Current Oncology

12 pages, 1187 KiB

Open AccessArticle

Fostering the Conversation About Complementary Medicine: Acceptability and Usefulness of Two Communication-Supporting Tools for Patients with Cancer

by Marit Mentink, Janneke Noordman, Anja Timmer-Bonte, Martine Busch and Sandra van Dulmen

Curr. Oncol. 2024, 31(11), 7414-7425; https://doi.org/10.3390/curroncol31110547 - 20 Nov 2024

Viewed by 210

Abstract

Both patients and providers experience barriers to discussing complementary medicine during oncology consultations. This study describes the development of two communication tools—a question prompt sheet and a visual slideshow—and aims to evaluate their acceptability, perceived usefulness, and intention to use among patients with [...] Read more.

Both patients and providers experience barriers to discussing complementary medicine during oncology consultations. This study describes the development of two communication tools—a question prompt sheet and a visual slideshow—and aims to evaluate their acceptability, perceived usefulness, and intention to use among patients with cancer. Nine (former) patients with breast cancer were involved in the development of the tools as co-researchers. The 15-item evaluation questionnaire was completed by 144 participants recruited from three Dutch hospitals, a patient panel, and the Dutch Breast Cancer Society. The tools’ content and layout were generally acceptable, although suggestions were made to include items on exercise and diet in the question prompt sheet. About half of the participants found the tools useful, while the other half felt they were unnecessary, either because they could already discuss complementary medicine with their healthcare provider or had no interest in the topic. The tools were considered particularly helpful for fellow patients. The tools were well received though minor modifications were suggested. The lack of perceived need by half of the participants may have influenced the results. For effective use of the tools, it is important to identify patients who need extra support in discussing complementary medicine. Full article

(This article belongs to the Section Psychosocial Oncology)

► Show Figures

Figure 1

11 pages, 500 KiB

Open AccessSystematic Review

Electrochemotherapy in the Locoregional Treatment of Metastatic Colorectal Liver Metastases: A Systematic Review

by Pierluigi Barbieri, Alessandro Posa, Valentina Lancellotta, David C. Madoff, Alessandro Maresca, Patrizia Cornacchione, Luca Tagliaferri and Roberto Iezzi

Curr. Oncol. 2024, 31(11), 7403-7413; https://doi.org/10.3390/curroncol31110546 - 20 Nov 2024

Viewed by 213

Abstract

Background: The global incidence of secondary liver cancer is rising due to multiple risk factors, presenting significant challenges in public health. Similarly, colorectal cancer (CRC) remains a leading cause of cancer-related mortality with the development of frequent liver metastases. Surgical resection of CRC [...] Read more.

Background: The global incidence of secondary liver cancer is rising due to multiple risk factors, presenting significant challenges in public health. Similarly, colorectal cancer (CRC) remains a leading cause of cancer-related mortality with the development of frequent liver metastases. Surgical resection of CRC liver metastases is only suitable for a limited subset of patients, necessitating alternative nonsurgical treatments such as electrochemotherapy (ECT); Methods: This review adhered to the S.P.I.D.E.R. framework. Systematic searches of PubMed, Cochrane, and Scopus databases were conducted for studies published between 2003 and 2023, following PRISMA guidelines. Inclusion criteria were full-text clinical studies in English focusing on ECT-treated CRC liver metastases, excluding reviews, editorials, and non-clinical papers. The GRADE approach was utilized to assess evidence quality, considering study limitations, consistency, and other factors; Results: From 38 identified articles, 4 met the inclusion criteria, encompassing 78 patients and 128 treated lesions. The studies demonstrated variability in design and follow-up duration (3–11 months). Complete response (CR) rates ranged from 33.3% to 63.0%, while progression disease (PD) rates were high, ranging from 23.0% to 55.6%. Median overall survival (OS) spanned 11.3 to 29.0 months. No severe ECT-related complications were reported. Conclusions: ECT appears to be a safe and effective modality for the treatment of CRC liver metastases, especially for lesions unsuitable for other ablative techniques. Further prospective and randomized studies are essential to better define the role of ECT in managing CRC liver metastases and to compare its efficacy with other ablative methods. Full article

(This article belongs to the Topic Advances in Gastrointestinal and Liver Disease: From Physiological Mechanisms to Clinical Practice)

► Show Figures

Graphical abstract

13 pages, 3956 KiB

Open AccessCommunication

Exploiting Integrin-αVβ3 to Enhance Radiotherapy Efficacy in Medulloblastoma via Ferroptosis

by Célia Gotorbe, Fabien Segui, William Echavidre, Jérôme Durivault, Thays Blanchard, Valérie Vial, Marina Pagnuzzi-Boncompagni, Rémy Villeneuve, Régis Amblard, Nicolas Garnier, Cécile Ortholan, Benjamin Serrano, Vincent Picco, Jacques Pouysségur, Milica Vucetic and Christopher Montemagno

Curr. Oncol. 2024, 31(11), 7390-7402; https://doi.org/10.3390/curroncol31110545 - 20 Nov 2024

Viewed by 145

Abstract

Medulloblastoma, a malignant pediatric brain tumor, has a poor prognosis upon relapse, highlighting a critical clinical need. Our previous research linked medulloblastoma cell radioresistance to integrin-αvβ3 expression. β3-depleted (β3_KO) medulloblastoma cells exhibit lipid hydroxyperoxide accumulation after radiotherapy, indicating ferroptosis, a regulated cell death [...] Read more.

Medulloblastoma, a malignant pediatric brain tumor, has a poor prognosis upon relapse, highlighting a critical clinical need. Our previous research linked medulloblastoma cell radioresistance to integrin-αvβ3 expression. β3-depleted (β3_KO) medulloblastoma cells exhibit lipid hydroxyperoxide accumulation after radiotherapy, indicating ferroptosis, a regulated cell death induced by ROS and inhibited by antioxidants such as cysteine, glutathione (GSH), and glutathione peroxidase 4 (GPx4). However, the link between αvβ3 expression, ferroptosis inhibition, and sensitivity to radiotherapy remains unclear. We showed that irradiated β3_KO medulloblastoma cells primarily die by ferroptosis, with β3-subunit expression correlating with radiotherapy sensitivity and anti-ferroptotic protein levels. Our findings suggest that integrin-αvβ3 signaling boosts oxidative stress resilience via mTORC1. Thus, targeting integrin-αvβ3 could enhance radiotherapy efficacy in medulloblastoma by inducing ferroptotic cell death. Full article

(This article belongs to the Special Issue Radiotherapy for Pediatric Tumors)

► Show Figures

Figure 1

11 pages, 579 KiB

Open AccessArticle

by Sara Frida Cohen, Diane Cruiziat, Jeremy Naimer, Victor Cohen, Goulnar Kasymjanova, Alan Spatz and Jason Agulnik

Curr. Oncol. 2024, 31(11), 7379-7389; https://doi.org/10.3390/curroncol31110544 - 20 Nov 2024

Viewed by 205

Abstract

Background: Immunotherapy with ICIs has revolutionized the treatment for NSCLC. The impact of sex on treatment outcomes remains unclear. The aim of this study was to evaluate sex-related differences in immunotherapy outcomes in a real-world population of NSCLC patients. Methods: Demographics, clinical, pathological [...] Read more.

Background: Immunotherapy with ICIs has revolutionized the treatment for NSCLC. The impact of sex on treatment outcomes remains unclear. The aim of this study was to evaluate sex-related differences in immunotherapy outcomes in a real-world population of NSCLC patients. Methods: Demographics, clinical, pathological characteristics, and treatment-related variables were analyzed to understand the differences in efficacy and safety outcomes in relation to sex. Results: 174 advanced NSCLC patients receiving first-line ICIs, either alone or in conjunction with chemotherapy, were included. No differences based on gender were observed in PFS and OS. Prognostic factors for OS and PFS included liver metastases and CRP levels at treatment discontinuation (TD). IrAE-related TD occurred at a significantly higher rate in females. GI toxicity, including hepatitis and colitis, was predominantly observed in females, whereas pneumonitis was the most frequent irAE leading to TD in males. Conclusions: Despite no significant differences based on gender being observed in survival outcomes, our study showed that female patients with advanced NSCLC receiving ICIs are at a substantially greater risk of severe symptomatic irAEs and TD. This finding indicates that broad-based sex differences could potentially exist and emphasizes the need for further investigations into the role played by gender in immunity and cancer immunotherapy treatment. Full article

(This article belongs to the Special Issue Clinical Management and Outcomes of Lung Cancer Patients)

► Show Figures

Figure 1

16 pages, 498 KiB

Open AccessArticle

Sociocultural and Clinical Determinants of Sexual Dysfunction in Perimenopausal Women with and Without Breast Cancer

by Osiris G. Delgado-Enciso, Valery Melnikov, Gustavo A. Hernandez-Fuentes, Jessica C. Romero-Michel, Daniel A. Montes-Galindo, Veronica M. Guzmán-Sandoval, Josuel Delgado-Enciso, Mario Ramirez-Flores, Iram P. Rodriguez-Sanchez, Margarita L. Martinez-Fierro, Idalia Garza-Veloz, Karmina Sánchez-Meza, Carmen A. Sanchez-Ramirez, Carmen Meza-Robles and Ivan Delgado-Enciso

Curr. Oncol. 2024, 31(11), 7363-7378; https://doi.org/10.3390/curroncol31110543 - 20 Nov 2024

Viewed by 274

Abstract

Breast cancer survivorship is a recognized risk factor for sexual dysfunction, with various clinical, sociocultural, and psychological factors potentially interacting differently across populations. This study compared sexual dysfunction, anxiety, and depression between females with breast cancer and those without, aiming to identify associated [...] Read more.

Breast cancer survivorship is a recognized risk factor for sexual dysfunction, with various clinical, sociocultural, and psychological factors potentially interacting differently across populations. This study compared sexual dysfunction, anxiety, and depression between females with breast cancer and those without, aiming to identify associated factors. A total of 362 females participated, including 227 with sexual dysfunction and 135 controls. Among them, 195 are breast cancer survivors, while 167 have no personal history of cancer. Key variables were analyzed using Student’s t-test for quantitative data and Fisher’s exact test for categorical data, while logistic regression models were used to assess the association between sexual dysfunction and various factors. Multivariate analysis revealed that, in sexually active females, breast cancer survivorship increased the odds of sexual dysfunction 2.7-fold (95% CI: 1.17–6.49; p = 0.020). Anxiety was significantly associated with sexual dysfunction, regardless of cancer status (AdOR 6.00; 95% CI: 2.50–14.43; p < 0.001). The interaction between cancer survival and anxiety further increased the odds of sexual dysfunction by more than 11-fold (AdOR 11.55; 95% CI: 3.81–35.04; p < 0.001). Additionally, obesity was found to be a protective factor among cancer survivors (AdOR 0.149; 95% CI: 0.027–0.819; p = 0.029). In conclusion, breast cancer has a significant impact on sexual function, with psychological factors like anxiety playing a crucial role. Addressing these issues requires a holistic, patient-centered approach that considers the complex interplay of physical, emotional, and sociocultural factors. Full article

(This article belongs to the Topic Life of Cancer Survivor)

► Show Figures

Figure 1

11 pages, 216 KiB

Open AccessArticle

Associations Between Cancer-Related Fatigue and Healthcare Use During Cancer Follow-Up Care: A Survey-Administrative Health Data Linkage Study

by Robin Urquhart, Cynthia Kendell and Lynn Lethbridge

Curr. Oncol. 2024, 31(11), 7352-7362; https://doi.org/10.3390/curroncol31110542 - 19 Nov 2024

Viewed by 306

Abstract

Little is known about the impacts of fatigue after cancer treatment, including whether cancer-related fatigue impacts people’s use of healthcare. This study sought to examine how cancer-related fatigue impacts healthcare use after completing cancer treatment. A population-based survey was administered in Nova Scotia, [...] Read more.

Little is known about the impacts of fatigue after cancer treatment, including whether cancer-related fatigue impacts people’s use of healthcare. This study sought to examine how cancer-related fatigue impacts healthcare use after completing cancer treatment. A population-based survey was administered in Nova Scotia, Canada, to examine survivors’ experiences and needs after completing cancer treatment. Respondents included survivors of breast, melanoma, colorectal, prostate, hematologic, and young adult cancers who were 1–3 years post-treatment. Survey responses were linked to cancer registry, physicians’ claims, hospitalization, and ambulatory care data. Data were analyzed descriptively and using regression models. The final study cohort included 823 respondents. Younger respondents reported higher levels of cancer-related fatigue compared to older respondents. More females than males reported cancer-related fatigue. Upon adjusted analyses, those with cancer-related fatigue had lower odds of being discharged to primary care for their cancer-related follow-up (odds ratio = 0.71, p = 0.029). Moreover, those with cancer-related fatigue had 19% higher primary care use (incidence rate ratio = 1.19, p < 0.0001) and 37% higher oncology use (incidence rate ratio = 1.37, p < 0.016) during the follow-up period compared to those without cancer-related fatigue. Providers (oncology and primary care) may require additional support to identify clinically relevant fatigue and refer patients to appropriate resources and services. Full article

22 pages, 1421 KiB

Open AccessSystematic Review

Towards a Risk-Based Follow-Up Surveillance Imaging Schedule for Children and Adolescents with Low-Grade Glioma

by Kleoniki Roka, Karina J. Kersbergen, Antoinette Y. N. Schouten-van Meeteren, Shivaram Avula, Astrid Sehested, Maria Otth and Katrin Scheinemann

Curr. Oncol. 2024, 31(11), 7330-7351; https://doi.org/10.3390/curroncol31110541 - 18 Nov 2024

Viewed by 426

Abstract

The frequency and duration of imaging surveillance in children and adolescents with pediatric low-grade gliomas (pLGGs) aims for the early detection of recurrence or progression. Although surveillance of pLGGs is performed routinely, it is not yet standardized. The aim of the current review [...] Read more.

The frequency and duration of imaging surveillance in children and adolescents with pediatric low-grade gliomas (pLGGs) aims for the early detection of recurrence or progression. Although surveillance of pLGGs is performed routinely, it is not yet standardized. The aim of the current review is to provide a comprehensive synthesis of published studies regarding the optimal frequency, intervals, and duration of surveillance. Several key influencing factors were identified (age, the extent of resection, the tumor location, the histological type, and specific molecular characteristics). However, the lack of consistent definitions of recurrence/progression and the extent of resection meant that it was not possible to perform a meta-analysis of the data from the 18 included articles. This review highlights the need for updating the definition of these terms for uniform and global use both in routine clinical practice as well as in upcoming trials. Thus, future studies on the heterogenous group of pLGGs will allow for the better tailoring of both the frequency and duration of imaging surveillance protocols in relevant settings. Full article

(This article belongs to the Section Childhood, Adolescent and Young Adult Oncology)

► Show Figures

Graphical abstract

11 pages, 3642 KiB

Open AccessCase Report

Inflammatory Mesenteric Disease and Sarcoidosis-like Reaction in a Patient with Lung Adenocarcinoma Who Received Pembrolizumab: Paraneoplastic Syndrome, Secondary to Checkpoint Inhibitor or Chance Finding?

by Luis Posado-Domínguez, María Escribano-Iglesias, Lorena Bellido-Hernández, Johana Gabriela León-Gil, María Asunción Gómez-Muñoz, Felipe Gómez-Caminero López, María Martín-Galache, Sandra M. Inés-Revuelta and Emilio Fonseca-Sánchez

Curr. Oncol. 2024, 31(11), 7319-7329; https://doi.org/10.3390/curroncol31110540 - 18 Nov 2024

Viewed by 304

Abstract

Summary: Anti PD1/PD-L1 agents, including pembrolizumab, have revolutionized the oncological treatment of different types of cancer, including non-small cell lung cancer. The most frequent complications associated with this type of treatment are mild and are located at the thyroid, pulmonary or hepatic [...] Read more.

Summary: Anti PD1/PD-L1 agents, including pembrolizumab, have revolutionized the oncological treatment of different types of cancer, including non-small cell lung cancer. The most frequent complications associated with this type of treatment are mild and are located at the thyroid, pulmonary or hepatic level. Sarcoid like reaction and mesenteric panniculitis secondary to pembrolizumab treatment are two very rare adverse effects. We present the case of a patient with these complications. Purpose: the treatment of metastatic non-small cell lung cancer has undergone a major change in the last 10 years, largely due to the advent of immunotherapy. Anti PD1 agents such as pembrolizumab have increased the median survival of these patients from 13 to 26 months. Most frequent immunorelated side effects are hypothyroidism, pneumonitis or elevated liver enzymes. However, there are other adverse effects, including sarcoid-like reaction and mesenteric panniculitis, which should be known by the professionals involved in the diagnosis and treatment of this type of patient. We present the case of a 62-year-old man with a history of unresectable and non-irradiable stage IIIB epidermoid lung carcinoma with a PD-L1 expression of 30% in whom pembrolizumab was discontinued after 4 cycles due to immunorelated arthritis. One year later he consulted for severe abdominal pain. A PET-CT scan was performed, showing hilar lymphadenopathy and inflammation of abdominal mesenteric fat. A biopsy of lesions in both areas showed non-necrotizing granulomatous lymphadenitis in hilar adenopathy and patchy fibrosis of mesenteric fat. The picture was classified as sarcoidosis-like reaction and mesenteric panniculitis secondary to pembrolizumab. Anti-PD1 agents cause hyperactivation of the immune system through T-cell proliferation. Sarcoid-like reaction is a very rare complication that can mask progressive tumor disease. Awareness of immunorelated complications by oncologists, internists, and radiologists is important for an appropriate diagnostic approach and targeted test ordering. Full article

(This article belongs to the Section Thoracic Oncology)

► Show Figures

Figure 1

11 pages, 1745 KiB

Open AccessCase Report

Novel Fibroblast Growth Factor Receptor 3–Fatty Acid Synthase Gene Fusion in Recurrent Epithelioid Glioblastoma Linked to Aggressive Clinical Progression

by Miguel A. Diaz, Felisa Vázquez-Gómez, Irene Garrido, Francisco Arias, Julia Suarez, Ismael Buño and Álvaro Lassaletta

Curr. Oncol. 2024, 31(11), 7308-7318; https://doi.org/10.3390/curroncol31110539 - 18 Nov 2024

Viewed by 400

Abstract

Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, with a median overall survival (OS) of 15–18 months despite standard treatments. Approximately 8% of GBM cases exhibit genomic alterations in fibroblast growth factor receptors (FGFRs), particularly FGFR1 and FGFR3. Next-generation [...] Read more.

Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, with a median overall survival (OS) of 15–18 months despite standard treatments. Approximately 8% of GBM cases exhibit genomic alterations in fibroblast growth factor receptors (FGFRs), particularly FGFR1 and FGFR3. Next-generation sequencing techniques have identified various FGFR3 fusions in GBM. This report presents a novel FGFR3 fusion with fatty acid synthase (FASN) in a 41-year-old male diagnosed with GBM. The patient presented with a persistent headache, and imaging revealed a right frontal lobe lesion. Surgical resection and subsequent histopathology confirmed GBM. Initial NGS analysis showed no mutations in the IDH1, IDH2 or H3F3 genes, but revealed a TERT promoter mutation and CDKN2A/2B and PTEN deletions. Postoperative treatment included radiotherapy and temozolomide. Despite initial management, recurrence occurred four months post-diagnosis, confirmed by MRI and histology. A second surgery identified a novel FGFR3-FASN fusion, alongside increased Ki67 expression. The recurrence was managed with regorafenib and bevacizumab, though complications like hand–foot syndrome and radiation necrosis arose. Despite initial improvement, the patient died 15 months after diagnosis. This case underscores the importance of understanding GBM’s molecular landscape for effective treatment strategies. The novel FGFR3-FASN fusion suggests potential implications for GBM recurrence and lipid metabolism. Further studies are warranted to explore FGFR3-FASN’s role in GBM and its therapeutic targeting. Full article

► Show Figures

Figure 1

7 pages, 201 KiB

Open AccessCommentary

Whose Responsibility Is It? Implementing Patient-Prioritized Healthcare System Change in Oncology

by Holly Etchegary, John King and Sevtap Savas

Curr. Oncol. 2024, 31(11), 7301-7307; https://doi.org/10.3390/curroncol31110538 - 18 Nov 2024

Viewed by 323

Abstract

This brief commentary describes the reflections on a fundamental question by the Public Interest Group on Cancer Research, a successful academic-community partnership focused on cancer research, education, public engagement, and advocacy in Canada’s Eastern province of Newfoundland and Labrador. Our Group has achieved [...] Read more.

This brief commentary describes the reflections on a fundamental question by the Public Interest Group on Cancer Research, a successful academic-community partnership focused on cancer research, education, public engagement, and advocacy in Canada’s Eastern province of Newfoundland and Labrador. Our Group has achieved some success in a short time with very limited funding. It has successfully created public spaces for conversations about cancer care and priorities for research and regularly advocated for health service change prioritized by input from patients and family members. However, we remain challenged in our understanding of how to truly implement change within oncology care contexts that is informed by patients and families affected by cancer. In this short reflection, we hope to raise awareness of this important issue and question whose responsibility it is to work with patients and families and follow through on prioritized healthcare issues and services. We suggest this may be a matter of integrated knowledge translation and a better understanding of where patients and families fit in this space. We hope to encourage reflection and conversation among all relevant stakeholders about how best to implement patient-prioritized change in oncology care and policy. Full article

(This article belongs to the Special Issue The 30th Anniversary of Current Oncology: Perspectives in Clinical Oncology Practice)

14 pages, 680 KiB

Open AccessArticle

Bouncing Beyond Adversity in Oncology: An Exploratory Study of the Association Between Professional Team Resilience at Work and Work-Related Sense of Coherence

by Dominique Tremblay, Djamal Berbiche, Mathieu Roy, Catherine Prady, Marie-José Durand, Marjolaine Landry and Sylvie Lessard

Curr. Oncol. 2024, 31(11), 7287-7300; https://doi.org/10.3390/curroncol31110537 - 17 Nov 2024

Viewed by 440

Abstract

Team resilience at work (TR@W) is an important resource for bouncing beyond adverse situations. Adopting a health-promoting salutogenic approach, this cross-sectional study explores whether oncology team resilience, which is significantly associated with work-related sense of coherence (Work-SoC), and examines the roles of team [...] Read more.

Team resilience at work (TR@W) is an important resource for bouncing beyond adverse situations. Adopting a health-promoting salutogenic approach, this cross-sectional study explores whether oncology team resilience, which is significantly associated with work-related sense of coherence (Work-SoC), and examines the roles of team member characteristics, quality of work life, and perceived impact of COVID-19. Team members (n = 189) from four oncology settings in Québec (Canada) completed self-administered e-questionnaires. Structural equation modeling was used to identify the best-fitting model and significant relationships among study variables. The results showed a significant positive reciprocal relationship between TR@W and Work-SoC (R = 0.20) and between Work-SoC and TR@W (R = 0.39). These two variables were influenced by gender, gender roles, age, or COVID-19. The resulting model confirms our initial assumption that a higher level of TR@W is significantly associated with a more positive Work-SoC. Our findings provide new insights into subscale items perceived positively by oncology team members, such as perseverance, connectedness, and capability; and identify areas, such as self-care, within the team that may require greater attention to bounce beyond adversity. They also suggest there may be different levels (individual, team, and organizational) of resources under the health salutogenic umbrella. Full article

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

► Show Figures

Figure 1

12 pages, 592 KiB

Open AccessReview

Exploration of the Dual Role of Dectin-1 in Tumor Development and Its Therapeutic Potential

by Yuxuan Cai and Ke Wu

Curr. Oncol. 2024, 31(11), 7275-7286; https://doi.org/10.3390/curroncol31110536 - 17 Nov 2024

Viewed by 306

Abstract

Immunotherapy, particularly immune checkpoint inhibitors like PD-1, PD-L1, and CTLA-4, has revolutionized cancer treatment. However, the role of the innate immune system, especially pattern recognition receptors, in cancer development and immunity is gaining more and more attention. Dectin-1, a C-type lectin receptor primarily [...] Read more.

Immunotherapy, particularly immune checkpoint inhibitors like PD-1, PD-L1, and CTLA-4, has revolutionized cancer treatment. However, the role of the innate immune system, especially pattern recognition receptors, in cancer development and immunity is gaining more and more attention. Dectin-1, a C-type lectin receptor primarily involved in antifungal immunity, has emerged as a significant player in cancer biology, exhibiting both pro-tumor and anti-tumor roles. This dual function largely depends on the tumor type and microenvironment. Dectin-1 can promote immune responses against tumors like melanoma and breast cancer by enhancing both innate and adaptive immunity. However, in tumors like pancreatic ductal adenocarcinoma and colorectal cancer, Dectin-1 activation suppresses T cell immunity, facilitating tumor progression. This review explores the complex mechanisms by which Dectin-1 modulates the tumor microenvironment and discusses its potential as a therapeutic target for cancer treatment. Full article

► Show Figures

Figure 1

17 pages, 740 KiB

Open AccessArticle

A Phase II, Open-Label Study of Lenalidomide and Dexamethasone Followed by Donor Lymphocyte Infusions in Relapsed Multiple Myeloma Following Upfront Allogeneic Stem Cell Transplant

by Richard LeBlanc, Stéphanie Thiant, Rafik Terra, Imran Ahmad, Jean-Sébastien Claveau, Nadia Bambace, Léa Bernard, Sandra Cohen, Jean-Sébastien Delisle, Silvy Lachance, Thomas Kiss, Denis-Claude Roy, Guy Sauvageau and Jean Roy

Curr. Oncol. 2024, 31(11), 7258-7274; https://doi.org/10.3390/curroncol31110535 - 16 Nov 2024

Viewed by 480

Abstract

Background: To date, the only potential curative treatment for multiple myeloma (MM) remains allogeneic (allo) hematopoietic cell transplant (HCT), although, most patients will eventually relapse. In relapsed patients, donor lymphocyte infusions (DLIs) have been reported to control disease, but the optimal strategy prior [...] Read more.

Background: To date, the only potential curative treatment for multiple myeloma (MM) remains allogeneic (allo) hematopoietic cell transplant (HCT), although, most patients will eventually relapse. In relapsed patients, donor lymphocyte infusions (DLIs) have been reported to control disease, but the optimal strategy prior to and doses of DLIs remain unclear. With this study (NCT03413800), we aimed to investigate the efficacy and toxicity of lenalidomide and dexamethasome (Len/Dex) followed by escalating pre-determined doses of DLIs in MM patients who relapsed after allo HCT. Methods: Patients aged 18–65 years with relapsed MM following upfront tandem autologous (auto)/allo HCT were eligible. Treatment consisted of six cycles of Len/Dex followed by three standardized doses of DLIs: 5 × 10⁶ CD3+/kg, 1 × 10⁷/kg and 5 × 10⁷/kg every 6 weeks. Bone marrow minimal measurable disease (MRD) using flow cytometry (10⁻⁵) was performed at enrolment, then every 3 months for 2 years or until disease progression, in a subset of patients. The primary endpoint was efficacy as measured by progression-free survival (PFS) at 2 years following Len/Dex/DLIs. Secondary objectives were safety including GVHD, response including MRD status and overall survival (OS). Results: A total of 22 patients participated in this study, including 62% with high-risk cytogenetics. With a median follow-up of 5.3 years (range: 4.1–6.1), PFS and OS were 26.5% (95% CI: 10.4–45.9%) and 69.2% (95% CI: 43.3–85.1%), respectively. Overall, the best responses achieved post-Len/Dex + DLIs were complete remission in 9.1%, very good partial response in 50%, and progressive disease in 40.9%. Among the nine patients tested for MRD, only two achieved a negative status after receiving DLIs. Six patients died, all due to disease progression. No acute GVHD was observed after DLIs. We report a very low incidence of moderate/severe chronic GVHD of 18.2% with no need for systemic immunosuppressants one year after diagnosis. No unexpected adverse events were observed. Interestingly, a positive correlation between response to Len/Dex re-induction and response to DLIs was found (p = 0.0032). Conclusions: Our findings suggest that Len/Dex/DLIs in second line treatment after upfront tandem auto/allo HCT in relapsed MM patients remains feasible and safe. With a potential correlation between induction chemotherapy and DLI responses, more potent induction regimens together with higher doses of DLIs should be considered in the future. Full article

(This article belongs to the Section Cell Therapy)

► Show Figures

Figure 1

14 pages, 1830 KiB

Open AccessArticle

Expansion of an Academic Molecular Tumor Board to Enhance Access to Biomarker-Driven Trials and Therapies in the Rural Southeastern United States

by Anivarya Kumar, Jennifer R. Owen, Nicholette T. Sloat, Elizabeth Maynard, Vanessa M. Hill, Christopher B. Hubbard, Matthew S. McKinney, Linda M. Sutton, Shannon J. McCall, Michael B. Datto, Ashley N. Moyer, Bennett A. Caughey, John H. Strickler and Ryne C. Ramaker

Curr. Oncol. 2024, 31(11), 7244-7257; https://doi.org/10.3390/curroncol31110534 - 16 Nov 2024

Viewed by 340

Abstract

Targeting tumor-specific molecular alterations has shown significant clinical benefit. Molecular tumor boards (MTBs) connect cancer patients with personalized treatments and clinical trials. However, rural cancer centers often have limited access to MTB expertise. We established an academic–community partnership expanding our academic MTB to [...] Read more.

Targeting tumor-specific molecular alterations has shown significant clinical benefit. Molecular tumor boards (MTBs) connect cancer patients with personalized treatments and clinical trials. However, rural cancer centers often have limited access to MTB expertise. We established an academic–community partnership expanding our academic MTB to affiliated rural community cancer centers. We developed a centralized molecular registry of tumors (MRT) to aggregate the comprehensive genomic profiling (CGP) results and facilitate multidisciplinary MTB review. Of the 151 patients included, 87 (58%) had actionable genomic biomarkers, 42 (28%) were eligible for a targeted off-label therapy, and 27 (18%) were matched to a clinical trial. Of those with a clinical trial match, only 1 of 27 (3%) was enrolled in the identified trial. One year into implementation, community oncology providers were anonymously surveyed on persistent barriers to precision treatment utilization. The primary barriers to clinical trial enrollment were the distance to the trial center (70%), lack of transportation (55%), and lack of local trials (50%). This study offers a framework to improve access to molecular expertise, but significant barriers to the equitable use of CGP and trial enrollment persist. Full article

► Show Figures

Graphical abstract

18 pages, 3047 KiB

Open AccessGuidelines

Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for Clinical Staging of Patients Newly Diagnosed with Breast Cancer

by Jeffrey Q. Cao, Brae Surgeoner, Mita Manna, Jean-François Boileau, Karen A. Gelmon, Muriel Brackstone, Christine Brezden-Masley, Katarzyna J. Jerzak, Ipshita Prakash, Sandeep Sehdev, Stephanie M. Wong, Nathaniel Bouganim, David W. Cescon, Stephen Chia, Ian S. Dayes, Anil Abraham Joy and Jan-Willem Henning

Curr. Oncol. 2024, 31(11), 7226-7243; https://doi.org/10.3390/curroncol31110533 - 15 Nov 2024

Viewed by 755

Abstract

The accurate staging of breast cancer is fundamental for guiding treatment decisions and predicting patient outcomes. However, there can be considerable variation in routine clinical practice based on individual interpretation of guidelines and depending on the healthcare provider initially involved in working up [...] Read more.

The accurate staging of breast cancer is fundamental for guiding treatment decisions and predicting patient outcomes. However, there can be considerable variation in routine clinical practice based on individual interpretation of guidelines and depending on the healthcare provider initially involved in working up patients newly diagnosed with breast cancer, ranging from primary care providers, triage nurses, surgeons, and/or oncologists. The optimal approach for clinical staging, particularly in asymptomatic patients presenting with intermediate-risk disease, remains a topic of dialogue among clinicians. Given this area of uncertainty, the Research Excellence, Active Leadership (REAL) Canadian Breast Cancer Alliance conducted a modified Delphi process to assess the level of agreement among Canadian expert clinicians on various staging recommendations. In total, 20 items were drafted covering staging based on biological status, the utilization of localization clips, both for the axilla during diagnosis and primary surgical site for margins and radiation therapy planning, and the use of advanced imaging for the investigation of distant metastases. Overall, the consensus threshold among all participants (i.e., ≥75% agreement) was reached in 20/20 items. Differences in clinical practice and recent findings from the literature are provided in the discussion. These consensus recommendations are meant to help standardize breast cancer staging practices in Canada, ensuring accurate diagnosis and optimal treatment planning. Full article

(This article belongs to the Special Issue The 30th Anniversary of Current Oncology: Perspectives in Clinical Oncology Practice)

► Show Figures

Figure 1

22 pages, 3386 KiB

Open AccessSystematic Review

Immunotherapy Responses in Viral Hepatitis-Induced HCC: A Systematic Review and Meta-Analysis

by Junaid Anwar, Hafiz Muhammad Arslan, Zouina Sarfraz, Juwairiya Shuroog, Ahmed Abdelhakeem, Ali Saeed and Anwaar Saeed

Curr. Oncol. 2024, 31(11), 7204-7225; https://doi.org/10.3390/curroncol31110532 - 15 Nov 2024

Viewed by 436

Abstract

Background: Hepatocellular carcinoma (HCC) is a prevalent liver cancer with poor prognosis, often linked to hepatitis B (HBV) and C (HCV) infections. This meta-analysis evaluates the efficacy of immunotherapy in HCC, particularly in cases arising from viral hepatitis. Methods: In adherence [...] Read more.

Background: Hepatocellular carcinoma (HCC) is a prevalent liver cancer with poor prognosis, often linked to hepatitis B (HBV) and C (HCV) infections. This meta-analysis evaluates the efficacy of immunotherapy in HCC, particularly in cases arising from viral hepatitis. Methods: In adherence to PRISMA Statement 2020 guidelines, the immunotherapeutic outcomes comprised objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Data were analyzed from randomized controlled trials up to April 2024 using the fixed-effects models in R (V.4.3.3.) and RevMan (Cochrane). Results: This study included 9 trials with 5316 patients. The ORR was slightly higher in the viral group at 27.93% compared to 24.07% in the non-viral group, though this difference was not significant (p = 0.15). Viral HCC patients exhibited a median PFS of 7.3 months (IQR: 6.2–8.4) compared to 5.8 months (IQR: 5.48–6.13) in non-viral patients, a significant improvement (p = 0.005). Similarly, median OS was longer in the viral group at 16.8 months (IQR: 12.99–20.61) versus 15.2 months (IQR: 13.25–17.15) for non-viral HCC, which was also significant (p < 0.0001). The median OS for viral HCC was 16.8 months (IQR: 14.11–19.49 months), with HBV patients experiencing slightly higher survival at 17.15 months (IQR: 14.3–20 months) compared to 16.8 months (IQR: 12.99–20.61 months) for HCV patients; this difference was not statistically significant (p = 0.89). Conclusions: Immunotherapy shows potential in treating HCC, with significantly better outcomes in viral HCC, particularly HBV-associated cases. The heterogeneity highlights the need for personalized treatment approaches based on the viral background of HCC patients. Further research should aim to optimize these therapies to improve survival rates. Full article

(This article belongs to the Special Issue Novel Targeted Therapy, Immunotherapy, and Immune Biomarkers for Gastroesophageal and Liver Cancer)

► Show Figures

Figure 1

14 pages, 971 KiB

Open AccessReview

Soft Tissue Reconstruction and Integration to Implant After Bone-Tumor Resection: A Current Concept Review

by Elisa Pesare, Raffaele Vitiello, Tommaso Greco, Giuseppe Solarino, Giulio Maccauro and Antonio Ziranu

Curr. Oncol. 2024, 31(11), 7190-7203; https://doi.org/10.3390/curroncol31110531 - 15 Nov 2024

Viewed by 318

Abstract

Introduction: With the advancements in chemotherapy for malignant bone tumors, the number of patients eligible for limb salvage surgery has increased. Surgeons face a subsequent challenge in limb-sparing resection due to the need for reconstructing soft tissue coverage. The aim of this review [...] Read more.

Introduction: With the advancements in chemotherapy for malignant bone tumors, the number of patients eligible for limb salvage surgery has increased. Surgeons face a subsequent challenge in limb-sparing resection due to the need for reconstructing soft tissue coverage. The aim of this review is to focus on the present state of the field in these areas, highlighting recent advancements. Methods: A literature research was conducted using keywords such as “soft tissue”, “integration”, “reconstruction”, “megaprosthesis”, and “soft tissue coverage”, on different databases, and following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria, a total of 35 studies were selected. Results: In recent times, there has been a growing emphasis on different techniques such mesh application, allograft-prosthesis composites, allograft reconstruction, a polyethylene terephthalate (PET) tube, prosthesis itself and certain metals utilized for implant coatings are used in soft tissue reconstruction. Conclusion: While tissue-engineered constructs and advancements in biological and cellular approaches have shown potential for enhancing osseointegration and interactions with soft tissues and implants, the actual clinical outcomes have frequently fallen short of expectations. The success of soft tissue integration is crucial for achieving functional outcomes, minimizing complications, and ensuring the long-term stability of orthopedic implants. Full article

(This article belongs to the Section Bone and Soft Tissue Oncology)

► Show Figures

Figure 1

10 pages, 2301 KiB

Open AccessArticle

Clinically Significant Prostate Cancer Prediction Using Multimodal Deep Learning with Prostate-Specific Antigen Restriction

by Hayato Takeda, Jun Akatsuka, Tomonari Kiriyama, Yuka Toyama, Yasushi Numata, Hiromu Morikawa, Kotaro Tsutsumi, Mami Takadate, Hiroya Hasegawa, Hikaru Mikami, Kotaro Obayashi, Yuki Endo, Takayuki Takahashi, Manabu Fukumoto, Ryuji Ohashi, Akira Shimizu, Go Kimura, Yukihiro Kondo and Yoichiro Yamamoto

Curr. Oncol. 2024, 31(11), 7180-7189; https://doi.org/10.3390/curroncol31110530 - 15 Nov 2024

Viewed by 397

Abstract

Prostate cancer (PCa) is a clinically heterogeneous disease. Predicting clinically significant PCa with low–intermediate prostate-specific antigen (PSA), which often includes aggressive cancers, is imperative. This study evaluated the predictive accuracy of deep learning analysis using multimodal medical data focused on clinically significant PCa [...] Read more.

Prostate cancer (PCa) is a clinically heterogeneous disease. Predicting clinically significant PCa with low–intermediate prostate-specific antigen (PSA), which often includes aggressive cancers, is imperative. This study evaluated the predictive accuracy of deep learning analysis using multimodal medical data focused on clinically significant PCa in patients with PSA ≤ 20 ng/mL. Our cohort study included 178 consecutive patients who underwent ultrasound-guided prostate biopsy. Deep learning analyses were applied to predict clinically significant PCa. We generated receiver operating characteristic curves and calculated the corresponding area under the curve (AUC) to assess the prediction. The AUC of the integrated medical data using our multimodal deep learning approach was 0.878 (95% confidence interval [CI]: 0.772–0.984) in all patients without PSA restriction. Despite the reduced predictive ability of PSA when restricted to PSA ≤ 20 ng/mL (n = 122), the AUC was 0.862 (95% CI: 0.723–1.000), complemented by imaging data. In addition, we assessed clinical presentations and images belonging to representative false-negative and false-positive cases. Our multimodal deep learning approach assists physicians in determining treatment strategies by predicting clinically significant PCa in patients with PSA ≤ 20 ng/mL before biopsy, contributing to personalized medical workflows for PCa management. Full article

(This article belongs to the Special Issue New Aspects in Prostate Cancer Imaging)

► Show Figures

Figure 1

3 pages, 187 KiB

Open AccessCorrection

Correction: Alvarado-Miranda et al. Capecitabine Plus Aromatase Inhibitor as First Line Therapy for Hormone Receptor Positive, HER2 Negative Metastatic Breast Cancer. Curr. Oncol. 2023, 30, 6097–6110

by Alberto Alvarado-Miranda, Fernando Ulises Lara-Medina, Wendy R. Muñoz-Montaño, Juan W. Zinser-Sierra, Paula Anel Cabrera Galeana, Cynthia Villarreal Garza, Daniel Sanchez Benitez, Jesús Alberto Limón Rodríguez, Claudia Haydee Arce Salinas, Alberto Guijosa and Oscar Arrieta

Curr. Oncol. 2024, 31(11), 7177-7179; https://doi.org/10.3390/curroncol31110529 - 15 Nov 2024

Viewed by 189

Abstract

In the original publication [...] Full article

12 pages, 467 KiB

Open AccessArticle

Oncology Camp Participation and Psychosocial Health in Children Who Have Lived with Cancer—A Pilot Study

by Sarah O’Connell, Nathan O’Keeffe, Greg D. Wells and Sarah L. West

Curr. Oncol. 2024, 31(11), 7165-7176; https://doi.org/10.3390/curroncol31110528 - 15 Nov 2024

Viewed by 337

Abstract

Children with lived cancer experience encounter adversity, therefore experiences promoting psychosocial health are necessary. This pilot study determined the impact of recreational oncology camps (ROC) on resilience, hope, social support, and mental well-being in youth who have lived with cancer. Youth (6–18 years) [...] Read more.

Children with lived cancer experience encounter adversity, therefore experiences promoting psychosocial health are necessary. This pilot study determined the impact of recreational oncology camps (ROC) on resilience, hope, social support, and mental well-being in youth who have lived with cancer. Youth (6–18 years) with cancer experience enrolled in an 11-day session of ROC (Muskoka, Ontario, Canada) were invited to participate. Participants completed a survey [Children’s Hope Scale (CHS), Child and Youth Resilience Measure (CYRM-R), Social Provisions Scale (SPS-5), and Short Warwick–Edinburgh Mental Wellbeing Scale (SWEMWBS)] on the first (T1) and last day (T2) of camp, and 3 months post-camp (T3). Repeated-measures ANOVAs evaluated differences in survey scores among time points. Ten participants (14.1 ± 2.5 years) were included in the analysis. CHS scores at T3 were lower than T1 and T2 (F = 9.388, p = 0.008). CYRM-R, SPS-5, and SWEMWBS scores were high but did not differ between time points. Hope decreased 3 months post-camp, suggesting a need for continued psychosocial support. Overall, the ROC environment is associated with positive psychosocial health. Full article

(This article belongs to the Special Issue Interventions to Prevent and Reduce Late Effects in Childhood, Adolescent, and Young Adult Cancer Survivors)

► Show Figures

Figure 1

11 pages, 1172 KiB

Open AccessArticle

Population Pharmacokinetics of Tamibarotene in Pediatric and Young Adult Patients with Recurrent or Refractory Solid Tumors

by Takuya Azechi, Yutaka Fukaya, Chika Nitani, Junichi Hara, Hiroshi Kawamoto, Tomoaki Taguchi, Kenichi Yoshimura, Akihiro Sato, Naoko Hattori, Toshikazu Ushijima and Toshimi Kimura

Curr. Oncol. 2024, 31(11), 7155-7164; https://doi.org/10.3390/curroncol31110527 - 14 Nov 2024

Viewed by 572

Abstract

Tamibarotene is a synthetic retinoid that inhibits tumor cell proliferation and promotes differentiation. We previously reported on the safety and tolerability of tamibarotene in patients with recurrent or refractory solid tumors. Therefore, in this study, we aimed to evaluate the pharmacokinetic properties of [...] Read more.

Tamibarotene is a synthetic retinoid that inhibits tumor cell proliferation and promotes differentiation. We previously reported on the safety and tolerability of tamibarotene in patients with recurrent or refractory solid tumors. Therefore, in this study, we aimed to evaluate the pharmacokinetic properties of tamibarotene and construct a precise pharmacokinetic model. We also conducted a non-compartmental analysis and population pharmacokinetic (popPK) analysis based on the results of a phase I study. Targeted pediatric and young adult patients with recurrent or refractory solid tumors were administered tamibarotene at doses of 4, 6, 8, 10, and 12 g/m²/day. Serum tamibarotene concentrations were evaluated after administration, and a popPK model was constructed for tamibarotene using Phoenix NLME. During model construction, we considered the influence of various parameters (weight, height, body surface area, and age) as covariates. Notably, 22 participants were included in this study, and 109 samples were analyzed. A two-compartment model incorporating lag time was selected as the base model. In the final model, the body surface area was included as a covariate for apparent total body clearance, the central compartment volume of distribution, and the peripheral compartment volume of distribution. Visual prediction checks and bootstrap analysis confirmed the validity and predictive accuracy of the final model as satisfactory. Full article

(This article belongs to the Special Issue Updates on Diagnosis and Treatment for Pediatric Solid Tumors)

► Show Figures

Figure 1

11 pages, 790 KiB

Open AccessArticle

Facilitation of Enrollment onto Cancer Clinical Trials Using a Novel Navigator-Assisted Program: A Cross-Sectional Study

by Mahmoud Hossami, Rhonda Abdel-Nabi, Farwa Zaib, Kayla Touma, Renee Nassar, Sanghyuk Claire Rim, Milica Paunic, Olla Hilal, Pratham Gupta, Roaa Hirmiz, Michael Touma, Govana Sadik, Emmanuel Akingbade, Depen Sharma, Swati Kalia, Rija Fatima, Anthony Luginaah, Ibrahim Mohamed, Rong Luo, Megan Delisle and Caroline Hamm Show full author list Hide full author list

Curr. Oncol. 2024, 31(11), 7144-7154; https://doi.org/10.3390/curroncol31110526 - 14 Nov 2024

Viewed by 432

Abstract

Introduction: Clinical trials are essential to the advancement of clinical therapies that improve the outcomes of people with cancer. However, enrollment in clinical trials remains a challenge. The Clinical Trial Navigator [CTN] Program was designed to address the current gap in the cancer [...] Read more.

Introduction: Clinical trials are essential to the advancement of clinical therapies that improve the outcomes of people with cancer. However, enrollment in clinical trials remains a challenge. The Clinical Trial Navigator [CTN] Program was designed to address the current gap in the cancer care journey by assisting with the clinical trials search process. Methods: Between March 2019 and July 2024, applicants of the CTN program included people with cancer, their family members, and/or their care team. Applicants entered the CTN program through a REDCap^® survey that collected the patient’s medical history. A final curated list of potential clinical trials was provided to the applicant. Metrics of success included clinical trial referral and enrollment, and we examined the factors that impacted these outcomes. Results: A total of 445 people with cancer applied to the CTN program during the study. Of the 262 patients with referral and enrollment information, a trial referral occurred in 27.5% [n = 72]. Of the 72 patients who were referred to a clinical trial, 13 [18.1%] were enrolled, 9 [12.5%] are pending enrollment, and 50 [69.4%] were not enrolled. We identified a potential trial for 88% of applicants, with a median of one potential trial per patient. Physicians were highly involved as applicants. Interpretation: The CTN program is successful in searching for clinical trials for people with cancer. Ongoing implementation into other Canadian sites, assessments of patient-reported outcomes, website and social media campaigns, and research into the factors that impact referral and enrollment are underway. Full article

► Show Figures

Figure 1

15 pages, 2410 KiB

Open AccessSystematic Review

Risk Factors of Immune-Mediated Hepatotoxicity Induced by Immune Checkpoint Inhibitors in Cancer Patients: A Systematic Review and Meta-Analysis

by Ying Jiang, Ranyi Li, Xiaoyu Li and Ningping Zhang

Curr. Oncol. 2024, 31(11), 7129-7143; https://doi.org/10.3390/curroncol31110525 - 13 Nov 2024

Viewed by 492

Abstract

Immune checkpoint inhibitors (ICIs) significantly improve survival, while immune-mediated hepatotoxicity (IMH) has been reported. To evaluate the incidence and potential risk factors of IMH among cancer patients treated by ICIs, PubMed/Medline, Web of Science, Cochrane, and Embase were searched before 30 March 2024 [...] Read more.

Immune checkpoint inhibitors (ICIs) significantly improve survival, while immune-mediated hepatotoxicity (IMH) has been reported. To evaluate the incidence and potential risk factors of IMH among cancer patients treated by ICIs, PubMed/Medline, Web of Science, Cochrane, and Embase were searched before 30 March 2024 for systematic review and meta-analysis. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated. Quality assessment was completed using the Newcastle–Ottawa scale. Of 1217 articles identified, 24 consisting of 9076 patients were included, with one study being prospective and the rest retrospective. The overall incidence of any grade IMH and grade ≥ 3 secondary to ICIs was 14% and 7%, respectively. The cholestatic pattern was more prevalent than the hepatocellular and mixed patterns. The meta-analysis revealed that ICI treatment was related to reduced risk of IMH in older patients (SMD: −0.18; 95% CI: −0.33 to −0.04), individuals with higher body mass index (WMD: −2.15; 95% CI: −3.92 to −0.38), males (OR: 0.44; 95% CI: 0.27 to 0.72), and patients with lung cancer (OR: 0.58, 95%CI 0.41 to 0.83). On the other hand, patients with liver metastasis (OR: 1.80; 95% CI: 1.47 to 2.20), history of ICI treatment (OR: 3.09; 95% CI: 1.21 to 7.89), diabetes (OR: 2.19; 95% CI: 1.36 to 3.51), chronic HBV (OR: 3.06; 95% CI: 1.11 to 8.46), and concomitant use of ICIs (OR: 8.73; 95% CI: 2.41 to 31.59) increased the risk of developing IMH. This study will provide clinicians with information on potentially high-risk groups for IMH, who need to be cautiously monitored for liver function when receiving immunotherapy. Full article

► Show Figures

Figure 1

12 pages, 8141 KiB

Open AccessCase Report

Radiation Therapy for Cutaneous Blastic Plasmacytoid Dendritic Cell Neoplasm: A Case Report and Review of the Literature

by Masashi Taka, Shinichiro Toyoshima, Shigeyuki Takamatsu and Satoshi Kobayashi

Curr. Oncol. 2024, 31(11), 7117-7128; https://doi.org/10.3390/curroncol31110524 - 13 Nov 2024

Viewed by 376

Abstract

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a clinically aggressive hematologic malignancy derived from plasmacytoid dendritic cells. It commonly presents as cutaneous lesions. To date, no standard treatment protocol for BPDCN exists. Traditionally treated similarly to acute leukemia or lymphoma, its prognosis remains [...] Read more.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a clinically aggressive hematologic malignancy derived from plasmacytoid dendritic cells. It commonly presents as cutaneous lesions. To date, no standard treatment protocol for BPDCN exists. Traditionally treated similarly to acute leukemia or lymphoma, its prognosis remains poor. Radiation therapy is employed for isolated skin lesions, for patients that are ineligible for chemotherapy due to age or comorbidities and for post-chemotherapy recurrence. However, very limited reports are available on radiotherapy for BPDCN. We present a case involving a 94-year-old BPDCN patient treated with radiation therapy, highlighting an atypical situation of two separate radiotherapy sessions with different dosages for isolated skin lesions. Initially, 45 Gy was administered in 15 fractions (45 Gy/15 Fr), followed by a second session of 30 Gy in 10 fractions (30 Gy/10 Fr) after disease recurrence. This case is unique in detailing radiation therapy for the exceedingly rare BPDCN, particularly dose fractionation. The findings indicate that 45 Gy/15 Fr can provide adequate local control, while even a lower dose of 30 Gy/10 Fr may be effective. This case report contributes to the limited literature by proposing potential therapeutic approaches and dosage guidelines to refine future BPDCN treatment protocols. Full article

(This article belongs to the Topic Cancer Biology and Radiation Therapy (Volume II))

► Show Figures

Figure 1

10 pages, 2086 KiB

Open AccessArticle

Urinary Diversion Can Improve the Chance of Implementing New Therapeutic Lines in Patients with Malignant Ureteral Obstruction: A Multicenter Study

by Marcelo Cartapatti, Roberto Dias Machado, José Carlos Mesquita, Raphael Freua, Diego Cáceres and Rodolfo Borges dos Reis

Curr. Oncol. 2024, 31(11), 7107-7116; https://doi.org/10.3390/curroncol31110523 - 13 Nov 2024

Viewed by 335

Abstract

Purpose: Malignant ureteral obstruction is generally associated with a poor disease prognosis; therefore, managing these cases is challenging. We describe our experience in treating malignant ureteral obstruction with urinary diversion and the impact of these procedures on the indication for new antineoplastic therapy [...] Read more.

Purpose: Malignant ureteral obstruction is generally associated with a poor disease prognosis; therefore, managing these cases is challenging. We describe our experience in treating malignant ureteral obstruction with urinary diversion and the impact of these procedures on the indication for new antineoplastic therapy and survival. Materials and Methods: We retrospectively reviewed the data of patients with advanced cancer associated with malignant ureteral obstruction who underwent urinary diversion at three tertiary institutions between January 2013 and July 2022. Results: This study included 420 patients (mean age, 58.7 years (range, 18–90 years) with a mean follow-up of 20.3 months. Cervical (36.2%) and bladder cancers (18.6%) were the most prevalent primary neo-plastic sites. The mean creatinine values measured before diversion, 30 days after surgery, and most recently were 3.45, 1.84, and 2.59 mg/dL, respectively. In total, 300 patients (71.4%) received antineoplastic treatment, 195 received palliative treatment, and 105 received curative treatment. After an average of 251.87 postoperative days, 265 (64%) patients died. The mean overall survival was 610.76 days. Patients with prostate and cervical neoplasms had the most prolonged overall survival (573.13 and 549.28 days, respectively), whereas patients with bladder and colorectal cancer had the worst overall survival (480.25 and 370.53 days, respectively). Conclusions: Urinary diversion improves kidney function and opens a therapeutic window for a new line of antineoplastic therapy that provides a cure or increases patient survival. Full article

(This article belongs to the Section Surgical Oncology)

► Show Figures

Figure 1

19 pages, 729 KiB

Open AccessReview

Antibody–Drug Conjugates: A Start of a New Era in Gynecological Cancers

by Samir Fasih, Stephen Welch and Ana Elisa Lohmann

Curr. Oncol. 2024, 31(11), 7088-7106; https://doi.org/10.3390/curroncol31110522 - 13 Nov 2024

Viewed by 549

Abstract

Antibody–drug conjugates (ADCs) are a new class of therapeutic agents designed to target specific antigens on tumor cells, combining the specificity of monoclonal antibodies with the cytotoxicity of chemotherapy agents. ADCs have been available for over a decade, but in gynecological cancers, these [...] Read more.

Antibody–drug conjugates (ADCs) are a new class of therapeutic agents designed to target specific antigens on tumor cells, combining the specificity of monoclonal antibodies with the cytotoxicity of chemotherapy agents. ADCs have been available for over a decade, but in gynecological cancers, these agents are relatively new with great promise ahead. More than 80% of ongoing trials in gynecological cancers are evaluating ADCs’ safety and efficacy, of which 40% are early-phase trials. Around twenty ADCs are currently under investigation, either alone or in combination with chemotherapies or immune checkpoint inhibitors. Among them, mirvetuximab soravtansine has been recently approved by the Food and Drug Administration (FDA) in platinum-resistant ovarian cancer with high folate-α receptor expression, as a single agent or in combination. Tisotumab vedotin and trastuzumab deruxtecan are also now approved by the FDA in patients with pre-treated cervical and uterine cancers and further investigation is ongoing. Overall, the toxicity profiles of ADCs are acceptable. Ocular toxicity is one of the specific side effects of some ADCs, but most of the cases are manageable with the use of prophylactic steroids and dose adjustments. This review aims to provide an overview of the fundamental and operational features of ADCs and examine the latest and most promising data, with a particular focus on the Canadian viewpoint. Full article

(This article belongs to the Topic Recent Advances in Anticancer Strategies)

► Show Figures

Figure 1

14 pages, 481 KiB

Open AccessArticle

The Prognostic Role of Pre-Treatment Neutrophil-to-Lymphocyte Ratio in an Asian Cohort of Patients with Oropharyngeal Squamous Cell Carcinoma

by Isabelle J. H. Jang, Hanis B. Abdul Kadir, Kok Hing Lim, Wen Chao Daniel Chew, Jacqueline S. G. Hwang and Chwee Ming Lim

Curr. Oncol. 2024, 31(11), 7074-7087; https://doi.org/10.3390/curroncol31110521 - 12 Nov 2024

Viewed by 371

Abstract

Purpose: The neutrophil-to-lymphocyte ratio is a simple biomarker that reflects the balance between the systemic inflammatory and immunity status. Here we investigate the prognostic role of pre-treatment neutrophil-to-lymphocyte ratio (NLR) in an Asian cohort of oropharyngeal squamous cell carcinoma (OPSCC) patients. Methods: A [...] Read more.

Purpose: The neutrophil-to-lymphocyte ratio is a simple biomarker that reflects the balance between the systemic inflammatory and immunity status. Here we investigate the prognostic role of pre-treatment neutrophil-to-lymphocyte ratio (NLR) in an Asian cohort of oropharyngeal squamous cell carcinoma (OPSCC) patients. Methods: A retrospective review of OPSCC patients from a tertiary institution was conducted. The NLR was calculated from the haematological specimen taken within a month before treatment. Survival rates were estimated via the Kaplan–Meier method, and Cox proportional hazards regression was performed for univariable and multivariable analyses. The NLR cutpoint was determined using maximally selected log-rank statistics. Results: In a cohort of 148 OPSCC patients, 43% were p16-positive and 44% were p16-negative, with a median follow-up of 24 months. The p16-positive patients were younger (median age 62 vs. 67 years) and exhibited a lower prevalence of heavy smoking (47% vs. 69%). The p16-negative cases frequently presented at an advanced disease stage (74% vs. 41%), with a history of previous radiotherapy (26% vs. 3%). The p16-negative patients displayed a higher median NLR (2.91 vs. 2.49). The 3-year disease-specific survival (DSS) in p16-positive was higher compared to p16-negative patients (89.9% vs. 41.6%). The optimal NLR cutpoint was determined as 3.56 and predicted for decreased DSS (hazard ratio [HR] 2.59, p = 0.004). Multivariable analysis revealed smoking, high NLR ≥ 3.56, and p16-negativity as independent variables associated with poorer DSS and overall survival (OS) across the cohort. Conclusion: A high NLR is independently prognostic of poorer DSS in OPSCC, independent of p16 and smoking status. A NLR of more than 3.56 was highly prognostic for poorer survival and warrants further validation in larger cohorts of OPSCC. Full article

(This article belongs to the Section Head and Neck Oncology)

► Show Figures

Figure 1

13 pages, 264 KiB

Open AccessArticle

Modification and Validation of the System Causability Scale Using AI-Based Therapeutic Recommendations for Urological Cancer Patients: A Basis for the Development of a Prospective Comparative Study

by Emily Rinderknecht, Dominik von Winning, Anton Kravchuk, Christof Schäfer, Marco J. Schnabel, Stephan Siepmann, Roman Mayr, Jochen Grassinger, Christopher Goßler, Fabian Pohl, Peter J. Siska, Florian Zeman, Johannes Breyer, Anna Schmelzer, Christian Gilfrich, Sabine D. Brookman-May, Maximilian Burger, Maximilian Haas and Matthias May

Curr. Oncol. 2024, 31(11), 7061-7073; https://doi.org/10.3390/curroncol31110520 - 11 Nov 2024

Viewed by 331

Abstract

The integration of artificial intelligence, particularly Large Language Models (LLMs), has the potential to significantly enhance therapeutic decision-making in clinical oncology. Initial studies across various disciplines have demonstrated that LLM-based treatment recommendations can rival those of multidisciplinary tumor boards (MTBs); however, such data [...] Read more.

The integration of artificial intelligence, particularly Large Language Models (LLMs), has the potential to significantly enhance therapeutic decision-making in clinical oncology. Initial studies across various disciplines have demonstrated that LLM-based treatment recommendations can rival those of multidisciplinary tumor boards (MTBs); however, such data are currently lacking for urological cancers. This preparatory study establishes a robust methodological foundation for the forthcoming CONCORDIA trial, including the validation of the System Causability Scale (SCS) and its modified version (mSCS), as well as the selection of LLMs for urological cancer treatment recommendations based on recommendations from ChatGPT-4 and an MTB for 40 urological cancer scenarios. Both scales demonstrated strong validity, reliability (all aggregated Cohen’s K > 0.74), and internal consistency (all Cronbach’s Alpha > 0.9), with the mSCS showing superior reliability, internal consistency, and clinical applicability (p < 0.01). Two Delphi processes were used to define the LLMs to be tested in the CONCORDIA study (ChatGPT-4 and Claude 3.5 Sonnet) and to establish the acceptable non-inferiority margin for LLM recommendations compared to MTB recommendations. The forthcoming ethics-approved and registered CONCORDIA non-inferiority trial will require 110 urological cancer scenarios, with an mSCS difference threshold of 0.15, a Bonferroni corrected alpha of 0.025, and a beta of 0.1. Blinded mSCS assessments of MTB recommendations will then be compared to those of the LLMs. In summary, this work establishes the necessary prerequisites prior to initiating the CONCORDIA study and validates a modified score with high applicability and reliability for this and future trials. Full article

(This article belongs to the Special Issue Shaping the Future of Oncology: The Role of Generative AI in Clinical and Research Environments)

10 pages, 436 KiB

Open AccessArticle

Median Meld at Transplant Minus 3 Reduces the Mortality of Non-Hepatocellular Carcinoma Patients on the Liver Transplant Waitlist

by Panthea Pouramin, Susan E. Allen, Joseph L. Silburt and Boris L. Gala-Lopez

Curr. Oncol. 2024, 31(11), 7051-7060; https://doi.org/10.3390/curroncol31110519 - 11 Nov 2024

Viewed by 381

Abstract

Liver transplants (LTs) are prioritized by mortality risk, which is estimated by MELD scores. Since hepatocellular carcinoma (HCC) patients present with lower MELD scores, they are allocated MELD exception points. Concerns persist that HCC recipients are over-prioritized, resulting in disproportionate waitlist mortality among [...] Read more.

Liver transplants (LTs) are prioritized by mortality risk, which is estimated by MELD scores. Since hepatocellular carcinoma (HCC) patients present with lower MELD scores, they are allocated MELD exception points. Concerns persist that HCC recipients are over-prioritized, resulting in disproportionate waitlist mortality among non-HCC patients. We assessed whether the Median Meld at Transplant minus 3 (MMaT-3) scoring system would balance waitlist mortality and transplantation rates between HCC and non-HCC patients. We reviewed 266 patient charts listed for an LT from 2015 to 2023; 46.2% were listed in the MMaT-3 era. Amongst non-HCC patients, MMaT-3 implementation significantly increased 1-year transplant rate and reduced 1-year waitlist mortality among non-HCC patients (p = 0.003). Pre-MMaT-3 gaps in transplantation (p = 0.004) and waitlist dropout (p = 0.01) were eliminated post-implementation (p > 0.05). Amongst HCC patients, MMaT-3 implementation had no impact on the 1-year transplant rate (p = 0.92) or 1-year waitlist mortality (p = 0.66). Fine-gray proportional hazard multivariable analysis revealed that MMaT-3 significantly reduced waitlist mortality among non-HCC patients (asHR: 0.44, 95% CI [0.23, 0.83], p = 0.01) and limited impact on HCC patients (p = 0.31). MMaT-3 allocation did not significantly alter 2-year post-transplant survival for both populations. We show that the MMaT-3 system decreased the waitlist mortality of non-HCC patients with limited impacts on outcomes for HCC patients listed for an LT. Full article

► Show Figures

Figure 1

11 pages, 540 KiB

Open AccessArticle

Evaluating the Efficacy of Immunotherapy in Fragile Hospitalized Patients

by Charles Vincent Rajadurai, Guillaume Gagnon, Catherine Allard, Mandy Malick and Michel Pavic

Curr. Oncol. 2024, 31(11), 7040-7050; https://doi.org/10.3390/curroncol31110518 - 10 Nov 2024

Viewed by 391

Abstract

Background: Immunotherapy is the cornerstone of treatment for many cancers. The effectiveness of immunotherapy in hospitalized patients is unknown due to the exclusion of this fragile population from clinical trials. This study evaluates the efficacy of immunotherapy in fragile hospitalized patients. Method: We [...] Read more.

Background: Immunotherapy is the cornerstone of treatment for many cancers. The effectiveness of immunotherapy in hospitalized patients is unknown due to the exclusion of this fragile population from clinical trials. This study evaluates the efficacy of immunotherapy in fragile hospitalized patients. Method: We conducted a single-center retrospective study involving 49 patients who started an immunotherapy (IO) during a hospitalization or within 3 months after a hospitalization at the Centre Hospitalier de l’Université de Sherbrooke (CHUS). Efficacy analysis included objective response rate (ORR), overall survival (OS), and progression-free survival (PFS). Results: Immunotherapy resulted in 30.6% of all grades combined and 18.4% of grade three to four immune-related adverse events (irAE). Efficacy outcomes were inferior in the fragile cohort of patients with ORR of 38.9%, PFS of 2.8 months (95% CI [2.17–3.35]), and OS of 3.2 months (95% CI [1.60–4.84]). Performance status of ECOG three to four compared to ECOG zero predicts poor OS (HR 5.666 [1.207–26.594]; p = 0.028) and PFS (HR 4.136 [0.867–19.733]; p = 0.075). Fitness to receive four to six cycles (HR 0.335 [0.152–0.0.738]; p < 0.007) or more predicts greater OS compared to one to three cycles of immunotherapy. Low levels of serum albumin (HR 0.917 [0.852–0.987]; p = 0.021) and elevated levels of serum LDH (HR 2.224 [1.469–3.367]; p < 0.001) are associated with a reduced OS. Conclusion: The effectiveness of immunotherapy in fragile hospitalized patients is compromised, although they exhibit significant irAE. Excellent performance status, fitness to receive many IO treatments, and normal levels of serum LDH and albumin may be useful in selecting patients who will benefit from immunotherapy. Full article

► Show Figures

Figure 1

Journal Menu

Journal Browser

Curr. Oncol., Volume 31, Issue 11 (November 2024) – 68 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI