ecancermedicalscience最新文献

{"title":"Management of epithelial ovarian cancer in sub-Saharan Africa: a survey of practicing physicians.","authors":"Ya Haddy Sallah, Verna Vanderpuye, Rahel Ghebre, Khadija Warfa, Alex Mutombo Baleka, Hannah Naa Gogwe Ayettey Anie, Pa Omadou Sallah, Esayas Berhanu Enoro, Namugga Jane, Rose Anorlu","doi":"10.3332/ecancer.2026.2125","DOIUrl":"10.3332/ecancer.2026.2125","url":null,"abstract":"<p><p>The purpose of this study was to evaluate current practices in the management of epithelial ovarian cancer (OC) in sub-Saharan Africa (SSA). A 27-question survey was distributed to SSA-based physicians who managed OC and were members of the African Organisation for Research and Training in Cancer (AORTIC) via Research Electronic Data Capture. Questions evaluated diagnostics, imaging, surgical capacity, guideline adherence, access and barriers to systemic therapies, genetic testing and palliative care. Survey responses from 58 providers in 25 SSA countries were analysed. Clinical/medical oncologists and gynaecologic oncologists made up 52% and 36% of the respondents, respectively. Harmonised guidelines for SSA and the European Society of Medical Oncology guidelines were the most commonly used guidelines among respondents. Surgeries were performed by gynaecologic oncologists (53%) and general gynaecologists (38%). Complete cytoreductive surgery was the primary surgical goal for 38% of the respondents. Lymphadenectomy was routinely performed in 34% of patients with early-stage disease. The majority of systemic therapies were prescribed by clinical/medical oncologists (76%). Platinum/taxane doublet chemotherapy was the prevalent choice for adjuvant (90%) and neoadjuvant indications (83%). Single-agent gemcitabine was preferred for treating platinum-resistant disease (55%). Bevacizumab was prescribed by 33% of the providers. BRCA testing was limited. Drugs that target BRCA-positive tumours were prescribed by 12% of the respondents. Referral to routine palliative care services for advanced disease was performed by 41% of the respondents. The survey results demonstrate areas of guideline-concordant care for OC in SSA despite several challenges, including limited subspecialty surgical capacity and highlight important remaining gaps. To improve OC outcomes in SSA, increasing gynaecologic oncology capacity, promoting and adopting context-specific guidelines and supporting implementation-focused research require prioritisation.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2125"},"PeriodicalIF":1.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419478","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}

{"title":"Clinical and laboratory characteristics and management in patients diagnosed with multiple myeloma: real-world cohort in a Peruvian referral clinic.","authors":"Victor Rivera Francia, Alejandro Leon Garrido-Lecca, Virgilio E Failoc-Rojas, Robert Villacorta, Yesenia Huerta-Collado, Carlos Carracedo, Marco Villena-Lazo, Luis Casanova Marquez","doi":"10.3332/ecancer.2026.2127","DOIUrl":"10.3332/ecancer.2026.2127","url":null,"abstract":"<p><strong>Background: </strong>Multiple myeloma (MM) is a malignant proliferation of clonal plasma cells causing bone lesions, renal impairment, anemia and hypercalcemia. Real-world data on the clinical characteristics, treatment patterns and outcomes of patients with MM in Latin America, particularly in Peru, remain scarce. This study aimed to describe the clinical and laboratory features, characteristics, treatment and 5-year survival of MM patients in a Peruvian referral clinic.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including adult patients diagnosed with MM (ICD-10 C90.0) between 2016 and 2020, identified from institutional clinical records. Demographic, clinical, laboratory and treatment data were collected. Overall survival was estimated using Kaplan-Meier.</p><p><strong>Results: </strong>Among transplant recipients, women predominated (52.2%), whereas men predominated in the total cohort (52.4%). The mean age was 55.5 years for transplant patients and 60.6 for all patients. Eastern Cooperative Oncology Group (ECOG) 1 was most common (52.2%) and stage III was frequent (48.9% transplant; 47.3% overall). Vertebral lesions were predominant (69.6% transplant; 65.5% overall). Bortezomib-lenalidomide-dexamethasone (VRd) was the main first-line regimen (69.6% and 68.3%, respectively). Five-year survival was 87.9% for transplant recipients and 64.8% overall.</p><p><strong>Conclusion: </strong>MM patients commonly presented with advanced stage, vertebral lesions, ECOG 1 and received VRd; transplant recipients achieved excellent survival.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2127"},"PeriodicalIF":1.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419610","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}

{"title":"Milestones and Horizons: Highlights from the 4th International Children's Palliative Care Network Conference in Manila, Philippines.","authors":"Callie Daniels-Howell, Rumalie Corvera, Lizzie Chambers, Alex Daniels, Rhea Jayma, B-Etta 'Babes' Ayon, Nenacia Nirena Ranali 'Rana' Mendoza, Fatima Lorenzo, Liza Naranjo, Carmen Auste, Poh Heng Chong, Mike Palfreman, Justin N Baker, Michael J McNeil, Megan Doherty, Julia Downing","doi":"10.3332/ecancer.2026.2126","DOIUrl":"10.3332/ecancer.2026.2126","url":null,"abstract":"<p><p>The International Children's Palliative Care Network (ICPCN) held its 4th international conference in Manila, Philippines (12th-15th November 2025), in partnership with The Ruth Foundation. The conference, 'Milestones & Horizons,' marked ICPCN's 20th anniversary and convened 419 delegates from 49 countries across all World Health Organisation regions to celebrate the progress of children's palliative care (CPC), while identifying priorities for equitable access for the 21 million children with life-threatening and life-limiting conditions. Hosted in the Philippines, it showcased local developments, including the National Children's Hospital Pediatric Palliative Care Unit and community models, catalysing CPC's formal recognition as a specialty by the Philippine Pediatric Society. The conference featured 155 accepted abstracts (63 oral, 26 rapid-fire and 46 posters), 10 keynotes, 5 plenary panels, 7 'Meet the Expert' sessions and 9 workshops on leadership, research, advocacy, spiritual care, touch therapy and equity. Sessions highlighted milestones in system building, service integration, interdisciplinary collaboration and family-informed research, alongside horizons in digital innovation, humanitarian reach and children's voices. Several sessions highlighted significant CPC 'Milestones', focusing on health system strengthening, service integration and diverse multidisciplinary research. Around the theme of 'Horizons', key conference sessions explored future directions such as digital innovation, care in humanitarian settings, interprofessional leadership and amplifying children's voices through co-design and creative therapies. Conference evaluations emphasised the high value of the in-person event with the opportunity for increasing personal motivation, peer support and new collaborations. The 2025 ICPCN conference demonstrated CPC's maturation through interdisciplinary collaboration while catalysing local progress in the Philippines. Critically, the conference demonstrated the irreplaceable value of in-person convening for relationship-building across diverse organisations, creating momentum toward shared goals of universal access and health system integration. Evaluations confirmed this collaborative energy as uniquely motivating, fostering cross-border partnerships and actionable commitments amid constrained resources, climate challenges and humanitarian needs.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2126"},"PeriodicalIF":1.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419453","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}

{"title":"A hospital-based study of survival in colon cancer patients of Tata Memorial Hospital (Mumbai).","authors":"Tushar Ambekar, Amey Oak, Sivaranjini Kannusamy, Sandhya Cheulkar, Riya R John, Shalmali Chavan, Saket Mendhe, Supriya Kadam, Mamta Lade, Ganesh Balasubramanium, Ashwin Desouza, Avanish Saklani, Rajesh Dikshit, Pankaj Chaturvedi, Sudeep Gupta","doi":"10.3332/ecancer.2026.2123","DOIUrl":"10.3332/ecancer.2026.2123","url":null,"abstract":"<p><strong>Introduction: </strong>Colon cancer, a type of cancer affecting the large intestine, is the fourth most common cancer worldwide, with 1,142,286 new cases and the fifth leading cause of cancer death, with 538,167 deaths reported in 2022 (GLOBOCAN). This retrospective study examines overall survival (OS) and the impact of sociodemographic and clinical factors on colon cancer patients.</p><p><strong>Methodology: </strong>The study included colon cancer patients diagnosed and treated at Tata Memorial Hospital, Mumbai, between January and December 2017, with a 5-year follow-up until 2022. Of the 761 cases registered, 434 received treatment and were eligible for analysis. OS and its variation by socio-demographics were assessed using the Kaplan-Meier method and log-rank test, while the Cox proportional hazard model variables indicate the impact of multiple factors on survival.</p><p><strong>Results: </strong>Among 434 patients (mean age 50 ± 13.6 years, 64% male), adenocarcinoma was the predominant histology (81.7%), with 98% microscopically confirmed diagnoses. Regional and distant disease were present in 32.9% and 23.5%, respectively. The 1-, 3- and 5-year OS rates were 88%, 77% and 71%. Survival was significantly higher in early-stage disease than advanced disease (5-year OS: 89% versus 43%). On multivariable analysis, advanced clinical extent (aHR 7.42; 95% CI: 3.67-14.9) and signet ring cell histology (aHR 1.95; 95% CI: 1.06-3.59) were independently associated with increased mortality, while combined-modality treatment was independently protective (aHR 0.48; 95% CI: 0.25-0.91).</p><p><strong>Conclusion: </strong>The study suggests that improving socioeconomic conditions and encouraging proactive treatment-seeking behaviour are key to increasing colon cancer survival. Cancer hospitals, together with India's public healthcare system, including clinicians and policymakers, should implement these strategies to strengthen cancer care in low- and middle-income countries.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2123"},"PeriodicalIF":1.5,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419637","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}

{"title":"Capecitabine-based triplet (TPX) as induction chemotherapy in advanced head and neck cancer: a daycare-based cohort study.","authors":"Rituparna Biswas, Krishnangshu Bhanja Choudhury, Anirban Halder","doi":"10.3332/ecancer.2026.2124","DOIUrl":"10.3332/ecancer.2026.2124","url":null,"abstract":"<p><strong>Background: </strong>Head and neck squamous cell carcinoma (HNSCC) remains a global health burden. Induction chemotherapy using the regimen docetaxel, cisplatin and 5-fluorouracil (TPF) improves outcomes in advanced cases but requires continuous 5-FU infusion, limiting feasibility in daycare settings. Capecitabine, an oral prodrug of 5-FU, offers a convenient alternative. This study evaluates the efficacy and tolerability of a capecitabine-based triplet regimen docetaxel, carboplatin, capecitabine (TPX) as induction chemotherapy in a resource-limited, outpatient setting.</p><p><strong>Methods: </strong>This retrospective cohort study included 52 patients with stage IVA-IVB HNSCC treated between August 2023 and March 2025 at a Medical college in West Bengal, India. Patients were intended to receive four cycles of TPX every 21 days. Tumour response was assessed using Response Evaluation Criteria in Solid Tumours, version 1.1 after induction and following definitive therapy (surgery or chemoradiotherapy (CTRT)). Toxicities were recorded per Common Terminology Criteria for Adverse Events, version 5.0. Primary outcomes were response rates and toxicity; secondary outcome was feasibility of proceeding to curative treatment.</p><p><strong>Results: </strong>The cohort (median age 46 years; 65.4% male) had 38.5% oral cavity tumours. Following induction chemotherapy, the overall response rate (ORR) was 84.6%, with 100% ORR after definitive treatment. Oral cavity tumours showed 80% partial response (PR) post-induction; ten patients underwent successful surgery, while others received CTRT. In non-oral cavity cancers, 75% had a PR and 12.5% achieved a complete response post-induction. Toxicity was manageable; grade 3/4 neutropenia occurred in 9.6%, high-grade non-hematologic toxicity was also meagre and no treatment-related deaths were reported. Most patients (76.9%) completed all four cycles.</p><p><strong>Conclusion: </strong>The TPX regimen is a well-tolerated and effective alternative to TPF for induction chemotherapy in advanced HNSCC, especially in daycare settings. It enables high response rates and facilitates curative treatment while avoiding the logistical challenges of infusional 5-FU. Further prospective studies are warranted to confirm survival benefits and support broader adoption.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2124"},"PeriodicalIF":1.5,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419618","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}

{"title":"Integrative systematic review and transcriptomic -machine learning analysis of molecular signatures in metaplastic breast cancer.","authors":"Joshua Agilinko, Sonam Patel, Jogitha Selvarajah, Nicholas Tekkis, Mathew Vithayathil, Suzette Samlalsingh","doi":"10.3332/ecancer.2026.2119","DOIUrl":"10.3332/ecancer.2026.2119","url":null,"abstract":"<p><strong>Background: </strong>Metaplastic breast cancer (MpBC) is a rare and aggressive breast cancer subtype characterised by marked histological heterogeneity, therapeutic resistance and poor clinical outcomes. Despite increasing molecular research, existing evidence remains fragmented, heterogeneous and poorly integrated, limiting clinical translation and biomarker validation.</p><p><strong>Methods: </strong>We developed an integrative analytical framework combining systematic review, quantitative meta-analysis, transcriptomic profiling and interpretable machine learning to identify and prioritise molecular markers in MpBC. A Preferred Reporting Items for Systematic Reviews and Meta Analyses-guided systematic review was conducted across PubMed, arXiv and Semantic Scholar. Effect sizes were standardised to Cohen's d and synthesised using a random-effects model. Transcriptomic analysis was performed on the GSE165407 dataset using DESeq2 in R (RStudio version 1.1.463), with differentially expressed genes cross-referenced against literature-derived biomarkers. Supervised models including a multi-layer perceptron and boosted random forest were applied, with performance evaluated using receiver operating characteristic analysis. Model interpretability was assessed using SHapley Additive exPlanations.</p><p><strong>Results: </strong>Eleven studies met inclusion criteria. Meta-analysis demonstrated low heterogeneity and a pooled effect size of d = 0.74 (95% CI 0.59-0.88), indicating a consistent moderate-to-large biomarker signal across studies. Pathway enrichment revealed convergence on PI3K/AKT/mTOR signalling, immune modulation and epithelial -mesenchymal transition. Transcriptomic profiling demonstrated concordance with literature-derived markers. The random forest model achieved strong classification performance (AUC = 0.91), with high specificity and minimal misclassification. SHapley Additive exPlanations analysis identified both canonical (PI3KCA, RPL39, EXO1) and non-canonical (CD55, LARGE2) contributors to model prediction.</p><p><strong>Conclusion: </strong>This study provides an integrated synthesis linking systematic evidence, transcriptomic validation and interpretable machine learning in MpBC. By reconciling fragmented literature with data-driven modelling, we identify a biologically coherent and clinically tractable molecular signature, offering a foundation for biomarker-driven stratification and translational validation.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2119"},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404025","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}

{"title":"Haematological, renal and hepatic toxicity profiles of infusional 5-fluorouracil versus capecitabine in African gastrointestinal cancer patients: a retrospective cohort study.","authors":"Tinashe Adrian Mazhindu, Ntokozo Ndlovu, Margaret Z Borok, Kevin Grimes, Collen Masimirembwa","doi":"10.3332/ecancer.2026.2121","DOIUrl":"10.3332/ecancer.2026.2121","url":null,"abstract":"<p><strong>Introduction: </strong>Infusional 5-fluorouracil (5-FU) or capecitabine are commonly used in the management of gastrointestinal tract. So far very few studies have evaluated non dermatological, neurological and intestinal treatment related toxicities between these two fluoropyrimidine in African patients - evaluating the healthcare burden related to hospitalisations, blood transfusions and use of granulocyte colon-stimulating factor (G-CSF) - all of which are costly and scarce in Africa.</p><p><strong>Methods: </strong>We conducted a 10-year retrospective cohort study of black African patients with gastrointestinal cancer who received either 5-FU or capecitabine-based chemotherapy - extracted and analysed data on treatment related adverse events (TRAEs) incidence, severity and management.</p><p><strong>Results: </strong>A total of 179 participants were analysed: 100 received 5-FU and 79 received capecitabine. The incidence of any TRAE was 75/100 (75%) in the 5-FU group and 51/79 (65%) in the capecitabine group relative risk (RR 0.86, 95% confidence interval (CI) 0.7-1.05; p = 0.15). Severe TRAEs occurred at similar rates: 33% for both groups (RR 0.99, 95% CI 0.7-1.52; p = 0.95). Haematological TRAEs were comparable except for neutropenia, which was less common with capecitabine (33% versus 52%, RR 0.63, 95% CI 0.43-0.91; p = 0.01). Severe anaemia occurred more frequently in the capecitabine group compared to the 5-FU group, with a RR of 2.6 (95% CI 1.02-6.55). Hypokalemia was also lower with capecitabine (6% versus 17%, RR 0.37, 95% CI 0.14-0.97; p = 0.04). Hospitalisation, G-CSF use and red blood cell transfusions were similar between groups, but treatment interruptions were less frequent with capecitabine (16% versus 50%, RR 0.33, 95% CI 0.19-0.56; p < 0.0001). Treatment completion rates were 60% for 5-FU and 54% for capecitabine (p = 0.10).</p><p><strong>Conclusion: </strong>Both infusional 5-FU and capecitabine are generally well tolerated among African patients with gastrointestinal cancer. However, capecitabine is associated with a significantly lower risk of neutropenia and hypokalemia but a higher RR of severe anaemia with overall fewer incidents of treatment interruption.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2121"},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419608","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}

{"title":"Epidemiological, histopathological and clinical profile of breast cancer in Eastern Morocco: data from the Taza RHRC (2016-2024).","authors":"Nacer Bakloul, Fouzia Elaissaoui, Khalil Hammani, El Hassan Elharchli","doi":"10.3332/ecancer.2026.2122","DOIUrl":"10.3332/ecancer.2026.2122","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) represents a major public health issue in Morocco. This study aims to describe the epidemiological, clinical and histopathological profile of women with BC diagnosed at the Taza Reproductive Health Reference Center in eastern Morocco between November 2016 and December 2024.</p><p><strong>Methods: </strong>This was a descriptive, retrospective, cross-sectional study of 412 confirmed cases of BC. Data were collected from archived medical records and analysed using IBM SPSS Statistics software.</p><p><strong>Results: </strong>412 new cases were identified, with an increasing trend over the years, from 15.1 per 100,000 in 2017 to 29.2 per 100,000 in 2024. The mean age at diagnosis was 51.5 ± 11.8 years. The majority of patients (59%) were aged between 40 and 59, 70.9% were married and 52.6% lived in rural areas. Most were housewives (97.3%). Regarding health coverage, 73.5% were insured, including 40.3% affiliated with RAMED's health insurance regime. Clinically, the left breast was affected in 54.1% of cases and the predominant tumour localisation was the superolateral quadrant (57.8%). The most frequent histological type was invasive ductal carcinoma (95%). According to Scarff-Bloom-Richardson (SBR) histoprognostic grade, 68% of tumours were grade II, 28% grade III and 4% grade I.</p><p><strong>Conclusion: </strong>This study highlights a progressive increase in the incidence of SBR in the Taza region, as well as a socio-economic profile marked by precariousness and rurality. Intermediate-grade infiltrating ductal carcinoma is the dominant histological form. These results underline the importance of early detection and improved access to care, particularly in rural areas.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2122"},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419651","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}

{"title":"Community-based palliative care service provision framework (PALLIUM framework) in a resource-limited setting.","authors":"Deepak Sudhakaran, Anoushka Arora, Smriti Rana, Amirtha Thampi, Sunilkumar, Parth Sharma","doi":"10.3332/ecancer.2026.2120","DOIUrl":"10.3332/ecancer.2026.2120","url":null,"abstract":"<p><strong>Background: </strong>Palliative care addresses the complex needs of individuals with life-limiting illnesses (LLIs), encompassing physical, psychological, social and spiritual dimensions of suffering. In India, access to such care remains extremely limited, with less than 4% of those in need receiving it. Existing services often focus narrowly on pain relief, neglecting the broader concept of 'total pain'. Moreover, community-based delivery models that address these holistic needs within resource-constrained environments are largely missing.</p><p><strong>Case presentation: </strong>This case report describes the development and structure of a community-based palliative care framework implemented by Pallium India, a leading non-profit organisation in the field. Using a modified Delphi method, the framework was developed through iterative discussions with clinical and non-clinical team members, incorporating expert consultations and consensus-building exercises. The resulting model outlines a decision-making flowchart for identifying eligibility, determining care pathways and integrating psychosocial support. Care is delivered through home visits, outpatient clinics, inpatient units or telehealth, depending on the severity of symptoms and geographical access. The framework includes provisions for individuals with diagnostic uncertainty, linking them to higher centers when feasible or offering provisional support. It actively addresses non-medical needs through interventions such as education support, housing repairs and vocational rehabilitation. Social officers assess and address financial and community-based needs and referrals are made to local services when appropriate.</p><p><strong>Conclusion: </strong>The Pallium India framework presents a comprehensive, equitable and context-sensitive approach to community-based palliative care. It emphasises early identification, telehealth integration, interdisciplinary care and strong community linkages. While not yet formally evaluated for outcomes such as quality of life or cost-effectiveness, the framework represents a scalable and sustainable model for resource-limited settings. Its design aligns with public health principles of equity, community participation and multisectoral collaboration, offering a promising strategy to bridge the current palliative care gap in India and other low-resource regions.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2120"},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677772","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}

{"title":"Pathologic complete response and survival in early-stage HER2-positive breast cancer patients treated with or without anthracyclines.","authors":"Francisco Acevedo, Benjamín Walbaum, Lidia Medina, Maritza Abud, Roger Gejman, Pablo Zoroquiain, Francisco Domínguez, Mauricio Camus, Catalina Vargas, Marisel Navarro, Constanza Pinto, Catalina Muñoz, Manuel Manzor, César Sánchez","doi":"10.3332/ecancer.2026.2118","DOIUrl":"10.3332/ecancer.2026.2118","url":null,"abstract":"<p><p>The development of novel human epidermal growth factor receptor type-2 (HER2)-targeted therapies for HER2-positive breast cancer (HER2+ breast cancer (BC)) in recent decades has called for a reassessment of the benefit of including anthracyclines in neoadjuvant regimens, given their association with cardiotoxicity and secondary malignancies. Our study assessed the value of adding anthracyclines in a real-world cohort of early-stage HER2+ BC patients treated with trastuzumab with or without pertuzumab. We retrospectively evaluated 446 patients with early-stage HER2+ BC treated with neoadjuvant chemotherapy at two Chilean centers between 2010 and 2023. Patients received trastuzumab alone or trastuzumab plus pertuzumab, with anthracycline-containing or anthracycline-free regimens. Our primary endpoint was pathological complete response (pCR; ypT0/is ypN0). Secondary endpoints included invasive disease-free survival (iDFS) and overall survival (OS). Multivariate models assessed the predictive role of anthracyclines and pathological biomarkers (ER status, Ki67, HER2 amplification). Elevated Ki67, low ER expression and increased HER2 amplification were independent predictors of pCR. The addition of anthracyclines did not significantly improve pCR rates, even among patients treated with single HER2 targeted therapy (trastuzumab alone). With a median follow-up of 47 months, anthracyclines had no impact on iDFS (log-rank p = 0.19) or OS (p = 0.96). Subgroup and interaction analyses confirmed no benefit in other biomarker-defined populations. Overall, anthracyclines did not improve response to treatment or survival in HER2+ BC, even without dual HER2 blockade. These findings support anthracycline-free regimens, even in health systems with limited access to dual HER2-blockade with pertuzumab.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2118"},"PeriodicalIF":1.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403978","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}