Greater Poland Cancer Center

Background and Objectives: Soft tissue sarcomas account for approximately 7% of all malignant tumors in the pediatric population. Diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurements may provide early functional biomarkers of treatment response by reflecting changes in tumor cellularity. This study evaluated whether ADC-derived parameters can serve as quantitative biomarkers of neoadjuvant chemotherapy response in pediatric rhabdomyosarcoma. Materials and Methods: This retrospective single-center study included 14 patients aged ≤18 years with histopathologically confirmed rhabdomyosarcoma who underwent MRI before treatment and after three cycles of chemotherapy. Twenty-five patients were initially identified; eleven were excluded due to imaging artifacts or absence of baseline examination. ADC maps were generated on 1.5T and 3T scanners. Regions of interest were placed over the entire lesion and areas with the lowest ADC signal. Relative ADC (rADC) was calculated by normalizing tumor ADC to adjacent healthy muscle. Paired t-tests were used to compare pre- and post-treatment values. Results: At baseline, 13/14 patients (93%) demonstrated diffusion restriction. Mean ADC increased from 1.11 × 10−3 mm2/s (SD ± 0.48) at baseline to 1.63 × 10−3 mm2/s (SD ± 0.67) after treatment. The paired t-test for rADC yielded t = −3.089 (p = 0.0086, 95% CI: −0.79 to −0.14), indicating a statistically significant change. There was a significant difference between the ADC values of the entire lesion and the areas with the lowest signal in tumors with a heterogenic structure, t = 2.862, p = 0.013. Conclusions: ADC and rADC increased significantly after neoadjuvant chemotherapy in pediatric rhabdomyosarcoma, suggesting potential utility as early functional biomarkers of treatment response. These preliminary findings require validation in larger multicenter prospective studies with correlation to histopathological response and clinical outcomes before clinical implementation.

IntroductionSurgical resection is a cornerstone of curative treatment for early-stage lung cancer. Multimodal prehabilitation, a comprehensive, patient-centered program integrating physical exercise, nutritional status, and psychological support, has emerged as a promising approach to enhance patients’ physiological and psychological resilience prior to surgery. While multimodal prehabilitation is valuable for optimizing patients’ tolerance of oncological treatment, there is a scarcity of studies incorporating multimodal interventions, likely due to the absence of clear guidelines for lung cancer patients. This systematic review aimed to assess the comprehensiveness and effectiveness of prehabilitation activities for lung cancer patients undergoing thoracic surgery.Evidence AcquisitionA systematic literature search was conducted according to PRISMA guidelines. The search was performed in PubMed, Google Scholar, PEDro, and Cochrane Library, with additional publications identified from reference lists. The search was completed on February 27, 2024. Studies published between 2019 and 2024 were included to capture the most recent evidence. The study was registered in PROSPERO (registration number CRD42024499622).Evidence SynthesisOut of 1233 identified studies, 10 randomized controlled trials were included. Prehabilitation programs varied in duration and setting. Only three studies (Liu et al, 2020; Yao et al, 2022; Ferreira et al, 2021) employed a comprehensive multimodal approach integrating physical exercise, psychological care, and nutrition interventions. Prehabilitation was associated with improved exercise capacity (eg, increased 6MWT distance), reduced postoperative complications, and potential benefits for quality of life and psychological well-being. However, the impact on length of stay and cognitive function remains unclear.ConclusionThis review highlights a significant gap in the implementation of comprehensive multimodal prehabilitation for lung cancer patients. While physical exercise is widely adopted, psychological and nutritional components are often overlooked. Further research is needed to establish clear guidelines and elucidate the full benefits of a comprehensive multimodal prehabilitation approach, particularly regarding its impact on mental health, quality of life, and long-term outcomes in lung cancer patients.

Theranostics, the integration of diagnostic imaging with targeted radiopharmaceutical therapy, is reshaping the practice of nuclear medicine worldwide. This article provides a global perspective on how multidisciplinary teams deliver theranostics care in diverse health care systems. Contributions from experts across Asia, Europe, South Africa, Australia, Latin America, and the United States highlight the shared and region-specific roles of nuclear medicine physicians, technologists, radiopharmacists, physicists, and nurses in patient selection, radiopharmaceutical preparation, treatment delivery, and posttherapy care. A consistent theme across regions is the central role of the nuclear medicine physician in treatment oversight and the expanding responsibilities of nuclear medicine technologists in imaging protocols, radiopharmaceutical administration, patient care, and dosimetry. The roles of radiopharmaceutical scientists, medical physicists, nurses, and trial coordinators are variable but overall beneficial in delivering a successful theranostics service. Workforce shortages, financial barriers, and regulatory challenges continue to be significant obstacles to equitable patient access. Despite these challenges, multidisciplinary collaboration, tumor board integration, and shared care models are improving patient outcomes and advancing the field.

BackgroundOncology care is a complex, multidisciplinary process requiring coordinated collaboration among various healthcare professionals. The role of the Oncology Care Coordinator (OCC) has gained prominence as a key component in enhancing the quality and efficiency of cancer care. Coordinators assist patients in navigating the healthcare system, provide emotional support, and help minimize delays in diagnosis and treatment. The aim of this study was to analyze the level of professional competencies among oncology care coordinators working within the Polish healthcare system. The study assessed self-perceived proficiency across ten key domains and examined the relationships between these competencies and sociodemographic factors such as education level and work experience.Materials and methodsThis was a cross-sectional, quantitative study using a custom-designed self-assessment questionnaire (OCCCSAQ). Participants included a total of 300 coordinators from various healthcare institutions across Poland. The questionnaire measured competencies in communication, work organization, patient education, psychological support, knowledge of procedures and law, stress management, digital literacy, and conflict resolution. Data were analyzed using descriptive and inferential statistics (t-tests, ANOVA, Pearson correlations).ResultsThe highest-rated competencies were interpersonal communication (M = 8.7), psychological support (M = 8.6), and both work organization and patient education (M = 8.5). The lowest-rated were legal knowledge (M = 7.2) and stress management (M = 7.5). Education level significantly influenced perceived competence, with higher-educated coordinators scoring better in procedural knowledge, digital systems, and conflict resolution. Experience positively affected knowledge of procedures and law, but not stress management.ConclusionsOncology care coordinators demonstrated high competence in key areas of patient interaction and care coordination. However, there are gaps in legal knowledge and stress management that should be addressed through targeted training. Specialized roles — for example, focusing on patient education or psychological support — may also enhance service quality and job performance.

IntroductionThe chloride intracellular channels (CLICs) engage in cancer pathogenesis and have been considered various cancer biomarkers and therapeutic targets. Preliminary research suggests CLICs may be important players in head and neck squamous cell carcinoma (HNSCC). There is a need for reliable HNSCC biomarkers besides well-known HPV and PD-L1.AimThe study aimed to assess the role of CLICs in HNSCC pathogenesis and as potential disease biomarkers.MethodsWe compared the CLIC1–CLIC6 genes expression between the HNSCC tumors (n = 99) and the tissue from the free surgical margin (n = 74) at the mRNA level with RT-qPCR and at the protein level with Western Blot. To investigate the role of CLIC1-CLIC6 proteins as potential HNSCC blood biomarkers, we performed the ELISA assays on blood serum from 38 HNSCC patients and eight healthy individuals.ResultsWe found significant differences in the expression of every analyzed CLIC. At the mRNA level, CLIC1 and CLIC4 were overexpressed in oral cancer tissue, CLIC3, CLIC5, and CLIC6 were down-expressed; in laryngeal cancer tissue, CLIC2 and CLIC3 were down-expressed. Tumor staging impacted CLIC1 and CLIC6 tissue expression, and histological grade impacted CLIC6 tissue expression. At the protein level, CLIC3 was down-expressed in oral cancer tissue. Furthermore, CLIC1 and CLIC3 proteins were overexpressed, and CLIC4 and CLIC6 were down-expressed in the oral cancer patients’ blood serum compared to the control group.ConclusionThe different expression patterns of CLICs in HNSCC patients’ tissues and blood serum suggest that they may play an essential role in HNSCC pathogenesis and serve as biomarkers for HNSCC detection.

Introduction. In patients with advanced melanoma with BRAF mutation, the BRAF and MEK inhibitors can be used before or after immunotherapy, and even as third-line systemic treatment. To date, majority of available data on encorafenib plus binimetinib comes from clinical trials. Material and methods. This was a multicenter retrospective study, which aimed to investigate the efficacy of encorafenib plus binimetinib (E+B) treatment in patients with unresectable stage III or IV melanoma in the real-world setting. The study did not include patients treated with adjuvant intent. Progression-free survival (PFS) and overall survival (OS) estimates were obtained using Kaplan-Meier method. Results. There were 130 patients treated in the first-line setting. Their median follow-up was 24.1 (95% CI 20.9–32) months. Median age of the group treated with E+B first line treatment was 63.5 years and LDH level was abnormal in 53.1% of cases, while 25.4% of patients had brain metastases. The median PFS was 10.3 (95% CI 8–12.4) months, 1- and 3-year PFSs were 40.1% (95% CI 31.9–50.3) and 12.3% (95% CI 6.1–24.7), while the objective response rate (ORR) was 58.5%. After the progression of the disease, 32 (24.6%) patients received second-line treatment (including immunotherapy in 28, 87.5% cases) and 5 (3.8%) patients received third-line treatment. The median OS from the start of the first-line treatment was 15.8 (95% CI 12–23.5) months, while the 1-year and 3-year OS rates were 58% (95% CI 49.6–67.9) and 20% (95% CI 11.9–33.6), respectively. In the second-line treatment, after the anti-PD-1-based first-line treatment, the E+B was administered in 82 patients. The median PFS was 8.5 (95% CI 6.5–12) months, and the ORR was 42 (51.2%). The median OS from the start of the second-line treatment was 13.2 (95% CI 10.9–22) months. In the third-line treatment, E+B was used in 23 patients, with 6- and 12-month PFS being 23% (95% CI 10.7–49.6), and 13.8% (95% CI 4.8–39.4), respectively. The median PFS in third-line setting was 3.6 (95% CI 2.8–5.3) months. Conclusions. This real-world evidence supports the clinically meaningful efficacy of the combination of E+B in first-, second- and third-line treatment.