Current Oncology

18 pages, 803 KB

Open AccessArticle

Idiopathic Pneumonia Syndrome and Pulmonary Toxicity After Total Body Irradiation for Bone Marrow Transplantation in the Modern Transplant Era

by Ruijia Jin, Justin Oh, Iman Baharmand, Matthew Chan, Jessica Chan, Andrea C. Lo, Cassidy Northway, Conrad Yuen, I. A. Popescu, T. P. L. Nghiem, Yasser Abou Mourad and Cheryl Duzenli

Curr. Oncol. 2026, 33(9), 545; https://doi.org/10.3390/curroncol33090545 - 9 Sep 2026

Abstract

Total body irradiation (TBI) is commonly used for myeloablative conditioning prior to allogeneic hematopoietic stem cell transplantation (HSCT) in high-risk, relapsed, or refractory hematologic malignancies. Pulmonary toxicity (PT)—including pneumonia, diffuse alveolar hemorrhage, and interstitial pneumonitis—is a serious complication after HSCT. Idiopathic pneumonia syndrome [...] Read more.

Total body irradiation (TBI) is commonly used for myeloablative conditioning prior to allogeneic hematopoietic stem cell transplantation (HSCT) in high-risk, relapsed, or refractory hematologic malignancies. Pulmonary toxicity (PT)—including pneumonia, diffuse alveolar hemorrhage, and interstitial pneumonitis—is a serious complication after HSCT. Idiopathic pneumonia syndrome (IPS), defined as widespread alveolar injury without cardiogenic or infectious causes, represents a non-infectious form of PT. This study characterizes PT and IPS and explores associated factors following TBI-based HSCT in adults. We conducted a retrospective review of a prospectively collected database of adult patients treated with TBI-based HSCT from 2015 to 2022. Clinical records and chest imaging were reviewed to identify PT and IPS. IPS occurred in 20 patients (18%) of the cohort, with 8 patients (7%) within 100 days and 13 patients (13%) after 100 days. One patient experienced both early- and late-onset IPS and was counted once in the cumulative analysis. Early pulmonary infection was associated with reduced overall survival in both univariable (p = 0.002) and multivariable 100-day landmark analyses (p = 0.047). Acute graft-versus-host disease (GVHD) was independently associated with improved survival (p = 0.017), whereas chronic GVHD was not statistically significant in the landmark analyses. PT and IPS incidences were consistent with previously published adult TBI cohorts. While no significant clinical or radiation-related predictors of IPS were identified, pulmonary infection emerged as a predictor of inferior overall survival. Full article

(This article belongs to the Special Issue 2nd Edition: Allogeneic Stem Cell Transplantation: Does the Conditioning Regimen Intensity Still Matter?)

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17 pages, 31178 KB

Open AccessCase Report

High-Grade Chondrosarcoma Involving the Xiphoid Process and Lower Sternum—The Continuing Role of Extended Open Chest Wall Surgery in the Era of Minimally Invasive Thoracic Surgery: A Case Report

by Thomas Rallis, Maria Mironidou-Tzouveleki, Vasileios Theocharidis, Apostolos Gogakos, Dimitrios Paliouras, Achilleas Lazopoulos, Nikolaos Christoglou, Panagiotis Panousis, Michael Katsamakas, Paraskevas Vrochidis, Meropi Koutourini, Myrto Tzinevi, Pipitsa Valsamaki, Alexandra Mpakosi and Nikolaos Barmpetakis

Curr. Oncol. 2026, 33(9), 544; https://doi.org/10.3390/curroncol33090544 - 9 Sep 2026

Abstract

Primary chondrosarcoma of the sternum is a rare malignancy whose anatomical location can create major diagnostic, resection, and reconstruction challenges. We report a 62-year-old man with severe obesity and a heavy smoking history who presented with a progressively enlarging, painful sternal swelling. Preoperative [...] Read more.

Primary chondrosarcoma of the sternum is a rare malignancy whose anatomical location can create major diagnostic, resection, and reconstruction challenges. We report a 62-year-old man with severe obesity and a heavy smoking history who presented with a progressively enlarging, painful sternal swelling. Preoperative imaging conducted via computed tomography and positron emission tomography–computed tomography demonstrated a large heterogeneous mass at the anterior thoracoabdominal junction infiltrating the xiphoid process. CT-guided biopsy established grade III chondrosarcoma. Because of the tumor’s size, location, and infiltrative features, bilateral transverse thoraco-sternotomy (“Clamshell” Procedure) was performed. “En bloc” resection included the middle and lower sternum, involved soft tissues and adjacent costal arches, followed by prosthetic synthetic polypropylene mesh reconstruction. The final pathology documented tumor-free examined margins (R₀), with an approximately 10 mm closest reported clearance. The postoperative course was prolonged and complex. The patient required 18 days of intensive care and tracheostomy on postoperative day 8 because of delayed awakening and intermittent oxygen desaturation. Wound dehiscence necessitated surgical revisions on postoperative days 29 and 44; during the second revision, the infected mesh was removed. The tracheostomy was removed on day 64, and the patient was discharged in a stable condition two days later. This case demonstrates that extensive open approaches remain indispensable for selected chest wall malignancies. It also emphasizes the importance of coordinated multidisciplinary perioperative care from diagnosis through recovery, while illustrating how reconstructive resources, patient risk, and infection can determine the procedure’s outcome. Full article

(This article belongs to the Section Thoracic Oncology)

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Graphical abstract

16 pages, 275 KB

Open AccessArticle

From Availability to Access: A Mixed-Methods Study of Digital Prostate Cancer Survivorship Support for Black Men

by Olamide Okedara, Gabriela Ilie, Maren Brodovsky, Ross J. Mason, Ricardo Rendon, Andrea Kokorovic, Greg Bailly, Howard Evans, Kunal Jana, Jasmir G. Nayak, Ernest Chan, Stanley Flax, Nikhilesh Patil, David Bowes, Duvern Ramiah, Shingai Mutambirwa, Andrew Oberholzer, Lola Riley, Jordan Cole, William Carruthers, Sarah Taylar and Robert David Harold Rutledge Show full author list Hide full author list

Curr. Oncol. 2026, 33(9), 543; https://doi.org/10.3390/curroncol33090543 - 9 Sep 2026

Abstract

Introduction: Black men experience persistent disparities across the prostate cancer continuum, including inequities in access to survivorship support. This study examined the perceived value, acceptability, and experiences of accessing a multicomponent digital survivorship program among Black men with prostate cancer. Methods: This exploratory [...] Read more.

Introduction: Black men experience persistent disparities across the prostate cancer continuum, including inequities in access to survivorship support. This study examined the perceived value, acceptability, and experiences of accessing a multicomponent digital survivorship program among Black men with prostate cancer. Methods: This exploratory mixed-methods study was embedded within the ongoing international Phase 4 implementation trial of the Prostate Cancer Patient Empowerment Program (PC-PEP), a six-month digital intervention integrating exercise, pelvic floor muscle training, nutrition, stress management, psychosocial support, and peer connection. Fourteen self-identified Black participants contributed six-month program evaluation and qualitative data collected through open-ended responses and conference-based focus group discussions. Nine participants (64%) had undergone surgery with or without radiation and/or hormone therapy, four (29%) had received radiation with or without hormone therapy, and one (7%) was on active surveillance or had received no treatment. Quantitative data were summarized descriptively, and qualitative data were analyzed using inductive thematic analysis. Results: PC-PEP was highly valued, with median ratings of 10 (IQR 8–10) for likelihood of recommending the program and 9 (IQR 8–10) for overall usefulness. Among participants with available item-level data, 11/13 (85%) reported lifestyle improvement and 12/13 (92%) endorsed offering PC-PEP as standard care. Qualitative findings identified the value of holistic survivorship support, peer connection, normalization of vulnerability, and support for physical and psychological self-management. Participants also described limited awareness of PC-PEP at diagnosis and reliance on individual clinicians or incidental opportunities to learn about the program. Participants emphasized the need for earlier referral, greater representation, and culturally relevant community outreach. Conclusions: Black men who accessed PC-PEP reported high perceived value and identified benefits across multiple dimensions of survivorship. Their experiences, however, highlighted an important distinction between program availability and meaningful access: participants’ experiences suggest that availability alone may not ensure timely connection to survivorship support. Earlier referral, culturally responsive outreach, and integration of survivorship support into routine prostate cancer care may help close this gap. Full article

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

17 pages, 2049 KB

Open AccessFeature PaperArticle

Toxicity, Dose Intensity, and Clinical Outcomes with First-Line Enfortumab Vedotin Plus Pembrolizumab in Advanced Urothelial Carcinoma: A Multicenter Real-World Study

by Samad Sayed, Rishikesh Kumar, Martin Zarba, Md Mahsin, Amina Taleb, Lateefah Alshammari, Simon Mairs, Naveen Basappa, Michael Kolinsky, Meghan Mahoney, Vishal Navani, Tina Cheng, Safiya Karim, Richard Lee-Ying, Steven Yip, Daniel Y. C. Heng, Scott North and Nimira Alimohamed

Curr. Oncol. 2026, 33(9), 542; https://doi.org/10.3390/curroncol33090542 - 9 Sep 2026

Abstract

Background: Enfortumab vedotin plus pembrolizumab (EVP) is the standard first-line treatment for locally advanced or metastatic urothelial carcinoma (la/mUC); however, real-world toxicity patterns, timing of onset, and prognostic significance of treatment-related adverse events (AEs) remain incompletely characterized. Methods: We conducted a retrospective, multicenter [...] Read more.

Background: Enfortumab vedotin plus pembrolizumab (EVP) is the standard first-line treatment for locally advanced or metastatic urothelial carcinoma (la/mUC); however, real-world toxicity patterns, timing of onset, and prognostic significance of treatment-related adverse events (AEs) remain incompletely characterized. Methods: We conducted a retrospective, multicenter analysis of 60 la/mUC patients treated with first-line EVP in Alberta, Canada (September 2024–January 2026). Treatment related toxicities, time to AE onset, dose modifications, and treatment discontinuation were assessed. Progression-free survival (PFS) and overall survival (OS) were analyzed. Results: The median age was 69 years, 82% of patients were male, and 80% had metastatic disease at treatment initiation. Histology was pure urothelial in 82% and mixed in 18%. Median follow-up was 10.3 months, and the median number of EV and pembrolizumab cycles was seven and eight, respectively. Rash (63%), fatigue (57%), and peripheral neuropathy (47%) were the most common adverse events, with median onset at 17, 29, and 90 days, respectively. Dose reductions occurred in 62%, dose delays in 43%, and treatment discontinuation in 38%. An initial enfortumab vedotin dose of 1.25 mg/kg was associated with improved PFS (HR 0.30, 95% CI 0.13–0.68; p = 0.004) and OS (HR 0.32, 95% CI 0.10–0.97; p = 0.044) compared with 1.0 mg/kg. Neuropathy was associated with improved PFS (HR 0.32, 95% CI 0.14–0.73; p = 0.007) and OS (HR 0.24, 95% CI 0.07–0.87; p = 0.029), while rash was associated with improved OS (HR 0.31, 95% CI 0.11–0.91; p = 0.032). Conclusions: EVP was associated with frequent treatment-related adverse events requiring dose modifications, and the development of rash and peripheral neuropathy was associated with favorable survival outcomes. Full article

(This article belongs to the Section Genitourinary Oncology)

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9 pages, 648 KB

Open AccessArticle

Investigating Quality of Life and Decision Regret in Patients Undergoing Laryngectomy

by Dagmawi Lulseged, Jedeiah Dickerson, Lauren Ottenstein, Margie Dixon, Rebecca Pentz and Nicole C. Schmitt

Curr. Oncol. 2026, 33(9), 541; https://doi.org/10.3390/curroncol33090541 - 9 Sep 2026

Abstract

Total laryngectomy is a surgical procedure for advanced laryngeal cancer and can affect speech, swallowing, and breathing. This study compared the quality of life, swallowing function, and decision regret among patients who underwent primary total laryngectomy with adjuvant radiation (Group 1) versus salvage [...] Read more.

Total laryngectomy is a surgical procedure for advanced laryngeal cancer and can affect speech, swallowing, and breathing. This study compared the quality of life, swallowing function, and decision regret among patients who underwent primary total laryngectomy with adjuvant radiation (Group 1) versus salvage laryngectomy (Group 2). A survey was completed by 25 Group 1 patients and 27 Group 2 patients. Quality of life and swallowing ability were assessed using the University of Washington Quality of Life Questionnaire (UW-QOL) and M.D. Anderson Dysphagia Inventory (MDADI), while decision regret was measured using the Decision Regret Scale. Group 1 patients reported a higher mean total UW-QOL score (74.4) than Group 2 (68.2). Similarly, Group 1 patients demonstrated better swallowing outcomes, with a mean MDADI score of 70.28 compared to 63.90 in Group 2. Decision Regret scores were lower in Group 1 patients (31.4) than in Group 2 (35.37), indicating less regret regarding treatment decisions. However, all these differences did not reach statistical significance. Overall, these findings highlight the importance of fully informing patients of the impact of surgery on quality of life to assist them in their decision-making. Future studies can recruit larger cohorts and investigate the effectiveness of other laryngectomy treatments/procedures. Full article

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

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24 pages, 4527 KB

Open AccessArticle

Assessing Quality Gaps and Clinician Perspectives on AI Integration in Colorectal Cancer NGS Pathways

by Luxiga Thanabalachandran, Darya Ali, Avery Newman-Simmons, Claire Norman, Daniel Jafari, Tamara Grahovac, Aaron Pollett, Weei-Yuarn Huang, Lina Chen, Shaqil Kassam, Carly C. Barron, Suneil Khanna, Kristin Wright, Stephanie Snow, Ron Burkes, Tao Wang, Andrea Grin, Taylor Moffat and Yuchen Li

Curr. Oncol. 2026, 33(9), 540; https://doi.org/10.3390/curroncol33090540 - 9 Sep 2026

Abstract

Next-generation sequencing (NGS) is integral to colorectal cancer (CRC) care, but its value depends on results being available when treatment decisions are made. We conducted a qualitative study to identify quality gaps in CRC NGS pathways and assess perspectives on digital and artificial [...] Read more.

Next-generation sequencing (NGS) is integral to colorectal cancer (CRC) care, but its value depends on results being available when treatment decisions are made. We conducted a qualitative study to identify quality gaps in CRC NGS pathways and assess perspectives on digital and artificial intelligence (AI)-enabled workflow support. Semi-structured interviews were conducted with 22 medical oncologists and pathologists from 14 Ontario hospitals, and transcripts were analyzed thematically. Five themes emerged: (1) clinical indications and test ordering, where initiation was inconsistent because of unclear reflex-testing criteria, reliance on upstream clinicians, staging uncertainty, evolving indications, and funding constraints; (2) tissue, pathology, and laboratory workflow, where participants attributed bottlenecks and turnaround variability to send-out testing, staffing, infrastructure, and capacity; (3) interdisciplinary communication and tracking, where informal communication, unclear ownership, and manual tracking highlighted the need for closed-loop confirmation and alerts; (4) reporting and clinical integration, where report clarity, interpretability, and timing affected use; and (5) electronic health record integration and AI integration, where fragmented systems and limited interoperability delayed result access. Participants supported clinician-supervised digital or AI-enabled tools for case identification, triage, tracking, and overdue-result alerts. CRC NGS optimization requires standardized reflex criteria, clearer ownership, closed-loop tracking, reliable routing, structured reporting, and interoperable infrastructure. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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14 pages, 640 KB

Open AccessArticle

Community-Based HPV Self-Sampling to Enhance Access to Cervical Cancer Prevention: A Continuum-of-Care Model from Urban Nepal

by Shreekrishna Maharjan, Anamika Maharjan, Kushala K. Bista, Pranali G. Patel, Jitendra Pariyar, Pema Lhaki and Sadeep Shrestha

Curr. Oncol. 2026, 33(9), 539; https://doi.org/10.3390/curroncol33090539 - 5 Sep 2026

Abstract

Cervical cancer remains the leading cause of cancer-related mortality among women in Nepal, where national screening coverage is approximately 16%. This study evaluated the feasibility of a community-based, door-to-door self-sampling strategy for high-risk human papillomavirus (hrHPV) detection in an urban municipality of central [...] Read more.

Cervical cancer remains the leading cause of cancer-related mortality among women in Nepal, where national screening coverage is approximately 16%. This study evaluated the feasibility of a community-based, door-to-door self-sampling strategy for high-risk human papillomavirus (hrHPV) detection in an urban municipality of central Nepal and assessed hrHPV prevalence, genotype distribution, screening outcomes, and associated demographic factors. A cross-sectional study was conducted between September 2023 and May 2024 in Ward No. 3 of Lalitpur Metropolitan City. Women aged 30–60 years were recruited through trained community health workers, provided education and home-based self-sampling kits, and completed a demographic questionnaire. Dry cervical swabs from 418 participants were tested for hrHPV. Women with positive results underwent visual inspection with acetic acid (VIA), followed by colposcopy, biopsy when indicated, and thermal ablation for confirmed precancerous lesions. Overall participation was 64.1%, and hrHPV prevalence was 10.3%. Non-16/18 hrHPV genotypes predominated (55.8%), followed by HPV16 (20.9%). Women aged > 50 years were more likely to be hrHPV- and VIA-positive (OR = 7.39, p = 0.02). Six pre-cancer cases were identified: five cervical intraepithelial neoplasia (CIN1) and one CIN3 case. Community-based hrHPV self-sampling was found to be feasible and achieved effective linkage to triage and treatment, supporting its consideration for strengthening cervical cancer screening in Nepal. Full article

(This article belongs to the Special Issue Global Strategies and Equity Challenges in Cervical Cancer Prevention and Elimination)

14 pages, 1907 KB

Open AccessArticle

Higher Negative Margin Rates with Intraoperative Ultrasound-Guided Excision for Myxofibrosarcoma: A Single-Center Cohort Study with External Comparisons

by Youngkeun Lee, Sujin Lee, Sang Ah Chi and Sung Wook Seo

Curr. Oncol. 2026, 33(9), 538; https://doi.org/10.3390/curroncol33090538 - 4 Sep 2026

Abstract

Background/Objectives: Myxofibrosarcoma (MFS) shows infiltrative fascial extensions that complicate margin achievement and drive local recurrence. We evaluated whether intraoperative ultrasound guidance improves negative margin achievement and oncological outcomes compared with conventional excision. Methods: In this retrospective cohort study at a single [...] Read more.

Background/Objectives: Myxofibrosarcoma (MFS) shows infiltrative fascial extensions that complicate margin achievement and drive local recurrence. We evaluated whether intraoperative ultrasound guidance improves negative margin achievement and oncological outcomes compared with conventional excision. Methods: In this retrospective cohort study at a single tertiary referral center, patients with MFS underwent conventional excision (2008–2013; n = 15) or ultrasound-guided excision (2014–2024; n = 50; primary comparative analysis n = 47 after excluding three patients). The primary outcome was negative margin achievement; secondary outcomes were overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS). Exploratory matching-adjusted indirect comparisons (MAICs) were performed against seven published international MFS cohorts. Results: Overall R0 (negative) margin rates did not differ between cohorts (97.9% vs. 93.3%; p = 0.428). Among R0 margins, however, a wide clearance (R0-wide, ≥1 mm) was more frequent in the US-guided cohort, whereas R0-close (<1 mm) margins predominated after conventional excision (R0-wide 83.0% vs. 46.7%; odds ratio 5.38, 95% CI 1.30–23.73; p = 0.014). Median follow-up was 49 months; five-year OS, LRFS, and DMFS were 97.5%, 94.3%, and 83.7%. In the internal historical comparison, LRFS was directionally higher with ultrasound guidance (94.3% vs. 68.2%; HR 0.26; p = 0.059). In MAICs, LRFS favored the US-guided cohort in all five comparisons and OS in two of four. Conclusions: Intraoperative ultrasound guidance was associated with a higher rate of wide (R0-wide, ≥1 mm) negative margins and favorable local disease control in MFS; whether wider microscopic clearance itself improves local control requires prospective multicenter evaluation. Full article

(This article belongs to the Special Issue Advances in the Orthopaedic Oncology)

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13 pages, 1670 KB

Open AccessArticle

Post-Mastectomy Emergency Department Visits in Alberta: Understanding Patient Perspectives

by Emily M. Heath, Julia Chai, Susan Isherwood, Riley Martens Mulangu, Steven Langer and May Lynn Quan

Curr. Oncol. 2026, 33(9), 537; https://doi.org/10.3390/curroncol33090537 - 4 Sep 2026

Abstract

Same-day surgery for mastectomy increased in Alberta from 1.7% to 73% in 2022, after implementation of a perioperative pathway in 2016. However, rates of unplanned visits to the emergency department (ED) remained >20%. Previous research explored reasons for this using administrative data but [...] Read more.

Same-day surgery for mastectomy increased in Alberta from 1.7% to 73% in 2022, after implementation of a perioperative pathway in 2016. However, rates of unplanned visits to the emergency department (ED) remained >20%. Previous research explored reasons for this using administrative data but lacked patient-level data. Our study aims to explore patient-reported factors influencing unplanned ED visits after mastectomy. A survey study was conducted of patients who underwent mastectomy in Alberta between July 2021 and June 2022. Patients were identified from the Canadian Institute of Health Information database; chart review was performed to confirm ED visit details. Survey questions evaluated medical, socioeconomic, and psychologic domains, as well as patient-reported experiences of perioperative care. Of 556 patients who underwent mastectomy during the study period, 23% presented to the ED unplanned within 30 days. The survey was sent to 87 patients meeting inclusion criteria; 38% responded. Most patients presented on a weekend, stating the ED was the only choice available at the time. The most common patient concerns were related to infection (38%) and drain function (38%). Despite high postoperative ED visit rates, overall, 84% felt prepared for surgery, only 15% felt uncomfortable with drain management, and 78% of patients were satisfied with surgery. Difficulty accessing their surgical team postoperatively was reported as the main challenge. Future initiatives should focus on improved access to outpatient care and education on post-mastectomy emergencies. Full article

(This article belongs to the Section Breast Cancer)

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15 pages, 17273 KB

Open AccessCase Report

Long-Term Cutaneous Hyperpigmentation During Adjuvant Osimertinib Therapy in a Resected Stage IIB EGFR L858R-Mutated Lung Adenocarcinoma in an Older Adult: A Rare Case Report with Two-Year Follow-Up and Literature Review

by Marclesson Santos Alves, Juliana Palácio de Queiroz Ventura Barros, Danielle Calheiros Campelo Maia, Igor Santos Costa, Ormando Rodrigues Campos Junior and Howard Lopes Ribeiro Junior

Curr. Oncol. 2026, 33(9), 536; https://doi.org/10.3390/curroncol33090536 - 3 Sep 2026

Abstract

The use of targeted therapies has improved outcomes in patients with resected epidermal growth factor receptor-mutated non-small cell lung cancer, but uncommon and persistent dermatologic toxicities remain poorly characterized. We report a 71-year-old woman with resected lung adenocarcinoma harboring an epidermal growth factor [...] Read more.

The use of targeted therapies has improved outcomes in patients with resected epidermal growth factor receptor-mutated non-small cell lung cancer, but uncommon and persistent dermatologic toxicities remain poorly characterized. We report a 71-year-old woman with resected lung adenocarcinoma harboring an epidermal growth factor receptor exon 21 L858R mutation. Following right upper lobectomy and systematic mediastinal lymph node dissection, pathological staging was pT2aN1M0 (stage IIB). She received four cycles of adjuvant cisplatin plus pemetrexed followed by planned three-year adjuvant Osimertinib. During Osimertinib treatment, she developed a persistent violaceous rash accompanied by progressive cutaneous hyperpigmentation. Osimertinib was temporarily interrupted, and dermatologic evaluation was performed, resulting in partial clinical improvement. Hyperpigmentation, however, persisted during follow-up. Other adverse events included grade 1 diarrhea, transient arthralgia, anorexia, and weight loss. Osimertinib was subsequently resumed and maintained. Nearly two years after surgery, the patient remains free of disease recurrence, with stable pigmentary skin changes. This case highlights an uncommon and prolonged dermatologic manifestation associated with Osimertinib and emphasizes the importance of recognizing atypical cutaneous toxicity to facilitate appropriate management and to facilitate appropriate dermatologic evaluation and individualized management of treatment-related toxicity. Full article

(This article belongs to the Section Thoracic Oncology)

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Graphical abstract

3 pages, 151 KB

Open AccessCorrection

Correction: Gould et al. Emergency Use of Targeted Osmotic Lysis for the Treatment of a Patient with Aggressive Late-Stage Squamous Cell Carcinoma of the Cervix. Curr. Oncol. 2021, 28, 2115–2122

by Harry J. Gould III, Paige R. Miller, Samantha Edenfield, Kelly Jean Sherman, Chad K. Brady and Dennis Paul

Curr. Oncol. 2026, 33(9), 535; https://doi.org/10.3390/curroncol33090535 - 3 Sep 2026

Abstract

In the original publication [...] Full article

16 pages, 5052 KB

Open AccessArticle

Pretreatment Ki67-to-ADC Ratio Predicts Prognosis in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy: A Retrospective Cohort Study

by Jun Fan, Lin Lin, Yang Tao, Yanjia Fan, Yudi Jin and Fajin Lv

Curr. Oncol. 2026, 33(9), 534; https://doi.org/10.3390/curroncol33090534 - 2 Sep 2026

Abstract

(1) Background: Neoadjuvant chemotherapy (NAC) is important for breast cancer, but prognosis varies widely. Ki67 and apparent diffusion coefficient (ADC) reflect proliferation and cellularity, respectively. This study evaluated the prognostic value of the Ki67/ADC ratio (KA) and post-treatment ADC change (δADC) in breast [...] Read more.

(1) Background: Neoadjuvant chemotherapy (NAC) is important for breast cancer, but prognosis varies widely. Ki67 and apparent diffusion coefficient (ADC) reflect proliferation and cellularity, respectively. This study evaluated the prognostic value of the Ki67/ADC ratio (KA) and post-treatment ADC change (δADC) in breast cancer patients receiving NAC, and developed a survival prediction model incorporating these indicators. (2) Methods: Two cohorts of breast cancer patients treated with NAC were collected. Pre- and post-treatment breast MRI with diffusion-weighted imaging were obtained; ADC values were measured by two blinded radiologists. KA was calculated as pre-treatment Ki67 divided by pre-treatment ADC, and δADC as post-ADC minus pre-ADC. Disease-free survival (DFS) was the primary outcome. Cox regression and a predictive Cox model were used. (3) Results: A total of 419 patients were analyzed. Both KA and δADC were associated with survival. In multivariable analysis, KA remained an independent prognostic factor (HR 0.40, 95% CI 0.19–0.84, p = 0.015). High KA was associated with worse prognosis, particularly in patients without pathological complete response. The model incorporating KA showed better predictive performance than clinicopathological variables alone and effectively stratified high- vs. low-risk patients. (4) Conclusion: KA is a promising complementary biomarker for prognosis in breast cancer patients undergoing NAC. Its integration into a prognostic model improved survival risk prediction and may aid individualized post-treatment management. Full article

(This article belongs to the Section Breast Cancer)

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25 pages, 2762 KB

Open AccessArticle

Beyond Tumor Diameter: Exploratory Cohort-Derived Calcitonin Secretory Categories and Invasive Pathology in Medullary Thyroid Carcinoma

by Adem Ozcan, Gizem Gunes, Ali Bal, Abdulkadir Unsal, Furkan Savas and Mustafa Omer Yazicioglu

Curr. Oncol. 2026, 33(9), 533; https://doi.org/10.3390/curroncol33090533 - 2 Sep 2026

Abstract

Background: Serum calcitonin is commonly interpreted as a marker of tumor burden in medullary thyroid carcinoma (MTC), but patients with comparable tumor diameters may show markedly different calcitonin levels. This exploratory study aimed to derive cohort-specific, tumor diameter–adjusted calcitonin secretory categories and examine [...] Read more.

Background: Serum calcitonin is commonly interpreted as a marker of tumor burden in medullary thyroid carcinoma (MTC), but patients with comparable tumor diameters may show markedly different calcitonin levels. This exploratory study aimed to derive cohort-specific, tumor diameter–adjusted calcitonin secretory categories and examine their relationship with invasive pathological features. Methods: This retrospective single-center study included 70 unique patients with histopathologically confirmed MTC. Seventeen patients with preoperative serum calcitonin below the assay reporting limit (<2 pg/mL) were evaluated separately. In 53 patients with detectable calcitonin, residuals from a log-linear model of calcitonin according to dominant tumor diameter were divided into tertiles to define exploratory hyposecretory, normosecretory, and hypersecretory categories. Sensitivity analyses accounted for sex, metastatic lymph-node count, documented distant metastatic disease, and restriction to patients with pN0 disease and no documented distant metastasis. Results: Preoperative calcitonin correlated with dominant tumor diameter (Spearman rho = 0.644, p < 0.001), and the primary model explained 45.2% of calcitonin variability (R² = 0.452). The cohort-derived categories included 18 hyposecretory, 17 normosecretory, and 18 hypersecretory tumors. In a hypothesis-driven exploratory contrast, lymphovascular invasion (55.6% vs. 25.7%; nominal p = 0.040) and perineural invasion (33.3% vs. 8.6%; nominal p = 0.048) were more frequent in the hypersecretory category. However, the global three-group comparisons were not statistically significant (p = 0.135 and p = 0.117, respectively), and both false-discovery-rate-adjusted q values were 0.072. The tumor diameter–calcitonin relationship remained significant after adjustment for sex and metastatic burden and in the pN0 subgroup without documented distant metastasis. Conclusions: The exploratory, cohort-derived hypersecretory category showed hypothesis-generating enrichment for lymphovascular and perineural invasion, but these associations did not meet the false-discovery-rate-adjusted significance threshold. External validation is required before these categories can be considered biologically established or clinically applicable. Full article

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

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12 pages, 540 KB

Open AccessArticle

Identifying Distinct Quality-of-Life Profiles in Prostate Cancer Patients: A Latent Profile Approach

by Linan Cheng

Curr. Oncol. 2026, 33(9), 532; https://doi.org/10.3390/curroncol33090532 - 2 Sep 2026

Abstract

Background: Prostate cancer substantially affects patients’ quality of life (QoL). However, whether distinct QoL profiles exist among patients remains unclear. Objective: This study aimed to identify latent QoL profiles among patients with prostate cancer and explore factors associated with profile membership. Methods: A [...] Read more.

Background: Prostate cancer substantially affects patients’ quality of life (QoL). However, whether distinct QoL profiles exist among patients remains unclear. Objective: This study aimed to identify latent QoL profiles among patients with prostate cancer and explore factors associated with profile membership. Methods: A cross-sectional study included 200 patients with prostate cancer recruited from a tertiary hospital in China between May and December 2024. QoL was assessed using the Functional Assessment of Cancer Therapy–Prostate (FACT-P). Latent profile analysis was performed using Mplus 8.3, and the optimal model was selected according to information criteria, entropy, and likelihood ratio tests. Multivariable logistic regression was used to examine factors associated with profile membership. Results: LPA identified two distinct subgroups: low QoL (32.5%) and high QoL (67.5%). Medium and heavy economic burden significantly increased odds of low QoL (OR = 4.13, 95% CI: 1.13–15.02, p = 0.032; OR = 11.12, 95% CI:1.55–79.86, p = 0.017). Urinary continence markedly reduced odds of low QoL (OR = 0.08, 95% CI: 0.02–0.25, p < 0.001). Longer diagnosis-to-treatment intervals were associated with membership in the low-QoL profile (1–3 months: OR = 2.99, 95% CI: 1.26–7.08, p = 0.013; >3 months: OR = 3.36, 95% CI: 1.02–11.07, p = 0.046). Conclusions: This study identified two QoL profiles among patients with prostate cancer. The findings suggest that person-centered QoL assessment may facilitate early identification of patients with greater supportive care needs and contribute to more individualized survivorship care. Full article

(This article belongs to the Section Oncology Nursing)

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13 pages, 4672 KB

Open AccessArticle

Tumour GDF-15 Expression and Clinical Outcomes in Intermediate-Risk Metastatic Clear-Cell Renal Cell Carcinoma Treated with Second-Line Nivolumab

by Orhun Akdogan, Betul Ogut, Osman Sutcuoglu, Melike Urganci, Burcu Ulas Kahya, Ipek Isik Gonul, Hatice Azra Begum Salimoglu, Tuba Ugur Tuzcu, Ozan Yazici, Ahmet Ozet and Nuriye Ozdemir

Curr. Oncol. 2026, 33(9), 531; https://doi.org/10.3390/curroncol33090531 - 2 Sep 2026

Abstract

Background: Immune checkpoint inhibitors have improved outcomes in metastatic clear-cell renal cell carcinoma (mRCC), yet clinically applicable tissue biomarkers remain limited. Growth differentiation factor-15 (GDF-15) promotes tumour immune evasion and has emerged as a potential therapeutic target in immuno-oncology. We evaluated the prognostic [...] Read more.

Background: Immune checkpoint inhibitors have improved outcomes in metastatic clear-cell renal cell carcinoma (mRCC), yet clinically applicable tissue biomarkers remain limited. Growth differentiation factor-15 (GDF-15) promotes tumour immune evasion and has emerged as a potential therapeutic target in immuno-oncology. We evaluated the prognostic significance of tumour GDF-15 expression in patients with intermediate-risk clear-cell mRCC treated with second-line nivolumab. Methods: Forty-six patients with intermediate-risk clear-cell mRCC who received nivolumab after one line of tyrosine kinase inhibitor therapy were retrospectively evaluated. Tumour GDF-15 expression was assessed by immunohistochemistry and classified as low (0–1+) or high (2–3+). Objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and the development of cancer-associated cachexia were compared between expression groups. Results: High tumour GDF-15 expression was observed in 23 patients (50%). ORR was significantly higher in the low-expression group than in the high-expression group (57% vs. 26%, p = 0.036). Low tumour GDF-15 expression was associated with significantly longer PFS (24.5 vs. 7.5 months; HR 0.38, 95% CI 0.18–0.80; p = 0.009) and OS (28.6 vs. 12.6 months; HR 0.43, 95% CI 0.19–0.98; p = 0.041). The association with OS remained significant after adjustment for age. The frequency of cancer-associated cachexia did not differ according to tumour GDF-15 expression (43% vs. 35%, p = 0.546). Conclusions: Low tumour GDF-15 expression was associated with better objective response and longer progression-free and overall survival in patients with intermediate-risk metastatic clear-cell renal cell carcinoma treated with second-line nivolumab, with the association with overall survival remaining significant after adjustment for age. Tumour GDF-15 represents a promising tissue biomarker for prognostic risk stratification and warrants validation in larger prospective studies. Full article

(This article belongs to the Special Issue Advances in Novel Biomarkers for Kidney Cancer)

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10 pages, 449 KB

Open AccessArticle

Comparative Pharmacovigilance Analysis of Safety Signals Among Advanced Prostate Cancer Therapies Using FAERS (FDA Adverse Event Reporting System)

by Zaid Ahmed, Rashid Sayyid, Omid Yazdanpanah, Ravand Samaeekia, Arash Rezazadeh Kalebasty, David I. Lee and Mohammed Shahait

Curr. Oncol. 2026, 33(9), 530; https://doi.org/10.3390/curroncol33090530 - 2 Sep 2026

Abstract

Therapeutic options for advanced prostate cancer have expanded in recent years, incorporating multiple-system treatment approaches with differing mechanisms of action. However, comparative real-world safety data following drug approval remain limited. As such, the aim of this study is to characterize adverse events and [...] Read more.

Therapeutic options for advanced prostate cancer have expanded in recent years, incorporating multiple-system treatment approaches with differing mechanisms of action. However, comparative real-world safety data following drug approval remain limited. As such, the aim of this study is to characterize adverse events and disproportionate safety signals among advanced prostate cancer therapies using the FDA Adverse Event Reporting System (FAERS). A retrospective pharmacovigilance study of FAERS reports evaluated enzalutamide, darolutamide, apalutamide, abiraterone acetate, relugolix, niraparib/abiraterone, talazoparib, rucaparib, cabazitaxel, sipuleucel-T, and lutetium-177 vipivotide. Adverse events were categorized by System Organ Class and Preferred Terms. Reporting odds ratios (RORs) with 95% confidence intervals identified safety signals. Among 172,440 reports, most involved patients aged 65–85 years. Cabazitaxel had the highest proportion of serious reports (86.6%) and deaths (22%), whereas relugolix had the lowest (23.3% and 4.8%). Nervous system disorders predominated with enzalutamide and darolutamide, gastrointestinal disorders with abiraterone, rucaparib, and niraparib/abiraterone, and hematologic toxicities with cabazitaxel, talazoparib, and lutetium-177 vipivotide. Significant safety signals were identified for abiraterone and cabazitaxel, but not other therapies. The absence of a detected signal should not be interpreted as evidence of safety or equivalence, as reporting volume, detection bias, and statistical power varied across therapies. Overall, the therapies demonstrated distinct toxicity profiles, which may inform treatment selection, toxicity monitoring, and patient counseling. Full article

(This article belongs to the Section Genitourinary Oncology)

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13 pages, 787 KB

Open AccessArticle

Real-World Outcomes of Second-Line Chemotherapy in Metastatic Urothelial Carcinoma

by İlkay Çıtakkul, Hayati Arvas, Mert Karaoğlan, Bahadır Köylü, Nazan Demir, Gözde Balkaya Aykut, Elif Şahin, Mesut Yılmaz, Zuhat Urakçı, Duygu Bayır Garbioğlu, Fatih Selçukbiricik, Ece Baydar, Beşire Nurdan Tazebay, Melike Yazıcı, Yasemin Bakkal Temi, Devrim Çabuk, Kazım Uygun and Umut Kefeli

Curr. Oncol. 2026, 33(9), 529; https://doi.org/10.3390/curroncol33090529 - 2 Sep 2026

Abstract

Second-line chemotherapy is widely used in metastatic urothelial carcinoma after progression on first-line platinum-based therapy, but its independent contribution to survival, as opposed to selection of healthier patients, remains unclear. In this multicenter retrospective cohort of 142 patients treated with first-line platinum-based chemotherapy [...] Read more.

Second-line chemotherapy is widely used in metastatic urothelial carcinoma after progression on first-line platinum-based therapy, but its independent contribution to survival, as opposed to selection of healthier patients, remains unclear. In this multicenter retrospective cohort of 142 patients treated with first-line platinum-based chemotherapy across seven Turkish centers, overall survival (OS) from first-line progression was compared between patients who received second-line chemotherapy (n = 80) and those who did not (n = 62), using multivariable Cox regression, inverse probability of treatment weighting (IPTW), propensity-score matching, landmark analysis, and a time-dependent Cox model. Median OS was 7.4 versus 4.7 months (log-rank p = 0.064). Second-line chemotherapy was independently associated with improved OS on multivariable analysis (adjusted hazard ratio [aHR] 0.620; 95% confidence interval [CI] 0.423–0.907; p = 0.014); Eastern Cooperative Oncology Group (ECOG) performance status ≥ 2 (aHR 3.881; p = 0.001) and lower albumin (aHR 0.671; p = 0.018) were also independent predictors. The association remained significant after IPTW (HR 0.648; p = 0.025) and after a time-dependent Cox model (HR 0.632; p = 0.019), and was unchanged in ECOG-restricted and Bellmunt-adjusted analyses (p = 0.008, p = 0.029); it narrowly missed significance after propensity-score matching (HR 0.645; p = 0.051) and did not reach significance in the 3-month landmark analysis (HR 0.743; p = 0.180). Power was limited (~49%). In a time-dependent Cox model—the analysis least susceptible to immortal-time bias, as it retains the full cohort and classifies pre-treatment person-time as unexposed—second-line chemotherapy remained independently associated with improved OS (HR 0.632; p = 0.019), closely consistent with the primary multivariable estimate. The conventional Cox, IPTW, and propensity-score-matched analyses, which treat second-line receipt as a baseline exposure, were directionally concordant but share a common time-related bias and are therefore not independent confirmations. ECOG performance status was a consistent predictor throughout. Full article

(This article belongs to the Special Issue Treatment Strategies for Advanced Urothelial Carcinoma)

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17 pages, 2242 KB

Open AccessArticle

Explainable Deep Learning Model for Predicting Overall Survival in Patients Receiving Palliative Radiotherapy for Bone Metastases

by Yui Watanabe, Takuya Tomoda, Akiko Iwata, Hirokazu Matsuno, Hiroto Hayakawa and Takeshi Nagata

Curr. Oncol. 2026, 33(9), 528; https://doi.org/10.3390/curroncol33090528 - 2 Sep 2026

Abstract

Purpose: Although machine learning-based prediction of overall survival (OS) in palliative radiotherapy for bone metastases has been investigated, explainable deep learning (DL) models remain underexplored. This study aimed to develop and validate an explainable DL model to predict OS in this setting, and [...] Read more.

Purpose: Although machine learning-based prediction of overall survival (OS) in palliative radiotherapy for bone metastases has been investigated, explainable deep learning (DL) models remain underexplored. This study aimed to develop and validate an explainable DL model to predict OS in this setting, and to examine whether this flexible model provides predictive value beyond a standard Cox model based on routinely collected baseline variables. Methods and Materials: We analyzed all 472 eligible patients who received palliative radiotherapy for bone metastases between January 2013 and August 2024; patients alive with less than one year of follow-up were retained as right-censored observations. The primary endpoint was OS over a fixed 1-year horizon. A DeepSurv model using 14 baseline predictors, including the planned prescribed dose (biologically effective dose, BED10), was developed with repeated 5-fold cross-validation (K = 5, R = 10) and compared with standard and ridge-penalized Cox models fitted on identical splits. Performance was assessed by the time-dependent concordance index (C-index), integrated Brier score (IBS), time-dependent area under the curve (AUC) at 90, 180, and 365 days, and a calibration analysis at one year; 95% confidence intervals (CI) were obtained by patient-level bootstrapping of the pooled out-of-fold predictions. Shapley Additive Explanations (SHAP) and SurvLIME were computed on the held-out test sets. Results: Within one year, 242 patients (51.3%) died; median OS was 225 days (95% CI: 189–287). The DeepSurv model achieved a pooled time-dependent C-index of 0.779 (95% CI: 0.751–0.807), an IBS of 0.135 (95% CI: 0.122–0.149), and AUCs of 0.892 (0.857–0.925), 0.862 (0.822–0.895), and 0.856 (0.814–0.895) at 90, 180, and 365 days, with an observed/expected ratio of 0.94 and a calibration slope of 1.02; discrimination was comparable to the Cox model (C-index 0.763, 95% CI: 0.737–0.789). SHAP identified poor performance status as the dominant predictor (mean |SHAP| 0.178), followed by male sex (0.067), high-risk primary tumor type (0.063), multiple bone metastases (0.047), and planned dose (0.033), the latter being the only leading feature associated with lower predicted mortality; SurvLIME gave consistent results. In multivariable Cox analysis, performance status (hazard ratio [HR] 2.21 per standard deviation [SD], p < 0.001) and planned dose (HR 0.71 per SD, p < 0.001) were independently associated with OS. Conclusions: The explainable DL model predicted OS after palliative radiotherapy for bone metastases with discrimination and calibration comparable to those of a well-specified Cox model, and its feature attributions agreed with the Cox coefficients, suggesting that the prognostic information in these baseline variables is essentially additive and can therefore be delivered at the bedside as a simple score, without dedicated AI infrastructure and without loss of predictive performance. The combined use of SHAP and SurvLIME verified that the model relies on established clinical factors, most prominently performance status, and provides patient-level explanations. Pending external validation, such prediction may support individualized decisions on treatment goals and radiation schedules. Full article

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

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15 pages, 5624 KB

Open AccessCase Report

Case of MYB-Rearranged Prostatic Adenoid Cystic Carcinoma

by Sha Liu, Yuhan Liu, Ziyu Zhang, Shuiping Yin, Xinyi Wu, Ying Dai and Yingying Du

Curr. Oncol. 2026, 33(9), 527; https://doi.org/10.3390/curroncol33090527 - 1 Sep 2026

Abstract

Background: Prostatic adenoid cystic carcinoma/basal cell carcinoma (ACC/BCC) has been reclassified under the fifth edition of the World Health Organization’s classification of tumors, distinguishing it from basal cell cancer of the skin. This malignant neoplasm exhibits distinct biological characteristics that differ from those [...] Read more.

Background: Prostatic adenoid cystic carcinoma/basal cell carcinoma (ACC/BCC) has been reclassified under the fifth edition of the World Health Organization’s classification of tumors, distinguishing it from basal cell cancer of the skin. This malignant neoplasm exhibits distinct biological characteristics that differ from those of typical prostatic adenocarcinoma. However, optimal clinical management of prostatic ACC/BCC remains uncertain because of its rarity and the limited evidence available. Methods: This study retrospectively reviews the treatment course of a 62-year-old male patient presenting with more than six months of dysuria. Initial management included transurethral plasmakinetic resection of the prostate (TUPKP), followed by robot-assisted radical prostatectomy and bilateral pelvic lymph node dissection. Postoperative fluorescence in situ hybridization (FISH) demonstrated MYB rearrangement, providing molecular support for the pathological classification of prostatic ACC/BCC and facilitating diagnostic reclassification. Results: Pathological examination of the TUPKP specimen indicated poorly differentiated carcinoma, with findings consistent with prostatic ACC/BCC. Preoperative imaging showed an irregular soft-tissue lesion in the prostate/bladder neck region, without definite pelvic lymph node or distant organ metastasis. Histological analysis demonstrated cribriform structures and perineural invasion, while immunohistochemistry supported a basal cell phenotype; together with these findings, detection of MYB rearrangement via FISH supported reclassification of the tumor as prostatic ACC/BCC. Following radical surgery, adjuvant paclitaxel plus carboplatin was administered as an individualized empirical treatment in the absence of an established disease-specific standard. The patient completed six cycles of adjuvant chemotherapy and remained clinically stable during follow-up, with no radiological evidence of recurrence at the latest evaluation. Conclusions: This case highlights the diagnostic challenges of prostatic ACC/BCC and underscores the value of integrating molecular findings with histopathological and immunohistochemical features to support accurate tumor classification and individualized clinical management. MYB rearrangement may provide useful molecular support for diagnosis and classification; however, its biological and potential therapeutic significance in prostatic ACC/BCC requires further investigation in larger cohorts. Full article

(This article belongs to the Section Genitourinary Oncology)

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