Journals
2026 EN
Bønløkke Sara · Blaakær Jan · Steiniche Torben
+1 more
ABSTRACT Introduction This nationwide case–control study investigated the risk of second primary cancers among cervical cancer (CC) survivors compared to cancer‐free women. Methods Women aged ≥ 18 diagnosed with CC from 1987 to 2012 were identified via the Danish Cancer Registry (DCR) and matched 1:5 by age and residence to cancer‐free controls. A subpopulation with histologically confirmed squamous cell carcinoma of the cervix (SCC‐C) was defined using the Danish Pathology Register. Adjusted sub‐hazard ratios (aSHR) for subsequent primary cancers were estimated. Results The study included 10,728 CC cases and 53,597 matched controls, including 7910 SCC‐C cases and 39,358 controls. Over a median follow‐up of 14.2 years, CC survivors had a modest but statistically significant reduction in the overall risk of second primary cancers (aSHR: 0.87; 95% CI, 0.81–0.93), including lower risks of colorectal cancer (aSHR: 0.77; 95% CI, 0.63–0.93), breast cancer (aSHR: 0.76; 95% CI, 0.67–0.87), and malignant melanoma (aSHR: 0.59; 95% CI, 0.42–0.84). In contrast, the risk of lung cancer was increased (aSHR: 1.33; 95% CI, 1.15–1.54). Among SCC‐C survivors, the risk of second SCC was increased at both HPV‐related sites (aSHR: 1.78; 95% CI, 1.18–2.68) and non‐HPV sites (aSHR: 2.59; 95% CI, 1.92–3.47), primarily due to a marked increased risk of lung SCC (aSHR: 2.88; 95% CI, 1.97–4.20). Discussion Although the overall risk of second primary cancers was lower among CC survivors compared to controls, the increased incidence of second SCCs, particularly lung SCC, highlights the need for targeted long‐term surveillance strategies.
Journals
2026 EN
Swartz Maria C. · Zhang Shiming · Kelly Donna
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ABSTRACT Introduction Occupational and physical therapy (OT/PT) referrals and utilization barriers for childhood cancer patients have not been adequately examined. The current study investigated factors influencing referrals to and utilization of OT/PT services among children with cancer at an NIH‐designated cancer center. Methods This retrospective cohort study included pediatric cancer patients (up to 18.99 years) presenting to the center over a 33.5‐month period. Variables that could influence referrals to OT/PT were extracted from the electronic medical record (EMR) including OT and PT referrals (inpatient and outpatient), OT and PT consult completion, age at diagnosis, cancer type, sex, race/ethnicity, insurance, cancer treatment, comorbidities, and social vulnerability index. Mixed‐effect logistic regression models were applied. Results The cohort included 1080 patients (mean age 10.9 years; 55.1% male; 40.7% non‐Hispanic White; 52.0% privately insured; 40.8% diagnosed with a non‐neural solid tumor). Overall, 55.1% of inpatients and 22.5% of outpatients were referred for OT/PT, and 32.6% (93.6% of referrals) of inpatients and 13.7% (60.9% of referrals) of outpatients completed their OT/PT consults. Patients aged 18 to < 19 years at diagnosis had lower odds of inpatient OT/PT referral, and patients who underwent surgeries involving hardware placement or had conditions affecting mobility and function, pain, or cardiopulmonary diseases had higher odds of inpatient OT/PT referral. Compared with children with leukemia or lymphoma, children with central nervous system tumors had higher odds of outpatient OT/PT referral, and a non‐neural solid tumor diagnosis was associated with greater odds of outpatient rehabilitation utilization. Conclusion Barriers to rehabilitation included age ≥ 18 years, outpatient setting, and leukemia diagnosis. More research is needed to identify strategies, such as using patient navigation and automated referrals, to improve utilization of OT/PT services for the pediatric cancer population.
Journals
2026 EN
Mascagni Ilaria · Laffi Alice · Grimaudo Maria Susanna
+14 more
ABSTRACT Background In the absence of randomized trials, selecting second or later‐line therapies in advanced sarcoma generally hinges on histology, patient performance status, and toxicity profile. We herein report a real‐world sarcoma referral center experience on continuous infusion Ifosfamide (ciIFO), in advanced Soft tissue sarcomas (STS) and bone sarcomas (BS) patients, assessing both efficacy and toxicity profile. Methods We retrospectively collected data of STS and BS patients treated with ciIFO (14 g/m 2 as a 14‐day continuous infusion every 4 weeks) at our Institute from January 2013 to April 2023. The analysis included patients’ demographic and clinical characteristics, pathology details, treatment history, radiological response rates (RR), and toxicities per Common Terminology Criteria for Adverse Events (CTCAE) v5. Results Ninety eight patients were included in the analysis. Median age at diagnosis was 49 years, 61% had previously received ifosfamide (IFO) and 83% anthracycline in earlier lines of treatment. Disease control rate (DCR) was 32%, with 9 PR and 22 stable disease (SD). Synovial sarcomas had the best (DCR) (60%). No statistically significant differences in DCR were seen according to sex, previous exposure to ifosfamide‐based CT, or ciIFO treatment line. mPFS was 3.0 months; mOS was 11.2 months. ciIFO was well tolerated, with an 11% discontinuation rate and no severe renal toxicity observed. Conclusions ciIFO showed activity across different lines of therapy, achieving a DCR of 32%, and appeared better tolerated than standard‐dose IFO regimens, even in a cohort of heavily pretreated patients (18% had an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥ 2). Synovial and bone sarcoma patients derived the greatest benefit (6‐month PFS of 45% in both groups).
Journals
2026 EN
Rae Sarah · Baldwin Annie · Lagonera Maria Julia
+3 more
ABSTRACT Introduction Somatic mutation testing in solid tumours represents a rapidly advancing field which increases opportunities for access to molecularly targeted therapeutics and clinical trials. This systematic review determined whether socio‐demographic inequalities affect utilisation of novel somatic mutation testing. Methods Following PRISMA 2020 guidance, MEDLINE, EMBASE, Scopus, CINAHL, Web of Science, PubMed and PsycINFO were searched for peer‐reviewed studies (January 2018–March 2025). Data was extracted reporting utilisation of novel somatic mutation testing panels, including Oncotype DX, for solid tumours by socio‐demographic measures. A modified International Society for Pharmacoeconomics and Outcomes Research (ISPOR) checklist assessed study quality. Unadjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated where needed and narrative synthesis undertaken. Data was stratified by receipt of Oncotype DX testing and next‐generation sequencing (NGS) panels. Results The 27,749 citations screened identified 24 studies meeting the inclusion criteria. These reported on two modalities of testing (Oncotype DX and other NGS sequencing panels) across five cancers. Twenty‐three studies were from US populations. These highlighted disparities in utility of testing across socio‐demographic measures and particularly decreased utilisation with increased age, non‐white ethnicity, lower socio‐economic status, and non‐private insurance. The mean study quality score by a modified ISPOR checklist was 8.3/10. Conclusion These results provide a contemporary update on evidence of disparities in access to novel genomic testing. As an expanding field, this requires further investigation to prevent accentuations in inequitable implementation of precision oncology and differences in outcomes between different socio‐demographic groups.
Journals
2026 EN
Mancin Stefano · Ferrara Gaetano · Palomares Sara Morales
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ABSTRACT Introduction Bladder cancer is a common malignancy with a high recurrence rate, posing a significant public health burden. Beyond its role in bone health, vitamin D has been suggested to influence cancer risk, including bladder cancer. Aim To evaluate the association between serum vitamin D levels, dietary intake, and supplementation with bladder cancer risk. Methods This umbrella review included systematic reviews and meta‐analyses from multiple databases, focusing on serum levels or intake of vitamin D and bladder cancer risk. Study quality was assessed using the JBI Critical Appraisal Tool. The Corrected Covered Area showed a 15.5% overlap. Considerable heterogeneity in study design, populations, and vitamin D assessment was noted. Two second‐order meta‐analyses were conducted for quantitative synthesis. Results Eight studies met the inclusion criteria. Adequate serum vitamin D was generally defined as levels ≥ 30 nmol/L. Low serum vitamin D was significantly associated with increased bladder cancer risk (RR = 1.32; 95% CI: [1.27, 1.38]). Higher serum levels were linked to a non‐significant risk reduction (RR = 0.86; 95% CI: [0.63, 1.16]). Evidence on dietary intake was inconsistent, with some analyses suggesting a modest protective effect, particularly when combined with specific dietary patterns. Conclusions Low serum vitamin D is consistently associated with increased bladder cancer risk, while maintaining levels above 30 nmol/L may provide some protection. Evidence on dietary intake and supplementation remains inconclusive. Future studies should adopt standardized methods for vitamin D measurement, explore the role of free versus total vitamin D, and clarify population‐specific differences to better define vitamin D's role in bladder cancer prevention.
Journals
2026 EN
Cohen Elysia R. · Andersen Clark · Moody Karen
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ABSTRACT Purpose Osteosarcoma is the most common primary bone tumor in childhood and adolescence. Many patients face long‐term impairments in their mobility and function after treatment, leading to a decrease in their quality of life. Exercise has been shown to improve functional recovery and improve quality of life in patients with cancer, though data specific to children with osteosarcoma are sparse. Exercise has also been shown to be feasible in patients undergoing chemotherapy, with numerous potential benefits to health and quality of life. To design the most effective exercise interventions for children and adolescents with osteosarcoma, we must first understand the activity patterns in this population throughout the treatment and survivorship continuum. Methods In this study, we provided wearable activity trackers to osteosarcoma patients to evaluate physical activity patterns. Inclusion criteria allowed for any age, gender, or stage of treatment (including after treatment completion). Results Twenty‐six patients had valid data defined as 3 or more days with more than 10 h of continuous heart rate data. The average steps per day across all treatment stages including post treatment was 3184 ± SD 2552.74, range 0–27,828 steps on treatment days and 4884 ± 2447.30, range 0–22,500 steps on off treatment days. Values for specific treatment periods (neoadjuvant, adjuvant, relapse, off therapy) are presented. Though activity patterns varied widely between patients, all patients except one were below recommended values for daily step counts until after therapy was complete. Conclusion Our results suggest that tailoring an exercise program to encourage activity on days when patients receive antineoplastic therapy, and to have the more intensive exercise days well after antineoplastic therapy, may be a good approach. Further research is needed to define interventions to improve physical activity in this population.
Journals
2026 EN
Oliva Stefania · Martello Marina · Saraci Elona
+35 more
ABSTRACT Background The level of measurable residual disease (MRD) is one of the most important features correlating depths of response and long‐term outcomes in multiple myeloma (MM) and MRD evaluation is currently the gold standard tool for assessing treatment response. Nevertheless, reproducibility across laboratories is a major concern, as discrepancies among results make comparability impractical. Aims: herein, we report preliminary results from the “Italian MM‐MRD network” project. Patients & Methods MRD in bone marrow (BM) samples have been measured from newly diagnosed MM patients using next‐generation flow‐cytometry (NGF) or next‐generation sequencing (NGS) approaches in different laboratories. Results The NGF workgroup (7 laboratories) implemented the Euro‐Flow Standard‐Operating‐Protocol to reach minimum 1 × 10 −5 sensitivity. The inter‐operator retrospective study (Stage 1) showed high inter‐center concordance in monoclonal plasma cells detection (ICC = 0.90, p < 0.001), whereas moderate concordance was observed in the inter‐laboratory correlation (Stage 2) in in‐vivo samples (ICC = 0.63, p < 0.001), reaching a median limit‐of‐detection (LOD) and limit‐of‐quantification (LOQ) of 8 × 10−6 and 2 × 10 −5 , respectively. Greater variability was also observed in the analysis of other BM cell populations. The NGS workgroup (4 laboratories) employed a targeted amplicon‐based approach to detect clonotypic IGH/IGK gene rearrangements in diagnostic samples, subsequently used to track MRD in mock samples. The experimental design was divided into three quality‐control (QC) rounds, focused on finding a shared strategy for clonotype identification (QC1: 100% concordance among centers), or quantifying MRD in mock samples (concordance: 81% [QC2]; 91% [QC3]). The 10 −5 ‐sensitivity level was successfully reached in most of tested dilutions (QC2: 19/20 = 95%; QC3: 19/23 = 83%). Conclusion Overall, this pilot study provided preliminary data for MRD harmonization across Italian centers, paving the way for an expanded network, aiming at reducing variability, improving comparability, and enabling broader use of MRD‐monitoring in clinical practice.
Journals
2026 EN
Mendes Sara · YahiaouiDoktor Maryam · Fallenberg Eva Maria
+2 more
ABSTRACT Background As the data on BRCA1/2 ‐associated breast and ovarian cancer prevalence after prophylactic surgery has not been exhaustively investigated yet, we aimed to evaluate the cancer prevalence in a single center cohort of BRCA1 and BRCA2 carriers after conducting prophylactic mastectomy, as well as prophylactic bilateral salpingo‐oophorectomy (PBSO) respectively. Methods We included 875 women that were tested positive for a germline variant in the BRCA1/BRCA2 gene (gPV) between 2002 and 2022 at the Center of Hereditary Breast and Ovarian Cancer of the Technical University Munich Germany. Mean follow up was 7.2 years (range 0–44 years; 95% CI: 6.70 to 7.70). We differentiated breast and/or ovarian cancer diseased ( n = 643) and non‐diseased BRCA1/2 carriers ( n = 232). Results Our analysis confirmed the effectiveness of prophylactic surgeries in genetically predisposed women with a gPV in the BRCA1 /2 gene. We observed no breast cancer after prophylactic bilateral mastectomy, 2 contralateral breast cancer diseases after contralateral prophylactic mastectomy and 1 extraovarian serous adenocarcinoma after PBSO. Within the entire study collective, a total of 293 have undergone PBSO, with 6 women having an incidental finding of ovarian cancer and STIC respectively (=2.0%; 1.7% gBRCA1 and 0.3% gBRCA2 ). Our data suggests that, particularly regarding ipsilateral secondary cancer (ISC), higher oncological safety can be achieved through mastectomy rather than breast‐conserving surgery (BCS). In the group of patients who had a second breast cancer and were treated with BCS during their first cancer, 18.3% showed an ISC. Within the patients who were first treated with a mastectomy, only 4.3% showed an ISC. Conclusions Prophylactic surgeries demonstrate high oncological effectiveness in gPV BRCA1/2 carriers. In particular, mastectomy may provide greater protection against ISC compared with BCS. Further studies will have to be conducted to compare ipsilateral cancer prevalence after breast‐sparing surgery and mastectomy.
Journals
2026 EN
Petrelli Fausto · Antista Maria · Ghidini Antonio
+9 more
ABSTRACT Background and Aims Microsatellite instability (MSI), programmed death‐ligand 1 (PD‐L1) expression, and Epstein–Barr virus (EBV) positivity are emerging biomarkers in gastric cancer prognosis and treatment selection, particularly in immunotherapy. This review evaluates their prognostic significance through a systematic review and meta‐analysis. Methods Relevant studies from PubMed, EMBASE, and the Cochrane Library (January 2010 to December 2024) were analyzed. Studies included assessing MSI, PD‐L1, and EBV status in gastric cancer using immunohistochemistry, PCR, or in situ hybridization, and reported outcomes such as overall survival (OS), disease‐free survival (DFS), or progression‐free survival. Data extraction adhered to PRISMA guidelines, and pooled analyses were conducted using a random‐effects model (DerSimonian‐Laird method). Heterogeneity was assessed using I 2 statistics and Cochran's Q test. Results A total of 25 studies involving 6494 patients were reviewed. In localized gastric cancer, MSI‐high status was associated with significantly improved DFS (hazard ratio [HR], 0.42; 95% confidence interval [CI], 0.23–0.75; p = 0.004) but showed no significant impact on OS (HR, 0.78; 95% CI, 0.48–1.28; p = 0.33) compared to microsatellite stable/PD‐L1‐negative tumors. EBV‐positive/PD‐L1‐positive cancers demonstrated a prognosis similar to EBV‐negative/PD‐L1‐negative cases (OS: HR, 1.08; 95% CI, 0.81–1.45; p = 0.59). Conclusions In metastatic disease, MSI and EBV status were not associated with significant prognostic effects. MSI and EBV status have minimal prognostic value in gastric cancer, particularly for OS, but are essential for selecting candidates for immune checkpoint inhibitors. Standardizing biomarker evaluation is critical to enhancing their clinical relevance.
Journals
2026 EN
Dutra Oliveira Alcione Maria Soares · Dutra Oliveira Peterson Antônio · Pereira Tarcísio Junqueira
+1 more
Abstract Background Hereditary gingival fibromatosis (HGF) is one of the categories of non‐plaque‐induced gingival diseases of genetic origin. Current studies show high genetic heterogeneity and suggest that not all forms of HGF are the same and that more than one biological mechanism may result in gingival growth. This report presents a case of syndromic HGF with generalized and complex clinical manifestations associated with other conditions such as body hypertrichosis and hearing deficit. Methods This is a case report of a male patient with HGF, detailing the orthodontic and periodontal management that began at the age of 8 and was completed by 21. Results and Conclusions The results of this case report demonstrated the importance of early diagnosis and the establishment of a correct treatment plan that provided, in the long‐term, highly positive effects, minimizing impacts affecting the oral health‐related quality of life of individuals with HGF. Key points This is a case report of a male patient with HGF, detailing the orthodontic and periodontal management that began at age 8 and was completed by age 21. Clinical, genetic, and histological data are reported over the 13 years of follow‐up. Due to the numerous complications caused by HGF, early diagnosis and the establishment of an appropriate treatment plan are imperative.Plain Language Summary Hereditary gingival fibromatosis (HGF) is one of the categories of non‐dental‐plaque‐induced gingival diseases of genetic origin. This report presents a case of syndromic HGF with generalized and complex clinical manifestations associated with other systemic conditions. The most common effects are prolonged retention of deciduous teeth, dental migration, delayed eruption, crossbites, open bites, prominent lips, open lip posture, and phonetic and aesthetic problems. This condition can have a negative psychological effect and impact the patient's self‐esteem significantly affecting quality of life. The therapy for HGF consists of surgical treatment combined with rigorous control of dental biofilm. This is a case report of a male patient with HGF, detailing the orthodontic and periodontal tratment that began at the age of 8 and was completed by 21. Due to the numerous complications caused by HGF, early diagnosis and the establishment of an appropriate treatment plan are imperative, as they can provide highly positive long‐term effects and thus minimize the impacts affecting the oral health‐related quality of life of these individual.