Frontiers in Oncology

BackgroundGastric cancer is one of the most common malignancies worldwide and is associated with poor prognosis, placing a considerable burden on public health. Overall treatment outcomes remain unsatisfactory, and accurate lymph node staging is essential for optimizing therapeutic strategies and improving survival. This study aimed to compare the prognostic value of different lymph node staging systems in patients with gastric adenocarcinoma and to provide a more refined prognostic assessment t...

PurposeThis study evaluated the safety and effectiveness of an intraoral light-emitting diode (LED)-based photobiomodulation (PBM) device to reduce the incidence and severity of oral mucositis (OM) from intensity modulated radiation therapy (IMRT) for head and neck cancer (HNC). MethodsThis randomized, double-blind, sham-controlled trial enrolled patients with HNC undergoing high-dose IMRT over 6-8 weeks, with or without concurrent chemotherapy. Participants received daily 10-minute PBM or sham...

PurposePrognosis in metastatic non-seminomatous germ cell tumors (mNSGCT) is currently guided by the IGCCCG classification, which incorporates tumor markers, organs involved with metastatic disease, and primary site but not histologic subtype. We aimed to evaluate whether specific histological components provide additional prognostic information in a large international mNSGCT cohort. Patient and MethodsWe analyzed clinical, pathologic, and outcome data from 662 patients with mNSGCT across mult...

BackgroundLeptomeningeal disease (LMD) is a serious complication of metastatic breast cancer (MBC) with poor survival. This single-institution retrospective study compares overall survival (OS) among MBC patients with LMD based on CSF parameters (glucose, protein, and WBC count) MethodologyMBC patients who were diagnosed with LMD between 2010-2023 at Wilmot Cancer Institute were screened for eligibility. Only those with available data on CSF glucose, protein, and WBC count were included. OS was...

Immunotherapy with immune checkpoint inhibitors and immunotherapy combined with chemotherapy have represented promising treatments for NSCLC patients leading to prolonged survival. However, the majority of patients with advanced NSCLC have a poor prognosis. The identification and development of biomarkers for stratifying responders and non responders to immune checkpoint inhibitors contribute to unravel the mechanism of immune checkpoint pathway and the immune tumor interaction underlying the re...

BackgroundPATZ1 fusion-positive central nervous system (CNS) tumors frequently harbor MN1::PATZ1 fusions as driver mutations, provisionally classified as a rare DNA methylation class of low-grade neuroepithelial tumors. Radiographically, they resemble pilocytic astrocytomas with tumor and cystic components, but their supratentorial cortex location and higher recurrence rates are distinguishing features. An intermediate clinical course, despite focal high-grade histopathology, underscores the nee...

IntroductionBuilding on our previously published methodology for claims-based pathway mapping, we extended the analysis by incorporating disease staging. The aim of this study was to develop and evaluate quality indicators (QIs) in patients with non-small cell lung cancer (NSCLC). MethodsThis retrospective, longitudinal cohort study spanned 2017-2023, with follow-up data extending to September 2025. Data were obtained from the National Cancer Registry (NCR), the National Registry of Reimbursed ...

Recurrence scores based on a 21-gene assay are clinically useful for predicting prognosis and chemotherapy benefit in postmenopausal node-positive breast cancer patients, but its performance in premenopausal patients is inconsistent. Here, we evaluated Ataraxis Breast RISK (ATX), an AI test that predicts recurrence risk, and compared it with the genomic assay. ATX identified high risk patients misclassified as low risk by the genomic assay and therefore may refine selection of patients for adjuv...

Background and ObjectivePatients with upper urinary tract urothelial carcinoma (UTUC) undergoing radical surgery are at high risk of developing intravesical recurrences (IVR). The biology of IVR after surgery for UTUC is poorly understood, and urine markers to replace cystoscopic surveillance of the bladder are lacking. Here, we characterized the genomic landscape of UTUC and paired IVR to discover therapeutic targets and identify diagnostic markers for IVR. MethodsWe performed targeted next-ge...

BackgroundGlioblastoma (GBM), Isocitrate dehydrogenase-wildtype (IDH-wt) is characterised by diffuse infiltration, with progression often arising from perilesional tissue and occult white-matter damage. We investigated whether radiomics from the T2/FLAIR-defined oedema and the structural disconnectome improve prediction of progression-free survival (PFS). MethodsWe retrospectively analysed 387 adults with newly diagnosed GBM, IDH-wt treated at a single tertiary centre (2005-2020). A deep-learni...

BackgroundAlthough DCIS has a relatively low recurrence rate, many patients still receive adjuvant radiotherapy or endocrine therapy, raising concerns about overtreatment. Reliable biomarkers are therefore needed to predict an individual patients risk and guide treatment decisions. Recent studies suggest that the composition of the tumour-associated stroma (TAS) affects progression and outcome, highlighting TAS-derived biomarkers as promising candidates for further investigation. MethodsWe trai...

BackgroundQuality-of-life (QoL) assessment is essential in breast cancer care, yet limited evidence describes how interrelated QoL domains change during pharmacotherapy. This study aimed to evaluate correlations among functional and symptom scales using the EORTC QLQ-C30 and QLQ-BR23, highlighting their ability to reveal multidimensional QoL patterns. MethodsA prospective observational study was conducted in two second-referral hospitals in Indonesia, enrolling 106 female breast cancer patients...

BackgroundThe management of residual axillary disease after neoadjuvant therapy (NAT) remains controversial, as current recommendations often treat ypN1 breast cancer as a homogeneous entity despite potential prognostic heterogeneity. Evidence supporting uniform axillary surgical strategies across different levels of residual nodal burden is limited. We investigated whether survival associations related to axillary surgical evaluation differ according to residual nodal burden in ypN1 disease, us...

IntroductionThe precise determination of diagnostic cut-off points is essential for the development of multimarker panels in oncology. In previous work on pulmonary nodules, it was observed that the standard two-parameter logistic fit could be insufficient for biomarkers with asymmetric distributions. Furthermore, the calculation of empirical cut-off points based on graphical visualization presented limitations in precision and reproducibility. ObjectiveThis study presents a methodological adva...

BackgroundPancreatic ductal adenocarcinoma is one of the most aggressive and lethal malignancies of the gastrointestinal tract. The poor prognosis is largely attributed to late-stage diagnosis, pronounced tumor heterogeneity, and limited therapeutic efficacy. These challenges underscore the urgent need for the identification of robust molecular biomarkers and novel therapeutic targets. MethodsGene expression data from a total of 146 pancreatic tissue samples, comprising 72 normal and 74 tumor s...

BackgroundTamoxifen is a cornerstone of endocrine treatment for hormone receptor-positive breast cancer, reducing recurrence and breast cancer-specific mortality. However, its use is associated with a small, yet clinically relevant, increase in uterine cancer. As diagnosis of this cancer remains symptom-triggered, it is essential for patients to be aware of this risk and report symptoms promptly for optimal outcomes. We therefore assessed risk awareness among breast cancer survivors while explor...

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by profound molecular heterogeneity and inconsistent responses to gemcitabine-based therapy. Although KRAS mutations are nearly ubiquitous, the broader RTK-RAS and MAPK signaling networks, and their association with therapeutic response, remain insufficiently characterized. We performed an integrative clinical-genomic study of 184 PDAC tumors, stratified by age at diagnosis and gemcitabine exposure, systematically...

PurposeCirculating tumor DNA (ctDNA) analyses are informative as an early indicator of immunotherapy response in advanced non-small cell lung cancer (NSCLC); however, the clinical value of ctDNA molecular response requires further validation. Patients and MethodsAs part of a prospective clinical protocol (NCT05995821), we conducted targeted error-correction sequencing of ctDNA (n=328) and matched WBC DNA (n=109) from 109 patients with metastatic NSCLC who received anti-PD-(L)1 either as monothe...

IntroductionDespite advancements in non-small cell lung cancer (NSCLC) management through the use of molecular biomarkers, the recently introduced 9th edition of the TNM staging system remains based exclusively on anatomic descriptors, with no consistently demonstrated improvement in risk stratification for early-stage disease. This study explores the integration of a molecular prognostic classifier into the conventional TNM staging system. MethodsWe analyzed 502 patients with stage I-III lung ...

BackgroundCystoscopy is a core component of haematuria investigations but is invasive and resource-intensive. GALEAS Bladder is a DNA-based diagnostic urine test that measures alterations in 23 bladder cancer-associated genes. ObjectiveTo assess the diagnostic performance and clinical utility of GALEAS Bladder as a molecular triage tool in real-world haematuria investigation pathways. MethodsPatients referred for urgent investigation of haematuria were prospectively enrolled across seven UK NH...