Comprehensive genomic profiling (CGP) is a meaningful advancement in the field of oncology, enabling critical clinical decision-making regarding precision treatments that have biological rationale. In June 2025, the Colorectal Cancer Resource & Action Network (CCRAN) hosted their annual pan-tumour Biomarkers Conference, a virtual meeting of clinicians, scientists, and patients, to discuss recent progress in overcoming barriers to CGP access for patients in Canada with metastatic cancer. The meeting's cornerstone was the presentation of the first national costs and benefits analysis of universal CGP for five metastatic tumour types; findings demonstrated this diagnostic's potential, with the model estimating a gain of 3440 life years while generating $87M-134M of potential healthcare system savings, over a six-year time horizon. Additionally, conference sessions focused on the clinical value of CGP, strategies to leverage the economic analysis results and learn from international experiences, as well as mechanisms to prepare the Canadian healthcare system for future adoption. The conference led to calls to action for a national strategy to reduce disparities in equitable access to CGP, funding allocation for CGP as a standard of care for all patients with metastatic cancer, and pathways to enhance current infrastructure to expedite CGP across the country.
Background: Over 90% of all thyroid cancers are differentiated thyroid cancer (DTC) with an excellent overall survival rate after thyroidectomy with or without radioactive iodine (RAI) therapy. There is a large variation in the use of RAI therapy in DTC. This population-based study was performed to study the survival advantage offered by RAI therapy in DTC. Methods: In this population-based retrospective cohort study, we reviewed the medical records of 3330 patients with DTC operated on between 1970 and 2020 and recorded patient and disease characteristics and the oncological status to January 1, 2025. Disease-specific survival (DSS) and disease-free survival (DFS) were estimated by the Kaplan-Meier product limit method, and the association of the individual prognostic factors on DSS and DFS was assessed by the log-rank test. Multivariable analyses were performed with Cox proportional hazards models. Inverse probability of treatment weighting was used to adjust for the difference between the prognostic factors in RAI and non-RAI groups using propensity scores. Secondary analyses were performed using competing risk models to account for the competing influence of non-DTC-related causes of death. Results: Our cohort included 783 males and 2547 females with a mean age of 48 years. RAI therapy was administered to 34.9% of all cases (24.2% of low, 31.1% of intermediate, and 68.4% of high-risk cases, respectively). 10-year DSS was 97.2% after a median follow-up of 14.1 years. DSS was adversely influenced by the presence of distant metastasis, incomplete resection, advanced age, male sex, non-papillary histology, and advanced T stage. RAI therapy was not significantly associated with DSS overall, but it was associated with over 80% risk reduction in metastatic DTC in the Cox proportional hazards model (hazard ratio 0.192; [CI: 0.088-0.417]; p < 0.001) and competing risk analysis (sub-hazard ratio 0.162; [CI: 0.072-0.368]; p < 0.001). Conclusions: Excellent DSS can be achieved in DTC with selective use of adjuvant RAI, with the greatest benefit of RAI seen in those with metastatic DTC.
Purpose Hepatocellular carcinoma (HCC) is the most common and highly morbid primary liver malignancy. In this retrospective study, we describe the clinical characteristics of patients with HCC, identify factors determining the type of delivered treatment, and evaluate the overall survival (OS). Materials and methods Demographic and treatment details were collected for HCC patients diagnosed in Manitoba between January 2011 and December 2021. The cohort was divided according to the treatment that was delivered: curative, non-curative, and supportive care-only groups. Results A total of 800 patients were identified. Complete staging information was not available for all patients. The mean age was 67 years, and men represented 72.5% of the cohort. One hundred ninety-five (24.4%) patients received curative treatment, 188 (23.5%) received non-curative treatment, and 417 (52.1%) received supportive care only. Alcoholic cirrhosis was the most common etiology of chronic liver disease (20.3%). Patients were less likely to receive curative treatment if they had portal hypertension or multifocal disease. Patients with ascites or distant metastasis were more likely to receive supportive care only. The one- and five-year OS rates for the full cohort were 50% and 23%, respectively. Between 2011 and 2021, the prevalence of non-curative therapies has increased. Trans-arterial chemoembolization (TACE) was the most common non-curative treatment with one- and three-year OS rates of 88% and 41%, respectively. Conclusion The OS of patients with HCC in Manitoba improved between 2011 and 2021 and was temporally associated with increased utilization of non-curative local therapies, including TACE. However, given the retrospective nature of the study, these findings demonstrate association rather than causal effect.
Clear cell renal cell carcinoma (ccRCC) is characterized by inactivation of the von Hippel-Lindau (VHL) pathway, resulting in stabilization of hypoxia-inducible factors (HIFs) and activation of transcriptional programs involved in angiogenesis, metabolism, and tumour survival. This biology established HIF-2α as a rational therapeutic target and led to the development of belzutifan, the first HIF-2 inhibitor to demonstrate randomized clinical benefit in ccRCC. In this review, we summarize the biologic rationale for HIF inhibition in ccRCC, review the key data supporting belzutifan with a focus on the LITESPARK-005, LITESPARK-011, and LITESPARK-022 studies, discuss next-generation HIF-2 inhibitors, including casdatifan, and briefly highlight other emerging therapeutic targets in ccRCC.
BACKGROUND:Deep learning (DL)-based artificial intelligence (AI) models, the fourth generation in autosegmentation, have been adopted both for commercial and research applications worldwide and have shown great promise as reliable and comprehensive resource strategies for radiotherapy workflows. METHODS:A comprehensive search will be conducted on Medline (PubMed), Scopus, the Cochrane Library, EMBASE, and Web of Science between January 2004 and December 2025. We will conduct a title, abstract, and full-text screening of all studies as per the eligibility criteria. Two reviewers will be involved in screening studies, quality appraisal, and data extraction, and a third reviewer will be consulted to resolve conflicts. Based on data availability, the data will be synthesised via meta-analysis and narrative synthesis. The reporting will be performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, ensuring the reliability and validity of the results. DISCUSSION:The model's performance will be assessed using various quantitative indices, qualitative tools, timesavings, and dosimetry. This review will enable us to determine the accuracy of autosegmentation for targets and various pelvic organs, boosting clinicians' confidence in facilitating the clinical implementation of such tools in routine clinical practice. SYSTEMATIC REVIEW REGISTRATION:The protocol is prospectively registered on PROSPERO. The registration ID is CRD42024491066.
