Ahmad Alkhaledi, Laila Alhaj Hussaen, Linda Kahla, Baraa Sammoud, Suha Giselle Ghanem
Background
Therapy-related AML (t-AML) is a subtype of acute myeloid leukemia (AML) that arises in the bone marrow and primarily affects white blood cells. It is associated with prior exposure to cytotoxic agents, including chemotherapy and radiotherapy. The risk of the disease increases with age and treatment intensity. Although t-AML represents 25%–30% of all AML cases, its occurrence following radiotherapy is relatively rare. Diagnosis is confirmed via bone marrow biopsy, with differential diagnoses including other leukemias, lymphomas, and myelodysplastic syndromes. Prognosis is generally poor. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the most effective curative option, though elderly patients often have limited eligibility due to comorbidities and poor performance status.
Case
Five years after treatment for stage IIA rectal cancer, including radiotherapy, chemotherapy, and surgery, a 77-year-old male smoker presented with fatigue, weight loss, progressive dyspnea, headache, dizziness, blurred vision, and melena. Physical examination revealed pallor, purpura, skin crusts, and pustules. Laboratory findings showed anemia, thrombocytopenia, and circulating blasts. Bone marrow biopsy confirmed lymphoid infiltration. He was diagnosed with therapy-related AML (t-AML). Despite receiving three cycles of Azacitidine, he died of septic shock 7 months later.
Conclusion
This case highlights the rare development of therapy-related acute myeloid leukemia in a colorectal cancer survivor following combined pelvic radiation and capecitabine plus oxaliplatin (CAPOX) chemotherapy, underscoring the importance of long-term hematologic surveillance in such patients.
{"title":"Acute Myeloid Leukemia Secondary to Radiation Therapy for Rectal Cancer: A Case Report","authors":"Ahmad Alkhaledi, Laila Alhaj Hussaen, Linda Kahla, Baraa Sammoud, Suha Giselle Ghanem","doi":"10.1002/cnr2.70379","DOIUrl":"10.1002/cnr2.70379","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Therapy-related AML (t-AML) is a subtype of acute myeloid leukemia (AML) that arises in the bone marrow and primarily affects white blood cells. It is associated with prior exposure to cytotoxic agents, including chemotherapy and radiotherapy. The risk of the disease increases with age and treatment intensity. Although t-AML represents 25%–30% of all AML cases, its occurrence following radiotherapy is relatively rare. Diagnosis is confirmed via bone marrow biopsy, with differential diagnoses including other leukemias, lymphomas, and myelodysplastic syndromes. Prognosis is generally poor. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the most effective curative option, though elderly patients often have limited eligibility due to comorbidities and poor performance status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case</h3>\u0000 \u0000 <p>Five years after treatment for stage IIA rectal cancer, including radiotherapy, chemotherapy, and surgery, a 77-year-old male smoker presented with fatigue, weight loss, progressive dyspnea, headache, dizziness, blurred vision, and melena. Physical examination revealed pallor, purpura, skin crusts, and pustules. Laboratory findings showed anemia, thrombocytopenia, and circulating blasts. Bone marrow biopsy confirmed lymphoid infiltration. He was diagnosed with therapy-related AML (t-AML). Despite receiving three cycles of Azacitidine, he died of septic shock 7 months later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the rare development of therapy-related acute myeloid leukemia in a colorectal cancer survivor following combined pelvic radiation and capecitabine plus oxaliplatin (CAPOX) chemotherapy, underscoring the importance of long-term hematologic surveillance in such patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. J. Cao-Alvira, E. F. Luciano, M. Sauane, and C. de la Parra, “Objective Assessment of Physical Activity in Breast Cancer Survivors: Associations With Adiposity and Metabolic Parameters of Glucose and Insulin—Insights From NHANES,” Cancer Reports 8, no. 9 (2025): e70339, https://doi.org/10.1002/cnr2.70339.
In the published article, affiliation 5 is incomplete. It currently reads:
5 City University of New York, New York, New York, USA
It should read:
5 Ph.D. Programs in Biochemistry and Biology, The Graduate Center, City University of New York, New York, New York, USA
We apologize for this error.
J. J. Cao-Alvira， E. F. Luciano， M. Sauane， C. de la Parra，“乳腺癌幸存者身体活动的客观评估：与肥胖和葡萄糖和胰岛素代谢参数的关联——来自NHANES的观察”，癌症杂志，第8期。9 (2025): e70339, https://doi.org/10.1002/cnr2.70339.In已发表文章，隶属关系5不完整。它现在是：5 City University of New York， New York, New York， usa它应该是：5 Ph.D. Programs in Biochemistry and Biology, The Graduate Center, City University of New York, New York, usa。我们为这个错误道歉。
{"title":"Correction to “Objective Assessment of Physical Activity in Breast Cancer Survivors: Associations With Adiposity and Metabolic Parameters of Glucose and Insulin—Insights From NHANES”","authors":"","doi":"10.1002/cnr2.70424","DOIUrl":"10.1002/cnr2.70424","url":null,"abstract":"<p>J. J. Cao-Alvira, E. F. Luciano, M. Sauane, and C. de la Parra, “Objective Assessment of Physical Activity in Breast Cancer Survivors: Associations With Adiposity and Metabolic Parameters of Glucose and Insulin—Insights From NHANES,” <i>Cancer Reports</i> 8, no. 9 (2025): e70339, https://doi.org/10.1002/cnr2.70339.</p><p>In the published article, affiliation 5 is incomplete. It currently reads:</p><p>5 City University of New York, New York, New York, USA</p><p>It should read:</p><p>5 Ph.D. Programs in Biochemistry and Biology, The Graduate Center, City University of New York, New York, New York, USA</p><p>We apologize for this error.</p>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12687562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Epidermal growth factor receptor (EGFR) mutations are detected in approximately 40%–50% of patients with lung adenocarcinoma in Asian populations and in around 10% of patients in Western populations. Among these, the EGFR L861R mutation is uncommon and undetectable using conventional polymerase chain reaction methods. Recently, clinically available next-generation sequencing (NGS) has been used to detect L861R mutations, potentially increasing the number of identified cases of L861R-positive non-small cell lung cancer. Herein, we present two cases of EGFR L861R-mutated lung adenocarcinoma treated with afatinib and osimertinib to evaluate the clinical efficacy and tolerability of these targeted therapies.
Case
Case 1: A 63-year-old man with lung adenocarcinoma harboring an EGFR L861R mutation (cStage IVB) received afatinib 40 mg/day. Computer tomography (CT) on Day 49 showed shrinkage of the primary tumor, accompanied by a decrease in tumor markers. The afatinib dose was reduced to 30 mg/day due to Grade 1 diarrhea and an acneiform rash. Ground-glass opacities were subsequently observed around the tumor. Although pneumonitis was initially suspected, the findings were subsequently considered consistent with carcinomatous lymphangitis. Consequently, afatinib was discontinued on Day 56. Case 2: An 83-year-old man with lung adenocarcinoma harboring an EGFR L861R mutation (cStage IVB) received osimertinib 80 mg/day. Afatinib was avoided due to concerns regarding tolerability in the elderly. CT imaging on Day 14 showed tumor shrinkage with reduced attenuation and decreased levels of tumor markers. However, osimertinib was discontinued on Day 104 due to a Grade 3 skin rash. The response to osimertinib was evaluated as stable disease. Following treatment discontinuation, the disease progressed to multiple brain metastases, and supportive care was initiated.
Conclusion
Here, we present the first case showing the anti-tumor efficacy of afatinib and the second case showing the anti-tumor efficacy of osimertinib in a patient with EGFR L861R-positive lung adenocarcinoma. Despite their short treatment durations, afatinib and osimertinib may have potential clinical activity in patients with EGFR L861R-positive lung cancer.
{"title":"Two Cases of Epidermal Growth Factor Receptor L861R Mutation-Positive Lung Adenocarcinoma Treated With Osimertinib and Afatinib","authors":"Kei Kagawa, Takeshi Masuda, Kiyofumi Shimoji, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Yasushi Horimasu, Taku Nakashima, Hiroshi Iwamoto, Hironobu Hamada, Noboru Hattori","doi":"10.1002/cnr2.70420","DOIUrl":"10.1002/cnr2.70420","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Epidermal growth factor receptor (EGFR) mutations are detected in approximately 40%–50% of patients with lung adenocarcinoma in Asian populations and in around 10% of patients in Western populations. Among these, the EGFR L861R mutation is uncommon and undetectable using conventional polymerase chain reaction methods. Recently, clinically available next-generation sequencing (NGS) has been used to detect L861R mutations, potentially increasing the number of identified cases of L861R-positive non-small cell lung cancer. Herein, we present two cases of EGFR L861R-mutated lung adenocarcinoma treated with afatinib and osimertinib to evaluate the clinical efficacy and tolerability of these targeted therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case</h3>\u0000 \u0000 <p>Case 1: A 63-year-old man with lung adenocarcinoma harboring an EGFR L861R mutation (cStage IVB) received afatinib 40 mg/day. Computer tomography (CT) on Day 49 showed shrinkage of the primary tumor, accompanied by a decrease in tumor markers. The afatinib dose was reduced to 30 mg/day due to Grade 1 diarrhea and an acneiform rash. Ground-glass opacities were subsequently observed around the tumor. Although pneumonitis was initially suspected, the findings were subsequently considered consistent with carcinomatous lymphangitis. Consequently, afatinib was discontinued on Day 56. Case 2: An 83-year-old man with lung adenocarcinoma harboring an EGFR L861R mutation (cStage IVB) received osimertinib 80 mg/day. Afatinib was avoided due to concerns regarding tolerability in the elderly. CT imaging on Day 14 showed tumor shrinkage with reduced attenuation and decreased levels of tumor markers. However, osimertinib was discontinued on Day 104 due to a Grade 3 skin rash. The response to osimertinib was evaluated as stable disease. Following treatment discontinuation, the disease progressed to multiple brain metastases, and supportive care was initiated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Here, we present the first case showing the anti-tumor efficacy of afatinib and the second case showing the anti-tumor efficacy of osimertinib in a patient with EGFR L861R-positive lung adenocarcinoma. Despite their short treatment durations, afatinib and osimertinib may have potential clinical activity in patients with EGFR L861R-positive lung cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnr2.70420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evaluating biomarkers, such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2), in pathological specimens is crucial for guiding breast cancer treatment. Since biomarker expression may differ between primary and metastatic lesions, biopsy of metastatic sites is recommended whenever feasible. The liver is a common metastatic site for breast cancer, and percutaneous biopsy has traditionally been the standard approach. Recently, endoscopic ultrasound-guided tissue acquisition (EUS-TA) has emerged as an alternative method for sampling focal liver lesions. However, the utility of EUS-TA in assessing breast cancer biomarkers remains unclear.
Aim
To evaluate the diagnostic performance of EUS-TA, including its ability to assess biomarkers in liver metastases from breast cancer.
Methods
This single-center, retrospective observational study included patients who underwent EUS-TA for breast cancer liver metastases between 2016 and 2023. Clinical characteristics and specimen adequacy were analyzed. A pathologist classified the obtained tissue samples into four categories: (A) insufficient for diagnosis, (B) diagnosis possible only at the cytology level, (C) histological evaluation possible, but additional immunostaining for biomarkers not feasible, and (D) histological evaluation and additional immunostaining for biomarkers feasible.
Results
Fifteen cases were included, with a median patient age of 68 years (all female). The median liver lesion size was 20 mm (range: 8–50 mm). The lesions were located in the left lobe in 12 cases and the right lobe in 3 cases. A 22G needle was used in 14 cases, while a 25G needle was used in 1 case. Specimen adequacy was classified as follows: category A in 1 case (6.6%), B in 2 cases (13.3%), C in 0 cases (0%), and D in 12 cases (80%). Biomarker evaluation was feasible in the majority of cases. No procedure-related adverse events were observed.
Conclusion
EUS-TA is a valuable method for obtaining tissue samples from breast cancer liver metastases, enabling biomarker assessment in most cases.
{"title":"Endoscopic Ultrasound-Guided Tissue Acquisition for Breast Cancer Liver Metastases Enables the Detection of Biomarkers Essential for Treatment","authors":"Yuichi Takano, Naoki Tamai, Masataka Yamawaki, Jun Noda, Tetsushi Azami, Fumitaka Niiya, Naotaka Maruoka, Tatsuya Yamagami, Masatsugu Nagahama","doi":"10.1002/cnr2.70414","DOIUrl":"10.1002/cnr2.70414","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evaluating biomarkers, such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2), in pathological specimens is crucial for guiding breast cancer treatment. Since biomarker expression may differ between primary and metastatic lesions, biopsy of metastatic sites is recommended whenever feasible. The liver is a common metastatic site for breast cancer, and percutaneous biopsy has traditionally been the standard approach. Recently, endoscopic ultrasound-guided tissue acquisition (EUS-TA) has emerged as an alternative method for sampling focal liver lesions. However, the utility of EUS-TA in assessing breast cancer biomarkers remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the diagnostic performance of EUS-TA, including its ability to assess biomarkers in liver metastases from breast cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective observational study included patients who underwent EUS-TA for breast cancer liver metastases between 2016 and 2023. Clinical characteristics and specimen adequacy were analyzed. A pathologist classified the obtained tissue samples into four categories: (A) insufficient for diagnosis, (B) diagnosis possible only at the cytology level, (C) histological evaluation possible, but additional immunostaining for biomarkers not feasible, and (D) histological evaluation and additional immunostaining for biomarkers feasible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen cases were included, with a median patient age of 68 years (all female). The median liver lesion size was 20 mm (range: 8–50 mm). The lesions were located in the left lobe in 12 cases and the right lobe in 3 cases. A 22G needle was used in 14 cases, while a 25G needle was used in 1 case. Specimen adequacy was classified as follows: category A in 1 case (6.6%), B in 2 cases (13.3%), C in 0 cases (0%), and D in 12 cases (80%). Biomarker evaluation was feasible in the majority of cases. No procedure-related adverse events were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EUS-TA is a valuable method for obtaining tissue samples from breast cancer liver metastases, enabling biomarker assessment in most cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnr2.70414","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm arising from the digestive tract; however, esophageal GIST is a very rare entity and represents < 1% of all GIST cases. Furthermore, esophageal GIST is most commonly located in the lower esophagus, while esophageal GIST in the upper esophagus is rare among them. Therefore there are very few reports regarding their resection methods.
Case
This report describes a very rare resectable case of large upper esophageal GIST that extended to the cervical esophagus to be completely resected by performing thoracoscopic mobilization of the esophagus, followed by transection of the cervical esophagus via a cervical approach. The operative procedure was as follows: ensuring an adequate macroscopic margin for esophageal resection from within the thoracic cavity was judged to be difficult; therefore, only dissection of the thoracic and cervical esophagus was performed with thoracoscopic procedure, and the cervical esophagus was resected via a cervical approach. The abdominal procedure was carried out laparoscopically, and the specimen, including the tumor, was extracted from a small incision. Next, reconstruction using a gastric tube via a retrosternal approach was done. We also describe a literature review of upper esophageal GISTs.
Conclusion
The surgical approach of large tumors of the upper thoracic and cervical esophageal GIST, including esophageal resection and reconstruction methods, needs to be carefully considered in advance. A cervical approach for esophageal resection is considered useful when it is difficult to resect the tumor's proximal end within the thoracic cavity safely.
{"title":"The Rare Upper Thoracic and Cervical Esophageal GIST Resected Through Thoracoscopic Esophageal Mobilization and a Cervical Approach: A Case Report","authors":"Kenjiro Ishii, Erica Nishimura, Yuki Tajima, Kumiko Hongo, Hiroto Fujisaki, Motohito Nakagawa, Kiminori Takano, Osahiko Hagiwara, Toshiyuki Enomoto, Takaharu Kiribayashi, Koji Asai, Takuya Nagata, Manabu Watanabe, Yoshihisa Saida","doi":"10.1002/cnr2.70423","DOIUrl":"10.1002/cnr2.70423","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm arising from the digestive tract; however, esophageal GIST is a very rare entity and represents < 1% of all GIST cases. Furthermore, esophageal GIST is most commonly located in the lower esophagus, while esophageal GIST in the upper esophagus is rare among them. Therefore there are very few reports regarding their resection methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case</h3>\u0000 \u0000 <p>This report describes a very rare resectable case of large upper esophageal GIST that extended to the cervical esophagus to be completely resected by performing thoracoscopic mobilization of the esophagus, followed by transection of the cervical esophagus via a cervical approach. The operative procedure was as follows: ensuring an adequate macroscopic margin for esophageal resection from within the thoracic cavity was judged to be difficult; therefore, only dissection of the thoracic and cervical esophagus was performed with thoracoscopic procedure, and the cervical esophagus was resected via a cervical approach. The abdominal procedure was carried out laparoscopically, and the specimen, including the tumor, was extracted from a small incision. Next, reconstruction using a gastric tube via a retrosternal approach was done. We also describe a literature review of upper esophageal GISTs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The surgical approach of large tumors of the upper thoracic and cervical esophageal GIST, including esophageal resection and reconstruction methods, needs to be carefully considered in advance. A cervical approach for esophageal resection is considered useful when it is difficult to resect the tumor's proximal end within the thoracic cavity safely.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnr2.70423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer of unknown primary (CUP) presents diagnostic and management challenges, particularly when associated with rare subsets such as pelvic squamous cell carcinoma (SCC) of unknown primary origin. Human papillomavirus (HPV) is increasingly recognized as a prognostic and potentially predictive biomarker. HPV-associated SCCs often demonstrate better response to treatment and improved outcomes.
Cases
We present two cases of pelvic SCC with unknown primary origin, both positive for HPV genotype 16. Case 1 involved a 54-year-old woman with persistent abdominal pain who was diagnosed with an infiltrative 110 × 100 × 65 mm tumoral mass on the right side of the pelvic cavity, significantly involving the right iliac bone and right iliopsoas muscle; despite chemotherapy, the patient developed metastases. Case 2 featured a 46-year-old woman with progressive left lower limb pain, whose pelvic SCC was incidentally discovered on imaging with an 80 × 75 mm mass with an abnormal signal in the left iliac bone with extension to the left iliopsoas muscle involving the lower aspect of the iliopsoas muscle, and also involving the anterior aspect of the left sacral bone. She achieved a complete response to chemotherapy and chemoradiotherapy, with no evidence of recurrence during follow-up.
Conclusion
HPV-associated pelvic SCC of unknown primary presents both diagnostic complexity and therapeutic opportunity. The detection of HPV genotype 16 in both cases supports a growing body of case-based evidence suggesting a potential association with a favorable prognosis. However, further studies are needed to clarify its role in guiding management.
{"title":"HPV-Related Pelvic Squamous Cell Carcinoma of Unknown Primary: Two Case Studies","authors":"Sepideh Soltani, Sahar Dashti, Maryam Garousi, Elahe Mirzaee, Majid Kaheh, Masoome Zolfaghari, Maryam Abolhasani, Alireza Nikoofar","doi":"10.1002/cnr2.70402","DOIUrl":"10.1002/cnr2.70402","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cancer of unknown primary (CUP) presents diagnostic and management challenges, particularly when associated with rare subsets such as pelvic squamous cell carcinoma (SCC) of unknown primary origin. Human papillomavirus (HPV) is increasingly recognized as a prognostic and potentially predictive biomarker. HPV-associated SCCs often demonstrate better response to treatment and improved outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Cases</h3>\u0000 \u0000 <p>We present two cases of pelvic SCC with unknown primary origin, both positive for HPV genotype 16. Case 1 involved a 54-year-old woman with persistent abdominal pain who was diagnosed with an infiltrative 110 × 100 × 65 mm tumoral mass on the right side of the pelvic cavity, significantly involving the right iliac bone and right iliopsoas muscle; despite chemotherapy, the patient developed metastases. Case 2 featured a 46-year-old woman with progressive left lower limb pain, whose pelvic SCC was incidentally discovered on imaging with an 80 × 75 mm mass with an abnormal signal in the left iliac bone with extension to the left iliopsoas muscle involving the lower aspect of the iliopsoas muscle, and also involving the anterior aspect of the left sacral bone. She achieved a complete response to chemotherapy and chemoradiotherapy, with no evidence of recurrence during follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HPV-associated pelvic SCC of unknown primary presents both diagnostic complexity and therapeutic opportunity. The detection of HPV genotype 16 in both cases supports a growing body of case-based evidence suggesting a potential association with a favorable prognosis. However, further studies are needed to clarify its role in guiding management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
George M. Edwards, Lucas W. Ashley, Austin Holmes, Andrew W. Ju, Arjun Bhatt, Michael C. Larkins
Objectives
Penile squamous cell carcinoma (PSCC) is the most common penile cancer, accounting for ≥ 95% of cases, though it accounts for < 1% of all malignancies in men in the United States. We report an updated, stage-stratified analysis of the efficacy of surgery, radiation, and chemotherapy, including adjuvant and neoadjuvant chemoradiation, with further analysis of demographic and clinical factors.
Methods
Using the Surveillance, Epidemiology, and End Results (SEER) database, patients with PSCC diagnosed between 2000 and 2018 were identified. Five-year overall survival Cox regression analysis as well as univariate Kaplan–Meier analysis were performed, stratified by demographic and treatment variables.
Results
Two thousand seven hundred eight patients with PSCC were identified, with 57.8% being older than 65 years at diagnosis and 94.2% undergoing surgical intervention. With multivariate analysis, increasing disease stage (p < 0.001), age < 65 years (p < 0.001), lower disease grade (p < 0.001) were all associated with increased survival, while treatment with chemotherapy or radiotherapy was both associated with decreased survival (p = 0.002 and < 0.001, respectively). On univariate analysis, less invasive surgery was associated with increased survival among patients with low-grade, local (p < 0.001) or regional (p = 0.03) disease. Among those with high-grade disease, local excision was associated with increased survival (p = 0.008), though among those with regional disease no survival difference was seen (p = 0.86). Patients with regional disease saw increasing survival with four or more lymph nodes dissected (69% vs. 61%, respectively; p = 0.002).
Conclusions
Surgical management of penile SCC remains the mainstay treatment, and less invasive surgery is associated with noninferior or improved 5-year overall survival regardless of disease stage and grade. Patients with regional disease had increased survival when four or more lymph nodes were dissected. Future analysis of these trends stratified by disease subhistology and more granular analysis of the role of lymphadenectomy are warranted.
{"title":"Demographics, Clinical Characteristics, and a Stage-Based Analysis of Treatments and Outcomes for Squamous Cell Carcinoma of the Penis","authors":"George M. Edwards, Lucas W. Ashley, Austin Holmes, Andrew W. Ju, Arjun Bhatt, Michael C. Larkins","doi":"10.1002/cnr2.70383","DOIUrl":"10.1002/cnr2.70383","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Penile squamous cell carcinoma (PSCC) is the most common penile cancer, accounting for ≥ 95% of cases, though it accounts for < 1% of all malignancies in men in the United States. We report an updated, stage-stratified analysis of the efficacy of surgery, radiation, and chemotherapy, including adjuvant and neoadjuvant chemoradiation, with further analysis of demographic and clinical factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the Surveillance, Epidemiology, and End Results (SEER) database, patients with PSCC diagnosed between 2000 and 2018 were identified. Five-year overall survival Cox regression analysis as well as univariate Kaplan–Meier analysis were performed, stratified by demographic and treatment variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two thousand seven hundred eight patients with PSCC were identified, with 57.8% being older than 65 years at diagnosis and 94.2% undergoing surgical intervention. With multivariate analysis, increasing disease stage (<i>p</i> < 0.001), age < 65 years (<i>p</i> < 0.001), lower disease grade (<i>p</i> < 0.001) were all associated with increased survival, while treatment with chemotherapy or radiotherapy was both associated with decreased survival (<i>p</i> = 0.002 and < 0.001, respectively). On univariate analysis, less invasive surgery was associated with increased survival among patients with low-grade, local (<i>p</i> < 0.001) or regional (<i>p</i> = 0.03) disease. Among those with high-grade disease, local excision was associated with increased survival (<i>p</i> = 0.008), though among those with regional disease no survival difference was seen (<i>p</i> = 0.86). Patients with regional disease saw increasing survival with four or more lymph nodes dissected (69% vs. 61%, respectively; <i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Surgical management of penile SCC remains the mainstay treatment, and less invasive surgery is associated with noninferior or improved 5-year overall survival regardless of disease stage and grade. Patients with regional disease had increased survival when four or more lymph nodes were dissected. Future analysis of these trends stratified by disease subhistology and more granular analysis of the role of lymphadenectomy are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Palbociclib, which is an oral small-molecule cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor, demonstrated its efficacy in hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer together with endocrine therapy. However, patients with visceral crises (symptomatic visceral dissemination) are recommended to consider chemotherapy rather than endocrine-based therapy. Currently, more reports and evidence support that patients with aggressive visceral metastasis can be effectively managed using both a CDK4/6 inhibitor and endocrine therapy.
Case
We report two premenopausal patients with HR+/HER2− metastatic breast cancer, whose diseases diffusely involved major organs and were successfully managed with palbociclib and endocrine therapies as the initial therapy.
Conclusion
In the two cases we reported, first-line palbociclib therapy shows adequate and timely responses for premenopausal HR+/HER2− metastatic breast cancer patients. Although not widely utilized, frontline therapy with palbociclib combined with endocrine treatments may be a choice for HR+/HER2− metastatic breast cancer patients experiencing severe visceral metastasis.
{"title":"Premenopausal Patients With Clinically Aggressive Metastatic Breast Cancer Successfully Treated With a First-Line Palbociclib-Containing Regimen: Two Cases and Literature Review","authors":"Pei-An Fu, Ya-Chun Hsu, Hui-Ping Hsu, Tzu-Chien Lin, Wei-Pang Chung","doi":"10.1002/cnr2.70417","DOIUrl":"10.1002/cnr2.70417","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Palbociclib, which is an oral small-molecule cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor, demonstrated its efficacy in hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer together with endocrine therapy. However, patients with visceral crises (symptomatic visceral dissemination) are recommended to consider chemotherapy rather than endocrine-based therapy. Currently, more reports and evidence support that patients with aggressive visceral metastasis can be effectively managed using both a CDK4/6 inhibitor and endocrine therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case</h3>\u0000 \u0000 <p>We report two premenopausal patients with HR+/HER2− metastatic breast cancer, whose diseases diffusely involved major organs and were successfully managed with palbociclib and endocrine therapies as the initial therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the two cases we reported, first-line palbociclib therapy shows adequate and timely responses for premenopausal HR+/HER2− metastatic breast cancer patients. Although not widely utilized, frontline therapy with palbociclib combined with endocrine treatments may be a choice for HR+/HER2− metastatic breast cancer patients experiencing severe visceral metastasis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Breast cancer remains one of the most common and lethal malignancies among women. Despite advanced targeted therapies and precision medicine, therapeutic resistance continues to undermine durable clinical responses. Increasing evidence links epigenetic dysregulation and autophagy as central contributors to breast cancer progression, therapy resistance, and metabolic changes. Histone modifications, non-coding RNAs, and DNA methylation dynamically regulate autophagy-related genes (ATGs), while autophagy itself co-regulates the epigenetic landscape under chemotherapeutic stress. This two-way interplay determines tumor cell fate, influencing sensitivity to chemotherapy, endocrine therapy, and targeted agents.
Aims
This article reviews recent studies on epigenetic mechanisms modulating autophagy and their impact on resistance pathways in breast cancer. Furthermore, this article highlighted the emerging role of epigenetic-autophagy as a biomarker for early detection, disease monitoring, and predicting therapeutic response.
Conclusion
Finally, the review outlined new therapeutic methods that combine epigenetic modulators and autophagy inhibitors with particular attention to AI-driven drug discovery and precision oncology. Collectively, this review emphasizes the potential of targeting epigenetic–autophagy crosstalk to overcome therapy resistance and improve patient outcomes.
{"title":"Epigenetic Regulation of Autophagy in Breast Cancer: Implications for Biomarker Discovery and Personalized Therapy","authors":"Bushra Faryal","doi":"10.1002/cnr2.70389","DOIUrl":"10.1002/cnr2.70389","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Breast cancer remains one of the most common and lethal malignancies among women. Despite advanced targeted therapies and precision medicine, therapeutic resistance continues to undermine durable clinical responses. Increasing evidence links epigenetic dysregulation and autophagy as central contributors to breast cancer progression, therapy resistance, and metabolic changes. Histone modifications, non-coding RNAs, and DNA methylation dynamically regulate autophagy-related genes (<i>ATGs</i>), while autophagy itself co-regulates the epigenetic landscape under chemotherapeutic stress. This two-way interplay determines tumor cell fate, influencing sensitivity to chemotherapy, endocrine therapy, and targeted agents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This article reviews recent studies on epigenetic mechanisms modulating autophagy and their impact on resistance pathways in breast cancer. Furthermore, this article highlighted the emerging role of epigenetic-autophagy as a biomarker for early detection, disease monitoring, and predicting therapeutic response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Finally, the review outlined new therapeutic methods that combine epigenetic modulators and autophagy inhibitors with particular attention to AI-driven drug discovery and precision oncology. Collectively, this review emphasizes the potential of targeting epigenetic–autophagy crosstalk to overcome therapy resistance and improve patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marc C. Cavaliere, Silvana Spadafora, Michela Febbraro
Background
Durvalumab is a PD-L1 inhibitor that triggers a blockade resulting in enhanced anti-tumor responses related to increased T-cell activation. There is potential for numerous immune-related adverse events (irAEs) with this treatment, most of which have been shown to be effectively managed with high-dose steroids. Immunotherapy-related gastritis, while rare compared to other irAEs is an emerging concern as the use of immune checkpoint inhibitors (ICIs) increases.
Case
This case study examines a 66-year-old female with extensive-stage small cell lung cancer (ES-SCLC) treated with durvalumab, alongside chemotherapy. Twenty-three months into treatment, she developed non-specific gastrointestinal (GI) symptoms including abdominal pain, appetite loss, and significant weight loss. Despite conservative management, resolution only occurred following the use of high-dose steroids, a finding consistent with immunotherapy-related gastritis. The patient then went onto a successful rechallenge of immunotherapy.
Conclusion
This case represents the first report on the rare occurrence of immune-related gastritis in an ES-SCLC patient who has been on immunotherapy for nearly 2 years. Current literature is limited in the understanding of underlying mechanisms of PD-L1-related irAEs and optimal management strategies for rare toxicities like gastritis in immunotherapy-treated cancer patients. This report aims to address the unmet need for further research on rare toxicities to immunotherapy in unique cases.
{"title":"Immunotherapy-Related Gastritis in Small Cell Lung Cancer Treatment With Durvalumab—A Case Report","authors":"Marc C. Cavaliere, Silvana Spadafora, Michela Febbraro","doi":"10.1002/cnr2.70422","DOIUrl":"10.1002/cnr2.70422","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Durvalumab is a PD-L1 inhibitor that triggers a blockade resulting in enhanced anti-tumor responses related to increased T-cell activation. There is potential for numerous immune-related adverse events (irAEs) with this treatment, most of which have been shown to be effectively managed with high-dose steroids. Immunotherapy-related gastritis, while rare compared to other irAEs is an emerging concern as the use of immune checkpoint inhibitors (ICIs) increases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case</h3>\u0000 \u0000 <p>This case study examines a 66-year-old female with extensive-stage small cell lung cancer (ES-SCLC) treated with durvalumab, alongside chemotherapy. Twenty-three months into treatment, she developed non-specific gastrointestinal (GI) symptoms including abdominal pain, appetite loss, and significant weight loss. Despite conservative management, resolution only occurred following the use of high-dose steroids, a finding consistent with immunotherapy-related gastritis. The patient then went onto a successful rechallenge of immunotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case represents the first report on the rare occurrence of immune-related gastritis in an ES-SCLC patient who has been on immunotherapy for nearly 2 years. Current literature is limited in the understanding of underlying mechanisms of PD-L1-related irAEs and optimal management strategies for rare toxicities like gastritis in immunotherapy-treated cancer patients. This report aims to address the unmet need for further research on rare toxicities to immunotherapy in unique cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9440,"journal":{"name":"Cancer reports","volume":"8 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12672020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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