Nutrition is an essential component of colorectal cancer (CRC) care, influencing treatment tolerance, functional status, and quality of life, yet it remains inconsistently integrated into practice. This study examined experiences with nutrition management and gaps in nutrition care among patients with CRC, caregivers, and healthcare professionals across Canada through a multi-center, cross-sectional survey conducted from July 2025 to February 2026. A total of 243 participants completed the survey, including 121 patients, 45 caregivers, and 77 healthcare professionals. Among patients, 51.2% reported that nutritional status was discussed or assessed during treatment, while 24.0% reported it was never discussed. More than half of patients (55.4%) said they did not receive adequate information regarding weight loss during treatment. Caregivers described substantial nutrition impact symptoms and identified a need for clearer guidance, emotional support, and improved access to dietitians. Healthcare professionals rated nutrition care as highly important yet reported barriers to effective delivery, including limited staffing, lack of standardized screening, and reactive care processes. Across groups, respondents emphasized the importance of timely, personalized, and culturally relevant nutrition care. Overall, nutrition remains insufficiently embedded in CRC care, highlighting the need for routine screening, standardized referral pathways, earlier intervention, and integrated patient-centered nutrition care models to improve CRC care.

Enfortumab vedotin plus pembrolizumab (EVP) is the standard first-line treatment for locally advanced or metastatic urothelial carcinoma (la/mUC); however, real-world toxicity patterns, timing of onset, and prognostic significance of treatment-related adverse events (AEs) remain incompletely characterized.

We conducted a retrospective, multicenter analysis of 60 la/mUC patients treated with first-line EVP in Alberta, Canada (September 2024-January 2026). Treatment related toxicities, time to AE onset, dose modifications, and treatment discontinuation were assessed. Progression-free survival (PFS) and overall survival (OS) were analyzed.

The median age was 69 years, 82% of patients were male, and 80% had metastatic disease at treatment initiation. Histology was pure urothelial in 82% and mixed in 18%. Median follow-up was 10.3 months, and the median number of EV and pembrolizumab cycles was seven and eight, respectively. Rash (63%), fatigue (57%), and peripheral neuropathy (47%) were the most common adverse events, with median onset at 17, 29, and 90 days, respectively. Dose reductions occurred in 62%, dose delays in 43%, and treatment discontinuation in 38%. An initial enfortumab vedotin dose of 1.25 mg/kg was associated with improved PFS (HR 0.30, 95% CI 0.13-0.68; p = 0.004) and OS (HR 0.32, 95% CI 0.10-0.97; p = 0.044) compared with 1.0 mg/kg. Neuropathy was associated with improved PFS (HR 0.32, 95% CI 0.14-0.73; p = 0.007) and OS (HR 0.24, 95% CI 0.07-0.87; p = 0.029), while rash was associated with improved OS (HR 0.31, 95% CI 0.11-0.91; p = 0.032).

EVP was associated with frequent treatment-related adverse events requiring dose modifications, and the development of rash and peripheral neuropathy was associated with favorable survival outcomes.

Second-line chemotherapy is widely used in metastatic urothelial carcinoma after progression on first-line platinum-based therapy, but its independent contribution to survival, as opposed to selection of healthier patients, remains unclear. In this multicenter retrospective cohort of 142 patients treated with first-line platinum-based chemotherapy across seven Turkish centers, overall survival (OS) from first-line progression was compared between patients who received second-line chemotherapy (n = 80) and those who did not (n = 62), using multivariable Cox regression, inverse probability of treatment weighting (IPTW), propensity-score matching, landmark analysis, and a time-dependent Cox model. Median OS was 7.4 versus 4.7 months (log-rank p = 0.064). Second-line chemotherapy was independently associated with improved OS on multivariable analysis (adjusted hazard ratio [aHR] 0.620; 95% confidence interval [CI] 0.423-0.907; p = 0.014); Eastern Cooperative Oncology Group (ECOG) performance status ≥ 2 (aHR 3.881; p = 0.001) and lower albumin (aHR 0.671; p = 0.018) were also independent predictors. The association remained significant after IPTW (HR 0.648; p = 0.025) and after a time-dependent Cox model (HR 0.632; p = 0.019), and was unchanged in ECOG-restricted and Bellmunt-adjusted analyses (p = 0.008, p = 0.029); it narrowly missed significance after propensity-score matching (HR 0.645; p = 0.051) and did not reach significance in the 3-month landmark analysis (HR 0.743; p = 0.180). Power was limited (~49%). In a time-dependent Cox model-the analysis least susceptible to immortal-time bias, as it retains the full cohort and classifies pre-treatment person-time as unexposed-second-line chemotherapy remained independently associated with improved OS (HR 0.632; p = 0.019), closely consistent with the primary multivariable estimate. The conventional Cox, IPTW, and propensity-score-matched analyses, which treat second-line receipt as a baseline exposure, were directionally concordant but share a common time-related bias and are therefore not independent confirmations. ECOG performance status was a consistent predictor throughout.

Background: Borderline ovarian tumors (BOTs) represent a distinct group of rare epithelial ovarian neoplasms with excellent prognosis, but persistent uncertainty in patient understanding and clinical management. This study evaluated disease awareness, perceptions, and treatment patterns among affected women in Germany. Methods: The national multicenter Expression VIII survey was conducted across 34 centers by the North-Eastern German Society of Gynecologic Oncology (NOGGO). Using a standardized 46-item questionnaire, 286 patients with BOTs provided data on symptoms, treatment, fertility, follow-up, and illness perception. Descriptive analyses were performed. Results: Most participants (mean age 51 years) underwent surgery (94%), while systemic therapy was infrequent (chemotherapy 9%, bevacizumab 4%). Fertility-sparing surgery was performed in 14% overall, corresponding to 71% of those desiring future childbearing. Although 81% identified their physician as their main information source and rated information quality highly (mean 8.6/10), 29% believed they had ovarian cancer and 64% were unaware of their tumor stage. Nearly all patients (97%) received regular follow-up, though 18% were uncertain about the procedures performed. Disease severity was rated moderately high (mean 5.4/10), and recurrence risk and mortality were often overestimated. Conclusions: Despite good overall physician communication, substantial misconceptions persist among patients with BOTs, including the mistaken belief that they have been diagnosed with cancer, suggesting a need for clearer, structured education about its favorable prognosis and management of the disease. Improved guideline adherence and treatment centralization in specialized centers may reduce overtreatment and optimize fertility-preserving approaches.

Adjuvant and perioperative immune checkpoint inhibitors (ICIs) have created a growing population of patients who relapse after prior programmed death-1 or programmed death-ligand 1 blockade, yet these patients were underrepresented in many trials that established metastatic standards. We performed a structured narrative review of PubMed/MEDLINE, ClinicalTrials.gov, reference lists, and international oncology guideline repositories through 15 August 2026. Eligible reports addressed recurrence patterns or treatment after curative-intent ICI in melanoma, non-small-cell lung cancer (NSCLC), renal cell carcinoma (RCC), urothelial carcinoma, or triple-negative breast cancer (TNBC); landmark metastatic studies were included only when direct evidence was unavailable and are labeled as extrapolation. Timing was standardized as on-treatment recurrence, early off-treatment recurrence (after the last ICI dose through 12 months), and late recurrence (>12 months). Shorter disease-free interval is consistently prognostic, but treatment-by-timing interactions are rarely available; timing should not be described as a validated pan-tumor predictive biomarker. Direct post-adjuvant evidence supports switching away from anti-PD-1 monotherapy for melanoma recurring on treatment, while selected late relapses may retain sensitivity. In RCC, retrospective post-adjuvant data support VEGF-targeted options, whereas CONTACT-03 and TiNivo-2 discourage routine ICI-TKI rechallenge specifically after prior ICI-treated metastatic RCC. Evidence in NSCLC, urothelial carcinoma, and TNBC is largely indirect. IMpassion132 was not an ICI-rechallenge trial, and only a small minority of ASCENT-04 participants had prior perioperative ICI. Treatment should integrate tumor-specific biology, actionable alterations, recurrence distribution, prior toxicity, comorbidity, access, and patient preference. Prospective trials dedicated to post-adjuvant ICI recurrence are needed.

The sequential use of anti-programmed cell death (ligand)-1 [PD-(L)1] immune-checkpoint inhibitors (ICIs) followed by targeted tyrosine-kinase inhibitors (TKIs) for advanced non-small cell lung cancer (NSCLC) with oncogenic alterations raises questions about tolerance and efficacy. Recent study results suggested an increased risk of adverse events (AEs) with this sequence.

Multicenter retrospective study on advanced NSCLC patients treated with ICIs followed by targeted therapies between 2015 and 2021. The primary endpoint was the rate of grade 3-5 adverse events (AEs). Main secondary endpoints were progression-free survival (PFS), time-to-treatment failure and overall survival (OS).

The analysis included 109 patients (most with EGFR, 30.3%; BRAF, 17.4%; MET exon-14, 17.4%; ALK, 10.1%; and RET, 6.4% gene alterations); 28/109, which is 25.7% of the patients, experienced grade 3/4 AEs and 4/109 (3.7%) experienced grade 5 AEs, leading to the definitive cessation of targeted therapy treatment in 14/32 (44%) of cases; higher grade 3-5 rates were observed with the dabrafenib-trametinib combination (12/16, 75%), capmatinib (4/8, 50%) and crizotinib (8/16, 50%). A last ICI-administration-to-targeted therapy-start interval of <90 days appeared to be associated with grade ≥ 3 AEs (32/82, 39% vs. 0/27 p = 0.001). In these sequential strategies, effectiveness of targeted therapies, in this second-line or later setting, appears to be lower than that in the published historical data.

According to this analysis, sequential ICI-targeted therapy use for advanced NSCLC appeared to be associated with more grade 3-5 AEs.

Analyze the prevalence of anxiety and depression in hospitalized cancer patients and associated clinical and psychosocial factors.

A single-center, prospective, observational study was conducted in the Oncology Department of Miguel Servet Hospital (HUMS). Patients completed Hospital Anxiety and Depression Scale (HADS), Duke-UNC Functional Social Support Questionnaire (DUKE), and Consumer Assessment of Healthcare Providers and Systems (CAHPS). Clinical and psychosocial variables were collected.

166 patients were included. Prevalence of anxiety at admission was 47% (95% CI: 39-55%) and depression 43% (95% CI: 35-51%), decreasing at discharge to 40% (95% CI:32-48%) and 39% (95% CI:31-47%), respectively. Baseline anxiety was associated with anxiolytics (29.5% vs 13.6%; p = 0.012) and antidepressants use (25.6% vs 11.4%; p = 0.017); baseline depression with Eastern Cooperative Oncology Group Performance Status (ECOG) ≥ 2 (64.7% vs 42.1%; p = 0.022) and opioid (62% vs 41.1%; p = 0.008). At discharge, higher anxiety was associated with poorer patient-oncologist relationship (26.7% vs 12.1%; p = 0.022), and higher anxiety (r = -0.15, p = 0.01) and depression (r = -0.3, p = 0.001) with lower social support. At discharge, fatigue was associated with increased anxiety (36.7% vs 18.7%; p = 0.013) and depression (35.6% vs 19.6%; p = 0.028); pre-admission anxiolytics use, to greater anxiety (28.3% vs 14.3%; p = 0.034) and depression (27.1% vs 15.2%; p = 0.074); pre-admission antidepressants use (30.5% vs 9.8%; p = 0.001) and opioids (57.6% vs 39.1%; p = 0.026) with greater depression.

Hospitalized cancer patients show high prevalence of anxiety and depression. Poorer doctor-patient relationship, less social support, fatigue, and pre-admission anxiolytics use were associated with greater anxiety and depression; pre-admission antidepressants and opioids were associated with depression.

Malignant transformation of a mature cystic teratoma (MCT) is rare, with mucinous adenocarcinoma being an even more uncommon subtype. Accurate diagnosis requires distinction from metastatic gastrointestinal tumors. A woman in her 30s presented with a 19 cm right ovarian mass. She underwent exploratory laparotomy with right salpingo-oophorectomy, left ovarian cystectomy, omentectomy, peritoneal biopsies, and bilateral pelvic and para-aortic lymphadenectomy with intraoperative rupture of the mass. Frozen section suggested immature teratoma, but final pathology revealed mucinous adenocarcinoma arising within a mature teratoma. The tumor showed CK20, CDX2, SATB2 positivity, patchy CK7, and loss of PAX8. All lymph nodes and staging biopsies were negative for carcinoma. Final stage: FIGO IC1. This case highlights the diagnostic and staging challenges in malignant transformation (MT) of a MCT. Thorough sampling, immunohistochemistry (IHC), and clinical correlation are critical to differentiate primary ovarian neoplasms from metastatic disease. Accurate classification is essential to guide appropriate management.

This study aimed to objectively assess changes in total physical activity (PA) and moderate-to-vigorous physical activity (MVPA) from head and neck cancer (HNC) diagnosis up to two years post-treatment, and to identify demographic, lifestyle, and clinical factors associated with total PA and MVPA levels and their trajectories.

Data were derived from the prospective NET-QUBIC cohort. PA and MVPA were measured using a waist-worn accelerometer (ActiGraph wGT3X) before treatment and at 6, 12, and 24 months post-treatment. Linear mixed models were used to examine changes in total PA and MVPA and to identify factors associated with these changes.

In total, 517 patients were included. Univariable analyses showed higher total PA and MVPA at 24 months compared with baseline. In multivariable analyses, overall time effects were not significant, but alcohol use and sex showed time-dependent associations. Alcohol users were more active at baseline than non-users, whereas activity levels became comparable during follow-up. Females had higher total PA at baseline, but males showed consistently higher total PA and MVPA after treatment. Comorbidities, older age, and smoking were associated with lower total PA and MVPA, while a WHO performance score of one or two was associated with lower total PA.

Total PA and MVPA did not significantly change over time after adjustment, although trajectories differed by alcohol use and sex. Comorbidities, older age, smoking, and higher WHO performance score were consistently associated with lower activity levels. These findings may inform risk profiles and support tailored rehabilitation strategies for patients with HNC.

Aberrant DNA methylation is a hallmark of prostate cancer (PCa) and plays a critical role in sustaining the epigenetic silencing of tumor suppressor genes. However, how oncogenic signaling pathways interface with the DNA methylation machinery remains poorly understood. In this study, we identify AURKA as a key regulator of global DNA methylation in PCa cells. AURKA depletion markedly reduces genomic 5-methylcytosine (5mC) levels, indicating its essential role in DNA methylation maintenance. Mechanistically, AURKA directly interacts with UHRF1-a crucial epigenetic regulator that recruits DNMT1 to hemimethylated DNA, and phosphorylates it at Ser76, thereby enhancing UHRF1 protein stability. AURKA depletion accelerates UHRF1 degradation via the ubiquitin-proteasome pathway, whereas AURKA overexpression stabilizes UHRF1 by suppressing its polyubiquitination. The phospho-deficient UHRF1 S76A mutant exhibits reduced stability and increased polyubiquitination, confirming that phosphorylation at Ser76 is critical for AURKA-mediated UHRF1 stabilization. Functionally, disruption of the AURKA-UHRF1 axis de-represses p16 and p21 and significantly impairs PCa cell proliferation; these effects are contingent upon UHRF1 phosphorylation, as only wild-type UHRF1, not the phospho-deficient S76A mutant, can rescue the observed phenotypic impairments. Collectively, our study reveals a previously unrecognized AURKA-UHRF1 signaling axis that links kinase activity to epigenetic maintenance. By phosphorylating UHRF1 at Ser76 and stabilizing its protein, AURKA sustains global DNA methylation and promotes PCa cell proliferation. These findings provide novel mechanistic insights into PCa biology and suggest that targeting this pathway may offer a promising therapeutic strategy.