2026-03-20
Barry J. A. Laird, Lorenzo Antonuzzo, Darío Sánchez Cabrero, Ece Esin, Fieke Froeling, Karin Jordan, Domina Kekez, Richard Skipworth, Marieke Schooneman, Şuayib Yalçın, Carla M. Prado, Maurizio Muscaritoli
BackgroundCancer significantly impacts nutritional status, thereby affecting treatment tolerance, quality of life, and survival. However, nutrition remains underutilized in oncology care.MethodsThis paper describes current evidence to examine challenges, and propose strategies, for embedding nutrition into routine oncology care across the cancer continuum.ResultsThe complexity of cancer-related malnutrition demands simple, validated, and cancer-specific tools for nutritional screening and assessment. Terminology such as “cachexia” and “malnutrition” may not appear positive for clinicians or patients; alternatives like “nutritional fitness” are suggested. Barriers to integration include misconceptions about cachexia as solely end-of-life, poor adherence to clinical guidelines, limited training for oncologists, and lack of access to dietitians. Integration of nutrition into clinical drug trials and perioperative care (e.g., prehabilitation) is essential. Emerging tools like PRONTO and composite indices incorporating body composition and inflammation may offer practical pathways forward.ConclusionEarly and ongoing nutritional monitoring, positive communication, regulatory alignment, and education of all stakeholders, including oncologists, surgeons, and patients are critical to embedding nutrition in oncology. By reframing nutritional care as a core component of treatment rather than supportive care, outcomes can be improved and practice re-shaped.
DOI: 10.3389/or.2026.16394942026-03-16
Xinyu Yi, Zhaoyi Zhao, Jin Li
ObjectiveTo develop and validate a risk prediction model for Chemical cystitis in patients with non-muscle-invasive bladder cancer (NMIBC) undergoing intravesical instillation.MethodsThis study retrospectively enrolled 225 patients with NMIBC who received intravesical instillation between January 2024 and January 2026. Predictive variables, including demographic characteristics, oncological features, medical history, treatment-related factors, and procedural anatomy, were collected. Feature selection was performed using the Least Absolute Shrinkage and Selection Operator (LASSO) regression from 18 candidate variables. A multivariable logistic regression model was constructed based on the selected variables and visualized as a risk prediction nomogram. The model’s performance was evaluated and validated using the Area Under the Curve (AUC), calibration curves, and Decision Curve Analysis (DCA) to assess discrimination, calibration, and clinical utility.ResultsFive independent predictors were identified from the candidate variables through LASSO and multivariable logistic regression analysis: type of instillation agent, tumor multifocality, retention time of the agent, bladder capacity, and tumor grade. The predictive model demonstrated robust discriminative ability in both the training and validation cohorts, with AUC values of 0.840 and 0.868, respectively. Calibration curves showed high consistency between the predicted and observed risks, and DCA further confirmed the model’s positive net benefit in clinical decision-making.ConclusionWe successfully developed and validated a practical nomogram for the individualized prediction of Chemical cystitis risk in patients with NMIBC. This tool can assist clinicians in identifying high-risk patients prior to treatment, thereby enabling more targeted monitoring and preventive strategies. This study is limited by its single-center retrospective design, and external prospective validation is warranted.
DOI: 10.3389/or.2026.17918932026-02-23
Kexun Li, Simiao Lu, Changding Li, Jie Mao, Huan Zhang, Kangning Wang, Guangyuan Liu, Yongtao Han, Lin Peng, Xuefeng Leng
BackgroundTo evaluate the impact of Body Mass Index (BMI) on survival and postoperative complications in older patients with esophageal squamous cell carcinoma (ESCC) following esophagectomy, we designed this study.Materials and methodsWe retrospectively analyzed 469 patients aged ≥70 years with thoracic ESCC who underwent esophagectomy at Sichuan Cancer Hospital (May 2016–August 2021). Patients were grouped by WHO BMI categories: underweight (<18.5 kg/m2), normal (18.5–24.9 kg/m2), and overweight/obese (≥25 kg/m2). Primary outcomes were overall survival (OS) and disease-free survival (DFS); secondary outcomes included Clavien-Dindo grade III–IV complications. Kaplan-Meier, Cox models, and restricted cubic splines (RCS) were used.ResultsMedian follow-up was 47.5 months; R0 resection was achieved in 96.4%. BMI distribution: 7.3% low, 76.8% normal, 16.0% high. Median OS was 44.9 months overall, with no significant OS or DFS differences among BMI groups. RCS demonstrated a significant U-shaped association between continuous BMI and survival: protective ranges were approximately 21.9–27.0 kg/m2 for OS (P non-linearity = 0.014) and 20.2–27.2 kg/m2 for DFS (P non-linearity = 0.033).ConclusionIn elderly ESCC patients after esophagectomy, BMI does not independently influence OS or DFS, though low BMI is associated with specific serious complications. Perioperative optimization—particularly nutritional support for underweight patients—remains essential.
DOI: 10.3389/or.2026.17575302026-01-22
Davide Treré, Lorenzo Montanaro, Massimo Derenzini, Claudio Agostinelli, Enrico Derenzini
Many drugs currently used in cancer chemotherapy exert their toxic action mainly by inhibiting ribosome biogenesis (RiBi). This is due to the fact that after inhibition of rRNA transcription ribosomal proteins, no longer used for ribosome building, bind to and neutralize the activity of the murine double minute 2 protein (MDM2, HMD2 in humans), thus hindering cell proliferation and possibly inducing apoptotic cell death. Here, we discuss the existing literature showing how RiBi rate and genomic alterations of ribosomal proteins (RP mutations/deletions) influence the degree of MDM2 inhibition after treatment with RiBi inhibitors in cancer cells. There is evidence that a high RiBi rate is associated with a high RPs release with strong inhibition of MDM2 activity and consequent induction of apoptotic cell death in response to RiBi inhibitors, whereas a low RiBi rate or RP mutations/deletions are associated with a degree of MDM2 inhibition insufficient to kill cancer cells. In the latter case, in cells with wild type p53, association with drugs which stabilize p53 with different mechanisms may overcome cancer cells resistance to RiBi inhibition, whereas in cancers lacking functional p53 addition of MDM2 inhibitors should be considered. From this, the necessity to evaluate the rate of ribosome biogenesis together with the presence of RP mutations/deletions in cancer tissues for predicting the sensitivity of cancer cells to RiBi inhibitors in order to choose more appropriate therapeutic protocols.
DOI: 10.3389/or.2025.17402612025-11-25
Vishwajeet Singh, Mukul Kumar Singh, Anil Kumar, Ashutosh Shrivastava, Dinesh Kumar Sahu, Mayank Jain, Anuj Kumar Pandey
IntroductionEarly prognostication in non-muscle-invasive bladder cancer (NMIBC) is essential for optimizing therapy and follow-up. Epigenetic mechanisms, particularly DNA methylation, have emerged as promising biomarkers for predicting disease outcome.Materials and MethodsA systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate the prognostic significance of promoter DNA methylation in NMIBC. Comprehensive searches of PubMed, Web of Science, Embase, MEDLINE, and the Cochrane Library (January 2010–October 2022) identified eligible studies. The Newcastle–Ottawa scale was used for quality assessment, and pooled hazard ratios with 95% confidence intervals were calculated using random-effects models.ResultsEleven studies with 3,065 NMIBC patients were analyzed. Promoter methylation was significantly associated with poor progression-free survival (pooled hazard ratios (HR) = 2.88; 95% CI = 2.03–4.09; p < 0.0001) and recurrence-free survival (pooled HR = 2.65; 95% CI = 1.93–3.63; p < 0.0001). Although overall survival showed pathway-specific variation (pooled HR = 0.96; 95% CI = 0.36–2.60; p = 0.94), methylation of adhesion and apoptosis-related genes exhibited the strongest associations. Subgroup analyses revealed a greater prognostic impact in Asian cohorts (p < 0.0001), suggesting regional differences in epigenetic susceptibility.ConclusionPromoter DNA methylation constitutes a robust prognostic biomarker for recurrence and progression in NMIBC, with stronger effects in Asian populations. Standardization of validated gene panels, assay thresholds, and cross-regional prospective validation will be essential for clinical translation. Integrating methylation-based classifiers into risk stratification models could improve individualized management and long-term outcomes in NMIBC.
DOI: 10.3389/or.2025.16799742025-11-20
Blanca Gonzalez-Garcia, Cristina Aparicio, Rocio Abia, Francisco J. G. Muriana, Sara M. Jaramillo-Carmona
DOI: 10.3389/or.2025.1704345