Current oncology最新文献

{"title":"Trends in Volume, Timeliness, and Reporting Quality of Oncology Systematic and Scoping Reviews: A 25-Year Analysis.","authors":"Nandi Edwards, Hadia Malik, Daniel Zhang, Gabriel Boldt, Michael Lock, Jennifer Leigh, Ronald Chow","doi":"10.3390/curroncol33090571","DOIUrl":"10.3390/curroncol33090571","url":null,"abstract":"<p><p>Systematic and scoping reviews synthesize evidence in oncology's fast-moving therapeutic landscape, informing clinical and policy decisions. However, little is known about how review volume has changed over time, how quickly reviews reach publication, or how often protocol registration is reported within review abstracts. We searched Medline (PubMed), Embase, and the Cochrane Library (2000 to 9 October 2025) for oncology-focused articles labelled as systematic or scoping reviews, screened in duplicate by a human reviewer and a ChatGPT-5-assisted system, with a third reviewer resolving disagreements. Cancer subspecialty, search-to-publication interval, and abstract-level protocol registration status and registry type were extracted. Of 92,800 references, 49,378 (53%) were systematic (<i>n</i> = 46,318) or scoping (<i>n</i> = 3060) reviews. Review volume rose sharply from 2000 (<i>n</i> = 61) to 2024 (<i>n</i> = 6313), with scoping reviews increasing steadily. Data for 2025 were available only through 9 October and were therefore not directly comparable with prior complete years. Among 9297 reviews reporting search dates, mean search-to-publication lag was 13 months, unchanged over time (<i>p</i> = 0.09). Only 2235 reviews (4.5%) reported protocol registration in their abstract, predominantly via the International Prospective Register of Systematic Reviews (PROSPERO). Oncology evidence-synthesis output has grown, yet publication timeliness and abstract-level registration reporting have not improved, raising questions about its currency and verifiability.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sentinel Lymph Node Mapping Without Intraoperative Frozen Section in Preoperative Endometrial Intraepithelial Neoplasia/Atypical Endometrial Hyperplasia: Feasibility, Diagnostic Yield, and the Estimated Consequence of Frozen-Section Triage.","authors":"Mehmet Sait Bakır, Hasan Turan, Osman Doğan, Mürşide Çevikoğlu Kıllı, Numan Bilgiç, Şahin Yüksek","doi":"10.3390/curroncol33090570","DOIUrl":"10.3390/curroncol33090570","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Endometrial intraepithelial neoplasia/atypical endometrial hyperplasia (EIN/AEH) carries a substantial risk of concurrent endometrial carcinoma at hysterectomy. Sentinel lymph node (SLN) mapping requires cervical injection into an intact uterus, so the decision to map must be made before uterine pathology is known. A strategy that defers that decision to intraoperative frozen section therefore does not choose between mapping and no mapping; it forecloses mapping altogether. We evaluated the technical feasibility and diagnostic yield of SLN mapping performed without frozen section in patients with preoperative EIN/AEH and estimated how much of the nodal disease identified might not have been detected under a frozen-section-guided pathway.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective single-center study, 86 patients with a preoperative diagnosis of EIN/AEH underwent hysterectomy, bilateral salpingo-oophorectomy, and SLN mapping with methylene blue between November 2021 and May 2026. No patient underwent intraoperative frozen section, and all SLNs underwent ultrastaging. Patients were grouped by final histopathology, and carcinomas were staged according to FIGO 2023. A counterfactual analysis applied the Mayo intraoperative triage criteria to the final uterine pathology and considered two mechanisms separately: patients who would not have undergone nodal assessment at all, and patients who would have undergone lymphadenectomy but whose disease volume might not have been detected by conventional nodal pathology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Final pathology showed persistent EIN/AEH in 37 patients (43.0%) and endometrial carcinoma in 49 (57.0%). Patients upgraded to carcinoma were older (60.3 ± 9.5 vs. 53.1 ± 10.4 years, &lt;i&gt;p&lt;/i&gt; = 0.001), more often postmenopausal (87.8% vs. 54.1%, &lt;i&gt;p&lt;/i&gt; = 0.001), and had greater endometrial thickness (18.6 ± 8.7 vs. 13.5 ± 5.4 mm, &lt;i&gt;p&lt;/i&gt; = 0.004). At least one SLN was retrieved in 82 of 86 patients (95.3%) and bilaterally in 76 (88.4%); bilateral detection did not differ significantly between groups (94.6% vs. 83.7%, &lt;i&gt;p&lt;/i&gt; = 0.177). SLNs lay in the obturator region in 62.2% of hemipelves and in the external iliac region in 26.3%, together accounting for 88.5%. Nodal involvement was identified in 11 patients (12.8% of the cohort; 22.4% of carcinomas): isolated tumor cells in two, micrometastasis in six, and macrometastasis in three. Among the patients who underwent additional non-sentinel nodal assessment, no metastatic non-SLN was identified in the presence of negative SLNs; no reference standard was applied to the remaining SLN-negative patients, so a false-negative rate cannot be estimated. No patient with EIN/AEH-only pathology had nodal involvement. Under simulated frozen-section triage, 2 of the 11 node-positive patients (18.2%) would not have undergone nodal assessment at all; a further 6 had low-volume disease that might not have been identified by conventio","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Immune Checkpoint Inhibitor-Induced Liver Injury in Patients with Gastrointestinal Cancer: Machine Learning Modeling for Time-Stratified Risk Assessment.","authors":"Ying Jiang, Ranyi Li, Hong Gao, Xiaoyu Li, Ningping Zhang","doi":"10.3390/curroncol33090568","DOIUrl":"10.3390/curroncol33090568","url":null,"abstract":"<p><p><b>Background:</b> Immunotherapy has transformed cancer treatment and is widely used in the Chinese mainland. Though advances have been made, immune checkpoint inhibitor-related liver injury (ICILI) remains a significant clinical challenge. Existing risk models commonly lack time-specific risk stratification for ICILI. The present study aimed to develop and validate interpretable machine learning models to predict grade 2 or higher ICILI at multiple time points in patients with gastrointestinal cancer (GC). <b>Methods:</b> This retrospective cohort study encompassed GC patients who commenced their initial ICI medication between January 2019 and June 2023 at Zhongshan Hospital, Fudan University. Five machine learning algorithms, including Logistic Regression, Random Forest, Extreme Gradient Boosting (XGBoost), Gradient Boosting (GradientBoost), and Adaptive Boosting (AdaBoost), were utilized to develop predictive models for grade ≥ 2 ICILI at specific intervals of 3 months, 6 months, and 12 months. The evaluation of model performance was conducted using the area under the curve (AUC), accuracy, precision, recall, and F1-score. The Shapley Additive exPlanations (SHAP) method was employed to assess feature importance and interpret the final model. <b>Results:</b> A total of 1337, 849, and 401 patients were enrolled in the follow-up groups at 3 months, 6 months, and 12 months. The final model for grade ≥ 2 ICILI was developed with GradientBoost and achieved an AUC of 0.769 (95% CI: 0.732-0.806), with a test set accuracy of 0.834. XGBoost yielded AUCs of 0.671 (95% CI: 0.636-0.706) at 3-month indication, 0.678 (95% CI: 0.638-0.718) at 6 months, and 0.644 (95% CI: 0.589-0.699) at 12-month follow-up in the 5-fold cross-validation. The DCA curve demonstrated solid clinical benefit, whereas the calibration curve indicated good predictive reliability. SHAP analysis identified several parameters as predictive features at different intervals, which suggested that the ICILI determinants varied from acute inflammatory to host-related characteristics. <b>Conclusions:</b> A temporal stratification prediction model for grade ≥ 2 ICILI in GC patients was developed and validated at various intervals using ML algorithms with SHAP interpretability. This methodology facilitated early recognition of varying parameters across different treatment phases, enhancing clinical management and elevating treatment outcomes.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Spondylectomy Radiofrequency Ablation for Spinal Chordoma: An Illustrative Case and Systematic Review of Clinical Applications and Outcomes.","authors":"Holden Husbands, Drake Johnston, Matthan Tharakan, Ahmed Hussan, Kishore Balasubramanian, Patrick Bettiol, Benjamin Chou, Sanaa Hameed, Zachary A Smith, M Burhan Janjua, John F Burke, Hakeem J Shakir","doi":"10.3390/curroncol33090569","DOIUrl":"10.3390/curroncol33090569","url":null,"abstract":"<p><p>Chordomas are rare, locally aggressive spinal tumors. En bloc resection may improve local control but can cause substantial morbidity. Thermal ablation may provide a less invasive adjunct or alternative in selected cases. We systematically reviewed reports of radiofrequency ablation (RFA), cryoablation, laser interstitial thermal therapy, high-intensity focused ultrasound, and similar thermal techniques for spinal or sacral chordoma to characterize their clinical applications and reported clinical and radiographic outcomes across pre-resection, primary non-operative, and palliative settings. Eligible studies reported at least one ablation-related clinical or radiographic outcome. Data were descriptively synthesized, and risk of bias was assessed using the Joanna Briggs Institute criteria. Thirteen studies including 33 patients and 34 ablated sites were identified. Cryoablation was used in 21 patients, RFA in 11 patients, and laser interstitial thermal therapy in one patient. Ablation was used as a pre-resection adjunct, primary treatment for unresectable disease, or palliation for recurrent or metastatic lesions. Most reports described pain improvement, short-term local stability, and few major complications. We also report an L4 chordoma treated with CT-guided RFA and vertebroplasty before staged en bloc spondylectomy, without a new neurologic deficit or local recurrence at 18 months. Thermal ablation may be a technically feasible adjunct, primary non-operative option, or palliative strategy for carefully selected spinal and sacral chordomas. In the presented mobile-spine case, planned pre-spondylectomy RFA was feasible before staged en bloc resection; however, limited follow-up and sparse heterogeneous literature preclude conclusions regarding long-term local control, recurrence reduction, survival, or routine use. Ablation should not replace oncologically appropriate en bloc resection when that procedure can be safely achieved and should be considered selectively within multidisciplinary chordoma care.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidimensional Recovery Trajectories Throughout Breast Cancer Treatment and Survivorship: A Prospective Longitudinal Study.","authors":"Laura Lorenzo-Gallego, Nicola S Diciolla, Fernando Ramos-Gómez, Virginia Prieto-Gómez, Aldina Couso-González, María Torres-Lacomba","doi":"10.3390/curroncol33090567","DOIUrl":"10.3390/curroncol33090567","url":null,"abstract":"<p><p><b>Background</b>: Breast cancer survivors frequently experience persistent sensory, psychosocial, and functional sequelae that may not be captured by pain measures alone. Understanding recovery trajectories throughout treatment and survivorship may help identify women at risk of long-term recovery-related difficulties. <b>Objective</b>: To investigate sensory, psychosocial, functional, and quality-of-life trajectories throughout breast cancer treatment. <b>Methods</b>: This prospective longitudinal study included women undergoing unilateral breast cancer surgery assessed at six time points before and after surgery, including before and after adjuvant treatments when applicable. Outcomes included sensory function, pain, upper-limb function, psychosocial variables, and quality of life. <b>Results</b>: Seventy-two women (57 ± 11 years) were included. Despite stable pain intensity and self-reported sensitization symptoms, fear of movement increased (TSK-11: MD [95%CI] = +9[0;22]), quality of life deteriorated (FACT-B: 3-12 month MD [95%CI] = -10[-19;-1]), and upper-limb function initially worsened before partially recovering. Objective sensory alterations suggested dynamic changes in somatosensory processing but were not consistently accompanied by greater pain intensity or self-reported sensitization symptoms. <b>Conclusions</b>: Recovery after breast cancer treatment is multidimensional and cannot be adequately reflected by pain intensity alone. Multidimensional assessment may help identify women at risk of persistent recovery-related difficulties and support personalized survivorship care.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Artificial Intelligence Chatbots by Newly Diagnosed Cancer Patients: A Descriptive Phenomenological Study.","authors":"Mustafa Serkan Alemdar, Yağmur Çolak, İlhan Günbayı, Hasan Mutlu","doi":"10.3390/curroncol33090563","DOIUrl":"10.3390/curroncol33090563","url":null,"abstract":"<p><p>After a cancer diagnosis, patients experience intense uncertainty and increasingly resort to artificial intelligence chatbots in this process; however, how this use is experienced by patients has not been adequately studied. This study aimed to explore the experiences of adult patients diagnosed with cancer in the last six months using artificial intelligence (AI) chatbots. Using a descriptive phenomenological approach, face-to-face semi-structured interviews were carried out with 20 adults sampled by a criterion-based purposive sampling method in an oncology clinic in Türkiye. The data were analyzed according to Colaizzi's method, and the following four main themes were revealed: artificial intelligence usage purposes, the experience of interacting with AI, the effect of the patient's reflection on the AI experience on the relationship with the treatment team, and evaluation of the use of AI. The participants used chatbots as an intermediate resource during the period of uncertainty between the examination result and clinical explanation; some learned their diagnosis for the first time in this way. However, the relief provided by chatbots was temporary, and trust in chatbot results was constantly tested by the statements of the healthcare professional. As a result, some participants hid their use of chatbots for fear of being judged. AI chatbots served as a complementary source of information, but they did not replace the relationship with the healthcare professional. These findings suggest that healthcare professionals should ask patients about chatbot use without judgment, and that support provided during the post-examination waiting process could be strengthened.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Perspectives on Prostate Cancer Prehabilitation: A Qualitative Study Using the Behaviour Change Wheel to Investigate Barriers and Facilitators to Engagement.","authors":"Hannah Harsanyi, Nicole Slot, Ashley J Housten, Yun Yun Lee, M Eric Hyndman, Lin Yang","doi":"10.3390/curroncol33090564","DOIUrl":"10.3390/curroncol33090564","url":null,"abstract":"<p><p>Cancer prehabilitation aims to improve outcomes by helping patients physically and mentally prepare for treatment. This qualitative study aimed to investigate barriers and facilitators to engaging in prostate cancer prehabilitation and create recommendations for designing interventions. Semi-structured interviews were used to explore perspectives on cancer prehabilitation among men diagnosed with prostate cancer in Alberta, Canada. Interviews were thematically analyzed to identify barriers and facilitators to engagement. Themes were mapped to the Behaviour Change Wheel (BCW) to create recommendations for intervention development. Thirty-four men diagnosed with prostate cancer completed interviews. Key facilitators to engaging in prehabilitation included opportunities for social connection, strategies to reduce treatment-related side effects, and support coping with the psychological impact of diagnosis. Barriers included competing care priorities, lack of familiarity with prehabilitation, logistical challenges, and stigmatized perceptions of help-seeking. To promote improved patient engagement, prehabilitation interventions should be initiated near diagnosis, offer personalized, goal-oriented interventions with multiple components, and have options for virtual participation to increase accessibility. These recommendations may help improve the uptake and impact of prehabilitation programming in prostate cancer care. Further research to identify evidence-based interventions for mitigating treatment-related side effects may help increase patient motivation to engage in cancer prehabilitation.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Implant Design: Surgical Principles and Early Outcomes of Patient-Specific Scapular Reconstruction After Total Scapulectomy.","authors":"Adyb-Adrian Khal, Ruxandra Florina Bodog, Florian Dorel Bodog, Ovidiu-Gogu Cacuci","doi":"10.3390/curroncol33090565","DOIUrl":"10.3390/curroncol33090565","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Total scapulectomy for malignant scapular tumors remains a major reconstructive challenge because resection removes the osseous framework, muscular insertions, and biomechanical support required for shoulder function. Patient-specific three-dimensional (3D)-printed implants may improve anatomical reconstruction, but the indications and surgical principles underlying successful total scapular replacement remain poorly defined. <b>Methods</b>: This retrospective single-center case series included the first three consecutive patients who underwent total scapulectomy followed by immediate reconstruction using a patient-specific 3D-printed scapular prosthesis between January 2024 and December 2025. Clinical, radiographic, oncological, and functional outcomes were reviewed. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) score and active shoulder range of motion. <b>Results</b>: The cohort included two women and one man with a median age of 53 years (range, 43-58 years). Diagnoses were chondrosarcoma in two patients and osteosarcoma in one. All tumors were Enneking stage IIB. Negative margins were achieved in all patients, and the axillary nerve and principal shoulder-girdle stabilizers were preserved in every case. Median follow-up was 13 months (range, 12-27 months). At latest follow-up, two patients had no evidence of disease and one was alive with disease after developing pulmonary metastases. The median MSTS score was 25/30 (range, 21-26). Median active elbow flexion, abduction, and forward flexion measured 88°, 80°, and 80°, respectively. Two patients experienced complications: one clavicular fracture and one aseptic wound dehiscence; neither resulted in implant failure or required revision of the reconstruction. <b>Conclusions</b>: Patient-specific total scapular reconstruction may provide satisfactory early radiographic and functional outcomes in carefully selected patients, although outcomes remain variable depending on individual patient and tumor characteristics. Implant design, patient selection, preservation of the axillary nerve and viable innervated shoulder-girdle musculature, and soft-tissue reconstruction should be considered complementary components of this reconstructive strategy.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Twins for Targeted Therapy in Head and Neck Cancer: From Molecular Stratification to Resistance-Aware Combination Strategies.","authors":"Francisca Gonçalves, Marta Gonçalves, Pedro Barata, Nuno Vale","doi":"10.3390/curroncol33090566","DOIUrl":"10.3390/curroncol33090566","url":null,"abstract":"<p><p>Head and neck squamous cell carcinoma (HNSCC) remains clinically challenging because of its marked inter- and intra-tumour heterogeneity, the dynamic emergence of therapeutic resistance, and the limited ability of current biomarkers to guide treatment adaptation over time. Recent advances in digital twin (DT) technology have motivated the development of patient-specific, continuously updated computational models capable of integrating multi-scale data to support precision oncology. However, no current DT framework for HNSCC combines molecular stratification, longitudinal monitoring of resistance, pharmacodynamic modelling, and clinical decision support within a single adaptive system. In this review, we critically examine the current state of DT-enabled approaches for targeted therapy in HNSCC and propose a conceptual framework for their future clinical implementation. We discuss how genomic and multi-omic stratification, mechanistic imaging models, pharmacokinetic/pharmacodynamic modelling, longitudinal liquid biopsy (ctDNA and exosomes), ex vivo functional testing, toxicity prediction, and artificial intelligence could be integrated into a continuously updated patient-specific model. We further examine the biological mechanisms driving resistance to targeted therapies and immunotherapy, highlighting how these dynamic processes should inform adaptive therapeutic decision-making. We discuss existing DT-like approaches and evaluated them according to their capacity to fulfil the DT criteria, while also presenting DT-enabling technologies. Among the frameworks currently available, the deep reinforcement learning-based DITTO platform represents the closest approximation to a clinically relevant HNSCC digital twin. However, it does not yet incorporate molecular signalling networks, longitudinal resistance biomarkers, or multimodal biological data. We therefore identify the integration of these complementary data layers as the principal challenge and opportunity for the next generation of DTs. Collectively, this review provides a conceptual DT framework in which four main data domains could fulfil different roles within the DT. By sharing different parameters across these layers, the framework could forecast emerging resistance and update model predictions longitudinally. Such a DT could support biomarker-guided patient stratification, adaptive treatment selection, rational combination therapies, toxicity prediction, and future clinical trial design in HNSCC. We also highlight challenges and limitations that need to be addressed for future clinical translation, including data integration, interpretability, clinical validation, workflow integration, and ethical and regulatory considerations.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Insights from Operationalizing a Remote Symptom Monitoring Program Using a Commercial Platform in a Canadian Community Cancer Clinic: A Post-Implementation Qualitative Evaluation.","authors":"Melissa J Chao, Eric Liow, Nasia A Sheikh, Jeremy Ho","doi":"10.3390/curroncol33090561","DOIUrl":"10.3390/curroncol33090561","url":null,"abstract":"<p><p>Remote symptom monitoring using electronic patient-reported outcomes reduces symptom burden and acute care use in oncology, but most programs have been established in academic centers or funded trials using purpose-built software. We examined how the REmote Symptom and Patient mONitoring System (RESPONSe) was implemented and subsequently funded as a recurrent clinical service at a Canadian community cancer clinic using a configured commercial platform, patients' own devices, and no formal institutional mandate. We conducted a qualitative post-implementation process evaluation at Richmond Cancer Clinic, British Columbia, reported following the Consolidated Criteria for Reporting Qualitative Research. Eight staff, purposively sampled by role and phase of involvement, were invited and participated, which consisted of one oncologist, three nurses, two virtual health staff, and two administrators. Interviews were analyzed using deductive-inductive thematic analysis. Three themes were identified: tailoring technology for clinical fit; designing care around patient and clinician users, centered on a dedicated symptom management nurse; and managing up towards operationalization. Operationalization was achievable using a customizable commercial platform, but depended on the interaction of iterative technology adaptation, dedicated clinical ownership, evolving care workflows, and sustained organizational advocacy. We propose five transferable implementation strategies mapped to established implementation frameworks.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13605967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}