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Cancers
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Cancer and Chronic Illness
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Cancer and Chronic Illness

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Pathophysiology".

Deadline for manuscript submissions: 15 April 2025 | Viewed by 10989

Special Issue Editors

Dr. Silvia Riondino

E-Mail Website
Guest Editor
Medical Oncology Unit, Department of Systems Medicine, Tor Vergata Clinical Center University Hospital, Viale Oxford, 81-00133 Rome, Italy
Interests: cancer; artificial intelligence
Dr. Vincenzo Formica

E-Mail Website
Guest Editor
Medical Oncology Unit, Department of Systems Medicine, University of Rome, Tor Vergata, Via Montpellier, 1-00133 Rome, Italy
Interests: oncology; colorectal cancer; gastrointestinal cancer

Special Issue Information

Dear Colleagues, 

Cancer has been increasingly classified as a chronic disease, sharing many risk factors with the most common chronic disorders, such as aging and an unhealthy lifestyle, underlying which an inflammatory substrate is recognized. In addition to being major causes of death and disability, some chronic diseases can also predispose to cancer and thus be considered independent risk factors. Advances in the field of drug discovery and the development of novel life-prolonging strategies have led to an increase in extended treatments involving immunotherapy, targeted therapy, radiation therapy, and hormone therapy, which, while not being able to cure the disease, can nevertheless control it for months or even years, thus exposing patients to chronic-treatment-related toxicities. In addition, many cancer patients will inevitably suffer from chronic comorbid conditions that pose a major challenge for the overall clinical management. Moreover, it has been found in many settings that chronic comorbid conditions might play a role as both prognostic and predictive factors influencing patient outcome and response to treatment. 

This Special Issue will focus on the importance of chronic conditions both as sequelae of anticancer therapies and as influencing factors of the disease natural history and treatment sensitivity. Recent advances in understanding the multiple interconnections among cancer and chronic illnesses with potential effects on the trajectory of cancer burden and patient prognosis will be described.

Dr. Silvia Riondino
Dr. Vincenzo Formica
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cancer
  • chronic disease
  • inflammatory disease
  • cytokines
  • immune disease
  • radiotherapy-induced diseases
  • immunotherapy-induced disease
  • gastrointestinal chronic disorders
  • end-stage renal disease
  • lung cancer chronic disease

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Published Papers (6 papers)

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Research

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11 pages, 450 KiB  
Article
Impact of Breast Cancer on Cardiometabolic Health in Spanish Women ≥50 Years with Pre-Existing Type 2 Diabetes Mellitus
by Lucía Fernández-Arce, Nena Robles-Rodríguez, Ana Fernández-Feito, Rocío Fernández-Iglesias, María del Mar Fernández-Álvarez and Alberto Lana
Cancers 2024, 16(16), 2853; https://doi.org/10.3390/cancers16162853 - 15 Aug 2024
Viewed by 979
Abstract
During breast cancer (BC), cardiometabolic disorders can worsen prognosis, particularly in women with type 2 diabetes mellitus (T2DM). This study aimed to determine the impact of BC diagnosis on cardiometabolic parameters and the incidence of complication in women over 50 years of age [...] Read more.
During breast cancer (BC), cardiometabolic disorders can worsen prognosis, particularly in women with type 2 diabetes mellitus (T2DM). This study aimed to determine the impact of BC diagnosis on cardiometabolic parameters and the incidence of complication in women over 50 years of age (90% aged ≥ 65 years) with pre-existing T2DM. Using primary care registries from Asturias (Spain), a total of 106 women diagnosed with T2DM followed by BC were selected and matched with women with T2DM (n = 212) in a cohort study. Indicators of cardiometabolic health and microvascular complications associated with T2DM were collected. Women were monitored from two years prior to five years after BC diagnosis. Conditional logistic regressions were used to compare the adjusted odds of staying below each indicator’s threshold. During follow-up, women with T2DM+BC had a higher risk of fasting blood glucose ≥126 mg/dL (adjusted odds ratio [aOR] = 1.83; 95% confidence interval [CI95%]: 1.01–3.32) and glycosylated hemoglobin (Hb1Ac) ≥ 48 mmol/mol or 6.5% (aOR: 2.44; IC95%: 1.21–4.91). There was no difference between the groups regarding the incidence of microvascular complications. BC incidence negatively impacted the glycemic control of Spanish women with pre-existing T2DM measured by basal blood glucose and HbA1c, but not cardiometabolic health indicators or T2DM complications. Full article
(This article belongs to the Special Issue Cancer and Chronic Illness)
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10 pages, 829 KiB  
Article
Preventing Cardiotoxicity in Personalized Breast Irradiation
by Edy Ippolito, Carlo Greco, Maristella Marrocco, Carla Germana Rinaldi, Michele Fiore, Luca Eolo Trodella, Rolando Maria D’Angelillo and Sara Ramella
Cancers 2023, 15(21), 5153; https://doi.org/10.3390/cancers15215153 - 26 Oct 2023
Viewed by 1278
Abstract
Background: This study aims to assess the benefit of a deep inspiration breath hold (DIBH) over the standard irradiation technique, and eventually to identify anatomical and/or treatment preplanning characteristics correlated with the LAD dose. Methods: Patients with left-sided breast cancer undergoing whole breast [...] Read more.
Background: This study aims to assess the benefit of a deep inspiration breath hold (DIBH) over the standard irradiation technique, and eventually to identify anatomical and/or treatment preplanning characteristics correlated with the LAD dose. Methods: Patients with left-sided breast cancer undergoing whole breast radiotherapy with DIBH were analyzed. All patients included in the analysis had plans in DIBH and free-breathing (FB). Receiving operating characteristics (ROC analysis) were used to identify the cut-off point of parameters to predict the LAD maximum dose > 10 Gy and LAD mean dose > 4 Gy, and the areas under the curve (AUCs) were computed. Post-test probability has been performed to evaluate the effect of parameters’ combination. Results: One hundred ninety-seven patients were analyzed. The LAD dose was significantly reduced in DIBH plans with the maximum and mean dose reduced by 31.7% (mean value 3.5 Gy vs. 4.8 Gy, p ≤ 0.001) and 28.1% (mean value 8.2 Gy vs. 12.8 Gy, p ≤ 0.001) in DIBH plans compared to FB plans. The strongest predictor of the LAD dose (maximum > 10 Gy and mean > 4 Gy) was the minimum distance of LAD from tangent open fields. Other parameters were lung volume and heart volume (LAD Dmax > 10 Gy) and lung volume, heart volume, and breast separation (LAD Dmean > 4 Gy). Conclusion: The dosimetric advantage of DIBH is clear in all patients and DIBH should always be preferred. Full article
(This article belongs to the Special Issue Cancer and Chronic Illness)
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13 pages, 1400 KiB  
Article
Untailored vs. Gender- and Body-Mass-Index-Tailored Skeletal Muscle Mass Index (SMI) to Assess Sarcopenia in Advanced Head and Neck Squamous Cell Carcinoma (HNSCC)
by Cristina Morelli, Vincenzo Formica, Paolo Bossi, Michela Rofei, Simona Guerriero, Silvia Riondino, Renato Argirò, Noemi Pucci, Tonia Cenci, Luca Savino, Carla G. Rinaldi, Francesco Garaci, Augusto Orlandi, Rolando M. D’Angelillo, Hendrik-Tobias Arkenau and Mario Roselli
Cancers 2023, 15(19), 4716; https://doi.org/10.3390/cancers15194716 - 25 Sep 2023
Cited by 3 | Viewed by 1524
Abstract
(1) Background: Sarcopenia lasting >1 year might be considered a chronic condition in many HNSCC patients. CT-scan-derived Skeletal Muscle Mass Index (SMI) is an established surrogate of sarcopenia; yet, the cut-off reported in the literature (literature-based, lb-SMI < 43.2) is mainly based on [...] Read more.
(1) Background: Sarcopenia lasting >1 year might be considered a chronic condition in many HNSCC patients. CT-scan-derived Skeletal Muscle Mass Index (SMI) is an established surrogate of sarcopenia; yet, the cut-off reported in the literature (literature-based, lb-SMI < 43.2) is mainly based on the risk of chemoradiotherapy-induced toxicity, and the optimal value to discriminate OS is under-investigated. (2) Methods: The effect on OS of the lb-SMI cutoff was compared with an untailored OS-oriented SMI cutoff obtained in a cohort of consecutive advanced HNSCC patients treated with primary chemoradiotherapy, bio-chemotherapy or chemo-immunotherapy (cohort-specific, cs-SMI cutoff). Gender- and BMI-tailored (gt-SMI and bt-SMI) cut-offs were also evaluated. Cutoff values were identified by using the maximally selected rank statistics for OS. (3) Results: In 115 HNSCC patients, the cs-SMI cutoff was 31.50, which was lower compared to the lb-SMI reported cut-off. The optimal cut-off separately determined in females, males, overweight and non-overweight patients were 46.02, 34.37, 27.32 and 34.73, respectively. gt-SMI categorization had the highest effect on survival (p < 0.0001); its prognostic value was independent of the treatment setting or the primary location and was retained in a multivariate cox-regression analysis for OS including other HNSCC-specific prognostic factors (p = 0.0004). (4) Conclusions: A tailored SMI assessment would improve clinical management of sarcopenia in chemoradiotherapy-, bio-chemotherapy- or chemo-immunotherapy-treated HNSCC patients. Gender-based SMI could be used for prognostication in HNSCC patients. Full article
(This article belongs to the Special Issue Cancer and Chronic Illness)
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Review

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20 pages, 1479 KiB  
Review
Effectiveness of Immunotherapy in Non-Small Cell Lung Cancer Patients with a Diagnosis of COPD: Is This a Hidden Prognosticator for Survival and a Risk Factor for Immune-Related Adverse Events?
by Silvia Riondino, Roberto Rosenfeld, Vincenzo Formica, Cristina Morelli, Giusy Parisi, Francesco Torino, Sabrina Mariotti and Mario Roselli
Cancers 2024, 16(7), 1251; https://doi.org/10.3390/cancers16071251 - 22 Mar 2024
Cited by 2 | Viewed by 1889
Abstract
The interplay between the immune system and chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC) is complex and multifaceted. In COPD, chronic inflammation and oxidative stress can lead to immune dysfunction that can exacerbate lung damage, further worsening the respiratory [...] Read more.
The interplay between the immune system and chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC) is complex and multifaceted. In COPD, chronic inflammation and oxidative stress can lead to immune dysfunction that can exacerbate lung damage, further worsening the respiratory symptoms. In NSCLC, immune cells can recognise and attack the cancer cells, which, however, can evade or suppress the immune response by various mechanisms, such as expressing immune checkpoint proteins or secreting immunosuppressive cytokines, thus creating an immunosuppressive tumour microenvironment that promotes cancer progression and metastasis. The interaction between COPD and NSCLC further complicates the immune response. In patients with both diseases, COPD can impair the immune response against cancer cells by reducing or suppressing the activity of immune cells, or altering their cytokine profile. Moreover, anti-cancer treatments can also affect the immune system and worsen COPD symptoms by causing lung inflammation and fibrosis. Immunotherapy itself can also cause immune-related adverse events that could worsen the respiratory symptoms in patients with COPD-compromised lungs. In the present review, we tried to understand the interplay between the two pathologies and how the efficacy of immunotherapy in NSCLC patients with COPD is affected in these patients. Full article
(This article belongs to the Special Issue Cancer and Chronic Illness)
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14 pages, 276 KiB  
Review
Selective RET Inhibitors (SRIs) in Cancer: A Journey from Multi-Kinase Inhibitors to the Next Generation of SRIs
by Liz Clark, Geoff Fisher, Sue Brook, Sital Patel and Hendrik-Tobias Arkenau
Cancers 2024, 16(1), 31; https://doi.org/10.3390/cancers16010031 - 20 Dec 2023
Viewed by 2048
Abstract
RET is a receptor tyrosine kinase that plays an important role in the development of neurons and kidneys. The gene encoding the rearranged-during-transfection (RET) receptor tyrosine kinase was first discovered in the 1980s. Activating RET mutations and rearrangements have since been [...] Read more.
RET is a receptor tyrosine kinase that plays an important role in the development of neurons and kidneys. The gene encoding the rearranged-during-transfection (RET) receptor tyrosine kinase was first discovered in the 1980s. Activating RET mutations and rearrangements have since been identified as actionable drivers of oncogenesis in numerous cancer types and are most prevalent in thyroid and non-small-cell lung cancer. Following the modest success of repurposed RET-active multikinase inhibitors, the first selective RET inhibitors (SRIs), selpercatinib and pralsetinib, received regulatory approval in 2020. Now, thousands of patients with RET-altered cancers have benefited from first-generation SRIs, with impressive deep and durable responses. However, following prolonged treatment with these SRIs, a number of acquired on-target resistance mutations have been identified together with other non-RET-dependent resistance mechanisms. Today, the focus is on how we can further evolve and improve the treatment of RET-altered tumors with next-generation SRIs, and a number of candidate drugs are in development. The ideal next-generation SRIs will be active against on-target acquired resistance alterations, including those that emerge in the CNS, and will have improved safety and tolerability relative to first-generation SRIs. In this review, we will provide an update on these candidates and their potential to meet the unmet clinical need for patients who progress on first-generation SRIs. Full article
(This article belongs to the Special Issue Cancer and Chronic Illness)
22 pages, 876 KiB  
Review
The Onco-Nephrology Field: The Role of Personalized Chemotherapy to Prevent Kidney Damage
by Annalisa Noce, Giulia Marrone, Manuela Di Lauro, Anna Paola Mitterhofer, Maria Josè Ceravolo, Nicola Di Daniele, Guglielmo Manenti and Antonino De Lorenzo
Cancers 2023, 15(8), 2254; https://doi.org/10.3390/cancers15082254 - 12 Apr 2023
Cited by 1 | Viewed by 2369
Abstract
In recent years, the onco-nephrology field has acquired a relevant role in internal medicine due to the growing number of cases of renal dysfunction that have been observed in cancer patients. This clinical complication can be induced by the tumor itself (for example, [...] Read more.
In recent years, the onco-nephrology field has acquired a relevant role in internal medicine due to the growing number of cases of renal dysfunction that have been observed in cancer patients. This clinical complication can be induced by the tumor itself (for example, due to obstructive phenomena affecting the excretory tract or by neoplastic dissemination) or by chemotherapy, as it is potentially nephrotoxic. Kidney damage can manifest as acute kidney injury or represent a worsening of pre-existing chronic kidney disease. In cancer patients, physicians should try to set preventive strategies to safeguard the renal function, avoiding the concomitant use of nephrotoxic drugs, personalizing the dose of chemotherapy according to the glomerular filtration rate (GFR) and using an appropriate hydration therapy in combination with nephroprotective compounds. To prevent renal dysfunction, a new possible tool useful in the field of onco-nephrology would be the development of a personalized algorithm for the patient based on body composition parameters, gender, nutritional status, GFR and genetic polymorphisms. Full article
(This article belongs to the Special Issue Cancer and Chronic Illness)
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