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Perfusion Bioreactor Technology for Organoid and Tissue Culture
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Debulking Therapy with Obinutuzumab Is Helpful and Safe in Chronic Lymphocytic Leukemia with Extreme Hyperleukocytosis: A Case Report
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Adult B-Cell Acute Lymphoblastic Leukaemia Antigens and Enriched Pathways Identify New Targets for Therapy
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The Role of Therapeutic Vaccines in Cancer Immunotherapy
Journal Description
Onco
Onco
is an international, peer-reviewed, open access journal on the whole field of oncotargets and cancer therapies research published quarterly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 27.8 days after submission; acceptance to publication is undertaken in 2.8 days (median values for papers published in this journal in the second half of 2024).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
- Onco is a companion journal of Cancers.
Latest Articles
Navigating Rarity: Pathological Challenges and Diagnostic Ambiguity in Rare Gliomas—A Case Series with a Focus on Personalized Treatment and Quality of Life
Onco 2025, 5(2), 28; https://doi.org/10.3390/onco5020028 (registering DOI) - 10 Jun 2025
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Gliomas are incurable, heterogeneous brain tumors, with rare forms often constituting diagnostic and treatment challenges. Molecular diagnostics, mainly implemented through the World Health Organization (WHO) 2021 guidelines, have refined the classification, but highlight difficulties in diagnosing rare gliomas remain. This case series analyzes
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Gliomas are incurable, heterogeneous brain tumors, with rare forms often constituting diagnostic and treatment challenges. Molecular diagnostics, mainly implemented through the World Health Organization (WHO) 2021 guidelines, have refined the classification, but highlight difficulties in diagnosing rare gliomas remain. This case series analyzes four patients with rare gliomas treated at the University Hospital, Ulm, between 2002 and 2024. Patients were selected based on unique histopathological features and long-term clinical follow-up. Clinical records, imaging, and histological data were reviewed. Molecular diagnostics followed WHO 2021 guidelines. Quality of life was assessed using standardized tools including the EQ-5D-5L, EQ VAS, the Distress Thermometer, and the Montreal Cognitive Assessment (MoCA). In the first case, a 51-year-old male’s diagnosis evolved from pleomorphic xanthoastrocytoma to a high-grade glioma with pleomorphic and pseudopapillary features, later identified as a neuroepithelial tumor with a PATZ1 fusion over 12 years. Despite multiple recurrences, extensive surgical interventions led to excellent outcomes. The second case involved a young female with long-term survival of astroblastoma, demonstrating significant improvements in both longevity and quality of life through personalized care. The third case involved a patient with oligodendroglioma, later transforming into glioblastoma, emphasizing the importance of continuous diagnostic reevaluation and adaptive treatment strategies, contributing to prolonged survival and quality of life improvements. Remarkably, the patient has achieved over 20 years of survival, including 10 years of being both therapy- and progression-free. The fourth case presents a young woman with neurofibromatosis type 1, initially misdiagnosed with glioblastoma based on histopathological findings. Subsequent molecular diagnostics revealed a subependymal giant cell astrocytoma-like astrocytoma, highlighting the critical role of early advanced diagnostic techniques. These cases underscore the importance of precise molecular diagnostics, individualized treatments, and ongoing diagnostic reevaluation to optimize outcomes. They also address the psychological impact of evolving diagnoses, stressing the need for comprehensive patient support. Even in complex cases, extensive surgical interventions can yield favorable results, reinforcing the value of adaptive, multidisciplinary strategies based on evolving tumor characteristics.
Full article
Open AccessReview
Molecular Insight and Antioxidative Therapeutic Potentials of Plant-Derived Compounds in Breast Cancer Treatment
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Sandhya Shukla, Arvind Kumar Shukla, Adarsha Mahendra Upadhyay, Navin Ray, Fowzul Islam Fahad, ArulKumar Nagappan, Sayan Deb Dutta and Raj Kumar Mongre
Onco 2025, 5(2), 27; https://doi.org/10.3390/onco5020027 - 9 Jun 2025
Abstract
Breast cancer is one of the most common and difficult-to-treat cancers affecting women globally. Long-term treatment success is still limited by problems like drug resistance, toxicity, and recurrence, even with advancements in conventional therapies. The application of substances derived from plants for medical
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Breast cancer is one of the most common and difficult-to-treat cancers affecting women globally. Long-term treatment success is still limited by problems like drug resistance, toxicity, and recurrence, even with advancements in conventional therapies. The application of substances derived from plants for medical purposes, or phytotherapy, has become a viable adjunctive approach to the treatment of breast cancer. An integrative approach to phytotherapy is examined in this review, focusing on how it can alter important molecular pathways implicated in the development, progression, and metastasis of breast cancer. By focusing on important signaling cascades like TGF-β, Wnt, Hedgehog, Notch, IL-6, Integrins, VEGF, HER2, EGFR, PI3K/Akt, and MAPK, and estrogen receptor pathways, a variety of phytochemicals, such as flavonoids, alkaloids, terpenoids, and polyphenols, demonstrate strong anticancer effects. This review also discusses how they affect immune modulation, angiogenesis, cell cycle regulation, and apoptosis. Moreover, it also emphasizes the challenges with these natural compounds’ bioavailability, standardization, and clinical translation while highlighting preclinical and clinical research that supports their therapeutic potential. This review attempts to give a thorough grasp of how plant-based compounds can support efficient and focused breast cancer treatments by fusing molecular insights with phytotherapeutic approaches.
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(This article belongs to the Special Issue The Evolving Landscape of Contemporary Cancer Therapies)
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Open AccessReview
Locoregional Hyperthermia in Cancer Treatment: A Narrative Review with Updates and Perspectives
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Giammaria Fiorentini, Donatella Sarti, Andrea Mambrini, Gianmaria Mattioli, Massimo Bonucci, Laura Ginocchi, Giuseppe Cristina, Girolamo Ranieri, Salvatore Bonanno, Carlo Milandri, Roberto Nani, Patrizia Dentico, Grazia Lazzari, Antonella Ciabattoni and Caterina Fiorentini
Onco 2025, 5(2), 26; https://doi.org/10.3390/onco5020026 - 3 Jun 2025
Abstract
The applicability of RHT in the treatment and supportive care of tumors has been discussed for years in many publications. There are hundreds of articles that have reported on the good acceptance and feasibility of HT, as well as its value in terms
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The applicability of RHT in the treatment and supportive care of tumors has been discussed for years in many publications. There are hundreds of articles that have reported on the good acceptance and feasibility of HT, as well as its value in terms of controlling malignant diseases, enhancing response and, in some randomized controlled trials (RCTs), clear improvements in OS. Despite this, HT has never fully been accepted as a standard treatment among radiation and medical oncologists. The increased activity that HT offers in the context of chemotherapy (CHT), radiotherapy (RT), chemoradiotherapy (CRT), and immunotherapy, thus facilitating programmed cell death (PCD), has been documented in many studies. This aspect has been demonstrated in many tumors, including soft tissue sarcoma, cancers of the cervix, esophagus, stomach, colon/rectum, pancreas, breast, head and neck, and prostate, and bone metastases. HT improves cancer cell death through many modalities, targeting both the tumor microenvironment (TME) and the cancer cells directly. Targeted HT increases the temperature of the primary tumor and surrounding tissues to 39–43 °C, causing the tumor cells to become more immune-responsive. HT can also activate the immune response of the TME through inducing heat shock proteins (HSPs), which also promote an immunological response and PCD. HT can oxygenate hypoxic tumors, facilitating RT-induced DNA damage in cancer cells. At present, it seems that the combination of HT and RT, CHT, and immunotherapy might lead to immune enhancement effects in the TME, making cancer cells more responsive to immunotherapies. This narrative review presents the novel aspects of HT reported in recent years.
Full article
Open AccessReview
The Relationships Among Perineural Invasion, Tumor–Nerve Interaction and Immunosuppression in Cancer
by
Jozsef Dudas, Rudolf Glueckert, Maria do Carmo Greier and Benedikt Gabriel Hofauer
Onco 2025, 5(2), 25; https://doi.org/10.3390/onco5020025 - 23 May 2025
Abstract
Tumor cells and the tumor microenvironment (TME) produce factors, including neurotrophins, that induce axonogenesis and neurogenesis, and increase local nerve density. Proliferative growing cancer cell clusters and disseminated invasive tumor cells undergoing partial epithelial-to-mesenchymal transition (pEMT) can invade peripheral nerves. In the early
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Tumor cells and the tumor microenvironment (TME) produce factors, including neurotrophins, that induce axonogenesis and neurogenesis, and increase local nerve density. Proliferative growing cancer cell clusters and disseminated invasive tumor cells undergoing partial epithelial-to-mesenchymal transition (pEMT) can invade peripheral nerves. In the early stages of tumor–nerve interactions, Schwann cells (SCs) dedifferentiate, become activated and migrate to cancer cell nests; later, they induce pEMT in tumor cells and activate tumor cell migration along nerves. The SC–tumor–nerve interaction attracts myeloid-derived suppressor cells (MDSCs) and inflammatory monocytes, and the latter differentiate into macrophages. SCs and MDSCs are responsible for the activation of transforming growth factor-beta (TGF-beta) signaling. Intra-tumoral innervation is followed by perineural invasion (PNI), which has an unfavorable prognosis. What are the interventional options against PNI: local reduction in tumor nerves or inhibition of TGF-beta-related events, inhibition of downstream signaling of TGF-beta or immune activation, or intervention against immunosuppression? This systematic review is based on the Prisma 2009 search method and provides an overview of tumor–nerve interaction.
Full article
(This article belongs to the Special Issue Immune–Cancer Cell Interactions: Impact on Clinical Outcomes and Opportunities for Therapy)
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Open AccessReview
Targeting Pathways and Mechanisms in Gynecological Cancer with Antioxidant and Anti-Inflammatory Phytochemical Drugs
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Sandhya Shukla, Arvind Kumar Shukla, Navin Ray, Adarsha Mahendra Upadhyay, Fowzul Islam Fahad, Sayan Deb Dutta, Arulkumar Nagappan and Raj Kumar Mongre
Onco 2025, 5(2), 24; https://doi.org/10.3390/onco5020024 - 9 May 2025
Abstract
Globally, women’s cancer-related morbidity and death are still caused mainly by gynecologic cancer. Antioxidant and anti-inflammatory drugs have shown promise in treating gynecologic cancer because of the complex interactions among oxidative stress, inflammation, and the development of tumors. This review focuses on how
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Globally, women’s cancer-related morbidity and death are still caused mainly by gynecologic cancer. Antioxidant and anti-inflammatory drugs have shown promise in treating gynecologic cancer because of the complex interactions among oxidative stress, inflammation, and the development of tumors. This review focuses on how these drugs, which include polyphenols, terpenoids, and thiols-related phytochemical-derived compounds target different pathways associated with developing and progressing gynecologic cancer. We investigate what factors affect the tumor microenvironment, specifically how they affect immunological response and vasculogenesis. Through the review of recent studies, we have gained an extensive understanding of the molecular pathways that anti-inflammatory and antioxidant drugs use to achieve their therapeutic benefits. Gynecologic cancer is still a potent cause of cancer-related deaths and fatalities for women globally. Antioxidant and anti-inflammatory drugs have shown promise in treating gynecologic cancer because of the complex interactions among oxidative stress, inflammation, and the development of tumors. This review focuses on how these drugs target different pathways associated with developing and progressing gynecologic cancer. We investigate what factors affect the tumor microenvironment, specifically how they affect immunological response and vasculogenesis. Through the review of recent studies, we have gained an extensive understanding of the molecular pathways that anti-inflammatory and antioxidant drugs use to achieve their therapeutic benefits.
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(This article belongs to the Special Issue Targeting of Tumor Dormancy Pathway)
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Open AccessArticle
Noninvasive Screening of Basal Cell Carcinomas: A Comparison of the Structure and Physical Properties of Large and Small Nodular Lesions Using Vibrational OCT and Histopathology
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Frederick H. Silver, Tanmay Deshmukh, Gayathri Kollipara and Aanal Patel
Onco 2025, 5(2), 23; https://doi.org/10.3390/onco5020023 - 1 May 2025
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Approximately 5.4 million nonmelanoma skin cancers are treated each year in the US. Of this number 80 to 90% are basal cell carcinomas. In this study, we compare optical coherence tomography (OCT) images and vibrational optical coherence tomography (VOCT) measurements made on small
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Approximately 5.4 million nonmelanoma skin cancers are treated each year in the US. Of this number 80 to 90% are basal cell carcinomas. In this study, we compare optical coherence tomography (OCT) images and vibrational optical coherence tomography (VOCT) measurements made on small and large nodular basal cell carcinomas (BCCs) using histopathology, OCT images, and VOCT physical measurements. OCT images were broken into green, blue, and red subchannel images and compared to histopathology conducted on the excised tissue. While our results suggest that both small and large BCCs have similar morphologies that include circular nodules with palisading cells surrounding the lesions, no part of the excised lesions appeared like normal skin. In the small lesion, the nodule is surrounded by tissue that may be considered to have “clear” margins even though the rete ridges are missing, and the ECM does not resemble normal skin. The edges of the lesion are free of palisading cells with only some inflammatory cells being present. In contrast, the mechanovibrational spectrum of the large lesion appeared to have an increased amount of large fibrotic peaks with decreased vibrations for normal cells and cancer-associated fibroblasts compared to the smaller nodule. These results indicate that it is possible to identify the location of the BCC nodules noninvasively using VOCT. The ability to noninvasively identify nodular BCCs using this technique makes it a useful adjunct to visual inspection and dermoscopy to identify cancerous lesions seen in the clinic. Since VOCT can be operated remotely, it can serve as a noninvasive screening tool to be used by general practitioners in areas where dermatologists are in short supply.
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Open AccessSystematic Review
IOTA Three-Step Strategy for Classifying Adnexal Masses: A Systematic Review and Meta-Analysis
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Juan Luis Alcázar, Francisco Vargas, Guillem Boscá, Blanca Salazar, Juan Carlos Aguilar, Cynthia Catalan, Arleana Balazs, Daniela Burky, Magdalena Pertkiewicz, José Carlos Vilches and Rodrigo Orozco
Onco 2025, 5(2), 22; https://doi.org/10.3390/onco5020022 - 1 May 2025
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Background: Our goal was to assess the diagnostic performance of the IOTA 3-step strategy for discriminating benign from malignant adnexal masses. Methods: Systematic review and meta-analysis design. A systematic search across three databases (Medline [PubMed], SCOPUS, and Web of Science) was conducted to
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Background: Our goal was to assess the diagnostic performance of the IOTA 3-step strategy for discriminating benign from malignant adnexal masses. Methods: Systematic review and meta-analysis design. A systematic search across three databases (Medline [PubMed], SCOPUS, and Web of Science) was conducted to identify primary studies reporting on the use of the IOTA three-step strategy from January 2012 to July 2024. Prospective cohort studies utilizing the three-step strategy, with histologic diagnosis or conservative management confirming spontaneous resolution or persistence in cases of benign-appearing masses for at least one year of follow-up, were used as the reference standard. Studies unrelated to the topic, those not addressing the IOTA three-step strategy, studies focusing on other prediction models, letters to the editor, commentaries, narrative reviews, consensus documents, and studies lacking data for constructing a 2 × 2 table were excluded. Quantitative synthesis was done, calculating the pooled sensitivity, specificity, and positive and negative likelihood ratios. Qualitative synthesis was done using QUADAS-2. Results: A total of 448 citations were initially identified, with 7 studies meeting inclusion criteria, comprising 5722 patients. The mean prevalence of ovarian malignancy was 28%. The quality of the studies was considered good. IOTA 3-step strategy showed a pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of the three-step strategy for adnexal mass classification were 94% (95% CI = 91–95%), 94% (95% CI = 91–97%), 17.0 (95% CI = 10–28.8), and 0.07 (95% CI = 0.05–0.1), respectively. Heterogeneity for sensitivity was moderate, and for specificity it was high. Conclusions: We conclude that the three-step strategy has good diagnostic performance, reducing the need for expert examiner evaluation.
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Open AccessArticle
The Role of the Bone Marrow Microenvironment in Physical Function and Quality of Life in Patients with Multiple Myeloma After First-Line Treatment with Novel Agents and Autologous Transplantation
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Polyxeni Spiliopoulou, Pantelis Rousakis, Chrysanthi Panteli, Evangelos Eleutherakis-Papaiakovou, Magdalini Migkou, Nikolaos Kanellias, Ioannis Ntanasis-Stathopoulos, Panagiotis Malandrakis, Foteini Theodorakakou, Despina Fotiou, Evangelos Terpos, Vassilios Myrianthopoulos, Maria Gavriatopoulou, Ourania E. Tsitsilonis, Efstathios Kastritis, Meletios Athanasios Dimopoulos and Gerasimos Terzis
Onco 2025, 5(2), 21; https://doi.org/10.3390/onco5020021 - 1 May 2025
Abstract
Background/Objectives: Multiple myeloma is a malignancy of plasma cells detected in the bone marrow, inducing symptoms like anemia, hypercalcemia, renal problems, and bone fractures in multiple myeloma patients, affecting their quality of life. The bone marrow microenvironment plays a crucial role in the
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Background/Objectives: Multiple myeloma is a malignancy of plasma cells detected in the bone marrow, inducing symptoms like anemia, hypercalcemia, renal problems, and bone fractures in multiple myeloma patients, affecting their quality of life. The bone marrow microenvironment plays a crucial role in the prognosis and progression of the disease. The purpose of this study was to examine the relationship between the percentages of the major cell populations of the bone marrow, including immune cells, and physical function/quality of life in multiple myeloma patients after first-line treatment. Methods: Twenty-one multiple myeloma patients (N = 14 men, N = 7 women) participated in the study after completing first-line treatment. Bone marrow and blood samples were taken one hundred days after transplantation, while physical function (6 min walking test, handgrip test, maximal aerobic power, and isometric strength), health-related quality of life (QLQ-C30), and body composition (DXA) were assessed 2–5 days later. Flow cytometry was used to assess the percentages of plasma cells, mast cells, B cells (total, precursors, naïve, and memory), T cells (total, CD27− and CD27+), NK/NKT cells (total, CD27− and CD27+), eosinophils, monocytes, neutrophils, myeloid progenitors, erythroblasts, and erythroid progenitors, expressed as percentages of total nucleated cells of the bone marrow. Results: The percentage of CD27+ NK/NKT cells was correlated with five parameters of the quality of life questionnaire: physical function (r = 0.78, p = 0.005), role functioning (r = 0.69, p = 0.020), fatigue (r = −0.86, p = 0.000), pain (r = 0.68, p = 0.021), and dyspnea (r = −0.80, p = 0.003). Conclusions: In conclusion, stronger immune surveillance in the bone marrow from CD27+ NK/NKT cells is correlated with better quality of life in multiple myeloma patients.
Full article
(This article belongs to the Special Issue Targeting of Tumor Dormancy Pathway)
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Open AccessArticle
A Regional Experience of Adult Granulosa Cell Tumours: A Retrospective Analysis
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Joanne Moffatt, Jo Morrison, Srividya Sundararajan, Rebecca Newhouse, Laura Atherton, Jonathan Frost, Philip Rolland, Kirsty Milford, Katharine Edey, Jane Borley, Amy Sanders, Axel Walther and Claire Newton
Onco 2025, 5(2), 20; https://doi.org/10.3390/onco5020020 - 1 May 2025
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Background: Adult granulosa cell tumours (AGCT) of the ovary account for 2–5% of ovarian tumours, with 30% occurring in women of childbearing age. Despite a good prognosis, up to 25% recur. There is a paucity of high-quality evidence to guide management. Objective: To
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Background: Adult granulosa cell tumours (AGCT) of the ovary account for 2–5% of ovarian tumours, with 30% occurring in women of childbearing age. Despite a good prognosis, up to 25% recur. There is a paucity of high-quality evidence to guide management. Objective: To describe management of AGCT across multiple gynaecological cancer centres. Methods: Retrospective analysis of electronic patient records from six gynaecological cancer centres in Southwest England between 2000 and 2021 (n = 119). Results: We included 107 patients with a median follow-up of 60 months (0–261 months). Most (97/107; 90.7%) were diagnosed with stage I disease (31.8% stage Ic). Primary management was staging surgery in 33/107 (30.8%), hysterectomy and bilateral salpingo-oophorectomy (BSO) (28/107; 26.2%), or conservation of an ovary (17/107; 15.9%). Three had a subsequent pregnancy. A quarter (27/107; 25.2%) were diagnosed with recurrent disease. Fifteen patients (15/107; 14%) had multiple recurrences. Recurrence was more likely if cyst rupture was reported at surgery (38.7%) compared with no rupture (14.3%; p < 0.001). The recurrence rate was higher with ovarian conservation (6/17; 35.3%) compared with BSO (21/90; 23.3%; p < 0.01), and all recurrences involved the residual ovary. Of the 11 deaths, 6 (54.5%) were attributed to progressive disease. Conclusions: Although survival with early-stage disease is good, ovarian cystectomy or unilateral ovarian conservation was associated with increased risk of recurrence. There is no conclusive evidence to support a contralateral oophorectomy in pre-menopausal women, but completion surgery should at least be considered, either immediately or after childbearing/assisted reproductive treatment.
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Open AccessArticle
Adult B-Cell Acute Lymphoblastic Leukaemia Antigens and Enriched Pathways Identify New Targets for Therapy
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Eithar Mohamed, Sara Goodman, Leah Cooksey, Daniel M. Fletcher, Olivia Dean, Viktoriya B. Boncheva, Ken I. Mills, Kim H. Orchard and Barbara-ann Guinn
Onco 2025, 5(2), 19; https://doi.org/10.3390/onco5020019 - 22 Apr 2025
Abstract
Background: Adult B-cell acute lymphoblastic leukaemia (aB-ALL) is characterised by abnormal differentiation and proliferation of lymphoid progenitors. Despite a significant improvement in relapse-free and overall survival for children with B-ALL, aB-ALL has a particularly poor prognosis with a 5-year survival rate of 20%.
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Background: Adult B-cell acute lymphoblastic leukaemia (aB-ALL) is characterised by abnormal differentiation and proliferation of lymphoid progenitors. Despite a significant improvement in relapse-free and overall survival for children with B-ALL, aB-ALL has a particularly poor prognosis with a 5-year survival rate of 20%. First remission is achieved for most patients, but relapse is common with a high associated mortality. New treatments such as immunotherapy offer an opportunity to extend remission and prevent relapse. Methods: aB-ALL antigens were identified using different sources—immunoscreening, protoarrays, two microarrays and one cancer-testis antigen database, and a review of the genomic analyses of aB-ALL. A total of 385 aB-ALL-associated gene products were examined for their association with patient survival. Results: We identified 87 transcripts with differential expression between aB-ALL and healthy volunteers (peripheral blood, bone marrow and purified CD19+ cells), and 42 that were associated with survival. Enrichr analysis showed that the Transforming Growth Factor-β (TGFβ), Wnt and Hippo pathways were highly represented (p < 0.02). We found that SOX4 and ROCK1 were upregulated in all types of B-ALL (ROCK1 having a p < 0.001 except in t(8;14) patients), as well as SMAD3 and TEAD4 upregulation being associated with survival (p = 0.0008, 0.05 and 0.001, respectively). Expression of each aB-ALL antigen was verified by qPCR, but only TEAD4 showed significant transcript upregulation in aB-ALL compared to healthy volunteer CD19+ cells (p = 0.01). Conclusions: We have identified a number of antigens and their pathways that play key roles in aB-ALL and may act as useful targets for future immunotherapy strategies.
Full article
(This article belongs to the Special Issue Immune–Cancer Cell Interactions: Impact on Clinical Outcomes and Opportunities for Therapy)
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Open AccessReview
The Role of Genomics and Transcriptomics in Characterizing and Predicting Patient Response to Treatment in Triple Negative Breast Cancer (TNBC)
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Franklin Eduardo Corea-Dilbert and Muhammad Zubair Afzal
Onco 2025, 5(2), 18; https://doi.org/10.3390/onco5020018 - 22 Apr 2025
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Breast cancer is a complex disease that is one of the leading causes of cancer-related mortality in women worldwide. Of the subtypes of breast cancer, the most aggressive subtype is triple negative breast cancer (TNBC) due to its lack of targets that could
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Breast cancer is a complex disease that is one of the leading causes of cancer-related mortality in women worldwide. Of the subtypes of breast cancer, the most aggressive subtype is triple negative breast cancer (TNBC) due to its lack of targets that could be leveraged for treatment in other subtypes. Current treatment options for both local and metastatic TNBC include radiation therapy, chemotherapy, surgery, targeted therapy, and immunotherapy, which has been gaining popularity in recent years. The role of targeted therapy in TNBC is somewhat limited due to the paucity of therapeutic personalized targets, and, due to the heterogeneity of the disease, the effectiveness of these different modalities varies from patient to patient. These unique elements are the foundation of personalized medicine where genomics and transcriptomics play a critical role in increasing granularity in patients’ disease and treatment. The purpose of these molecular tools is to identify biomarkers that could be used to further characterize each patient’s unique disease features and to predict how certain treatment modalities will affect patient survival and prognosis. The interplay between these biomarkers and molecular pathways involved in treatment response with disease progression and aggressiveness is a complex phenomenon. In this review, we describe the current state of the literature in regard to biomarkers that show promise in the clinical setting to predict response to treatments such as chemotherapy, radiation, and surgery in locally advanced and metastatic TNBC.
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Open AccessReview
Perfusion Bioreactor Technology for Organoid and Tissue Culture: A Mini Review
by
Paola Avena, Lucia Zavaglia, Ivan Casaburi and Vincenzo Pezzi
Onco 2025, 5(2), 17; https://doi.org/10.3390/onco5020017 - 9 Apr 2025
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Organoid culture is an emerging and promising 3D culture system by which three-dimensional cell aggregates have been produced from different organs and tissues. This new innovative culture technology preserves parental gene expression, as well as the biological features of parental cells in vitro
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Organoid culture is an emerging and promising 3D culture system by which three-dimensional cell aggregates have been produced from different organs and tissues. This new innovative culture technology preserves parental gene expression, as well as the biological features of parental cells in vitro and ensures maintenance of three-dimensional cell culture for prolonged periods, opening new encouraged scientific scenarios and making them a functioning and valid system for testing new drugs for tissue engineering studies and precision oncology medicine. Various research focused on organoids has been performed in perfusion bioreactors, an advanced device able to mimic the tumor environment, providing a physiological growth state and a long-term culture viability. Perfusion bioreactors have been used for the maintenance and growth of organoids as well as for tumor patient samples improving proliferation while supporting the development of extracellular matrix (ECM). The ability to mimic the tumor environment and to maintain patient-derived biopsies for a long time makes perfusion bioreactors an essential model for preclinical testing.
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Open AccessArticle
Feasibility of a Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Program for Gastrointestinal and Gynecological Cancer Care in Newfoundland and Labrador
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Kala Hickey, Stephanie Gill, Zoë Breen, Kaitlyn Harding, Hannah Yaremko, Alex Mathieson, Patti Power, David Pace and Joannie Neveu
Onco 2025, 5(2), 16; https://doi.org/10.3390/onco5020016 - 7 Apr 2025
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Peritoneal carcinomatosis is a common presentation found in advanced-stage gastrointestinal (GI) and gynecological cancers. Combined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with significant survival benefits for select patients. CRS/HIPEC is not currently provided in Newfoundland and Labrador (NL). The
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Peritoneal carcinomatosis is a common presentation found in advanced-stage gastrointestinal (GI) and gynecological cancers. Combined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with significant survival benefits for select patients. CRS/HIPEC is not currently provided in Newfoundland and Labrador (NL). The Canadian HIPEC Collaborative Group recommends that centres complete a minimum of one case monthly to maintain competency and achieve good outcomes. Thus, we aimed to demonstrate that the annual patient volume in NL justifies the feasibility of implementing a combined surgical and gynecological oncology CRS/HIPEC program. Methods: A retrospective chart review of the NL Cancer Care Registry identified patients with stage IV colorectal, appendiceal, or gastric cancer and stage III to IV epithelial ovarian cancer over a 1-year period (1 January 2020–31 December 2020) to identify the number of patients meeting the criteria for CRS/HIPEC and/or those referred out of province to receive the treatment. The results are presented as proportions and percentages. Results: Thirty-one patients were eligible to receive CRS/HIPEC during the study period (11 GI, 20 gynecological). Of the GI patients, 63% were referred out of province for the procedure. Gynecological patients underwent CRS and systemic therapy +/− outpatient intraperitoneal chemotherapy in NL. Conclusions: Allowing patients to receive this standard of care treatment near home reduces financial, social, and emotional stressors. Our results confirm a sufficient patient volume to support a combined CRS/HIPEC program in NL. The implementation of this program will require multidisciplinary collaboration, specialized training, equipment, and protocol development.
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Open AccessArticle
Assessing First and Multiple Reoperations in 23,301 Breast Reconstructions: Immediate Versus Delayed Reconstructions in Women with Breast Cancer
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Kathryn E. Royse, Tina M. Smith, Cissy M. Tan, Eric Y. Lin, Robert G. Neumann, Jessica E. Harris, Elizabeth W. Paxton and Winnie M. Tong
Onco 2025, 5(2), 15; https://doi.org/10.3390/onco5020015 - 2 Apr 2025
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Background: Few studies have compared the risk of reoperation by timing in breast reconstruction surgery after mastectomy. We evaluated the first and total number of reoperations by reconstruction timing in women with breast cancer undergoing primary mastectomy. Methods: A cohort study of 23,301
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Background: Few studies have compared the risk of reoperation by timing in breast reconstruction surgery after mastectomy. We evaluated the first and total number of reoperations by reconstruction timing in women with breast cancer undergoing primary mastectomy. Methods: A cohort study of 23,301 primary mastectomies in women with breast cancer undergoing either immediate breast reconstruction (IBR) or delayed reconstruction was carried out within Kaiser Permanente between 2010 and 2022. The first reoperation rate was calculated using cause-specific Cox Proportional Hazards Models, while Multiplicative Cox Proportional Hazards Models were used to account for mortality and timing in reoperation. Patients were continuously monitored for death, outcome of interest, loss to follow-up through healthcare membership termination, or study end date (31 December 2022). Results: In total, 78.4% (n = 18,276) of the cohort underwent IBR. The average follow-up time was 5.9 years (±3.8). The following covariates were imbalanced (standardized mean difference [SMD] ≥ 0.20) between IBR and delayed groups: BMI, smoking status, year of mastectomy, bilateral procedures, and reconstruction type. The crude incidence of first reoperation was 33.04% vs. 31.72% in IBR vs. delayed patients and the risk of reoperation was 18% higher in IBR patients (HR = 1.18, 95% CI = 1.12–1.25). There was no difference in the risk of reoperation by timing (p > 0.05) when assessing multiple reoperations. The reoperation risk was the highest for IBR patients who did not complete reconstruction or single-stage reconstruction. In addition, the first reoperation rate of IBR patients was higher in those who underwent expander–implant-based reconstruction. Conclusions: The first reoperation rate was higher in IBR patients compared to those who delayed reconstruction, although we failed to detect a difference for multiple returns to surgery, except in certain subgroups. Assessing reoperation risk by timing among different reconstruction modalities can aid patients in making informed decisions about the type of breast reconstruction to undergo.
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Open AccessReview
State-of-the-Art Therapy in Peritoneal Carcinomatosis Management
by
Elbek Fozilov, Anthony Weng, Snigdha Kanadibhotla, Nina D. Kosciuszek, Zhaosheng Jin and Sherif R. Abdel-Misih
Onco 2025, 5(2), 14; https://doi.org/10.3390/onco5020014 - 1 Apr 2025
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This paper reviews the surgical management of peritoneal carcinomatosis as new surgical methods have been developed within the past few decades. Traditional methods included cytoreductive surgery with hyperthermic intraperitoneal chemotherapy; however, a new method has been developed, Pressurized Intraperitoneal Aerosol Chemotherapy. This method
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This paper reviews the surgical management of peritoneal carcinomatosis as new surgical methods have been developed within the past few decades. Traditional methods included cytoreductive surgery with hyperthermic intraperitoneal chemotherapy; however, a new method has been developed, Pressurized Intraperitoneal Aerosol Chemotherapy. This method is minimally invasive while allowing for promising outcomes in those who have exhausted therapy options or require palliative therapy. The goal of this paper is to compare and contrast the traditional and standard method with the newer method for intraoperative delivery of chemotherapy.
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Open AccessReview
Advancing Bladder Cancer Biomarker Discovery: Integrating Mass Spectrometry and Molecular Imaging
by
Vadanasundari Vedarethinam
Onco 2025, 5(2), 13; https://doi.org/10.3390/onco5020013 - 24 Mar 2025
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Bladder cancer, a highly heterogeneous disease, necessitates precise diagnostic and therapeutic strategies to enhance patient outcomes. Metabolomics, through comprehensive small-molecule analysis, provides valuable insights into cancer-associated metabolic alterations at the cellular, tissue, and systemic levels. Concurrently, molecular imaging modalities like PET, MRI, and
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Bladder cancer, a highly heterogeneous disease, necessitates precise diagnostic and therapeutic strategies to enhance patient outcomes. Metabolomics, through comprehensive small-molecule analysis, provides valuable insights into cancer-associated metabolic alterations at the cellular, tissue, and systemic levels. Concurrently, molecular imaging modalities like PET, MRI, and CT enable the non-invasive, real-time visualization of tumor biology, facilitating the spatial and functional assessment of biomarkers. Key findings highlight the identification of metabolomic profiles correlated with cancer progression, recurrence, and treatment responses across serum, urine, and tissue samples. Advanced analytical platforms, such as LC-MS and NMR, uncover distinct metabolic signatures and pathway alterations in glycolysis, amino acid metabolism, and lipid biosynthesis. Molecular imaging further enhances staging accuracy and treatment monitoring by visualizing metabolic activity and receptor expression. The integration of these technologies addresses the limitations of invasive diagnostic methods and paves the way for precision oncology. Future advancements should focus on multi-omics integration, AI-driven analysis, and large-scale clinical validation to ensure broad accessibility and transformative impacts on bladder cancer management.
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Open AccessArticle
Risk Factors for Periprosthetic Infection Following Limb Salvage Surgery in Bone Sarcomas
by
Diogo Nóbrega Catelas, Lucinda Correia, Alexandra Santos, Catarina Pereira, Diogo Rodrigues, Afonso Faria, Guilherme Madeira, Pedro Cardoso and Vânia Oliveira
Onco 2025, 5(1), 12; https://doi.org/10.3390/onco5010012 - 17 Mar 2025
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Background: Multimodal treatment of bone sarcomas has improved survival and allowed limb salvage surgery in the majority of these patients. Periprosthetic joint infection (PJI) constitutes a challenging complication. Controversy remains regarding the risk factors for PJI. Here, we aim to identify them. We
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Background: Multimodal treatment of bone sarcomas has improved survival and allowed limb salvage surgery in the majority of these patients. Periprosthetic joint infection (PJI) constitutes a challenging complication. Controversy remains regarding the risk factors for PJI. Here, we aim to identify them. We also discuss pathogens and treatments. Methods: The authors reviewed the institutional database to retrieve endoprostheses implanted after bone sarcoma resection from 2014 to 2021. In total, 66 eligible patients were identified. Results: A total of 14 (21.21%) periprosthetic infections were diagnosed. Of these, 10 occurred in men (71.43%, p = 0.143). Mean BMI, age at the time of surgery, and ASA score were significantly higher among patients who developed PJI (p = 0.003, 0.044, and 0.033, respectively). Site was an important factor as well (p = 0.029). The number of comorbidities and the Charlson Comorbidity Index were also higher among these patients (p = 0.264, 0.060, respectively). Histology did not play a role in PJI (p = 0.385). Conclusions: Our data allow surgeons to better understand and control risk factors for PJI. We identified BMI, age, ASA score, site, and the Charlson Comorbidity Index as the main risk factors. Polymicrobial infections and methicillin-resistant Staphylococcus aureus are associated with recurrent infections. A multicentric study with a larger cohort is needed.
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Open AccessReview
The Role of Therapeutic Vaccines in Cancer Immunotherapy
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Constantin N. Baxevanis, Ourania E. Tsitsilonis, Maria Goulielmaki, Nikolaos Tsakirakis and Angelos D. Gritzapis
Onco 2025, 5(1), 11; https://doi.org/10.3390/onco5010011 - 5 Mar 2025
Abstract
Cancer vaccines offer an exciting option for active immunotherapy, providing a potentially safe and effective treatment that also prevents or minimizes toxic side effects in vaccinated patients. Clinical results from previous phase III clinical trials have suggested that the efficacy of cancer vaccines
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Cancer vaccines offer an exciting option for active immunotherapy, providing a potentially safe and effective treatment that also prevents or minimizes toxic side effects in vaccinated patients. Clinical results from previous phase III clinical trials have suggested that the efficacy of cancer vaccines largely depends on their potential to trigger robust immunological responses. A preexisting immune response to cancer-specific peptides is crucial for achieving a meaningful clinical outcome during vaccinations. However, various factors may hinder the effectiveness of therapeutic vaccines. By overcoming these challenges, cancer vaccines have the potential to become a cornerstone in immunotherapy. This review aims to share our insights on the major challenges that are encountered when optimizing the potential of cancer vaccines, particularly focusing on important aspects regulating their clinical efficacy, such as vaccine composition, the adjuvant to be used and the HLA-restricting element for the tumor peptides targeted by a particular vaccine. Additionally, we discuss several obstacles which hindered the successful clinical development of therapeutic cancer vaccines, such as the standard of care, the clinical design, and the choice of the antigen(s) to be included in vaccine formulation. The identification of patients that are most likely to respond to vaccinations by developing immunological responses and the desirable clinical efficacy are also crucial, and, therefore, predictive biomarkers are strictly required. Finally, we present our views on future prospects that may lead to an enhancement of the anticancer effects of vaccines, ensuring their pivotal role in cancer immunotherapy.
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(This article belongs to the Special Issue The Evolving Landscape of Contemporary Cancer Therapies)
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Open AccessCase Report
Debulking Therapy with Obinutuzumab Is Helpful and Safe in Chronic Lymphocytic Leukemia with Extreme Hyperleukocytosis: A Case Report
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Dario Leotta, Andrea Duminuco, Marina Silvia Parisi, Laura Caruso, Uros Markovic, Ermelinda Longo, Francesco Di Raimondo, Giuseppe Alberto Palumbo and Annalisa Chiarenza
Onco 2025, 5(1), 10; https://doi.org/10.3390/onco5010010 - 1 Mar 2025
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Chronic lymphocytic leukemia (CLL) represents the most frequent leukemia in the Western world, with an incidence of 4 [...]
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Open AccessReview
HCC and Immunotherapy: The Potential Predictive Role of Gut Microbiota and Future Therapeutic Strategies
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Carmelo Laface, Eleonora Lauricella, Girolamo Ranieri, Francesca Ambrogio, Felicia Maria Maselli, Elena Parlagreco, Giulia Bernardi, Elena Fea and Gianmauro Numico
Onco 2025, 5(1), 9; https://doi.org/10.3390/onco5010009 - 27 Feb 2025
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During the last decade, a new therapeutic revolution has involved the management of hepatocellular carcinoma (HCC). This is made possible thanks to the documented efficacy of immunotherapy for this disease. In addition, new evidence has demonstrated the role of the gut–liver axis and
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During the last decade, a new therapeutic revolution has involved the management of hepatocellular carcinoma (HCC). This is made possible thanks to the documented efficacy of immunotherapy for this disease. In addition, new evidence has demonstrated the role of the gut–liver axis and gut microbiota in host homeostasis, tumor development, and response to therapies. In particular, intestinal dysbiosis can alter the tumor microenvironment, leading to the activation of intracellular signaling pathways that promote carcinogenesis. The composition of gut microbiota proved to influence the immune checkpoint inhibitors (ICIs) efficacy and drug toxicities. Therefore, this review aims to deepen knowledge about the immunomodulatory role of gut microbiota and its possible employment as diagnostic and predictive biomarkers in diagnosis and response to HCC immunotherapy, respectively. The research was conducted through the analysis of Pubmed and Web of Science (WoS) databases for literature studies on the relationship between gut microbiota and HCC from 2015 to 2025.
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