Head and neck neuroendocrine carcinoma (HN-NEC) is exceedingly rare. Standardized treatment strategies for this malignancy remain unestablished. This study aimed to explore promising treatment modalities, and to identify prognostic factors in HN-NEC.

Thirty-nine patients diagnosed with HN-NEC at West China Hospital of Sichuan University between 2006 and 2025 were enrolled. The 5-year survival rates were estimated by Kaplan-Meier analysis. The log-rank test and Firth's penalized Cox multivariable analysis regression model were used to identify prognostic factors.

The 5-year locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS) rates for patients who did and did not receive radiotherapy were 63.2% vs. 29.6% (p = 0.031), 75.5% vs. 48.0% (p = 0.065), and 81.4% vs. 46.9% (p = 0.039), respectively. Laryngeal NEC was associated with poorer 5-year DMFS (41.2% vs. 87.5%, p = 0.023) and 5-year OS (38.1% vs. 92.9%, p = 0.027) compared with non-laryngeal HN-NEC. Radiotherapy (HR = 0.152, 95% CI: 0.025-0.757, p = 0.022) was a potentially protective factor influencing LRRFS.

Radiotherapy may be associated with improved LRRFS in patients with HN-NEC. HN-NEC originating in the larynx appeared to be associated with a poorer prognosis compared with other primary sites of the head and neck.

Background: Small-cell lung cancer (SCLC) accounts for 15% of lung cancers, with 70% diagnosed at extensive-stage (ES). Systemic therapy is often considered in very unwell patients, although outcomes for inpatients with ES-SCLC are not well understood. Methods: We reviewed patients with de novo ES-SCLC who had an inpatient medical oncology consultation at the Ottawa Hospital between 2013 and 2021. The primary endpoint was overall survival (OS). Secondary endpoints included length of stay (LOS) and tumor lysis syndrome (TLS) incidence. Results: There were 127 patients identified. Median age was 68 years (range 50-87), 58% female, 99% had prior smoking history, 22% had brain metastases, and 64% had liver metastases. Ninety-two (72%) received chemotherapy. Median OS for treated patients was 5.9 months (95% CI, 4.5-7.3 m), and a median LOS of 13 days. Patients in the non-treatment cohort had a median OS of 14 days (95% CI, 0.2-0.7 m), a median LOS of 11 days, and 54% in-hospital death rate. TLS occurred in six of the 76 (8%) evaluated patients, all dying within 7 days of chemotherapy. Conclusions: Chemotherapy was associated with longer survival among inpatients with ES-SCLC. TLS was rare but uniformly fatal, highlighting the need for aggressive prophylaxis among patients with identified risk factors.

Cancer patients receiving systemic therapy experience substantial treatment-related symptoms. Nurse-led digital health interventions, e.g., interactive voice response systems, web platforms, mobile apps, and telehealth, have emerged as strategies to strengthen supportive care. To evaluate its effectiveness, this systematic review summarizes evidence exclusively from randomized controlled trials (RCTs). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, four databases were searched from inception to January 2025 for eligible RCTs involving adults undergoing anticancer therapy; evaluating nurse-led or nurse-co-led interventions using digital or telecommunication technologies; reporting validated symptom or health-related quality of life (HRQoL) outcomes. Risk of bias was assessed. Nine RCTs (N = 3344) met criteria; seven had low risk of bias. Interventions using telephone systems, web portals, mobile apps, or videoconferencing reduced symptom burden and improved HRQoL. The Symptom Care at Home system reduced symptom burden by ~43%, with greatest effects from combined automated monitoring and nurse practitioner follow-up. Additional benefits included improved anxiety, self-efficacy, patient participation, fewer severe toxicities and hospitalization days. In conclusion, nurse-led digital interventions effectively reduce symptom burden and support HRQoL during systemic therapy. Multicomponent models integrating automated monitoring with structured nursing follow-up and decision support appear most beneficial.

Background/objectives: To describe and compare Korean AYAs' and parental perspectives on the family environment in terms of agreement and significant differences and examine which variables were associated with AYAs' symptom distress. Sample and setting: Self-report data were collected from a total sample of 113 AYAs, recruited from a pediatric-oncology outpatient clinic at a university-affiliated hospital and community group in South Korea. Because each study aim required different data sources, different analytic samples were used. Specifically, 54 AYA-parent dyads were included for Aim 1, whereas self-report data from 111 AYAs with complete data were used for Aim 2. Methods and variables: This subgroup analysis used a quantitative-descriptive, cross-sectional design. AYAs' and parent perceptions of the family environment (family cohesion and adaptability, family strength, and social support from family) and AYAs' symptom distress were collected using reliable and validated self-report questionnaires and analyzed using descriptive and inferential statistics. Results: AYAs and their parents showed low (family support) to moderate agreement (family strength, family cohesion, and adaptability) on perceptions of family environment (ICC = 0.374-0.612). AYAs reported significantly lower perceptions of family support than their parents, with a small to moderate effect (p < 0.001, d = 0.48). All family environment variables were correlated with AYAs' symptom distress (p < 0.05). Among these variables, AYAs' perceived family strength emerged as the only family environment variable significantly associated with their symptom distress (F = 14.309, p < 0.001, R² = 0.359, R²adj = 0.334), which was stronger during treatment. Conclusions: AYAs' perceived family strength should be routinely assessed, especially during cancer treatment. Additional nursing interventions focusing on enhancing AYAs' families as a support group are needed.

Accurate risk stratification of intraductal papillary mucinous neoplasms (IPMNs) remains clinically challenging. This study evaluates a structured imaging-based scoring approach for IPMN risk stratification, referred to as the Tübingen Dignity Score (TDS), and compares its diagnostic performance with established methods.

In this retrospective study, imaging findings from patients with suspected IPMN were analyzed using MRI, CT, and ultrasound. The TDS was applied as an imaging-based scoring system. Diagnostic performance was assessed in a histopathological subset and compared with MRI-based assessment and Fukuoka criteria.

MRI showed high sensitivity (94.4%) but limited specificity (57.1%). Fukuoka criteria showed high sensitivity (100%) and high specificity (91.3%) in this cohort, although with a lower positive predictive value. In contrast, the TDS showed high specificity (100%) and positive predictive value, but lower sensitivity (40%), reflecting a different diagnostic profile. These findings indicate a trade-off between sensitivity and specificity across the evaluated approaches. However, the limited number of malignant cases limits the robustness and generalizability of these estimates.

The TDS may serve as a complementary, imaging-based tool within a multimodal diagnostic framework for IPMN. Its potential value lies in supporting clinical decision-making in selected cases, particularly where established criteria yield inconclusive results. Given the limited sample size, retrospective single-center design, and exploratory nature of this study, external prospective multicenter validation is required before routine clinical application can be recommended.

Background/Objectives: Tumor-infiltrating lymphocyte (TIL) therapy is an important option for patients with metastatic melanoma progressing after standard systemic therapy, but real-world data on treatment delivery, toxicity monitoring, and immune recovery remain limited. We evaluated clinical outcomes, treatment tolerance, immune reconstitution, and cardiac biomarker dynamics across three Mayo Clinic sites. Methods: We retrospectively analyzed adults with metastatic melanoma who received lymphodepleting chemotherapy followed by TIL infusion and high-dose interleukin-2 (IL-2) between April 2024 and December 2025. Clinical outcomes, treatment delivery, and adverse events were assessed. Longitudinal immune monitoring included CD4 and CD8 T-cell counts, CD4:CD8 ratio, and immunoglobulin G (IgG) at baseline and follow-up. In a prespecified cardiac sub-cohort, high-sensitivity troponin (hs-Tn) was measured during IL-2 administration to evaluate associations with cardiac events and IL-2 interruption. Results: Thirty-six patients underwent TIL infusion. The objective response rate was 50.0%, including complete responses in 13.9%, and the disease control rate was 72.2%. Median progression-free survival was 3.61 months, and median overall survival was 12.94 months. M1d disease was associated with inferior overall survival on univariable analysis (HR 6.55, 95% CI 2.03-21.17; p = 0.002), with attenuation after multivariable adjustment. Receipt of ≥3 IL-2 doses was associated with longer overall survival on univariable analysis (HR 0.20, 95% CI 0.06-0.64; p = 0.007), but this association also attenuated after adjustment. Longitudinal immune monitoring demonstrated persistent CD4 lymphopenia through 6 months, sustained inversion of the CD4:CD8 ratio, and declining IgG at months 3 and 6. In the cardiac sub-cohort (24 patients; 87 IL-2 doses), post-dose hs-Tn ≥15 ng/L was associated with clinically significant cardiac events (OR 9.6, 95% CI 1.5-60.6; p = 0.016) and IL-2 interruption (OR 3.4, 95% CI 1.1-10.7; p = 0.036). For cardiac events, hs-Tn ≥15 ng/L had 100% sensitivity and 100% negative predictive value. Conclusions: In routine practice, TIL therapy was feasible and active in metastatic melanoma. M1d disease identified a subgroup with poor survival, peri-dose hs-Tn showed promise as a tool to support safer IL-2 delivery, and prolonged CD4 suppression with IgG decline suggests that recovery after TIL therapy extends beyond initial hematologic reconstitution. These findings support prospective validation of biomarker-guided IL-2 monitoring and extended post-treatment immune surveillance.

The fifth annual pan-tumour Early Age Onset Cancer (EAOC) Symposium, held in November 2025 and organized by the Colorectal Cancer Resource & Action Network (CCRAN), convened clinicians, researchers, policymakers, patients, and caregivers to address the rising incidence of cancers in individuals under 50 years. In addition to discussions around diagnostic and therapeutic advances for patients with late-stage disease, content centered on addressing critical gaps along the EAOC care continuum, including (i) diagnostic delays related to limited awareness and suboptimal primary care pathways, (ii) screening eligibility criteria for colorectal cancer (CRC) that no longer reflect current disease epidemiology, and (iii) insufficient age-appropriate infrastructure to meet the EAOC population's unique unmet needs with respect to psychosocial support, fertility counseling, financial navigation, and survivorship planning. The symposium generated consensus recommendations such as the embedding of EAOC education into medical training curricula to increase the index of suspicion of EAOC in primary care, lowering the CRC screening age to 45 years to match this population's rising disease incidence, and expanding multidisciplinary adolescent and young adult (AYA) and EAOC programs-including through the use of virtual models-to ensure that patients receive coordinated, comprehensive, equitable and age-appropriate care across the country.

A subgroup of adolescent and young adult patients (AYAs; 18 to 39 years at diagnosis) face an uncertain or poor cancer prognosis (UPCP). Previous qualitative research identified dual coping pathways in this population: engagement in life versus the reality of premature death. This study examines whether similar psychosocial profiles can be identified through quantitative data, aiming to differentiate patient experiences and identify characteristic features of each cluster. Additionally, this study examines the association between cluster membership and social support needs to understand psychosocial disparities.

Eligible participants completed questionnaires assessing physical, psychosocial, and existential outcomes related to their disease and prognosis. An ensemble clustering approach was applied, including evaluation of clustering tendency and multiple algorithms, with stable clusters identified through majority voting. Associations with social support needs were analyzed using Fisher's exact test.

Data from 155 AYAs with a UPCP were included. The mean age at diagnosis was 31.2 years, with glioma (34.8%) and breast cancer (17.4%) as the most common diagnoses. Two distinct clusters were identified: one (22%) characterized by poorer functional outcomes and fewer protective factors (e.g., hope, meaning in life), and another cluster (78%) with better functioning and less frequent needs for social support (p < 0.00043).

Findings revealed divergent psychosocial profiles within the AYA-UPCP population, highlighting the importance of early identification of vulnerable subgroups. Strengthening protective factors may enhance resilience and reduce unmet support needs. Validation in larger, external datasets is needed to confirm these pathways and guide tailored supportive care strategies.

Patients with acute myeloid leukemia (AML) experience severe infections frequently during and after chemotherapy. The purpose of this study was to develop an early risk assessment tool to identify newly diagnosed AML patients at high risk of developing sepsis during the early phase of induction chemotherapy.

The records of 192 newly diagnosed AML patients from February 2017 to December 2023 at our institution were retrospectively reviewed. Kaplan-Meier survival analysis was performed to explore the prognosis difference between groups with or without sepsis. Mann-Whitney U test, Chi-square test, and multivariable logistic regression analysis were used to identify independent risk factors and establish a nomogram for early risk stratification of sepsis. The predictive accuracy of the nomogram was evaluated using the area under the curve (AUC), calibration curves, and concordance index (C-index). The nomogram is intended for application on days 3-5 of induction chemotherapy.

Multivariate logistic regression identified TP53 mutation, elevated aspartate aminotransferase (AST) and C-reactive protein (CRP) at diagnosis, increased procalcitonin (PCT), and higher urea levels post-induction as independent risk factors for sepsis progression. The bootstrap-corrected AUC was 0.892 (C-index 0.892). The bias-corrected calibration curve was close to the ideal line, demonstrating strong consistency between actual observations and predictions. Patients with sepsis experienced a poorer prognosis (p < 0.001) both at 1-year and 5-year survival rates. The incidence rates of pneumonia and invasive fungal infection were higher in the sepsis group.

We developed a nomogram for early identification of sepsis risk in newly diagnosed AML patients during their initial induction chemotherapy. This tool may assist clinicians in identifying patients requiring close monitoring and intensive supportive care.

Allogeneic hematopoietic cell transplantation (allo-HCT) improves survival in patients with acute myeloid leukemia (AML); however, posttransplant relapse remains the most common cause of treatment failure and death. Limited data exist on posttransplant health care resource utilization (HCRU) and costs, particularly for patients initiating maintenance therapy.

To describe HCRU and costs among commercially insured patients, Medicaid enrollees from participating US states, and Medicare-eligible beneficiaries with employer-sponsored supplemental coverage who received maintenance therapy after allo-HCT compared with those receiving allo-HCT alone.

We conducted a retrospective cohort study of patients with AML who underwent allo-HCT using claims data from the Merative MarketScan database from October 1, 2015, to March 31, 2024. Patients receiving maintenance therapy were identified by a claim for 1 of the following agents after allo-HCT: azacitidine, decitabine, enasidenib, gemtuzumab ozogamicin, gilteritinib, glasdegib, ivosidenib, midostaurin, quizartinib, sorafenib, or venetoclax. Groups were balanced using inverse probability treatment weighting (IPTW) based on baseline characteristics. We assessed differences in all-cause monthly HCRU and costs. HCRU included emergency department (ED) visits, inpatient (IP) admissions, outpatient (OP) visits, and hospital length of stay throughout the 12-month follow-up period. Poisson and negative binomial regression models estimated event rates. Per patient per month mean costs were reported with SEs, and between-group differences were assessed using mean differences, bootstrapped 95% CIs, and P values. Cumulative costs were summarized using the mean with bootstrapped 95% CIs and the median. IPTW-weighted mean monthly costs were also calculated for each cohort. Transfusion burden was also evaluated.

Of the 373 patients who met the inclusion criteria, 43 were prescribed maintenance therapy following allo-HCT. The maintenance therapy group demonstrated significantly higher HCRU across service types. Both office (incidence rate ratio [IRR] = 3.23, P = 0.004) and OP visits (IRR = 4.26, P < 0.001) were more than tripled compared with the allo-HCT-only group, and IP admissions rose by 34% (IRR = 1.34, P = 0.034). Specialist clinic and ED visit rates were higher but not statistically significant (IRR = 3.03, P = 0.060 and IRR = 1.51, P = 0.483, respectively). Health care costs transitioned from predominantly IP at transplant to mostly pharmacy-driven by month 4, with similar trends across both groups. The maintenance therapy group had significantly higher per patient per month pharmacy costs ($6,433.81 vs $3,132.51, P = 0.002). Blood transfusion requirements were minimal in both groups. Weighted mean length of stay was significantly longer in the allo-HCT-only cohort compared with the maintenance therapy group (26.53 [SE = 1.29] vs 21.40 [SE = 1.21] days, respectively), with a mean difference of -5.13 days (95% CI = -8.60 to -1.65; P = 0.004).

Those who received maintenance therapy following allo-HCT had higher IP admission and OP use rates and incurred more pharmacy costs. These findings highlight the need to balance the clinical benefits of maintenance therapy with its increased demands on health care resources.