Current Oncology Reports最新文献

Purpose of review: Cancer is the leading cause of mortality among incarcerated individuals in the United States, with lung cancer being the most prevalent. This review aims to evaluate current data on lung cancer within carceral settings and to describe disparities between incarcerated and non-incarcerated populations. We conducted a narrative review of published papers and studies addressing lung cancer screening, prevalence, mortality, and treatment in correctional facilities.

Findings: While the literature is limited, existing studies indicate that lung cancer has a higher prevalence, is diagnosed at more advanced stages, and carries a higher mortality among incarcerated individuals compared to non-incarcerated individuals. Although lung cancer screening is recommended based on eligibility criteria for the general population, there is a paucity of data on how screening is implemented in carceral settings, and the existing studies suggest that even eligible individuals with significant smoking history often do not undergo lung cancer screening. Furthermore, the literature provides minimal insight into lung cancer treatment for incarcerated patients. This review underscores the urgent need for expansion of lung cancer screening efforts and further studies on lung cancer diagnosis, treatment, and outcomes among incarcerated populations.

Purpose of review: This narrative review aims to explore research advances in multimodal rehabilitation for advanced cancer pain, with a primary focus on nonpharmacological intervention approaches, to offer comprehensive treatment strategies for cancer pain management.

Recent findings: While the WHO analgesic regimen holds a central position, long-term medication use may lead to drug resistance and side effects. Nonpharmacological interventions have shown potential as effective adjuncts to pharmacological treatments, particularly in reducing medication side effects and enhancing patients' quality of life. Disparities in access, cultural acceptability, and cost-effectiveness-especially in low- and middle-income countries(LMICs)-along with publication bias and study heterogeneity remain significant challenges. Emerging technologies such as virtual reality and artificial-intelligence-driven applications show promise in addressing coverage gaps. Based on the comprehensive review of current evidence, multimodal rehabilitation incorporating nonpharmacological strategies-such as physical therapy, exercise training, psychological interventions, and complementary therapies-effectively complements pharmacologic management in alleviating advanced cancer pain and enhancing quality of life. Future efforts should focus on standardizing interventions, expanding access, and integrating these approaches within multidisciplinary frameworks to optimize pain control and functional outcomes.

Purpose of review: The incidence of human papillomavirus (HPV)-positive oropharyngeal cancer has increased to epidemic-like proportions in the United States and other industrialized nations. However, geographical variations are notable across the world. While significant progress has been made in the understanding of this disease with respect to its etiology, underlying biology, and pathogenesis, numerous uncertainties persist. The purpose of this review is to thus present some of the controversies and questions surrounding this disease focusing on its unique epidemiology. A selected series of critical points were presented related to the epidemiology, pathogenesis, and diagnosis of HPV-positive oropharyngeal cancer. Interpretive viewpoints were provided after a comprehensive review of the literature.

Recent findings: HPV is now estimated to cause approximately 70% of oropharyngeal cancers in the United States and other developed countries. However, in developing countries, the incidence of HPV-positive oropharyngeal cancer is significantly lower. Data has also established that HPV-positive and HPV-negative oropharyngeal cancer represents distinct entities that generally originate in different settings. Since HPV-positive oropharyngeal cancer is increasingly being recognized as a sexually transmitted disease with unique modes of transmission, the epidemiological implications are of practical relevance. The resultant geographical variation in incidence rates among countries across the world is thus believed to be due to differing lifestyles and sexual norms. Although there is currently no role for screening, efforts to promote general awareness particularly among high-risk groups should be prioritized. The development of a novel staging system specific for patients with HPV-positive oropharyngeal cancer also has important ramifications with respect to treatment. HPV-positive oropharyngeal cancer is increasingly recognized as a public health problem with a unique worldwide geographical distribution. As the etiology of this disease is increasingly elucidated, efforts to promote awareness and education are warranted.

Background: Gastrointestinal (GI) cancers remain a significant global health burden with high mortality rates. Chinese herbal medicine (CHM) has emerged as a complementary therapy, yet limited real-world evidence regarding its use and effectiveness in GI cancers.

Methods: This scoping review evaluated findings on CHM usage patterns and survival outcomes in GI cancer patients from studies using the Taiwan National Health Insurance Research Database, a uniquely data source covering 99.99% of the Taiwanese population. Five databases were searched for studies from January 1, 1997, to November 30, 2024. Information on exposures and outcomes were extracted, alongside study designs, patient characteristics, methodologies, and results.

Results: We identified seven studies focusing on liver (n = 3), gastric (n = 2), pancreatic (n = 1) and colon (n = 1) cancers. Of the 6 studies that evaluated usage patterns, Bai-Hua-She-She-Cao (Oldenlandia Diffusae Herba) and Dan-Shen (Salviae Miltiorrhizae Radix et Rhizoma) were the most frequently used herbs among Taiwanese GI cancer patients. Of the 6 studies that investigated survival, complementary CHM use was associated with lower mortality (adjusted HRs = 0.41-0.68) compared to conventional treatment only. Subgroup analyses showed longer durations of CHM use were associated with greater survival benefits. However, potential for confounding and bias tempers any conclusions.

Conclusion: This review underscores the potential role of CHM as a complementary treatment for improving survival in GI cancers in real-world settings. These findings will require future rigorously-designed multinational observational studies and trials to further identify the role of specific herbal treatment in contemporary oncological care to improve outcomes for people with GI cancer.

Purpose: Social determinants of health are increasingly recognized as key contributors to disparities in healthcare access and outcomes. With robotic-assisted radical prostatectomy now widely adopted as the preferred surgical approach for localized prostate cancer, this systematic review evaluates how individual social determinants of health influence access to robotic surgery and postoperative outcomes.

Materials and methods: This review adhered to PRISMA guidelines and was registered with PROSPERO (CRD420256270179). A comprehensive search of PubMed and EBSCO identified studies examining social determinants of health in patients undergoing robotic prostatectomy. Extracted data included patient demographics, social determinants of health variables, and perioperative outcomes. Risk of bias was assessed using the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale.

Results: Eighteen studies met inclusion criteria. Commonly assessed variable included socioeconomic status, race/ethnicity, insurance, education, occupation, and geographic location. Lower socioeconomic status was linked to decreased robotic prostatectomy access, treatment at low-volume or non-robotic centers, and worse outcomes. Racial and ethnic disparities were consistent; non-White patients were less likely to receive definitive therapy and more likely to undergo surgery by low-volume providers. Rural patients experienced reduced access to robotic surgery and lower rates of pelvic lymph node dissection. Lower education levels were associated with delayed continence and reduced return-to-work capacity.

Conclusions: Social determinants of health significantly impact access to robotic prostatectomy and postoperative outcomes. Urologists and policymakers should integrate awareness of these factors into patient counseling and institutional planning. Future research should explore mechanisms underlying these disparities to inform equity-driven strategies in prostate cancer care.

Purpose of review: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Liquid biopsy by peripheral blood circulating tumor DNA (ctDNA) measurement has emerged as a promising biomarker in the management of CRC. We aimed to summarize the current landscape of ctDNA assessment in CRC by briefly addressing relevant technicalities of ctDNA assays, reviewing the current body of evidence regarding the utility of ctDNA across the clinical spectrum, and providing considerations and prospectus for the future of ctDNA in CRC.

Recent findings: Data from prospective trials investigating the use of ctDNA in CRC is rapidly accumulating. Positive ctDNA status is a strong prognostic factor for recurrence, now recognized in cancer treatment guidelines, and is emerging as a potential guide for adjuvant therapies in the setting of resected localized and metastatic disease. Mounting evidence also suggests that ctDNA measurement can potentially have a meaningful impact for CRC screening, multi-cancer early detection, and longitudinal surveillance of tumor biology in the setting of systemic therapies such as anti-EGFR rechallenge. There is a paucity of randomized controlled trial data supporting ctDNA use. ctDNA assessment may improve the clinician's ability to gain granular information about tumor biology and activity across the spectrum of CRC. The results of ongoing randomized trials will further inform the value of routine ctDNA testing while helping steer future investigation.

Purpose of review: Malignant brain cancer, the most severe form is glioblastoma (GBM), has a dismal prognosis, despite maximal resection followed by radio-chemotherapy. First line therapeutics are alkylating drugs, notably the DNA-methylating temozolomide (TMZ), administered concomitantly with radiation. Radio-chemotherapy induces not only apoptosis, but also cellular senescence in GBM cells. Senescent cells change the tumor microenvironment, cause an inflammatory response in the affected area and can be reactivated, contributing to recurrences. To eliminate therapy-induced senescent cells, senotherapeutics have gained attention. Here, we describe the pathways triggered in GBM cells leading to cellular senescence and update drugs and natural compounds acting as senolytics, senomorphics and senopreventics.

Recent findings: There is an increasing amount of data showing that temozolomide induces cellular senescence, which is even the main response of GBM cells following treatment. We outline the mechanism of senescence in glioblastoma cells and show that it rests on some unique cellular responses that may explain the low curability and aggressiveness of glioblastoma. Thus, senescent GBM cells are incompletely blocked in G2 following temozolomide treatment and undergo endoreduplications. This is presumably fostered by inactivation of CDKN2A, which is frequently mutated in gliomas. Since cellular senescence is a key event induced by temozolomide and radiation in GBM cells, it is reasonable to conclude that glioma cells cannot be completely eliminated, neither by radiation or chemotherapy alone nor in combination. Based on the data, new treatment options with senopreventics, senolytics and senostatics/senomorphics as important supportive medication during or after radiochemotherapie are discussed.

Purpose of review: This review aims to explore key clinical considerations for prescribing exercise in individuals with multiple myeloma (MM) and to evaluate current evidence to develop exercise regimens that prioritize both safety and efficacy.

Recent findings: MM is a hematological cancer characterized by complex complications, including unstable bone lesions, cardiac amyloidosis, peripheral neuropathy, and cytopenia, which collectively impair patients' health and quality of life. Exercise training has emerged as a critical component of supportive care in MM; however, the complexity of the disease and its associated comorbidities pose challenges to designing safe and effective interventions. Recent evidence underscores the potential benefits of aerobic and resistance training, yet there is no consensus on optimal exercise protocols. Tools such as cardiopulmonary exercise testing, fracture risk assessment, and blood biomarker monitoring have shown promise in personalizing exercise prescriptions. Although the feasibility and short-term benefits of exercise interventions for MM are well-established, significant gaps in knowledge persist regarding their long-term effects on disease progression, survival, and quality of life. Future research is needed to address these gaps and refine evidence-based exercise guidelines for this unique patient population.

Purpose of review: Concurrent chemoradiotherapy (cCRT) remains the standard of care for limited-stage SCLC (LS-SCLC), while long-term survival remains suboptimal. This review aims to summarize recent advances in combining immunotherapy with cCRT in LS-SCLC and highlight future directions in this evolving treatment landscape.

Recent findings: The ADRIATIC trial demonstrated significant improvements in overall survival (OS) and progression-free survival (PFS) with durvalumab consolidation post-concurrent chemoradiotherapy (cCRT). Other studies explore various immunotherapeutic agents and combination strategies, underscoring the potential of PD-1/PD-L1 blockade and other novel targets such as BTLA and TIGIT in the treatment of LS-SCLC. However, challenges remain in determining the appropriate timing of immunotherapy and the optimal radiotherapy fraction schedule, as well as the role of prophylactic cranial irradiation (PCI) in the context of immunotherapy. Integrating immunotherapy into LS-SCLC treatment represents a promising strategy with the potential to improve outcomes beyond what is achievable with cCRT alone. Ongoing trials are expected to provide further insights, potentially reshaping LS-SCLC treatment strategies.