Search Results (173)

Cutaneous and oral mucosal adverse events (AEs) are among the most common non-hematologic toxicities observed during breast cancer treatment. These complications arise across various therapeutic modalities including chemotherapy, targeted therapy, hormonal therapy, radiotherapy, and immunotherapy. Although often underrecognized compared with systemic side effects, dermatologic and mucosal toxicities can severely impact the patients’ quality of life, leading to psychosocial distress, pain, and reduced treatment adherence. In severe cases, these toxicities may necessitate dose reductions, treatment delays, or discontinuation, thereby compromising oncologic outcomes. The growing use of precision medicine and novel targeted agents has broadened the spectrum of AEs, with some therapies linked to distinct dermatologic syndromes and mucosal complications such as mucositis, xerostomia, and lichenoid reactions. Early detection, accurate classification, and timely multidisciplinary management are essential for mitigating these effects. This review provides a comprehensive synthesis of current knowledge on cutaneous and oral mucosal toxicities associated with modern breast cancer therapies. Particular attention is given to clinical presentation, underlying pathophysiology, incidence, and evidence-based prevention and management strategies. We also explore emerging approaches, including nanoparticle-based delivery systems and personalized interventions, which may reduce toxicity without compromising therapeutic efficacy. By emphasizing the integration of dermatologic and mucosal care, this review aims to support clinicians in preserving treatment adherence and enhancing the overall therapeutic experience in breast cancer patients. The novelty of this review lies in its dual focus on cutaneous and oral complications across all major therapeutic classes, including recent biologic and immunotherapeutic agents, and its emphasis on multidisciplinary, patient-centered strategies. Full article

Background/Objectives: Oral leukoplakia (OL) is a prevalent oral potentially malignant disorder. Despite its clinical relevance, the molecular basis of its progression to malignancy is not yet fully elucidated. This scoping review of systematic reviews and meta-analyses aimed to synthesize current knowledge and evidence gaps regarding the implications of hallmarks of cancer expression in OL malignant transformation. Methods: A systematic search was conducted in MEDLINE, Embase, DARE, and the Cochrane Library to identify systematic reviews (with or without meta-analysis) published up to April-2025. Results: Twenty-two systematic reviews were included. The most frequently explored hallmark was activation of invasion and metastasis (n = 12; 32.40%), followed by tumor-promoting inflammation (n = 10; 27.03%), evasion of growth suppressors (n = 8; 21.60%), sustained proliferative signaling (n = 3; 8.10%), energy metabolism reprogramming (n = 2; 5.40%), replicative immortality (n = 1; 2.70%), and resistance to cell death (n = 1; 2.70%). No evidence was found for angiogenesis or immune evasion in OL. Conclusions: Available evidence indicates that OL may develop oncogenic mechanisms in early stages of oral oncogenesis, especially those related to sustained proliferation, evasion of growth suppressor signals, and cellular migration and invasion. Chronic inflammation also may facilitate the acquisition of other hallmarks throughout the multistep process of oral carcinogenesis. These findings also reveal evidence gaps in underexplored hallmarks of cancer, which highlights the need to expand future primary- and secondary-level investigations to better define the molecular mechanisms underlying OL malignant transformation. Full article

Oral cancer, the most common form of head and neck cancer, is worldwide a serious public health problem. Most patients present a locally advanced disease, and face poor prognosis, even with multimodality treatment. They may also develop second primary tumors in the entirety of their upper aerodigestive tract. The most altered signaling pathways are the PI3K/AKT/mTOR, TP53, RB, and the WNT/β-catenin pathways. Genomic and molecular cytogenetic analyses have revealed frequent losses at 3p, 8p, 9p, and 18q, along with gains at 3q, 7p, 8q, and 11q, and several genes frequently affected have been identified, such as TP53, CCND1, CTTN, CDKN2A, EGFR, HRAS, PI3K, ADAM9, MGAM, SIRPB1, and FAT1, among others. Various epigenetic alterations were also found, such as the global hypomethylation and hypermethylation of CDKN2A, APC, MGMT, PTEN, CDH1, TFP12, SOX17, GATA4, ECAD, MGMT, and DAPK. Several microRNAs are upregulated in oral cancer, including miR-21, miR-24, miR-31, miR-184, miR-211, miR-221, and miR-222, while others are downregulated, such as miR-203, miR-100, miR-200, miR-133a, miR-133b, miR-138, and miR-375. The knowledge of this molecular pathogenesis has not yet been translated into clinical practice, apart from the use of cetuximab, an EGFR antibody. Oral tumors are also genetically heterogenous and affect several pathways, which means that, due to the continuous evolution of these genetic alterations, a single biopsy is not sufficient to fully evaluate the most adequate molecular targets when more drugs become available. Liquid biopsies, either resorting to circulating tumor cells, extracellular vesicles or cell-free nucleic acids, have the potential to bypass this problem, and have potential prognostic and staging value. We critically review the current knowledge on the molecular, genetic and epigenetic alterations in oral cancer, as well as the applications and challenges of liquid biopsies in its diagnosis, follow-up, and prognostic stratification. Full article

Gastric cancer (GC) remains a major global health burden, with high morbidity and mortality rates, particularly in regions with prevalent Helicobacter pylori (H. pylori) infection. While H. pylori has long been recognized as a primary carcinogenic agent, recent research has underscored the broader contribution of the gastric microbiota to gastric carcinogenesis. Alterations in the microbial community, or dysbiosis, contribute to chronic inflammation, immune modulation, and epithelial transformation through a range of mechanisms, including disruption of mucosal integrity, activation of oncogenic signaling pathways (e.g., PI3K/Akt, NF-κB, STAT3), and epigenetic alterations. Furthermore, microbial metabolites, such as short-chain fatty acids, secondary bile acids, and lactate, play dual roles in either promoting or suppressing tumorigenesis. Oral and gut-derived microbes, translocated to the gastric niche, have been implicated in reshaping the gastric microenvironment and exacerbating disease progression. The composition of the microbiota also influences responses to cancer immunotherapy, suggesting that microbial profiles can serve as both prognostic biomarkers and therapeutic targets. Emerging strategies, such as probiotics, dietary interventions, and fecal microbiota transplantation (FMT), offer new avenues for restoring microbial balance and enhancing therapy response. This review synthesizes current knowledge on the complex interplay between microbiota and gastric cancer development and emphasizes the potential of microbiome modulation in both preventive and therapeutic frameworks. Full article

OPN is a phosphorylated glycoprotein found in all vertebrate organisms and expressed in many tissues and secretions. It is a pleiotropic protein that plays diverse roles in various pathological and physiological processes. OPN is involved in many tissue transformation events such as intestinal and brain development, the regulation of immune system activity, immune cell activation, and inflammatory responses. This protein increases the functionality of the digestive system by regulating the intestinal microbiome and may help strengthen the intestinal barrier. OPN can also influence cognitive development and behavior. In addition, its recent association with cancer has gained critical importance. The increased expression of OPN has been observed in many cancer types, which may promote tumor cell metastasis. OPN is also effective in bacterial interaction and infections; it can prevent bacterial adhesion, supporting the development of new therapeutic approaches for oral care. Furthermore, the supplementation of OPN in infant formula has positively influenced the immune and intestinal health of infants. Many recent studies have focused on these aspects. This article provides a review and comparison of the existing knowledge on the structure and functions of OPN. It emphasizes how milk-derived OPN impacts human and infant health and disease. Full article

Background: There are known associations between periodontitis and colorectal cancer, but knowledge on the connections existing between the two are not fully understood. The aim of our study was to assess prevalence and clinical severity of periodontitis in patients with localized colorectal cancer. Secondly, the dynamics of metabolic derangements, particularly glucose metabolism, insulin resistance, and diabetes mellitus were studied as well. Methods: Diagnostic procedures included endoscopies with patohistology, laboratory exams, the insulin resistance homeostatic model assessment method (HOMA index), anthropometrics, and radiology imaging. Periodontal status was evaluated by full-mouth periodontal examination. Results: A total of 79 patients with localized colorectal carcinoma, with slight male predominance of 55.7%, and an age of 65.7 ± 12.4 years participated in this study. Three-quarters of patients (73.4%; 95% CI: 63.0–82.2%) were diagnosed with periodontitis. Patients with periodontitis and colorectal cancer had significantly increased glucose levels (fasting and after oral glucose challenge), (both p < 0.05). Also, increased values of the HOMA index were found in patients with periodontitis vs. controls (without periodontitis) and colorectal cancer; 6.38 ± 5.74 vs. 3.58 ± 2.6 (p = 0.012); Spearman’s Rho correlation coefficient = 0.271 (p = 0.039). There were significant differences in high-density cholesterol in patients with periodontitis vs. controls, 1.41 ± 0.28 vs. 1.23 ± 0.35 mmol/L (p = 0.016), but correlations were insignificant; Rho c.c. = 0.045 (p = 0.738). Conclusions: The most consorted connections between periodontitis and colorectal cancer were found among parameters of metabolic domain, especially glucose concentrations and insulin resistance. Further studies, which would include novel and emerging antidiabetic treatments and their effects on the prevention or control of both diseases, would be warranted. Full article

Objective: This study aimed to evaluate and compare the knowledge and attitudes of dentists and dental students regarding the early diagnosis of oral cancer. Study Design: Data were collected using a questionnaire administered to students on an integrated master’s degree in dentistry and to dentists. The data were then entered into SPSS, where they were statistically processed. Results: A total of 192 responses were considered (102 from dentists and 90 from dental students). Although both groups correctly recognized the gender most affected by the pathology, as well as the most common type of oral cancer, only 22.5% of dentists and 14.4% of students knew how to identify the sites with the greatest potential for malignancy. In both cases, the majority carried out a thorough intraoral assessment. Only less than half have ever performed a biopsy during their clinical practice. Only 4.9% of dentists and 3.3% of students consider their ability to diagnose pathology to be very good. Conclusions: Some gaps were observed and should be addressed, particularly in terms of knowledge about lesions with malignant potential. Therefore, it is crucial to invest in training in this area to halt the progression of this pathology. Full article

Background: Human papillomavirus (HPV) infection in pediatric populations is an emerging area of interest due to its potential role in early viral transmission and long-term oncogenic risk. The oral cavity may serve as a reservoir for high-risk HPV types; however, its prevalence in children remains under-investigated and unclear. The HOPE (Human papillomavirus Oral infection in PEdiatric population) project aims to assess the prevalence of oral HPV using an innovative salivary sampling method, also exploring the influence of social determinants on parental awareness and attitudes toward HPV vaccination. This paper presents the findings from a cross-sectional pilot study. Methods: This pilot investigation included a total of 70 children (0–14 years) who underwent an oral examination and non-invasive salivary sampling using the novel LolliSponge device. HPV detection was performed using INNO-LiPA^® HPV genotyping. Parents completed a questionnaire assessing socio-demographic factors and HPV-related knowledge. Associations between oral health status, social determinants, and HPV awareness were analyzed. Results: The LolliSponge device demonstrated excellent acceptability among the pilot population. The mean age at recruitment of the children thus far (8 years) appears to correlate with the absence of oral HPV infection. Regarding parental knowledge and attitudes, 51 out of the 70 respondents (72.9%, 95% CI: 62–83%) reported having heard of HPV; however, 94.3% (66/70) were unaware of its transmission routes, and 60% (42/70) did not know that it can cause cancer. Only 4 out of the 70 participants (5.7%) reported that their child had received the HPV vaccine. Lower awareness of the HPV vaccine was significantly associated with a lower educational level (p = 0.001), being married (p = 0.03), and having three or more children (p = 0.039). Awareness of the vaccine’s existence also varied significantly by parental occupation (p = 0.02). Conclusions: The pilot findings of the HOPE project highlight both the potential of innovative strategies for detecting oral HPV infection in children and critical gaps in parental knowledge and vaccine uptake. Preliminary data also reveal an age-related bias in HPV status, suggesting the need for further investigations in a larger cohort of younger children (<5 years). Full article

Background: Human papillomavirus (HPV) is a virus belonging to the Papillomaviridae family. Infection may be asymptomatic, mildly symptomatic, or clinically evident. It is mostly transmitted through sexual activity. It is estimated that approximately half of sexually active individuals will be infected with HPV, and among women over 50, this percentage increases to 80%. The aim of this study was to assess the level of awareness among medical and dental students regarding the impact of HPV infection on oral health. Materials and methods: This was a prospective study of 562 Polish medical and dental students. The questionnaire was originally designed based on the available literature and consisted of two sections: demographic questions and detailed questions about HPV and its impact on oral health. The data were analyzed using Statistica v. 13.3. All tests were considered statistically significant at p ≤ 0.05. Results: After excluding incomplete questionnaires, 541 remained and were included in the analysis. The medical students achieved a significantly higher average score compared to the dental students (p < 0.001). The students of higher years of studies were more knowledgeable. This tendency was observed both among all respondents together and among the medical and dentistry students separately. Conclusions: The medical students demonstrated a significantly higher level of knowledge on the discussed topic. However, both groups provided correct answers at a relatively unsatisfactory level because the overall value of the results obtained was below 60%. By the end of their education, the students in both fields demonstrated improved knowledge. The dental students gave an average of 74% correct answers, while the medical students achieved 73%. Therefore, the quality of university education regarding the relationship between HPV infection and oral lesions should be improved. Full article

(1) Introduction: Human papillomavirus (HPV) is a significant public health concern associated with various cancers, including a rising incidence of oropharyngeal cancer (OPC). Despite the availability of effective vaccines targeting high-risk HPV types, vaccination rates remain suboptimal. Dental professionals are uniquely positioned to contribute to HPV prevention through education, vaccination advocacy, and early detection. (2) Methods: This narrative review synthesized the literature from 2006 to 2024 on HPV epidemiology, pathophysiology, vaccine efficacy, and the role of dental providers in HPV prevention. Sources included peer-reviewed articles listed in Pubmed and Google Scholar, including observational studies and review articles, guidelines, clinical trials, and governmental data. Key barriers to HPV-related care in dental practice and strategies for overcoming them were analyzed. (3) Results: The review underscores the critical role of dentists in HPV-related disease prevention, highlighting their ability to detect HPV-related lesions, promote vaccine uptake, and address patient concerns. Barriers such as limited knowledge, discomfort discussing HPV, and misinformation were identified. Strategies like incorporating HPV education into dental training, utilizing emerging diagnostic tools, and adopting effective communication approaches can enhance the role of dental professionals in reducing HPV-associated cancer risks. (4) Conclusion: By integrating HPV education, vaccination advocacy, and early detection into routine dental care, dental professionals can play a transformative role in public health. A dental provider’s endorsement can increase HPV vaccine uptake and help prevent oral cancer. These efforts align with broader health promotion goals, offering a significant opportunity to reduce the burden of HPV-associated cancers and improve long-term patient outcomes. Full article

Background/Objectives: The rising popularity of e-cigarette use is creating new challenges for oral healthcare. Factors such as targeted marketing, appealing flavors, and the perception that e-cigarettes are a safer alternative to traditional smoking have contributed to their widespread adoption. This trend is particularly prevalent among young adults and teenagers, many of whom turn to e-cigarettes despite having no prior history of regular cigarette use. This study aimed to evaluate dentists’ knowledge and perceptions regarding e-cigarettes, focusing on their health effects, regulatory status, and potential risks to oral health. Assessing dentists’ knowledge of e-cigarette risks is important, as they guide patients on the potential oral health dangers of vaping. E-cigarette use has been linked to several oral health problems. Methods: A cross-sectional survey was conducted among 189 dentists in Kosovo, comprising both general dentists and specialists. The questionnaire assessed participants’ awareness of e-cigarettes’ FDA approval status, their perceptions of health impacts, and their understanding of e-cigarettes’ association with oral conditions such as caries, periodontal disease, and oral cancer. Data were analyzed using SPSS 22, with significance set at p < 0.05. Results: The findings revealed significant knowledge gaps, with 74.1% of respondents being uncertain about the FDA approval status of e-cigarettes and 82.0% recognizing their harmful effects on general and oral health. Nearly half (49.7%) of the participants identified e-cigarettes as a potential risk factor for caries, while 66.1% and 64.6% associated their use with oral cancer and periodontal disease, respectively. Gender and professional specialization did not significantly influence these perceptions. Conclusions: Dentists need better education on the risks of e-cigarette use, including their harmful effects on oral health. Incorporating this knowledge into dental curricula and professional training is essential to give dentists the information needed to advise patients effectively. Raising public awareness through dental health professionals can help mitigate the oral health risks associated with e-cigarettes. Full article

Natural plant products have been used for cancer treatment since ancient times and continue to play a vital role in modern anticancer drug development. However, only a small fraction of identified medicinal plants has been thoroughly investigated, particularly for their effects on cellular pathways in lung and colorectal cancers, two under-researched cancers with poor prognostic outcomes (lung cancers). This review focuses on the lung and colorectal cancer signaling pathways modulated by bioactive compounds from eleven traditional medicinal plants: Curcuma longa, Astragalus membranaceus, Glycyrrhiza glabra, Althaea officinalis, Echinacea purpurea, Sanguinaria canadensis, Codonopsis pilosula, Hydrastis canadensis, Lobelia inflata, Scutellaria baicalensis, and Zingiber officinale. These plants were selected based on their documented use in traditional medicine and modern clinical practice. Selection criteria involved cross-referencing herbs identified in a scoping review of traditional cancer treatments and findings from an international survey on herbal medicine currently used for lung and colorectal cancer management by our research group and the availability of existing literature on their anticancer properties. The review identifies several isolated phytoconstituents from these plants that exhibit anticancer properties by modulating key signaling pathways such as PI3K/Akt/mTOR, RAS/RAF/MAPK, Wnt/β-catenin, and TGF-β in vitro. Notable constituents include sanguinarine, berberine, hydrastine, lobeline, curcumin, gingerol, shogaol, caffeic acid, echinacoside, cichoric acid, glycyrrhizin, 18-β-glycyrrhetinic acid, astragaloside IV, lobetyolin, licochalcone A, baicalein, baicalin, wogonin, and glycyrol. Curcumin and baicalin show preclinical effectiveness but face bioavailability challenges, which may be overcome by combining them with piperine or using oral extracts to enhance gut microbiome conversion, integrating traditional knowledge with modern strategies for improved outcomes. Furthermore, herbal extracts from Echinacea, Glycyrrhiza, and Codonopsis, identified in traditional knowledge, are currently in clinical trials. Notably, curcumin and baicalin also modulate miRNA pathways, highlighting a promising intersection of modern science and traditional medicine. Thus, the development of anticancer therapeutics continues to benefit from the synergy of traditional knowledge, scientific innovation, and technological advancements. Full article

Background/Objectives: HPV is the most common sexually transmitted infectious agent worldwide and adolescents are at high risk of contracting HPV. The aim of our study was to find out how much adolescents know about the virus and its effects, and to obtain information on attitudes and behaviors regarding HPV vaccination to close these gaps. Methods: As part of the ESPRIT project, 598 lower secondary (11–14 years) and upper secondary (14–19 years) school students from three Italian regions were surveyed between December 2023 and March 2024 using a seven-question online questionnaire on awareness, knowledge, and attitudes about HPV and the HPV vaccine. Count and zero-inflation models were used to determine correlations between sexes, urban/suburban, province of residence, and school type with knowledge. Results: Lower secondary students believed that HPV causes HIV/AIDS (8.9%) or hepatitis C (3.0%) and rarely mentioned anal (21%) and oral sex (9.6%) as ways of transmission. Among upper secondary students, misconceptions were similar, with worrying rates of students stating that HPV only causes cancer in females (18%) or males (2.4%), and low rates of identifying transmission risk through anal (41%) and oral (34%) sex and genital contact (38%). The HPV vaccination rate was quite low (47% in lower secondary students, 61% in upper secondary students). In the regressions, sex, urban/suburban area, and province were the variables associated with higher levels of knowledge for lower secondary students; for upper secondary students, level of knowledge was associated with sex, urban/suburban area, school type, and province of residence. Conclusions: Awareness and knowledge of HPV and the HPV vaccine are low among Italian students in this study and reported vaccination coverage is below the national target. Coordinated efforts at the national level are needed to address this public health issue. Full article

Background/Objectives: This single-center analysis evaluated the number of potential candidates for endocrine-based oral maintenance therapy in a real-world setting, focusing on three therapeutic agents, namely, olaparib, abemaciclib, and ribociclib, for patients with hormone receptor-positive HER2-negative early breast cancer. Methods: All breast cancer cases from the past 10 years (n = 3230) that underwent treatment at the certified Breast Cancer Center of the Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Lübeck Campus, were analyzed. Results: Of a total of 2038 patients with HR+ HER2− eBC, 685 patients (33.6%) qualified for one or more of the three agents—olaparib, abemaciclib, and ribociclib. Of these 685 patients, 523 patients (76.4%) had node-positive and 162 (23.6%) node-negative disease. Moreover, 368 patients (18.1% of a total of 2038 patients with HR+ HER2− eBC) were eligible exclusively for ribociclib, including all node-negative patients. A total of 141 patients (6.9%) met the criteria for all three agents. In contrast, 1353 patients (66.4%) had no indication for combined endocrine therapy. Conclusions: To our knowledge, this is the largest analysis addressing all three therapeutic strategies for combined endocrine therapy. The broad indication criteria of the NATALEE study may increase clinic workloads due to more frequent physician/patient interactions. It also remains unclear how therapy recommendations will influence actual treatment, as increased visits and potential side effects could affect patient compliance and adherence. Full article

Cannabis sativa L. contains numerous compounds with antioxidant and anti-inflammatory properties, including the flavonoids and the cannabinoids, particularly Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Cannabinoids have an effect on the endocannabinoid system (ECS), a cellular communication network, and are, hence, widely studied for medical applications. Epidiolex^®, a 99% pure oral CBD extract, has been approved by the FDA for the treatment of epilepsy. Nabiximols (Sativex) is an oromucosal spray containing equal volume of THC and CBD, and it is commonly used as an add-on treatment for unresponsive spasticity in multiple sclerosis (MS) patients. Several in vitro and in vivo studies have also shown that cannabinoids can be used to treat various types of cancer, such as melanoma and brain glioblastoma; the first positive clinical trials on the anticancer effect of a THC:CBD blend with temozolomide (TMZ) in the treatment of highly invasive brain cancer are very promising. The cannabinoids exert their anticancer properties in in vitro investigations by the induction of cell death, mainly by apoptosis and cytotoxic autophagy, and the inhibition of cell proliferation. In several studies, cannabinoids have been found to induce tumor regression and inhibit angiogenic mechanisms in vitro and in vivo, as well as in two low-numbered epidemiological studies. They also exhibit antiviral effects by inhibiting ACE2 transcription, blocking viral replication and fusion, and acting as anti-inflammatory agents; indeed, prior CBD consumption (a study of 93,565 persons in Chicago) has also been associated with a much lower incidence of SARS-CoV-2 infections. It is postulated that cannabis extracts can be used in the treatment of many other diseases such as systemic lupus erythematosus, type 1 diabetes, or various types of neurological disorders, e.g., Alzheimer’s disease. The aim of this review is to outline the current state of knowledge regarding currently used medicinal preparations derived from C. sativa L. in the treatment of selected cancer and viral diseases, and to present the latest research on the potential applications of its secondary metabolites. Full article