Current Oncology

15 pages, 758 KB

Open AccessArticle

Expression VIII: Final Results of the Individual Perception and Level of Information of Patients with Borderline Tumors of the Ovary

by Sara Alavi-Demirci, Laura N. Beckmann, Hannah Woopen, Clemens Liebrich, Yasemine Virk, Pauline Wimberger, Karol Kubiak, Anette Ligl-Löhner, Hans-Martin Enzinger, Vera Czolk, Georg Kunz, Mandy Mangler, Tilmann Lantzsch, Alexander Mustea, Susanne Fechner, Aline Burdack, Jürgen Terhaag, Dorothea Fischer, Cornelia Müller and Jalid Sehouli

Curr. Oncol. 2026, 33(9), 516; https://doi.org/10.3390/curroncol33090516 (registering DOI) - 28 Aug 2026

Abstract

Background: Borderline ovarian tumors (BOTs) represent a distinct group of rare epithelial ovarian neoplasms with excellent prognosis, but persistent uncertainty in patient understanding and clinical management. This study evaluated disease awareness, perceptions, and treatment patterns among affected women in Germany. Methods: The national [...] Read more.

Background: Borderline ovarian tumors (BOTs) represent a distinct group of rare epithelial ovarian neoplasms with excellent prognosis, but persistent uncertainty in patient understanding and clinical management. This study evaluated disease awareness, perceptions, and treatment patterns among affected women in Germany. Methods: The national multicenter Expression VIII survey was conducted across 34 centers by the North-Eastern German Society of Gynecologic Oncology (NOGGO). Using a standardized 46-item questionnaire, 286 patients with BOTs provided data on symptoms, treatment, fertility, follow-up, and illness perception. Descriptive analyses were performed. Results: Most participants (mean age 51 years) underwent surgery (94%), while systemic therapy was infrequent (chemotherapy 9%, bevacizumab 4%). Fertility-sparing surgery was performed in 14% overall, corresponding to 71% of those desiring future childbearing. Although 81% identified their physician as their main information source and rated information quality highly (mean 8.6/10), 29% believed they had ovarian cancer and 64% were unaware of their tumor stage. Nearly all patients (97%) received regular follow-up, though 18% were uncertain about the procedures performed. Disease severity was rated moderately high (mean 5.4/10), and recurrence risk and mortality were often overestimated. Conclusions: Despite good overall physician communication, substantial misconceptions persist among patients with BOTs, including the mistaken belief that they have been diagnosed with cancer, suggesting a need for clearer, structured education about its favorable prognosis and management of the disease. Improved guideline adherence and treatment centralization in specialized centers may reduce overtreatment and optimize fertility-preserving approaches. Full article

(This article belongs to the Section Gynecologic Oncology)

11 pages, 18729 KB

Open AccessCase Report

Combined Interhemispheric and Endoscopic Endonasal Resection of a Rare Olfactory Schwannoma with Preservation of Olfactory Function

by Leonardo Anselmi, Alexandre Lavé, Kristof Egervari, Basile N. Landis, Philippe Bijlenga, Julien W. Hsieh and Paul E. Constanthin

Curr. Oncol. 2026, 33(9), 515; https://doi.org/10.3390/curroncol33090515 (registering DOI) - 28 Aug 2026

Abstract

Introduction: Olfactory groove schwannomas (OGSs) are exceptionally rare intracranial tumors, with fewer than 80 cases reported. Their imaging features often mimic meningiomas or esthesioneuroblastomas, complicating preoperative diagnosis. Their origin remains debated due to the absence of Schwann cells in the olfactory nerve. Research [...] Read more.

Introduction: Olfactory groove schwannomas (OGSs) are exceptionally rare intracranial tumors, with fewer than 80 cases reported. Their imaging features often mimic meningiomas or esthesioneuroblastomas, complicating preoperative diagnosis. Their origin remains debated due to the absence of Schwann cells in the olfactory nerve. Research Question: To describe a rare case of olfactory groove schwannoma with ethmoidal extension, successfully treated through a combined interhemispheric and endoscopic endonasal approach, and to discuss its diagnostic and surgical implications in light of the current literature. Furthermore, to measure the respective olfactory function before and after surgery. Material and Methods: A 52-year-old man presented with transient visual disturbances, headache, lexical access difficulties, slight executive dysfunction with impaired inhibition, and anterograde verbal memory impairment. He had no olfactory complaints but olfactory testing revealed unilateral, left-sided anosmia. Preoperative MRI demonstrated a large left olfactory groove mass with solid–cystic components, bone erosion, and inferior ethmoidal extension. A combined transcranial interhemispheric and endoscopic endonasal approach was performed to achieve total resection and ensure skull base reconstruction. Results: Gross total tumor removal was achieved. Histopathological examination confirmed a WHO grade I schwannoma. Postoperative recovery was uneventful, with improvement in neuropsychological and left-sided olfactory function. There was no residual lesion on follow-up MRI. Discussion and Conclusions: OGS should be included in the differential diagnosis of anterior skull base tumors with cystic or sinonasal extension. In selected cases, a combined cranio-endoscopic approach allows safe and radical resection while minimizing morbidity. Accurate histopathological evaluation remains essential for definitive diagnosis, as radiological features alone may be misleading. Olfactory function should be systematically measured since preservation and even improvement of olfactory function are possible. This supports a non-olfactory origin of the tumor, suggesting secondary compression rather than primary involvement of the olfactory system. Full article

(This article belongs to the Section Neuro-Oncology)

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18 pages, 1393 KB

Open AccessReview

KRAS in Colorectal Cancer: Tumorigenesis, Surgical Implications and Evolving Treatment Target

by Sahar Iftikhar, Alexander H. Xiao, Zhaohui Jin and Emad H. Aly

Curr. Oncol. 2026, 33(9), 514; https://doi.org/10.3390/curroncol33090514 - 28 Aug 2026

Abstract

Purpose: This review aims to provide an updated overview of Kirsten rat sarcoma viral oncogene homologue (KRAS) mutations in colorectal carcinoma (CRC), focusing on their role in tumorigenesis, prognostic implications, and recent advances in targeted therapy. Major findings: KRAS mutations occur in approximately [...] Read more.

Purpose: This review aims to provide an updated overview of Kirsten rat sarcoma viral oncogene homologue (KRAS) mutations in colorectal carcinoma (CRC), focusing on their role in tumorigenesis, prognostic implications, and recent advances in targeted therapy. Major findings: KRAS mutations occur in approximately 40% of colorectal cancers and play a central role in tumour initiation and progression through constitutive activation of MAPK pathways. Clinically, KRAS mutations are well established as predictors of resistance to anti-EGFR therapy. Increasing evidence also supports their role as prognostic biomarkers, with KRAS-mutant tumours associated with increased recurrence risk and reduced survival, including in patients undergoing hepatic metastasectomy. Therapeutically, recent advances, most notably KRAS G12C inhibitors and combination strategies targeting upstream or parallel pathways, have expanded treatment options, although efficacy varies across KRAS mutation subtypes. Conclusions: KRAS mutations have important implications for the behaviour, prognosis, and management of colorectal cancer. Integrating KRAS mutational status into clinical decision-making may enable more personalised prognostication and treatment strategies. Continued research is required to broaden effective targeted therapies for the diverse spectrum of KRAS-mutant disease. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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11 pages, 206 KB

Open AccessArticle

Real-World Toxicities and Outcomes of Pembrolizumab in Early-Stage Triple-Negative Breast Cancer

by Emmanuel Joran Boujeke, Aaron Catalan, Laurice Arayan, Alfred Patrick Mina, Christian Edward James-McDonald, Rasna Gupta, Swati Kulkarni, Abdullah Nasser, Deepro Chowdhury, Muriel Brackstone, John Mathews and Caroline Hamm

Curr. Oncol. 2026, 33(9), 513; https://doi.org/10.3390/curroncol33090513 - 27 Aug 2026

Abstract

Purpose: Pembrolizumab combined with chemotherapy is the standard of care for early-stage triple-negative breast cancer (TNBC) following KEYNOTE-522. However, real-world data on immune-related adverse events (irAEs) remain limited. We evaluated the incidence, severity, and clinical consequences of irAEs in a real-world cohort and [...] Read more.

Purpose: Pembrolizumab combined with chemotherapy is the standard of care for early-stage triple-negative breast cancer (TNBC) following KEYNOTE-522. However, real-world data on immune-related adverse events (irAEs) remain limited. We evaluated the incidence, severity, and clinical consequences of irAEs in a real-world cohort and compared outcomes with KEYNOTE-522. Methods: We conducted a retrospective cohort study of patients with stage II–III TNBC treated according to the KEYNOTE-522 regimen at two Ontario cancer centres between June 2022 and May 2024. Data on irAEs, treatment discontinuation, and pathological complete response (pCR) were collected and contextualized against trial outcomes. Results: Among 79 patients, the pCR rate was higher than that reported in KEYNOTE-522 (77.2% vs. 64.8%). irAEs were documented in 51.9% of patients, compared with 33.5% in the trial. Permanent discontinuation due to irAEs occurred in 22.8% of patients, compared with 15.7% reported in KEYNOTE-522. Most discontinuations occurred during the neoadjuvant phase. Conclusions: Real-world patients experienced higher observed rates of low-grade irAEs and treatment discontinuation than reported in KEYNOTE-522; however, differences in study design limit direct comparison. These findings highlight the need for optimized toxicity management and further study of the impact of treatment duration on long-term outcomes. Full article

(This article belongs to the Section Breast Cancer)

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13 pages, 225 KB

Open AccessReview

Management of Advanced Solid Tumors Recurring After Adjuvant Immune Checkpoint Inhibitors: A Structured Narrative Review

by Fausto Petrelli, Lorenzo Dottorini, Antonio Ghidini and Alberto Zambelli

Curr. Oncol. 2026, 33(9), 512; https://doi.org/10.3390/curroncol33090512 - 27 Aug 2026

Abstract

Adjuvant and perioperative immune checkpoint inhibitors (ICIs) have created a growing population of patients who relapse after prior programmed death-1 or programmed death-ligand 1 blockade, yet these patients were underrepresented in many trials that established metastatic standards. We performed a structured narrative review [...] Read more.

Adjuvant and perioperative immune checkpoint inhibitors (ICIs) have created a growing population of patients who relapse after prior programmed death-1 or programmed death-ligand 1 blockade, yet these patients were underrepresented in many trials that established metastatic standards. We performed a structured narrative review of PubMed/MEDLINE, ClinicalTrials.gov, reference lists, and international oncology guideline repositories through 15 August 2026. Eligible reports addressed recurrence patterns or treatment after curative-intent ICI in melanoma, non-small-cell lung cancer (NSCLC), renal cell carcinoma (RCC), urothelial carcinoma, or triple-negative breast cancer (TNBC); landmark metastatic studies were included only when direct evidence was unavailable and are labeled as extrapolation. Timing was standardized as on-treatment recurrence, early off-treatment recurrence (after the last ICI dose through 12 months), and late recurrence (>12 months). Shorter disease-free interval is consistently prognostic, but treatment-by-timing interactions are rarely available; timing should not be described as a validated pan-tumor predictive biomarker. Direct post-adjuvant evidence supports switching away from anti-PD-1 monotherapy for melanoma recurring on treatment, while selected late relapses may retain sensitivity. In RCC, retrospective post-adjuvant data support VEGF-targeted options, whereas CONTACT-03 and TiNivo-2 discourage routine ICI-TKI rechallenge specifically after prior ICI-treated metastatic RCC. Evidence in NSCLC, urothelial carcinoma, and TNBC is largely indirect. IMpassion132 was not an ICI-rechallenge trial, and only a small minority of ASCENT-04 participants had prior perioperative ICI. Treatment should integrate tumor-specific biology, actionable alterations, recurrence distribution, prior toxicity, comorbidity, access, and patient preference. Prospective trials dedicated to post-adjuvant ICI recurrence are needed. Full article

10 pages, 624 KB

Open AccessArticle

Return to Intended Oncologic Therapy After Brain Metastasis Surgery: Mapping the Early Postoperative Pathway

by Alexis Hadjiathanasiou, Martin Liebisch, Johanna Dahn, Johannes Lemcke and Patrick Schuss

Curr. Oncol. 2026, 33(9), 511; https://doi.org/10.3390/curroncol33090511 - 27 Aug 2026

Abstract

Surgery for brain metastases (BM) is embedded in a multidisciplinary oncologic pathway. This study evaluated oncologic readiness and return to intended oncologic therapy (RIOT) after surgery for BM. Patients undergoing surgery for histologically confirmed BM were retrospectively identified. Oncologic readiness was defined as [...] Read more.

Surgery for brain metastases (BM) is embedded in a multidisciplinary oncologic pathway. This study evaluated oncologic readiness and return to intended oncologic therapy (RIOT) after surgery for BM. Patients undergoing surgery for histologically confirmed BM were retrospectively identified. Oncologic readiness was defined as sufficient postoperative clinical and neurological recovery to allow the next indicated oncologic treatment. RIOT was defined as postoperative radiotherapy and/or systemic treatment within 30 days after surgery. Exploratory analyses assessed factors associated with oncologic readiness and RIOT after readiness. Among 126 patients, oncologic readiness was achieved in 114 (90%) and RIOT in 99 (79%). Absence of oncologic readiness was associated with postoperative morbidity and persistent neurological deficit, whereas absence of RIOT after readiness showed no distinct clinical or BM-related profile. Change in patient preference, neurological or functional deterioration, and organizational delay were the most frequent reasons for no RIOT after readiness. Oncologic readiness distinguished patients with insufficient surgical recovery from those who recovered but did not proceed to further treatment. These findings support RIOT as a process endpoint for the transition from BM surgery to postoperative oncologic care. Full article

(This article belongs to the Special Issue Recent Advancements in the Surgical Treatment of Brain Tumors—2nd Edition)

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9 pages, 249 KB

Open AccessArticle

Tolerance and Efficacy of Targeted Therapies After Immunotherapy for Advanced Non-Small Cell Lung Cancers Harboring Oncogenic Alterations: The GFPC-TOXIMAD Study

by Thomas Pierret, Jean-Bernard Auliac, Charles Ricordel, Catherine Daniel, Jessica Nguyen, Florian Guisier, Aurélie Swalduz, Hubert Curcio, Anne Laure Desage, Laurence Bigay-Game, Eric Huchot, Lionel Falchero, Hélène Doubre, Olivier Bylicki, Christos Chouaïd and Laurent Greillier

Curr. Oncol. 2026, 33(9), 510; https://doi.org/10.3390/curroncol33090510 - 27 Aug 2026

Abstract

Background: The sequential use of anti-programmed cell death (ligand)-1 [PD-(L)1] immune-checkpoint inhibitors (ICIs) followed by targeted tyrosine-kinase inhibitors (TKIs) for advanced non-small cell lung cancer (NSCLC) with oncogenic alterations raises questions about tolerance and efficacy. Recent study results suggested an increased risk of [...] Read more.

Background: The sequential use of anti-programmed cell death (ligand)-1 [PD-(L)1] immune-checkpoint inhibitors (ICIs) followed by targeted tyrosine-kinase inhibitors (TKIs) for advanced non-small cell lung cancer (NSCLC) with oncogenic alterations raises questions about tolerance and efficacy. Recent study results suggested an increased risk of adverse events (AEs) with this sequence. Methods: Multicenter retrospective study on advanced NSCLC patients treated with ICIs followed by targeted therapies between 2015 and 2021. The primary endpoint was the rate of grade 3–5 adverse events (AEs). Main secondary endpoints were progression-free survival (PFS), time-to-treatment failure and overall survival (OS). Results: The analysis included 109 patients (most with EGFR, 30.3%; BRAF, 17.4%; MET exon-14, 17.4%; ALK, 10.1%; and RET, 6.4% gene alterations); 28/109, which is 25.7% of the patients, experienced grade 3/4 AEs and 4/109 (3.7%) experienced grade 5 AEs, leading to the definitive cessation of targeted therapy treatment in 14/32 (44%) of cases; higher grade 3–5 rates were observed with the dabrafenib–trametinib combination (12/16, 75%), capmatinib (4/8, 50%) and crizotinib (8/16, 50%). A last ICI-administration-to-targeted therapy-start interval of <90 days appeared to be associated with grade ≥ 3 AEs (32/82, 39% vs. 0/27 p = 0.001). In these sequential strategies, effectiveness of targeted therapies, in this second-line or later setting, appears to be lower than that in the published historical data. Conclusion: According to this analysis, sequential ICI–targeted therapy use for advanced NSCLC appeared to be associated with more grade 3–5 AEs. Full article

13 pages, 13097 KB

Open AccessCase Report

Radiation-Induced Morphea of the Breast in a Patient with Pre-Existing Mycosis Fungoides: A Diagnostic Challenge

by Tala Mobayed, Toufic Eid, Ossama Abbas, Hiba Moukadem, Nagi El Saghir and Zeina Ayoub

Curr. Oncol. 2026, 33(9), 509; https://doi.org/10.3390/curroncol33090509 - 26 Aug 2026

Abstract

Radiation-induced morphea (RIM) is a rare, immune-mediated late complication of breast radiotherapy that may clinically mimic radiation fibrosis, malignancy, or other inflammatory dermatoses. Diagnosis is particularly challenging in patients with pre-existing cutaneous T-cell lymphoma (CTCL), in whom new post-radiation skin lesions may raise [...] Read more.

Radiation-induced morphea (RIM) is a rare, immune-mediated late complication of breast radiotherapy that may clinically mimic radiation fibrosis, malignancy, or other inflammatory dermatoses. Diagnosis is particularly challenging in patients with pre-existing cutaneous T-cell lymphoma (CTCL), in whom new post-radiation skin lesions may raise concern for lymphoma involvement or progression. To the best of our knowledge, based on a non-systematic search of the available literature, this is the first reported case of radiation-induced morphea occurring in a patient with pre-existing mycosis fungoides (MF). A 55-year-old woman with a history of MF and right breast invasive lobular carcinoma underwent bilateral mastectomy followed by adjuvant chest wall radiotherapy. Approximately 6.5 years later, she developed a progressive erythematous, indurated plaque within the irradiated field. Given her history of MF, cutaneous lymphoma involvement and radiation-associated sarcoma were important diagnostic considerations. Punch biopsy demonstrated dermal collagen homogenization with a mixed inflammatory infiltrate, while immunohistochemistry showed preserved pan-T-cell antigen expression without an aberrant phenotype, supporting RIM rather than lymphoma. The patient was treated with topical corticosteroids followed by methotrexate, with mild-to-moderate improvement in erythema without complete resolution; subsequent reconstructive revision was followed by further improvement in erythema, breast softness, and cosmesis. This case highlights the diagnostic overlap between RIM and CTCL and underscores the importance of prompt biopsy and careful clinicopathological correlation in evaluating persistent or atypical post-radiation skin changes. Full article

(This article belongs to the Section Breast Cancer)

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14 pages, 1405 KB

Open AccessArticle

DNA Damage Response Alterations Stratify Response to ICI-Based Therapy in Advanced NSCLC with High PD-L1 Expression

by Fang Hao, Linlin Zhang and Diansheng Zhong

Curr. Oncol. 2026, 33(9), 508; https://doi.org/10.3390/curroncol33090508 - 26 Aug 2026

Abstract

Background: Although high PD-L1 expression correlates with improved outcomes to immune checkpoint inhibitor (ICI), it remains an imperfect predictive biomarker. DNA damage response (DDR) pathway alterations are closely associated with antitumor immunity, shaping tumor immunogenicity and the immune microenvironment. This study evaluates [...] Read more.

Background: Although high PD-L1 expression correlates with improved outcomes to immune checkpoint inhibitor (ICI), it remains an imperfect predictive biomarker. DNA damage response (DDR) pathway alterations are closely associated with antitumor immunity, shaping tumor immunogenicity and the immune microenvironment. This study evaluates the distribution and clinical impact of DDR alterations in advanced Non-small cell lung cancer (NSCLC) with Programmed death-ligand 1 (PD-L1) ≥ 50%, providing insights for personalized treatment selection and response prediction. Experimental Design: Patients with advanced NSCLC and PD-L1 expression ≥ 50% who received first-line ICI-based therapy were retrospectively enrolled. Tumor tissue samples underwent targeted next-generation sequencing using a comprehensive cancer panel, with a predefined 35-gene DDR panel used to identify and classify pathogenic or likely pathogenic DDR alterations. The associations between genomic DDR alteration status, clinicopathologic characteristics, cytokine profiles, and immunotherapy outcomes were evaluated. Results: Among 121 patients, 72 (59.5%) were classified as DDR-positive and 49 (40.5%) as DDR-negative based on genomic DDR alterations. DDR-positive patients exhibited a higher burden of DDR alterations and TMB, and DDR-positive status remained independently associated with improved outcomes after adjustment for clinical factors and TMB. DDR-positive patients had higher DCB rates and IL-2 levels, whereas TNF-α and IL-6 levels were elevated in DDR-negative patients. DDR-positive status was associated with longer PFS than DDR-negative status (median, 12.7 vs. 8.9 months), with the benefit of chemo-immunotherapy mainly observed in DDR-positive patients. Conclusions: Genomic DDR alterations are associated with distinct immune profiles and may represent a potential biomarker for immunotherapy stratification. DDR-positive patients may derive greater benefit from chemo-immunotherapy, supporting further prospective investigation. Full article

(This article belongs to the Section Thoracic Oncology)

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17 pages, 1867 KB

Open AccessArticle

Expert Consensus Develops Multidisciplinary Pathway for Cancer Pain Management in Italy: A Delphi Study

by Francesco Cellini, Leonardo Consoletti, Massimo Di Maio, Diego Maria Michele Fornasari, Gianpaolo Fortini, Marta Gentili, Marco Krengli, Ernesto Maranzano, Silvia Natoli and on behalf of the Cancer Pain Management in Italy Working Group

Curr. Oncol. 2026, 33(9), 507; https://doi.org/10.3390/curroncol33090507 - 26 Aug 2026

Abstract

Background: Cancer pain remains highly prevalent and undertreated despite established guidelines. In Italy, Law 38/2010 mandates systematic pain assessment, yet only 26% of clinicians routinely evaluate pain at each clinical visit, and fewer than one-quarter have received formal training in pain medicine or [...] Read more.

Background: Cancer pain remains highly prevalent and undertreated despite established guidelines. In Italy, Law 38/2010 mandates systematic pain assessment, yet only 26% of clinicians routinely evaluate pain at each clinical visit, and fewer than one-quarter have received formal training in pain medicine or palliative care. A national multidisciplinary roundtable, convened in Rome in March 2025, formally identified four systemic gaps—insufficient education, fragmented care pathways, unclear professional roles, and challenges in implementing shared diagnostic and therapeutic pathways—and planned the development of a structured Delphi consensus. Methods: A Delphi consensus process was undertaken in accordance with CREDES guidelines. The Steering Committee, comprising representatives of six Italian scientific societies (AIRO, AIOM, AISD, Federdolore-SICD, SICP, ACD-SIAARTI) and a patient advocacy group (Fondazione Nora e Alberto Gentili), developed 15 clinical statements addressing pain assessment, management, referral criteria, monitoring, and documentation over five online meetings held between March and September 2025. Sixty-six Italian clinicians from various specialties were invited to participate; the survey was open from 1 October to 31 December 2025, with reminders every 10 days. Consensus was defined as ≥75% agreement (scoring 4 or 5 on a 5-point Likert scale). Results: Fifty-six clinicians completed the survey (response rate: 84.8%), representing medical oncology, radiation oncology, pain therapy, and palliative care specialties; individual statements were rated by 53–54 panelists, as skipping single items was permitted. All statements reached consensus in the first round (77.8–100%), precluding the need for a second voting round. Panelists’ qualitative comments informed minor wording refinements; substantial content was unchanged. Conclusions: The Delphi process produced a validated, multidisciplinary clinical pathway for cancer pain management in the Italian National Health System (NHS). The pathway establishes structured roles for the clinical reference physician and specialist consultants, objective decision thresholds for analgesic titration and referral, and minimum requirements for standardized pain documentation. These consensus-based statements provide actionable clinical guidance that may help address analgesic undertreatment and support the implementation of Law 38/2010 across Italian oncology centers. Full article

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

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9 pages, 5666 KB

Open AccessReview

Lenalidomide Exposure and TP53-Mutated Myelodysplastic Syndromes/Neoplasms

by Bahga Katamesh and Rory M. Shallis

Curr. Oncol. 2026, 33(9), 506; https://doi.org/10.3390/curroncol33090506 - 26 Aug 2026

Abstract

The benefits of lenalidomide, which leverages TP53-dependent apoptosis and promotion of megakaryocytic differentiation, in lower-risk MDS (LR-MDS) with del(5q) are well-established and drive its frequent use in clinical practice. In parallel, advances in molecular testing have elucidated the clear impact of TP53 mutations [...] Read more.

The benefits of lenalidomide, which leverages TP53-dependent apoptosis and promotion of megakaryocytic differentiation, in lower-risk MDS (LR-MDS) with del(5q) are well-established and drive its frequent use in clinical practice. In parallel, advances in molecular testing have elucidated the clear impact of TP53 mutations on response to therapies and prognosis, with diversity in the latter informed by variant allele frequency (VAF) and/or predicted allelic state. In this review, we discuss the converging pre-clinical and clinical evidence that implicates TP53 mutations not only as a driver of lenalidomide resistance in del(5q) LR-MDS, but as a source of selective clonal advantage under lenalidomide exposure. Lenalidomide-induced CK1α degradation triggers TP53-mediated apoptosis in wild-type clones, inadvertently favoring the survival and expansion of TP53-mutated cells. Clinically, this dynamic has been demonstrated across multiple studies, with rising TP53 variant allele frequency and clonal evolution observed following treatment. These findings underscore the importance of baseline molecular assessment in patients with MDS and, in select cases, serial monitoring during therapy. Investigational approaches for del(5q) LR-MDS with the TP53 mutation include GATA2-directed strategies aimed at restoring lenalidomide sensitivity, as well as immune-based therapies targeting the tumor microenvironment characteristic of TP53-mutated disease. Full article

(This article belongs to the Section Hematology)

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15 pages, 6296 KB

Open AccessArticle

Charting the Future of Canadian Adult Acute Myeloid Leukemia (AML) Laboratory Testing: A Canadian Leukemia Study Group Current State Mapping of Diagnostic AML Laboratory Practice

by Tina Yu Xuan Luo, Sila Usta, Eric McGinnis, Cheryl A. Mather, Julie Bergeron, Tanya Gillan, Etienne Mahe, José-Mario Capo-Chichi, Philip Berardi, Paul C. Park, Doha Itani, Ashish Rajput, Benjamin Chin-Yee, Fei-Yu Han, Darci T. Butcher, Jennifer Fesser, John DeCoteau, Graeme Quest, Elizabeth McCready and Hubert Tsui

Curr. Oncol. 2026, 33(9), 505; https://doi.org/10.3390/curroncol33090505 - 25 Aug 2026

Abstract

Clinical decision making in Acute Myeloid Leukemia (AML) critically relies on rapid genomic characterization. To better understand the AML diagnostic landscape in Canada, the Canadian Leukemia Study Group (CLSG) conducted a survey of laboratory hematology leadership (n = 18) at 16 laboratories across [...] Read more.

Clinical decision making in Acute Myeloid Leukemia (AML) critically relies on rapid genomic characterization. To better understand the AML diagnostic landscape in Canada, the Canadian Leukemia Study Group (CLSG) conducted a survey of laboratory hematology leadership (n = 18) at 16 laboratories across 10 provinces, administered using Google Forms in September 2024. Nearly all surveyed sites were equipped to deliver a full suite of testing platforms through existing on-site infrastructure or laboratory partnerships. Reporting practices varied in terms of genomic integration into bone marrow results and the use of AML classification systems. Turn-around-time (TAT) targets were predominantly determined through internal institutional consensus (62%) or recommendations by provincial cancer agencies/international groups (44%). TAT reduction was a top priority for 56% of laboratories, suggesting timely biomarker results to be an active area for improvement. Various treatment-determining biomarkers were frequently assessed as rapid-tests (defined as a 5-day TAT), including FLT3-ITD (69%), FLT3-TKD (56%), and NPM1 (56%), while others such as IDH1 and TP53 were rapid at a limited number of laboratories. Respondents demonstrated a strong shared interest in joint projects such as the validation of AML measurable residual disease (MRD) assays (56%). There was also unanimous support for establishing CLSG AML laboratory consensus guidelines. This survey documents the current state of Canadian AML laboratories and provides a foundation for future shared development projects. Full article

(This article belongs to the Special Issue Future Perspectives for Treatment and Diagnosis of Acute Myeloid Leukemia (AML))

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12 pages, 543 KB

Open AccessArticle

Initial Experience with MR-Guided or CT-Guided Stereotactic Body Radiotherapy for Prostate Cancer

by Marc Vincent N. Barcelona, Noelia Sanmamed Salgado, Enrique Gutierrez Valencia, Alejandro Berlin, Rachel Glicksman, Charles Catton, Andrew McPartlin, Jeff D. Winter, Jennifer Dang, Vickie Kong, Yangqing Deng and Peter Chung

Curr. Oncol. 2026, 33(9), 504; https://doi.org/10.3390/curroncol33090504 - 25 Aug 2026

Abstract

We report early toxicity outcomes after institutional implementation of prostate SBRT using 42.7 Gy in seven fractions delivered with either MR-guided adaptive SBRT (MRgSBRT) or CT-guided non-adaptive SBRT (CTgSBRT). Between July 2019 and May 2023, 216 patients received this regimen. Genitourinary (GU) and [...] Read more.

We report early toxicity outcomes after institutional implementation of prostate SBRT using 42.7 Gy in seven fractions delivered with either MR-guided adaptive SBRT (MRgSBRT) or CT-guided non-adaptive SBRT (CTgSBRT). Between July 2019 and May 2023, 216 patients received this regimen. Genitourinary (GU) and gastrointestinal (GI) toxicities were retrospectively assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Most patients had intermediate-risk disease (86%), and 14% had high-risk disease. Median prostate volume was 40 mL, and median baseline International Prostate Symptom Score (IPSS) was 8 among patients with available data. MRgSBRT and CTgSBRT were used in 100 (46%) and 116 (54%) patients, respectively. At a median follow-up of 19 months, 12- and 24-month grade ≥ 2 GU toxicity rates were 20.0% and 18.2%, while grade ≥ 2 GI toxicity rates were 3.5% and 3.6%, respectively. No statistically significant platform-related differences were detected; however, these comparisons were exploratory and potentially confounded by nonrandomized platform selection, treatment era, rectal-spacer use, adaptive workflow and differing PTV margins. On univariable analysis, baseline GU symptoms were associated with higher 12-month grade ≥ 2 GU toxicity (OR, 3.68; 95% CI, 1.52–10.37; p = 0.007), while prostate-volume category was not significantly associated with this endpoint. Full article

(This article belongs to the Special Issue Hypofractionated Radiotherapy for Prostate Cancer: Emerging Evidence and Clinical Practice)

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10 pages, 419 KB

Open AccessArticle

Tumor Characteristics and Event Free Survival in Older and Younger Women with Early Breast Cancer

by Samantha Kodikara, Alexis C. Wardell, Allison M. Deal, Annie Page, Hyman B. Muss and Kirsten A. Nyrop

Curr. Oncol. 2026, 33(9), 503; https://doi.org/10.3390/curroncol33090503 - 25 Aug 2026

Abstract

Background: Age, race, body mass index (BMI), breast density, parity, smoking and alcohol use are associated with increased risk for breast cancer. These factors, as well as tumor characteristics, treatment regimens and comorbidities, are analyzed for associations with five-year event free survival (EFS) [...] Read more.

Background: Age, race, body mass index (BMI), breast density, parity, smoking and alcohol use are associated with increased risk for breast cancer. These factors, as well as tumor characteristics, treatment regimens and comorbidities, are analyzed for associations with five-year event free survival (EFS) in a sample of women with Stage I-III breast cancer who received chemotherapy with curative intent. Methods: EFS was defined in terms of breast cancer recurrence, second primary, metastasis, and overall survival. Analyses were stratified by age (under age 65 vs. over age 65). EFS was estimated using the Kaplan–Meier method and compared using a Cox proportional hazard model. Results: In a sample of 821 women, mean age at diagnosis was 54 years, with 75% White and 22% Black. Younger women had higher proportions of Stage II and III tumors (p = 0.005), larger tumor size (p = 0.0004), and higher breast density (p = 0.003). Five-year EFS was 91% among younger vs. 82% among older women (p = 0.0005). In women aged < 65, there were 48 EFS events, and triple negative patients had significantly worse EFS compared to other subtypes (p = 0.003). Smokers also had worse EFS (p = 0.04). In women aged ≥ 65, there were 26 events, and both tumor size (p = 0.02) and mastectomy (p = 0.03) were significant for EFS. Conclusions: In our sample, triple negative subtype, smoking history, tumor size, and surgery type were significantly associated with shorter EFS. Race, BMI, alcohol use, parity, breast density, radiation treatment, and specific chemotherapy regimen were not significant for EFS in either age group. Full article

(This article belongs to the Section Breast Cancer)

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14 pages, 1335 KB

Open AccessArticle

Learning Curve and Video-Based Technical Assessment of a Standardized Vesicourethral Anastomosis in Novice Robotic Surgeons

by Federico Germinale, Manfredi Bruno Sequi, Antonia Di Domenico, Andrea Benelli, Federico Dotta, Marco Ennas, Giovanni Guano, Claudia Brusasco, Mattia Tosi, Martina Manfredi, Antonio Luigi Pastore, Antonio Carbone, Andrea Fuschi and Carlo Introini

Curr. Oncol. 2026, 33(9), 502; https://doi.org/10.3390/curroncol33090502 - 25 Aug 2026

Abstract

Background/Objectives: Vesicourethral anastomosis (VUA) is one of the most technically demanding steps of robot-assisted radical prostatectomy (RARP) and may influence perioperative outcomes and early urinary continence recovery. Objective assessment of technical performance during the learning curve remains limited. We evaluated the learning [...] Read more.

Background/Objectives: Vesicourethral anastomosis (VUA) is one of the most technically demanding steps of robot-assisted radical prostatectomy (RARP) and may influence perioperative outcomes and early urinary continence recovery. Objective assessment of technical performance during the learning curve remains limited. We evaluated the learning curve and technical performance of a standardized VUA technique among novice robotic surgeons using a structured video-based assessment. Methods: In this retrospective single-center study, 100 consecutive patients undergoing RARP performed by four novice robotic surgeons were analyzed. All surgeons used the same standardized VUA technique. Operative videos were reviewed and assessed using a modified Robotic Anastomosis Competency Evaluation (RACE) score. Learning-curve trends were analyzed using LOWESS smoothing and mixed-effects regression models. The primary outcome was VUA time. Secondary outcomes included technical performance, anastomosis-related complications, catheterization duration, and urinary continence recovery. Results: A total of 100 procedures were included (25 per surgeon). Increasing surgical experience was significantly associated with shorter VUA time (β = −6.93, 95% CI −7.42 to −6.44; p < 0.001) and higher modified RACE scores (β = 4.99, 95% CI 4.55–5.43; p < 0.001). Median VUA time decreased from 32 min (IQR 29–37) during the early phase to 19 min (IQR 18–20.3) during the late phase (p < 0.001), while median RACE score improved from 13 (IQR 11–15) to 22 (IQR 21–23) (p < 0.001). Positive leak tests decreased from 37.5% to 12.5% (p = 0.03), and the need for additional stitches decreased significantly (p < 0.001). Catheterization time was reduced from 8 to 6 days (p < 0.001). Early urinary continence improved from 37.5% to 65% at 30 days (p = 0.025) and from 60% to 85% at 90 days (p = 0.04), whereas differences were no longer significant at longer follow-up. Conclusions: Novice robotic surgeons performing a standardized VUA technique showed progressive improvements in procedural efficiency and technical performance during their early learning curve. These findings describe technical progression within a standardized operative framework but do not establish an independent effect of standardization itself. Enhanced technical proficiency was accompanied by improved perioperative parameters and a faster recovery of early urinary continence. Video-based assessment may represent a valuable tool for objective monitoring of skill acquisition during robotic surgical training. Full article

(This article belongs to the Section Genitourinary Oncology)

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17 pages, 1124 KB

Open AccessArticle

Breast Cancer Patients’ Parenting Concerns User Personas: A Qualitative Analysis

by Ying Zhang, Ming Liu, Xiaoning Fan, Hailing Tu, Yin Wang and Jingfang Hong

Curr. Oncol. 2026, 33(9), 501; https://doi.org/10.3390/curroncol33090501 - 24 Aug 2026

Abstract

Breast cancer disproportionately affects young women raising minor children. Unresolved parenting concerns can impair patients mental health, reduce treatment adherence, and compromise long-term oncological outcomes. However, previous studies have paid limited attention to the heterogeneity of parenting concerns in this population and lack [...] Read more.

Breast cancer disproportionately affects young women raising minor children. Unresolved parenting concerns can impair patients mental health, reduce treatment adherence, and compromise long-term oncological outcomes. However, previous studies have paid limited attention to the heterogeneity of parenting concerns in this population and lack a theory-grounded classification framework for stratified supportive care. This descriptive qualitative study, framed by social role theory, recruited 17 Chinese breast cancer patients through maximum variation sampling and conducted semi-structured in-depth interviews. From four dimensions—role expectation, role load, role resources, and role adaptation—the study extracted four distinct parenting concern personas: role overload, role strain, role resilience, and role disablement. The four subgroups differed significantly in maternal role expectations, treatment-related physical burden, family support resources, and coping strategies. These findings can assist clinicians in identifying the specific types of distress faced by different patient subgroups, thereby providing a basis for developing stratified and individualized precision support strategies. Full article

(This article belongs to the Section Breast Cancer)

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20 pages, 6111 KB

Open AccessArticle

Development of a Clinicopathological Prognostic Model and Risk Classification to Predict Disease-Free Survival in Patients with Gastric Adenocarcinoma Following Neoadjuvant Chemotherapy and Curative Gastrectomy

by Erdoğan Şeyran and Emre Hafızoğlu

Curr. Oncol. 2026, 33(9), 500; https://doi.org/10.3390/curroncol33090500 - 24 Aug 2026

Abstract

Background: Prognostic assessment after neoadjuvant chemotherapy and curative gastrectomy remains challenging in patients with gastric adenocarcinoma because postoperative outcomes are influenced by both pretreatment disease burden and pathological response. We aimed to develop and internally validate a clinicopathological prognostic model and a simple [...] Read more.

Background: Prognostic assessment after neoadjuvant chemotherapy and curative gastrectomy remains challenging in patients with gastric adenocarcinoma because postoperative outcomes are influenced by both pretreatment disease burden and pathological response. We aimed to develop and internally validate a clinicopathological prognostic model and a simple postoperative risk classification for predicting disease-free survival (DFS). Methods: This single-center retrospective cohort study included patients with gastric adenocarcinoma who underwent neoadjuvant chemotherapy followed by curative gastrectomy. Pretreatment clinicopathological variables, Becker tumor regression grade (TRG), and serum tumor markers were evaluated. Logistic regression was used to identify predictors of favorable pathological response, whereas Cox proportional hazards regression was performed to identify independent prognostic factors for disease-free survival (DFS). Sequential prognostic models were developed and internally validated using 1000 bootstrap resamples. A simplified postoperative clinicopathological risk classification based on pretreatment clinical N stage and Becker tumor regression grade was additionally developed to facilitate clinical interpretation and postoperative risk stratification. Results: A total of 109 patients were included. Favorable pathological response (Becker TRG1–2) was achieved in 68 patients (62.4%), whereas 41 patients (37.6%) had minimal or no pathological response (TRG3). In multivariable logistic regression analysis, pretreatment clinical T stage (cT4 vs. cT1–3) and clinical N stage (cN2–3 vs. cN0–1) were independently associated with a lower likelihood of achieving a favorable pathological response. For disease-free survival, pretreatment clinical N stage, Becker tumor regression grade, and log10-transformed CA19-9 remained independent prognostic factors in the multivariable Cox model. Sequential model development demonstrated progressive improvement in model discrimination, with the optimism-corrected Harrell’s C-index increasing from 0.697 for the clinical N stage model to 0.770 for the final model incorporating clinical N stage, Becker tumor regression grade, and CA19-9. Bootstrap internal validation demonstrated minimal optimism, and calibration analysis showed good agreement between predicted and observed disease-free survival. A simple postoperative clinicopathological risk classification successfully stratified patients into distinct prognostic groups. Conclusions: A clinicopathological prognostic model integrating pretreatment clinical N stage, Becker tumor regression grade, and serum CA19-9 demonstrated improved prognostic discrimination for disease-free survival compared with clinical N stage alone. The derived postoperative risk classification may provide a simple framework for postoperative risk stratification and could assist in individualizing postoperative surveillance. External validation is warranted before routine clinical implementation. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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18 pages, 1378 KB

Open AccessArticle

Identifying Barriers and Strategies to Support a Community Navigator-Driven Approach for Lung Cancer Screening

by Miranda J. Reid, Jennifer H. LeLaurin, Saba Ali, Caroline Sorial, Carma L. Bylund, Jennifer N. Woodard, Easton N. Wollney, Dianne L. Goede, Ji-Hyun Lee, Danielle S. Nelson, Lisa Carter-Bawa and Ramzi G. Salloum

Curr. Oncol. 2026, 33(9), 499; https://doi.org/10.3390/curroncol33090499 - 24 Aug 2026

Abstract

Background/Objectives: Although lung cancer is the leading cause of cancer-related deaths in the United States, rates of screening have remained persistently low nationwide. This study sought to identify barriers, facilitators, and support strategies necessary for implementing a novel community health navigator workflow [...] Read more.

Background/Objectives: Although lung cancer is the leading cause of cancer-related deaths in the United States, rates of screening have remained persistently low nationwide. This study sought to identify barriers, facilitators, and support strategies necessary for implementing a novel community health navigator workflow to improve lung cancer screening uptake in both rural and urban settings. Methods: Semi-structured interviews were conducted with primary care providers (n = 5), community scientists (n = 7), community health navigators (n = 4), and radiology staff (n = 2). Interview transcripts were analyzed using a rapid qualitative analysis approach. Three authors coded based on the Consolidated Framework for Implementation Research (CFIR) and the Expert Recommendations for Implementing Change (ERIC) frameworks using a hybrid deductive–inductive approach. Results: Participants highlighted several primary barriers: access to knowledge and information (e.g., knowledge of eligibility, knowledge of insurance coverage), IT infrastructure (e.g., quality of pack-year data), relative priority (e.g., need to discuss other conditions), and patient needs and resources (e.g., time off work, transportation, difficulty scheduling). Key facilitators for screening were again IT infrastructure (e.g., automated electronic health record alerts) as well as relational connections (e.g., trust between patients and providers). To address provider-level barriers, participants recommended educational meetings, using clinical champions, and providing feedback on current lung cancer screening rates. To address patient-level barriers, participants recommended health education tools, providing transportation vouchers, hosting weekend lung cancer screening clinics, and assisting with scheduling. Conclusions: A community navigator approach to lung cancer screening should address key barriers to implementation on both the patient and provider level, including knowledge, prioritization, and patient access. Full article

(This article belongs to the Section Thoracic Oncology)

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17 pages, 261 KB

Open AccessReview

Combining Radiation Therapy and Tumor-Infiltrating Lymphocyte Therapy: Biological Rationale, Clinical Synergies, and Future Directions

by Sean Maroongroge, Heather M. McGee, Kelly Mahuron, Savita Dandapani, Terence M. Williams, Yan Xing, Myo Htut, Colton J. Ladbury, Yufei Liu and Arya Amini

Curr. Oncol. 2026, 33(9), 498; https://doi.org/10.3390/curroncol33090498 - 24 Aug 2026

Abstract

Tumor-infiltrating lymphocyte (TIL) therapy is the first adoptive cellular therapy approved to treat solid tumors and has demonstrated durable responses in advanced melanoma. However, its clinical implementation is limited by the need for tumor harvesting, manufacturing delays, and lymphodepleting conditioning. These logistic challenges [...] Read more.

Tumor-infiltrating lymphocyte (TIL) therapy is the first adoptive cellular therapy approved to treat solid tumors and has demonstrated durable responses in advanced melanoma. However, its clinical implementation is limited by the need for tumor harvesting, manufacturing delays, and lymphodepleting conditioning. These logistic challenges are also opportunities for physicians and scientists to consider combining TIL therapy with radiation therapy (RT), a modality with well-established roles in cancer care. RT exerts both immunostimulatory and immunosuppressive effects, influencing antigen presentation and T-cell trafficking while also contributing to lymphocyte depletion in a dose- and context-dependent manner. These properties provide a strong biologic rationale for integration with TIL therapy but also introduce important uncertainties. Preclinical studies suggest RT can enhance TIL expansion and function, while early clinical experience supports the feasibility of RT delivery before and after TIL therapy in selected scenarios. However, prospective clinical data remain limited, and key questions regarding optimal timing, dose, and target selection are unresolved. In this review, we propose a workflow-based framework for combining RT with TIL therapy across pre-harvest, bridging, peri-infusion, and post-infusion settings. RT is a promising partner to TIL therapy, but prospective studies will ultimately be needed to define how best to integrate RT in order to translate biologic synergy into consistent clinical benefit. Full article

(This article belongs to the Special Issue The Combination of Immunotherapy and Radiotherapy for Cancer Treatment)

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