Onco, Volume 5, Issue 1 (March 2025) – 6 articles

Background/Objectives: Treatment options for advanced HCC are limited. Immunotherapy, a promising new therapeutic, has recently been incorporated as a first-line systemic treatment. This study evaluates immunotherapy uptake and disparities in its adoption prior to first-line approval, which are currently unknown. Methods: Patients diagnosed with stage IV HCC between 2014 and 2019 were identified in the National Cancer Database (NCDB). Multivariable logistic regression analysis was performed for demographic and clinical variables to determine their association with the receipt of immunotherapy. Results: A total of 18,248 patients were diagnosed with stage IV HCC, of which 977 (5.35%) received immunotherapy. From 2014 to 2019, the rate of immunotherapy uptake increased each year, with an approximate 25-fold increase overall. On multivariable analysis, patients with a more recent period of diagnosis (OR: 30.19, 95% CI: 16.47–55.33), with private insurance (OR: 2.56, 95% CI: 1.62–4.04), with treatment at an academic or research center (OR: 1.97, 95% CI: 1.37–2.82), or with an income ≥ USD 63,333 (OR: 1.27, 95% CI: 1.01–1.59) were more likely to receive immunotherapy. Conclusions: Various demographic factors impact the receipt of immunotherapy in the pre-approval setting, such as income, insurance status, and treatment center. As immunotherapy use will likely further expand and these disparities may potentially persist following first-line approval, strategies to mitigate them are especially important. Full article

Background/Objectives: Lip cancer represents one of the most prevalent malignant neoplasms in the oral cavity worldwide. This study investigated the prevalence, epidemiological profile, and survival rates of lip squamous cell carcinoma cases at the Liga Norte Riograndense Contra o Câncer (LNRCC) through a 15-year retrospective analysis. Methods: Data collection included sociodemographic characteristics, risk factors, tumor features, staging, and treatment modalities from 348 patient records. Statistical analysis was performed using Stata 12.0 and SPSS 22.0. Results: Results showed a predominance of male patients (70.4%), with a mean age of 65.51 years, mostly brown-skinned, illiterate individuals working in rural areas and residing in the state’s eastern region. Moderately differentiated squamous cell carcinoma (82.8%) affecting the lower lip (89.1%) was most frequent, with a tendency toward advanced staging. The overall survival rate was 88.90%, with lower rates observed among white, illiterate, and substance-using patients, as well as those with advanced-stage disease and chemotherapy treatment. Conclusions: Notably, race emerged as the most significant survival predictor, with white individuals showing consistently lower survival rates regardless of disease characteristics or treatment approach. Full article

Tumor dormancy plays a pivotal role in cancer relapse. Dormant tumor cells have been identified in distant sites, even in early-stage tumors, and are associated with worse outcomes. This review explores the current understanding of the molecular and cellular mechanisms behind tumor dormancy, including the role of the immune system and the microenvironment. Targeting dormant tumor cells could be a therapeutic strategy to offer long-term remission and potentially cure cancer. Unfortunately, the translation of this knowledge in clinical practice is lacking. We assess the feasibility of detecting and measuring dormant tumor cells in clinical practice, and give an overview of potential therapeutic targets, both in terms of maintaining tumor cells in a dormant state, and in terms of eradicating this tumor population. Full article

The integration of small interfering RNA (siRNA) with traditional cancer therapies represents a promising frontier in oncology aimed at enhancing treatment effectiveness, reducing side effects, and overcoming drug resistance. This review highlights the potential of siRNA to selectively silence genes that are overexpressed or uniquely expressed in cancer cells, thereby disrupting critical pathways that support tumor growth and survival. Key target genes discussed include survivin, VEGF, EGFR, c-MET, HER2, MUC1, and Bcl-2, all of which play vital roles in tumor proliferation, angiogenesis, and resistance to therapies. Clinical trials investigating various siRNA candidates, such as EZN-3042 and ALN-VSP, indicate that these therapies are generally well-tolerated; however, significant challenges persist, including the effective delivery and stability of siRNA. Recent advancements in nanoparticle-based delivery systems have shown promise in addressing these issues. Future research will focus on optimizing siRNA delivery methods, personalizing therapies based on individual genetic profiles, and establishing clearer regulatory guidelines for approval. As the field evolves, siRNA-based combination therapies are poised to become an integral part of precision oncology, offering new therapeutic options and hope for patients with difficult-to-treat cancers. Full article

Background/Objectives: Multiple immune-modulatory strategies have been tested in efforts to mitigate the pro-tumor microenvironment in pediatric high-grade glioma. HSV1716 is an oncolytic virus that previously demonstrated evidence of response in adult and pediatric patients. PBTC-037 was a single-center phase I trial developed and performed by the Pediatric Brain Tumor Consortium (PBTC) to estimate the maximum tolerated dose or recommended phase II dose of HSV1716 administered during surgical resection. Methods: Patients aged 12 to 21 years with recurrent or refractory high-grade glioma for whom surgical resection was clinically indicated were eligible. After maximal tumor resection, patients received one intraoperative dose of HSV1716. Results: Two patients were enrolled; one was later deemed ineligible yet was continued in follow up for safety. Both patients underwent complete tumor resection with the administration of HSV1716. Shortly after the enrollment of the two patients, this study was closed to accrual due to a change in the sponsor’s investment focus. One patient completed the 8-week reporting period without toxicity. The second patient who was later deemed ineligible had no evidence of dose-limiting toxicity. The two patients had progressive disease at 1.9 and 2.9 months after enrollment; both eventually died due to progressive disease at 7.5 months. Conclusion: We describe the administration of HSV1716 to two pediatric patients with recurrent high-grade glioma, without evidence of dose-limiting toxicity. Oncolytic viruses are currently being tested in pediatric patients in larger combinatorial trials. Despite the limited numbers, the data presented here will hopefully provide incremental steps toward improved immunovirotherapy of pediatric brain tumors. Full article