Current Oncology

18 pages, 733 KB

Open AccessArticle

Survival Outcomes of Immune Checkpoint Inhibitors in Conjunction with Cranial Radiation for Older Adults with Non-Small Cell Lung Cancer and Synchronous Brain Metastasis

by Ruchira V. Mahashabde, Sajjad A. Bhatti, Bradley C. Martin, Jacob T. Painter, Mausam Patel, Analiz Rodriguez, Jun Ying and Chenghui Li

Curr. Oncol. 2025, 32(9), 499; https://doi.org/10.3390/curroncol32090499 - 5 Sep 2025

Abstract

Immune checkpoint inhibitors (ICIs) display efficacy in non-small cell lung cancers (NSCLCs) with brain metastases (BMs) and studies suggest potential synergy with cranial radiation (CR). However, population-based evaluations of optimal time between ICI-CR combinations are limited in the US. Using SEER-Medicare database (2010–2019), [...] Read more.

Immune checkpoint inhibitors (ICIs) display efficacy in non-small cell lung cancers (NSCLCs) with brain metastases (BMs) and studies suggest potential synergy with cranial radiation (CR). However, population-based evaluations of optimal time between ICI-CR combinations are limited in the US. Using SEER-Medicare database (2010–2019), we analyzed patients aged ≥65 years with NSCLC and BM receiving ICI-CR within 6 months of diagnosis, excluding those receiving targeted therapies. First treatment after diagnosis (ICI or CR) was defined as index treatment; followed by subsequent treatment. Findings were validated using an independent cohort from the TriNetX LIVE™ Platform. Patients were grouped by interval between the end of the index treatment and the start of the subsequent treatment: ≤15 days (n = 117), 16–30 days (n = 42), and >30 days (n = 77). Overall survival (OS) was measured from the start of the subsequent treatment until death, end of insurance coverage, or study end. Kaplan–Meier survival curves and multivariable Cox proportional hazards models estimated differences between groups. Among 236 patients, median OS was 134 days, 92 days, and 209 days, respectively. No significant OS differences were found across intervals. However, a survival benefit emerged approximately 300 days after follow-up when ICI was administered within 15 days of CR. These findings offer insight into treatment sequencing in NSCLC with BM and support further investigation in larger cohorts. Full article

(This article belongs to the Section Thoracic Oncology)

► Show Figures

Figure 1

16 pages, 608 KB

Open AccessArticle

Trend and Cancer-Specific Prevalence of Kidney Stones Among US Cancer Survivors, 2007–2020

by Chao Cao, Ruixuan Wang, Xiangren Wang, Mohammad Abufaraj, Thomas Waldhoer, Geoffrey T. Gotto, Shahrokh F. Shariat and Lin Yang

Curr. Oncol. 2025, 32(9), 498; https://doi.org/10.3390/curroncol32090498 - 5 Sep 2025

Abstract

Purpose: To evaluate the prevalence and cancer-specific patterns of kidney stones among U.S. cancer survivors compared to non-cancer adults. Methods: This was a serial cross-sectional, descriptive epidemiologic analysis of a US nationally representative sample from the National Health and Nutrition Examination Survey from [...] Read more.

Purpose: To evaluate the prevalence and cancer-specific patterns of kidney stones among U.S. cancer survivors compared to non-cancer adults. Methods: This was a serial cross-sectional, descriptive epidemiologic analysis of a US nationally representative sample from the National Health and Nutrition Examination Survey from 2007 to 2020. Weighted prevalence of kidney stones was estimated for both non-cancer adults and cancer survivors by study cycle. Multivariable logistic regression was conducted to examine factors associated with higher probability of kidney stones in both non-cancer adults and cancer survivors. Results: From 2007–2008 to 2017–2020, kidney stone prevalence rose in both non-cancer adults (8.5% to 9.2%, p for trend = 0.013) and cancer survivors (13.1% to 17.3%, p for trend = 0.033). Throughout the study period, prevalence was consistently higher in cancer survivors. The overall prevalence from 2007 to 2020 was 15.8% (95% CI: 14.0–17.5%) in cancer survivors and 9.2% (95% CI: 8.8–9.6%) in non-cancer adults. After adjusting for sociodemographic, lifestyle, and health factors, cancer survivors had higher odds of kidney stones (OR = 1.28, 95% CI: 1.10–1.49). Compared with non-cancer adults, survivors of ovarian (OR = 3.71, 95% CI: 1.77–7.78), kidney (OR = 2.88, 95% CI: 1.46–5.68), bone and soft tissue (OR = 2.86, 95% CI: 1.12–7.30), uterine (OR = 1.94, 95% CI: 1.17–3.22), cervix (OR = 1.68, 95% CI: 1.08–2.61) and prostate (OR = 1.41, 95% CI: 1.06–1.87) cancers were statistically more likely to report kidney stones. The prevalence was numerically highest among survivors of kidney cancer (34.7%), followed by bone and soft tissue (29.9%), ovarian (29.8%), and testicular (26.3%) cancers. Conclusions: The higher prevalence of kidney stones in cancer survivors, with substantial variation by cancer type, highlights the urgent need for effective clinical management of kidney stones in oncology settings and mechanistic research. Full article

(This article belongs to the Section Genitourinary Oncology)

► Show Figures

Figure 1

12 pages, 518 KB

Open AccessArticle

Dual PET Imaging with [⁶⁸Ga]Ga-DOTA-TOC and [¹⁸F]FDG to Localize Neuroendocrine Tumors of Unknown Origin

by Ali Zaidi, Pavithraa Ravi, Ingrid Bloise, Sara Harsini, Heather C. Stuart, Hagen F. Kennecke, Ian Alberts, François Bénard, Don Wilson, Patrick Martineau and Jonathan M. Loree

Curr. Oncol. 2025, 32(9), 497; https://doi.org/10.3390/curroncol32090497 - 5 Sep 2025

Abstract

Neuroendocrine tumors of unknown primary (CUP-NET) present a diagnostic challenge when conventional imaging fails to localize the primary tumor. This study aimed to evaluate the diagnostic value of concurrent [⁶⁸Ga]Ga-DOTA-TOC and [¹⁸F]FDG PET/CT imaging in localizing primary tumors in [...] Read more.

Neuroendocrine tumors of unknown primary (CUP-NET) present a diagnostic challenge when conventional imaging fails to localize the primary tumor. This study aimed to evaluate the diagnostic value of concurrent [⁶⁸Ga]Ga-DOTA-TOC and [¹⁸F]FDG PET/CT imaging in localizing primary tumors in patients with histologically confirmed CUP-NET. Thirty-four patients underwent both imaging modalities as part of a prospective imaging protocol after negative conventional imaging or [¹¹¹In]In-octreotide scintigraphy. Primary tumor detection rates were assessed, and imaging characteristics compared between the two modalities. The overall localization rate was 58.9% (20/34). Of these, 90% (18/20) of primary tumors were identified solely by [⁶⁸Ga]Ga-DOTA-TOC PET/CT, with the remaining two visualized by both modalities. [¹⁸F]FDG PET/CT did not independently localize any primary tumors. Identified primaries were limited to grade 1 (60%) or grade 2 (40%) tumors, predominantly in the small intestine (95%). Among localized cases, 45% (9/20) underwent surgical resection and 15% (3/20) became eligible for peptide receptor radionuclide therapy. [⁶⁸Ga]Ga-DOTA-TOC PET/CT demonstrated superior detection of metastatic lesions compared to [¹⁸F]FDG PET/CT (97.1% vs. 70.6%, p = 0.006). No significant survival differences were observed between patients with localized versus non-localized primaries. These findings support the value of [⁶⁸Ga]Ga-DOTA-TOC PET/CT for identifying primary tumors in CUP-NET. Further research is warranted to explore the role of [¹⁸F]FDG PET/CT in high-grade NETs. Full article

► Show Figures

Graphical abstract

21 pages, 2159 KB

Open AccessReview

The Interleukin-8-CXCR1/2 Axis as a Therapeutic Target in Peritoneal Carcinomatosis

by Christopher Sherry, Neda Dadgar, Zuqiang Liu, Yong Fan, Kunhong Xiao, Ali H. Zaidi, Vera S. Donnenberg, Albert D. Donnenberg, David L. Bartlett and Patrick L. Wagner

Curr. Oncol. 2025, 32(9), 496; https://doi.org/10.3390/curroncol32090496 - 5 Sep 2025

Abstract

Peritoneal carcinomatosis (PC) is a late-stage manifestation of abdominopelvic malignancies with poor prognosis and limited treatment options. Unique biochemical mechanisms within the peritoneal cavity play a key role in disease progression and resistance to therapy. Despite current therapies like systemic chemotherapy and cytoreductive [...] Read more.

Peritoneal carcinomatosis (PC) is a late-stage manifestation of abdominopelvic malignancies with poor prognosis and limited treatment options. Unique biochemical mechanisms within the peritoneal cavity play a key role in disease progression and resistance to therapy. Despite current therapies like systemic chemotherapy and cytoreductive surgery, patients frequently develop severe complications, including bowel obstruction, nutritional decline, and ascites, driving the need to address the pro-tumorigenic niche in the peritoneal cavity. The immune microenvironment in PC is marked by elevated proinflammatory mediators, such as IL-6 and IL-8, which skew the response toward innate rather than adaptive immune responses. IL-8 signaling, through its receptors CXCR1 and CXCR2, promotes neutrophil recruitment, chronic inflammation, angiogenesis, epithelial–mesenchymal transition, and immune evasion, making the IL-8/CXCR1/CXCR2 axis a potential therapeutic target in PC. Pre-clinical models provide evidence that IL-8 or CXCR1/CXCR2 blockade may be a valuable therapeutic strategy. IL-8 targeting agents such as monoclonal antibodies (BMS-986253) and small-molecule inhibitors (SX-682, AZD5069, navarixin) have shown efficacy in mitigating tumor growth and improving the efficacy of immune checkpoint inhibitors. Phase I and II trials have demonstrated encouraging safety profiles and preliminary efficacy when treating multiple abdominopelvic malignancies. In this review, we discuss the influence of the IL-8/CXCR1/CXCR2 axis within the peritoneal immune environment in PC and highlight recent work using IL-8 or CXCR1/CXCR2 blockade as a therapeutic strategy for PC. Continued research into the peritoneal immune microenvironment and the development of targeted therapies are essential for improving the management and prognosis of PC, potentially enhancing antitumor immunity and patient outcomes. Full article

(This article belongs to the Section Gastrointestinal Oncology)

► Show Figures

Graphical abstract

9 pages, 674 KB

Open AccessCommunication

CAR-T Access Disparities for Multiple Myeloma in the Midwest: A Social Determinants of Health Perspective

by Michael Weise, Shebli Atrash, Briha Ansari, Muhammad Umair Mushtaq, Joseph McGuirk, Al-Ola Abdallah, Zahra Mahmoudjafari and Nausheen Ahmed

Curr. Oncol. 2025, 32(9), 495; https://doi.org/10.3390/curroncol32090495 - 3 Sep 2025

Abstract

Background: Multiple Myeloma (MM) is the most common type of blood cancer among black individuals. CAR-T therapy is crucial, but often inaccessible to many black patients and those from underserved communities. The University of Kansas Health System administers over 100 CAR-T treatments annually [...] Read more.

Background: Multiple Myeloma (MM) is the most common type of blood cancer among black individuals. CAR-T therapy is crucial, but often inaccessible to many black patients and those from underserved communities. The University of Kansas Health System administers over 100 CAR-T treatments annually and aims to evaluate barriers to CAR-T therapy access related to the social determinants of health in the Midwest area. Methods: This study examined patients with MM referred for CAR-T therapy from January 2021 to December 2023, assessing how race, socioeconomic status, and insurance influenced eligibility for leukapheresis. Data on income and travel were gathered from the 2022 US Census and analyzed using R software. Results: The study included 271 referrals for MM CAR-T therapy involving 179 patients, with a median age of 66 years (51% male). Demographics: 80% white, 16% black, 2.2% other races, 1.8% Asian, with a median income of $70,644. Nearly half lived more than 30 min from the center (Mainly from Kansas, Missouri and Nebraska). Apheresis rates were similar across racial groups: 54% for whites, 54% for blacks, and 50% for others, while none of the three Asian patients proceeded. Nine patients (5%) could not proceed because of caregiver or insurance barriers, and cell collection rates were comparable regardless of distance (34% vs. 35%). Conclusion: This study showed that black representation in CAR-T access matches local demographics, indicating less disparity among minorities. Unlike national reports, distance, income, and insurance do not significantly affect access, suggesting the need for a national study on the social determinants impacting CAR-T access for multiple myeloma. Full article

(This article belongs to the Section Cell Therapy)

► Show Figures

Graphical abstract

13 pages, 421 KB

Open AccessArticle

Implementation and Outcomes of a Perioperative Geriatrics Strategy, PRIME, for Older Adults Undergoing Gastrointestinal Cancer Surgery

by Gabriella Jacob, Eric K. C. Wong, Rachel Fuh, Tyler R. Chesney and Camilla L. Wong

Curr. Oncol. 2025, 32(9), 494; https://doi.org/10.3390/curroncol32090494 - 3 Sep 2025

Abstract

Introduction: The number of older adults living with frailty undergoing gastrointestinal cancer surgery is increasing. To address the unique needs of the population, a whole pathway perioperative geriatrics strategy—PRIME—was developed to integrate geriatric principles into surgical care. The objective of this study was [...] Read more.

Introduction: The number of older adults living with frailty undergoing gastrointestinal cancer surgery is increasing. To address the unique needs of the population, a whole pathway perioperative geriatrics strategy—PRIME—was developed to integrate geriatric principles into surgical care. The objective of this study was to evaluate the implementation of PRIME using validated structural, process, and outcome quality indicators. Materials and Methods: This retrospective cohort study included 106 consecutive patients aged 70 years and older who underwent gastrointestinal surgery for cancer or pre-cancerous lesions at a single institution between 1 July 2020 and 5 October 2023. The whole pathway perioperative geriatrics strategy, PRIME, includes preoperative comprehensive geriatric assessment (CGA), collaborative care between surgery, geriatrics, and anesthesia, and post-operative co-management. Implementation was evaluated using validated structural, process, and outcome quality indicators. Results: Most structural indicators (five of eight) were implemented. In terms of process indicators, 96.2% (n = 102) received CGA prior to or within 24 h of admission. Adherence to screening was high: 97.2% for dementia, 96.2% for functional status, and 95.3% for frailty. The median number interventions resulting from CGA was 17 (IQR 14–20). Serious complication, delirium, and functional decline occurred in 19.8%, 27.1%, and 19.8%, respectively. Conclusions: Implementation of a perioperative geriatrics strategy for older adults undergoing gastrointestinal cancer/pre-cancer lesion surgery is feasible, with high adherence to structural and process quality indicators. Full article

(This article belongs to the Special Issue Advances in Geriatric Oncology: Toward Optimized Cancer Care)

► Show Figures

Graphical abstract

17 pages, 737 KB

Open AccessReview

Tumor Immune Microenvironment and Current Status of Immune Checkpoint Inhibitor Therapy in Colorectal Cancer Liver Metastasis

by Dandan Cao and Aiping Zhou

Curr. Oncol. 2025, 32(9), 493; https://doi.org/10.3390/curroncol32090493 - 2 Sep 2025

Abstract

Colorectal cancer is one of the most common malignancies worldwide, with liver metastasis being one of its primary metastatic patterns and a significant cause of death. For most patients with unresectable colorectal cancer liver metastasis, a comprehensive treatment strategy that includes chemotherapy and [...] Read more.

Colorectal cancer is one of the most common malignancies worldwide, with liver metastasis being one of its primary metastatic patterns and a significant cause of death. For most patients with unresectable colorectal cancer liver metastasis, a comprehensive treatment strategy that includes chemotherapy and targeted therapy is the primary therapeutic strategy. However, significant breakthroughs in immune therapy for liver metastasis have yet to be achieved. In this article, we summarize the characteristics of the immune microenvironment in colorectal cancer liver metastases and the mechanisms of immune resistance. Additionally, we compile recent clinical trial results on immune combination strategies and biomarker studies and discuss the prospects for applying immune checkpoint inhibitors in the treatment of colorectal cancer liver metastasis. Full article

(This article belongs to the Section Gastrointestinal Oncology)

► Show Figures

Figure 1

9 pages, 204 KB

Open AccessReview

Nurse Practitioner Care Delivery Models: Meeting the Rapidly Expanding Needs of Cancer Patients

by Tammy O’Rourke, Marcie Smigorowsky, Danielle Moch, Tara Hoffman, Krista Rawson, Teresa Ruston, Julia Beranek, Cindy Railton, Cecilia Joy Kennett, Calvin P. Kruger, Shuang Lu, Nanette Cox-Kennett and Edith Pituskin

Curr. Oncol. 2025, 32(9), 492; https://doi.org/10.3390/curroncol32090492 - 2 Sep 2025

Abstract

Half of all Canadians will develop cancer at some point in their lifetimes. These rates have increased substantially over the last decade alongside increasing effectiveness and complexity of treatment options. Therefore, the need for patients to receive both an early diagnosis and ongoing [...] Read more.

Half of all Canadians will develop cancer at some point in their lifetimes. These rates have increased substantially over the last decade alongside increasing effectiveness and complexity of treatment options. Therefore, the need for patients to receive both an early diagnosis and ongoing care has never been so important. In Alberta, referrals to oncology specialty care have increased 18% in the last 7 years with no commensurate increase in the number of oncology health care professionals. Challenges with oncologic care access and provider recruitment are not unique to Alberta. In 2004, Cancer Care Alberta, specifically the Cross Cancer Institute (CCI), embarked on an initiative focusing on nurse practitioner (NP) care provision, aiming to address these gaps. The purpose of this article is a description of four distinct NP care models: the Assigned model, Consultative model, Partner model, and Most Responsible Provider (MRP model) significantly contributing to enhanced and expanded cancer care delivery at CCI. To the best of our knowledge, we are the first to demonstrate how NPs can significantly address the rapidly expanding demands for specialist oncology care. This work highlights roles and exemplars of NP care to meet the evolving needs of cancer patients, the multidisciplinary care team and the health system. Full article

(This article belongs to the Special Issue Feature Reviews in Section "Oncology Nursing")

20 pages, 1290 KB

Open AccessArticle

Insights from a Patient-Centered Lung Cancer Navigation Program in a Low-Resource Community

by Tanyanika Phillips, Anjaney Kothari, Africa Robison, Jeffrey Mark Erfe and Dan J. Raz

Curr. Oncol. 2025, 32(9), 491; https://doi.org/10.3390/curroncol32090491 - 1 Sep 2025

Abstract

Barriers to cancer care, including transportation and Internet insecurity, are of special concern in low-resource communities. A patient-centered, telehealth-based, barrier-focused lay navigator program may mitigate such barriers. We share insights from a quality improvement project wherein we developed and delivered a lay navigator [...] Read more.

Barriers to cancer care, including transportation and Internet insecurity, are of special concern in low-resource communities. A patient-centered, telehealth-based, barrier-focused lay navigator program may mitigate such barriers. We share insights from a quality improvement project wherein we developed and delivered a lay navigator program in a low-resource community in the Mojave Desert. We identified 68 patients scheduled for lung cancer detection/management at our institution, 55 of whom completed a barrier assessment, enrolled in the program, and could be evaluated. Participants were predominantly older (76%), White (84%), had a cancer diagnosis at enrollment (69%), and lived in socioeconomically disadvantaged neighborhoods. Thirty-three (60%) patients had ≥1 barrier, the most common being transportation (31%), Internet (24%), and financial (24%) concerns. These barriers were more frequent among patients with a lung cancer diagnosis at enrollment. Crisis-focused and after-hours encounters were more frequently initiated by older and advanced cancer patients. Transportation and Internet concerns were significantly associated with missed appointment rates. While the scope of our findings is limited, the delivery of a telehealth-based, barrier-focused lay lung navigator program in this low-resource setting was feasible. Neighborhood context and barrier resource planning are important for the implementation of similar programs within our institution’s clinical practice network. Full article

(This article belongs to the Section Thoracic Oncology)

► Show Figures

Figure 1

19 pages, 324 KB

Open AccessReview

Advances in Systemic Therapy for Hepatocellular Carcinoma and Future Prospects

by Rie Sugimoto, Miho Kurokawa, Yuki Tanaka, Takeshi Senju, Motoyuki Kohjima and Masatake Tanaka

Curr. Oncol. 2025, 32(9), 490; https://doi.org/10.3390/curroncol32090490 - 31 Aug 2025

Abstract

The focus of treatment of hepatocellular carcinoma (HCC) has shifted significantly from local therapy to systemic drug therapy. Recently, the efficacy of drug therapy for HCC has made rapid progress. We have transitioned from eras of sorafenib monotherapy and sequential therapy with multiple [...] Read more.

The focus of treatment of hepatocellular carcinoma (HCC) has shifted significantly from local therapy to systemic drug therapy. Recently, the efficacy of drug therapy for HCC has made rapid progress. We have transitioned from eras of sorafenib monotherapy and sequential therapy with multiple tyrosine kinase inhibitors that slightly improved patient prognoses, to an era where the introduction of immunotherapy combining atezolizumab and bevacizumab has achieved further improvements in patient prognosis. The availability of highly effective drugs has expanded the range of diseases treatable by drug therapy. Additionally, instead of initiating drug therapy at advanced stages, combining it with local therapies such as transarterial chemoembolization at an earlier stage with the aim of achieving a cure has become possible, improving treatment outcomes further. Currently, the number of regimens available for HCC, including combinations of multiple drugs and local therapies, has increased, leading to numerous clinical trials. Additionally, HCC cases that were previously unresectable are now resectable after drug therapy, necessitating the establishment of a resectability classification system. This review summarizes the current evidence for drug therapy for HCC and discusses future treatment strategies, treatment combinations, and prospects. Full article

(This article belongs to the Special Issue Combined Therapies for Hepatocellular Carcinoma)

14 pages, 1154 KB

Open AccessArticle

The Clinical Characteristics, Treatment, and Prognosis of Lung Cancer in Young Patients in the New Era of Cancer Treatment: A Retrospective and Comprehensive Analysis

by Xiaoyi Feng, Shengjie Li, Siyuan Yu, Yunxin Liu, Zhanxian Peng, Haoran Zhang, Xiaoxing Gao, Xiaoyan Liu, Minjiang Chen, Jing Zhao, Wei Zhong, Yan Xu and Mengzhao Wang

Curr. Oncol. 2025, 32(9), 489; https://doi.org/10.3390/curroncol32090489 - 31 Aug 2025

Abstract

Background: This study was aimed to comprehensively investigate the clinical and molecular characteristics, treatments, and outcomes of young patients with lung cancer in the new era of cancer treatment. Methods: Clinical data from patients aged 18 to 45 with lung cancer, treated at [...] Read more.

Background: This study was aimed to comprehensively investigate the clinical and molecular characteristics, treatments, and outcomes of young patients with lung cancer in the new era of cancer treatment. Methods: Clinical data from patients aged 18 to 45 with lung cancer, treated at our hospital from January 2014 through January 2024, were systematically collected and analyzed. Results: This study enrolled a total of 343 patients, with a predominance of females, never-smokers, and those diagnosed at an advanced stage. Adenocarcinoma was the most common histology (72.0%), and rare tumors could also be seen in young patients, such as pulmonary sarcomatoid carcinoma and pulmonary mucoepidermoid carcinoma. The mutation rate of the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) in NSCLC patients were 35.9% (111/309) and 14.2% (44/309), respectively. PD-L1 expression was assessed in 55 patients, with 14 showing high expression (≥50%) and 24 showing negative expression (<1%). The median overall survival (mOS) for the entire cohort was 80.2 months, with a 5-year survival rate of 55.7%. For patients with stage I, II, and III disease, the mOS had not yet been reached, whereas the mOS for stage IV patients was 39.7 months. Targeted therapy, particularly second-generation ALK tyrosine kinase inhibitors (TKIs), significantly improved the prognosis of patients with driver gene mutations. Chemotherapy combined with immunotherapy was beneficial for patients with progressive disease or driver gene negativity in NSCLC and was associated with improved OS in small cell lung cancer (SCLC). Female, family history of lung cancer, positive driver genes, and first-line use of second-generation ALK-TKIs are independent prognostic factors in young patients with advanced NSCLC. Conclusions: Our findings highlight the importance of early diagnosis, targeted therapy, and immunotherapy in improving outcomes for young patients with lung cancer. Full article

(This article belongs to the Section Thoracic Oncology)

► Show Figures

Figure 1

17 pages, 4401 KB

Open AccessArticle

Correlation of TP53 Genetic Alterations with p53 Immunohistochemical Expression and Their Prognostic Significance in DLBCL

by Chen Chen, Zijuan Hu, Min Ren, Longlong Bao, Ran Wei, Tian Tian, Xiaoli Zhu, Qianming Bai, Baohua Yu, Xiaoqiu Li and Xiaoyan Zhou

Curr. Oncol. 2025, 32(9), 488; https://doi.org/10.3390/curroncol32090488 - 31 Aug 2025

Abstract

TP53 genetic alterations represent a critical molecular feature in diffuse large B-cell lymphoma (DLBCL), with well-established associations with aggressive disease behavior and therapeutic resistance. However, significant controversy persists regarding the clinical utility of p53 immunohistochemical (IHC) expression as a surrogate marker. This study [...] Read more.

TP53 genetic alterations represent a critical molecular feature in diffuse large B-cell lymphoma (DLBCL), with well-established associations with aggressive disease behavior and therapeutic resistance. However, significant controversy persists regarding the clinical utility of p53 immunohistochemical (IHC) expression as a surrogate marker. This study presents a thorough investigation of TP53 genetic alterations and their correlation with p53 protein expression in 664 cases of DLBCL. Using targeted next-generation sequencing (tNGS), we identified TP53 alterations (mutations and/or copy number losses (CNLs)) in 170 cases (25.6%). Among them, 161 cases had mutations. Concurrent analysis of copy number variations (CNVs) in 109 cases revealed TP53 CNLs in 17.4% (19/109), with 68.4% (13/19) of these showing coexisting mutations. Immunohistochemical evaluation of p53 expression in 371 cases demonstrated strong positivity (≥65% cells) in 21% (78/371), complete negativity (<1%) in 5.7% (21/371), and wild-type pattern (1–65%) in 73.3% (272/371) of cases. The p53 IHC laboratory-developed test (LDT) showed 79.2% sensitivity and 91.6% specificity for detecting TP53 alterations overall, though sensitivity varied significantly by mutation type: 86.2% for missense mutations but only 14.3% for nonsense mutations. Clinically, cases with TP53 alterations exhibited more aggressive disease characteristics, including higher ECOG performance scores, increased frequency of B symptoms, and poorer initial treatment responses (complete response rate 68.3% vs. 82.5% in wild-type cases). Most importantly, TP53 genetic alterations, but not p53 protein expression patterns, emerged as an independent prognostic factor for progression-free survival. Our findings demonstrate that tNGS effectively identifies most TP53 alterations and complementary CNV analysis enhances detection of copy number losses. The p53 IHC LDT serves as a useful but imperfect screening tool, with high specificity but variable sensitivity depending on mutation types. These results have important implications for molecular diagnostics in DLBCL, supporting the necessity for comprehensive genetic testing rather than reliance on protein expression analysis alone for accurate risk stratification and treatment planning. Full article

(This article belongs to the Section Oncology Biomarkers)

► Show Figures

Figure 1

10 pages, 363 KB

Open AccessArticle

Safety of Combination TARE and SBRT in Hepatocellular Carcinoma: A Review of Literature & Single-Center Case Series

by Bahareh Gholami, Ali Afrasiabi, Andrew M. Moon, Ted K. Yanagihara, Hui Wang, Sandra Gad, Alex Villalobos, David M. Mauro, Hyeon Yu, Johannes L. du Pisanie and Nima Kokabi

Curr. Oncol. 2025, 32(9), 487; https://doi.org/10.3390/curroncol32090487 - 31 Aug 2025

Abstract

Hepatocellular carcinoma (HCC) is the most common primary liver cancer. At the time of diagnosis, many HCC patients are not candidates for surgical resection and are considered for other locoregional therapies, including transarterial radioembolization (TARE) and stereotactic body radiation therapy (SBRT). To date [...] Read more.

Hepatocellular carcinoma (HCC) is the most common primary liver cancer. At the time of diagnosis, many HCC patients are not candidates for surgical resection and are considered for other locoregional therapies, including transarterial radioembolization (TARE) and stereotactic body radiation therapy (SBRT). To date only a few studies have explored the safety and efficacy of combining TARE and SBRT. Therefore, we aimed to evaluate it. Patients who received both SBRT and TARE from 2016 to 2024 were retrospectively evaluated for treatment-related toxicity based on criteria for adverse events (CTCAE v4.0). Treatment response was evaluated by modified response evaluation criteria for solid tumors (m-RECIST). We identified 12 patients with median age of 66.5 (range: 40, 87) and median follow up of 12 months. The median time between TARE and SBRT was 6.5 months (range: 1.5 to 24). Following the second treatment, ALBI grade remined the same among all patients at 3-month post treatment compared to baseline. Baseline CP was A among all patients and remained unchanged during follow-up and no higher than grade 3 clinical or biochemical toxicity was seen. The objective response rate (ORR) among patients receiving treatment to the same lesion was 100%. The combination treatment was consistent with prior studies in which the combination of TARE and SBRT has been shown to have good local control with few cases of grade 3 toxicity. Our study demonstrates that treatment with TARE and SBRT was safe and effective among our small sample of patients. Full article

(This article belongs to the Special Issue Combined Therapies for Hepatocellular Carcinoma)

► Show Figures

Figure 1

26 pages, 2031 KB

Open AccessArticle

Trajectories of Posttraumatic Growth Among Latvian Parents of Children with Cancer: A Mixed Methods Approach

by Inese Lietaviete, Reinis Alksnis and Baiba Martinsone

Curr. Oncol. 2025, 32(9), 486; https://doi.org/10.3390/curroncol32090486 - 30 Aug 2025

Abstract

Background: This study explores post-traumatic growth (PTG) among parents of childhood cancer survivors (CCSs), a group often underrepresented in research. Method: A convergent parallel mixed-methods design integrating Bayesian Multilevel Latent Class Analysis and Thematic Analysis was utilized in a longitudinal study involving 58 [...] Read more.

Background: This study explores post-traumatic growth (PTG) among parents of childhood cancer survivors (CCSs), a group often underrepresented in research. Method: A convergent parallel mixed-methods design integrating Bayesian Multilevel Latent Class Analysis and Thematic Analysis was utilized in a longitudinal study involving 58 caregivers (50 mothers, 8 fathers) from the Children’s Clinical University Hospital in Riga. Quantitative data were collected at diagnosis using the Psychosocial Assessment Tool (PAT) and Big Five Inventory-10 (BFI-10). Follow-up assessments post-treatment included the Responses to Stress Questionnaire (RSQ), Impact of Event Scale-Revised (IES-R), and the Post-traumatic Growth Inventory (PTGI). Qualitative data were collected through structured interviews. Results: A 2-class model distinguished parents with low PTG from those with moderate to high PTG. Change in values, detachment from trivial stressors, and acceptance of life emerged as key indicators of growth. PTG was not significantly correlated with overall post-traumatic stress symptoms, but engagement coping strategies showed a positive association with PTG and personality traits like extraversion and openness. Conclusions: The mixed methods approach revealed sample-specific PTG elements not reflected in standardized tools. Initial perceptions of the cancer diagnosis shaped psychological outcomes, with PTG facilitated by adaptive coping, self-reflection, support, emotional disclosure, and psychological struggle. This study offers the first insights into PTG among Latvian parents of CCSs, a previously unexplored area. Full article

(This article belongs to the Special Issue Quality of Life and Management of Pediatric Cancer)

► Show Figures

Figure 1

10 pages, 1354 KB

Open AccessBrief Report

Assessing Disparities in Who Accepts an Early Palliative Care Consultation

by Heather Halperin, Philip Akude, Seema King, Patricia Biondo, Aynharan Sinnarajah, Desiree Hao and Jessica Simon

Curr. Oncol. 2025, 32(9), 485; https://doi.org/10.3390/curroncol32090485 - 30 Aug 2025

Abstract

Early palliative care improves quality of life for patients with life-limiting illnesses, but access is often inequitable. The goal of this study was to assess disparities in early specialist palliative care (SPC) consultation among newly diagnosed stage IV lung cancer patients. All newly [...] Read more.

Early palliative care improves quality of life for patients with life-limiting illnesses, but access is often inequitable. The goal of this study was to assess disparities in early specialist palliative care (SPC) consultation among newly diagnosed stage IV lung cancer patients. All newly diagnosed stage IV lung cancer patients in southern Alberta, Canada (June 2021–March 2022) were offered SPC consultations from a multidisciplinary team, post-oncology visit. A retrospective chart review analyzed demographic factors and consultation outcomes (accepted, ineligible, declined/unreachable), using the Pampalon Deprivation Index and NamSor surname analysis as proxies for equity-related variables. Of 113 patients, 76.2% were eligible for consultation, and 67.4% of those accepted consultation. Older age (>65 years), male sex, and high deprivation were linked to declining SPC (p < 0.05–0.01). Conversely, living alone or with a non-partner increased acceptance (p < 0.05). Age, sex, deprivation, and living situation influenced SPC acceptance. Identifying disparities can guide interventions to improve equitable access. Full article

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

► Show Figures

Figure 1

16 pages, 1230 KB

Open AccessReview

The Rethinking Clinical Trials (REaCT) Program: A Pragmatic Research Strategy to Improve Cancer Care for Patients, Caregivers, and Healthcare Systems

by Marie-France Savard, Mark Clemons and Sharon F. McGee

Curr. Oncol. 2025, 32(9), 484; https://doi.org/10.3390/curroncol32090484 - 29 Aug 2025

Abstract

Cancer care has become increasingly complex, expensive, and inaccessible, with patients often exposed to increased treatment-related harms for marginal benefits. Pragmatic clinical trials offer a solution by conducting real-world studies that evaluate dose optimization, toxicity, quality of life, and resource utilization. Pragmatic trials [...] Read more.

Cancer care has become increasingly complex, expensive, and inaccessible, with patients often exposed to increased treatment-related harms for marginal benefits. Pragmatic clinical trials offer a solution by conducting real-world studies that evaluate dose optimization, toxicity, quality of life, and resource utilization. Pragmatic trials can also address the efficacy–effectiveness gap: the poorer outcomes and greater toxicity observed in everyday practice compared to those reported in many clinical trials. The Rethinking Clinical Trials (REaCT) program was designed to conduct patient-centered practice-changing research by involving patients, their families, and healthcare providers in the design of inclusive, real-world clinical trials. The REaCT process starts with surveys and systematic reviews to identify knowledge gaps and uses this information to design pragmatic clinical trials that address these deficits. Since 2014, the program has conducted 17 patient and 17 healthcare provider surveys with 2298 and 1033 responses, respectively. With these results, the program has performed 22 systematic reviews. These surveys and systematic reviews have resulted in 19 completed and 8 ongoing REaCT clinical trials that have recruited over 5000 patients from across Canada. Here, we present some of the practice-changing research conducted by the REaCT program and address challenges facing the growth of pragmatic research. Full article

► Show Figures

Figure 1

9 pages, 205 KB

Open AccessArticle

Real-World Selection of Patients for Allogeneic HCT at a Single Centre: Lack of a Suitable Donor and Other Reasons for Not Proceeding

by Madeline Monaghan, An Duong, Kalina Abrol, Trang Doan, Carolina Cieniak, Harold Atkins, Natasha Kekre, Ashish Masurekar, Ram Vasudevan Nampoothiri, Santhosh Thyagu, Christopher N. Bredeson, Michael Kennah and David S. Allan

Curr. Oncol. 2025, 32(9), 483; https://doi.org/10.3390/curroncol32090483 - 29 Aug 2025

Abstract

The reasons why patients cannot proceed with HCT, including cases where no suitable donor is identified, remain poorly described. We reviewed all referrals for allogeneic HCT to our programme between 1 January 2019 and 31 December 2023. Of 880 patients referred for allogeneic [...] Read more.

The reasons why patients cannot proceed with HCT, including cases where no suitable donor is identified, remain poorly described. We reviewed all referrals for allogeneic HCT to our programme between 1 January 2019 and 31 December 2023. Of 880 patients referred for allogeneic HCT, 494 (61.8%) proceeded to transplant (mean 52 ± 14.8 years, 61.5% male) using HLA-matched unrelated (64.2%) or related (19.4%) donors and HLA-mismatched (13%) or haploidentical (3%) donors. Of patients that did not proceed with HCT (386, 38.2%), disease-related causes (54.2%), patient preference (15.8%), and significant patient comorbidity (11.4%) were the most common reasons. Eleven patients (2.9% of transplants that did not proceed; 1.3% of all referrals) lacked a suitable donor and had HLA phenotypes most associated with Caucasian (six patients, 55%), First Nations, Inuit or Metis (two patients, 18%), Black African, Caribbean or African American (one patient, 9%), Asian or Pacific Islander (9%), or unknown ethnicity (one patient, 9%). Very few patients were unable to proceed with transplant due to lack of a suitable donor; however, those cases are overrepresented by non-Caucasian ethnicity relative to the population. Full article

(This article belongs to the Section Cell Therapy)

13 pages, 554 KB

Open AccessArticle

De-Escalation of Treatment in Women Aged ≥80 Years with Breast Cancer: A Retrospective Analysis from Two Breast Centers

by Gianmarco Piccolino, Giulia Cardelli, Francesca Arienzo, Emanuele Zarba Meli, Elena Del Giudice, Leopoldo Costarelli, Rosalinda Rossi, Claudia Scaringi, Tiziana Mastropietro, Laura Broglia, Valeria Vitale, Federica Bergamo, Elena Manna, Massimo La Pinta, Lorenzo Palleschi, Andrea Loreti, Augusto Lombardi and Lucio Fortunato

Curr. Oncol. 2025, 32(9), 482; https://doi.org/10.3390/curroncol32090482 - 28 Aug 2025

Abstract

Background: Breast cancer is frequently diagnosed in older women. However, the impact of surgery on survival is not well studied and prognosis for women ≥ 80 years of age is progressively depending on comorbidities. Methods: Medical records of consecutive women aged ≥ 80 [...] Read more.

Background: Breast cancer is frequently diagnosed in older women. However, the impact of surgery on survival is not well studied and prognosis for women ≥ 80 years of age is progressively depending on comorbidities. Methods: Medical records of consecutive women aged ≥ 80 years diagnosed with primary breast cancer treated with upfront surgery at two Breast Centers from 2011 to 2021 were retrospectively analyzed. Results: A total of 553 consecutive women with a median age of 83 years and a median tumor diameter of 21 mm were analyzed (574 lesions). Clinical Stages II or III were found in 263/574 (46%) and 101/574 cases (18%), respectively. Axillary staging was completely omitted for 94/542 invasive lesions (17%), and this increased over time from 2% to 33% (p < 0.001). Adjuvant hormone therapy and radiotherapy were omitted in 134/490 (27%) and in 122/420 patients (29%), respectively, while only 26/195 (13%) of patients with a clear clinical indication received adjuvant chemotherapy. At a median follow-up of 61 months (6–147) the 5- and 10-years overall survival (OS) were 64% and 21%, while breast cancer-specific survival (BCSS) at 5 and 10 years were 94% and 78%, respectively. Adjuvant therapies were not associated with a significant improvement in BCSS, while worse OS was associated with older age or more comorbidities as measured by the Charlson Comorbidity Index (CCI) (p < 0.001 and p = 0.012, respectively). Conclusions: Breast surgery, when possible, has a primary role even for women > 80 years of age, and it is associated with a reasonable BCSS. De-escalation of adjuvant therapies should be considered in this setting because survival is largely determined by age and co-morbidities. Full article

(This article belongs to the Section Breast Cancer)

► Show Figures

Figure 1

13 pages, 234 KB

Open AccessReview

Liver Transplantation for Unresectable Colorectal Liver Metastases: A Scoping Review on Redefining Boundaries in Transplant Oncology

by Berkay Demirors, Vrishketan Sethi, Abiha Abdullah, Charbel Elias, Francis Spitz, Jason Mial-Anthony, Godwin Packiaraj, Sabin Subedi, Shwe Han, Timothy Fokken and Michele Molinari

Curr. Oncol. 2025, 32(9), 481; https://doi.org/10.3390/curroncol32090481 - 28 Aug 2025

Abstract

Historically, colorectal liver metastases (CRLMs) have been considered a contraindication for liver transplantation (LT), primarily due to limited organ availability and concerns about oncologic efficacy. However, emerging evidence indicates that highly selected patients with unresectable CRLM can achieve long-term survival following LT—often with [...] Read more.

Historically, colorectal liver metastases (CRLMs) have been considered a contraindication for liver transplantation (LT), primarily due to limited organ availability and concerns about oncologic efficacy. However, emerging evidence indicates that highly selected patients with unresectable CRLM can achieve long-term survival following LT—often with outcomes superior to those obtained through conventional systemic therapies. To evaluate the evolving role of LT in this setting, we conducted a scoping review of the literature. A comprehensive search was performed across PubMed, Embase, Web of Science, Scopus, and ClinicalTrials.gov, as well as ProQuest Dissertations & Theses and Google Scholar to capture gray literature. The search included English-language articles published between January 2015 and April 2025. Eligible studies included those reporting on the application of LT for patients with unresectable CRLM. This scoping review synthesizes current evidence on patient selection criteria, overall and disease-free survival, recurrence patterns, and emerging biomarkers that may guide transplant eligibility. In addition, we explore innovations in organ utilization—including living donor LT and machine perfusion technologies—that aim to expand access while addressing ethical concerns related to organ allocation. As LT for CRLM transitions from investigational use to clinical implementation, this review outlines the key challenges and future opportunities that will shape its role in the landscape of transplant oncology. Full article

(This article belongs to the Special Issue Recent Advances in Surgical Strategies for Managing Metastatic Colorectal Cancer)

► Show Figures

Graphical abstract

Journal Description

Current Oncology

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Topical Collections

Further Information

Guidelines

MDPI Initiatives

Follow MDPI