision medicine by selectively delivering cytotoxic agents to tumors. With growing insights into the biology of NPC and evolving therapeutics, the integration of immunotherapy, targeted agents, and biomarker-driven strategies is poised to transform NPC treatment, emphasizing biology-driven, multimodal approaches to optimize patient outcomes. Full article

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

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3 pages, 139 KB

Open AccessEditorial

Surgical Oncology in 2025: Challenges, Innovations, and the Road Ahead for Young Surgical Oncologists

by Jörg Kleeff and Artur Rebelo

Curr. Oncol. 2025, 32(9), 478; https://doi.org/10.3390/curroncol32090478 - 25 Aug 2025

Abstract

As cancer care becomes increasingly complex and multidisciplinary, the role of surgical oncology continues to evolve at the forefront of innovation [...] Full article

(This article belongs to the Section Surgical Oncology)

11 pages, 275 KB

Open AccessReview

The Role of Insulin Resistance in Cancer

by Bal Krishna Subedi, Charishma Bhimineni, Shivani Modi, Atousa Jahanshahi, Katherine Quiza and Daniel Bitetto

Curr. Oncol. 2025, 32(9), 477; https://doi.org/10.3390/curroncol32090477 - 25 Aug 2025

Abstract

Insulin resistance (IR) is a prevalent metabolic condition characterized by reduced cellular responsiveness to insulin and consequent hyperinsulinemia, and it is a key component of type 2 diabetes and metabolic syndrome. A growing body of evidence suggests IR is a critical accomplice in [...] Read more.

Insulin resistance (IR) is a prevalent metabolic condition characterized by reduced cellular responsiveness to insulin and consequent hyperinsulinemia, and it is a key component of type 2 diabetes and metabolic syndrome. A growing body of evidence suggests IR is a critical accomplice in the pathogenesis of various cancers. This review synthesizes evidence on underlying molecular mechanisms, including the integrated roles of the insulin/IGF system, chronic inflammation, metabolic reprogramming, and mitochondrial dysfunction. This review proposes that metabolic dysregulation should be viewed as a modifiable oncogenic force. This perspective illuminates new pathways for understanding cancer development and offers promising avenues for prevention and therapeutic intervention. Full article

14 pages, 390 KB

Open AccessArticle

Focal Therapy for Localized Prostate Cancer: A Case Series with Cost Analysis

by Maxwell Sandberg, David Thole, Jackson Nowatzke, Gavin Underwood, Emily Ye, Soroush Rais-Bahrami, Ronald Davis and Alejandro Rodriguez

Curr. Oncol. 2025, 32(9), 476; https://doi.org/10.3390/curroncol32090476 - 23 Aug 2025

Abstract

Focal therapy for prostate cancer (PCa) provides approaches to treat PCa patients in a less invasive manner than traditional whole-gland surgical or radiation modalities. This manuscript provides a case series of high-intensity focused ultrasound (HIFU), cryoablation, and irreversible electroporation (IRE) for PCa at [...] Read more.

Focal therapy for prostate cancer (PCa) provides approaches to treat PCa patients in a less invasive manner than traditional whole-gland surgical or radiation modalities. This manuscript provides a case series of high-intensity focused ultrasound (HIFU), cryoablation, and irreversible electroporation (IRE) for PCa at a single institution and cost analysis with a review of the literature. All patients who underwent HIFU, cryoablation, or IRE for localized PCa were retrospectively reviewed, excluding patients who received whole-gland therapy. Functional outcomes were erectile dysfunction and lower urinary tract symptoms. Cost data were collected. A total of 45 patients were included in the study with focal therapy ranging from 2023 to 2025 (4 HIFU, 20 cryoablation, 21 IRE). A total of 30 patients had focally treated lesions, and 15 patients had hemi-gland treatment. The mean preoperative PSA was 7.7 ng/mL. On the paired sample t-test, there was no significant difference between pre-focal and post-focal therapy PSA. Three patients experienced biochemical recurrence requiring prostate biopsy after focal treatment. Mean cost was USD 3804.50 and not significantly different by focal treatment. No metastatic events occurred nor deaths at a median follow-up of 6 months. Patients in this series had largely unaltered functional outcomes. Cost analysis in contemporary publications is lacking. Although follow-up was short, cancer control was adequate. Full article

(This article belongs to the Special Issue Evolution of Treatments of Prostate Cancer: From Biology to Current Advanced Technologies)

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14 pages, 236 KB

Open AccessArticle

Factors Associated with Quality of Life (QoL) in Adolescents and Young Adults with Cancer

by Reanna George, Geoff Eaton, Pam Crotty, Cheryl Heykoop, Norma D’Agostino, Sapna Oberoi, Joshua A. Rash and Sheila N. Garland

Curr. Oncol. 2025, 32(9), 475; https://doi.org/10.3390/curroncol32090475 - 22 Aug 2025

Abstract

Adolescents and young adults (AYAs) diagnosed with cancer between the ages of 15 and 39 years face unique challenges that impact their long-term quality of life (QoL). Physical functioning, relationship status, social support, anxiety, and depression have been associated with QoL in AYAs [...] Read more.

Adolescents and young adults (AYAs) diagnosed with cancer between the ages of 15 and 39 years face unique challenges that impact their long-term quality of life (QoL). Physical functioning, relationship status, social support, anxiety, and depression have been associated with QoL in AYAs with cancer. This study explored factors associated with increased QoL in a sample of 392 AYAs with cancer in Canada who participated in the initial Young Adult Cancer Canada RECOVER survey. The EORTC QLQ-C30 was used to measure QoL. Adjusting for relevant demographic, cancer, and clinical variables, the only factors significantly associated with QoL in multivariable analysis were symptoms of depression [Mild (β = −0.420, p < 0.001); Moderate (β = −0.937, p < 0.001); Moderately Severe (β = −1.188, p < 0.001); Severe (β = −2.182, p < 0.001)] and generalized anxiety [Mild (β = −0.244, p = 0.012); Moderate (β = −0.420, p = 0.002); Moderately severe (β = −0.400, p = 0.012); Severe (β = −0.697, p = 0.010)], as well as having completed treatment (β = −0.347, p < 0.001). Age, gender, time since diagnosis, having children, education, income, fear of recurrence, and social support were not significantly associated with QoL. These results support the need for age-appropriate resources to help AYAs manage the long-term psychological impacts of cancer. Full article

(This article belongs to the Special Issue Quality of Life and Follow-Up Care Among AYA Cancer Survivors)

14 pages, 996 KB

Open AccessArticle

The Relation Between Post-Operative Surgical Site Infection and Time to Start Adjuvant Treatment in Ovarian and Uterine Cancers

by Karlijn M. C. Cornel, Julie My Van Nguyen, Lilian T. Gien, Allan Covens and Danielle Vicus

Curr. Oncol. 2025, 32(8), 474; https://doi.org/10.3390/curroncol32080474 - 21 Aug 2025

Abstract

Surgical site infections (SSIs) occur in 10–15% of patients and are linked to up to 29% of delays in starting adjuvant treatment. This study assessed the association between SSIs in patients with ovarian and uterine cancer and their impact on time to adjuvant [...] Read more.

Surgical site infections (SSIs) occur in 10–15% of patients and are linked to up to 29% of delays in starting adjuvant treatment. This study assessed the association between SSIs in patients with ovarian and uterine cancer and their impact on time to adjuvant therapy and oncologic outcomes. Patients who underwent surgery from 1 January 2015 to 30 September 2017 were included, using institutional National Surgical Quality Improvement Program (NSQIP) data and chart reviews. Among 371 patients (median follow-up 4.1 years), 243 (65.5%) received adjuvant treatment. The median time to start was 39 days for chemotherapy, 61 days for radiotherapy, and 42 days for combined therapy (p < 0.001). Patients with ovarian cancer began treatment sooner than those with uterine cancer (39 vs. 52 days, p < 0.001), but no significant difference was observed between those with or without SSIs. In 238 patients with uterine cancer, those with SSIs had a twofold higher recurrence risk (HR 1.97, p = 0.022) and over threefold lower overall survival (HR 3.45, p = 0.018). Multivariable analysis showed that surgical route and disease stage were independent predictors; SSI was not an independent factor. No survival difference related to SSIs was found in patients with ovarian cancer. Further research is needed to clarify the impact of SSIs on treatment timing and recurrence. Full article

(This article belongs to the Special Issue Optimizing Surgical Management for Gynecologic Cancers)

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15 pages, 3719 KB

Open AccessArticle

Construction and Verification of a Predictive Nomogram for Overall Survival in Patients with Large Retroperitoneal Liposarcoma: A Population-Based Cohort Study

by Huan Deng, Zhenhua Lu, Yajie Wang, Lin Xiao and Yisheng Pan

Curr. Oncol. 2025, 32(8), 473; https://doi.org/10.3390/curroncol32080473 - 21 Aug 2025

Abstract

Objective This study aimed to show the clinicopathological characteristics of large retroperitoneal liposarcoma (RLS) and to develop a customized nomogram model for patients with large RLS. Methods A total of 1735 patients diagnosed with RLS were selected from the public SEER database. Among [...] Read more.

Objective This study aimed to show the clinicopathological characteristics of large retroperitoneal liposarcoma (RLS) and to develop a customized nomogram model for patients with large RLS. Methods A total of 1735 patients diagnosed with RLS were selected from the public SEER database. Among them, 1113 patients with a maximum tumor diameter greater than 150 mm were included for further analysis. Nomogram models were developed based on Lasso and multivariate Cox regression analyses. A total of 166 patients that presented in the same period at our institution were used for external validations. Results A larger tumor size in RLS was associated with worse survival outcomes. Lasso and Cox regression analyses consistently identified age, TNM stage, occurrence pattern, histology, and surgery as important prognostic factors for OS. The constructed model demonstrated robust predictive performance, with better time-ROC (time-dependent receiver operating characteristic) for 1-year (83.1%), 3-year (83.8%), and 5-year (81.4%) survival in the training cohort. The concordance index (C-index) was approximately 0.80 in both the training and validation cohorts, reflecting excellent discriminatory ability of the model. Survival risk stratification analysis revealed significant differences in survival outcomes of large RLS (HR = 4.12 [3.31–5.12], p < 0.001, in the training cohort). Decision curve analysis (DCA) confirmed that the nomogram provided greater net benefits across a range of threshold probabilities. Conclusion This study identified important prognostic factors for survival in patients with large RLS and developed a reliable nomogram for predicting OS. The model’s strong predictive performance supports its use in personalized treatment strategies, improving prognosis assessment and clinical decision making for these patients. Full article

(This article belongs to the Special Issue Sarcoma Surgeries: Oncological Outcomes and Prognostic Factors)

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16 pages, 3553 KB

Open AccessArticle

Real-World Effectiveness and Safety of Immune Checkpoint Inhibitors Combined with Chemotherapy in Taiwanese Patients with Extensive-Stage Small Cell Lung Cancer

by Cheng-Yu Chang, Yu-Feng Wei, Shih-Chieh Chang and Chung-Yu Chen

Curr. Oncol. 2025, 32(8), 472; https://doi.org/10.3390/curroncol32080472 - 19 Aug 2025

Abstract

Purpose: Extensive-stage small cell lung cancer (ES-SCLC) has poor prognosis. While immune checkpoint inhibitors (ICIs) with chemotherapy show survival benefits in trials, real-world data from Asia are scarce. This study evaluates real-world efficacy and safety of chemotherapy with or without ICIs in Taiwanese [...] Read more.

Purpose: Extensive-stage small cell lung cancer (ES-SCLC) has poor prognosis. While immune checkpoint inhibitors (ICIs) with chemotherapy show survival benefits in trials, real-world data from Asia are scarce. This study evaluates real-world efficacy and safety of chemotherapy with or without ICIs in Taiwanese patients with ES-SCLC and identifies survival predictors. Materials and Methods: A retrospective cohort study analyzed 114 patients with ES-SCLC treated between 2017 and 2023 at four Taiwanese medical centers. Patients received first-line chemotherapy alone (n = 68) or with ICIs (atezolizumab, durvalumab, pembrolizumab; n = 46). Primary endpoints were overall survival (OS) and progression-free survival (PFS), assessed via Kaplan–Meier methods and Cox regression. Results: Baseline characteristics were comparable, except poorer ECOG performance (≥2) in the chemotherapy group (27% vs. 9%; p = 0.021). IO–chemotherapy significantly improved OS (16.1 vs. 9.4 months; HR = 0.32, 95% CI: 0.20–0.52; p < 0.001) and PFS (7.8 vs. 5.5 months; HR = 0.40, 95% CI: 0.26–0.63; p < 0.001). Multivariate analysis confirmed IO–chemotherapy as an independent positive predictor (OS adjusted HR = 0.25, 95% CI: 0.14–0.44; PFS adjusted HR = 0.37, 95% CI: 0.22–0.61; both p < 0.001). Skin rash was more common with IO–chemotherapy (24% vs. 3%; p < 0.001). Immune-related adverse events (AEs) correlated with improved survival (median OS: 21.4 months with 1–2 AEs, 16.6 months with 3–4 AEs, 12.5 months without AEs). Conclusion: Immunochemotherapy significantly improves survival in Taiwanese patients with ES-SCLC, with manageable toxicity, supporting ICIs’ incorporation into standard treatment. Full article

(This article belongs to the Special Issue Clinical Advances and Therapeutic Challenges in Small-Cell Lung Cancer and Rare Thoracic Cancers)

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13 pages, 788 KB

Open AccessArticle

Treatment Disparities, Heterogeneities, and Barriers to Access for Patients with Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer: A National Survey from Brazil

by Heloisa Resende, Vinícius de Q. Aguiar, Nataline F. de A. Santos, João Vitor Siqueira Jardim and André Ornelas

Curr. Oncol. 2025, 32(8), 471; https://doi.org/10.3390/curroncol32080471 - 19 Aug 2025

Abstract

Breast cancer (BC) is the most common malignancy among Brazilian women, with a high percentage of the cases diagnosed at advanced or metastatic stages (mBC). In Brazil, where 75% of the population depends on the resource-limited public health system (SUS), mBC poses significant [...] Read more.

Breast cancer (BC) is the most common malignancy among Brazilian women, with a high percentage of the cases diagnosed at advanced or metastatic stages (mBC). In Brazil, where 75% of the population depends on the resource-limited public health system (SUS), mBC poses significant treatment challenges and disparities. To characterize this scenario, we conducted an online survey assessing treatment strategies available for HER2-negative, hormone receptor (HR)-positive mBC across public and private health systems. The 48-question survey addressed topics such as waiting time (WT) from oncology unit entry to treatment initiation, availability of oncologic medications, and access to palliative and multidisciplinary care teams. Between 2 August 2022 and 30 September 2022, a total of 180 oncologists were invited, and 150 met the inclusion criteria. The median WT for surgery was 60 days in the SUS versus 30 days in the private sector (p < 0.0001), and for chemotherapy, 30 days in the SUS versus 15 days privately (p < 0.0001). Endocrine therapy was the preferred first-line treatment in the SUS (83.3%), while fulvestrant was available to only 48% of respondents. Additionally, specialized palliative care teams were available according to 66% of SUS respondents compared with 82% in the private system (p = 0.001). These findings underscore persistent disparities in mBC treatment, likely driven by limited governmental health investment. Full article

(This article belongs to the Section Breast Cancer)

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13 pages, 857 KB

Open AccessCase Report

Extended Survival with Pancreatic Carcinosarcoma: A Case Report and Literature Review

by Tian Xiao, Claire Browne, Morgan Black, Celia Marginean and Elena Tsvetkova

Curr. Oncol. 2025, 32(8), 470; https://doi.org/10.3390/curroncol32080470 - 18 Aug 2025

Abstract

Pancreatic carcinosarcoma is a rare and aggressive malignancy that can mimic pancreatic adenocarcinomas in presentation but often has different disease biology and different responses to conventional treatment for pancreatic adenocarcinoma. Case reports have documented a 5-year overall survival of approximately 13% only if [...] Read more.

Pancreatic carcinosarcoma is a rare and aggressive malignancy that can mimic pancreatic adenocarcinomas in presentation but often has different disease biology and different responses to conventional treatment for pancreatic adenocarcinoma. Case reports have documented a 5-year overall survival of approximately 13% only if the disease is caught at an earlier stage and is amenable to multi-modality treatment, including surgery, chemotherapy, and radiation. In the advanced stage, treatments do not often provide benefit, and patients may decline rapidly. There are currently no studies demonstrating survival benefits with chemotherapy in patients with metastatic carcinosarcoma, owing to both the rarity and the often late diagnosis of this aggressive entity. We present a case of a 71-year-old male patient diagnosed with metastatic pancreatic carcinosarcoma who received four lines of palliative-intent treatment: gemcitabine and nab-paclitaxel, modified FOLFIRINOX, GTX, and doxorubicin. With careful selection of chemotherapeutic regimen as well as his ability to tolerate four lines of treatment, this resulted in an unprecedented 26-month survival. We also reviewed the literature on the histopathology, diagnosis, and treatment of this rare entity. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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8 pages, 279 KB

Open AccessCase Report

Pembrolizumab-Induced Simultaneous and Refractory Systemic Capillary Leak and Cytokine Release Syndromes: A Case Report

by Eugénie Roberge-Maltais, Eric Lévesque, Vincent Castonguay, Nicolas Marcoux, Louis-Philippe Grenier and Martin Veilleux

Curr. Oncol. 2025, 32(8), 469; https://doi.org/10.3390/curroncol32080469 - 18 Aug 2025

Abstract

Systemic Capillary Leak Syndrome (SCLS) and Cytokine Release Syndrome (CRS) have both been described as rare but severe adverse reactions induced by Programmed cell death protein 1 (PD-1) inhibitors such as pembrolizumab. We report the case of a 40-year-old woman undergoing treatment with [...] Read more.

Systemic Capillary Leak Syndrome (SCLS) and Cytokine Release Syndrome (CRS) have both been described as rare but severe adverse reactions induced by Programmed cell death protein 1 (PD-1) inhibitors such as pembrolizumab. We report the case of a 40-year-old woman undergoing treatment with pembrolizumab for a stage 4 cervical squamous cell carcinoma who presented with anasarca, hypotension, hemoconcentration and signs of multisystemic inflammation. After elimination of alternative causes such as nephrotic syndrome, cardiac dysfunction and cirrhosis, she was diagnosed with both pembrolizumab-induced SCLS and CRS. She was successfully treated with a multimodal treatment approach including intravenous immunoglobulins, steroids, diuretics and axitinib for SCLS as well as ruxolitinib for CRS. After several months of hospitalization, her symptoms finally improved with this treatment regimen, and she was able to attain euvolemic state and be discharged from the hospital. This case highlights certain rare and severe adverse effects of treatment with PD-1 inhibitors. Furthermore, it proposes a novel therapeutic approach for similar cases based upon probable underlying physiopathological mechanisms in SCLS and CRS. Full article

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13 pages, 472 KB

Open AccessArticle

Association Between Quality of Discharge Teaching and Post-Discharge Coping Difficulty in Postoperative Lung Cancer Patients: A Chain Mediation Model

by Minghui Wang, Hailing Tu and Jingfang Hong

Curr. Oncol. 2025, 32(8), 468; https://doi.org/10.3390/curroncol32080468 - 18 Aug 2025

Abstract

The post-discharge coping difficulties experienced by patients can affect their quality of life and the occurrence of unplanned readmissions. This study aimed to explore the chain mediation effect of self-efficacy and readiness for hospital discharge between quality of discharge teaching and post-discharge coping [...] Read more.

The post-discharge coping difficulties experienced by patients can affect their quality of life and the occurrence of unplanned readmissions. This study aimed to explore the chain mediation effect of self-efficacy and readiness for hospital discharge between quality of discharge teaching and post-discharge coping difficulty among postoperative lung cancer patients. This study employed a cross-sectional design and surveyed 358 postoperative patients with lung cancer. Demographic and Disease-Related Data Questionnaire, Quality of Discharge Teaching Scale, General Self-Efficacy Scale, Readiness for Hospital Discharge Scale, and Post-Discharge Coping Difficulty Scale were used. A structural equation model was utilized to explore the mediation effects of self-efficacy and readiness for hospital discharge. The total score for post-discharge coping difficulty among postoperative lung cancer patients was 34.32 ± 10.00. Quality of discharge teaching not only directly negatively predicted post-discharge coping difficulty (β = −0.154, p < 0.05), but also indirectly affected it through the chain mediation effect of self-efficacy and readiness for hospital discharge (β = −0.040, p = 0.001). Healthcare providers should pay attention to postoperative lung cancer patients’ post-discharge coping difficulties and formulate targeted discharge teaching strategies to enhance patients’ self-efficacy and readiness for discharge to alleviate their post-discharge coping difficulties. Full article

(This article belongs to the Section Thoracic Oncology)

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21 pages, 1925 KB

Open AccessReview

Targeting Senescence in Oncology: An Emerging Therapeutic Avenue for Cancer

by Satoru Meguro, Syunta Makabe, Kei Yaginuma, Akifumi Onagi, Ryo Tanji, Kanako Matsuoka, Seiji Hoshi, Tomoyuki Koguchi, Emina Kayama, Junya Hata, Yuichi Sato, Hidenori Akaihata, Masao Kataoka, Soichiro Ogawa, Motohide Uemura and Yoshiyuki Kojima

Curr. Oncol. 2025, 32(8), 467; https://doi.org/10.3390/curroncol32080467 - 18 Aug 2025

Abstract

Since cancer is often linked to the aging process, the importance of cellular senescence in cancer has come under the spotlight. While senescence in cancer cells can serve as a natural barrier against cancer due to its proliferation arrest, its secretory phenotypes and [...] Read more.

Since cancer is often linked to the aging process, the importance of cellular senescence in cancer has come under the spotlight. While senescence in cancer cells can serve as a natural barrier against cancer due to its proliferation arrest, its secretory phenotypes and alterations in the surface proteome can paradoxically promote or suppress tumor progression. Senescent cancer-associated fibroblasts, endothelial cells, and immune cells can also contribute to cancer promotion. During therapeutic interventions for cancer, not only their therapeutic effects, but also therapy-induced senescence may have an impact on cancer outcomes. Senotherapeutics, therapy targeting senescent cells, have been reported as novel cancer therapy in recent studies, and the combination of senescence induction and senotherapeutics has been increasingly recognized. Although some clinical trials of senotherapeutic drugs for cancer with or without senescence-inducible therapy are ongoing, there is as yet no satisfactory clinical application. With further research into targeting senescence in oncology, it is expected that senotherapeutics, particularly in combination with senescence-inducing therapy, will become a novel therapeutic strategy. Full article

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