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Current Oncology
Volume 31
Issue 9
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Curr. Oncol., Volume 31, Issue 9 (September 2024) – 64 articles

Cover Story (view full-size image): Breast cancer incidence and mortality exhibit rising trends globally, suggesting that there are serious errors in our preventive and therapeutic measures. In breasts, defective estrogen signaling correlates with genomic instability and cancer development, while estrogen treatment induces the self-directed death of tumors and silences peritumoral immune cell infiltration. Understanding the genome-repairing efforts of breast tumors may achieve progress in cancer therapy via applying supportive care instead of genotoxic measures. View this paper
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13 pages, 994 KiB  
Review
Chemotherapy-Induced Alopecia by Docetaxel: Prevalence, Treatment and Prevention
by Aleymi M. Perez, Nicole I. Haberland, Mariya Miteva and Tongyu C. Wikramanayake
Curr. Oncol. 2024, 31(9), 5709-5721; https://doi.org/10.3390/curroncol31090423 - 23 Sep 2024
Viewed by 1772
Abstract
Docetaxel is a commonly used taxane chemotherapeutic agent in the treatment of a variety of cancers, including breast cancer, ovarian cancer, prostate cancer, non-small cell lung cancer, gastric cancer, and head and neck cancer. Docetaxel exerts its anti-cancer effects through inhibition of the [...] Read more.
Docetaxel is a commonly used taxane chemotherapeutic agent in the treatment of a variety of cancers, including breast cancer, ovarian cancer, prostate cancer, non-small cell lung cancer, gastric cancer, and head and neck cancer. Docetaxel exerts its anti-cancer effects through inhibition of the cell cycle and induction of proapoptotic activity. However, docetaxel also impacts rapidly proliferating normal cells in the scalp hair follicles (HFs), rendering the HFs vulnerable to docetaxel-induced cell death and leading to chemotherapy-induced alopecia (CIA). In severe cases, docetaxel causes persistent or permanent CIA (pCIA) when hair does not grow back completely six months after chemotherapy cessation. Hair loss has severe negative impacts on patients’ quality of life and may even compromise their compliance with treatment. This review discusses the notable prevalence of docetaxel-induced CIA and pCIA, as well as their prevention and management. At this moment, scalp cooling is the standard of care to prevent CIA. Treatment options to promote hair regrowth include but are not limited to minoxidil, photobiomodulation (PBMT), and platelet-rich plasma (PRP). In addition, a handful of current clinical trials are exploring additional agents to treat or prevent CIA. Research models of CIA, particularly ex vivo human scalp HF organ culture and in vivo mouse models with human scalp xenografts, will help expedite the translation of bench findings of CIA prevention and/or amelioration to the clinic. Full article
(This article belongs to the Topic Life of Cancer Survivor)
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15 pages, 593 KiB  
Review
Canadian Expert Recommendations on Safety Overview and Toxicity Management Strategies for Sacituzumab Govitecan Based on Use in Metastatic Triple-Negative Breast Cancer
by Mita Manna, Michelle Brabant, Rowen Greene, Michael Dean Chamberlain, Aalok Kumar, Nimira Alimohamed and Christine Brezden-Masley
Curr. Oncol. 2024, 31(9), 5694-5708; https://doi.org/10.3390/curroncol31090422 - 21 Sep 2024
Viewed by 2096
Abstract
Sacituzumab Govitecan (SG) is an antibody-drug conjugate (ADC) comprised of an anti-Trop-2 IgG1 molecule conjugated to SN-38, the active metabolite of irinotecan, via a pH-sensitive hydrolysable linker. As a result of recent Canadian funding for SG in advanced hormone receptor (HR)-positive breast cancer [...] Read more.
Sacituzumab Govitecan (SG) is an antibody-drug conjugate (ADC) comprised of an anti-Trop-2 IgG1 molecule conjugated to SN-38, the active metabolite of irinotecan, via a pH-sensitive hydrolysable linker. As a result of recent Canadian funding for SG in advanced hormone receptor (HR)-positive breast cancer and triple-negative breast cancer (TNBC), experience with using SG and managing adverse events (AEs) has grown. This review presents a summary of evidence and adverse event recommendations derived from Canadian experience, with SG use in metastatic TNBC for extrapolation and guidance in all indicated settings. SG is dosed at 10 mg/kg on day 1 and day 8 of a 21-day cycle. Compared to treatment of physicians’ choice (TPC) the phase III ASCENT and TROPiCS-02 studies demonstrated favorable survival data in unresectable locally advanced or metastatic TNBC and HR-positive HER2 negative metastatic breast cancer, respectively. The most common AEs were neutropenia, diarrhea, nausea, fatigue, alopecia, and anemia. This review outlines AE management recommendations for SG based on clinical trial protocols and Canadian guidelines, incorporating treatment delay, dose reductions, and the use of prophylactic and supportive medications. Full article
(This article belongs to the Special Issue The 30th Anniversary of Current Oncology: Perspectives in Clinical Oncology Practice)
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17 pages, 3984 KiB  
Article
A Preliminary Analysis of Circulating Tumor Microemboli from Breast Cancer Patients during Follow-Up Visits
by Hung-Chih Lai, Hsing-Hua Huang, Yun-Jie Hao, Hsin-Ling Lee, Chiao-Chan Wang, Thai-Yen Ling, Jen-Kuei Wu and Fan-Gang Tseng
Curr. Oncol. 2024, 31(9), 5677-5693; https://doi.org/10.3390/curroncol31090421 - 21 Sep 2024
Viewed by 799
Abstract
Background: Most breast cancer-related deaths are caused by distant metastases and drug resistance. It is important to find appropriate biomarkers to monitor the disease and to predict patient responses after treatment early and accurately. Many studies have found that clustered circulating tumor cells, [...] Read more.
Background: Most breast cancer-related deaths are caused by distant metastases and drug resistance. It is important to find appropriate biomarkers to monitor the disease and to predict patient responses after treatment early and accurately. Many studies have found that clustered circulating tumor cells, with more correlations with metastatic cancer and poor survival of patients than individual ones, are promising biomarkers. Methods: Eighty samples from eleven patients with breast cancer during follow-up visits were examined. By using a microfluidic chip and imaging system, the number of circulating tumor cells and microemboli (CTC/CTM) were counted to assess the distribution in stratified patients and the potential in predicting the disease condition of patients after treatments during follow-up visits. Specific components and subtypes of CTM were also preliminarily investigated. Results: Compared to CTC, CTM displayed a distinguishable distribution in stratified patients, having a better AUC value, in predicting the disease progression of breast cancer patients during follow-up visits in this study. Four subtypes were categorized from the identified CTM by considering different components. In combination with CEA and CA153, enumerated CTC and CTM from individual patients were applied to monitor the disease condition and patient response to the therapy during follow-up visits. Conclusions: The CTM and its subtypes are promising biomarkers and valuable tools for studying cancer metastasis and longitudinally monitoring cancer patients during follow-up visits. Full article
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15 pages, 2208 KiB  
Article
Real-World Treatment Patterns, Sequencing, and Outcomes in Patients with Locally Advanced or Metastatic Urothelial Carcinoma Receiving Avelumab First-Line Maintenance in the United States
by Helen H. Moon, Mairead Kearney, Seyed Hamidreza Mahmoudpour, Chiemeka Ike, Valerie Morris, Andrew Rava, Sonia Kim, Haiyan Sun, Marley Boyd and Gabriel Gomez Rey
Curr. Oncol. 2024, 31(9), 5662-5676; https://doi.org/10.3390/curroncol31090420 - 21 Sep 2024
Viewed by 1185
Abstract
For patients with locally advanced/metastatic urothelial carcinoma (la/mUC), first-line (1L) treatment with platinum-based chemotherapy (PBC) followed by avelumab 1L maintenance (1LM) is a recommended therapy per treatment guidelines in patients without disease progression. However, contemporary real-world (rw) data among patients receiving this treatment [...] Read more.
For patients with locally advanced/metastatic urothelial carcinoma (la/mUC), first-line (1L) treatment with platinum-based chemotherapy (PBC) followed by avelumab 1L maintenance (1LM) is a recommended therapy per treatment guidelines in patients without disease progression. However, contemporary real-world (rw) data among patients receiving this treatment are necessary to understand clinical outcomes and optimal treatment sequencing. This retrospective cohort study analyzed rw treatment patterns and clinical outcomes, including overall survival (rwOS) and progression-free survival (rwPFS), in patients with la/mUC receiving avelumab 1LM. From the Flatiron Health database, 214 patients who received avelumab 1LM following 1L PBC were included. From the start of avelumab 1LM, median rwOS was 23.8 months (95% CI: 18.2—not estimable [NE]) and median rwPFS was 5.1 months (95% CI: 4.1–7.0). A total of 96 patients received second-line (2L) therapy, with 53 receiving enfortumab vedotin (EV). From the start of 2L EV, median rwOS was 11.2 months (95% CI: 6.8—NE) and median rwPFS was 4.9 months (95% CI: 3.9–8.8). Treatment patterns and clinical outcomes in this study align with guidelines and outcomes observed in the JAVELIN Bladder 100 and EV-301 clinical trials and other rw studies, supporting the use of 1L PBC followed by avelumab 1LM and 2L EV for eligible patients. Full article
(This article belongs to the Section Genitourinary Oncology)
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10 pages, 1189 KiB  
Communication
The Clinical Utilisation and Duration of Treatment with HER2-Directed Therapies in HER2-Positive Recurrent or Metastatic Salivary Gland Cancers
by Joseph Edward Haigh, Karan Patel, Sam Rack, Pablo Jiménez-Labaig, Guy Betts, Kevin Joseph Harrington and Robert Metcalf
Curr. Oncol. 2024, 31(9), 5652-5661; https://doi.org/10.3390/curroncol31090419 - 21 Sep 2024
Viewed by 885
Abstract
Salivary gland cancers (SGC) are rare tumours with limited availability of systemic therapies. Some SGC subtypes overexpress HER2, and this represents a potential therapeutic target, but the evidence base is limited. This study sought to analyse real-world data on the efficacy of HER2-directed [...] Read more.
Salivary gland cancers (SGC) are rare tumours with limited availability of systemic therapies. Some SGC subtypes overexpress HER2, and this represents a potential therapeutic target, but the evidence base is limited. This study sought to analyse real-world data on the efficacy of HER2-directed therapies in SGC. This is a retrospective observational study using anonymised data from commercial compassionate-use access registrations and a privately funded pharmacy prescribing register. Treatment duration was defined as the time from drug initiation to treatment discontinuation. Kaplan–Meier analysis of treatment duration was performed using R for Windows (v4.3.2). A case report is also provided of an exceptional responder. Eighteen patients were identified who received HER2-directed therapies for HER2-positive recurrent/metastatic SGC, and complete data on treatment duration was available for 15/18. Histology was salivary duct carcinoma in 13/18 patients, adenocarcinoma NOS in 4/18, and carcinoma ex pleomorphic adenoma in 1/18. The median treatment duration was 8.3 months (95% CI: 6.41-not reached), and the range was 1.0–47.0 months. Choice of HER2-directed therapy varied, with ado-trastuzumab emtasine being the most common (9/18). At the time of analysis, HER2-directed therapy was ongoing for 9/15, discontinued due to disease progression for 4/15, discontinued due to toxicity for 1/15, and 1/15 was discontinued for an unspecified reason. An exceptional responder experienced a complete response with a treatment duration of 47.0 months. These real-world data are comparable to the median PFS observed with HER2-directed therapies in phase II trials and support the use of HER2-directed therapies in this group. Full article
(This article belongs to the Special Issue Head and Neck Cancer: Epidemiology, Prevention, Treatment, and Quality of Life)
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9 pages, 486 KiB  
Article
Estimating the Proportion of Overdiagnosis among Prostate, Breast, and Thyroid Cancers in China: Findings from the Global Burden of Disease 2019
by Shuting Wang, Yanlai Ji, Mingxue Ren, Jun Li and Zuyao Yang
Curr. Oncol. 2024, 31(9), 5643-5651; https://doi.org/10.3390/curroncol31090418 - 20 Sep 2024
Viewed by 758
Abstract
The incidence of prostate, breast, and thyroid cancers has increased in China over the past few decades. Whether and how much these increases can be attributed to overdiagnosis are less understood. This study aimed to estimate the proportion of overdiagnosis among these three [...] Read more.
The incidence of prostate, breast, and thyroid cancers has increased in China over the past few decades. Whether and how much these increases can be attributed to overdiagnosis are less understood. This study aimed to estimate the proportion of overdiagnosis among these three cancers in China during 2004–2019. The age-specific cancer incidence, cancer mortality, and all-cause mortality in China were extracted from the Global Burden of Diseases 2019. The lifetime risk of developing and that of dying from each cancer were calculated using the life table method. The proportion of overdiagnosis of a cancer was estimated as the difference between the lifetime risk of developing the cancer and that of suffering from the cancer (including death, metastasis, and symptoms caused by the cancer), further divided by the lifetime risk of developing the cancer. The highest possible values of these parameters were adopted in the estimation so as to obtain the lower bounds of the proportions of overdiagnosis. Sensitivity analyses assuming different lag periods between the diagnosis of a cancer and death from the cancer were performed. The results showed that the lifetime risk of developing prostate, breast, and thyroid cancer increased dramatically from 2004 to 2019 in China, while the increase in the lifetime risk of dying from these cancers was less pronounced. The proportions of overdiagnosis among prostate, breast, and thyroid cancers were estimated to be 7.88%, 18.99%, and 24.92%, respectively, in 2004, and increased to 18.20%, 26.25%, and 29.24%, respectively, in 2019. The increasing trends were statistically significant for all three cancers (all p < 0.001). In sensitivity analyses, the proportions of overdiagnosis decreased, but upward trends over time remained for all three cancers. In conclusion, the overdiagnosis of prostate, breast, and thyroid cancers in China increased from 2004 to 2019, with the highest proportion seen in thyroid cancer and the most rapid increase seen in prostate cancer. Multifaceted efforts by policy makers, guideline developers, and clinicians are needed to tackle this problem. Full article
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13 pages, 604 KiB  
Article
Postoperative Complications of Upfront Ovarian Cancer Surgery and Their Effects on Chemotherapy Delay
by Julia Heikkinen, Henna Kärkkäinen, Marja-Liisa Eloranta and Maarit Anttila
Curr. Oncol. 2024, 31(9), 5630-5642; https://doi.org/10.3390/curroncol31090417 - 19 Sep 2024
Viewed by 993
Abstract
Background: Extensive surgery on advanced-stage epithelial ovarian cancer is associated with increased postoperative morbidity, which may cause a delay in or omission of chemotherapy. We examined postoperative complications and their effects on adjuvant treatment in patients undergoing primary debulking surgery (PDS). Methods: Stage [...] Read more.
Background: Extensive surgery on advanced-stage epithelial ovarian cancer is associated with increased postoperative morbidity, which may cause a delay in or omission of chemotherapy. We examined postoperative complications and their effects on adjuvant treatment in patients undergoing primary debulking surgery (PDS). Methods: Stage IIIC-IV epithelial ovarian cancer patients who underwent PDS between January 2013 and December 2020 were included. Patients were divided into two groups according to the radicality of the operation, i.e., extensive or standard surgery, and their outcomes were compared. Results: In total, 172 patients were included; 119 underwent extensive surgery, and 53 had standard surgery. Clavien–Dindo grade 3–5 (CDC 3+) complications were detected in 41.2% of patients after extensive operations and in 17% after standard surgery (p = 0.002). The most common CDC 3+ complication was pleural effusion. Despite the difference in the complication rates, the delay in chemotherapy did not differ between the extensive and standard groups (p = 0.98). Conclusions: Complications are common after PDS. Extensive surgery increases the complication rate, but most complications can be treated effectively; therefore, a delay in adjuvant treatment is rare. Full article
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13 pages, 2268 KiB  
Article
The Safety and Efficacy of Peptide Receptor Radionuclide Therapy for Gastro-Entero-Pancreatic Neuroendocrine Tumors: A Single Center Experience
by Leandra Piscopo, Emilia Zampella, Fabio Volpe, Valeria Gaudieri, Carmela Nappi, Erica Di Donna, Stefania Clemente, Antonio Varallo, Mariano Scaglione, Alberto Cuocolo and Michele Klain
Curr. Oncol. 2024, 31(9), 5617-5629; https://doi.org/10.3390/curroncol31090416 - 18 Sep 2024
Viewed by 712
Abstract
The aim of the present study was to evaluate the safety and efficacy of radionuclide therapy with [177Lu]Lu-DOTA-TATE according to our single center experience at the University of Naples Federico II. For the present analysis, we considered 21 patients with progressive, [...] Read more.
The aim of the present study was to evaluate the safety and efficacy of radionuclide therapy with [177Lu]Lu-DOTA-TATE according to our single center experience at the University of Naples Federico II. For the present analysis, we considered 21 patients with progressive, advanced, well-differentiated G1 and G2 in patients with gastro-entero-pancreatic (GEP) neuroendocrine tumors (NETs) treated with [177Lu]Lu-DOTA-TATE according to the decisions of a multidisciplinary team. All patients underwent four cycles of 7–8 GBq of [177Lu]Lu-DOTA-TATE every 8 weeks. A whole-body scan (WBS) was performed 4, 48, and 168 h after each treatment. The dosimetry towards the organ at risk and target lesions was calculated. For each patient, renal and bone marrow parameters were evaluated before, during, and 3 months after the end of the treatment. Follow-up data were obtained and RECIST criteria were considered as the endpoint. Among 21 patients enrolled (mean age 65 ± 9 years); 17 (81%) were men and the small intestine was the most frequent location of disease (n = 12). A mild albeit significant variation (p < 0.05) in both platelets and white blood cell counts among all time points was observed, despite it disappearing 3 months after the end of the therapy. According to the RECIST criteria, 11 (55%) patients had a partial response to therapy and 8 (40%) had stable disease. Only one (5%) patient had disease progression 4 months after treatment. Our data confirm that [177Lu]Lu-DOTA is safe and effective in controlling the burden disease of G1/G2 GEP-NETs patients. Full article
(This article belongs to the Special Issue Application of Nuclear Medicine in Cancer Diagnosis and Treatment)
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9 pages, 997 KiB  
Article
Doxycycline Plus Bortezomib-Containing Regimens for the Treatment of Light-Chain Amyloidosis in the Frontline Setting: Experience from the Amyloidosis Program of Calgary
by Ellen Lewis, Nowell Fine, Sylvia McCulloch, Jason Tay, Peter Duggan, Paola Neri, Nizar Bahlis and Victor H. Jimenez-Zepeda
Curr. Oncol. 2024, 31(9), 5608-5616; https://doi.org/10.3390/curroncol31090415 - 18 Sep 2024
Viewed by 705
Abstract
Background: Pre-clinical and retrospective data suggest that doxycycline added to treatment regimens has benefit in AL amyloidosis. However, a recent multicenter, open-label, randomized controlled trial in AL amyloidosis patients treated with CyBorD did not demonstrate a progression-free survival (PFS) or cardiac PFS benefit [...] Read more.
Background: Pre-clinical and retrospective data suggest that doxycycline added to treatment regimens has benefit in AL amyloidosis. However, a recent multicenter, open-label, randomized controlled trial in AL amyloidosis patients treated with CyBorD did not demonstrate a progression-free survival (PFS) or cardiac PFS benefit with added doxycycline. Objective: The main objective of this study was to explore the role of doxycycline combined with bortezomib-containing regimens (BCRs) for newly diagnosed AL amyloidosis patients with cardiac involvement and to compare them with a cohort of concurrent patients treated with BCR only. Material and Methods: AL amyloidosis patients, newly diagnosed between January 2012 and March 2022, who were treated with BCR at the Amyloidosis Program of Calgary (APC) were evaluated. Results: Sixty-four concurrent patients were identified. Thirty-nine patients received doxycycline in addition to BCR (BCR-D) for a median of 8 months. The overall response rate was similar among the groups. No significant differences in VGPR/CR, dFLC at 1 month, time to first response, time to best response, or organ responses were noted between the BCR alone and BCR-D groups. Summary and Conclusions: Our retrospective study demonstrated that doxycycline combined with BCR failed to prolong OS, PFS, or cardiac responses compared with BCR alone in patients with cardiac AL amyloidosis. Full article
(This article belongs to the Special Issue Clinical Progression and Treatment Outcome of Multiple Myeloma)
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9 pages, 416 KiB  
Article
Is Canada Moving towards a More Agile Regulatory Approval and Reimbursement Process with a Shifting Role for Real-World Evidence (RWE) for Oncology Drugs?
by Catherine Y. Lau and Nigel S. B. Rawson
Curr. Oncol. 2024, 31(9), 5599-5607; https://doi.org/10.3390/curroncol31090414 - 18 Sep 2024
Viewed by 1224
Abstract
Canada is known to have a complex pathway for new drug approval and reimbursement, resulting in delayed access for patients with serious and life-threatening diseases, such as cancer. Several recent publications from key stakeholders, including patients, physicians and policymakers, highlight patient helplessness, physician [...] Read more.
Canada is known to have a complex pathway for new drug approval and reimbursement, resulting in delayed access for patients with serious and life-threatening diseases, such as cancer. Several recent publications from key stakeholders, including patients, physicians and policymakers, highlight patient helplessness, physician frustrations and policymakers entangled in a massive network of bureaucracy unable to make headway. Several quantitative and qualitative assessments using time from regulatory approvals to successful reimbursements confirm long review times and high rejection rates for oncology drugs, especially those receiving conditional approvals. A consensus forum of 18 Canadian oncology clinicians recently voiced frustration with the process and inability to deliver guideline-supported efficacious therapies to their patients. This manuscript compares data extracted from publicly available data sources from 2019 to June 2024 to previous publications. Methods: Public databases from Health Canada, the Canadian Agency for Drugs and Technologies in Health (CADTH), which is in the process of changing to Canada’s Drug Agency, and the pan-Canadian Pharmaceutical Alliance (pCPA) were reviewed and the data collected were analyzed with descriptive statistics. Results: From the data, three trends emerge, (i) an increasing number of oncology drugs are receiving conditional approvals from Health Canada, (ii) the percentage of conditionally approved oncology drugs receiving positive reimbursement recommendations from CADTH is still low but appears to be improving, but delays in access are now contingent upon pCPA deciding whether to negotiate price and then the duration of any negotiation, and (iii) real-world evidence is no longer part of the decision-making for conditional approvals. A slight increase in the positive endorsement of RWE used to support CADTH recommendations was observed. Conclusions: The lack of timely access to oncology drugs hurts Canadian patients. While a small trend of improvement appears to be emerging, longer-term data collection is required to ensure sustained patient benefits. Full article
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26 pages, 2105 KiB  
Review
Exploring Demographic Representation and Reporting in Lung Cancer Clinical Trials with Canadian Sites from 2013 to 2023
by Sierra A. Land, Rajvi J. Wani, Naila Inam, Hilary J. G. Hewitt, Paulo Eduardo Muniz Covizzi and Tarah Sheculski Rivard
Curr. Oncol. 2024, 31(9), 5573-5598; https://doi.org/10.3390/curroncol31090413 - 17 Sep 2024
Viewed by 848
Abstract
This review evaluates the reporting of demographic characteristics and the diversity of participants of phase III lung cancer clinical trials with Canadian research sites. A literature search was conducted using the ClinicalTrials.gov registry to identify clinical trials conducted between 1 January 2013, and [...] Read more.
This review evaluates the reporting of demographic characteristics and the diversity of participants of phase III lung cancer clinical trials with Canadian research sites. A literature search was conducted using the ClinicalTrials.gov registry to identify clinical trials conducted between 1 January 2013, and 31 December 2023. The demographic reporting practices and the representation of sex/gender, racial, and ethnic groups were assessed. The location of Canadian research sites was also examined for trends in reporting and representation. Associated publications were reviewed for demographic data collection methods. Of the 25 clinical trials, 24 reported race and 18 also reported ethnicity. All clinical trials reported sex/gender, and the city and province of the participating Canadian sites. Most participants were White (66.1%), identified as not Hispanic or Latino (81.4%), and were male (57.8%). The provinces with the most clinical trial sites were Ontario (43.6%) and Quebec (34.2%). Lung cancer clinical trials lack adequate demographic reporting and representation of females, diverse patient groups, and geographical locations in Canada with high lung cancer incidence rates. Specifically, the Indigenous Peoples of Canada and Nunavut require better representation in lung cancer clinical trials conducted in Canada. These findings highlight the need to improve diversity and demographic representation in clinical research. Full article
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16 pages, 534 KiB  
Article
The Quality of Life after Endometrial Cancer Study: Baseline Characteristics and Patient-Reported Outcomes
by Simrit Warring, Kathleen J. Yost, Andrea L. Cheville, Sean C. Dowdy, Stephanie S. Faubion, Amanika Kumar, Maureen A. Lemens, Chelsie C. Van Oort, Angela J. Fought, Michaela E. Mc Gree, Andrea Mariani and Gretchen Glaser
Curr. Oncol. 2024, 31(9), 5557-5572; https://doi.org/10.3390/curroncol31090412 - 17 Sep 2024
Viewed by 856
Abstract
Endometrial cancer (EC) patients make up the second largest group of female cancer survivors. Patient-reported outcomes (PROs) including quality of life (QOL) and sexual function and satisfaction (SF and S) are critical facets of survivorship. This prospective, longitudinal study assesses associations between baseline [...] Read more.
Endometrial cancer (EC) patients make up the second largest group of female cancer survivors. Patient-reported outcomes (PROs) including quality of life (QOL) and sexual function and satisfaction (SF and S) are critical facets of survivorship. This prospective, longitudinal study assesses associations between baseline characteristics and PROs after treatment. Herein, we report the baseline clinical characteristics and PROs prior to treatment initiation. Outcomes post-treatment over time will be reported separately. Patients with planned surgery for EC were prospectively enrolled in 2019–2021 and administered the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 30 (QLQ-C30), EORTC QLQ EC Module (EN24), Patient-Reported Outcomes Measurement Information System (PROMIS), and the Mayo Clinic lower extremity lymphedema (LEL) questionnaire. This study enrolled 198 patients with a mean (SD) age of 63.6 (9.8) years and body mass index of 35.5 (8.3) kg/m2. No significant differences in the PROs for the QOL were seen when compared to the reference means (SD) except for the lower interest in sexual activity (31.9 (9.8) vs. 47.5 (SE0.70)) and lower fatigue (21.3 (19.8) vs. 31.7 (25.9)). Increased obesity was associated with an increased likelihood of LEL (p < 0.01) and multiple QOL scales, including poorer global health status (p < 0.01) and physical functioning (p < 0.01). Prior to treatment initiation for EC, the patients had a similar QOL compared to that of the general population. The patients with increasing obesity, a known risk factor for EC, had worse overall global health status and physical functioning. A better understanding of these QOL measures is imperative for earlier identification and intervention of patients at risk of chronic impairments from EC treatment. Full article
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13 pages, 1452 KiB  
Article
The Landscape of Breast Cancer Molecular and Histologic Subtypes in Canada
by Anna N. Wilkinson, Larry F. Ellison, Sharon F. McGee, Jean-Michel Billette and Jean M. Seely
Curr. Oncol. 2024, 31(9), 5544-5556; https://doi.org/10.3390/curroncol31090411 - 17 Sep 2024
Viewed by 1457
Abstract
Purpose: To characterize the histologic and molecular subtype distribution of, and survival from, breast cancer (BC) among Canadian women overall, and by stage and age at diagnosis. Methods: Invasive BC cases from the Canadian Cancer Registry for women aged 15–99 years between 2012 [...] Read more.
Purpose: To characterize the histologic and molecular subtype distribution of, and survival from, breast cancer (BC) among Canadian women overall, and by stage and age at diagnosis. Methods: Invasive BC cases from the Canadian Cancer Registry for women aged 15–99 years between 2012 and 2017 in Canada, excluding Quebec, were examined using pre-existing mortality linkages. Stage at diagnosis, molecular, and histologic subtypes, and 5-year net survival (NS) by age, subtype, and stage were determined. Results: 107,271 women with BC were included. Luminal A was the most common subtype, present in increasing proportions as women aged, up to a maximum of 55% of cases in 70–74. Ductal and luminal A were most likely to be diagnosed at stage I, while HER2+ had the highest proportion of diagnosis at stage III; triple negative (TN) and unknown had the highest proportion of stage IV. For all stages combined, luminal A had a five-year NS of 98%, while TN was 74%. NS for stage I BC was 99–100% for all subtypes, excepting TN, which was 96%. Survival decreased with advancing stage, most markedly for TN, for which stage III was 47% and stage IV 7%. Survival by equivalent stage and subtype was comparable across age groups but declined in older age categories. Conclusions: The varying natural histories of BC subtypes and histologies can inform prognoses, health system economics, and screening practices. The NS of 96% or greater for stage I, regardless of subtype, highlights the importance of early detection for all subtypes of BC, especially in aggressive subtypes. Full article
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7 pages, 599 KiB  
Article
Retzius-Sparing Robot-Assisted Radical Prostatectomy Using the Hinotori Surgical Robot System Platform: Report of the First Series of Experiences
by Yuta Yamada, Shigenori Kakutani, Yoichi Fujii, Naoki Kimura, Yuji Hakozaki, Jun Kamei, Satoru Taguchi, Aya Niimi, Daisuke Yamada and Haruki Kume
Curr. Oncol. 2024, 31(9), 5537-5543; https://doi.org/10.3390/curroncol31090410 - 17 Sep 2024
Viewed by 637
Abstract
Background: The aim of this study is to describe the first series of six patients undergoing Retzius-sparing robot-assisted radical prostatectomy (rs-RARP) using the hinotori surgical robot system (hinotori SRS) and to compare the treatment outcomes with those achieved with the da Vinci surgical [...] Read more.
Background: The aim of this study is to describe the first series of six patients undergoing Retzius-sparing robot-assisted radical prostatectomy (rs-RARP) using the hinotori surgical robot system (hinotori SRS) and to compare the treatment outcomes with those achieved with the da Vinci surgical platform. Methods: This study included 20 cases involving the rs-RARP procedure (hinotori: N = 6; da Vinci: N = 14) that were performed between May 2021 and April 2024 in a single institution. Results: No significant differences were observed between the hinotori and da Vinci groups regarding the preoperative findings. In the hinotori group, there were four cases of pT2 that showed negative surgical margins in all the cases. However, positive surgical margins were observed in two of the cases with pT3. The surgical outcomes were also similar between the two groups except for console time, which tended to be shorter in the da Vinci group (p = 0.058). There were no major complications in the initial six cases with the hinotori SRS. Immediate urinary continence was observed in 50% of the cases with the hinotori group compared with 64% for the da Vinci group. Conclusion: This is the first study to report cases of rs-RARP performed on a hinotori SRS. It seems that the hinotori SRS shows similar treatment outcomes compared with the cases treated via the da Vinci platform. Full article
(This article belongs to the Special Issue New and Emerging Trends in Prostate Cancer)
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9 pages, 230 KiB  
Article
Long-Term Outcome of Patients with Low-Risk Differentiated Thyroid Cancer Treated with Total Thyroidectomy Alone
by Antonio Matrone, Alessio Faranda, Liborio Torregrossa, Carla Gambale, Elisa Minaldi, Alessandro Prete, Luigi De Napoli, Leonardo Rossi, Laura Agate, Virginia Cappagli, Luciana Puleo, Eleonora Molinaro, Gabriele Materazzi and Rossella Elisei
Curr. Oncol. 2024, 31(9), 5528-5536; https://doi.org/10.3390/curroncol31090409 - 16 Sep 2024
Viewed by 911
Abstract
Background: Differentiated thyroid carcinoma (DTC), mainly papillary (PTC), at low risk of recurrence is currently managed with active surveillance strategies or less aggressive surgeries. However, total thyroidectomy with 131I treatment is still performed both if these tumors are diagnosed before or occasionally [...] Read more.
Background: Differentiated thyroid carcinoma (DTC), mainly papillary (PTC), at low risk of recurrence is currently managed with active surveillance strategies or less aggressive surgeries. However, total thyroidectomy with 131I treatment is still performed both if these tumors are diagnosed before or occasionally after surgery. This real-life study aimed to evaluate the rate of biochemical, structural, and functional events in a large series of consecutive DTCs at low risk of recurrence treated by total thyroidectomy, but not with 131I, in a medium–long-term follow-up. Patients and Methods: We evaluated clinical–pathologic data of 383 consecutive patients (2006–2012) with unifocal DTC [T1a/b(s)] at low risk of recurrence, treated with total thyroidectomy but without lymph node dissection and 131I treatment after surgery. We evaluated if structural, biochemical, and functional events were detected during the follow-up. Results: Females accounted for 75.7% of our study group, and the median age was 50 years. The median tumor dimension was 0.4 cm (range 0.1–1.2). Most of the patients had a unifocal T1a tumor (98.9%), and 73.6% had a classic variant of PTC. We divided the patients according to the absence (group A—n = 276) or presence (group B—n = 107) of interfering TgAb at first control after surgery. After a median follow-up of 10 years, no structural events were detected. Sixteen out of three hundred and eighty-three (4.2%) patients developed biochemical events: 12/276 (4.3%) in group A and 4/107 (3.7%) in group B. The median time elapsed from surgery to detecting a biochemical event was 14.5 and 77.5 months in groups A and B, respectively. No patients performed additional treatments and were followed up with an active surveillance strategy. Conclusions: This study confirmed that patients with DTC at low risk of recurrence showed an excellent outcome in a medium long-term follow-up since no structural events were diagnosed. Significant variations in Tg/TgAb were detected in a few cases, all managed with an active surveillance strategy without the need for other treatments. Therefore, a relaxed follow-up with neck ultrasound and Tg/TgAb measurement is enough to early identify those very unusual cases of recurrence. Full article
(This article belongs to the Section Head and Neck Oncology)
12 pages, 894 KiB  
Article
Exploring Prostate Cancer Incidence Trends and Age Change in Cancer Registration Areas of Jiangsu Province, China, 2009 to 2019
by Hairong Zhou, Xin Hong, Weigang Miao, Weiwei Wang, Chenchen Wang, Renqiang Han and Jinyi Zhou
Curr. Oncol. 2024, 31(9), 5516-5527; https://doi.org/10.3390/curroncol31090408 - 14 Sep 2024
Viewed by 765
Abstract
(1) Background: Over the past few decades, Jiangsu Province, China, has witnessed a remarkable surge in the incidence of prostate cancer (PCa), accompanied by notable demographic shifts; (2) Methods: PCa data for Jiangsu Province from 2009 to 2019 were obtained from the Jiangsu [...] Read more.
(1) Background: Over the past few decades, Jiangsu Province, China, has witnessed a remarkable surge in the incidence of prostate cancer (PCa), accompanied by notable demographic shifts; (2) Methods: PCa data for Jiangsu Province from 2009 to 2019 were obtained from the Jiangsu Cancer Registry. We calculated crude and age-specific incidence rates (ASIRs), average age at onset, and age-specific composition ratios. Standardization was performed based on the Segi’s world population. Birth cohorts (1929–2019) were analyzed to assess PCa incidence by birth year. Trend analysis was conducted using the Joinpoint Regression Model, and average annual percent changes (AAPCs) with corresponding 95% confidence interval (CI) were computed. A linear regression model was used to analyze the relationship between the average age at diagnosis and calendar years; (3) Results: The ASIRs of PCa in Jiangsu Province increased significantly, with an AAPC of 11.25% (95%CI: 10.09%, 12.42%) from 2009 to 2019. This increase was observed across all age groups, particularly among those aged 0–59 years. Birth cohort analysis revealed a rising trend with earlier birth years showing higher incidence, notably in the 1959 cohort. In rural areas, the age-standardized average age at onset of PCa decreased from 75.45 years in 2009 to 73.39 years in 2019, and the peak age group shifted from 75–79 years in 2009 to 70–74 years in 2019; (4) Conclusions: The rising incidence of PCa in Jiangsu Province, along with an increased proportion of cases in younger age groups, highlights the need for targeted interventions. Full article
(This article belongs to the Special Issue New and Emerging Trends in Prostate Cancer)
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18 pages, 308 KiB  
Review
Immunotherapy in Patients with Advanced Non-Small-Cell Lung Cancer Under-Represented by Clinical Trials
by Daniel E. Meyers, Rebekah Rittberg, David E. Dawe and Shantanu Banerji
Curr. Oncol. 2024, 31(9), 5498-5515; https://doi.org/10.3390/curroncol31090407 - 14 Sep 2024
Viewed by 1915
Abstract
Since the initial US FDA approval of an immune checkpoint inhibitor (ICI) for the treatment of non-oncogene-driven non-small-cell lung cancer (NSCLC) nine years ago, this therapeutic strategy has been cemented as a crucial component of treatment for most of these patients. However, there [...] Read more.
Since the initial US FDA approval of an immune checkpoint inhibitor (ICI) for the treatment of non-oncogene-driven non-small-cell lung cancer (NSCLC) nine years ago, this therapeutic strategy has been cemented as a crucial component of treatment for most of these patients. However, there is a clear efficacy–effectiveness gap whereby patients in the ‘real world’ seem to have more modest clinical outcomes compared to those enrolled in landmark clinical trials. This gap may be driven by the under-representation of important patient populations, including populations defined by clinical or molecular characteristics. In this review, we summarize the data outlining the evidence of ICIs in patients with poor Eastern Cooperative Oncology Group performance status (ECOG PS), underlying autoimmune disease (AID), older age, active brain metastases (BMs), and molecular aberrations such as EGFR mutations, ALK fusions, BRAF mutations and ROS1 fusions. Full article
(This article belongs to the Special Issue Immunotherapy in Thoracic Malignancies)
14 pages, 619 KiB  
Review
Shared-Care in Complex Malignant Hematology: An Integrative Review Using the RE-AIM Evaluation Framework
by Shannon M. Nixon, Dawn C. Maze, Monica Parry and Samantha J. Mayo
Curr. Oncol. 2024, 31(9), 5484-5497; https://doi.org/10.3390/curroncol31090406 - 14 Sep 2024
Viewed by 994
Abstract
Complex malignant hematology (CMH) shared-care programs have been established to support patients with access to care closer to home. This integrative review examined what is known about CMH shared-care using the RE-AIM evaluation framework. We searched five electronic databases for articles published until [...] Read more.
Complex malignant hematology (CMH) shared-care programs have been established to support patients with access to care closer to home. This integrative review examined what is known about CMH shared-care using the RE-AIM evaluation framework. We searched five electronic databases for articles published until 16 January 2024. Articles were included if they were qualitative or quantitative studies, reviews or discussion papers, and reported on an experience with shared-care (defined as a reciprocal, ongoing patient-sharing relationship between a specialist centre and community hospital) for patients with hematological malignancies, and examined one or more aspects of the RE-AIM framework. The search yielded 6523 articles; 10 articles describing eight shared-care experiences. Indicators of reach were reported for 65% of the programs, and emphasized some patient eligibility criteria. Effectiveness indicators were reported for 28% of programs, and suggested favourable survival outcomes within a shared-care model; however, health system impact and quality of life studies were lacking. Indicators of adoption and implementation were reported for 56% and 42% of programs, respectively, and emphasized multidisciplinary teams, infrastructure support, and communication strategies. Maintenance was not reported. Common elements contribute to the implementation of existing CMH shared-care programs; however, a formal evaluation remains an area of need. Full article
(This article belongs to the Section Oncology Nursing)
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12 pages, 240 KiB  
Article
Trace Element Concentrations of Arsenic and Selenium in Toenails and Risk of Prostate Cancer among Pesticide Applicators
by Leslie K. Dennis, Marvin E. Langston, Laura Beane Freeman, Robert A. Canales and Charles F. Lynch
Curr. Oncol. 2024, 31(9), 5472-5483; https://doi.org/10.3390/curroncol31090405 - 14 Sep 2024
Viewed by 783
Abstract
Prostate cancer is a common cancer among males in the US, but little is known about its risk factors, including trace elements. The primary aim of this study was to examine prostate cancer and its association with arsenic and selenium in toenails. We [...] Read more.
Prostate cancer is a common cancer among males in the US, but little is known about its risk factors, including trace elements. The primary aim of this study was to examine prostate cancer and its association with arsenic and selenium in toenails. We conducted a small, nested case-control study of men residing in Iowa within the Agricultural Health Study cohort, where we also collected toenail samples to test for arsenic and other trace elements. Toenail samples were sent for neutron activation analysis aimed at long-lived trace elements, including arsenic. Logistic regression was used to estimate odds ratios (ORs) for trace element exposures and prostate cancer. A total of 66 prostate cancer cases and 173 healthy controls returned questionnaires, over 99% of which included toenail samples. An increased risk was seen for the highest levels of arsenic (OR = 3.4 confidence interval (CI) of 1.3–8.6 and OR = 2.2, 95% CI of 0.9–5.6) and the highest level of selenium (2.0, 95% CI of 1.0–4.0). These data also show detectable levels of over 50% for 14 of 22 elements detected in the toenails. The association seen here with arsenic and prostate cancer further supports ecological studies finding an association with community levels of arsenic and prostate cancer incidence and mortality. Full article
10 pages, 1325 KiB  
Article
Prognostic Value of Performance Status, Albumin, and CRP in Last-Line Chemotherapy for Pancreatic vs. Other Gastrointestinal Cancers—Simple Tools Matter
by Arne Westgaard, Aleksandra Pirnat, Marianne Jensen Hjermstad, Nina Aass, Stein Kaasa and Olav Faisal Dajani
Curr. Oncol. 2024, 31(9), 5462-5471; https://doi.org/10.3390/curroncol31090404 - 14 Sep 2024
Viewed by 799
Abstract
Patients with advanced gastrointestinal cancers often receive chemotherapy near the end of life (EoL), raising concerns about overtreatment. The PALLiON trial, a cluster-randomized trial, assessed the impact of a complex intervention on frequency of EoL treatment; the intervention involved palliative care referrals and [...] Read more.
Patients with advanced gastrointestinal cancers often receive chemotherapy near the end of life (EoL), raising concerns about overtreatment. The PALLiON trial, a cluster-randomized trial, assessed the impact of a complex intervention on frequency of EoL treatment; the intervention involved palliative care referrals and the use of PROMs. The present secondary analysis evaluated the prognostic value of baseline performance status (PS), albumin (alb), C-reactive protein (CRP), and body mass index (BMI) for overall survival, comparing pancreatic (PAN, n = 189) vs. other gastrointestinal cancer patients (GI, n = 286). Baseline PS, alb, CRP, mGPS (modified Glasgow prognostic score), and BMI were analyzed using Cox regression. Adjusted for age, sex, and hospital size, PS ≥ 2 and alb < 35 g/L predicted shorter survival in both PAN and GI cancers, while CRP > 10 predicted shorter survival only in GI cancers. In PAN, PS ≥ 2 predicted a 78.4% higher probability of shorter survival, and mGPS 2 predicted a 68.7% higher probability. In GI, mGPS 2 predicted a 70.8% higher probability, whereas PS was not significant. BMI did not improve predictive models. PS ≥ 2 and low albumin are strong predictors of short survival in PAN, whereas increased CRP and low albumin (mGPS 2) are predictors in GI. Full article
(This article belongs to the Special Issue New Frontiers in Treatment of Pancreatic Cancer)
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10 pages, 239 KiB  
Case Report
Insulinoma Unmasked: A Continuous Glucose Monitoring-Fueled Journey
by Andrijana Koceva and Mitja Krajnc
Curr. Oncol. 2024, 31(9), 5452-5461; https://doi.org/10.3390/curroncol31090403 - 14 Sep 2024
Viewed by 1065
Abstract
Insulinomas are rare functional neuroendocrine tumors that are usually indolent and small. Due to their rarity, there is often a delay in disease recognition and diagnosis, and small tumor size makes their localization challenging. Glucose monitoring and dietary modification with or without pharmacotherapy [...] Read more.
Insulinomas are rare functional neuroendocrine tumors that are usually indolent and small. Due to their rarity, there is often a delay in disease recognition and diagnosis, and small tumor size makes their localization challenging. Glucose monitoring and dietary modification with or without pharmacotherapy are crucial during diagnostics, and surgery is the only definite treatment. Continuous glucose monitoring (CGM) systems can be a valuable tool in managing insulinoma patients. We present three patients with confirmed endogenous hyperinsulinemic hypoglycemia undergoing tumor localization, medical treatment, and surgery while wearing a CGM system. By accurately depicting glucose fluctuations, CGM can help prevent hypoglycemia, decrease hypoglycemia unawareness, track hypoglycemia frequency, aid in medical therapy dose titration, and confirm a cure after surgery. Full article
13 pages, 957 KiB  
Article
Evaluating the Effects of Prostate Radiotherapy Intensified with Pelvic Nodal Radiotherapy and Androgen Deprivation Therapy on Myelosuppression: Single-Institution Experience
by Yousef Katib, Steven Tisseverasinghe, Ian J. Gerard, Benjamin Royal-Preyra, Ahmad Chaddad, Tania Sasson, Boris Bahoric, Federico Roncarolo and Tamim Niazi
Curr. Oncol. 2024, 31(9), 5439-5451; https://doi.org/10.3390/curroncol31090402 - 13 Sep 2024
Viewed by 805
Abstract
Background: Prostate cancer (PCa) management commonly involves the utilization of prostate radiotherapy (PRT), pelvic nodal radiotherapy (PNRT), and androgen deprivation therapy (ADT). However, the potential association of these treatment modalities with bone marrow (BM) suppression remains inadequately reported in the existing literature. This [...] Read more.
Background: Prostate cancer (PCa) management commonly involves the utilization of prostate radiotherapy (PRT), pelvic nodal radiotherapy (PNRT), and androgen deprivation therapy (ADT). However, the potential association of these treatment modalities with bone marrow (BM) suppression remains inadequately reported in the existing literature. This study is designed to comprehensively evaluate the risk of myelosuppression associated with PRT, shedding light on an aspect that has been underrepresented in prior research. Materials and Methods: We conducted a retrospective analysis of 600 patients with prostate cancer (PCa) treated with prostate radiotherapy (PRT) at a single oncology center between 2007 and 2017. Patients were categorized into four cohorts: PRT alone (n = 149), PRT + ADT, (n = 91), PRT + PNRT (n = 39), and PRT + PNRT + ADT (n = 321). To assess the risk of myelosuppression, we scrutinized specific blood parameters, such as hemoglobin (HGB), white blood cells (WBCs), neutrophils (NEUT), lymphocytes (LYM), and platelets (PLT) at baseline, mid-treatment (mRT), immediately post-RT (pRT), 1 month post-RT (1M-pRT), and 1 year post-RT (1Y-pRT). The inter-cohort statistical significance was evaluated with further stratification based on the utilized RT technique {3D conformal radiotherapy (3D-CRT), and intensity-modulated radiation therapy (IMRT)}. Results: Significant statistical differences at baseline were observed in HGB and LYM values among all cohorts (p < 0.05). Patients in the PRT + PNRT + ADT cohort had significantly lower HGB at baseline and 1M-pRT. In patients undergoing ADT, BMS had a significant impact at 1M-pRT {odds ratio (OR) 9.1; 95% Confidence Interval (CI) 4.8–17.1} and at 1Y-pRT (OR 2.84; CI 1.14–7.08). The use of 3D-CRT was linked to reduced HGB levels in the PRT + PNRT + ADT group at 1 month pRT (p = 0.015). Similarly, PNRT significantly impacted BMS at 1M-pRT (OR 6.7; CI 2.6–17.2). PNRT increased the odds of decreased WBC counts at 1Y-pRT (OR 6.83; CI: 1.02–45.82). Treatment with any RT techniques (3D-CRT or IMRT), particularly in the PRT + PNRT and PRT + PNRT + ADT groups, significantly increased the odds of low LYM counts at all time points except immediately pRT (p < 0.05). Furthermore, NEUT counts were considerably lower at 1M-pRT (p < 0.05) in the PRT + PNRT + ADT group. PLT counts were significantly decreased by PRT + PNRT + ADT at mRT (OR 2.57; 95% CI: 1.42–4.66) but were not significantly impacted by the RT technique. Conclusions: Treatment with PRT, ADT, PNRT, and 3D-CRT is associated with BMS. Despite this statistically significant risk, no patient required additional interventions to manage the outcome. While its clinical impact appears limited, its importance cannot be underestimated in the context of increased integration of novel systemic agents with myelosuppressive properties. Longer follow-up should be considered in future studies. Full article
(This article belongs to the Special Issue New and Emerging Trends in Prostate Cancer)
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17 pages, 707 KiB  
Systematic Review
Exploring the Efficacy of Combining Radiofrequency Thermal Ablation or Microwave Ablation with Vertebroplasty for Pain Control and Disease Management in Metastatic Bone Disease—A Systematic Review
by Eliodoro Faiella, Federica Vaccarino, Giuseppina Pacella, Domiziana Santucci, Elva Vergantino, Amalia Bruno, Raffaele Ragone, Bruno Beomonte Zobel and Rosario Francesco Grasso
Curr. Oncol. 2024, 31(9), 5422-5438; https://doi.org/10.3390/curroncol31090401 - 13 Sep 2024
Cited by 1 | Viewed by 954
Abstract
Background: Interventional radiology techniques have become pivotal in recent years in managing metastatic bone disease, which frequently results in skeletal complications such as fractures and severe pain. Thermoablative methods like radiofrequency ablation (RFA) and microwave ablation (MWA), when combined with vertebroplasty (VP), are [...] Read more.
Background: Interventional radiology techniques have become pivotal in recent years in managing metastatic bone disease, which frequently results in skeletal complications such as fractures and severe pain. Thermoablative methods like radiofrequency ablation (RFA) and microwave ablation (MWA), when combined with vertebroplasty (VP), are proving increasingly beneficial for these patients. Methods: The search was independently conducted by two radiologists on MEDLINE databases, using specified strings up to April 2024. Methodological quality was assessed using PRISMA guidelines. Studies meeting inclusion criteria investigated thermoablation techniques (RFA and/or MWA) combined with VP, focusing on pain management and disease control outcomes in adults. Results: Among 147 results, 42 articles met the criteria, with varied prospective and retrospective designs and sample sizes averaging 49 patients, predominantly involving RFA (30 studies), MWA (11 studies), and one comparative study. Our review highlights significant pain reduction, effective local tumor control, and favorable safety of combined RFA or MWA with VP, supporting its potential in managing vertebral pathologies and warranting further clinical integration. Conclusions: The combined treatment of RFA/MWA with VP demonstrates significant pain reduction and local tumor control, with a rapid onset of analgesic effect. These findings support its crucial role in clinical practice for managing vertebral metastases. Full article
(This article belongs to the Special Issue 2nd Edition: Treatment of Bone Metastasis)
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10 pages, 1381 KiB  
Case Report
Mogamulizumab and Concomitant Hypofractionated Low-Dose Total Skin Electron Beam Therapy (2 × 4 Gy) in Cutaneous T-Cell Lymphoma: Proof of Principle, Report of Two Cases
by Mathias Oymanns, Michael Daum-Marzian and Chalid Assaf
Curr. Oncol. 2024, 31(9), 5412-5421; https://doi.org/10.3390/curroncol31090400 - 13 Sep 2024
Viewed by 764
Abstract
Patients with advanced-stage mycosis fungoides (MF IIB–IVB) and Sézary syndrome (SS) have poor prognoses, with survival ranging from 4.7 to 1.4 years depending on the disease stage. There is a need for therapeutic approaches that lead to long-lasting responses and improved quality of [...] Read more.
Patients with advanced-stage mycosis fungoides (MF IIB–IVB) and Sézary syndrome (SS) have poor prognoses, with survival ranging from 4.7 to 1.4 years depending on the disease stage. There is a need for therapeutic approaches that lead to long-lasting responses and improved quality of life and survival. Mogamulizumab, a humanized antibody against the CCR4 molecule, and low-dose total skin electron beam therapy (TSEBT) are two known established treatments for MF and SS as a monotherapy. However, little is known about the potential additive effect on the combination of both treatments. We report here for the first time the concurrent use of low-dose hypofractionated TSEBT (2 × 4 Gy) with mogamulizumab. Based on two relapsed/refractory and advanced-stage CTCL patients, we show that this combination may be well tolerated in advanced-stage MF or SS and may potentially lead to an additive treatment effect on response times, particularly in the skin and blood within two weeks. We propose that this combination may be a treatment option for patients with SS. Further research is needed to understand the efficacy and tolerability profile of this therapeutic combination and to determine if there is an additive effect of the combination on the response rates when compared with the monotherapy. Full article
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13 pages, 652 KiB  
Article
Self-Screening for Cervical Cancer Offered through a Digital Platform in a Region of British Columbia with Lower Screening Rates
by Laurie W. Smith, Amy Booth, C. Sarai Racey, Brenda Smith, Ashwini Prabhakaran, Smritee Dabee, Quan Hong, Nazia Niazi and Gina S. Ogilvie
Curr. Oncol. 2024, 31(9), 5399-5411; https://doi.org/10.3390/curroncol31090399 - 13 Sep 2024
Viewed by 1131
Abstract
Cervical cancer is highly preventable through vaccination, early detection, and treatment, yet is the fourth most common cancer globally. HPV testing is superior to cytology for the detection of cervical pre-cancer, and jurisdictions around the world are implementing HPV primary screening, which offers [...] Read more.
Cervical cancer is highly preventable through vaccination, early detection, and treatment, yet is the fourth most common cancer globally. HPV testing is superior to cytology for the detection of cervical pre-cancer, and jurisdictions around the world are implementing HPV primary screening, which offers the opportunity for self-screening, an important self-care intervention. Digital health solutions are also increasingly important components of self-care. In this study, we assessed the acceptability and completion of self-screening for cervical cancer offered through a digital platform within a low screening uptake region of British Columbia. The primary objective of this study was to evaluate the acceptability of self-screening for cervical cancer offered through a digital platform as measured by return rates of self-screening kits. Patients due or overdue for cervix screening were invited to participate. Eligible participants registered online to receive a self-screening kit, which included a device for vaginal self-screening, instructions, and a return envelope, sent to their home. After self-screening using the vaginal device, HPV testing was conducted. HPV-negative participants were returned to routine screening, and HPV-positive participants were recommended for cytology or colposcopy. Attendance rates at follow-up were evaluated. Participants were invited to complete an acceptability survey. From April 2019 to December 2023, 283 participants were sent kits, with 207 kits returned for a completion rate of 73%. Of valid samples (n = 202), 15 were HPV positive, and 93% attended follow-up care. Most respondents found the CervixCheck website easy to use, informative, and secure and were satisfied with receiving their results online. CervixCheck had a high completion rate among participants who were sent a self-screening kit. High compliance with recommended follow-up and high acceptability of self-screening for cervical cancer was observed. Most participants indicated they would self-screen again in the future. Innovative approaches to cervical screening, including self-screening and the use of digital health interventions, are ways to enhance equity and improve uptake of cervical screening. Full article
(This article belongs to the Special Issue Action and Impact: Prevention and Screening Strategies Contributing to the Elimination of Cervical Cancer)
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15 pages, 1627 KiB  
Case Report
Cardiac Metastasis from Myxoid Liposarcoma Managed Successfully with Chemotherapy and Radiotherapy: Case Report and Review of the Literature
by Georgios M. Stergiopoulos, Brittany L. Siontis, Ivy A. Petersen, Matthew T. Houdek, Thanh P. Ho, Scott H. Okuno and Steven I. Robinson
Curr. Oncol. 2024, 31(9), 5384-5398; https://doi.org/10.3390/curroncol31090398 - 12 Sep 2024
Viewed by 767
Abstract
Background: Liposarcoma, one of the most prevalent sarcoma histologies, is recognized for its tendency for extra-pulmonary metastases. While oligometastatic cardiac disease is rarely reported, it poses a unique challenge as oligometastatic sarcomas are often managed with surgical resection. Case Report: We present a [...] Read more.
Background: Liposarcoma, one of the most prevalent sarcoma histologies, is recognized for its tendency for extra-pulmonary metastases. While oligometastatic cardiac disease is rarely reported, it poses a unique challenge as oligometastatic sarcomas are often managed with surgical resection. Case Report: We present a case of a 62-year-old man diagnosed with an oligometastatic myxoid liposarcoma (MLPS) to the heart 19 years after the primary tumor resection from the lower limb. The metastatic mass, situated in the pericardium adjacent and infiltrating the left ventricle, was not managed surgically but with a combination of chemotherapy and radiotherapy. The patient’s disease remains stable to date, for more than 10 years. Literature Review: We conducted a review of the literature to determine the preferred management approach for solitary cardiac metastases of sarcomas. We also conducted an in-depth analysis focusing on reported cases of MLPS metastasizing to the heart, aiming to extract pertinent data regarding the patient characteristics and the corresponding management strategies. Conclusions: Although clinical diagnoses of solitary or oligometastatic cardiac metastases from sarcomas are infrequent, this case underscores the significance of aggressive management employing chemotherapy and radiotherapy for chemosensitive and radiosensitive sarcomas, especially when surgical removal is high-risk. Furthermore, it challenges the notion that surgery is the exclusive therapeutic option leading to long-term clinical benefit in patients with recurrent sarcomas. Full article
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10 pages, 1937 KiB  
Review
Therapeutic Prospects of Abemaciclib for Patients with Endometrial Cancer
by Ahmad Awada and Sarfraz Ahmad
Curr. Oncol. 2024, 31(9), 5374-5383; https://doi.org/10.3390/curroncol31090397 - 12 Sep 2024
Viewed by 983
Abstract
Endometrial cancer (EC) is a common gynecologic malignancy with a rising incidence due to obesity, comorbid conditions, and related lifestyle factors. The standard of care for primary disease consists of surgical resection with/without chemotherapy ± radiotherapy for select patients. Recurrence is common in [...] Read more.
Endometrial cancer (EC) is a common gynecologic malignancy with a rising incidence due to obesity, comorbid conditions, and related lifestyle factors. The standard of care for primary disease consists of surgical resection with/without chemotherapy ± radiotherapy for select patients. Recurrence is common in patients with advanced-stage disease and/or high-risk features, who primarily are treated with systemic therapy. The identification of novel targets in malignant EC has led to the development of wide-range inhibitors. Abemaciclib is an orally active unique cyclin-dependent kinase (CDK) inhibitor, selective for the CDK4 and CDK6 cell cycle pathways. This agent has potential anti-neoplastic activity and is indicated in combination with various therapies such as endocrine therapy, aromatase inhibitors, and hormone therapies, primarily in breast cancer (BC). Herein, we sought to summarize the biochemical/pharmacological properties of abemaciclib and its therapeutic potential in EC. While the therapeutic role(s) of abemaciclib was fairly established in a subset of patients with advanced/metastatic BC through the pivotal MONARCH trials, its attributes and clinical utility in EC are limited. Thus, based on some promising pre-clinical/translational insights and a recent phase II study, we highlight abemaciclib’s properties and potential clinical usefulness in patients with EC, particularly in recurrent estrogen-receptor-positive cases. Full article
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7 pages, 193 KiB  
Brief Report
Disparities in Clinical Trial Participation: A Cross-Sectional Survey of Cancer Patients at a Midwest Academic Medical Center
by Katie Moreland, Melinda Butsch Kovacic, Shesh Rai and Davendra Sohal
Curr. Oncol. 2024, 31(9), 5367-5373; https://doi.org/10.3390/curroncol31090396 - 11 Sep 2024
Viewed by 1140
Abstract
Research conducted on homogenous populations can lead to biased and misleading findings, impeding the development of effective interventions and treatments for diverse populations. Low participation among minority groups further leads to disparities in access to innovative cancer care and treatment outcomes associated with [...] Read more.
Research conducted on homogenous populations can lead to biased and misleading findings, impeding the development of effective interventions and treatments for diverse populations. Low participation among minority groups further leads to disparities in access to innovative cancer care and treatment outcomes associated with trial participation. To better understand cancer patients’ attitudes and willingness to participate in clinical trials, solid tumor patients attending their clinic visits were invited to complete a survey. The survey included questions on demographics, previous trial participation, and future trial interest. Responses were analyzed with frequency tables and chi-square tests. Of 300 participants, only 96 (32%) were asked to participate in a clinical trial. Of these, 81 (84%) chose to participate and 15 (16%) did not. There were notable differences by race but not gender or education level. Of the 204 who had never been asked to participate, 70% indicated that they would be willing to participate in future, and there was a strong sex–race interaction. Non-White males were the most hesitant group. Of 204, 99% indicated that they would participate to access new treatments, and 57% would participate to contribute to research overall. This study shows that many solid tumor patients undergoing treatment are not offered clinical trials. Racial differences in attitudes toward trial participation are evident. Nonetheless, many patients are willing to participate in trials to access innovative treatments and to support research. Culturally relevant outreach to build trust with minority groups is needed to increase overall participation in clinical trials. Full article
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13 pages, 278 KiB  
Article
Biopsychosocial Associates of Psychological Distress and Post-Traumatic Growth among Canadian Cancer Patients during the COVID-19 Pandemic
by Karen M. Zhang, Som D. Mukherjee, Gregory Pond, Michelle I. Roque, Ralph M. Meyer, Jonathan Sussman, Peter M. Ellis and Denise Bryant-Lukosius
Curr. Oncol. 2024, 31(9), 5354-5366; https://doi.org/10.3390/curroncol31090395 - 10 Sep 2024
Viewed by 914
Abstract
Objective: Understanding both the positive and negative psychological outcomes among cancer patients during the pandemic is critical for planning post-pandemic cancer care. This study (1) examined levels of psychological distress and post-traumatic growth (PTG) among Canadian cancer patients during the COVID-19 pandemic and [...] Read more.
Objective: Understanding both the positive and negative psychological outcomes among cancer patients during the pandemic is critical for planning post-pandemic cancer care. This study (1) examined levels of psychological distress and post-traumatic growth (PTG) among Canadian cancer patients during the COVID-19 pandemic and (2) explored variables that were associated with psychological distress and PTG during the pandemic using a biopsychosocial framework. Method: A cross-section survey was undertaken of patients receiving ongoing care at a regional cancer centre in Ontario, Canada, between February and December 2021. Self-reported questionnaires assessing sociodemographic information, social difficulties, psychological distress (depression, anxiety fear of recurrence, and emotional distress), PTG, illness perceptions, and behavioural responses to the pandemic were administered. Disease-related information was extracted from patient health records. Results: Prevalences of moderate to severe levels of depression, anxiety, fear of recurrence and emotional distress were reported by 26.0%, 21.2%, 44.2%, and 50.0% of the sample (N = 104), respectively. Approximately 43% of the sample reported experiencing high PTG, and these positive experiences were not associated with levels of distress. Social factors, including social difficulties, being female, lower education, and unemployment status were prominent associative factors of patient distress. Perceptions of the pandemic as threatening, adopting more health safety behaviours, and not being on active treatment also increased patient likelihood to experience severe psychological distress. Younger age and adopting more health safety behaviours increased the likelihood of experiencing high PTG. The discriminatory power of the predictive models was strong, with a C-statistic > 0.80. Conclusions: Examining both the positive and negative psychological patient outcomes during the pandemic has highlighted the complex range of coping responses. Interventions that adopt a multi-pronged approach to screen and address social distress, as well as to leverage health safety behaviours, may improve the adjustments in the pandemic aftermath. Full article
10 pages, 1735 KiB  
Article
Low CD8+ Density Variation and R1 Surgical Margin as Independent Predictors of Early Post-Resection Recurrence in HCC Patients Meeting Milan Criteria
by Rokas Stulpinas, Ieva Jakiunaite, Agne Sidabraite, Allan Rasmusson, Dovile Zilenaite-Petrulaitiene, Kestutis Strupas, Arvydas Laurinavicius and Aiste Gulla
Curr. Oncol. 2024, 31(9), 5344-5353; https://doi.org/10.3390/curroncol31090394 - 10 Sep 2024
Viewed by 618
Abstract
Our study included 41 patients fulfilling the Milan criteria preoperatively and aimed to identify individuals at high risk of post-resection HCC relapse, which occurred in 18 out of 41 patients (43.9%), retrospectively. We analyzed whole slide images of CD8 immunohistochemistry with automated segmentation [...] Read more.
Our study included 41 patients fulfilling the Milan criteria preoperatively and aimed to identify individuals at high risk of post-resection HCC relapse, which occurred in 18 out of 41 patients (43.9%), retrospectively. We analyzed whole slide images of CD8 immunohistochemistry with automated segmentation of tissue classes and detection of CD8+ lymphocytes. The image analysis outputs were subsampled using a hexagonal grid-based method to assess spatial distribution of CD8+ lymphocytes with regards to the epithelial edges. The CD8+ lymphocyte density indicators, along with clinical, radiological, post-surgical and pathological variables, were tested to predict HCC relapse. Low standard deviation of CD8+ density along the tumor edge and R1 resection emerged as independent predictors of shorter recurrence-free survival (RFS). In particular, patients presenting with both adverse predictors exhibited 100% risk of relapse within 200 days. Our results highlight the potential utility of integrating CD8+ density variability and surgical margin to identify a high relapse-risk group among Milan criteria-fulfilling HCC patients. Validation in cohorts with core biopsy could provide CD8+ distribution data preoperatively and guide preoperative decisions, potentially prioritizing liver transplantation for patients at risk of incomplete resection (R1) and thereby improving overall treatment outcomes significantly. Full article
(This article belongs to the Special Issue Novel Biomarkers and Liver Cancer)
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