Current Oncology

20 pages, 2493 KiB

Open AccessArticle

The PREPARE Study: Acceptability and Feasibility of a Telehealth Trimodal Prehabilitation Program for Women with Endometrial Neoplasia

by Elise P. Legault, Paula A. B. Ribeiro, Danielle Moreau-Amaru, Emmanuelle Robert, Sara Forte, Alain S. Comtois, Vanessa Samouëlian and François Tournoux

Curr. Oncol. 2025, 32(1), 55; https://doi.org/10.3390/curroncol32010055 - 20 Jan 2025

Viewed by 604

Abstract

Patients with endometrial neoplasia (EN) often have multiple comorbidities and a higher surgical risk. Prehabilitation programs (PPs) combine various interventions to improve preoperative conditions and reduce impairment due to surgical stress. We conducted a pragmatic pilot study to evaluate the acceptability and feasibility [...] Read more.

Patients with endometrial neoplasia (EN) often have multiple comorbidities and a higher surgical risk. Prehabilitation programs (PPs) combine various interventions to improve preoperative conditions and reduce impairment due to surgical stress. We conducted a pragmatic pilot study to evaluate the acceptability and feasibility of a trimodal telehealth PP (exercise, nutrition, and psychological support) for EN patients. The participants could select their exercise group: (1) a supervised PP (SPP), group sessions 3×/week; (2) a semi-supervised PP (SSPP), group session 1×/week, training alone 2×/week; or (3) a physical activity counseling session (PACS). Out of the 150 EN patients awaiting surgery screened during the 18 months of the study recruitment, 66% (99/150) were eligible, and 40% consented to participate (SPP, n = 13; SSPP, n = 17; PACS, n = 9). The overall dropout was low (13%; 5/39), with no significant differences across groups. No serious adverse events occurred. We observed a positive impact on different outcomes across the different groups, such as in the Functional Assessment of Cancer Therapy quality of life score (SPP; delta = 6.1 [CI: 0.9; 12.6]) and functional capacity measured using the 30″ sit-to-stand test (PACS delta = 2.4 [CI: 1.2; 3.6]). The same-day hospital leave was high in the SSPP group (54.5%). Our pilot telehealth PP seems to be safe, feasible, and well accepted and may procure clinical and patient-centered gains that need to be confirmed in a larger trial. Full article

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

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15 pages, 8342 KiB

Open AccessArticle

MicroRNA-129-3p Suppresses Tumor Progression and Chemoradioresistance in Head and Neck Squamous Cell Carcinoma

by Tae Mi Yoon, Sun-Ae Kim, Eun Kyung Jung, Young-Kook Kim, Kyung-Hwa Lee and Sang Chul Lim

Curr. Oncol. 2025, 32(1), 54; https://doi.org/10.3390/curroncol32010054 - 20 Jan 2025

Viewed by 591

Abstract

(1) Background: MicroRNA-129 (miR-129) participates in tumor progression and chemoresistance in various cancer types. In this study, the role of miR-129-3p, the main mature form of miR-129, in tumor progression and chemoradiotherapy resistance in head and neck cancer was evaluated. (2) Methods: RT-PCR, [...] Read more.

(1) Background: MicroRNA-129 (miR-129) participates in tumor progression and chemoresistance in various cancer types. In this study, the role of miR-129-3p, the main mature form of miR-129, in tumor progression and chemoradiotherapy resistance in head and neck cancer was evaluated. (2) Methods: RT-PCR, western blotting, cell proliferation assays, cell apoptosis assays, and cell invasion and migration assays were used. (3) Results: In this study, the miR-129-3p overexpression suppressed the proliferation, invasion, and migration of SNU1041, SCC15, and SCC25 human HNSCC cell lines. Additionally, it induced apoptosis and enhanced radiation-/cisplatin-induced apoptosis of SNU1041, SCC15, and SCC25 cells. Therefore, miR-129-3p could suppress tumor progression and enhance chemoradiosensitivity in human HNSCC. Furthermore, miR-129-3p was downregulated in fresh tumor tissues from patients with HNSCC compared with that in the adjacent normal mucosa. In a nude mouse xenograft model with SNU15 cells, the miR-129-3p overexpression significantly decreased tumor growth, as measured by tumor weight and volume. (4) Conclusions: Our study provides evidence that miR-129-3p suppresses tumor progression and chemoradioresistance in HNSCC. This finding may serve as a basis for developing miR-129-3p-based therapeutic strategies. Full article

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

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30 pages, 2550 KiB

Open AccessSystematic Review

Systematic Review and Network Meta-Analysis on Treating Hormone Receptor-Positive Metastatic Breast Cancer After CDK4/6 Inhibitors

by Neha Pathak, Abhenil Mittal, Sudhir Kumar, Chitrakshi Nagpal, Eitan Amir, Partha Haldar, Bharath B. Gangadharaiah, Akash Kumar, Ashutosh Mishra and Atul Batra

Curr. Oncol. 2025, 32(1), 53; https://doi.org/10.3390/curroncol32010053 - 20 Jan 2025

Viewed by 774

Abstract

Introduction: The optimal treatment of estrogen receptor-positive (ER +) metastatic breast cancer (MBC) after progression on cyclin-dependent 4/6 kinase inhibitors (CDK4/6i) is unknown. Methods: We conducted a systematic review and network meta-analysis (NMA) of phase-II/-III randomized trials of ER + MBC post CDK4/6i [...] Read more.

Introduction: The optimal treatment of estrogen receptor-positive (ER +) metastatic breast cancer (MBC) after progression on cyclin-dependent 4/6 kinase inhibitors (CDK4/6i) is unknown. Methods: We conducted a systematic review and network meta-analysis (NMA) of phase-II/-III randomized trials of ER + MBC post CDK4/6i + ET progression. We calculated the hazard ratio (HR) for progression-free survival (PFS) and overall survival (OS) using generic inverse variance and odds ratios (ORs) using the Mantel–Haenszel method for adverse events (AEs) with Review-Manager version-5.4. NMA was executed using WINBUGS (Microsoft Excel). Three molecular subgroups were analyzed: HER2-low, PI3K/AKT/mTOR, and the ESR1 mutation subgroup for selective estrogen receptor degrader (SERD). Results: A total of 14 studies were included. In the HER2-low group, Sacituzumab govitecan and trastuzumab deruxtecan had a similar efficacy (HR, 95% CI): PFS (0.98; 0.63–1.43) and OS (1.08; 0.76–1.55). In PI3K/AKT/mTOR-altered cases, capivasertib was superior to alpelisib PFS (0.77; 0.53–1.12), and OS (0.80; 0.48–1.35). SERDs had worse PFS and OS versus ongoing CDK 4/6i (ribociclib). Conclusion: No therapy emerged as the unequivocal choice in the post-CDK 4/6i domain in unselected subgroups. In the HER2-low population, a similar efficacy and different toxicity spectrum was seen. In AKT-altered tumors, capivasertib was less toxic than alpelisib. PROSPERO ID: CRD4202236412. Full article

(This article belongs to the Section Breast Cancer)

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8 pages, 728 KiB

Open AccessCommunication

Real-World Experience with CDK4/6 Inhibitors in the First-Line Palliative Setting for HR+/HER2− Advanced Breast Cancer

by Ram Patel, John Mathews, Caroline Hamm, Swati Kulkarni, Rasna Gupta, Tarquin Opperman, John Dean Chiong and Abdullah Nasser

Curr. Oncol. 2025, 32(1), 52; https://doi.org/10.3390/curroncol32010052 - 20 Jan 2025

Viewed by 699

Abstract

Introduction: CDK4/6 inhibitors in combination with aromatase inhibitors (AIs) are the standard first-line treatment for hormone receptor-positive (HR+), HER2-negative (HER2−) metastatic breast cancer. Landmark trials have demonstrated a comparable progression-free survival (PFS) across CDK4/6 inhibitors, but the overall survival (OS) outcomes have varied. [...] Read more.

Introduction: CDK4/6 inhibitors in combination with aromatase inhibitors (AIs) are the standard first-line treatment for hormone receptor-positive (HR+), HER2-negative (HER2−) metastatic breast cancer. Landmark trials have demonstrated a comparable progression-free survival (PFS) across CDK4/6 inhibitors, but the overall survival (OS) outcomes have varied. This study aimed to evaluate the real-world PFS and OS for palbociclib and ribociclib when combined with AIs in patients with HR+/HER2− advanced breast cancer. Materials and Methods: This was a retrospective chart review of adult patients with HR+/HER2− metastatic breast cancer treated at a single academic center between 1 January 2015 and 1 December 2022. The baseline demographics, clinical characteristics, and treatment details were extracted. A Kaplan–Meier analysis was used to estimate the PFS and OS, and differences between the treatment groups were assessed using the log-rank test. Cox proportional hazards models were constructed to adjust for confounding factors. Results: Seventy-five patients were included in the final analysis. The cohort was predominantly female (98.7%) and postmenopausal (77.3%), with 52.0% having de novo stage IV disease. Palbociclib was prescribed to 74.7% of the patients, and ribociclib to 25.3%. The patients receiving ribociclib were significantly younger (57.6 vs. 67.5 years, p = 0.013) and more likely to be premenopausal (42.1% vs. 5.4%, p < 0.001). The real-world median PFS and OS for palbociclib were 20.3 months (95% CI: 14.8–46) and 37.2 months (95% CI: 20.3–not reached [NR]), respectively. For ribociclib, the median PFS and OS were not reached. The Cox proportional hazards models adjusting for age and menopausal status found no significant differences between ribociclib and palbociclib for the PFS (HR = 0.92, p = 0.86) or OS (HR = 0.95, p = 0.92). Conclusion: In this real-world analysis, palbociclib demonstrated a median PFS consistent with the results from landmark trials, although the observed OS was shorter. The ribociclib-treated patients had a numerically longer PFS and OS compared with those treated with palbociclib, but the differences were not statistically significant. The discontinuation rates were similar between the two groups. Full article

(This article belongs to the Special Issue Advances in Personalized Therapy for Breast Cancer)

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14 pages, 1349 KiB

Open AccessArticle

TP53 Mutation Predicts Worse Survival and Earlier Local Progression in Patients with Hepatocellular Carcinoma Treated with Transarterial Embolization

by Ken Zhao, Anita Karimi, Luke Kelly, Elena Petre, Brett Marinelli, Erica S. Alexander, Vlasios S. Sotirchos, Joseph P. Erinjeri, Anne Covey, Constantinos T. Sofocleous, James J. Harding, William Jarnagin, Carlie Sigel, Efsevia Vakiani, Etay Ziv and Hooman Yarmohammadi

Curr. Oncol. 2025, 32(1), 51; https://doi.org/10.3390/curroncol32010051 - 18 Jan 2025

Viewed by 501

Abstract

The aim of this study was to evaluate associations between TP53 status and outcomes after transarterial embolization (TAE) for the treatment of patients with hepatocellular carcinoma (HCC). This single-institution study included patients from 1/2014 to 6/2022 who underwent TAE of HCC and genomic [...] Read more.

The aim of this study was to evaluate associations between TP53 status and outcomes after transarterial embolization (TAE) for the treatment of patients with hepatocellular carcinoma (HCC). This single-institution study included patients from 1/2014 to 6/2022 who underwent TAE of HCC and genomic analysis of tumoral tissue. The primary outcome was overall survival (OS) with relation to TP53 status, and the secondary outcome was the time to progression. Survival analysis was performed using the Kaplan–Meier method. The time to progression with death or the last patient contact without progression as competing risks were used to obtain a cumulative incidence function, and the association with TP53 status was evaluated using the Gray test. In total, 75 patients (63 men) with a median age of 70.0 (IQR 62.0–76.3) years were included. Of these, 26/75 (34.7%) patients had TP53-mutant HCC. Patients with TP53-mutant HCC had a significantly worse median OS of 15.2 (95% CI, 9.5–29.3) months, versus 31.2 (95% CI, 21.2–52.4) months as the median OS (p = 0.023) for TP53 wild-type HCC. Competing risk analysis showed a shorter time to local hepatic progression (at the site of the previously treated tumor) after TAE in patients with TP53-mutant HCC. The cumulative incidences of local progression at 6 and 12 months for TP53-mutant HCC were 65.4% and 84.6%, versus 40.8% and 55.1% for TP53 wild-type HCC (p = 0.0072). A TP53 mutation may predict a worse overall survival and a shorter time to local progression in HCC patients treated with TAE. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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6 pages, 494 KiB

Open AccessCase Report

Extensive Morphea Following Adjuvant Radiotherapy for Breast Carcinoma—Case Report

by Alexandru Panaitescu, Hannah Nguyen, Laurence Masson-Côté and Carolina Lucena Fernandes

Curr. Oncol. 2025, 32(1), 50; https://doi.org/10.3390/curroncol32010050 - 18 Jan 2025

Viewed by 711

Abstract

Radiation-induced morphea (RIM) is a rare complication following radiotherapy (RT) for breast cancer treatment. Its distribution is usually confined to the breast having received radiotherapy. A generalized form of RIM also exists, defined as lesions extending beyond the radiotherapy site, but data on [...] Read more.

Radiation-induced morphea (RIM) is a rare complication following radiotherapy (RT) for breast cancer treatment. Its distribution is usually confined to the breast having received radiotherapy. A generalized form of RIM also exists, defined as lesions extending beyond the radiotherapy site, but data on the subject are scarce in the literature. This complication remains difficult to treat, due partly to the variable extent of disease and to individual clinical response rates to the wide array of available therapies, such as topical therapy (i.e., topical tacrolimus or topical corticosteroids), phototherapy, and systemic therapy (i.e., systemic immunosuppressants). We present a case of extensive morphea post RT for breast cancer with 2 years of favorable evolution under systemic therapy. Full article

(This article belongs to the Section Breast Cancer)

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12 pages, 2446 KiB

Open AccessArticle

Advancing Radiobiology: Investigating the Effects of Photon, Proton, and Carbon-Ion Irradiation on PANC-1 Cells in 2D and 3D Tumor Models

by Alexandra Charalampopoulou, Amelia Barcellini, Giuseppe Magro, Anna Bellini, Sara Sevan Borgna, Giorgia Fulgini, Giovanni Battista Ivaldi, Alessio Mereghetti, Ester Orlandi, Marco Giuseppe Pullia, Simone Savazzi, Paola Tabarelli De Fatis, Gaia Volpi and Angelica Facoetti

Curr. Oncol. 2025, 32(1), 49; https://doi.org/10.3390/curroncol32010049 - 18 Jan 2025

Viewed by 734

Abstract

Introduction: Pancreatic cancer (PC) is one of the most aggressive and lethal malignancies, calling for enhanced research. Pancreatic ductal adenocarcinoma (PDAC) represents 70–80% of all cases and is known for its resistance to conventional therapies. Carbon-ion radiotherapy (CIRT) has emerged as a promising [...] Read more.

Introduction: Pancreatic cancer (PC) is one of the most aggressive and lethal malignancies, calling for enhanced research. Pancreatic ductal adenocarcinoma (PDAC) represents 70–80% of all cases and is known for its resistance to conventional therapies. Carbon-ion radiotherapy (CIRT) has emerged as a promising approach due to its ability to deliver highly localized doses and unique radiobiological properties compared to X-rays. In vitro radiobiology has relied on two-dimensional (2D) cell culture models so far; however, these are not sufficient to replicate the complexity of the in vivo tumor architecture. Three-dimensional (3D) models become a paradigm shift, surpassing the constraints of traditional models by accurately re-creating morphological, histological, and genetic characteristics as well as the interaction of tumour cells with the microenvironment. Materials and Methods: This study investigates the survival of pancreatic cancer cells in both 2D and spheroids, a 3D model, following photon, proton, and carbon-ion irradiation by means of clonogenic, MTT, spheroid growth, and vitality assays. Results: Our results demonstrate that carbon ions are more efficient in reducing cancer cell survival compared to photons and protons. In 2D cultures, carbon-ion irradiation reduced cell survival to approximately 15%, compared to 45% with photons and 30% with protons. In the 3D culture model, spheroid growth was similarly inhibited by carbon-ion irradiation; however, the overall survival rates were higher across all irradiation modalities compared to the 2D cultures. Carbon ions consistently showed the highest efficacy in reducing cell viability in both models. Conclusions: Our research highlights the pivotal role of 3D models in unraveling the complexities of pancreatic cancer radiobiology, offering new avenues for designing more effective and precise treatment protocols. Full article

(This article belongs to the Special Issue New Treatments in Pancreatic Ductal Adenocarcinoma)

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19 pages, 614 KiB

Open AccessReview

A Canadian Perspective on Systemic Therapy for Recurrent or Metastatic Nasopharyngeal Carcinoma

by Anna Spreafico, Eric Winquist, Cheryl Ho, Brian O’Sullivan, Nathaniel Bouganim, Neil Chua, Sarah Doucette, Lillian L. Siu and Desiree Hao

Curr. Oncol. 2025, 32(1), 48; https://doi.org/10.3390/curroncol32010048 - 17 Jan 2025

Viewed by 725

Abstract

Although the majority of patients with nasopharyngeal carcinoma (NPC) present with early-stage or locoregional disease that can be treated with definitive radiotherapy, approximately 20% of patients experience disease recurrence, and 15% present with metastatic disease that is not amenable to curative therapy. Management [...] Read more.

Although the majority of patients with nasopharyngeal carcinoma (NPC) present with early-stage or locoregional disease that can be treated with definitive radiotherapy, approximately 20% of patients experience disease recurrence, and 15% present with metastatic disease that is not amenable to curative therapy. Management of patients with recurrent or metastatic (r/m) NPC who are not candidates for local salvage therapy is challenging in Canada, as there is uncertainty in extrapolating evidence that is largely generated from Southeast China to non-endemic regions such as Canada. Currently, treatment options in Canada are limited to chemotherapy regimens that can only achieve short-term response and prolongation of survival. The addition of anti-PD-1 monoclonal antibodies to chemotherapy has been shown to extend progression-free survival in recurrent r/m NPC compared to chemotherapy alone; however, approval of PD-1 inhibitors in Canada has lagged behind other jurisdictions where NPC is non-endemic. This paper reviews the current systemic treatment landscape for r/m NPC in Canada, highlights unmet treatment needs for patients who are not candidates for curative therapy, and discusses the challenges and opportunities that lie in emerging therapies. Full article

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

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29 pages, 415 KiB

Open AccessReview

Towards Personalized Radiotherapy in Pelvic Cancer: Patient-Related Risk Factors for Late Radiation Toxicity

by Anna C. Nuijens, Arlene L. Oei, Nicolaas A. P. Franken, Coen R. N. Rasch and Lukas J. A. Stalpers

Curr. Oncol. 2025, 32(1), 47; https://doi.org/10.3390/curroncol32010047 - 17 Jan 2025

Viewed by 760

Abstract

Normal tissue reactions vary significantly among patients receiving the same radiation treatment regimen, reflecting the multifactorial etiology of late radiation toxicity. Predicting late radiation toxicity is crucial, as it aids in the initial decision-making process regarding the treatment modalities. For patients undergoing radiotherapy, [...] Read more.

Normal tissue reactions vary significantly among patients receiving the same radiation treatment regimen, reflecting the multifactorial etiology of late radiation toxicity. Predicting late radiation toxicity is crucial, as it aids in the initial decision-making process regarding the treatment modalities. For patients undergoing radiotherapy, anticipating late toxicity allows for planning adjustments to optimize individualized care. Various dosimetric parameters have been shown to influence the incidence of late toxicity, and the literature available on this topic is extensive. This narrative review examines patient-related determinants of late toxicity following external beam radiotherapy for pelvic tumors, with a focus on prostate and cervical cancer patients. In Part I, we address various methods for quantifying radiation toxicity, providing context for interpreting toxicity data. Part II examines the current insights into the clinical risk factors for late toxicity. While certain factors—such as previous abdominal surgery, smoking behavior, and severe acute toxicity—have consistently been reported, most of the others show inconsistent associations. In Part III, we explore the influence of genetic factors and discuss promising predictive assays. Single-nucleotide polymorphisms (SNPs) likely elevate the risk in specific combinations. Advances in artificial intelligence now allow for the identification of SNP patterns from large datasets, supporting the development of polygenic risk scores. These innovations hold promise for improving personalized treatment strategies and reducing the burden of late toxicity in cancer survivors. Full article

(This article belongs to the Special Issue Radiotherapy for Genitourinary Cancer)

11 pages, 989 KiB

Open AccessSystematic Review

Treatment Options for Advanced Non-Small Cell Lung Cancer After Failure of Previous Immune Checkpoint Inhibitors and Chemotherapy: Meta-Analysis of Five Randomized Controlled Trials

by Andrea Messori, Andrea Ossato, Lorenzo Gasperoni, Luna Del Bono, Alessandro Inno and Vera Damuzzo

Curr. Oncol. 2025, 32(1), 46; https://doi.org/10.3390/curroncol32010046 - 17 Jan 2025

Viewed by 755

Abstract

Background: Immune checkpoint inhibitors (ICIs), either alone or in combination with platinum-based chemotherapy, are effective in the first-line treatment of metastatic, non-oncogene-addicted, non-small cell lung cancer (NSCLC). However, when NSCLC patients progress, the efficacy of available treatment options is limited. Methods: We undertook [...] Read more.

Background: Immune checkpoint inhibitors (ICIs), either alone or in combination with platinum-based chemotherapy, are effective in the first-line treatment of metastatic, non-oncogene-addicted, non-small cell lung cancer (NSCLC). However, when NSCLC patients progress, the efficacy of available treatment options is limited. Methods: We undertook a meta-analysis that compared combination regimens with the current standard of care. Only randomized controlled trials (RCTs) were included (endpoint, overall survival [OS]). Our analysis used an artificial intelligence software program that reconstructs individual patient data from Kaplan–Meier curves. Hazard ratio (HR) with 95% confidence interval (CI) was the main parameter. Heterogeneity was based on Wald’s test and likelihood ratio test. Results: Five RCTs were included, whose experimental arms included five different combinations. In our analysis, these combination regimes showed no OS benefit compared to chemotherapy (HR = 1.066, 95%CI, 0.9311 to 1.221; p = 0.35). Among the five control arms, cross-trial heterogeneity was remarkably low (likelihood ratio test = 3.76 on 4 df, p = 0.40; Wald test = 3.83 on 4 df, p = 0.40. Discussion: In conclusion, five new second-line combination treatments for patients with NSCLC were not found to determine any benefit in terms of OS in comparison with the current standard of care. Full article

(This article belongs to the Section Thoracic Oncology)

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13 pages, 231 KiB

Open AccessArticle

Perspectives of Women with Breast Cancer and Healthcare Providers Participating in an Adherence-Enhancing Program for Adjuvant Endocrine Therapy: A Qualitative Study

by Véronique Turcotte, Laurence Guillaumie, Martine Lemay, Anne Dionne, Julie Lemieux, Angéline Labbé, Carolyn Gotay, Line Guénette and Sophie Lauzier

Curr. Oncol. 2025, 32(1), 45; https://doi.org/10.3390/curroncol32010045 - 17 Jan 2025

Viewed by 471

Abstract

Background: Adjuvant endocrine therapy (AET) is prescribed for 5–10 years to women with hormone-sensitive breast cancer to prevent recurrence. However, a significant proportion of women do not adhere to AET. We developed SOIE, a one-year program designed to enhance the AET experience and [...] Read more.

Background: Adjuvant endocrine therapy (AET) is prescribed for 5–10 years to women with hormone-sensitive breast cancer to prevent recurrence. However, a significant proportion of women do not adhere to AET. We developed SOIE, a one-year program designed to enhance the AET experience and adherence. SOIE was pilot-tested in a mixed-methods randomized controlled trial. This report presents the experience of women and healthcare providers (HCPs) with SOIE. Methods: A descriptive qualitative study using semi-structured interviews and thematic analysis was conducted with 20 women and 7 HCPs who participated in the program. Results: Most women and HCPs reported high satisfaction with the program. Women felt it addressed their need for information and strategies to manage side effects. They felt supported and developed a more positive attitude toward AET, which contributed to their intention to pursue AET. They perceived that the program helped them navigate the AET experience and reduced their stress or fear regarding AET. HCPs corroborated these benefits. Conclusions: Findings suggest that SOIE can enhance the experience and motivation to pursue the AET treatment by meeting important needs for information, side-effects management, and psycho-emotional support. Programs like SOIE can have benefits beyond adherence by improving patients’ well-being during this crucial long-term treatment. Full article

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

17 pages, 762 KiB

Open AccessReview

IDH Mutant Cholangiocarcinoma: Pathogenesis, Management, and Future Therapies

by Alexander Bray and Vaibhav Sahai

Curr. Oncol. 2025, 32(1), 44; https://doi.org/10.3390/curroncol32010044 - 17 Jan 2025

Viewed by 578

Abstract

Mutations in isocitrate dehydrogenase (IDH) genes are among the most frequently encountered molecular alterations in cholangiocarcinoma (CCA). These neomorphic point mutations endow mutant IDH (mIDH) with the ability to generate an R-enantiomer of 2-hydroxyglutarate (R2HG), a metabolite that drives malignant transformation through aberrant [...] Read more.

Mutations in isocitrate dehydrogenase (IDH) genes are among the most frequently encountered molecular alterations in cholangiocarcinoma (CCA). These neomorphic point mutations endow mutant IDH (mIDH) with the ability to generate an R-enantiomer of 2-hydroxyglutarate (R2HG), a metabolite that drives malignant transformation through aberrant epigenetic signaling. As a result, pharmacologic inhibition of mIDH has become an attractive therapeutic strategy in CCAs harboring this mutation. One such inhibitor, ivosidenib, has already undergone clinical validation and received FDA approval in this disease, but there is still much work to be done to improve outcomes in mIDH CCA patients. In this publication we will review the pathogenesis and treatment of mIDH CCA with special emphasis on novel agents and combinations currently under investigation. Full article

(This article belongs to the Special Issue Biliary Tract Cancer Updates: Advancements and Insights)

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14 pages, 205 KiB

Open AccessArticle

Psychosocial Distress and the Quality of Life of Cancer Patients in Rural Hospitals in Limpopo Province: A Qualitative Study

by Dorah Ursula Ramathuba and Neo Jacqueline Ramutumbu

Curr. Oncol. 2025, 32(1), 43; https://doi.org/10.3390/curroncol32010043 - 16 Jan 2025

Viewed by 514

Abstract

Background: The diagnosis and treatment of cancer are associated with substantial physical, psychological, and social morbidity for most patients. Distress can be seen as an unpleasant experience of an emotional, psychological, social, or spiritual nature that interferes with the ability to cope with [...] Read more.

Background: The diagnosis and treatment of cancer are associated with substantial physical, psychological, and social morbidity for most patients. Distress can be seen as an unpleasant experience of an emotional, psychological, social, or spiritual nature that interferes with the ability to cope with cancer treatment. Purpose: The aim was to understand patients’ experiences of distress in their context and to analyze and interpret the findings. Method: An explorative, descriptive qualitative study was conducted among cancer patients receiving treatment and care at rural hospitals in Limpopo. A face-to-face individual interview was conducted to determine the participants’ cancer-related experiences and quality of life. Thematic analysis was conducted following Tesch’s method, and the themes developed were subjected to a triangulation process to ensure the validity and rigor of the findings. Findings: The participants revealed experiences of symptomatic distress resulting in biopsychosocial distress such as pain, fatigue, emotional distress related to prognosis and uncertainty about the future, psychosocial distress related to a lack or absence of support, financial instability, and poor self-esteem. Conclusions: Cancer patients face many challenges during their treatment journey. Participants were drained by anxiety and uncertainty of the cancer trajectory and required psychosocial support. The oncology team must provide supportive preventive measures for side effects management and culture-sensitive psychotherapy at an early stage to improve their quality of life. Full article

(This article belongs to the Section Psychosocial Oncology)

13 pages, 4644 KiB

Open AccessArticle

Impact of Bone-Modifying Agents on Post-Bone Metastasis Survival Across Cancer Types

by Hironari Tamiya, Kazumi Nishino, Yuji Kato, Reina Nakahashi-Kato, Yurika Kosuga-Tsujimoto, Shota Kinoshita, Rie Suzuki, Makiyo Watanabe, Toru Wakamatsu, Shigeki Kakunaga and Satoshi Takenaka

Curr. Oncol. 2025, 32(1), 42; https://doi.org/10.3390/curroncol32010042 - 15 Jan 2025

Viewed by 656

Abstract

Background: Bone metastasis is associated with a poor prognosis. Bone-modifying agents (BMA) are commonly used for the prevention or treatment of skeletal-related events (SRE) in patients with bone metastasis; however, whether or not treatment with BMA improves survival remains unclear. In this study, [...] Read more.

Background: Bone metastasis is associated with a poor prognosis. Bone-modifying agents (BMA) are commonly used for the prevention or treatment of skeletal-related events (SRE) in patients with bone metastasis; however, whether or not treatment with BMA improves survival remains unclear. In this study, we investigated whether BMA was involved in post-bone metastasis survival. Methods: A total of 539 cancer patients were retrospectively analyzed to identify significant independent factors in post-bone metastasis survival. Results: Among the overall population, patients with the following cancers had a median survival longer than 24 months: thyroid, 97.2 months; breast, 51.5 months; prostate, 47.2 months; and kidney, 38.8 months. In contrast, median post-bone metastasis survival was significantly shorter in gastrointestinal (GI) (6.5 months), head and neck (6.3 months), and urinary tract (3.4 months) cancers. In non-small cell lung cancer (NSCLC), the log-rank test demonstrated that the epidermal growth factor receptor (EGFR) mutation was a significant factor for post-bone metastasis survival: EGFR mutation (−) n = 67, median post-bone metastasis survival 11.5 months (95% CI: 6.0–15.2); EGFR mutation (+) n = 39, median post-bone metastasis survival 28.8 months (95% CI: 18.1–35.7) (p < 0.05). Intriguingly, treatment with BMA was a significant positive prognostic factor: BMA (−) n = 203, median post-bone metastasis survival 7.8 months (95% CI: 5.8–12.5); BMA (+) n = 336, median post-bone metastasis survival 21.9 months (95% CI: 16.1–26.4) (p < 0.001). Moreover, the Cox proportional hazards model showed that this was particularly evident in cancer types with poor prognosis such as GI cancer (hazard ratio [HR]: 0.62, 95% CI: 0.40–0.95; p < 0.05) and NSCLC without the epidermal growth factor receptor (EGFR) mutation (HR: 0.56, 95% CI: 0.34–0.91; p < 0.05). Conclusions: Treatment with BMA is recommended not only for the prevention and/or treatment of SRE, but also may have a positive impact on post-bone metastasis survival, particularly in cancers with typically poor post-bone metastasis survival such as GI cancer and NSCLC without the EGFR mutation. Full article

(This article belongs to the Special Issue 2nd Edition: Treatment of Bone Metastasis)

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19 pages, 1947 KiB

Open AccessCase Report

A Journey into the Complexity of Temporo-Insular Gliomas: Case Report and Literature Review

by Manuel De Jesus Encarnacion Ramirez, Gervith Reyes Soto and Carlos Castillo Rangel

Curr. Oncol. 2025, 32(1), 41; https://doi.org/10.3390/curroncol32010041 - 14 Jan 2025

Viewed by 600

Abstract

Introduction: Temporo-insular gliomas, rare brain tumors originating from glial cells, comprise about 30% of brain tumors and vary in aggressiveness from grade I to IV. Despite advancements in neuroimaging and surgical techniques, their management remains complex due to their location near critical cognitive [...] Read more.

Introduction: Temporo-insular gliomas, rare brain tumors originating from glial cells, comprise about 30% of brain tumors and vary in aggressiveness from grade I to IV. Despite advancements in neuroimaging and surgical techniques, their management remains complex due to their location near critical cognitive areas. Techniques like awake craniotomy have improved outcomes, but tumor heterogeneity and proximity to vital structures pose challenges. Radiotherapy and chemotherapy offer benefits post-surgery, though issues like resistance and side effects persist. This article discusses a case report and literature review to deepen understanding of temporo-insular gliomas, focusing on advanced diagnostic and treatment approaches. Materials and Methods: A systematic review was conducted using PubMed, Embase, and Google Scholar, covering studies from 2019 to July 2024. Keywords included ‘brain tumor’, ‘neurosurgery’, and ‘treatment’. Articles on glioma diagnosis, management, and outcomes were selected, excluding non-English studies, irrelevant reports, non-glioma research, and inaccessible texts. Results: From 156 studies, 11 met inclusion criteria, highlighting advanced diagnostics, surgical strategies, and adjunct therapies for temporo-insular gliomas (TIGs). Gross total resection (GTR) was achieved in 39% of cases. Awake craniotomy enhanced functional outcomes, while temozolomide and radiotherapy improved survival. Challenges included ischemic complications and treatment resistance. Two patient cases underscored the complexity of TIG management and the importance of individualized approaches, achieving satisfactory resection with minimal deficits. Conclusions: Temporo-insular gliomas (TIGs) necessitate a multidisciplinary strategy that integrates advanced imaging, meticulous surgical methods, and cutting-edge adjuvant therapies. Despite progress with techniques like awake craniotomy and the use of temozolomide improving patient outcomes, significant challenges persist in maintaining functional integrity and addressing treatment resistance. Ongoing research into targeted therapies, immunotherapies, and innovative technologies remains critical to advancing patient care and improving long-term prognosis. Full article

(This article belongs to the Section Neuro-Oncology)

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12 pages, 2951 KiB

Open AccessReview

Hepatocellular Carcinoma: Imaging Advances in 2024 with a Focus on Magnetic Resonance Imaging

by Matteo Renzulli and Emanuela Giampalma

Curr. Oncol. 2025, 32(1), 40; https://doi.org/10.3390/curroncol32010040 - 14 Jan 2025

Viewed by 495

Abstract

The EASL diagnostic algorithm for hepatocellular carcinoma, currently in use, dates back to 2018. While awaiting its update, numerous advancements have emerged in the field of hepatocellular carcinoma imaging. These innovations impact every step of the diagnostic algorithm, from surveillance protocols to diagnostic [...] Read more.

The EASL diagnostic algorithm for hepatocellular carcinoma, currently in use, dates back to 2018. While awaiting its update, numerous advancements have emerged in the field of hepatocellular carcinoma imaging. These innovations impact every step of the diagnostic algorithm, from surveillance protocols to diagnostic processes, encompassing aspects preceding a patient’s inclusion in surveillance programs as well as the potential applications of imaging after the hepatocellular carcinoma diagnosis. Notably, these diagnostic advancements are particularly evident in the domain of magnetic resonance imaging. For example, the sensitivity of ultrasound in diagnosing very early-stage and early-stage hepatocellular carcinoma during the surveillance phase is very low (less than 50%) and a potential improvement in this sensitivity value could be achieved by using abbreviated protocols in magnetic resonance imaging. The aim of this review is to explore the 2024 updates in magnetic resonance imaging for hepatocellular carcinoma, with a focus on its role in surveillance, nodular size assessment, post-diagnosis imaging applications, and its potential role before the initiation of surveillance. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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14 pages, 1160 KiB

Open AccessArticle

Comprehensive Evaluation of Inflammatory Biomarkers in Cervical Cancer Treated with Chemoradiotherapy

by Timur Koca, Nurcihan Gocen Vardar, Rahmi Atıl Aksoy and Aylin Fidan Korcum

Curr. Oncol. 2025, 32(1), 39; https://doi.org/10.3390/curroncol32010039 - 13 Jan 2025

Viewed by 565

Abstract

Objective: Inflammatory biomarkers have been shown to possess both prognostic and predictive significance in various cancers. Among the emerging biomarkers, the pan-immune-inflammation value (PIV) has recently been introduced as a novel indicator representing both the immune response and the systemic inflammatory state. [...] Read more.

Objective: Inflammatory biomarkers have been shown to possess both prognostic and predictive significance in various cancers. Among the emerging biomarkers, the pan-immune-inflammation value (PIV) has recently been introduced as a novel indicator representing both the immune response and the systemic inflammatory state. This study aims to comprehensively evaluate the predictive value of inflammatory biomarkers on survival outcomes in cervical cancer patients undergoing chemoradiotherapy. Methods: A total of 90 patients who had undergone chemoradiotherapy for cervical cancer were included. Data on demographics, treatment protocols, pre-treatment blood parameters, and survival outcomes were collected. The association between inflammatory biomarkers and survival outcomes was investigated through univariate and multivariate analyses. Results: The univariate analysis identified the following as predictors of progression-free survival (PFS): neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), monocyte–lymphocyte ratio (MLR), systemic immune-inflammation index (SII), PIV, C-reactive protein (CRP), albumin, and tumor size. Multivariate analysis revealed that only the PIV significantly predicted PFS (HR 3.05, 95% CI 1.0 to 9.3, p = 0.04). In the univariate analysis, several variables were predictive of overall survival (OS), including NLR, PLR, MLR, SII, PIV, CRP, LDH, albumin, tumor size, and Eastern Cooperative Oncology Group Performance Status (ECOG PS). Multivariate analysis revealed CRP (HR 3.41, 95% CI 1.5 to 7.7, p = 0.003) and ECOG PS (HR 4.78, 95% CI 1.3 to 17.3, p = 0.01) predictive of OS, with PIV approaching statistical significance (HR 2.56, 95% CI 0.8 to 7.6, p = 0.09). Conclusions: This study provides the first comprehensive analysis of the association between cervical cancer and various inflammatory biomarkers. Many of these biomarkers have demonstrated predictive value for survival outcomes in patients with cervical cancer undergoing definitive chemoradiotherapy. Among the biomarkers evaluated, CRP and PIV were identified as the most predictive, warranting further exploration in future research. Full article

(This article belongs to the Special Issue Clinical Management of Cervical Cancer)

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11 pages, 477 KiB

Open AccessArticle

Treatment Outcomes in Spinal Tumors According to Patients’ Perspectives: A Focus on Indeterminate Spinal Instability

by Victoria H. Schimmelpenning, Robin Brugger, Nikki Rommers, Johann Kunst, Martin Jäger, Christoph E. Albers and Helena Milavec

Curr. Oncol. 2025, 32(1), 38; https://doi.org/10.3390/curroncol32010038 - 13 Jan 2025

Viewed by 541

Abstract

The objective of this study was to analyze treatment approaches and outcomes according to patients’ perspectives for patients with indeterminate spinal instability caused by neoplastic lesions. Data were collected from 31 patients with a total of 147 spinal neoplastic lesions, 29 of whom [...] Read more.

The objective of this study was to analyze treatment approaches and outcomes according to patients’ perspectives for patients with indeterminate spinal instability caused by neoplastic lesions. Data were collected from 31 patients with a total of 147 spinal neoplastic lesions, 29 of whom had lesions classified as indeterminate. These lesions were divided into two groups: the low indeterminate group (SINS 7–9) and the high indeterminate group (SINS 10–12). Conservative treatment was the primary approach (93%), resulting in improvement in 59% of cases, stability in 22%, and asymptomatic outcomes in 19%. No significant differences in self-reported outcomes were found between surgical and non-surgical treatments (p = 0.98, p = 0.18). Surgery was reserved for patients with severe pain or impending neurological compromise. Our findings suggest that conservative management is a viable option for most patients with indeterminate spinal instability caused by neoplastic lesions, provided pain and neurological stability are adequately controlled. Full article

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

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8 pages, 2665 KiB

Open AccessCase Report

Insights into the Multidisciplinary Approach for Metastatic Acinic Cell Lung Carcinoma: The Pathologist’s Role in Romania Today

by Dorela-Codruta Lazureanu, Amelia Burlea, Robert Barna, Daniela Cipu, Mihaela Pasca Fenesan, Ioan Icma and Marioara Cornianu

Curr. Oncol. 2025, 32(1), 37; https://doi.org/10.3390/curroncol32010037 - 13 Jan 2025

Viewed by 540

Abstract

Background/Objectives: Acinic cell carcinoma (ACC) is a rare lung neoplasm that can affect both children and adults as a parenchymal or endobronchial mass. It is histologically similar to this kind of tumor described in salivary glands, but with a different immunophenotype. In [...] Read more.

Background/Objectives: Acinic cell carcinoma (ACC) is a rare lung neoplasm that can affect both children and adults as a parenchymal or endobronchial mass. It is histologically similar to this kind of tumor described in salivary glands, but with a different immunophenotype. In general, it poses a reduced degree of malignancy, with indolent growth and a favorable prognosis, with exceptionally rare cases associated with recurring disease or lymph node metastases. Methods: When clinicians are facing puzzling symptomatology in their patients, the main role of the multidisciplinary team in their review of oncological cases is to recommend imagistic-guided biopsies. Tissues samples were routinely processed, stained with hematoxylin-eosin (HE) and periodic acid–Schiff (PAS), and submitted to complementary immunohistochemistry tests. Results: Histopathological reports were consistent for lung ACC with regional lymph node involvement and remote metastases. Oncological therapies followed. Conclusions: Postponements of the presentation to the doctor at the onset of symptoms, as well as a lack of periodic health control for people insured by national health insurance companies, often lead to medical, human and financial complications that are difficult to manage. The pathologist involved in the discussion of oncological cases brings his expertise in solving cases, certifying the evolution of tumors considered less aggressive, such as in the case of lung ACCs. Full article

(This article belongs to the Section Thoracic Oncology)

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15 pages, 1527 KiB

Open AccessArticle

Rebiopsy Enhances Survival with Afatinib vs. Osimertinib in EGFR Exon 19 Deletion Non-Small Cell Lung Cancer: A Multicenter Study in Taiwan

by Jerry Shu-Hung Kuo, Cheng-Yu Chang, Shih-Chieh Chang, Yu-Feng Wei and Chung-Yu Chen

Curr. Oncol. 2025, 32(1), 36; https://doi.org/10.3390/curroncol32010036 - 10 Jan 2025

Viewed by 859

Abstract

Background: Afatinib and Osimertinib are first-line treatments for EGFR-mutated advanced non-small cell lung cancer (NSCLC), but their comparative efficacies and the patient groups that benefit the most remain unclear. This multicenter retrospective study evaluated the efficacy of first-line Afatinib and Osimertinib in NSCLC [...] Read more.

Background: Afatinib and Osimertinib are first-line treatments for EGFR-mutated advanced non-small cell lung cancer (NSCLC), but their comparative efficacies and the patient groups that benefit the most remain unclear. This multicenter retrospective study evaluated the efficacy of first-line Afatinib and Osimertinib in NSCLC patients with EGFR 19del and no brain metastases at diagnosis. Methods: The primary endpoints were time on treatment (ToT) and overall survival (OS). Survival analyses were performed for three groups: Afatinib followed by Osimertinib, Afatinib followed by other therapies, and Osimertinib (alone or followed by other therapies). Rebiopsy practices, including T790M mutation detection, were also analyzed in patients with disease progression on Afatinib. Results: Among 97 Afatinib-treated and 60 Osimertinib-treated patients, Osimertinib showed a significantly longer ToT (23.3 vs. 16.5 months; p = 0.007). Median OS was numerically higher for Afatinib with sequential Osimertinib (40.5 vs. 34.6 months for Osimertinib; p = 0.473). Osimertinib demonstrated advantages, with fewer brain metastases upon progression and fewer adverse effects. In the Afatinib group, 64% of patients with disease progression underwent rebiopsy, with 39% testing positive for T790M mutation and subsequently receiving Osimertinib. Rebiopsy was most frequently performed on the lung parenchyma using non-surgical methods. Conclusions: In this real-world study, Osimertinib achieved a significantly longer ToT compared to Afatinib in NSCLC patients with EGFR 19del and no brain metastases. The sequential use of Afatinib followed by Osimertinib showed a trend toward improved OS, highlighting the importance of rebiopsy for identifying T790M mutations to guide subsequent therapy. Full article

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

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23 pages, 18470 KiB

Open AccessArticle

Single-Cell RNA Sequencing Reveals LEF1-Driven Wnt Pathway Activation as a Shared Oncogenic Program in Hepatoblastoma and Medulloblastoma

by Christophe Desterke, Yuanji Fu, Jenny Bonifacio-Mundaca, Claudia Monge, Pascal Pineau, Jorge Mata-Garrido and Raquel Francés

Curr. Oncol. 2025, 32(1), 35; https://doi.org/10.3390/curroncol32010035 - 9 Jan 2025

Viewed by 608

Abstract

(1) Background: Hepatoblastoma and medulloblastoma are two types of pediatric tumors with embryonic origins. Both tumor types can exhibit genetic alterations that affect the β-catenin and Wnt pathways; (2) Materials and Methods: This study used bioinformatics and integrative analysis of multi-omics data at [...] Read more.

(1) Background: Hepatoblastoma and medulloblastoma are two types of pediatric tumors with embryonic origins. Both tumor types can exhibit genetic alterations that affect the β-catenin and Wnt pathways; (2) Materials and Methods: This study used bioinformatics and integrative analysis of multi-omics data at both the tumor and single-cell levels to investigate two distinct pediatric tumors: medulloblastoma and hepatoblastoma; (3) Results: The cross-transcriptome analysis revealed a commonly regulated expression signature between hepatoblastoma and medulloblastoma tumors. Among the commonly upregulated genes, the transcription factor LEF1 was significantly expressed in both tumor types. In medulloblastoma, LEF1 upregulation is associated with the WNT-subtype. The analysis of LEF1 genome binding occupancy in H1 embryonic stem cells identified 141 LEF1 proximal targets activated in WNT medulloblastoma, 13 of which are involved in Wnt pathway regulation: RNF43, LEF1, NKD1, AXIN2, DKK4, DKK1, LGR6, FGFR2, NXN, TCF7L1, STK3, YAP1, and NFATC4. The ROC curve analysis of the combined expression of these 13 WNT-related LEF1 targets yielded an area under the curve (AUC) of 1.00, indicating 100% specificity and sensitivity for predicting the WNT subtype in the PBTA medulloblastoma cohort. An expression score based on these 13 WNT-LEF1 targets accurately predicted the WNT subtype in two independent medulloblastoma transcriptome cohorts. At the single-cell level, the WNT-LEF1 expression score was exclusively positive in WNT-medulloblastoma tumor cells. This WNT-LEF1-dependent signature was also confirmed as activated in the hepatoblastoma tumor transcriptome. At the single-cell level, the WNT-LEF1 expression score was higher in tumor cells from both human hepatoblastoma samples and a hepatoblastoma patient-derived xenotransplant model; (4) Discussion: This study uncovered a shared transcriptional activation of a LEF1-dependent embryonic program, which orchestrates the regulation of the Wnt signaling pathway in tumor cells from both hepatoblastoma and medulloblastoma. Full article

(This article belongs to the Special Issue Novel Biomarkers and Liver Cancer)

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15 pages, 570 KiB

Open AccessArticle

Targeted Transition Readiness Workshops for Pediatric Brain Tumor Survivors: Feasibility, Acceptability, and Preliminary Effects

by Julie Carrier, Tziona Lugasi, Nathalie Labonté, Carole Provost, Andrea Saragosti, Claire Longpré, Bénédicte Koukoui, Émilie Régnier-Trudeau, Serge Sultan, Hallie Coltin, Sébastien Perreault, Marco Bonanno and Leandra Desjardins

Curr. Oncol. 2025, 32(1), 34; https://doi.org/10.3390/curroncol32010034 - 8 Jan 2025

Viewed by 498

Abstract

Pediatric brain tumor survivors (PBTS) are at risk for late effects related to their diagnosis and treatment. Long-term medical follow-ups are deemed essential, implying a transition from pediatric to adult healthcare settings. This pilot study aims to assess the feasibility, acceptability, and preliminary [...] Read more.

Pediatric brain tumor survivors (PBTS) are at risk for late effects related to their diagnosis and treatment. Long-term medical follow-ups are deemed essential, implying a transition from pediatric to adult healthcare settings. This pilot study aims to assess the feasibility, acceptability, and preliminary effects of a targeted transition readiness intervention for PBTS. The program consisted of three hybrid workshops that targeted disease-related self-management skills, social skills, and cognitive functioning, as well as parallel workshops for their caregivers. The feasibility and acceptability were assessed through recruitment, retention, and satisfaction rates. Preliminary effects were primarily assessed via a pre/post assessment of transition readiness skills using the Transition Readiness Assessment (TRAQ) questionnaire. Among the eligible dyads, 12 (38%) consented to participate. Ten dyads participated in at least two workshops, and six dyads participated in all workshops. Overall, the participants were satisfied with the intervention (parents = 86%; PBTS = 73%). Although not statistically significant, a clinically relevant post-workshop increase in transition readiness skills was observed for PBTS (d = 0.36) and their caregivers (d = 0.25). The results suggest the relevance of the intervention and encourage further developments. Adjustments are needed to optimize reach and efficacy. The workshops have the potential to be adapted to be more accessible and shorter. Full article

(This article belongs to the Special Issue Building Hope for the Next Decade of Psychosocial Oncology: Optimizing the Integration of Supportive Care into Oncology Care)

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11 pages, 191 KiB

Open AccessArticle

Engaging Nurses in Effective Cost of Care Conversations to Address Cancer-Related Financial Toxicity: Results from an Exploratory Survey

by Jean S. Edward, Amanda Thaxton Wiggins, Louis G. Baser, Haafsah Fariduddin, Joanna F. Doran, Monica F. Bryant, John A. D’Orazio and Kimberly D. Northrip

Curr. Oncol. 2025, 32(1), 33; https://doi.org/10.3390/curroncol32010033 - 8 Jan 2025

Viewed by 579

Abstract

Few evidence-based trainings exist on how to equip healthcare providers, particularly nurses, with the skills to engage in cost of care conversations with patients/caregivers to mitigate the impact of cancer-related financial toxicity. This study evaluated a pilot training developed in collaboration with Triage [...] Read more.

Few evidence-based trainings exist on how to equip healthcare providers, particularly nurses, with the skills to engage in cost of care conversations with patients/caregivers to mitigate the impact of cancer-related financial toxicity. This study evaluated a pilot training developed in collaboration with Triage Cancer^® to prepare oncology nurses to identify and assist patients/caregivers facing financial and/or legal barriers to care. Ten pediatric oncology nurses completed the training and pre/post-surveys on behaviors related to financial and legal need screening, frequency and comfort level of answering questions, knowledge, and behavior changes, along with training evaluation questions. At baseline, six nurses reported never screening for financial needs and nine for legal needs. Following the training, seven nurses stated they were likely to screen for financial/legal needs. At six months post-training, nurses had referred 85 patients/caregivers to financial/legal navigation services. Comfort levels in answering financial/legal questions increased by 6.5 points and knowledge scores increased by 1.7 points post-training. Most nurses recommended this training to other healthcare providers who work with patients with cancer and their caregivers. This study highlights the importance of providing oncology nurses with resources to engage in cost of care conversations and oncology financial legal navigation programs to mitigate the impact of cancer-related financial toxicity. Full article

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

11 pages, 1027 KiB

Open AccessArticle

Initial Treatment Modalities in Patients with Newly Diagnosed Primary Lung Cancer in Japan

by Qingqing Hu, Kuan-Chih Huang, Ko Nakajo, Yongjing Zhang and Hong Qiu

Curr. Oncol. 2025, 32(1), 32; https://doi.org/10.3390/curroncol32010032 - 7 Jan 2025

Viewed by 503

Abstract

Treatment for lung cancer continues to rapidly evolve. Here, we describe trends in the initial treatment of adults with newly diagnosed primary non-small-cell lung cancer in Japan. This retrospective cohort study used data from JMDC Inc. Claims Database from 2015 to 2023. Adults [...] Read more.

Treatment for lung cancer continues to rapidly evolve. Here, we describe trends in the initial treatment of adults with newly diagnosed primary non-small-cell lung cancer in Japan. This retrospective cohort study used data from JMDC Inc. Claims Database from 2015 to 2023. Adults with lung cancer, confirmed using a combination of diagnosis, treatment, or procedure codes, were enrolled. A total of 9373 patients were included, with a mean age of approximately 59 years. The median time from diagnosis to treatment initiation ranged from 38 days in patients treated surgically to 25 days in patients with distant metastases. The observed trends were a decrease in the percentage of newly diagnosed patients with distant metastases, a decline in chemotherapy use in patients with early-stage disease, and in advanced disease, a more than doubling in the use of targeted therapy, including checkpoint inhibitors, while radiotherapy and chemotherapy tended to decrease. The observed changes in treatment were driven mainly by the increased use of targeted therapies including checkpoint inhibitors and are aligned with current treatment guidelines in Japan. The observation of fewer patients with distant metastases over time possibly indicates earlier detection. Additional research is needed to understand if new therapies are being extended to older and frail patients with lung cancer in Japan. Full article

(This article belongs to the Section Thoracic Oncology)

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12 pages, 848 KiB

Open AccessArticle

Long-Term Oncological Outcomes Related to Lymphadenectomy in Clinical Stage I NSCLC: A Multicenter Retrospective Experience

by Beatrice Manfredini, Carmelina Cristina Zirafa, Alessandro Stefani, Gaetano Romano, Greta Alì, Riccardo Morganti, Ilaria Ceccarelli, Federico Davini, Pier Luigi Filosso and Franca Melfi

Curr. Oncol. 2025, 32(1), 31; https://doi.org/10.3390/curroncol32010031 - 5 Jan 2025

Viewed by 656

Abstract

Background: Lymphadenectomy is considered a key part of the radical treatment of resectable lung cancer, although its appropriate extension in early stages is a debated topic due to the great heterogeneity of studies in the literature. This study aims to evaluate the impact [...] Read more.

Background: Lymphadenectomy is considered a key part of the radical treatment of resectable lung cancer, although its appropriate extension in early stages is a debated topic due to the great heterogeneity of studies in the literature. This study aims to evaluate the impact of lymphadenectomy extent on survival and recurrence in the treatment of early-stage NSCLC patients undergoing lobectomy and lymph node dissection. Methods: Data from clinical stage I NSCLC patients undergoing lobectomy and hilar-mediastinal lymphadenectomy at two thoracic surgery centers from 2016 to 2019 were retrospectively evaluated. Information regarding perioperative outcomes and lymphadenectomy details was collected and analyzed, and their impact on OS, CSS, and DFS was assessed. Results: During the period under review, 323 patients with stage cI lung cancer underwent lobectomy with lymphadenectomy. Statistical analysis showed that the evaluated lymph nodal factors (mean number of lymph nodes removed and number and type of lymph node station explored) did not statistically significantly impact OS, CSS, and DFS at a median follow-up of 59 months (IQR 45–71). Conclusions: The results of this study suggest that a less invasive procedure than systematic lymphadenectomy could be performed in early-stage cases with adequate preoperative staging. Full article

(This article belongs to the Section Thoracic Oncology)

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16 pages, 4575 KiB

Open AccessArticle

Deep-Learning-Based Reconstruction of Single-Breath-Hold 3 mm HASTE Improves Abdominal Image Quality and Reduces Acquisition Time: A Quantitative Analysis

by Felix Kubicka, Qinxuan Tan, Tom Meyer, Dominik Nickel, Elisabeth Weiland, Moritz Wagner and Stephan Rodrigo Marticorena Garcia

Curr. Oncol. 2025, 32(1), 30; https://doi.org/10.3390/curroncol32010030 - 3 Jan 2025

Viewed by 523

Abstract

Purpose: Breath-hold T2-weighted half-Fourier acquisition single-shot turbo spin echo (HASTE) magnetic resonance imaging (MRI) of the upper abdomen with a slice thickness below 5 mm suffers from high image noise and blurring. The purpose of this prospective study was to improve image quality [...] Read more.

Purpose: Breath-hold T2-weighted half-Fourier acquisition single-shot turbo spin echo (HASTE) magnetic resonance imaging (MRI) of the upper abdomen with a slice thickness below 5 mm suffers from high image noise and blurring. The purpose of this prospective study was to improve image quality and accelerate imaging acquisition by using single-breath-hold T2-weighted HASTE with deep learning (DL) reconstruction (DL-HASTE) with a 3 mm slice thickness. Method: MRI of the upper abdomen with DL-HASTE was performed in 35 participants (5 healthy volunteers and 30 patients) at 3 Tesla. In a subgroup of five healthy participants, signal-to-noise ratio (SNR) analysis was used after DL reconstruction to identify the smallest possible layer thickness (1, 2, 3, 4, 5 mm). DL-HASTE was acquired with a 3 mm slice thickness (DL-HASTE-3 mm) in 30 patients and compared with 5 mm DL-HASTE (DL-HASTE-5 mm) and with standard HASTE (standard-HASTE-5 mm). Image quality and motion artifacts were assessed quantitatively using Laplacian variance and semi-quantitatively by two radiologists using five-point Likert scales. Results: In the five healthy participants, DL-HASTE-3 mm was identified as the optimal slice (SNR 23.227 ± 3.901). Both DL-HASTE-3 mm and DL-HASTE-5 mm were assigned significantly higher overall image quality scores than standard-HASTE-5 mm (Laplacian variance, both p < 0.001; Likert scale, p < 0.001). Compared with DL-HASTE-5 mm (1.10 × 10⁻⁵ ± 6.93 × 10⁻⁶), DL-HASTE-3 mm (1.56 × 10⁻⁵ ± 8.69 × 10⁻⁶) provided a significantly higher SNR Laplacian variance (p < 0.001) and sharpness sub-scores for the intestinal tract, adrenal glands, and small anatomic structures (bile ducts, pancreatic ducts, and vessels; p < 0.05). Lesion detectability was rated excellent for both DL-HASTE-3 mm and DL-HASTE-5 mm (both: 5 [IQR4–5]) and was assigned higher scores than standard-HASTE-5 mm (4 [IQR4–5]; p < 0.001). DL-HASTE reduced the acquisition time by 63–69% compared with standard-HASTE-5 mm (p < 0.001). Conclusions: DL-HASTE is a robust abdominal MRI technique that improves image quality while at the same time reducing acquisition time compared with the routine clinical HASTE sequence. Using ultra-thin DL-HASTE-3 mm results in an even greater improvement with a similar SNR. Full article

(This article belongs to the Special Issue Imaging-Based Early Diagnosis of Cancers Using Artificial Intelligence)

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15 pages, 3288 KiB

Open AccessArticle

Application of Ultrasound Radiomics in Differentiating Benign from Malignant Breast Nodules in Women with Post-Silicone Breast Augmentation

by Ling Hao, Yang Chen, Xuejiao Su and Buyun Ma

Curr. Oncol. 2025, 32(1), 29; https://doi.org/10.3390/curroncol32010029 - 3 Jan 2025

Viewed by 606

Abstract

Purpose: To evaluate the diagnostic value of ultrasound radiomics in distinguishing between benign and malignant breast nodules in women who have undergone silicone breast augmentation. Methods: A retrospective study was conducted of 99 breast nodules detected by ultrasound in 93 women who had [...] Read more.

Purpose: To evaluate the diagnostic value of ultrasound radiomics in distinguishing between benign and malignant breast nodules in women who have undergone silicone breast augmentation. Methods: A retrospective study was conducted of 99 breast nodules detected by ultrasound in 93 women who had undergone silicone breast augmentation. The ultrasound data were collected between 1 January 2006 and 1 September 2023. The nodules were allocated into a training set (n = 69) and a validation set (n = 30). Regions of interest (ROIs) were manually delineated using 3D Slicer software, and radiomic features were extracted and selected using Python programming. Eight machine learning algorithms were applied to build predictive models, and their performance was assessed using sensitivity, specificity, area under the ROC curve (AUC), accuracy, Brier score, and log loss. Model performance was further evaluated using ROC curves and calibration curves, while clinical utility was assessed via decision curve analysis (DCA). Results: The random forest model exhibited superior performance in differentiating benign from malignant nodules in the validation set, achieving sensitivity of 0.765, specificity of 0.838, and an AUC of 0.787 (95% CI: 0.561–0.960). The model’s accuracy, Brier score, and log loss were 0.796, 0.197, and 0.599, respectively. DCA suggested potential clinical utility of the model. Conclusion: Ultrasound radiomics demonstrates promising diagnostic accuracy in differentiating benign from malignant breast nodules in women with silicone breast prostheses. This approach has the potential to serve as an additional diagnostic tool for patients following silicone breast augmentation. Full article

(This article belongs to the Section Breast Cancer)

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10 pages, 2401 KiB

Open AccessArticle

Comparison of CT-Guided Microwave Ablation of Liver Malignancies with and Without Intra-Arterial Catheter Placement for Contrast Administration

by Anne Bettina Beeskow, Holger Gößmann, Hans-Jonas Meyer, Daniel Seehofer, Thomas Berg, Florian van Bömmel, Aaron Schindler, Manuel Florian Struck, Timm Denecke and Sebastian Ebel

Curr. Oncol. 2025, 32(1), 28; https://doi.org/10.3390/curroncol32010028 - 2 Jan 2025

Viewed by 581

Abstract

Background: The aim of this study was to compare microwave ablation (MWA) with and without prior placement of an intra-arterial catheter for the purpose of application of contrast medium (CM). Methods: 148 patients (45 female, 65.1 ± 14.9 years) with liver tumors who [...] Read more.

Background: The aim of this study was to compare microwave ablation (MWA) with and without prior placement of an intra-arterial catheter for the purpose of application of contrast medium (CM). Methods: 148 patients (45 female, 65.1 ± 14.9 years) with liver tumors who underwent CT-guided MWA were included. Of these, 25 patients had an IA catheter placed in the hepatic artery. Results: 37 patients underwent planning imaging for MWA without CM. A total of 86 patients received a standard dose of 80 mL intravenous (IV) CM for the planning scans. The patients with an IA catheter (n = 25) received an IA application of 10 mL CM. A total of 29 patients received contrast-enhanced scans in the PV phase for control of needle positioning after IV application of a standard dose of 80 mL CM. In patients with an IA catheter, control of the needle position was performed by single-slice scans. IA CM application during the ablation enabled monitoring of the ablation zone. Over the entire intervention, patients with IA catheters received less CM as compared to patients without an IA catheter (39.1 ± 10.4 mL vs. 141 ± 39.69 mL; p < 0.001). Conclusions: IA catheter placement was associated with a significant decrease of the amount of CM during MWA and enabled monitoring of the ablation zone. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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17 pages, 714 KiB

Open AccessArticle

Feasibility and Preliminary Effects of Acupuncture for Cognitive Dysfunction in Diverse Cancer Survivors: A Pilot, Randomized, Placebo-Controlled Trial

by Xiaotong Li, Kaitlin Lampson, Tim A. Ahles, James C. Root, Q. Susan Li, Yuelin Li, Anam Ahsan, Jun J. Mao and Kevin T. Liou

Curr. Oncol. 2025, 32(1), 27; https://doi.org/10.3390/curroncol32010027 - 1 Jan 2025

Viewed by 669

Abstract

(1) Background: This pilot study evaluates the feasibility and preliminary effects of acupuncture for cancer-related cognitive dysfunction (CRCD) in cancer survivors. (2) Methods: A randomized trial comparing real acupuncture (RA) to sham acupuncture (SA) and waitlist control (WLC) among cancer survivors reporting cognitive [...] Read more.

(1) Background: This pilot study evaluates the feasibility and preliminary effects of acupuncture for cancer-related cognitive dysfunction (CRCD) in cancer survivors. (2) Methods: A randomized trial comparing real acupuncture (RA) to sham acupuncture (SA) and waitlist control (WLC) among cancer survivors reporting cognitive difficulties. Interventions were delivered weekly over 10 weeks. Feasibility was evaluated by recruitment, treatment adherence, and assessment completion. Subjective CRCD was assessed by the Functional Assessment of Cancer Therapy-Cognitive Function—Perceived Cognitive Impairment subscale (FACT-Cog PCI) and objective CRCD was assessed by the Hopkins Verbal Learning Test—Revised (HVLT-R). (3) Results: 32 participants (57.1% of eligible patients) were enrolled. All participants in acupuncture groups completed ≥8 of 10 treatments. Assessment completion rate was 100% for all participants. From baseline to week 10, the RA group (n = 19) reported a clinically meaningful 17.3-point increase in FACT-Cog PCI (95% confidence interval [CI] 12.5 to 22.1), compared to 9.7 points (95% CI 2.8 to 16.7) in the SA group (n = 9), and 6.8 points (95% CI −3.7 to 17.2) in the WLC group (n = 4). In the subgroup analysis among patients with a below-average baseline HVLT-R (T-score < 50), the RA group (n = 8) increased FACT-Cog PCI scores by 20.4 (95% CI 13.6 to 27.3), compared to 11.1 points (95% CI 0.6 to 21.5) in the SA group (n = 5). The improvements from RA persisted through week 16 in both the total sample and the sub-group. Eleven mild adverse events were reported, with pain and bleeding at the needling sites being the most common. (4) Conclusions: The findings support the feasibility and safety of conducting a randomized, placebo-controlled trial to evaluate acupuncture for cognitive dysfunction in cancer survivors. Full article

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Open AccessArticle

Predicting High-Grade Acute Urinary Toxicity and Lower Gastrointestinal Toxicity After Postoperative Volumetric Modulated Arc Therapy for Cervical and Endometrial Cancer Using a Normal Tissue Complication Probability Model

by Tianyu Yang, Zhe Ji, Runhong Lei, Ang Qu, Weijuan Jiang, Xiuwen Deng and Ping Jiang

Curr. Oncol. 2025, 32(1), 26; https://doi.org/10.3390/curroncol32010026 - 1 Jan 2025

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Abstract

(1) Background: Volumetric modulated arc therapy (VMAT) can deliver more accurate dose distribution and reduce radiotherapy-induced toxicities for postoperative cervical and endometrial cancer. This study aims to retrospectively analyze the relationship between dosimetric parameters of organs at risk (OARs) and acute toxicities and [...] Read more.

(1) Background: Volumetric modulated arc therapy (VMAT) can deliver more accurate dose distribution and reduce radiotherapy-induced toxicities for postoperative cervical and endometrial cancer. This study aims to retrospectively analyze the relationship between dosimetric parameters of organs at risk (OARs) and acute toxicities and provide suggestions for the dose constraints. (2) Methods: A total of 164 postoperative cervical and endometrial cancer patients were retrospectively analyzed, and the endpoints were grade ≥ 2 acute urinary toxicity (AUT) and acute lower gastrointestinal toxicity (ALGIT). The normal tissue complication probability (NTCP) model was established using the logistic regression model. Restricted cubic spline (RCS) curves were used to explore the association between dosimetric parameters and toxicities. The receiver operating characteristic (ROC) curve, calibration curve, Akaike’s corrected information criterion (AICc), decision curve analysis (DCA), and clinical impact curve (CIC) were analyzed to evaluate the performance of NTCP models. (3) Results: Bladder V_40Gy was identified to develop the NTCP model of AUT, and the mean AUC was 0.69 (CI: 0.58–0.80). Three candidate predictors, namely the small intestine V_30Gy, colon D_45%, and rectum D_55%, were identified to develop the NTCP model of ALGIT, and the mean AUC was 0.71 (CI: 0.61–0.80). Both models were considered to have relatively good discriminative accuracy and could provide a high net benefit in clinical applications. (4) Conclusions: We developed NTCP models to predict the probability for grade ≥ 2 AUT and ALGIT. We recommend that bladder V_40Gy, the small intestine V_30Gy, colon D_45%, and rectum D_55% be controlled below 42%, 20.4%, 16.9 Gy, and 32.0 Gy, respectively. Full article

(This article belongs to the Section Gynecologic Oncology)

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Curr. Oncol., Volume 32, Issue 1 (January 2025) – 55 articles

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