Current Oncology doi: 10.3390/curroncol33080472

Authors: Çil Mıldanoğlu Kutlu Güren Sarı Ökten Atalah Baydaş Kıkılı Tural Bayramgil Aykut Yumuştutan Erçin Doğan Yılmaz Han Güney Olcar Odabaş Bilici Özçelik

Background: Second-line treatment selection in relapsed extensive-stage small-cell lung cancer (ES-SCLC) is commonly guided by the platinum-free interval, but the optimal approach for patients progressing 3–6 months after first-line platinum-based therapy remains uncertain. We compared platinum-containing doublet chemotherapy with single-agent chemotherapy in this clinically ambiguous subgroup. Methods: This multicenter retrospective real-world cohort study included patients with ES-SCLC or recurrent metastatic SCLC after prior limited-stage disease who received first-line platinum-based chemotherapy, achieved disease control, and progressed within a platinum-free interval of 90–180 days. Treatment allocation was at the discretion of the treating physician and was not randomized. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety. Because of the non-randomized design, the treatment effect was examined across multiple analytic approaches, including multivariable Cox regression, propensity score adjustment, and stabilized inverse probability of treatment weighting (IPTW). Results: Of 105 patients, 54 received single-agent chemotherapy and 51 received platinum-containing doublet therapy; 39 (37.1%) had received first-line atezolizumab. Baseline characteristics were imbalanced in favor of the doublet group, which had a longer platinum-free interval, fewer pleural metastases, and a higher rate of objective response to first-line therapy. ORR was higher with doublet therapy (31.4% vs. 11.1%, p = 0.016), as was DCR (62.7% vs. 33.3%, p = 0.003). Median PFS was 4.4 months (95% CI 3.4–5.8) with doublet therapy versus 3.1 months (95% CI 2.7–3.7) with single-agent chemotherapy (unadjusted HR 0.53, 95% CI 0.36–0.80; p = 0.002). Median OS was 6.5 months (95% CI 5.4–8.0) versus 5.4 months (95% CI 4.1–6.0), a difference that was not statistically significant (HR 0.68, 95% CI 0.46–1.01; p = 0.054). The PFS estimate favored doublet therapy in all sensitivity analyses but was attenuated with increasingly complete adjustment for treatment selection (multivariable HR 0.46, 95% CI 0.29–0.72; propensity-adjusted HR 0.58, 95% CI 0.38–0.88; IPTW HR 0.68, 95% CI 0.38–1.20, p = 0.184). No OS estimate reached statistical significance in any model. Grade ≥ 3 adverse events were similar between groups (66.7% vs. 64.8%, p = 0.842). Conclusions: In this non-randomized cohort of patients relapsing within a 90–180-day platinum-free interval, platinum-containing doublet chemotherapy was associated with higher response rates and longer PFS, without an increase in severe toxicity, but no overall survival benefit was demonstrated. Because baseline prognostic factors consistently favored the doublet group and the PFS advantage was attenuated after propensity-based adjustment, these findings should be regarded as hypothesis-generating. They are nonetheless consistent with randomized data showing improved PFS but not OS with platinum rechallenge, and support platinum-containing rechallenge as a reasonable option in carefully selected patients rather than as a demonstrated survival-prolonging strategy.

Current Oncology doi: 10.3390/curroncol33080471

Authors: Noor Lad Jayda Esplund Dennis Grauer Shebli Atrash Prerna Mewawalla Tejaswi Gadela Charles Porter Muhammad Mushtaq Jeries Kort Donald C. Moore Al-Ola Abdallah Zahra Mahmoudjafari Jordan Snyder

Background: Carfilzomib, a second-generation proteasome inhibitor, is widely used in multiple myeloma (MM) treatment but has been associated with cardiovascular adverse events (CVAEs). Real-world data evaluating the incidence and risk factors are limited. Methods: We conducted a multicenter retrospective cohort study of 385 adult MM patients treated with carfilzomib between January 2020 and August 2024 at three U.S. institutions. The primary objective of this study was to determine the incidence of carfilzomib-associated CVAEs. The secondary objectives included the identification of risk factors, characterization of cardiovascular events, and time-to-onset analysis. Results: Carfilzomib-associated CVAEs occurred in 25 patients (6.5%). The median time to event was 114 days. Heart failure was the most common manifestation (86%), followed by arrhythmias (32%) and acute coronary syndromes (8%). Patients with baseline heart failure had a significantly increased risk of CVAEs (HR 1.61, p = 0.042), whereas arrhythmias showed a trend toward significance. Traditional cardiovascular risk factors were not independently associated with an increased risk. CVAEs were associated with numerically inferior overall survival (45.7 vs. 97.3 months; HR 1.316, 95% CI 0.728–2.377, p = 0.361). Partial recovery of the left ventricular ejection fraction was observed following treatment discontinuation. Conclusion: Carfilzomib-associated CVAEs were infrequent but clinically meaningful in this multicenter cohort. These findings support consideration of a risk-adapted cardio-oncology approach, particularly in patients with pre-existing cardiac dysfunction, where closer surveillance and early intervention may help mitigate clinically significant cardiotoxicity.

Current Oncology doi: 10.3390/curroncol33080470

Authors: Kelly Zhang Ali Kiadaliri Mohammad Hajizadeh

Lymphomas are broadly categorized into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Despite treatment advances, they remain a major cause of cancer-related morbidity and mortality in Canada. This study examined temporal trends in socioeconomic inequalities in lymphoma mortality in Canada from 2000 to 2019. Using a unique census division level dataset (n = 280) constructed by pooling information from the Canadian Vital Statistics Death Database, the Canadian Census of Population and the National Household Survey, we measured mortality in HL and NHL in Canada. The age-standardized Concentration index (C) was used to quantify income and education inequalities in lymphoma. Time trend analyses were conducted to examine the changes in the observed socioeconomic inequalities. Crude HL mortality declined significantly over the study period. Crude NHL mortality remained largely unchanged in Canada overall, although modest declines were observed in the Prairies. The age-standardized C indicated persistent income and education inequalities for both lymphoma types. For NHL, mortality became increasingly concentrated among lower-income and lower-education populations over time. The persistent and widening socioeconomic inequalities observed in HL and NHL mortality, respectively, in Canada underscore the need for targeted public health interventions and more equitable distribution of resources to address systematic and avoidable differences in cancer outcomes associated with socioeconomic disadvantage.

Current Oncology doi: 10.3390/curroncol33080469

Authors: Meshail Baswaid Alaa Shahbar Afnan Noor Danyah Ahmed Katlan Abdulfattah Alhazmi Mohammed Alnuhait Aryaf Alsulami Baker Saemaldaher Hussam Magliah

Background: Immune checkpoint inhibitors (ICIs) are widely used in cancer treatment, but their safety in patients with pre-existing hepatitis B virus (HBV) infection remains uncertain. HBV reactivation is a recognized complication of immunosuppressive cancer therapy, yet evidence supporting routine antiviral prophylaxis during ICI treatment is limited. This study evaluated HBV reactivation and HBV-related outcomes among HBV-positive cancer patients receiving ICIs. Methods: This multicenter retrospective cohort study included adult patients treated with ICIs between January 2017 and December 2022. Patients were grouped according to receipt of antiviral prophylaxis. The primary outcome was HBV reactivation during ICI therapy. Secondary outcomes included hepatic flare, severity, and timing of reactivation, response to antiviral therapy, and factors associated with HBV-related outcomes. Results: A total of 160 patients were included; 68 received antiviral prophylaxis and 92 did not. HBV reactivation occurred in 3 patients (1.9%) and the odd ratio between antiviral prophylaxis and HBV reactivation was wide and imprecise (2.76; 95% CI 0.25–31.05). Hepatic flare occurred in 16 patients (10.0%) and was more frequent in the prophylaxis group than in the no-prophylaxis group (19.1% vs. 3.3%; p = 0.001). Conclusion: In this multicenter retrospective cohort study, the HBV reactivation rate was low and could not determine whether antiviral prophylaxis reduced the risk of reactivation. Hepatic flares were significantly more common among patients who received antiviral prophylaxis, likely reflecting a higher baseline risk of HBV-related complications in this group. A future randomized controlled trial is warranted to guide risk-adapted antiviral prophylaxis and monitoring.

Current Oncology doi: 10.3390/curroncol33080468

Authors: Patrick D. Michael Lauren Loebach Ruben Blachman-Braun Hangcheng Fu Braden Millan Jaskirat Saini Sandeep Gurram W. Marston Linehan Mark W. Ball

Hereditary kidney cancer syndromes predispose patients to multifocal, bilateral and/or recurrent renal tumors, requiring repeated interventions over a lifetime. Despite nephron-sparing surgery being the preferred management strategy, some patients ultimately require completion nephrectomy—radical nephrectomy following prior ipsilateral partial nephrectomy—when tumor burden, declining renal function, surgical complications, or pre-transplant indications necessitate definitive kidney removal. Data on outcomes in this population remain limited. We evaluated a prospectively maintained cohort of 58 patients who underwent completion nephrectomy at the National Institutes of Health between 2000 and 2024, following at least one prior ipsilateral partial nephrectomy. Perioperative complication rates and renal functional change were the primary outcomes of interest. Von Hippel–Lindau disease was the most common hereditary diagnosis (62.1%). Open surgery was performed in 56.9% of cases. Overall complications occurred in 43.1% of patients, with 24.1% experiencing a Clavien–Dindo grade ≥ 3 event; perioperative mortality was 6.9%. The median preoperative estimated glomerular filtration rate was 72 mL/min/1.73 m2, declining to 50 mL/min/1.73 m2 at the first postoperative clinic visit. Completion nephrectomy in hereditary kidney cancer syndrome patients is associated with substantial perioperative morbidity, mortality, and expected renal functional decline. These findings inform patient counseling and surgical decision-making in this high-risk population.

Current Oncology doi: 10.3390/curroncol33080467

Authors: Hatice Ayyıldız Sevim Galip Can Uyar Hayriye Şahinli

Background: The role of primary tumor resection (PTR) in patients with de novo stage IV colorectal cancer remains controversial, particularly in the context of patient selection and tumor biology. This study aimed to evaluate the association between PTR and survival outcomes and to identify clinical, molecular, and inflammatory-nutritional prognostic factors in patients with de novo stage IV colorectal cancer. Methods: Medical records of 204 patients with de novo stage IV colorectal adenocarcinoma treated at Ankara Etlik City Hospital from December 2022 to December 2025 were reviewed retrospectively. Patients were grouped according to PTR status. Baseline clinicopathological features, molecular tumor profile, metastatic disease extent, treatment characteristics, and inflammatory-nutritional markers were recorded. Survival outcomes were assessed in terms of progression-free survival (PFS) and overall survival (OS) using the Kaplan–Meier method and Cox proportional hazards regression models, as well as 1:1 propensity score matching and sensitivity analyses. Results: PTR was performed in 114 patients (55.9%), while 90 patients (44.1%) did not undergo PTR. Patients who underwent PTR were younger, had better Eastern Cooperative Oncology Group (ECOG) performance status, and more frequently had single-organ metastatic disease. In the unmatched cohort, patients who underwent PTR had longer median PFS and OS than those without PTR (15.88 vs. 11.03 months and 16.14 vs. 11.54 months, respectively; both log-rank p < 0.001). In the adjusted Cox models, PTR corresponded to lower risks of progression (hazard ratio [HR]: 0.50; 95% confidence interval [CI]: 0.34–0.74; p < 0.001) and death (HR: 0.48; 95% CI: 0.30–0.77; p = 0.002), whereas BRAF mutation showed higher risks of progression (HR: 3.00; 95% CI: 1.70–5.29; p < 0.001) and death (HR: 3.42; 95% CI: 1.83–6.38; p < 0.001). In the propensity score–matched cohort comprising 50 matched pairs, PTR remained associated with a lower risk of progression or death (HR: 0.59; 95% CI: 0.40–0.87; p = 0.007), whereas its association with OS was not statistically significant (HR: 0.69; 95% CI: 0.42–1.13; p = 0.141). Sensitivity analyses generally yielded estimates favoring PTR, although the statistical significance of the association with OS varied across analyses. Patients with higher prognostic nutritional index (PNI) values showed more favorable survival outcomes. Conclusions: In this retrospective cohort, PTR was consistently associated with longer PFS, whereas its association with OS was less robust across the adjusted analyses. Because these patients had a more favorable baseline profile, these associations should be viewed with caution and in relation to patient selection. BRAF mutation and PNI emerged as important prognostic factors, supporting a multidimensional approach to survival assessment that incorporates metastatic disease burden, tumor biology, and inflammatory-nutritional status.

Current Oncology doi: 10.3390/curroncol33080466

Authors: Lizhi Feng Haolan He Han Zhao Bo Liu Zhimin Chen Xinhua Liu Haisheng Yu Fengyu Hu Xiaoping Tang Linghua Li

Epstein–Barr virus (EBV) contributes to human immunodeficiency virus (HIV)-associated diffuse large B-cell lymphoma (DLBCL) pathogenesis. We retrospectively analyzed clinical features and outcomes of EBV-positive (n = 32) and -negative (n = 71) cases. EBV status was determined using in situ hybridization. Immunological parameters, histological subtype, systemic B symptoms, plasma EBV DNA, and response to therapy were examined. Survival was compared using Kaplan–Meier analysis. Factors associated with overall survival (OS) and progression-free survival (PFS) in EBV-positive patients were examined using Cox regression models. EBV-positive cases showed a higher proportion of non-germinal center B cell subtypes and B symptoms, higher circulating EBV viral loads, and lower CD4+ T-cell counts at diagnosis than EBV-negative cases. OS did not differ significantly within the full cohort but was shorter in EBV-positive cases with high International Prognostic Index scores or CD4+ T-cell counts ≥ 50 cells/μL. Concurrent infections and elevated plasma EBV DNA levels remained associated with unfavorable survival outcomes. EBV-positivity in HIV-associated DLBCL is related to more aggressive clinical and immunological features and independently predicts poorer survival outcomes in high-risk subgroups. Plasma EBV DNA may reliably indicate EBV status and serve as a prognostic biomarker. Integrating these features into clinical decision-making may enhance risk stratification and inform individualized treatments.

Current Oncology doi: 10.3390/curroncol33080465

Authors: Nathalie Daaboul Jason S. Agulnik Houda Bahig Normand Blais Marie-Ève Boucher Nicole Bouchard Marie-Hélène Denault Patrice Desmeules Pierre Olivier Fiset Marie Florescu Kevin Jao Catherine Labbé Magali Lecavalier-Barsoum Carmela Pepe Benjamin Shieh Sophie Stock-Martineau Nicolas Marcoux

The management of epidermal growth factor receptor-mutated (EGFRm) non-small cell lung cancer (NSCLC) after progression on osimertinib is becoming increasingly complex, particularly in Canada, where access to diagnostic testing and newer therapies remains uneven. Although treatment is evolving with regimens such as amivantamab−lazertinib (MARIPOSA/MARIPOSA-2) and osimertinib plus chemotherapy (FLAURA2), access to such treatments in first and second lines varies across provinces. This article provides a pragmatic Canadian perspective on post-osimertinib management informed by expert roundtable discussions, a focused clinician survey, and the contemporary literature. Key challenges identified include delays and barriers related to tissue biopsy, next-generation sequencing, timely immunohistochemistry in time to influence treatment decisions and access to novel therapies. These gaps reduce the ability to individualize care and often force clinicians to rely on platinum-pemetrexed therapy as the default systemic backbone, even when biologically relevant resistance mechanisms exist, highlighting that post-osimertinib care in Canada remains shaped as much by access and system constraints as by emerging evidence.

Current Oncology doi: 10.3390/curroncol33080464

Authors: Yuanjing Gao Yanwen Luo Zihan Niu Mengyuan Zhou Mengsu Xiao Tianjiao Chen Jia Lu Yuxin Jiang Bo Pan Qingli Zhu

The 70-gene signature (70-GS; MammaPrint) assay is useful for prognosis assessment in HR+/HER2− early breast cancer, but limited accessibility motivates development of noninvasive alternatives. We retrospectively enrolled 219 women with preoperative grayscale ultrasound and 70-GS results, including a development cohort (n = 125), an internal validation cohort (n = 53), and a temporally independent validation cohort (n = 41). Radiomic features were extracted from manually delineated ROIs using PyRadiomics, and a radiomics score was derived after LASSO selection. Candidate radiomics-only, clinicopathologic-only, and full clinicoradiomic models were explored. To reduce overfitting, we selected a parsimonious model combining the radiomics score and Ki67 as the primary model. The simplified model achieved AUCs of 0.878, 0.816, and 0.831 in the development, internal validation, and temporally independent validation cohorts, respectively. In 1000 bootstrap resamples, the optimism-corrected AUC was 0.872 and the corrected calibration slope was 0.953. Adding the radiomics score to a Ki67-only model significantly improved model fit (likelihood-ratio chi-square = 17.14, df = 1, p < 0.001). An ultrasound radiomics and Ki67 model may provide a noninvasive reference for estimating MammaPrint risk categorization, but it should be considered only as a supportive adjunct and not as a replacement for genomic testing.

Current Oncology doi: 10.3390/curroncol33080463

Authors: Mariem Galuia Julia Fedorova Eleftherios Mamounas Sabrina Pavri Sarfraz Ahmad Wassim Mchayleh

We thank Dr [...]

Current Oncology doi: 10.3390/curroncol33080462

Authors: Shinya Kajiura Hironaga Satake Ryuji Hayashi Takayuki Yoshino

Japan’s Center for Cancer Genomics and Advanced Therapeutics (C-CAT) provides a national platform for studying genomic-medicine-era care. We conducted a nationwide registry/database study to examine whether facility-level Japanese Society of Medical Oncology (JSMO) specialist availability was associated with first-line time to treatment failure (TTF) in lung cancer. The primary exposure was treating-facility JSMO specialist count (0–1 vs. ≥2); dual JSMO/Japanese Respiratory Society availability was a secondary lung-cancer-oriented exposure. First-line TTF was defined from systemic therapy start to recorded first-line treatment end or death, whichever occurred first. The cohort included 5456 patients at 241 facilities: 1477 in the 0–1 group and 3979 in the ≥2 group. Kaplan–Meier estimated median first-line TTF was 4.2 versus 5.1 months (log-rank p < 0.001). In the full clinical adjustment model, the HR for ≥2 versus 0–1 specialists was 0.911 (facility-cluster robust 95% CI, 0.806–1.029; robust p = 0.133). The point estimate was in the direction of longer recorded treatment-process duration, but the robust confidence interval included no association. Linking C-CAT with facility-level workforce data demonstrates a health-services use of national genomic registry data and supports the development of chemotherapy-specific databases with patient-level, time-anchored clinical information.

Current Oncology doi: 10.3390/curroncol33080461

Authors: Michael Eisenmann Zhounan Zhu Volker Arndt Melissa S. Y. Thong

Chimeric antigen receptor T-cell (CAR-T) therapy has substantially improved outcomes for patients with B-cell-associated hematological malignancies. While acute and early toxicities are well characterized, late complications (LCs) remain poorly understood. This scoping review aimed to identify and map the existing evidence on LCs in adult patients with hematological malignancies treated with CAR-T products approved by the European Medicines Agency (EMA). PubMed, Web of Science, and the Cochrane Library were searched for primary studies published from 2018 onwards. We included studies of adult patients receiving EMA-approved CAR-T therapies targeting CD19 or CD269. LCs were defined as diagnosis-based adverse events occurring ≥12 months after CAR-T infusion. Of 7715 records identified, 261 studies underwent full-text screening and 18 met the inclusion criteria. LCs clustered mainly as infections and secondary malignancies (SMs). Non-relapse mortality was reported in seven studies, with infections and SMs frequently reported as causes when cause-of-death data were available. Future studies should place emphasis on long-term clinical events after CAR-T therapy to improve the management of LCs and ultimately support better long-term outcomes for patients.

Current Oncology doi: 10.3390/curroncol33080460

Authors: Run Bao Jing Qin Rong Zhang Zhuo Xu Jiahao Liu Jiaofeng Shen Shunji Zhang Yusong Zhang Hong Zhu Chunyan Huang Yan Lu Tianhua Liu Wangyang Pu

This study aimed to characterize claudin 18.2 (CLDN18.2) expression in HER2-negative gastric or gastroesophageal junction cancer (GC/GEJC) and to evaluate whether CLDN18.2 status is associated with clinicopathological features and outcomes after first line chemoimmunotherapy. We retrospectively analyzed 189 patients with HER2-negative GC/GEJC treated at our institution from October 2019 to September 2024. CLDN18.2 expression was assessed by immunohistochemistry using two prespecified positivity thresholds: moderate to strong membranous staining (2+) in ≥40% or ≥75% of tumor cells. CLDN18.2 positivity was observed in 92/189 patients (48.7%) using the ≥40% threshold and 69/189 (36.5%) using the ≥75% threshold. PD L1 CPS ≥ 5 was less frequent in CLDN18.2 positive than in CLDN18.2 negative tumors at both thresholds (≥40%: 8.7% vs. 23.7%, p = 0.003; ≥75%: 8.7% vs. 20.8%, p = 0.019). Among 87 patients receiving first line chemoimmunotherapy, CLDN18.2 status was not associated with significant differences in objective response rate, progression free survival, or overall survival. CLDN18.2 positive tumors showed lower PD L1 expression, but CLDN18.2 status did not identify a subgroup with differential benefit from first line chemoimmunotherapy. These findings suggest that CLDN18.2 status does not appear to serve as a predictive biomarker for immune checkpoint inhibitor-based treatment.

Current Oncology doi: 10.3390/curroncol33080459

Authors: Ivana Mikolašević Petra Cotić Sara Matulić Čubranić Mario Franolić Iva Skočilić Tihana Salopek Marin Golčić Alojzije Košić Laura Radošić Blanka Josipović Karla Lisica Lea Juras Sara Francetić Ana Bešvir Andrej Belančić

Stereotactic body radiotherapy (SBRT) is an effective and increasingly utilized treatment modality for abdominal tumors, offering high rates of local control with generally acceptable toxicity profiles. Nevertheless, rare but severe late gastrointestinal complications, including radiation-induced ulceration, may occur and significantly impair patients’ quality of life, as well as continuation of oncologic treatment. Hyperbaric oxygen therapy (HBOT) has shown potential benefit in the management of chronic radiation-induced tissue injury, although evidence regarding its role following SBRT remains limited. We report the case of a 75-year-old woman with cholangiocellular carcinoma who developed severe radiation-induced duodenal ulceration following liver SBRT, presenting with persistent postprandial pain, nausea, vomiting, and substantial weight loss despite standard supportive treatment. Helicobacter pylori testing was negative, non-steroidal anti-inflammatory drug use was excluded, and histopathology showed chronic inflammatory and fibrotic mucosal injury with reactive epithelial changes. Despite high-dose proton pump inhibition, bismuth subcitrate, and nutritional support, symptoms and endoscopic ulceration persisted. HBOT was administered at 2.4 atmospheres absolute for 60 min over 30 sessions. Clinical improvement was noted after three sessions, and treatment was completed without adverse effects. Follow-up endoscopy demonstrated almost complete ulcer regression, with complete symptom resolution, improved oral intake, and a 10 kg weight gain. To the best of our knowledge, this represents the first reported case describing the successful use of HBOT as a potentially effective adjunctive treatment for severe radiation-induced duodenal ulceration following liver SBRT in a patient with cholangiocarcinoma. Although encouraging, this observation should be interpreted cautiously, and prospective clinical studies are needed to further evaluate the efficacy, safety, and optimal timing of HBOT in this setting.

Current Oncology doi: 10.3390/curroncol33080457

Authors: Minami Une Shinya Yamamoto Honoka Fuse Yusuke Yoneoka Kenjiro Noda

Background/Objectives: The incidence of bladder cancer has been increasing within the aging population. Transurethral resection of bladder tumor (TURBT) is the first-line treatment for bladder cancer, serving both diagnostic and therapeutic purposes. In this study, we aimed to investigate the incidence and predictors of postoperative complications following TURBT in a general hospital with a high proportion of older patients. Methods: We analyzed 141 Japanese patients retrospectively who had undergone TURBT for clinically diagnosed bladder cancer between January 2018 and December 2023. Postoperative complications occurring within 30 days were reviewed from medical records, and risk factors were evaluated. Results: Postoperative complications were observed in 49 patients (34.8%), with 28 patients (20%) classified as Clavien–Dindo grade I and 21 (15%) as grade II or higher. In univariable analysis, factors significantly associated with postoperative complications included older age (odds ratio [OR]: 1.04; p = 0.027), lower platelet count (OR: 0.91; p = 0.009), positive urine cytology (class III or higher) (OR: 2.69; p = 0.007), pathological T2 or higher stage (OR: 5.79; p = 0.013), larger tumor size (OR: 1.05; p = 0.005), and longer operative time (OR: 1.02; p = 0.009). In multivariable analysis, independent risk factors for postoperative complications were lower platelet count (OR: 0.89; p < 0.01), pathological T2 or higher (OR: 5.51; p = 0.03), and larger tumor size (OR: 1.05; p < 0.01). Notably, older age was not an independent risk factor. Conclusions: TURBT appears feasible in older patients when performed by experienced surgeons. Age alone should not be considered a limiting factor for surgical eligibility.

Current Oncology doi: 10.3390/curroncol33080458

Authors: Fariz Emrah Özkan Hacer Demir Semiha Urvay Yaşar Culha Beyza Ünlü Duygu Özaşkın Sedat Yıldız Canan Yıldız Merve Kuday Özkan

Background and Objectives: Palliative care awareness among family caregivers plays a critical role in the timely utilization of supportive care services. However, awareness levels and associated factors among caregivers of cancer patients remain insufficiently explored in Türkiye. This study aimed to evaluate palliative care awareness and identify factors associated with awareness among caregivers of cancer patients. Materials and Methods: This cross-sectional study included 550 caregivers of cancer patients receiving treatment at oncology clinics. Sociodemographic characteristics, caregiving-related factors, and palliative care awareness levels were assessed using a structured questionnaire. Associations between awareness and explanatory variables were evaluated using chi-square tests. Independent predictors of awareness were determined by multivariable logistic regression analysis. Results: Among the 550 caregivers included in the study, 277 (50.4%) reported no knowledge of palliative care, 141 (25.6%) reported sufficient knowledge, and 131 (23.8%) reported limited knowledge. Higher educational level, active employment, older age, closer relationship to the patient, advanced disease stage, and previous exposure to palliative care services were significantly associated with greater awareness. In multivariable logistic regression analysis, education level (OR = 2.05, 95% CI: 1.35–3.15, p < 0.001), employment status (OR = 1.79, 95% CI: 1.23–2.61, p = 0.003), age (OR = 1.04, 95% CI: 1.01–1.07, p = 0.004), disease stage (OR = 1.34, 95% CI: 1.05–1.72, p = 0.016), caregiver relationship (OR = 1.94, 95% CI: 1.18–3.17, p = 0.008), and having a relative who had previously received palliative care (OR = 2.34, 95% CI: 1.42–3.84, p < 0.001) were identified as independent predictors of awareness. Conclusions: Palliative care awareness among caregivers of cancer patients remains limited. Educational level, caregiving experience, and exposure to palliative care services significantly influence awareness. Strategies aimed at improving caregiver education and increasing public awareness may facilitate earlier integration of palliative care into oncology practice.

Current Oncology doi: 10.3390/curroncol33080456

Authors: Giuseppe Di Lorenzo Sara Di Lorenzo Antonio Verde Oriana Strianese Luigi Leo Carlo Buonerba

Background: Next-generation sequencing (NGS)-detected ERBB2 amplification occurs in a subset of urothelial carcinomas, but its role as a treatment-selection marker for trastuzumab deruxtecan (T-DXd) remains uncertain. Methods: We retrospectively reviewed four patients with metastatic urothelial carcinoma treated with T-DXd in routine practice from 2024. Treatment selection was based on NGS-detected ERBB2 amplification because HER2 immunohistochemistry and in situ hybridization were unavailable. Results: Four men aged 65–76 years received T-DXd: one in the second line and three in the fourth or fifth line. The best radiological responses, abstracted from contemporaneous radiology reports and oncology medical records, were complete response in one patient, partial response in one, and stable disease in two. Three patients had previously received enfortumab vedotin. Documented adverse events included fatigue, anemia, diarrhea, rash, and leukopenia. No interstitial lung disease or pneumonitis was documented in the available records. Conclusions: These observations are descriptive and hypothesis-generating. They do not establish the efficacy or safety of T-DXd or validate ERBB2 amplification as a predictive biomarker, but they support prospective evaluation of genomic ERBB2 amplification when standard HER2 testing is unavailable.

Current Oncology doi: 10.3390/curroncol33080455

Authors: Raymundo A. Munoz Luis G. Medina Jonathan S. Kim Allison Supernaw Matvey Tsivian

Radical cystectomy (RC) with urinary diversion (UD) is the standard treatment for muscle-invasive bladder cancer. Although the ileal conduit (IC) is the most commonly performed diversion, its reliance on bowel reconstruction leads to substantial perioperative morbidity and long-term complications. Cutaneous ureterostomy (CU) has re-emerged as an attractive alternative, particularly for elderly and medically frail patients, due to its technical simplicity and avoidance of intestinal manipulation. Recent single-stoma and tubeless modifications have aimed to overcome historical limitations of CU, including stomal stenosis and long-term stent dependence. Compared with IC, modern refinements of single-stoma CU showed shorter operative times and generally shorter hospital stays, largely reflecting avoidance of bowel reconstruction. Estimated blood loss and overall intraoperative complication rates were broadly comparable between diversion types. Contemporary retrospective data on single-stoma modifications showed lower rates of stomal stenosis and improved catheter-free outcomes compared with historical data, while infectious complications and readmission rates remained similar to those of IC in most series. Renal outcomes generally remained stable, with patient factors such as baseline renal function, hydronephrosis, and stent dependence appearing to be more influential for long-term deterioration than diversion type alone. Quality of life after contemporary single-stoma CU was similar to IC, based on the available retrospective evidence. Overall, contemporary single-stoma CU represents a valuable bowel-sparing urinary diversion that may potentially reduce operative burden while maintaining acceptable functional and quality-of-life outcomes. Current retrospective evidence supports its role as a particularly attractive option for elderly and frail patients, although prospective, multicenter comparative studies with standardized outcome reporting are still needed to better define patient selection and long-term outcomes.

Current Oncology doi: 10.3390/curroncol33080454

Authors: Aemélia Nègre Lorène Seguin Arthur Géraud Cremieux Frederic Viret Agnès Tallet Cornel Popovici Anthony Gonçalves Alexandre de Nonneville

Brain metastases in hormone receptor-positive metastatic breast cancer remain incompletely characterized at the molecular level. We report isolated central nervous system progression in a 60-year-old woman with hormone receptor-positive breast cancer initially diagnosed at the age of 38 and metastatic recurrence diagnosed at the age of 55. After approximately five years of extracranial disease control with letrozole plus palbociclib, she developed multiple brain metastases, including a large cerebellar lesion requiring surgical resection. Molecular profiling of the resected lesion identified ESR1 Y537S and ERBB2 Y772_A775dup, whereas postoperative plasma circulating tumor DNA analyzed using a sensitive next-generation sequencing assay showed no detectable somatic alteration. Extracranial disease remained in complete metabolic response. This tissue–plasma discordance is compatible with spatial genomic heterogeneity but may also reflect a low circulating tumor fraction, postoperative reduction in tumor burden, and limited release of tumor-derived DNA from CNS lesions into the systemic circulation. This case highlights the limitations of plasma circulating tumor DNA for evaluating CNS-limited progression and supports direct molecular profiling of brain metastases when tissue is available.

Current Oncology doi: 10.3390/curroncol33080453

Authors: Codruta Craciun Livia Stanga Danut Dejeu Ana-Maria Davidoiu Adrian Cosmin Ilie Patricia Octavia Mazilu Lavinia Craciun Stelian Pantea

Background and Objectives: Conversion therapy has expanded treatment options for patients with initially unresectable hepatocellular carcinoma (HCC), but the surgical literature remains focused more often on radiologic response than on the pathological, perioperative, and postoperative outcomes of patients who actually proceed to hepatectomy. This focused systematic review aimed to synthesize the available evidence on conversion hepatectomy after contemporary combination downstaging for initially unresectable HCC. Materials and Methods: A structured PubMed/MEDLINE search with backward reference-list screening was performed and last updated on 3 February 2026. The full Boolean strategy, field tags, and eligibility framework are now reported explicitly. Because the literature was observational and clinically heterogeneous, findings were synthesized narratively and complemented by structured assessments of reporting completeness, potential cohort overlap, and study-level bias. Results: Fourteen studies were included, nearly all retrospective and predominantly from East Asia. Treatment platforms clustered into systemic doublets, systemic plus HAIC strategies, and broader locoregional–systemic triplet or multimodal approaches. Across studies reporting pathological response, pathological complete response ranged from 28.0% to 50.0%, while R0 resection ranged from 85.7% to 100%, where stated. Postoperative morbidity ranged from 14.3% to 71.4%, and major complication rates from 9.5% to 16.9%; however, extent of resection, liver reserve, post-hepatectomy liver failure, transfusion, and perioperative mortality were not uniformly reported. Most studies carried moderate-to-high overall concerns for bias because of response-based surgical selection, heterogeneous denominators, incomplete perioperative reporting, and possible partial overlap among some cohorts. Conclusions: The available literature suggests that conversion hepatectomy can be feasible and oncologically meaningful in carefully selected patients treated in experienced centers, but current evidence remains hypothesis-generating rather than practice-standardizing because it is observational, heterogeneous, and incompletely reported.

Current Oncology doi: 10.3390/curroncol33080452

Authors: Ramy Habib Erika Arnold Tasin Obi Franco J. Vizeacoumar Shahid Ahmed

Background: Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal solid malignancies, with poor survival driven by late presentation, aggressive tumor biology, and limited responsiveness to conventional systemic therapy. Advances in molecular profiling have expanded opportunities for biomarker-guided and targeted therapeutic approaches. Methods: A literature review was conducted using PubMed and the Cochrane Library through July 2026, supplemented by abstracts and proceedings from major international oncology conferences. Results: Pancreatic cancer is driven mainly by somatic changes in KRAS, TP53, CDKN2A, and SMAD4. Established precision approaches include maintenance olaparib for selected platinum-sensitive tumors with germline BRCA1 or BRCA2 pathogenic variants, immune checkpoint inhibition for mismatch repair-deficient or microsatellite instability-high tumors, and tropomyosin receptor kinase inhibition for cancers with neurotrophic tyrosine receptor kinase gene fusions. Direct inhibition of KRAS and RAS represents a major therapeutic breakthrough. KRAS G12C inhibitors established proof of concept, while agents targeting the more common KRAS G12D mutation are showing encouraging early activity. In the randomized phase III RASolute 302 trial, the multiselective RAS inhibitor daraxonrasib improved survival compared with chemotherapy in previously treated metastatic disease with oncogenic RAS mutations. Early studies of zoldonrasib combinations have extended this progress to KRAS G12D-mutant disease, although confirmation is required. Molecular profiling, next-generation sequencing, patient-derived organoids, and circulating tumor DNA may further improve treatment selection and monitoring. Conclusions: Precision oncology is becoming clinically relevant in pancreatic ductal adenocarcinoma. KRAS- and RAS-directed therapies are central advances, but resistance, toxicity, limited durability, and access to comprehensive testing remain important challenges.

Current Oncology doi: 10.3390/curroncol33080451

Authors: Carolyn Owen Christopher Lemieux Mark Bosch Kelly Davison Nicholas Forward Roopesh Kanasara Mary Margaret Keating Anca Prica Colin Stewart Abi Vijenthira Laurie H. Sehn

Relapsed and/or refractory follicular lymphoma (R/R FL) remains a therapeutic challenge due to its chronic relapsing course and increasingly complex treatment landscape. Novel therapies, including immunomodulatory combinations, bispecific antibodies (BsAbs), Bruton tyrosine kinase inhibitors, and chimeric antigen receptor (CAR) T-cell therapies, have expanded treatment options and increased the complexity of treatment selection and sequencing. The Canadian Hematology Consensus Group (CHCG) convened a national panel of lymphoma experts to develop evidence-informed consensus recommendations for the management of adults with R/R FL in the Canadian context. Clinical questions informed a structured literature review of studies published through February 2026, including randomized trials, phase II studies, observational data, conference proceedings, and relevant guidelines. Recommendations were developed using a modified Delphi consensus process and graded using a framework adapted from the British Committee for Standards in Haematology. Key recommendations include repeat biopsy to exclude histologic transformation at relapse, individualized treatment selection based on timing of relapse and patient-specific factors, preferential use of lenalidomide-rituximab (LenR)-based triplet combinations in most second-line settings, and incorporation of BsAb and CAR T-cell therapy in third-line and later disease. These recommendations aim to provide practical guidance for Canadian clinicians managing patients with R/R FL.

Current Oncology doi: 10.3390/curroncol33080450

Authors: Jannis Tornikidis Filip Pazdirek Alan Stolz Marek Minarik

Background: Breast cancer treatment is often based on multimodal approaches in locally advanced stages typically including neoadjuvant chemotherapy (NACT). There are limited options for the assessment of prognosis and early identification of future non-responders, which has led to the study of circulating cell-free DNA (cfDNA) and its tumor-derived subset, circulating tumor DNA (ctDNA), for potential use as non-invasive markers for prediction of response and prognosis associated with NACT. Methods: We have evaluated the literature on approaches to the use of cfDNA and/or ctDNA as potential biomarkers for NACT. Results: Out of 142 references going back to 2010, we found there were 87 original research reports, 39 reviews, 10 clinical trial reports and six case reports. A detailed analysis revealed several distinctive ways that markers were evaluated in a clinical setting. The original studies have focused on cfDNA, especially cfDNA integrity, whereby increasing integrity levels correlate with tumor shrinkage, reductions in proliferation markers, and hence indicate a better prognosis. Similarly, epigenetic alterations have shown promising results, with methylated ctDNA levels decreasing in responders. Further studies demonstrated the utility of ctDNA persistence through the NACT as strongly associated with shorter disease-free and overall survival. The most recent approaches of longitudinal ctDNA monitoring were found to be valuable for early identification of patients at high risk for post-operative recurrence. Conclusions: It should be noted that while most reports indicate the important role of circulating DNA in the assessment of prognosis and early detection of recurrence, there is currently only a limited utility in the prediction of eventual neoadjuvant therapy outcomes.

Current Oncology doi: 10.3390/curroncol33080449

Authors: Ramon Staeger Leandra Gioia Ehrat Nicole Kamber Reinhard Dummer Mirjam C. Nägeli Egle Ramelyte

Introduction: Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin cancers, with a subset progressing to locally advanced (laSCC) or metastatic (mSCC) stages. The introduction of anti-PD1 immunotherapy has transformed treatment, but real-world data remain limited, particularly in immunosuppressed patients. Methods: This single-centre, retrospective study included 189 patients with advanced cSCC treated between 2012 and 2022. Demographic, clinical, and treatment data were analyzed to assess clinical management and outcomes before and after the introduction of anti-PD1. Results: Among the 189 patients, 72.5% were male, with a median age of 79 years. Overall, 86 patients presented with laSCC and 103 with mSCC. In 100 patients, a preceding primary cSCC was documented, and its complete resection (R0) was associated with significantly better overall survival (OS) after diagnosis of advanced disease (p < 0.001). Immunosuppressed patients, including organ transplant recipients and those with chronic lymphocytic leukemia (CLL), had significantly reduced OS (p = 0.017 and p = 0.0059, respectively). First-line treatment prior to 2018 predominantly involved surgery and radiotherapy. Following the introduction of anti-PD1 therapy, its use increased rapidly in both first- and second-line settings. From 2018 onward, the number of advanced cSCC cases discussed at the multidisciplinary tumorboard increased approximately threefold. Median OS was significantly longer for mSCC patients treated in the post-2018 era (p = 0.025), while the survival disadvantage of CLL patients compared to non-CLL patients widened, suggesting limited benefit from advances in systemic therapy in this subgroup. Best overall response to first-line anti-PD1 correlated significantly with OS, with complete responders achieving a 1-year progression-free survival of 83.3%. Conclusions: The introduction of anti-PD1 has demonstrated improved survival outcomes in advanced cSCC, though significant challenges remain for immunosuppressed patients, particularly those with CLL and solid organ transplant recipients. Future research should focus on optimizing treatment for these high-risk groups, therapeutic sequencing, and the role of perioperative (neoadjuvant and adjuvant) immunotherapy strategies.

Current Oncology doi: 10.3390/curroncol33080448

Authors: Mira Kheil Tariq Mekkaoui Emily Andresan Gloria Fung Madison Miller Jamie G. Joseph Anqi Wang Ali Al Asadi Mohamed Elshaikh Sarfraz Ahmad Ahmad Awada

Objective: To examine survival outcomes and identify clinicopathological factors associated with survival in patients with advanced-stage endometrial cancer who received neoadjuvant chemotherapy before interval debulking surgery (NACT-IDS). Methods: A single-center retrospective cohort study was conducted of patients who were diagnosed with advanced-stage (2009 FIGO IIIB, IIIC, IV) endometrial cancer (2012–2024) and underwent NACT-IDS. Tumor response to NACT was determined with computed tomography and the RECIST criteria, and demographic, clinicopathologic, perioperative, and tumor molecular features (mismatch repair protein [MMR] status and p53 pattern) were collected from medical chart review. Association between tumor molecular features and response to NACT was determined. Primary endpoints were progression-free and overall survival, analyzed with univariate Cox and stratified Kaplan–Meier analysis. Results: Of 42 consecutive patients (median age of 68 years), the majority (n = 26; 61.9%) had a partial tumor response to NACT, with only five (11.9%) having a complete response, four (9.5%) having stable disease, and seven (16.7%) having progressive disease. Most cases had no residual tumor after IDS (n = 35; 83.3%). MMR protein status was associated with the tumor response to NACT (p = 0.013), but p53 status was not. During follow-up, 24 patients died (57.1%), and 31 (73.8%) died or had disease progression. Tumor response to NACT and resection margin status were associated with progression-free survival in unadjusted analyses, but no covariate adjustment was possible with limited sample size. Conclusions: This study highlights MMR-deficiency, response to NACT, and surgical resection status as clinicopathologic features of interest for future studies of prognostic factors and alternative therapies in advanced-stage endometrial cancer.

Current Oncology doi: 10.3390/curroncol33080447

Authors: Latteefah Alnaeem Wafa A. Almohri Clare Reade Waldo Jimenez Sarah Mah Andra Nica Julie Nguyen Lua R. Eiriksson

Background: Waiting-room time is an important and neglected element of the outpatient experience in the field of oncology, which carries far-reaching consequences for overall patient satisfaction, perceptions of quality, and healthcare experience. Methods: We carried out a cross-sectional, mixed-methods study, conducted at the Juravinski Cancer Centre in Hamilton, Canada, from October to December 2024. Results: We studied 418 patients with a mean age of 61.6 years. Overall, 59.6% of respondents had spent less than 30 min in the waiting room, while 56.2% accepted a delay of 15–30 min. Waiting for more than 30–45 min was perceived as long by 61% of participants. In regards to physician choice, 59.8% of respondents preferred to be seen by their known provider, while 30.9% were ready to meet another one, particularly in terms of scheduled regular follow-up and urgent appointments followed by consultations. Interestingly, chemotherapy visits were the least common type of appointment where patients agreed to see different providers. A significant association was identified between appointment types and readiness to change physicians (p < 0.05). Although 78.7% agreed that delays were caused by complex conditions, only 29.2% received sufficient information about delays. Conclusions: Most gynecologic oncology patients want continuity of care, yet many are flexible with consultations, follow-up, and urgent visits. In outpatient clinics, patient-centered scheduling, balancing efficiency and patient satisfaction with better communication is an objective for system improvements.

Current Oncology doi: 10.3390/curroncol33080446

Authors: Ping Huang Yiqiong Yin Ziqiang Wang Zechuan Jin

Background: Patients with stage I rectal cancer generally have favorable outcomes after curative surgery, but prognosis is not completely homogeneous. This study explored the prognostic association of preoperative inflammation–nutrition indices with overall survival and developed an interpretable internally validated machine learning survival model. Methods: We retrospectively included 475 patients with primary pathological stage I rectal adenocarcinoma who underwent curative-intent radical surgery at Sichuan University West China Hospital between 2018 and 2021. Patients downstaged to ypStage I after neoadjuvant therapy or treated by local transanal excision without lymph node dissection were excluded. Candidate predictors included age, sex, carcinoembryonic antigen, and routinely available preoperative inflammation–nutrition indices. LASSO-Cox regression was used for feature selection. Six survival models were developed and evaluated using 1000 bootstrap resamples with out-of-bag internal validation. Model performance was assessed at 60 months using time-dependent AUC, C-index, Brier score, calibration, and decision curve analysis. SHAP analysis was used for model interpretation. Results: During a median follow-up of 68 months, 30 deaths occurred. LASSO-Cox regression identified five predictors: age, lymphocyte-to-white blood cell ratio, fibrinogen-to-lymphocyte ratio, albumin-to-alkaline phosphatase ratio, and neutrophil-to-HDL cholesterol ratio. In bootstrap out-of-bag internal validation, XGBoost-Cox achieved the highest, although only marginally higher, discriminative performance among the evaluated models, with a 60-month time-dependent AUC of 0.783, a C-index of 0.774, and a Brier score of 0.0507. The calibration intercept and slope of XGBoost-Cox were 0.519 and 1.070, respectively. SHAP analysis identified age as the most influential predictor, followed by the selected inflammation–nutrition indices. Decision curve analysis suggested potential clinical utility within threshold probabilities from 1% to 20%, although this finding remains exploratory. Conclusions: Preoperative inflammation–nutrition indices may contribute to overall survival prognostic stratification in primary pathological stage I rectal cancer. External validation in larger multicenter cohorts is required before clinical application.

Current Oncology doi: 10.3390/curroncol33080445

Authors: Stephanie Bowe Seamus O’Reilly Michelle Murphy Anne O’Mahony Sinead Harney Akbar Zulquernain John Bourke

The rapid expansion of biologic therapies for immune-mediated inflammatory diseases has raised significant clinical concerns regarding malignancy risk, particularly for patients with a history of cancer. This narrative review explores the safety of targeted therapies across dermatology, rheumatology, respiratory medicine, and gastroenterology to guide clinicians in these therapeutic dilemmas. We conducted a non-systematic review of the literature, prioritising longitudinal registry and real-world cohort data over clinical trials to better capture malignancy outcomes with long latency periods. Results indicate that tumour necrosis factor (TNF) inhibitors, which have the most extensive evidence base, do not consistently demonstrate an increased risk of overall incident malignancy or recurrence across specialties. Newer agents, including interleukin (IL)-17 and IL-23 inhibitors, show reassuring safety profiles in both trial and registry data. While dupilumab is associated with the potential diagnostic ‘unmasking’ of pre-existing cutaneous T-cell lymphoma, overall cancer rates remain stable among users. Most clinical guidelines support an individualised, multidisciplinary approach involving oncology consultation. We conclude that biologic agents can be used cautiously in certain patients with a history of malignancy following multidisciplinary discussion; however, in those with active malignancy there are no meaningful data that exist. Most evidence is heterogenous and excludes patients with a history of malignancy. Future management requires validated decision frameworks and mandatory participation in real-world patient co-created registries which leverage developing artificial intelligence tools to refine long-term safety assessments.

Current Oncology doi: 10.3390/curroncol33080444

Authors: Hyeran Jung Minsun Jung

Background/Objectives: Korea has experienced rapid and heterogeneous shifts in cancer epidemiology since 1999. We aimed to characterize divergent incidence trajectories across the 24 major cancer types, quantify sex-specific burdens, and project case counts through 2030. Methods: Annual incidence data—including new case counts and age-standardized incidence rates (ASIRs) per 100,000 (2020 Korean standard population) stratified by sex—were extracted from the KCCR via the Korean Statistical Information Service (KOSIS) for 1999–2023. Annual percent change (APC) was estimated by log-linear regression with 95% confidence intervals (CIs). Holt–Winters damped exponential smoothing generated 2024–2030 projections with 95% prediction intervals (PIs). Changes in case ascertainment and coding over the study period were considered in interpretation. Results: Total incidence increased from 101,854 (1999) to 288,613 cases (2023), a 183.4% increase. Overall ASIR rose from 402.7 to 522.9 per 100,000. Of the 24 cancer types, 15 showed statistically significant increasing ASIR trends, 6 showed significant decreasing trends, and 3 showed no significant change. The highest-APC cancers were thyroid (+7.56%), prostate (+6.98%), testis (+5.39%), breast (+5.03%), and corpus uteri (+5.03%; all p < 0.001). The largest significant declines occurred in cervix uteri (−3.81%), larynx (−3.18%), liver (−2.90%), and stomach (−2.20%; all p < 0.001). Female ASIR increased from 294.7 to 488.9 per 100,000 (+65.9%); male ASIR increased from 573.3 to 587.0 per 100,000 (+2.4%). Total cancer incidence is projected to reach 307,091 (95% PI: 281,200–332,983) in 2026 and 330,213 (95% PI: 290,663–369,763) by 2030, with the steepest projected relative growth for prostate (+48.9%), kidney (+33.7%), and breast (+31.3%) cancers. Conclusions: Korean cancer epidemiology is undergoing a pronounced transition from infection-related toward metabolic, hormonal, and aging-related malignancies, with a marked and widening sex-specific divergence. Cancer-type-resolved projections through 2030 provide an evidence base for strategic capacity planning in Korean oncology.

Current Oncology doi: 10.3390/curroncol33080443

Authors: Peter Traversa Sheila Garland

On behalf of the Canadian Association of Psychosocial Oncology, we are pleased to present the abstracts from the 2026 Annual Conference, titled “A New Horizon: Expanding the Access and Impact of Psychosocial Oncology”. The 41st Annual CAPO Conference was held in St. John’s, Newfoundland from 8 June 2026 to 9 June 2026. As we stand at a new horizon in psychosocial oncology, we recognize the unprecedented opportunities to expand both the access to and the impact of comprehensive cancer care. This conference will explore innovative strategies for breaking down traditional barriers that have historically limited access to psychosocial support, including geographic isolation, resource constraints, cultural disparities, and systemic inequities in healthcare delivery. This expansion of reach and influence represents not merely growth in service numbers, but a fundamental transformation in how we conceptualize, design, and implement patient-centered psychosocial care across diverse communities and care settings. We will explore scalable solutions that amplify impact while maintaining the deeply personal, human-centered approach that defines excellence in psychosocial oncology. From telehealth innovations and peer support networks to community-based interventions and integrated care models, this conference will showcase evidence-based strategies that expand our collective ability to support individuals and families navigating the cancer journey, wherever they may be. This conference brought together key stakeholders including multidisciplinary professionals from nursing, psychology, psychiatry, social work, spiritual care, nutrition, medicine, rehabilitation medicine, occupational health and radiation therapy for both adult and pediatric populations. Participants included clinicians, researchers, educators in cancer care, community-based organizations and patient representatives. Patients, caregivers and family members presented abstracts that speak to their role in managing cancer experiences and care. Over one-hundred and fifty (150) abstracts were submitted for presentation as symposia, 20 min oral presentations, 10 min oral presentations, 90 min workshops and poster presentations. We congratulate all the presenters on their research work and contributions.

Current Oncology doi: 10.3390/curroncol33080442

Authors: Shanshan Yu Rongxue Ma Yanjin Liu Yuting Chen Xinyu Lu Yuxi Zhang

Lymphoma currently ranks first in incidence among haematological malignancies, yet few have revealed the core dimensions of the illness experience which patient-reported during treatment. This study aimed to identify those core dimensions using Q-methodology, which combines qualitative and quantitative approaches. A concourse of 59 statements was developed through literature review and dual-perspective interviews with clinicians and patients, then refined to a 39-item Q-set. Seventeen hospitalized lymphoma patients performed Q-sorting, and data were analyzed by principal component analysis with varimax rotation. Four distinct factors emerged: need for a healing environment amid severe adverse reactions; active adaptation and positive coping with treatment; chronic symptom distress and fear of recurrence; and resilient persistence under heavy financial pressure. These findings reveal complex and diverse subjective experiences of lymphoma patients. Differentiated management approaches should be applied to patients with distinct experience patterns, such as improving the physical hospital environment, fostering active coping and post-traumatic growth, alleviating recurrence anxiety, and mitigating financial toxicity.

Current Oncology doi: 10.3390/curroncol33080441

Authors: Eleonora Palluzzi Amedeo Cefaliello Olga Martelli Mariagrazia Distefano Carolina Maria Sassu Valentina Weger Serena Maria Boccia Laura Vertechy Giorgia Russo Luca Romano Giacomo Corrado Carolina Bottoni Diana Giannarelli Christian Marth Anna Fagotti Francesco Fanfani Claudia Marchetti

Background: The prognostic role of the Systemic Immune-Inflammation Index (SII) in patients with endometrial cancer (EC) treated with pembrolizumab plus lenvatinib (Len-Pem) is unknown. In this study, the association between baseline SII and progression-free survival (PFS) was evaluated. Methods: This is a monocentric, observational, retrospective/ambispective study including patients with advanced, recurrent, or metastatic mismatch repair proficient (pMMR) EC treated with Len-Pem. Results: Fifty-three patients were enrolled, with a median age of 64 years. Median PFS in the overall population was 7.1 months; median OS was 15 months. Patients with baseline SII ≤ 540 had significantly longer PFS (12.5 months) compared to those with SII > 540 (5.5 months; HR 2.94, p = 0.004). Higher SII was also significantly associated with increased risk of specific toxicities, including nausea, anorexia, and vomiting. The Overall Response Rate (ORR) was 42%, and Disease Control Rate (DCR) was 71%. Conclusion: Our real-world study supports the hypothesis-generation of a prognostic role for SII in predicting outcomes and toxicity in EC patients treated with Len-Pem. SII may serve as a cost-effective, accessible biomarker to stratify patients and hypothetically guide clinical decision-making. Further prospective studies are warranted to validate its clinical utility and to optimize dosing strategies that balance efficacy and tolerability.

Current Oncology doi: 10.3390/curroncol33080440

Authors: Paolo Maione Francesco Jacopo Romano Cesare Gridelli

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Current Oncology doi: 10.3390/curroncol33080439

Authors: William J. Phillips Russell Leong Benjamin Yeung Ahmed Al Lawati D. Ross Camidge Bryan Lo Paul Wheatley-Price

Introduction: The prognostic significance of EGFR variant allele frequency (VAF) remains unclear in advanced EGFR-mutant (EGFR-mt) NSCLC. We examined the relationship of EGFR VAF and clinical outcomes in patients treated with first-line osimertinib. Methods: This retrospective cohort study evaluated patients with advanced EGFR-mt NSCLC treated at the Ottawa Hospital between July 2021 and June 2023. Baseline characteristics were collected from electronic medical records. Adjusted VAF (aVAF) was calculated by normalizing EGFR VAF to tumor cellularity and analyzed according to predefined thresholds: aVAF < 50% (low) and aVAF > 100% (high). The primary outcome was progression-free survival (PFS). Results: Of 141 patients diagnosed with EGFR-mt NSCLC, 59 were included. The median age was 70 years, and 70% were females. There were 23 (39.0%) cases with low aVAF and 16 (27.1%) with high aVAF. Neither aVAF < 50% (HR = 1.01; p = 0.76) or aVAF > 100% (HR = 0.81; p = 0.57) was associated with PFS. However, ECOG performance status ≥ 2 (vs 0–1; HR = 3.63, p < 0.001), EGFR exon 19 deletion (vs. L858R; HR = 0.50, p = 0.021), and liver involvement (HR = 2.65, p = 0.005) were associated with PFS on multivariable analysis. Discussion: EGFR aVAF was not associated with clinical outcomes. However, established prognostic factors including ECOG performance status, EGFR mutation subtype, and liver involvement were associated with PFS.

Current Oncology doi: 10.3390/curroncol33070436

Authors: Sabina Cauci Cinzia Buligan Patrizia Nacci Gianluca Petris Giuseppe Stinco

Immunity plays critical roles in cutaneous melanoma. We investigated the association between the pro-inflammatory interleukin-1β gene (IL-1B) rs16944 (-511 C > T) promoter single nucleotide polymorphism (SNP) and cutaneous melanoma susceptibility and clinical features. This observational case–control study included 133 patients with cutaneous melanoma and 900 healthy controls from Northeastern Italy. The rs16944 C > T polymorphism was determined by genomic DNA restriction fragment analysis. The IL-1B rs16944 C allele (OR = 1.44, p = 0.014) and CC genotype (OR = 1.48, p = 0.037) were associated with modestly higher odds of melanoma. Among melanoma patients, the CC genotype was associated with Stage I disease (OR = 2.45, p = 0.016) and Breslow thickness ≤ 0.75 mm (OR = 2.27, p = 0.049), whereas it was less frequent in Stage IV melanoma (OR = 0.37, p = 0.029). The CT genotype was associated with Stage IV melanoma (OR = 3.03, p = 0.014) and with lower-limb (OR = 2.45, p = 0.038) and lower-extremity (OR = 3.09, p = 0.005) melanoma. These divergent associations are exploratory and do not establish disease trajectory or a functional effect of rs16944; mechanistic interpretation remains uncertain because IL-1β expression or activity was not measured in this cohort. To our knowledge, this is the first report of an association between a genetic polymorphism and lower-limb/lower-extremity melanoma. These exploratory findings require confirmation in independent cohorts.

Current Oncology doi: 10.3390/curroncol33070438

Authors: Takao Sakai Hisaki Aiba Makoto Yamaguchi Koji Hagiwara Hideki Murakami Hiroaki Kimura

Sarcomas with Murine Double Minute 2 (MDM2) amplification are considered potential candidates for MDM2-targeted therapy. However, the limited efficacy of MDM2 inhibitor monotherapy suggests that additional biological factors may influence tumor behavior and prognosis. This study investigated the relationship between MDM2 expression and the Complexity Index in SARComas (CINSARC) transcriptomic signature, a gene expression signature that reflects cell division and chromosomal instability in soft tissue sarcomas. In the public GSE21050 dataset comprising 310 soft tissue sarcomas, the MDM2-low/CINSARC-low subgroup showed the most favorable metastasis-free survival, whereas the MDM2-high/CINSARC-low subgroup had an unfavorable metastasis-free survival comparable to that of the MDM2-high/CINSARC-high group. Among the representative genes in the 12q13-15 region, fibroblast growth factor receptor substrate 2 (FRS2) showed a strong positive correlation with MDM2 expression, but no significant correlation with CINSARC, suggesting an association independent of proliferative capacity. These findings suggest that proliferation-based risk assessment alone may underestimate the metastatic risk of a subset of MDM2-high sarcomas, and FRS2 may present a biologically relevant marker of aggressive behavior independent of tumor proliferation.

Current Oncology doi: 10.3390/curroncol33070437

Authors: Richard Lee-Ying Sharlene Gill Adrian Box Hannah Latour Scott Strum Vallerie Gordon Ralph Wong Petra Grendarova Tamara Gimon Shahid Ahmed Georgia Geller Christina Kim Duc Le Karen Mulder James Paul Branawan Gowrishankar

The 27th annual Western Canadian Gastrointestinal Cancer Consensus Conference (WCGCCC) was held in Calgary, Alberta, on 26–27 September 2025. The WCGCCC is an interactive multidisciplinary conference that was attended by healthcare professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) who are involved in the care of patients with colorectal cancer. Specialists from the fields of medical and radiation oncology, pathology, surgery, and a family physician in oncology participated in presentations and discussions for the purpose of developing the recommendations presented here. This consensus statement addresses recent advances in the management of colorectal cancer in a Western Canadian context, with respect to adjuvant exercise, as per the CHALLENGE trial, adjuvant Aspirin and PI3K testing, as per the ALASCCA trial, adjuvant immunotherapy, as per the ATOMIC trial, the use of encorafenib and an EGFR inhibitor with chemotherapy, as per the BREAKWATER trial, the use of combination immunotherapy as per the CHECKMATE 8HW trial and optimal strategies for omitting radiation and non-operative management of non-metastatic rectal cancer.

Current Oncology doi: 10.3390/curroncol33070435

Authors: Huong Nguyen Thi Thu Dang Nguyen Van Yen Le Thi Tung Nguyen Thanh Manh Pham Duy Nga Tran Thi Giang Quang Le Van

Introduction: Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL-NT), is a rare and aggressive lymphoma for which real-world data from resource-limited settings remain scarce. This study evaluated the efficacy and safety of frontline multimodal treatment strategies for localized ENKTL-NT. Methods: We retrospectively analyzed 62 patients with localized ENKTL-NT treated at the Vietnam National Cancer Hospital between May 2019 and June 2025. Patients received concurrent chemoradiotherapy followed by VIPD or VIDL, or sequential chemoradiotherapy with GELOX/PGEMOX. Treatment responses, survival outcomes, and toxicities were assessed. Results: The median age was 44 years, and 67.7% of patients had stage I disease. Baseline EBV-DNA positivity was detected in 46.8%, while 54.8% had PINKE scores of 1–2. The overall response rate was 93.5%, including an 85.5% complete response rate. Grade 3–4 neutropenia was the most common adverse event (18.7%). The estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 76.3% and 79.5%, respectively. Multivariable Cox analysis identified PINKE risk stratification as an independent predictor of both PFS and OS. Conclusions: Frontline multimodal treatment strategies achieved high response rates, favorable survival outcomes, and manageable toxicities in localized ENKTL-NT. The PINKE score remained an important prognostic factor, supporting risk-adapted treatment selection in routine clinical practice.

Current Oncology doi: 10.3390/curroncol33070434

Authors: Przemysław Dybcio Anna Kuraś Mikołaj Dyrka Michał Iwaszko Joanna Pec Jakub Kleinrok Agnieszka Korolczuk

Perineural invasion (PNI) is a distinct route of cancer spread associated with neuropathic pain, local recurrence, and poor survival across many solid tumours. Increasing evidence shows that PNI is not only a structural pattern of invasion but also a dynamic biological process involving neurodegeneration, nociceptor sensitisation, and marked local immunosuppression. This narrative review synthesises experimental, translational, and clinical data on the molecular, neurological, and immunological mechanisms of PNI in solid malignancies. PNI arises through complex crosstalk between tumour cells, Schwann cells, macrophages, fibroblasts, and neurotrophic pathways, leading to peripheral nerve remodelling, axonal degeneration, and abnormal regeneration. These changes promote neuropathic pain through ion-channel dysregulation, neurotrophin-driven sensitisation, and pathological neuroplasticity. At the same time, PNI creates an immunosuppressive microenvironment enriched in Tregs, M2 macrophages, and myeloid-derived suppressor cells, shaped by cholinergic, adrenergic, and neuropeptidergic signalling, which may contribute to immune exclusion and resistance to immunotherapy. We propose that PNI should be understood as a neuro-immuno-metabolic process and that recognising the PNI–pain–immunosuppression triad may support the development of targeted neuroprotective, analgesic, and immunomodulatory therapies.

Current Oncology doi: 10.3390/curroncol33070433

Authors: Gabriele Colasurdo Alvina Nadeem Nina Mason Juliette Royer Stephanie Soltys Henry Chan Richard K. Plante Julie Stakiw Joseph R. Mikhael Michelle Oana

Background: Inequitable access to clinical trials persists in blood cancers despite ongoing equity, diversity, and inclusion (EDI) efforts. Despite the critical role of clinical trials in improving survival and outcomes, recruitment remains suboptimal, limiting patient access to potentially life-saving therapies. Practical and scalable approaches are therefore needed to address the non-medical barriers that hinder patient readiness upstream of enrolment. Methods: Myeloma Canada led a national, multi-phase initiative using human-centred design (HCD) to operationalize EDI in clinical trials. Following an initial systems level workshop, the two-day Phase 0 workshop used a HCD approach that convened a purposively selected multidisciplinary group of stakeholders to co-design operational solutions for non-medical barriers affecting trial participation for patients. Given the use of purposive sampling, the results should be interpreted as reflecting a balanced range of diverse, informed perspectives across the Canadian clinical trial ecosystem. Results: Participants identified persistent cultural, logistical, financial, and linguistic barriers, along with fragmented awareness of available supports. Across diverse personas and care settings, all groups independently converged on a human-centred, equity-focused pre-trial navigation model supported by simple digital tools, including AI-enabled infrastructure drawing on curated resources from validated sources with appropriate governance, privacy, and oversight. Digital tools were proposed to support, rather than replace, human support and to align with existing health system realities. Conclusions: This hypothesis-generating work proposes a feasible, sustainable, and scalable equity-embedded, protocol-agnostic navigation framework. Its external hub-and-spoke structure can reduce non-medical barriers, strengthen trial access and accrual, and enhance representativeness. Pilot implementation that assesses feasibility, uptake, workflow impact, equity effects, and implementation burden is warranted.

Current Oncology doi: 10.3390/curroncol33070432

Authors: Onyebuchi Ononogbu Sydney Mohr Javeria Khalid Alyssa Glass Jane Emovon Hilary Ma Yaser Alkhatib Amit Correa

Background/Objectives: Multiple myeloma (MM) disproportionately affects older adults and racial/ethnic minorities, many of whom face socioeconomic barriers to care. Immunomodulators (IMiDs) are central to MM therapy, but their benefit relies on timely initiation and sustained adherence. In safety-net settings, barriers such as insurance approvals, Patient Medication Assistance Program (PMAP) enrollment, and Risk Evaluation and Mitigation Strategy (REMS) requirements may influence adherence. This study evaluated IMiD adherence during the first two years of therapy among socioeconomically vulnerable MM patients in a large safety-net hospital, with attention to PMAP enrollment and treatment delays. Methods: We conducted a retrospective cohort study of adults (≥18 years) with newly diagnosed MM between October 2010 and January 2022 who initiated lenalidomide or pomalidomide at a safety-net hospital. Adherence was measured using the proportion of days covered (PDC). Delays in initiation were defined as ≥1 month from diagnosis to first IMiD prescription fill. This threshold was selected a priori based on the REMS-mandated 28-day prescription supply limit for lenalidomide and pomalidomide, which establishes a natural monthly treatment cycle; a delay exceeding one full 28-day cycle before therapy initiation is operationally meaningful within the REMS framework. Results: Eighty patients met criteria (mean age 55.1 years; 56.3% Hispanic/Latino; 31.3% African American). Most were unemployed (63.8%), 42.5% uninsured, and 57.5% enrolled in PMAP. Only 12.5% achieved PDC ≥ 80%. Median PDC was higher among PMAP enrollees (0.40 vs. 0.31; p = 0.0293) and transplant-ineligible patients (0.46 vs. 0.27; p = 0.0218). Delays ≥ 1 month occurred in 65% of patients. Conclusions: Adherence to IMiDs was suboptimal in this younger safety-net cohort. Although PMAP improved adherence, program delays may reduce early treatment benefits, underscoring the need for streamlined access and targeted interventions to address both patient- and system-level barriers.

Current Oncology doi: 10.3390/curroncol33070431

Authors: Andre C. Schuh Joseph Brandwein Mahmoud Elsawy David Sanford Brian Leber

In the companion article in this issue of Current Oncology, ‘Management of AML in Older Patients: An Updated Canadian Consensus’, the authors have presented the third iteration of Canadian consensus guidelines on AML treatment in the elderly. While many aspects of AML treatment in the elderly have become better defined, some old questions remain and new questions and controversies have arisen. Here, we address three topics on which there is, at this time, no universal consensus. The first is the development and features of new risk-stratification systems specifically aimed at older, less-intensively treated patients. Several different systems now exist in parallel, potentially causing confusion amongst clinicians. The second topic is good-prognosis AML subtypes (IDH1- and NPM1-mutated AML). In the Canadian context, IDH1-mutated AML is of particular interest due to the new availability of ivosidenib in Canada. The third topic is adverse-risk AML subtypes (FLT3- and TP53-mutated AML). FLT3-mutated AML remains problematic, although it is anticipated that new drug approvals and measurable residual disease-based treatment approaches may alleviate this, at least in part. And in particular, TP53-mutated AML remains a major problem. Ongoing clinical trial enrollment is essential.

Current Oncology doi: 10.3390/curroncol33070430

Authors: Candost Hanedan Oğuz Kaan Köksal Şahin Kaan Baydemir Neslihan Öztürk Hande Nur Öncü Vakkas Korkmaz

Lymphovascular space invasion (LVSI) is a well-established prognostic factor in endometrial cancer; however, its independent contribution to para-aortic nodal metastasis remains incompletely defined. Identifying factors associated with nodal dissemination is important for surgical staging and postoperative management. This retrospective, single-center cohort study included 121 patients with endometrial cancer who underwent laparoscopic pelvic and para-aortic lymphadenectomy. The cohort was predominantly obese (median BMI: 32 kg/m2). Clinicopathological variables were analyzed using univariable and multivariable logistic regression models to identify associations with lymph node metastasis and para-aortic lymph node metastasis. Lymph node metastasis was observed in 16.5% of patients, including para-aortic involvement in 9.9%. In univariable analysis, the LVSI category was significantly associated with lymph node metastasis (p = 0.002), with substantial LVSI being present in 50.0% of patients with nodal metastasis compared with 14.9% of those without. LVSI was categorized as negative, focal, or substantial. In multivariable logistic regression analyses using negative LVSI as the reference category, substantial LVSI remained independently associated with both overall nodal metastasis (OR 5.44, 95% CI 1.67–17.65, p = 0.005) and para-aortic nodal metastasis (OR 6.98, 95% CI 1.81–26.78, p = 0.005), whereas focal LVSI was not significantly associated with either outcome. These findings suggest that the extent of LVSI may be relevant to nodal metastasis, with substantial LVSI showing a stronger association than focal LVSI.

Current Oncology doi: 10.3390/curroncol33070429

Authors: Andre C. Schuh Nicholas Chornenki Mohamed A. Elemary Mahmoud Elsawy Brett L. Houston Brian Leber Lee Mozessohn Mitchell Sabloff Brittany Salter David Sanford Joseph Brandwein

These are the third Canadian consensus guidelines on the management of acute myeloid leukemia (AML) in older patients. The first was published in 2013, and the second in 2017. The management of AML in older patients changed significantly over this time span, with decreasing emphasis on the use of intensive chemotherapy and the adoption of new standards of care based on less-intensive therapies: first azacitidine + venetoclax combinations, followed by azacitidine + ivosidenib. Increased use of these new therapies in older patients has raised questions about their use, including how to determine patient suitability, select the most effective therapy, and manage dosing and toxicity. In this third Canadian guideline, we address these questions to provide clarity around these new standards of care and improve clinician understanding and confidence in using them. As more new targeted agents become available and hypomethylating agent-based triplet combinations are used more widely, we fully anticipate that we will, in some years’ time, write a fourth guideline on the management of AML in older patients.

Current Oncology doi: 10.3390/curroncol33070428

Authors: Yolanda Andreu Ana Soto-Rubio Beatriz Gil-Juliá Carmen Picazo Inmaculada Maestu Silvia Fernández

The study aims to investigate the Health-Related Quality of Life (HRQOL) in lung cancer survivors, comparing it with the HRQOL of survivors of other types of cancer, analyzing its association with clinically significant distress, and exploring the modulating role of sociodemographic, clinical, and psychosocial variables. A total of 141 lung cancer survivors who had completed treatment with curative intent and were disease-free completed the Quality of Life in Adult Cancer Survivors questionnaire (QLACS), the Brief Symptom Inventory-18 (BSI-18), the Medical Outcomes Study–Social Support Survey (MOS-SSS), and the Utrecht Proactive Coping Competence scale (UPCC). Several multivariate analyses of variance (MANOVA) were performed to address the study objectives. Statistical analysis was performed using IBM SPSS Statistics 22.0. The overall HRQOL of lung cancer survivors did not differ from the HRQOL of hematologic, breast, and gynaecologic cancer survivors and was lower than that of colorectal, head/neck, prostate, and melanoma cancer survivors. HRQOL was associated with clinically significant distress. Younger age, female sex, lower levels of proactive coping, and less positive social interaction were independently associated with worse HRQOL in lung cancer survivors. The overall HRQOL of lung cancer survivors is among those with the poorest HRQOL compared with other cancer survivors’ groups. The modifiable nature of the psychosocial variables that characterize the risk profile (with the exception of sociodemographic ones) allows for the establishment of more ambitious goals than the simple establishment of subgroups on which to prioritize care. The team of professionals involved in the care of lung cancer survivors should also provide intervention strategies that improve their well-being.

Current Oncology doi: 10.3390/curroncol33070427

Authors: Amy Clark Sophie Van Tomme Lucinda Hetherington Carla Dias Barbosa Paul Cordero

The literature on the qualitative experiences of patients with non-Hodgkin lymphoma (NHL) is limited. Qualitative interviews were conducted to investigate participants’ experiences with two types of NHL (diffuse large B-cell lymphoma [n = 20] and mantle cell lymphoma [n = 10]) and evaluate the comprehensiveness of patient-reported outcome (PRO) measures. Fatigue, tiredness, body aches, night sweats, lethargy, headache, appetite loss, altered taste, and weakness were the most frequent and bothersome symptoms. Key impacts were decreased physical performance, restricted activity, sadness, distress, fear of recurrence, and worry about future. Most participants expressed positive opinions about the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 (EORTC QLQ-C30) (n = 22/28), EORTC QLQ-NHL-High Grade Module 29 (EORTC QLQ-NHL-HG29) (n = 12/16), EORTC QLQ-NHL-Low Grade Module 20 (EORTC QLQ-NHL-LG20) (n = 8/12), and Functional Assessment of Cancer Therapy–Lymphoma (FACT-Lym) (n = 10/14), considering them relevant to their experiences (22/27, 13/15, 9/13, and 10/12, respectively). All measures adequately captured their experiences with NHL (QLQ-C30: n = 26/26, NHL-HG29: n = 14/14, NHL-LG20: n = 11/11, and FACT-Lym: n = 12/13). These findings provide a valuable framework for informing the selection of appropriate PRO measures in NHL clinical trials and identifying potentially meaningful trial endpoints.

Current Oncology doi: 10.3390/curroncol33070426

Authors: Robert Puckrin Diego Villa Isabelle Fleury Jean-François Larouche John Kuruvilla

First-line (1L) therapy for mantle cell lymphoma (MCL) continues to evolve rapidly, with several recent phase II and phase III trials consistently showing the activity of novel covalent Bruton’s tyrosine kinase inhibitor (cBTKi) combinations. Historical treatment selection criteria such as patient age, fitness, and eligibility for autologous stem cell transplantation generally remain applicable for some, but not all, of these novel regimens. This potential for flexibility necessitates the consideration of additional factors during decision-making, such as MCL biology, patient risk tolerance, logistical and resource implications, and the impact on use of later-line options. This paper presents three illustrative patient cases to explore 1L therapy selection among these new and emerging cBTKi options. The realized and anticipated benefits, limitations, and challenges and persisting evidence gaps associated with these regimens are discussed.

Current Oncology doi: 10.3390/curroncol33070425

Authors: Nam Kyu Kang So Jung Lee Hye Jin Kang Hun-Joo Shin Jung Hyun Kwon Soon Kyu Lee Myungsoo Kim

Bile duct tumor thrombus (BDTT) is a rare manifestation of hepatocellular carcinoma (HCC) that causes obstructive jaundice and is associated with a poor prognosis, although a treatment algorithm has yet to be established. We review the treatment landscape for HCC with BDTT, including surgical, transarterial, systemic, and radiotherapy options, and report, to our knowledge, the first case series of magnetic resonance-guided radiotherapy (MRgRT) for this condition. Four patients with unresectable HCC and BDTT were treated on a 0.35-T MR-linac with real-time cine-MRI gating (50 Gy in 5 fractions, n = 3; 40 Gy in 5 fractions, n = 1), with tumor response assessed by modified RECIST. All patients completed treatment without interruption. The best response was complete response in two patients and partial response in two, and obstructive jaundice resolved in both affected patients. The maximum radiation-attributed toxicity was a transient grade 3 bilirubin elevation that resolved without biliary intervention, and no treatment-related deaths occurred. Overall survival ranged from 5.5 to 29 months, with the two Child-Pugh class A patients without portal vein tumor thrombosis surviving 22 and 29 months. MRgRT for HCC with BDTT appears feasible with acceptable short-term safety and merits prospective evaluation.

Current Oncology doi: 10.3390/curroncol33070424

Authors: Ting Xu Junya Ke Yalin Yue Zhiling Zhu Mingzhi Zhao Yun Wang

After radical hysterectomy for cervical cancer, postoperative bladder dysfunction is common. This randomized controlled trial evaluated whether adjunctive transcutaneous electrical acupoint stimulation (TEAS) reduces urinary retention. A total of 108 patients were assigned to a control group (standard bladder training, n = 53) or a TEAS group (standard training plus daily 30 min TEAS for 7 days from postoperative day 3, n = 55). The primary outcome was urinary retention (post-void residual > 100 mL on day 11). Secondary outcomes included residual volume, recovery time, recatheterization, urinary tract infection (UTI), treatment efficacy, and quality of life (SF-36). Urinary retention occurred in 35.8% of controls versus 23.6% of TEAS patients (p = 0.164). TEAS significantly reduced median residual volume (70 vs. 85 mL, p = 0.004), shortened median recovery time (2 vs. 4 h, p < 0.001), and lowered recatheterization (16.4% vs. 34.0%, p = 0.036). UTI rates were similar. Treatment efficacy favored TEAS (p = 0.009), and all eight SF-36 domains significantly improved (all p < 0.01). In conclusion, adjunctive TEAS did not significantly reduce the primary outcome of urinary retention but significantly improved multiple secondary bladder-emptying measures and quality of life after radical hysterectomy for cervical cancer.

Current Oncology doi: 10.3390/curroncol33070423

Authors: Narin Nard Carmel Neiderman Orr Raved Harel Sofer Idan Peled Idan Ben Nachum Ran Bilaus Tomer Ziv Baran Omer J. Ungar Lior Gonen Avraham Abergel

Background: Endoscopic endonasal approaches for pituitary adenomas are associated with improved clinical and quality of life (QOL) outcomes. However, the necessity of middle turbinate resection to optimize surgical exposure remains controversial, particularly regarding its potential impact on postoperative nasal and tumor-related QOL. Methods: This prospective cohort study included adult patients undergoing endoscopic endonasal transsphenoidal resection of pituitary adenomas between 2014 and 2021 at a tertiary center. Patients were divided into those undergoing bilateral middle turbinectomy and those with turbinate preservation. Tumor-related QOL was assessed using the Anterior Skull Base Disease-Specific Questionnaire (ASBS-Q), and nasal QOL using the Sinonasal Outcome Test-22 (SNOT-22), at baseline and multiple postoperative time points up to >6 months. Clinical and surgical variables were collected and compared between groups. Results: Our study included 73 patients, 51 (69.9.%) of whom underwent middle turbinate resection and 22 (30.1%) who did not. The difference in overall ASBS-Q scores did not alter significantly between both groups during the long-term postoperative course (>6 months). SNOT-22 score differences also did not alter significantly throughout the entire postoperative course. Conclusion: Middle turbinectomy during endoscopic endonasal resection of pituitary adenomas was not associated in our cohort to adversely affect long-term nasal or tumor-related QOL.

Current Oncology doi: 10.3390/curroncol33070422

Authors: Nicole Collaço Anna Kennington Natalie Greenberg Tara Imber Danae Warne Samantha Sodergren

Post cancer treatment, many young people often live with ongoing emotional, social, and physical difficulties, but support is not always accessed when it is needed. This study aimed to co-produce a conceptual model of support-seeking after cancer treatment with young people with lived experience of cancer, to better understand the triggers, timing, and pathways influencing engagement with support. This co-design work, informed by Bird et al.’s generative framework for co-production, built upon a prior study involving interviews and co-design workshops with young people and healthcare/allied health professionals, and informed a preliminary model of support-seeking. The current work involved two further co-production stages through an online survey and workshop to refine this model. Data were analysed using a thematic approach to support conceptual model development. Four interconnected themes shaped support-seeking: (1) readiness to engage: recognition, emotional readiness, and relational safety; (2) access and appraisal of support: visibility, fit, feasibility, and burden; (3) pathways to support: multi-modal, layered, and non-linear engagement; and (4) support trajectory: changing needs and recurrent engagement. Engagement in support-seeking depended on the alignment of readiness, recognition of need, and relational safety. This model offers a framework to improve how post-treatment support is designed and delivered in practice.

Current Oncology doi: 10.3390/curroncol33070421

Authors: Hikmat Abdel-Razeq Baha Sharaf

Hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) metastatic breast cancer (MBC) is the most prevalent subtype of advanced breast cancer and is predominantly driven by estrogen receptor (ER) signaling. Endocrine therapy (ET) has become the backbone of first-line treatment; however, both intrinsic and acquired resistance limit long-term disease control. The introduction of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors has fundamentally reshaped the therapeutic landscape even in subsets of patients with aggressive or symptomatic visceral metastatic disease. Advances in molecular profiling have also enabled more precise, adaptive therapy. Circulating tumor DNA (ctDNA)-based liquid biopsy now allows real-time detection of emerging resistance mutations, particularly in ESR1. Additionally, patients with PIK3CA-mutated tumors who had progressed on or within 12 months of completing adjuvant ET and had no prior systemic therapy for metastatic disease had better treatment outcomes when treated with the PI3K inhibitor inavolisib in combination with palbociclib and fulvestrant. Together, these developments mark a shift from fixed treatment sequencing toward a more dynamic, biomarker-driven approach in first-line HR+/HER2– MBC. Integration of CDK4/6 inhibitors with next-generation endocrine agents and liquid biopsy-guided therapy offers the potential to delay resistance, improve survival outcomes, and individualize treatment.

Current Oncology doi: 10.3390/curroncol33070420

Authors: Yiming Zhao Bingjie Wang Huihui Liu Xiaoying Yang Zhizhen Lai Bo Tang Weiwei Xie Hongtao Ling Shuanglian Xie Shujing Guo Xiaojuan Yu Yujun Dong

Renal involvement is an uncommon but clinically important manifestation of B-cell neoplasms, and direct comparisons between indolent and aggressive entities remain limited. This single-center retrospective biopsy-confirmed and tissue-selected study compared 28 biopsy-confirmed patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) or diffuse large B-cell lymphoma/high-grade B-cell lymphoma (DLBCL/HGBL), with 14 patients in each group, treated at Peking University First Hospital between June 2010 and June 2025. The aggressive comparator group included 13 DLBCL cases and one case annotated as HGBL with MYC and BCL2 rearrangements. Clinical features, timing of renal involvement recognition, dominant clinical entry points, pathological patterns, treatment strategies, and hematologic and renal responses were analyzed. CLL/SLL was associated with higher white blood cell and absolute lymphocyte counts, whereas DLBCL/HGBL showed higher lactate dehydrogenase and β2-microglobulin levels. The interval to renal involvement recognition was longer in CLL/SLL than in DLBCL (24.00 vs. 2.00 months, p = 0.007). At renal involvement recognition or biopsy, 24 h urinary protein excretion was nominally higher in the CLL/SLL group than in the DLBCL/HGBL group (3.90 vs. 1.58 g/24 h). CLL/SLL more often presented with proteinuria/edema, hematuria, or renal dysfunction and showed heterogeneous infiltrative lesions with concurrent glomerular or vascular involvement. DLBCL/HGBL more frequently presented with flank pain or renal mass-related manifestations and was dominated by direct infiltrative or mass-forming lesions. Treatment patterns differed markedly, whereas no significant difference in the distribution of renal responses was detected; however, this comparison was underpowered and should be interpreted descriptively. In this biopsy-confirmed, tissue-selected cohort, CLL/SLL and DLBCL/HGBL showed different observed patterns of renal involvement recognition, tissue acquisition, and renal pathological presentation. These findings support tissue-based evaluation of renal abnormalities in B-cell neoplasms but should be interpreted as descriptive and hypothesis-generating in view of the small sample size and the influence of diagnostic and biopsy pathways.

Current Oncology doi: 10.3390/curroncol33070419

Authors: Verna Cheung Marta Davidson Eshetu G. Atenafu Andrea Arruda Jaime O. Claudio Aniket Bankar Dawn Maze Vikas Gupta Hassan Sibai

The prognostic significance of myelodysplasia-related gene mutations (MDS-RGMs), defined by the ELN 2022 classification and Mutation-Enhanced International Prognostic Score System high-risk mutations (MIPSS70-HRM), in accelerated-phase (AP) and blast-phase (BP) myeloproliferative neoplasms (MPNs) remains unclear. We conducted a retrospective study of 101 AP/BP MPN patients with intermediate-risk cytogenetics, excluding TP53 mutations and adverse-risk karyotypes. We evaluated whether MDS-RGM or MIPSS70-HRM predicted treatment response, overall survival (OS), or disease-free survival (DFS) and whether treatment intensity affected OS. Patients included AP (29.7%) and BP (70.3%), with 55% receiving intensive therapy. Allogeneic stem cell transplant (ASCT) significantly improved OS (HR 0.31, 95% CI 0.19–0.50; p < 0.0001), as did AP versus BP at transformation (HR: 0.43, 95% CI 0.26–0.73; p = 0.0016). Among patients ≤ 70 years with ECOG 0–1 (N = 77), ASCT and reversion to chronic-phase MPN (cMPN) were associated with longer OS (p < 0.0001 and p = 0.0475). Treatment intensity alone did not significantly affect OS (p = 0.1991).

Current Oncology doi: 10.3390/curroncol33070418

Authors: Francesco Callegarin Elisa Masetto Beatrice Basaldella Paola Del Bianco Giulia Doria Denise Kilmartin Giovanna Magni Giacomo Moratello Giorgia Pagan Angela Paggio Lisa Perilli Paola Rescigno Gian Luca De Salvo

Background: Clinical research has evolved into a multidisciplinary field integrating Medical Devices (MD), In Vitro Diagnostics (IVD), and Artificial Intelligence (AI), governed by a modernized European regulatory framework including the Clinical Trial Regulation (CTR), the Medical Device Regulation (MDR), and the In Vitro Diagnostics Regulation (IVDR). In 2021, the Istituto Oncologico Veneto (IOV) IRCCS established the Clinical Trial Quality Team (CTQT) to provide support for non-profit trials and ensure high-quality standards. Methods: A descriptive analysis of trials managed between 2021 and 2025 was conducted using the REDCap platform. A team of 15 professionals assessed performance via Key Performance Indicators (KPIs) categorized into: ethical–regulatory compliance, operational efficiency and data quality. Results: The CTQT manages 18 studies (83% interventional, 50% multicentre), primarily focused on brain (17%) and genitourinary (23%) tumours. The mean time from internal feasibility to Ethics Committee discussion is 13 days. Total approval time (ethical and administrative) is 107 days. Operational metrics are strong, with Site Initiation Time averaging 27 days and First Patient In (FPI) at 41 days. Conclusions: A centralized, multidisciplinary structure effectively supports non-profit research in a complex regulatory environment. While operational speed is high, challenges such as staff turnover and query management variability remain. Future efforts will focus on standardizing post-approval administrative phases and optimizing data management to further improve trial efficiency and integrity.

Current Oncology doi: 10.3390/curroncol33070417

Authors: Guanqi Hang Zhuyi Rebekah Lee Anna Lois Lai Jyothirmayi Velaga Hua Thun Ho Shelby Xuan Lin Lam Yu Guang Tan Nye Thane Ngo John Shyi P. Yuen Li Yan Khor Melvin Lee Kiang Chua Kae Jack Tay Yan Mee Law

Focal therapy (FT) for localized prostate cancer induces architectural changes that complicate post-treatment multiparametric magnetic resonance imaging (mpMRI) surveillance. The Prostate Imaging after Focal Ablation (PI-FAB) system was developed to standardize the evaluation of in-field recurrence on mpMRI. This study assessed the diagnostic performance and inter-reader agreement of PI-FAB following focal cryoablation for localized prostate cancer. In this retrospective study (October 2019 to January 2024), 85 patients (140 lesion sites) underwent post-FT mpMRI and biopsy. Two radiologists (11 and 4 years of experience) independently scored mpMRIs using the three-point PI-FAB scale. Metrics included sensitivity, specificity, PPV, NPV, and accuracy. Inter-reader agreement was measured via quadratic weighted Cohen’s kappa (κ). Reader 1 (more experienced) demonstrated 83.9% sensitivity, 84.4% specificity, 60.5% PPV, and 94.8% NPV. Reader 2 demonstrated 71.4% sensitivity, 87.5% specificity, 58.8% PPV, and 92.5% NPV. Both achieved 84.3% accuracy. Inter-reader agreement was moderate (κ = 0.60). PI-FAB provides good diagnostic performance for detecting in-field recurrence after cryoablation. While reader experience may impact sensitivity, moderate agreement across experience levels supports PI-FAB’s validity and potential clinical utility in standardizing post-FT surveillance.

Current Oncology doi: 10.3390/curroncol33070416

Authors: Merve Turan Merve Çırak Balta

The prognostic significance of next-generation sequencing (NGS) findings during the hormone-sensitive phase of prostate cancer remains incompletely characterized. This retrospective cohort study included 92 patients who underwent NGS analysis on tumor tissue between 2019 and 2025. The primary endpoint was time to castration-resistant prostate cancer (CRPC) from androgen deprivation therapy (ADT) initiation; secondary endpoints were overall survival from ADT initiation (OS-ADT) and from diagnosis. Kaplan-Meier and Cox regression analyses were performed. CRPC developed in 66 patients (71.7%) at a median of 21.1 months. The most frequently altered genes were ATR (35.9%), PTEN (28.3%), TP53 (26.1%), and BRCA2 (15.2%). KMT2C alteration (5.4%) was the strongest independent genomic predictor of shorter time to CRPC (HR = 6.804, p = 0.003) and OS-ADT (HR = 4.730, p = 0.019). TP53 alteration independently predicted shorter OS-ADT (HR = 1.810, p = 0.038). High genomic burden independently predicted shorter time to CRPC (HR = 1.917, p = 0.032). Homologous recombination repair deficiency was not associated with outcomes, attributable to high ATR alteration frequency introducing pathway heterogeneity. Mismatch repair deficiency showed a borderline association with shorter OS-ADT (20.7 vs. 44.0 months; p = 0.060). An exploratory composite risk score stratified patients into three prognostic groups with markedly different outcomes (HR = 7.904, p = 0.001). NGS analysis during the hormone-sensitive phase identifies independent predictors of castration resistance, supporting its integration at ADT initiation for risk stratification and biomarker-guided treatment planning.

Current Oncology doi: 10.3390/curroncol33070415

Authors: Anne M. S. de Hoop Johanna A. Eggink Cindy Veenhof Cyrille A. M. Krul Jelle P. Ruurda Raymond H. H. Pieters Karin Valkenet

Background: Immune fitness (IF) reflects the body’s ability to mount appropriate immune responses. Monitoring IF could improve tailored treatment in oncological rehabilitation. The Immune Status Questionnaire (ISQ) and the Single-Item Scale (SIS) were developed to assess IF, but their clinimetric properties in cancer rehabilitation remain unknown. Aims: To evaluate the construct validity, responsiveness, and correlation between the ISQ and the SIS in oncological rehabilitation. Methods: The study population included people participating in oncological rehabilitation during or within one year after medical treatment. Data were collected prospectively via questionnaires. Construct validity and responsiveness were assessed through predefined hypotheses, including correlations with fatigue, sleep problems, malnutrition risk, activity impairment, and physical functioning. Results: In total, 97 individuals were included in the analyses. Median ISQ and SIS scores were 8/10 and 7/10, respectively. Correlations ranged from r = −0.21 to r = −0.50. Only the SIS correlations with fatigue and physical functioning, and the ISQ correlation with fatigue, met the predefined thresholds. Responsiveness hypotheses were not confirmed. Conclusions: The ISQ and the SIS demonstrated low construct validity and responsiveness in this population. IF scores were higher than expected. Correlations showed links between fatigue, physical functioning, and IF. Future research should develop tools tailored to the complex immune disturbances experienced by cancer survivors.

Current Oncology doi: 10.3390/curroncol33070414

Authors: Giulia Togo Luca Calabrese Giovanni dell’Aversana Orabona Franco Ionna Francesco Longo Renato de Falco Pietro Perotti Ottavio Piccin Luca Gazzini

Background/Objectives: Cutaneous squamous cell carcinomas (cSCC) of the head and neck district are among the most common non melanocytic malignant skin carcinomas. The proposal to differentiate, within the N stage, parotid metastases from lateral cervical metastases, originates from the different prognostic value of the metastatic region involved. Methods: We retrospectively evaluated 61 patients, surgically treated for parotid metastases from cSCC between January 2002 and June 2023, in four Departments of Surgery, to assess the geographic distribution of parotid metastases and to describe their recurrence patterns, to evaluate the prognostic value of the number of affected lateral cervical lymph nodes (LN) and the number of positive intra-glandular lymph nodes (IGLN) and to identify the main prognostic histopathological factors. Results: Our results did not show significant differences between participating centers in the distribution of parotid metastases, nor in their recurrence rates. However, our results highlight how adjuvant radiotherapy is deeply associated with the Overall Survival (OS), improving survival rates in patients with advanced-stage neoplasms (Odds Ratio 5.0), although causality cannot be inferred because of the retrospective study design. Moreover, a statistically significant correlation was found between the major inflammatory biomarkers and the OS. The presence of IGLN was identified as one of the main factors associated with recurrence and poor prognosis in patients with cSCC and in particular, in patients with N3b nodal stage. Conclusions: our findings suggest that both LN and IGLN could be used to propose an additional staging stratification for the N parameter, thereby guiding the treatment strategy and postoperative follow-up for patients with parotid metastases from cSCC of the head and neck district.

Current Oncology doi: 10.3390/curroncol33070413

Authors: Andrea Thoumi Yadurshini Raveendran Laura Fish M. J. Gathings Emily Rosario Shaun R. Jones Hayden B. Bosworth Linda Sutton John H. Strickler Tomi Akinyemiju

Genomic testing is a key component of precision oncology; however, Black patients receive genomic testing at lower rates. The purpose of this qualitative study was to identify individual and health system drivers of genomic testing disparities at a National Cancer Institute-designated comprehensive cancer center. We conducted interviews with 15 oncology providers and 11 Black cancer patients between September 2023 and October 2024. These patients were eligible for genomic testing based on National Comprehensive Cancer Network (NCCN) guidelines, being diagnosed within last 10 years (2014–2023), at least 18 years old, and English-speaking. Providers included oncologists and oncology patient navigators. Topics included motivators, barriers, and knowledge of genomic testing and factors influencing decision-making. The Penchansky and Thomas theoretical framework of healthcare access (e.g., availability, accessibility, accommodation, affordability, and acceptability) guided thematic analysis. Among patients eligible for genomic testing, most participants (n = 7) received genomic testing as part of their cancer treatment based on EMRs, however many patients (n = 7) could not recall discussing genomic testing with their oncologist. Most patients and all providers highlighted affordability as a challenge: patients were concerned about unexpected costs associated with testing, while providers were concerned about costs of matched molecular targeted therapy. Both patients and providers highlighted patient-centered communication to mitigate mistrust and promote patient engagement in care. Despite limited awareness, Black patients view genomic testing positively. Addressing multiple dimensions of access is key to improving system-level processes and ensuring that more patients benefit from lifesaving targeted therapy.

Current Oncology doi: 10.3390/curroncol33070412

Authors: Sitara Sharma Sarah Cleyn Haydn Bechthold Alicia Hilderley Amirrtha Srikanthan

Background: Adolescents and young adults (AYAs; aged 15–39) diagnosed with cancer face distinct challenges that are poorly addressed within traditional cancer care models. This qualitative study explored AYAs’ unmet supportive cancer care needs in Eastern Ontario (Canada) to inform the development of a tailored multidisciplinary program. Methods: As part of a larger mixed-methods study, AYAs receiving/post-cancer treatment in the Champlain region of Eastern Ontario were purposively recruited to complete a survey and a semi-structured interview. Demographic and interview data were analyzed descriptively and via thematic analysis, respectively. Results: Sixteen AYAs (Mage = 32.2 years [range: 19–42]; 56.3% female) were interviewed virtually using a co-designed, semi-structured guide between October 2024 and February 2025. Analysis revealed five themes (i.e., major care gaps) and 12 sub-themes, including: (1) lack of standardized fertility counselling, (2) neglected psycho-emotional impact, (3) limited sexual health education and support, (4) difficulty navigating the healthcare system, and (5) financial toxicity and the cost of being sick young. Conclusions: AYAs in Eastern Ontario face persistent gaps in supportive cancer care that undermine their quality of life. Our findings underscore the need for targeted system-level improvements and offer a foundation for co-designing an evidence-based regional AYA care model that better addresses the holistic needs of this growing population.

Current Oncology doi: 10.3390/curroncol33070411

Authors: Parsa Alan Marie-Odile Parat

Opioids are frequently prescribed for cancer pain management, yet accumulating evidence suggests that opioid exposure may be associated with inferior outcomes in patients also undergoing treatment with immune checkpoint inhibitors (ICIs). To synthesize mechanistic and clinical evidence linking opioids to the PD-1/PD-L1 axis, the literature was searched up to 18 January 2026, with study selection and data extraction focused on (i) cancer-cell and immune-cell effects of opioid agonism or antagonism on PD-1/PD-L1 biology, and (ii) clinical studies reporting ICI outcomes (progression-free survival, overall survival, or treatment duration) with concomitant opioid exposure. Preclinical studies support multiple, non-mutually exclusive mechanisms: opioids can induce PD-L1 in tumour cells, modulate innate-inflammatory pathways (including TLR4-linked cascades), promote dysfunctional T-cell phenotypes that reduce responsiveness to PD-1 blockade, and show context- and opioid-dependent effects. Clinical cohorts and meta-analytic datasets in non-small cell lung cancer and other tumour types report associations between opioid exposure (including higher morphine-equivalent dosing) and worse ICI outcomes. The intersection of opioid signaling with PD-1/PD-L1 biology likely operates across cancer cell-intrinsic and immune cell-intrinsic pathways, providing a mechanistic rationale for prospective evaluation of opioid-sparing strategies and/or peripheral opioid antagonism as adjuncts to checkpoint blockade.

Current Oncology doi: 10.3390/curroncol33070410

Authors: Annie M. Wu Surabi Thirugnanasampanthar Muriel Brackstone

Laparoscopically harvested pedicled omental flap (LHPOF) reconstruction is a minimally invasive autologous option for immediate breast reconstruction, but prior reviews have largely examined omental flaps broadly, combining open and laparoscopic harvests, free and pedicled transfers, and mixed reconstructive indications. This systematic review evaluated operative characteristics, peri-operative complications, and esthetic outcomes following LHPOF after oncologic breast surgery. MEDLINE, Cochrane and Embase were searched without language or date restrictions, with backward citation searching of included studies. Eligible studies included female patients undergoing immediate unilateral breast reconstruction with LHPOF after mastectomy or BCS. Twenty-two studies published between 2001 and 2025 were included, representing 1869 patients. Operative techniques were broadly consistent, most commonly involving transverse-colon-first omental harvest, preservation of the right gastroepiploic vessels, and tunnelling from the inframammary fold toward the xiphoid. Reported complications included omental fat necrosis, partial flap loss, hematoma, infection, epigastric bulging, and incisional or tunnel-site hernia. Esthetic outcomes were generally favourable but assessed using heterogeneous methods. Current evidence suggests this technique is feasible in selected patients and may offer favourable esthetic outcomes with limited donor-site morbidity. However, prospective comparative studies with standardized reporting are needed to define optimal patient selection, long-term safety, and esthetic durability.

Current Oncology doi: 10.3390/curroncol33070409

Authors: Aris I. Giotakis Evangelos Tagkalos Matthias Santer Daniel Dejaco Benedikt Hofauer

Background/Objectives: Data on the value of tumor debulking surgery are scarce. We aimed to examine whether tumor debulking surgery followed by non-surgical treatment (cases) improves survival compared to non-surgical treatment alone (controls) in patients with head and neck cancer (HNC). Methods: We performed a systematic review of studies published in the databases PubMed, Scopus and Cochrane Central Register of Controlled Trials up to 10 December 2024. Studies evaluating tumor debulking surgery followed by non-surgical treatment and reporting survival (local recurrence, disease-free survival or overall survival) in subjects with HNC were included; case reports were excluded. We assessed the quality of observational studies with the Newcastle–Ottawa Scale. Results: Among 11 retrospective small studies, three case–control studies (one of high quality, i.e., 7/9, and two of moderate quality, i.e., 6/9 and 5/9) suggested longer survival in 72 cases with predominantly squamous cell carcinoma (SCC) than in 40 controls with predominantly SCC. However, these survival benefits cannot be attributed solely to tumor debulking surgery, as confounding by indication is the most likely explanation. In supraglottic laryngeal SCC, one study reported a local recurrence-free survival rate and overall survival of 80% and 88%, respectively, in 25 cases compared with 86% and 77%, respectively, in 24 controls. In sarcomas, local recurrence-free survival was 25%, 65% and 100% for unknown resection margins, wide local excision and radical excision, respectively. Conclusions: The heterogeneous data indicate the need for higher-quality research. It would be interesting to investigate whether an attempt to surgically debulk paranasal sinus tumors while preserving adjacent vital organs (e.g., the orbit and/or brain) should be incorporated into the treatment strategy for patients with extended paranasal sinus squamous cell carcinoma. Tumor debulking surgery did not improve survival in supraglottic laryngeal SCC or head and neck soft tissue sarcomas.

Current Oncology doi: 10.3390/curroncol33070408

Authors: Anais Sánchez-Ros Francisco Tomás-Aguirre Marcelino Pérez-Bermejo María Teresa Murillo-Llorente María Ester Legidos-García Ignacio Ventura Teresa Mayordomo-Rodriguez

Background: Lung cancer carries a high psychosocial burden. Tobacco use, the stigma attached to the disease, and coping strategies are thought to interact and shape psychological outcomes, yet they have rarely been examined together. This review aimed to synthesise the evidence on the relationship between tobacco use, lung cancer stigma, and coping, and how these factors interact and influence patients’ psychological outcomes. Methods: Following the PRISMA 2020 guideline, PubMed/MEDLINE and Dialnet were searched (window 2014–April 2026) for empirical studies conducted in adults with lung cancer that addressed stigma, coping, or relevant psychological outcomes (e.g., anxiety, depression, distress, or quality of life). Study selection and data extraction were performed independently by two reviewers, with discrepancies resolved by consensus and, where needed, by a third reviewer. Methodological quality was appraised with design-specific tools (JBI for cross-sectional and cohort studies, CASP for qualitative studies, and COSMIN-oriented criteria for the psychometric study). Given the clinical and methodological heterogeneity, a structured narrative synthesis was conducted following the SWiM guideline. The protocol was registered in the Open Science Framework. Results: Twenty-four studies were included. Stigma was prevalent and consistently associated with depression, anxiety, distress, and poorer quality of life, with longitudinal evidence indicating that stigma precedes and predicts distress. Internalised stigma (guilt, shame, self-blame) was the facet most strongly linked to depression and anxiety. Smoking history graded stigma intensity (current > former > never smokers) but did not determine it, since clinically significant stigma also affected never-smokers. Adaptive coping (e.g., fighting spirit, positive reappraisal) and social support were consistently associated with better psychological adjustment and quality of life, while maladaptive coping (e.g., helplessness, avoidance, anxious preoccupation) was associated with worse outcomes; cross-sectional evidence further indicated that coping modes mediated the relationship between stigma and quality of life and that social support and self-compassion attenuated the impact of stigma on distress. Conclusions: Internalised stigma is a central, modifiable psychosocial stressor in lung cancer that affects smokers and never-smokers alike. Systematic screening for stigma, coping, and social support, together with non-stigmatising care, is warranted.

Current Oncology doi: 10.3390/curroncol33070407

Authors: Aykut Demirkıran Murat Araz Melek Karakurt Eryılmaz Mustafa Karaağaç Muhammed Muhiddin Er Berrin Benli Yavuz Mehmet Artaç

Clinical outcomes remain heterogeneous among patients with unresectable stage III non-small cell lung cancer treated with definitive chemoradiotherapy. We evaluated the prognostic value of the systemic immune-inflammation index (SII) and explored survival outcomes according to the concurrent chemotherapy backbone in this setting. This retrospective study included 101 patients treated with definitive chemoradiotherapy before consolidation durvalumab became standard practice. Baseline SII was calculated using routine blood counts. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan–Meier method and Cox proportional hazards models. With a median follow-up of 40.6 months, patients with low SII had significantly longer OS (26.1 vs. 10.9 months, p = 0.004) and PFS (15.6 vs. 7.2 months, p = 0.018) than those with high SII. Elevated SII remained independently associated with inferior OS in multivariable analysis (HR 1.99, 95% CI 1.21–3.27, p = 0.007). Although survival was numerically longer with cisplatin/etoposide than with carboplatin/paclitaxel, the difference was not statistically significant. Subgroup analysis according to SII level and chemotherapy regimen showed the poorest outcomes among patients with high SII receiving carboplatin/paclitaxel. These findings support the prognostic value of SII and suggest a potential role for risk stratification in patients with unresectable stage III NSCLC undergoing definitive chemoradiotherapy in the pre-durvalumab era.

Current Oncology doi: 10.3390/curroncol33070406

Authors: Samar Attieh Leonard Angka Christine Lafontaine Melinda Bachini Rebecca C. Auer Carmen G. Loiselle

Biliary tract cancers (BTCs), including cholangiocarcinoma and gallbladder cancers, are characterized by their rarity, poor prognosis, limited treatment options, and significant psychosocial burden among affected individuals. Hope and loneliness are known to play significant roles in shaping cancer-related experiences and outcomes; however, their trajectories in the context of rare cancers remain unexplored. The Canadian Cholangiocarcinoma Collaborative (C3) was founded to enhance access to treatment, research, and support for individuals affected by BTC in Canada. This mixed-methods study aimed to measure hope and loneliness among patients and caregivers over time and to gain a deeper understanding of their experiences. A total of 92 patients and 44 informal caregivers, self-, peer-, or physician-referred, consented to participate in this study. Participants completed electronic self-reported measures of hope (Hope Herth Index (HHI), 12 items) and loneliness (UCLA Loneliness scale, 20 items) upon joining C3 (baseline, T0), following the first informational session with a C3 research navigator (T1), and after two to three months (T2). A subsample (n = 14) also participated in two online focus groups. At baseline, participants reported relatively high levels of hope (patients: M = 39.8, SD = 4.9; caregivers: M = 38.9, SD = 4.68), with the HHI ranging from 12 to 48, where higher scores indicate higher hope. They also reported low-to-moderate levels of loneliness (patients: M = 32.13, SD = 9.63; caregivers: M = 36.69, SD = 12.37), with the scale ranging from 20 to 80, where low loneliness: 20–34; moderate: 35–49; moderately high: 50–64; and high: 65–80. At T1, a significant decrease in hope (mean difference [MD] = −1.38, 95% CI [−2.64, −0.11], p = 0.029) and a significant increase in loneliness (MD = 1.75, 95% CI [0.27, 3.23], p = 0.016) were found among patients, with no further significant changes from T1 to T2. Among caregivers, no significant changes were observed from baseline to T1; however, at T2, there was a significant decrease in hope (MD = −2.01, 95% CI [−3.61, −0.40], p = 0.010) and a significant increase in loneliness (MD = 4.54, 95% CI [1.31, 7.77], p = 0.004). No significant differences in hope or loneliness were found between participants who engaged in C3 activities and those who did not. Dyadic analysis revealed significant correlations between patients’ and caregivers’ hope and loneliness at baseline and at T2. Despite the significant changes, findings indicate consistently high levels of hope and low-to-moderate levels of loneliness over time. Focus group analyses further contextualize quantitative findings by highlighting patients’ and caregivers’ experiences in greater depth. The results serve to inform current and future initiatives aimed at providing timely, personalized psychosocial support to patients and caregivers affected by BTC.

Current Oncology doi: 10.3390/curroncol33070405

Authors: Fuad Damirov Junli Ke Javad Karimbayli Mircea G. Stoleriu Sascha Dreher Enole Boedeker Sibylle Gerz Rudolf A. Hatz Gerhard Preissler

This study aimed to identify risk factors for major postoperative complications (TMM) and their impact on overall survival in patients aged ≥80 years undergoing lung cancer surgery, a group at increased risk of morbidity. A total of 88 patients aged ≥80 years who underwent anatomical lung resections were retrospectively analyzed. Postoperative complications were classified into minor or no complications (TMM 0–2) and major (TMM ≥ 3) complications. Logistic regression analysis was performed to identify independent predictors of major complications. Kaplan–Meier estimates were used to measure overall survival. Major complications occurred in 24 patients (27.3%). Multivariable regression analysis identified perioperative blood transfusion as an independent risk factor for major complications (p = 0.0009). Patients with major complications exhibited significantly reduced overall survival (p = 0.0009). Subgroup analysis revealed that patients who underwent minimally invasive surgery had significantly better survival (p = 0.01). Moreover, perioperative transfusion correlated with diminished overall survival (p = 0.0027). In patients aged ≥80 years undergoing lung resections, the occurrence of major postoperative complications is associated with significantly impaired survival. Minimally invasive surgical approaches and blood conservation strategies may mitigate complications and enhance long-term outcomes in this high-risk group.

Current Oncology doi: 10.3390/curroncol33070404

Authors: Michelle Geddes Brett L. Houston Lalit Saini Ismail Sharif Rena Buckstein Ryan J. Stubbins

Hypomethylating agents (HMAs) are the cornerstone in the treatment of higher-risk myelodysplastic syndromes (MDSs), particularly for patients who are not candidates for allogeneic hematopoietic cell transplant (allo-HCT). Despite demonstrated efficacy in improving hematologic outcomes, the clinical management of HMA-associated myelosuppression remains a challenge. This review discusses the use of azacitidine and oral decitabine-cedazuridine (DEC-C) for MDS management in the Canadian context, with a focus on optimizing therapy to mitigate myelosuppression and prevent early HMA discontinuation due to toxicity. Close monitoring of complete blood counts is critical to early detection of myelosuppression and management of treatment-related cytopenias. In the real-world setting, specific HMA dose adjustments are used based on patient risk factors for myelosuppression or treatment-related complications. Supportive care strategies, including the use of growth factors and antimicrobials, can complement monitoring and dose modifications for HMA-related myelosuppression management, although their use is variable. This review summarizes current evidence and real-world management approaches for HMA-induced myelosuppression, with the aim of improving outcomes for patients undergoing treatment for MDS.

Current Oncology doi: 10.3390/curroncol33070403

Authors: Mohammad Biglari Sanji Ali Thiago Muniz Marcus Butler Marguerite Ennis Scott Ernst Ana Elisa Lohmann

Melanoma remains a major global health burden, though immunotherapy and targeted therapy have markedly improved survival. Obesity has paradoxically been associated with favorable outcomes in melanoma, yet body mass index (BMI) alone fails to capture its influence on treatment response. To address this gap, we conducted a multi-site cohort study within the Canadian Melanoma Research Network, including patients with advanced melanoma treated with immunotherapy or targeted therapy. Body composition was quantified using computerized tomography (CT) imaging to assess visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), skeletal muscle (SM) mass and intermuscular adipose tissue (IMAT), and associations with progression-free survival (PFS) and overall survival (OS) were evaluated. No overall association was seen for BMI, SAT, VAT, IMAT or SM with PFS or OS. In the targeted therapy subset, higher BMI, SAT, VAT and SM were associated with better OS (hazard ratios 0.56 to 0.65), while no effect was seen in the immunotherapy group. IMAT emerged as a novel prognostic marker, with elevated levels associated with lower OS in males and better OS in females. Our findings show that CT-based body composition is not associated with survival outcomes in patients with advanced melanoma receiving immunotherapy.

Current Oncology doi: 10.3390/curroncol33070402

Authors: Linhao Ran Jiangwei Chen Huan Liang Jiajian Xie Weichen Fu Dichun Yang Fan Li Ying Liu Li Jiang

Background: The incremental value of iodine-125 (I-125) seed implantation in advanced refractory lung squamous cell carcinoma (LUSC) with hemoptysis treated with bronchial artery chemoembolization (BACE) and immunotherapy remains unclear. Methods: This retrospective cohort study included 90 patients treated between June 2023 and June 2025. Patients receiving BACE plus immunotherapy were classified according to whether I-125 seed implantation was performed within 7 days after BACE: G1, BACE plus immunotherapy (n = 42), and G2, BACE, I-125 seed implantation, and immunotherapy (n = 48). Inverse probability of treatment weighting (IPTW) served as the primary adjustment method. Results: After IPTW, baseline covariates were well balanced; propensity score matching yielded 26 patients per group. Compared with G1, G2 was associated with longer hemoptysis-free survival (not reached vs. 11 months; HR = 0.34, 95% CI 0.18–0.64, p < 0.05), overall survival (19 vs. 14 months; HR = 0.26, 95% CI 0.15–0.44, p < 0.05), and progression-free survival (12 vs. 9 months; HR = 0.34, 95% CI 0.21–0.56, p < 0.05). The 6-month objective response rate (ORR) and disease control rate (DCR) were higher in G2, whereas no significant difference in 24-h hemostasis or recorded grade 3 or higher adverse events was observed. Conclusions: Adding I-125 seed implantation to BACE plus immunotherapy was associated with improved outcomes in selected patients, and prospective validation is warranted.

Current Oncology doi: 10.3390/curroncol33070401

Authors: Anca Maria Pop Markus Rütti

Among hematological malignancies, lymphoma is associated with an increased incidence of venous thromboembolism (VTE) ranging between 4 and 12%. Although Khorana score was validated for stratifying VTE risk in cancer, its discrimination reliability in lymphoma is reduced by the lack of specific predictors. The aim of this systematic review was to summarize the evidence regarding predictors and available risk assessment models (RAMs) for VTE in patients with lymphoma. A systematic search was conducted on PubMed, Embase and Scopus in order to identify papers published until February 2026, which evaluated predictors and RAMs for VTE in patients diagnosed with lymphoma. Out of 592 evaluated papers, 44 met the inclusion criteria. The widely used Khorana score failed to appropriately identify patients with lymphoma at high risk for VTE, while the Thrombosis Lymphoma predictive score (ThroLy) showed modest improvement. Strong predictors for VTE were a poor performance status, older age, previous history of VTE, the use of central venous catheters, and bulky disease. However, the lack of external validation, the small sample size and bias due to confounding factors limit the generalizability of the results. Therefore, larger studies with external validation cohorts are needed to design lymphoma-specific RAMs and to identify predictors with high discrimination power.

Current Oncology doi: 10.3390/curroncol33070400

Authors: Mustafa Serkan Alemdar Hakan Şat Bozcuk

Background: Psychological distress, particularly anxiety and depression, is highly prevalent among cancer patients, and is associated with impaired quality of life, reduced treatment adherence, and increased mortality risk. Standardized screening instruments, such as the Hospital Anxiety and Depression Scale (HADS), are effective, but face implementation barriers in busy oncology outpatient settings. This cross-sectional study investigated whether BERT-based Natural Language Processing (NLP) analysis of brief patient-generated free texts would correlate with HADS scores in a consecutive cohort of cancer outpatients. Material and Methods: A total of 165 consecutive adult cancer outpatients were enrolled at a tertiary oncology center in Turkey. All participants completed the HADS questionnaire and were asked to write freely about their current emotional state in Turkish. Patient-generated texts were analyzed using a pre-trained Turkish BERT model to derive a continuous BERT Sentiment Score (BSS) and a categorical BERT Sentiment Cluster (BSC) via unsupervised hierarchical clustering. Univariate and multivariate linear regression analyses were performed to examine associations between clinical, demographic, and NLP-derived variables and the logarithmically transformed HADS score. Results: The mean total HADS score was 10.46 (range, 0–33), consistent with a moderate level of psychological distress. In multivariate analysis, two variables were independently associated with HADS scores: female sex (β = 0.20, t = 2.14, p = 0.034), associated with higher HADS scores, and BERT Sentiment Score (BSS) (β = −0.18, t = −2.43, p = 0.016), with higher values corresponding to lower HADS scores. Hierarchical clustering identified two distinct thematic groups: ‘Coping and Fighting Spirit’ (74%), and ‘Hope and Negative Feelings’ (26%); however, cluster membership (BSC) was not independently associated with HADS scores (β = −0.02, p = 0.789). Clinical variables, including cancer stage, diagnosis type, treatment status, and time since diagnosis, also were not independently associated with HADS scores. Conclusions: BERT-based sentiment analysis of brief patient-generated free texts yielded a continuous measure that independently correlated with HADS scores in cancer outpatients, alongside female sex. These findings provide proof-of-concept evidence that NLP-derived sentiment scoring may offer a practical, scalable, and complementary approach to standardized psychological screening in routine oncology care.

Current Oncology doi: 10.3390/curroncol33070399

Authors: Matthew D. Martin Gabriella C. Torretto Kaamraan Islam Nicole E. Archer Harriet E. Feilotter Scott K. Davey

The BRCA1 protein serves an essential function in maintaining genomic integrity, to the extent that up to 80% of women carrying a pathogenic BRCA1 variant develop breast cancer (BC). Most of these carriers would benefit from prophylactic care, but genetic screens that uncover variants of uncertain significance (VUSs) do not provide insight on disease risk or clinical decision-making. In accordance with guidelines established by The American College of Molecular Genetics (ACMG) and Association for Molecular Pathology (AMP), this study produced computational and functional evidence to inform the reclassification of BRCA1 VUSs as pathogenic or benign, with a specific focus on the abundant subset of missense variants within the RING domain. A six-feature linear support vector machine (LSVM) specifically trained on BRCA1 RING variants performed well (84% accurate in predicting in vitro binding loss) and provided supporting classification evidence for 322 VUS. A mammalian cell co-immunoprecipitation (co-IP) assay that quantified the binding between variant BRCA RING constructs and endogenous BARD1 provided corroborating strong evidence for nine VUSs and correlated with a homology-directed repair (HDR) assay by Starita et al. (p = 0.04). The combined evidence warrants the reclassification of three VUSs as likely benign (N16S, A17D, and E100D) and one as likely pathogenic (H41P), and underscores the promise of domain-specific approaches for missense VUS reclassification.

Current Oncology doi: 10.3390/curroncol33070398

Authors: Amanda Moreira Tara Rosewall Jennifer Dang Aran Kim Anna T. Santiago Aruz Mesci Enrique Gutierrez Andrew Bayley Andrew McPartlin Rachel M. Glicksman Alejandro Berlin Jeff Winter Winnie Li Peter Chung

MR-guided adaptive radiotherapy (ART) enables daily plan optimization for prostate cancer but is resource-intensive. This study evaluated dosimetric and clinical outcomes following transition from radiation oncologist (RO)-led to radiation therapist (RTT)-led MR-guided ART. All prostate cancer patients treated with MR-guided ART on a 1.5T MR-linac were retrospectively reviewed. Consecutive RO-led (September 2019–November 2021) and RTT-led (April 2022–October 2023) cohorts were compared, excluding the actual transition period. Toxicities (CTCAE v5.0), dose–volume metrics from daily adapted plans, target volume variation, and biochemical recurrence-free survival (BRFS) were analyzed. A total of 166 patients were included (78 RO-led, 88 RTT-led; median follow-up 40 and 35 months). Dosimetric differences between the cohorts were statistically small (<1%). Rates of G2+ GI adverse events were similar across all timepoints. An increase in on-treatment GU events was observed in the RTT-led cohort (G2+ 27% vs. 9%, G3 incidence n = 2 vs. n = 0), likely reflecting higher baseline urinary dysfunction; no post-treatment differences persisted. Early biochemical outcomes were comparable, with 36-month BRFS of 93.5% (RO-led) and 95.0% (RTT-led). RTT-led MR-guided ART achieved comparable dosimetric quality and early biochemical outcomes to RO-led workflows with adverse advents that resolved in the long term. With structured training and a mature practice setting, RTT-led ART represents a scalable model to support future adaptive radiotherapy practice.

Current Oncology doi: 10.3390/curroncol33070397

Authors: Anna R. Franzén Jan Stubberud Torstein B. Rø Stian Lydersen Kaja S. Egset Ellen Ruud Siri Weider Mary-Elizabeth Eilertsen Anne Mari Sund Trude Reinfjell Magnus A. Hjort

Survivors of childhood acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and non-Hodgkin lymphoma (NHL) are at risk of developing long-term adverse effects after survival. This study examined observed proportions of perceived mental distress, fatigue, and executive function (EF) impairment in adult childhood cancer survivors (CCSs) of ALL, AML, and NHL. Secondly, it examined the association between perceived EF impairment and mental distress or fatigue. Participants (n = 132; 57% female) were recruited from two major Norwegian hospitals. Self-report questionnaires included the Behavior Rating Inventory of Executive Function, Adult Version, the Hopkins Symptom Checklist-25, and the Fatigue Severity Scale. Proportions exceeding established clinical thresholds were calculated, and groups were compared using Pearson’s chi-squared test and Newcombe confidence intervals. Overall, 49% and 41% of participants met the clinical thresholds for depression and anxiety; 43% for fatigue; and 28% for EF impairment. Perceived EF impairment was significantly associated with mental distress and fatigue. Mental distress, fatigue, and EF impairment are commonly reported and distressing late effects among CCSs of ALL, AML, and NHL. Follow-up care focusing on neurocognitive and psychological outcomes is important for the long-term functioning and well-being of this survivor group. Targeted neurocognitive rehabilitation may represent a key component of follow-up care.

Current Oncology doi: 10.3390/curroncol33070396

Authors: Anas Zayad Osama Younis Carmel Awadallah Ishita Kamboj Abdelrhman Mohammed Ahmad E. Shatnawi Amr Ali Hamed Alzatary Abdullah Mohammad Khan Hira Shaikh Omar Alkharabsheh Mansi R. Shah Prerna Mewawalla Joseph P. McGuirk Zahra Mahmoudjafari Muhammad Umair Mushtaq Jeries Kort Alma Habib Shebli Atrash Al-Ola Abdallah

Background: Multiple myeloma (MM) has experienced rapid therapeutic innovation over the past two decades, leading to a substantial increase in clinical trial activity. However, the geographic distribution of these trials and the representation of different economic regions remain poorly characterized. We evaluated the global distribution, growth patterns, and phase-specific trends of MM clinical trials and trial sites across different economic settings. Methods: We conducted a retrospective registry-based analysis interventional MM clinical trials registered on ClinicalTrials.gov between January 2006 and January 2026. Trials were categorized based on the economic classification of participating countries using World Bank income groups and Economic Co-operation and Development (OECD) status. Trial characteristics including phase, geographic distribution, number of participating sites, and site-years were analyzed. Population-adjusted trial density and compound annual growth rates (CAGR) were calculated to assess temporal trends and geographic representation. Results: A total of 845 interventional MM clinical trials were identified during the study period. Trial activity was highest in the United States (337 trials, 39.9%), followed by international trials (271, 32.1%), high-income-OECD countries (129, 15.3%), and upper-middle-income countries (103, 12.2%), while high-income non-OECD countries contributed only a small fraction of trials. Trial activity increased substantially over time across all regions with the highest growth observed in upper-middle-income countries (CAGR 18.5%). The US demonstrated the highest population-adjusted trial density (0.99 per million population) and accounted for the largest number of trial sites and site-years. Phase-specific analyses revealed distinct geographic patterns. Phase 1 trials were predominantly conducted in the US and in international collaborative trials. Phase 3 trials were largely international, although the majority of participating sites remained located in the US and High-income countries that are members of the OECD (HIC-OECD). Conclusions: Over the past two decades, MM clinical trial activity has expanded globally but remains highly concentrated in the United States and high income-OECD countries, particularly with respect to trial sites and population-adjusted trial density. Although upper-middle-income countries have shown the fastest growth in trial activity expanding clinical trial infrastructure and strengthening international collaboration will be essential to promote a more equitable global distribution of MM research.

Current Oncology doi: 10.3390/curroncol33070395

Authors: Tara Sampalli Gail Tomblin Murphy Stuart Peacock Sri Navaratnam Danielle Domm Kristi MacKenzie

The Canadian cancer care landscape faces rising cancer incidence, persistent inequities, and increasing system pressures. Led by the Canadian Association of Provincial Cancer Agencies (CAPCA), this scoping review applied an implementation science lens to evaluate the scalability of innovative cancer care models across Canada. Using a mixed-methods design, innovations were identified through a scoping review (n = 42), grey literature analysis (>50), a pan-Canadian survey (n = 72), and key informant interviews (n = 24). Guided by the Consolidated Framework for Implementation Research (CFIR), this review assessed feasibility, barriers, and facilitators influencing adoption and scale-up of identified innovations. Results revealed widespread adoption across various domains including virtual oncology, artificial intelligence (AI)-driven tools, and expansion of team-based care. At-home models, including home infusion, palliative care, and pharmacist-led chronic disease clinics, demonstrated improved access, patient satisfaction, and reduced hospital burden. CFIR mapping revealed cross-cutting facilitators including strong stakeholder engagement, structured training, and demonstrated patient benefits. However, persistent barriers include regulatory variability, funding instability, digital infrastructure gaps, and workforce capacity constraints. This paper highlights implemented innovations in cancer care and identifies strategic scaling opportunities needed to ensure all people living in Canada benefit from high-quality, person-centred equitable cancer care.

Current Oncology doi: 10.3390/curroncol33070394

Authors: Motaz Alaqeel Saad M. Alangari Abdulrahman Ahmed Almebki Abdulaziz Alderaywsh Falwa Alarnous Waleed Albishi Ibrahim Alshaygy Abdulrahman Alaseem

Sarcoma awareness among healthcare practitioners in our institution was limited, prompting an evaluation of their ability to recognize early presentations and initiate appropriate work-up for soft tissue and bone sarcomas. A structured survey assessed familiarity with key clinical features, recommended investigations, and perceived contributors to diagnostic delay. Overall awareness was modest, but higher among healthcare practitioners with prior sarcoma exposure, oncology-focused training, longer experience, or heavier patient loads; female practitioners and oncology nurses also scored higher. Confidence in identifying red-flag symptoms was strongly linked to familiarity with guideline-based practice. Despite these strengths, notable gaps persisted across specialties and training levels, indicating that exposure alone is insufficient. Targeted education, improved recognition of early warning signs, and clearer referral pathways are needed to reduce diagnostic delays and support timely management of suspected sarcomas.

Current Oncology doi: 10.3390/curroncol33070393

Authors: Shinya Kajiura Hironaga Satake Naohiko Nakamura Ryuji Hayashi

Facility-level availability of Japanese Society of Medical Oncology (JSMO) specialists may influence care processes, but national cancer genomic medicine data rarely capture patient-level specialist involvement. We conducted a nationwide retrospective analysis of pancreatic cancer cases in the Center for Cancer Genomics and Advanced Therapeutics (C-CAT). The primary exposure was facility-level registry-listed JSMO specialist count (0–1 vs. ≥2 specialists), with ≥2 interpreted as a proxy for minimum plural specialist-team availability. The primary endpoint was time from systemic therapy start to recorded first-line treatment end. The primary cohort included 14,568 patients at 261 facilities. Median recorded first-line treatment-process duration was 5.7 months in the 0–1 specialist group and 6.4 months in the ≥2 specialist group. In the clinical plus facility-adjusted Cox model, ≥2 specialist availability was associated with a lower hazard of recorded first-line treatment end (HR 0.895, 95% CI 0.810–0.988; p = 0.028). Supportive overall survival findings did not indicate a survival advantage, reinforcing the operational nature of the primary endpoint. These findings indicate a facility-level association with an operational treatment-process endpoint, not patient-level specialist involvement, treatment efficacy, survival benefit, facility ranking, or causality. Chemotherapy-specific national database elements are needed to evaluate specialist contribution directly.

Current Oncology doi: 10.3390/curroncol33070392

Authors: Emanuele Cencini Federica Orsini Marta Franceschini Sara Fredducci Mattia Bello Emanuele Pacini Marcello Bradaschia Anna Sicuranza Chiara Carrara Paolo Bertelli Monica Bocchia Alberto Fabbri

After first-line therapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), 20–30% of patients with diffuse large B-cell lymphoma (DLBCL) have relapsed or refractory disease. Semi-quantitative volume parameters on [18F]Fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT), performed at diagnosis, could represent variables with prognostic influence. We retrospectively analyzed 53 consecutive patients, treated between 2016 and 2022. Semi-quantitative metabolic parameters, assessed by the software LIFEx, included total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), Dmax and DmaxVox. All cases received R-CHOP/CHOP-like regimens with curative intent. The International Metabolic Prognostic Index (IMPI) was low in 43/53 cases (81.1%). CR was achieved in 49/53 patients (92.4%); 7/53 (13.2%) relapsed after achieving a CR. For the entire cohort, 2-year PFS and OS were 84.9% and 90.6%, respectively, while 5-year PFS and OS were 65.5% and 77.6%, respectively. IPI score, B symptoms, TMTV, Dmax and DmaxVox were associated with reduced PFS in an exploratory univariate analysis. IPI score was the only variable for which we found a significant association with reduced OS. In this exploratory analysis in a small, event-limited population, we suggest the baseline, semi-quantitative metabolic parameters of PET/CT at diagnosis could contribute to defining tumor burden and to predict PFS for DLBCL patients.

Current Oncology doi: 10.3390/curroncol33070391

Authors: Mei Liu Yu Li Yiming Lei Feng Cao

Background: This study aimed to investigate the prognostic value of peripheral blood inflammatory markers and nutritional indices for overall survival (OS) in young patients with advanced non-small cell lung cancer (NSCLC) at initial diagnosis. Additionally, we sought to develop a survival prediction model based on combined indicators. Methods: We retrospectively analyzed the clinicopathological characteristics, inflammatory markers, and nutritional indices of young patients with advanced NSCLC initially diagnosed at the Fourth Hospital of Hebei Medical University between January 2013 and March 2025. Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors for OS. Three prognostic models were constructed: a clinical–inflammation model, a clinical–nutrition model, and a clinical–inflammation–nutrition model. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), concordance index (C-index), and decision curve analysis (DCA), with TNM staging as the reference. Results: A total of 514 patients were included, with a median follow-up of 56.6 months and a median survival time of 27.2 months. Multivariate analysis identified sex, liver metastasis, gene mutation, targeted therapy, white blood cell count, and serum albumin level as independent prognostic factors for OS. Among the three models, the clinical–inflammation–nutrition model showed the best predictive performance, with 1-, 3-, and 5-year AUCs of 0.788, 0.756, and 0.704, respectively, and a C-index of 0.711 (95% CI: 0.696–0.726). DCA further demonstrated its clinical net benefit. Conclusions: Peripheral blood inflammatory markers and nutritional indices are closely associated with survival in young patients with advanced NSCLC. In this exploratory single-center study, a prognostic model integrating clinicopathological factors, inflammatory markers, and nutritional indices showed better apparent predictive performance than models based on single categories of variables or TNM staging, warranting further validation in independent cohorts.

Current Oncology doi: 10.3390/curroncol33070390

Authors: Chengyan Yang Kun Gao Shuangshuang He Mengyuan Liu Ping Ai

Background: Head and neck neuroendocrine carcinoma (HN-NEC) is exceedingly rare. Standardized treatment strategies for this malignancy remain unestablished. This study aimed to explore promising treatment modalities, and to identify prognostic factors in HN-NEC. Materials and Methods: Thirty-nine patients diagnosed with HN-NEC at West China Hospital of Sichuan University between 2006 and 2025 were enrolled. The 5-year survival rates were estimated by Kaplan–Meier analysis. The log-rank test and Firth’s penalized Cox multivariable analysis regression model were used to identify prognostic factors. Results: The 5-year locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS) rates for patients who did and did not receive radiotherapy were 63.2% vs. 29.6% (p = 0.031), 75.5% vs. 48.0% (p = 0.065), and 81.4% vs. 46.9% (p = 0.039), respectively. Laryngeal NEC was associated with poorer 5-year DMFS (41.2% vs. 87.5%, p = 0.023) and 5-year OS (38.1% vs. 92.9%, p = 0.027) compared with non-laryngeal HN-NEC. Radiotherapy (HR = 0.152, 95% CI: 0.025–0.757, p = 0.022) was a potentially protective factor influencing LRRFS. Conclusions: Radiotherapy may be associated with improved LRRFS in patients with HN-NEC. HN-NEC originating in the larynx appeared to be associated with a poorer prognosis compared with other primary sites of the head and neck.

Current Oncology doi: 10.3390/curroncol33070389

Authors: Aasa Shimizu Tadashi Watabe Frederik L. Giesel Yuriko Mori Keita Asano Yusaku Shimizu Sadahiro Naka Takashi Kamiya Daisuke Katayama Shinichiro Watanabe Hiroki Kato Kayako Isohashi Mitsuaki Tatsumi Noriyuki Tomiyama Yasuto Kinose Tadashi Iwamiya Shinya Matsuzaki Kenjiro Sawada Michiko Kodama

Background/Objectives: Accurate preoperative assessment of peritoneal dissemination is essential in ovarian cancer because it influences surgical strategy and the achievement of complete gross resection. However, [18F]FDG-PET may be limited in detecting lesions with low glycolytic activity and in differentiating malignancy from inflammatory changes. This case series evaluated the clinical relevance of [18F]FAPI-74 PET/CT for preoperative assessment of peritoneal dissemination in ovarian cancer. Methods: Four patients underwent [18F]FAPI-74 PET/CT as part of preoperative evaluation, with comparison to [18F]FDG-PET/CT when available. Imaging findings were correlated with intraoperative observations and histopathological results, including immunohistochemical assessment of fibroblast activation protein and α-smooth muscle actin. Results: FAPI-PET detected peritoneal dissemination not identified by FDG-PET in several cases, including occult metastasis confirmed histologically and additional lesions after neoadjuvant chemotherapy. FAPI-avid lesions showed stromal activation on immunohistochemistry, supporting the biological basis of FAPI uptake. In one case, additional FAPI uptake may have been partly influenced by inflammatory changes associated with bloody ascites. Conclusions: FAPI-PET may provide complementary information by visualizing stromal components of ovarian cancer and may support preoperative mapping of peritoneal dissemination, although interpretation should consider inflammatory conditions.

Current Oncology doi: 10.3390/curroncol33070388

Authors: Sara N. Gauthier Paul Wheatley-Price David J. Stewart Stephanie Brule Mikaela Ney Garth Nicholas Sara M. Moore

Background: Small-cell lung cancer (SCLC) accounts for 15% of lung cancers, with 70% diagnosed at extensive-stage (ES). Systemic therapy is often considered in very unwell patients, although outcomes for inpatients with ES-SCLC are not well understood. Methods: We reviewed patients with de novo ES-SCLC who had an inpatient medical oncology consultation at the Ottawa Hospital between 2013 and 2021. The primary endpoint was overall survival (OS). Secondary endpoints included length of stay (LOS) and tumor lysis syndrome (TLS) incidence. Results: There were 127 patients identified. Median age was 68 years (range 50–87), 58% female, 99% had prior smoking history, 22% had brain metastases, and 64% had liver metastases. Ninety-two (72%) received chemotherapy. Median OS for treated patients was 5.9 months (95% CI, 4.5–7.3 m), and a median LOS of 13 days. Patients in the non-treatment cohort had a median OS of 14 days (95% CI, 0.2–0.7 m), a median LOS of 11 days, and 54% in-hospital death rate. TLS occurred in six of the 76 (8%) evaluated patients, all dying within 7 days of chemotherapy. Conclusions: Chemotherapy was associated with longer survival among inpatients with ES-SCLC. TLS was rare but uniformly fatal, highlighting the need for aggressive prophylaxis among patients with identified risk factors.

Current Oncology doi: 10.3390/curroncol33070387

Authors: Emmanuel G. Villalpando Jamie Fertal Finly Zachariah Jeannine M. Brant Jessica T. Cheng

Patients with cancer often experience intertwined symptom burden and functional decline that contribute to falls, unsafe transfers, uncontrolled symptoms, caregiver strain, and crisis-driven care. Physical medicine and rehabilitation (PM&R), also known as physiatry, and specialty PC both address suffering and quality of life through complementary clinical approaches; however, collaborative care with and between these two specialties is inconsistent in routine oncology practice. This paper presents a clinical implementation framework informed by targeted literature synthesis for bidirectional referral and co-management between PM&R and PC in oncology. The framework was informed by the PC referral criteria literature, cancer rehabilitation triage literature, trigger-based serious illness identification models, and implementation science. Four clinic-usable tools are proposed, including a scope and overlap map, a clinical-needs gradient, a referral trigger table linking common clinical signals to the reason for referral and expected clinical actions, and a primary-service triage workflow. This framework is intended to clarify which service is best positioned to be the primary supportive service according to the patient’s current needs, when rehabilitation therapy alone may be sufficient, and when co-management should be the default. This concept-to-practice model is designed to facilitate early, needs-based referrals and coordinated supportive care in oncology settings.

Current Oncology doi: 10.3390/curroncol33070386

Authors: Omar Alqaisi Safia Darwish Faten Harb Melinda Hysenaj Lorent Sijarina Patricia Tai

Cancer patients receiving systemic therapy experience substantial treatment-related symptoms. Nurse-led digital health interventions, e.g., interactive voice response systems, web platforms, mobile apps, and telehealth, have emerged as strategies to strengthen supportive care. To evaluate its effectiveness, this systematic review summarizes evidence exclusively from randomized controlled trials (RCTs). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, four databases were searched from inception to January 2025 for eligible RCTs involving adults undergoing anticancer therapy; evaluating nurse-led or nurse-co-led interventions using digital or telecommunication technologies; reporting validated symptom or health-related quality of life (HRQoL) outcomes. Risk of bias was assessed. Nine RCTs (N = 3344) met criteria; seven had low risk of bias. Interventions using telephone systems, web portals, mobile apps, or videoconferencing reduced symptom burden and improved HRQoL. The Symptom Care at Home system reduced symptom burden by ~43%, with greatest effects from combined automated monitoring and nurse practitioner follow-up. Additional benefits included improved anxiety, self-efficacy, patient participation, fewer severe toxicities and hospitalization days. In conclusion, nurse-led digital interventions effectively reduce symptom burden and support HRQoL during systemic therapy. Multicomponent models integrating automated monitoring with structured nursing follow-up and decision support appear most beneficial.

Current Oncology doi: 10.3390/curroncol33070385

Authors: Heeyeon Son Springer Cary Sungsil Hong Jung Woo Han Cecile Lengacher Sharron L. Docherty

Background/objectives: To describe and compare Korean AYAs’ and parental perspectives on the family environment in terms of agreement and significant differences and examine which variables were associated with AYAs’ symptom distress. Sample and setting: Self-report data were collected from a total sample of 113 AYAs, recruited from a pediatric-oncology outpatient clinic at a university-affiliated hospital and community group in South Korea. Because each study aim required different data sources, different analytic samples were used. Specifically, 54 AYA–parent dyads were included for Aim 1, whereas self-report data from 111 AYAs with complete data were used for Aim 2. Methods and variables: This subgroup analysis used a quantitative–descriptive, cross-sectional design. AYAs’ and parent perceptions of the family environment (family cohesion and adaptability, family strength, and social support from family) and AYAs’ symptom distress were collected using reliable and validated self-report questionnaires and analyzed using descriptive and inferential statistics. Results: AYAs and their parents showed low (family support) to moderate agreement (family strength, family cohesion, and adaptability) on perceptions of family environment (ICC = 0.374–0.612). AYAs reported significantly lower perceptions of family support than their parents, with a small to moderate effect (p < 0.001, d = 0.48). All family environment variables were correlated with AYAs’ symptom distress (p < 0.05). Among these variables, AYAs’ perceived family strength emerged as the only family environment variable significantly associated with their symptom distress (F = 14.309, p < 0.001, R2 = 0.359, R2adj = 0.334), which was stronger during treatment. Conclusions: AYAs’ perceived family strength should be routinely assessed, especially during cancer treatment. Additional nursing interventions focusing on enhancing AYAs’ families as a support group are needed.

Current Oncology doi: 10.3390/curroncol33070384

Authors: Chian-Wei Chen Jui-Hung Tsai Sheng-Han Tsai Li-Jun Chen Szu-Chun Yang

Patients with BRAFV600E-mutated metastatic lung cancer benefit from both BRAF plus MEK inhibitors and immune checkpoint inhibitor (ICI)–chemotherapy. This study evaluated the cost-effectiveness of first-line ICI–chemotherapy compared with BRAF plus MEK inhibitors in these patients. This economic analysis, with a 15-year time horizon and an annual 3% discount, was conducted from the perspective of the healthcare sectors in Taiwan and the US. Simulated patients were entered into partitioned survival models upon initiation of first-line therapies. The model inputs were derived from the FRONT-BRAF study (progression-free/overall survival, adverse events, and subsequent therapies), insurance payments or retail prices (costs of drugs, physician visits, monitoring, adverse events, and end-of-life care), and a hospital cohort (health utility). Deterministic and probabilistic analyses were performed. The incremental cost-effectiveness ratios (ICERs) of ICI–chemotherapy compared with BRAF plus MEK inhibitors (Taiwan: $73,561/QALY; US: $290,279/QALY) exceeded the willingness-to-pay (WTP) thresholds (Taiwan: $70,000/QALY; US: $150,000/QALY). The drug costs of subsequent therapies and the utility values of the progressive-disease state were the major determinants of ICERs. In Taiwan, ICI–chemotherapy had a 41.0% probability of being cost-effective at the WTP threshold. ICI–chemotherapy had a higher probability of being cost-effective than BRAF plus MEK inhibitors when the WTP exceeded $300,000/QALY in the US. Our analysis suggests that, despite the longer survival of first-line ICI–chemotherapy compared with BRAF plus MEK inhibitors, ICI–chemotherapy is not a cost-effective strategy for patients with BRAFV600E-mutated metastatic lung cancer.

Current Oncology doi: 10.3390/curroncol33070383

Authors: Stefano Fusco Hannes F. Digomann Sabrina Groß Nisar Peter Malek Eckhart Fröhlich Tatjana Hoffmann

Background/Objectives: Accurate risk stratification of intraductal papillary mucinous neoplasms (IPMNs) remains clinically challenging. This study evaluates a structured imaging-based scoring approach for IPMN risk stratification, referred to as the Tübingen Dignity Score (TDS), and compares its diagnostic performance with established methods. Methods: In this retrospective study, imaging findings from patients with suspected IPMN were analyzed using MRI, CT, and ultrasound. The TDS was applied as an imaging-based scoring system. Diagnostic performance was assessed in a histopathological subset and compared with MRI-based assessment and Fukuoka criteria. Results: MRI showed high sensitivity (94.4%) but limited specificity (57.1%). Fukuoka criteria showed high sensitivity (100%) and high specificity (91.3%) in this cohort, although with a lower positive predictive value. In contrast, the TDS showed high specificity (100%) and positive predictive value, but lower sensitivity (40%), reflecting a different diagnostic profile. These findings indicate a trade-off between sensitivity and specificity across the evaluated approaches. However, the limited number of malignant cases limits the robustness and generalizability of these estimates. Conclusions: The TDS may serve as a complementary, imaging-based tool within a multimodal diagnostic framework for IPMN. Its potential value lies in supporting clinical decision-making in selected cases, particularly where established criteria yield inconclusive results. Given the limited sample size, retrospective single-center design, and exploratory nature of this study, external prospective multicenter validation is required before routine clinical application can be recommended.

Current Oncology doi: 10.3390/curroncol33070382

Authors: Kainat Saleem Sanjana Kamat Nigar A. Khurram Bassem S. Hendawy Sawa Ito Pooja Amarapurkar

Membranous nephropathy (MN) and minimal change disease (MCD) are the most common causes of nephrotic syndrome following hematopoietic stem cell transplantation (HSCT), a complication conventionally attributed to chronic graft-versus-host disease (GVHD). Paraneoplastic MCD is well described in lymphoid malignancies but is rarely reported in myeloid neoplasms. We report two cases of biopsy-confirmed MCD presenting as the initial manifestation of acute myeloid leukemia (AML) relapse following allogeneic HSCT. Both patients were White men in their sixties with relapsed/refractory AML who developed nephrotic-range proteinuria and acute kidney injury after matched unrelated donor HSCT without histologic evidence of GVHD. Renal biopsies confirmed MCD in both cases. Corticosteroid therapy was ineffective in halting renal deterioration; renal function improved only after initiation of leukemia-directed therapy, with one patient achieving dialysis independence. These cases highlight a rare paraneoplastic presentation of AML relapse. Nephrotic syndrome due to MCD may signal post-HSCT leukemia recurrence, and evaluation for AML relapse warrants consideration in steroid-refractory cases or those without concurrent GVHD. In such cases, control of the underlying malignancy, rather than escalation of immunosuppression, may be central to renal recovery.

Current Oncology doi: 10.3390/curroncol33070381

Authors: Beyza Ünlü Hacer Demir Sena Ece Davarcı Yaşar Culha Duygu Özaşkın Fariz Emrah Özkan Sedat Yıldız Canan Yıldız Meltem Baykara

Chemotherapy-induced nausea and vomiting substantially impair patients’ quality of life despite considerable advances in supportive care. Neurokinin-1 receptor antagonists, including oral aprepitant and intravenous fosaprepitant, constitute essential components of antiemetic regimens for highly emetogenic chemotherapy. In this prospective, non-randomized observational study, we compared the efficacy of oral aprepitant and intravenous fosaprepitant administered in combination with 5-hydroxytryptamine-3 receptor antagonists and dexamethasone in 136 chemotherapy-naive patients receiving cisplatin- or doxorubicin–cyclophosphamide-based regimens. Complete response rates during the acute (0–24 h), delayed (24–120 h), and overall (0–120 h) phases were comparable between the two groups, with no statistically significant differences in emesis severity. Multivariable analyses further demonstrated similar effectiveness irrespective of age, sex, or chemotherapy regimen. These findings indicate that no statistically significant differences in antiemetic efficacy were observed between aprepitant and fosaprepitant in routine clinical practice. Fosaprepitant may therefore represent a practical alternative when oral administration is not feasible.

Current Oncology doi: 10.3390/curroncol33070380

Authors: Catherine Bergeron Carmen G. Loiselle Martin Drapeau Annett Körner

Rising cancer incidence and survival rates have led to an unprecedented demand for psychosocial care. Yet, limited financial and practical resources present a barrier to the provision of evidence-based care. Clinical practice guidelines (CPGs) are well-positioned to enhance the quality and efficiency of psychosocial oncology care; however, little is known about their use and perceptions in the field. The present study explored the use and perceptions of CPGs among 172 Canadian psychosocial oncology clinicians via a cross-sectional, online survey. Findings revealed substantial variation in awareness, with over 20% of participants reporting no familiarity with CPGs, and low to moderate use of CPGs (M = 2.97, SD = 2.96) among users. Key barriers included a lack of formal training, limited applicability to local contexts, and systemic constraints such as high workloads. Conversely, participants highly endorsed facilitators, including accessible training programs, relevant tools/interventions, and greater institutional and community engagement. Clinician perspectives are paramount to the dissemination and implementation of psychosocial oncology CPGs. Our findings suggest that successful implementation requires broader accessibility, widespread adaptation, and greater community engagement. By addressing these systemic constraints, CPGs may be better positioned to bridge the gap between evidence and real-world service provision.

Current Oncology doi: 10.3390/curroncol33070379

Authors: Mohamed A. Aboelatta Jabra Zarka Nika Tchatchua Noureldin A. Aboelatta Jeffrey E. Johnson James W. Jakub Justin Desroches Justine Wilson-Miller Anthony Tabiim Deepti Behl Heather N. Montane Lisa A. Kottschade Anastasios Dimou Matthew S. Block Elisabeth I. Heath Bently Doonan Mahesh Seetharam Julian R. Molina Jonathan E. Charnin Paula Gill Yi Lin Binav Baral Svetomir N. Markovic Arkadiusz Z. Dudek

Background/Objectives: Tumor-infiltrating lymphocyte (TIL) therapy is an important option for patients with metastatic melanoma progressing after standard systemic therapy, but real-world data on treatment delivery, toxicity monitoring, and immune recovery remain limited. We evaluated clinical outcomes, treatment tolerance, immune reconstitution, and cardiac biomarker dynamics across three Mayo Clinic sites. Methods: We retrospectively analyzed adults with metastatic melanoma who received lymphodepleting chemotherapy followed by TIL infusion and high-dose interleukin-2 (IL-2) between April 2024 and December 2025. Clinical outcomes, treatment delivery, and adverse events were assessed. Longitudinal immune monitoring included CD4 and CD8 T-cell counts, CD4:CD8 ratio, and immunoglobulin G (IgG) at baseline and follow-up. In a prespecified cardiac sub-cohort, high-sensitivity troponin (hs-Tn) was measured during IL-2 administration to evaluate associations with cardiac events and IL-2 interruption. Results: Thirty-six patients underwent TIL infusion. The objective response rate was 50.0%, including complete responses in 13.9%, and the disease control rate was 72.2%. Median progression-free survival was 3.61 months, and median overall survival was 12.94 months. M1d disease was associated with inferior overall survival on univariable analysis (HR 6.55, 95% CI 2.03–21.17; p = 0.002), with attenuation after multivariable adjustment. Receipt of ≥3 IL-2 doses was associated with longer overall survival on univariable analysis (HR 0.20, 95% CI 0.06–0.64; p = 0.007), but this association also attenuated after adjustment. Longitudinal immune monitoring demonstrated persistent CD4 lymphopenia through 6 months, sustained inversion of the CD4:CD8 ratio, and declining IgG at months 3 and 6. In the cardiac sub-cohort (24 patients; 87 IL-2 doses), post-dose hs-Tn ≥15 ng/L was associated with clinically significant cardiac events (OR 9.6, 95% CI 1.5–60.6; p = 0.016) and IL-2 interruption (OR 3.4, 95% CI 1.1–10.7; p = 0.036). For cardiac events, hs-Tn ≥15 ng/L had 100% sensitivity and 100% negative predictive value. Conclusions: In routine practice, TIL therapy was feasible and active in metastatic melanoma. M1d disease identified a subgroup with poor survival, peri-dose hs-Tn showed promise as a tool to support safer IL-2 delivery, and prolonged CD4 suppression with IgG decline suggests that recovery after TIL therapy extends beyond initial hematologic reconstitution. These findings support prospective validation of biomarker-guided IL-2 monitoring and extended post-treatment immune surveillance.

Current Oncology doi: 10.3390/curroncol33070378

Authors: Jason King Talao Rohann Correa Lakshman Gunaratnam Ricardo Fernandes

Renal cell carcinoma (RCC) is a biologically heterogeneous malignancy characterized by variable clinical behavior and diverse molecular phenotypes. Although immune checkpoint inhibitors and targeted therapies have transformed the treatment landscape of advanced RCC, clinically validated biomarkers capable of improving risk stratification, therapeutic-decision making and disease monitoring remain lacking. Kidney injury molecule-1 (KIM-1), also known as hepatitis A virus cellular receptor-1 (HAVCR1) or T-cell immunoglobulin and mucin domain-containing protein-1 (TIM-1), has emerged as a biologically compelling investigational biomarker e because of its close relationship to proximal tubular epithelial injury and renal carcinogenesis. KIM-1 is a transmembrane glycoprotein minimally expressed in normal kidney tissue but markedly upregulated in dedifferentiated proximal tubular epithelial cells following injury, and in clear cell RCC, where its extracellular domain can be shed into plasma and urine. Beyond its role as a marker of tubular injury, KIM-1 participates in immune regulation, phagocytosis, inflammatory signaling and tissue remodeling, supporting its potential relevance to tumor biology. Clinical studies have demonstrated associations between elevated circulating KIM-1 levels and RCC diagnosis, recurrence risk, and survival outcomes, particularly in localized and postoperative disease settings. KIM-1 has additionally been investigated as a therapeutic target through antibody–drug conjugate approaches. Despite promising translational data, important limitations yet remain. Current evidence is predominantly prognostic rather than predictive, and substantial analytical and biological challenges continue to limit implementation. Assay standardization, clinically meaningful cutoffs, specimen selection, timing of sampling, and confounding by chronic kidney disease or nonmalignant renal injury remain incompletely resolved. Furthermore, evidence supporting incremental value beyond established clinicopathologic models remains limited. This review critically evaluates the biological rationale, analytical considerations and clinical evidence supporting KIM-1 in RCC. Particular emphasis is placed on distinguishing prognostic, predictive, pharmacodynamic, and therapeutic applications, as well as defining the evidentiary gaps that must be addressed before clinical implementation. Current evidence is derived predominantly from retrospective and exploratory analyses, and important limitations remain regarding assay standardization, biological specificity, chronic kidney disease-related confounding, and prospective validation. The review concludes with a summary of the evolving landscape of KIM-1-directed biomarker strategies in RCC, which may ultimately contribute to improved biologic risk stratification and biomarker-driven clinical investigation in RCC.

Current Oncology doi: 10.3390/curroncol33070377

Authors: Michael J. Raphael Darren R. Brenner Tanya Chawla Trudy Matwiy Stuart Peacock Robby Spring Perri R. Tutelman Eva Villalba Cassandra Macaulay Filomena Servidio-Italiano

The fifth annual pan-tumour Early Age Onset Cancer (EAOC) Symposium, held in November 2025 and organized by the Colorectal Cancer Resource & Action Network (CCRAN), convened clinicians, researchers, policymakers, patients, and caregivers to address the rising incidence of cancers in individuals under 50 years. In addition to discussions around diagnostic and therapeutic advances for patients with late-stage disease, content centered on addressing critical gaps along the EAOC care continuum, including (i) diagnostic delays related to limited awareness and suboptimal primary care pathways, (ii) screening eligibility criteria for colorectal cancer (CRC) that no longer reflect current disease epidemiology, and (iii) insufficient age-appropriate infrastructure to meet the EAOC population’s unique unmet needs with respect to psychosocial support, fertility counseling, financial navigation, and survivorship planning. The symposium generated consensus recommendations such as the embedding of EAOC education into medical training curricula to increase the index of suspicion of EAOC in primary care, lowering the CRC screening age to 45 years to match this population’s rising disease incidence, and expanding multidisciplinary adolescent and young adult (AYA) and EAOC programs—including through the use of virtual models—to ensure that patients receive coordinated, comprehensive, equitable and age-appropriate care across the country.

Current Oncology doi: 10.3390/curroncol33070376

Authors: Milou J. P. Reuvers Winette T. A. van der Graaf Olga Husson Leyla Azarang

Background: A subgroup of adolescent and young adult patients (AYAs; 18 to 39 years at diagnosis) face an uncertain or poor cancer prognosis (UPCP). Previous qualitative research identified dual coping pathways in this population: engagement in life versus the reality of premature death. This study examines whether similar psychosocial profiles can be identified through quantitative data, aiming to differentiate patient experiences and identify characteristic features of each cluster. Additionally, this study examines the association between cluster membership and social support needs to understand psychosocial disparities. Methods: Eligible participants completed questionnaires assessing physical, psychosocial, and existential outcomes related to their disease and prognosis. An ensemble clustering approach was applied, including evaluation of clustering tendency and multiple algorithms, with stable clusters identified through majority voting. Associations with social support needs were analyzed using Fisher’s exact test. Results: Data from 155 AYAs with a UPCP were included. The mean age at diagnosis was 31.2 years, with glioma (34.8%) and breast cancer (17.4%) as the most common diagnoses. Two distinct clusters were identified: one (22%) characterized by poorer functional outcomes and fewer protective factors (e.g., hope, meaning in life), and another cluster (78%) with better functioning and less frequent needs for social support (p < 0.00043). Conclusions: Findings revealed divergent psychosocial profiles within the AYA-UPCP population, highlighting the importance of early identification of vulnerable subgroups. Strengthening protective factors may enhance resilience and reduce unmet support needs. Validation in larger, external datasets is needed to confirm these pathways and guide tailored supportive care strategies.

Current Oncology doi: 10.3390/curroncol33070375

Authors: Cristina Benites Kirollos Armosh Edgar D. Uribe Sanchez Lauren A. Ruddocks Peter T. Dziegielewski

Aim: Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm with few reported mandibular cases. This review aims to describe the clinical characteristics, surgical management and outcomes of 13 mandibular IMT cases, and to introduce the Jaw in a Day (JIAD) approach as a novel surgical option. Methods: PubMed, Web of Science and Embase were searched systematically. From an initial pool of 261 articles, 13 studies met the inclusion criteria and were reviewed. Results: Thirteen mandibular IMT cases were identified in the literature. A new case is also presented: a 15-year-old female treated with surgical excision using the JIAD approach. At 12-month follow-up, oral function was restored with no disease recurrence. Discussion: Mandibular IMT is exceedingly rare. The JIAD approach offers immediate reconstruction with satisfactory functional outcomes, as supported by both the current case and the reviewed literature. Conclusions: The JIAD surgical approach may represent an effective management strategy for mandibular IMT. Further cases are needed to validate this approach and establish standardized treatment protocols.

Current Oncology doi: 10.3390/curroncol33060374

Authors: Hongshan Ji Yuhao Su Menglu Liu Yajing Wang Qiuying An Yage Jia Zihan Zhang Jin Yan Jingxin Bai Ping Zhang Zhiguo Zhou

The prognostic value of post-radiotherapy (RT) lymphocyte recovery remains unclear in locally advanced esophageal squamous cell carcinoma (ESCC), and tools to predict recovery are lacking. This study evaluated lymphocyte recovery as a survival predictor and developed a prediction model. We analyzed 233 patients (2019–2024; training:validation = 7:3). Lymphocyte recovery was assessed at 1 and 3 months post-RT (ΔALC1 > 0.41 and ΔALC3 > 0.25 × 109/L, calculated as ALC at each time point minus ALC at the end of RT). Patients were stratified into three groups by recovery status: no recovery (Group 0), recovery at both time points (Group 2), or at only one time point (Group 1). Multivariate logistic regression identified predictors of lymphocyte recovery, and a nomogram was developed and internally validated. Median overall survival (OS) was 26.4 months and median progression-free survival (PFS) was 13.9 months. OS differed significantly among groups: 16.0 months (Group 0), 26.0 months (Group 1), and 50.0 months (Group 2) (p < 0.001). Median PFS was 10.2, 12.0, and 36.6 months, respectively (p < 0.001). Independent predictors included ECOG 0 and thoracic spine V5 < 57.3%; planning target volume < 210 cm3 showed a trend toward association (p = 0.051). The nomogram demonstrated AUCs of 0.77 and 0.75 in the training and validation cohorts. Superior lymphocyte recovery appears to be associated with improved survival. The model, if externally validated, may facilitate individualized risk stratification.

Current Oncology doi: 10.3390/curroncol33060373

Authors: Gilla K. Shapiro Fredrick D. Ashbury Jonathan Avery Jacqueline L. Bender Sylvie Lambert Madeline Li

Psychosocial oncology is a discipline concerned with the social, psychological, emotional, spiritual, quality-of-life, and practical aspects of cancer for patients and families, with the aim of supporting whole-person care [...]