Neoadjuvant nivolumab and relatlimab in locally advanced MMR-deficient colon cancer: a phase 2 trial.

Mismatch repair deficiency (dMMR) is found in approximately 15% of non-metastatic colon cancers (CCs) and is characterized by a defective DNA mismatch repair system, resulting in hypermutated and highly immunogenic tumors. Although patients with dMMR CC have limited benefit from chemotherapy, these tumors have been shown to respond exceptionally well to neoadjuvant anti-PD-1 plus anti-CTLA-4, with high rates of pathologic responses. Here, based on data from melanoma studies, we postulated a high efficacy and favorable toxicity profile of anti-PD-1 plus anti-LAG-3.

Combined portal and hepatic vein embolisation in perihilar cholangiocarcinoma.

Background: Major hepatectomy in perihilar cholangiocarcinoma (pCCA) patients with a small future liver remnant (FLR) risks posthepatectomy liver failure (PHLF). This study examines combined portal and hepatic vein embolisation (PVE/HVE) to increase preoperative FLR volume and potentially decrease PHLF rates.

Methods: In this retrospective, multicentre, observational study, data was collected from centres affiliated with the DRAGON Trials Collaborative and the EuroLVD registry.

Opportunities and Challenges of Small Molecule Inhibitors in Glioblastoma Treatment: Lessons Learned from Clinical Trials.

Glioblastoma (GBM) is the most prevalent central nervous system tumour (CNS). Patients with GBM have a dismal prognosis of 15 months, despite an intensive treatment schedule consisting of surgery, chemoradiation and concurrent chemotherapy. In the last decades, many trials have been performed investigating small molecule inhibitors, which target specific genes involved in tumorigenesis.

What To Do With Suspected Nodal Regrowth on Magnetic Resonance Imaging During Follow-up in an Organ Preservation Approach for Rectal Cancer?

Background: For nodal regrowth in patients with rectal cancer following watch-and-wait standardized protocols on diagnostic procedures and subsequent treatment are lacking.

Objective: Evaluate the diagnosis and treatment of suspected nodal regrowth following an organ preservation approach.

Settings: Patients were included from national and institutional watch-and-wait -databases.

Using a modified Delphi procedure to select a PRO-CTCAE-based subset for patient-reported symptomatic toxicity monitoring in rectal cancer patients.

Purpose: Standardized patient-reported outcomes (PRO) monitoring during and after rectal cancer treatment provides insight into treatment-related toxicities patients experience and improves health-related quality-of-life as well as overall survival. We aimed to select a subset of the PRO version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) for standardized monitoring of treatment-related symptomatic toxicities in rectal cancer.

Methods: We used a mixed methods approach including a literature review, and semi-structured interviews with health care providers (HCPs) involved in rectal cancer care and rectal cancer patients.

Effects of a combined exercise and dietary intervention on clinical outcomes in patients with ovarian cancer: the Physical Activity and Dietary intervention in OVArian cancer (PADOVA) randomized controlled trial.

Objective: Chemotherapy treatment modifications can impact survival in patients with ovarian cancer, particularly when the relative dose intensity falls below 85%. Exercise and dietary interventions may benefit treatment tolerability. This study aimed to explore the effects of a combined exercise and dietary intervention on secondary outcomes of the Physical Activity and Dietary intervention in OVArian cancer (PADOVA) trial, specifically relative dose intensity and progression-free survival.

New diagnostic and nonsurgical local treatment modalities for early stage lung cancer.

This paper highlights developments in diagnostic and nonsurgical local treatment modalities that have changed the management of early-stage lung cancer. These innovations aim to enhance diagnostic accuracy, minimize invasiveness, and improve patient outcomes. Liquid biopsies are emerging as promising tools for non-invasive diagnosis and monitoring, enabling earlier intervention without being standardized yet as well as not yet anchored in the guidelines.

Prenatal cell-free DNA testing of women with pregnancy-associated cancer: a retrospective cross-sectional study.

Background: Incidentally, the non-invasive prenatal test (NIPT) shows chromosomal aberrations suspicious of a maternal malignancy, especially after genome-wide testing. The aim of this study is to determine how many cases of cancer in pregnancy are diagnosed or missed with NIPT and whether in retrospect subtle changes in NIPT results could have detected cancer.

Methods: We identified Dutch patients diagnosed in 2017-2021 with pregnancy-associated cancer from the International Network on Cancer, Infertility and Pregnancy (INCIP) Registry, who underwent NIPT in the Dutch NIPT implementation study (TRIDENT-2).

ESTRO-EPTN radiation dosimetry guidelines for the acquisition of proton pencil beam modelling data.

Proton therapy (PT) is an advancing radiotherapy modality increasingly integrated into clinical settings, transitioning from research facilities to hospital environments. A critical aspect of the commissioning of a proton pencil beam scanning delivery system is the acquisition of experimental beam data for accurate beam modelling within the treatment planning system (TPS). These guidelines describe in detail the acquisition of proton pencil beam modelling data.

Predicting axillary lymph node metastasis in breast cancer based on ultrasound radiofrequency time-series analysis.

Background: The status of axillary lymph nodes (ALN) plays a critical role in the management of patients with breast cancer. It is an urgent demand to develop highly accurate, non-invasive methods for predicting ALN status.

Purpose: To evaluate the efficacy of ultrasound radiofrequency (URF) time-series parameters, in combination with clinical data, in predicting ALN metastasis in patients with breast cancer.

Initial management of newly diagnosed WHO grade 2-3 adult meningioma following surgery: results from the Dutch Brain Tumour Registry (2016-2021).

Purpose: Meningiomas classified as grade 2-3 according to the World Health Organisation (WHO) require combined surgery and in most cases radiotherapy (RT). Their initial management was evaluated using the Dutch Brain Tumour Registry.

Methods: The study included 393 patients aged ≥ 18 years with newly diagnosed meningioma WHO grade 2-3 between 2016 and 2021.

Early-Stage Non-Small Cell Lung Cancer: New Challenges with Immune Checkpoint Blockers and Targeted Therapies.

The recent advent of tyrosine kinase inhibitors (TKIs) and immune checkpoint blockers (ICBs) in early-stage non-small cell lung cancer (NSCLC) has dramatically modified treatment strategies by improving the prognosis in this setting. Osimertinib and alectinib, both TKIs, have shown significant improvements in outcomes for patients with resected - and -positive NSCLC, respectively, changing the standard of care in these subgroups. More recently, the LAURA trial showed the efficacy of osimertinib after chemoradiotherapy in patients with unresectable stage III NSCLC harboring mutations.

The value of PROMs for predicting erectile dysfunction in prostate cancer patients with Bayesian network.

Purpose: This study aims to develop and externally validate a clinically plausible Bayesian network structure to predict one-year erectile dysfunction in prostate cancer patients by combining expert knowledge with evidence from data using clinical and Patient-reported outcome measures (PROMs) data. In addition, compare and contrast structures that stem from PROM information and routine clinical data.

Summary Of Background: For men with localized prostate cancer, choosing the optimal treatment can be challenging since each option comes with different side effects, such as erectile dysfunction, which negatively impacts their quality of life.

Development and Implementation of Semantic Information Standards for Oncology.

Data exchange in oncological healthcare is hindered by insufficient standardization agreements. An Information Standard comprises agreements facilitating accurate communication of care information with the necessary quality and timeliness. We introduce a structured approach to designing, implementing, and maintaining semantic information standards for oncology, supporting information use across medical scenarios.

Development and Implementation of Standardized, Structured Clinical Reporting for Oncology.

Reuse of clinical data within the healthcare process and for secondary purposes is particularly valuable. This study emphasizes the crucial role of Standardized, Structured Reports (SSRs) in supporting continuity of care while also advancing reusability of data, decision support functionalities, and accommodating future developments. Integrating SSRs with existing information systems poses a serious challenge.

Development and Implementation of Clinical Decision Algorithms for Oncology.

Decision-making in healthcare often relies on narrative guidelines; however, these instruments are poorly accessible for supporting clinical decision-making. This study explores the application of rule-based decision logic in algorithmic modeling, emphasizing its great potential in clinical decision support and research. Integrating rule-based algorithms with existing information systems and real-world data poses a serious challenge.

Central nervous system metastases in advanced non-small cell lung cancer: A review of the therapeutic landscape.

Up to 40% of patients with non-small cell lung cancer (NSCLC) develop central nervous system (CNS) metastases. Current treatments for this subgroup of patients with advanced NSCLC include local therapies (surgery, stereotactic radiosurgery, and, less frequently, whole-brain radiotherapy), targeted therapies for oncogene-addicted NSCLC (small molecules, such as tyrosine kinase inhibitors, and antibody-drug conjugates), and immune checkpoint inhibitors (as monotherapy or combination therapy), with multiple new drugs in development. However, confirming the intracranial activity of these treatments has proven to be challenging, given that most lung cancer clinical trials exclude patients with untreated and/or progressing CNS metastases, or do not include prespecified CNS-related endpoints.

Forecasting model for qualitative prediction of the results of patient-specific quality assurance based on planning and complexity metrics and their interrelations. Pilot study.

Background: The purpose was to analyse the interrelations between planning and complexity metrics and gamma passing rates (GPRs) obtained from VMAT treatments and build the forecasting models for qualitative prediction (QD) of GPRs results.

Materials And Method: 802 treatment arcs from the plans prepared for the head and neck, thorax, abdomen, and pelvic cancers were analysed. The plans were verified by portal dosimetry and analysed twice using the gamma method with 3%|2mm and 2%|2mm acceptance criteria.

PCD-CT enables contrast media reduction in abdominal imaging compared to an individualized kV-adapted contrast media injection protocol on EID-CT.

Objectives: This study aims to demonstrate reduced iodine contrast media (CM) in routine abdominal CT scans in portal venous phase (PVP) using a photon-counting detector CT (PCD-CT) compared to total body weight (TBW) and kV-adapted CM injection protocols on a state-of-the-art energy-integrating detector CT (EID-CT) while maintaining sufficient image quality (IQ).

Materials And Methods: Consecutive contrast-enhanced abdominal PVP CT scans from an EID-CT (Nov 2022-March 2024) and a PCD-CT (Sep 2023-Dec 2023) were compared. CM parameters (total iodine load (TIL), iodine delivery rate (IDR) and dosing factor (DF)) were reported.

Deep learning with uncertainty estimation for automatic tumor segmentation in PET/CT of head and neck cancers: impact of model complexity, image processing and augmentation.

Target volumes for radiotherapy are usually contoured manually, which can be time-consuming and prone to inter- and intra-observer variability. Automatic contouring by convolutional neural networks (CNN) can be fast and consistent but may produce unrealistic contours or miss relevant structures. We evaluate approaches for increasing the quality and assessing the uncertainty of CNN-generated contours of head and neck cancers with PET/CT as input.

Refining Treatment Planning in STereotactic Arrhythmia Radioablation: Benchmark Results and Consensus Statement From the STOPSTORM.eu Consortium.

Purpose: STereotactic Arrhythmia Radioablation (STAR) showed promising results in patients with refractory ventricular tachycardia. However, clinical data are scarce and heterogeneous. The STOPSTORM.