Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with a dismal prognosis, largely because of late-stage diagnosis and therapeutic resistance. PDAC incidence has been rising, with modifiable and non-modifiable risk factors contributing to disease development. Chronic pancreatitis, diabetes mellitus, smoking, obesity, and familial predisposition have been implicated in PDAC pathogenesis. Early clinical manifestations are vague and insidious; therefore, PDAC is often diagnosed at an advanced stage, limiting curative treatment options. Efforts to improve early detection have focused on serum biomarkers (e.g., carbohydrate antigen 19-9), imaging modalities, and liquid biopsies. Endoscopic ultrasound and magnetic resonance imaging have demonstrated potential in identifying early-stage disease in certain high-risk populations. Surgical resection remains the only potentially curative option, but only 15%-20% of patients have resectable disease at diagnosis. Neoadjuvant chemotherapy has emerged as a promising strategy to improve resectability and survival outcomes. For patients with locally advanced or metastatic PDAC, combination chemotherapy regimens such as FOLFIRINOX (folinic acid, 5-fluorouracil, irinotecan, and oxaliplatin), NALIRIFOX (5-fluorouracil, oxaliplatin, liposomal irinotecan, and leucovorin), and combined gemcitabine/nanoparticle albumen-bound paclitaxel offer survival benefits, although toxicity remains a concern, especially for platinum-based therapies. Several breakthroughs in molecular profiling have led to the development of targeted therapies, including sotorasib and olaparib. Immunotherapy has shown limited success in PDAC due to its immunosuppressive tumor microenvironment. However, novel combination approaches are under investigation, including quadruplet therapy, immune checkpoint inhibitors with oncolytic viruses, stromal-targeting agents, and personalized neoantigen vaccines. Key priorities for future research include identifying reliable biomarkers for early detection, refining patient selection for targeted therapies, and developing innovative strategies to overcome treatment resistance.

The therapeutic landscape for renal cell carcinoma (RCC) and urinary tract cancer (UTC) has transformed dramatically, creating complexity in treatment selection and sequencing. The 2025 Advanced Urologic Cancer Consensus Conference was convened to establish evidence-based expert consensus recommendations for optimal management. A multidisciplinary panel of 51 experts participated in a modified Delphi process addressing questions developed through iterative consensus-building covering RCC and UTC management. Voting occurred before and after the conference, and analyses focused on postmeeting responses. Consensus was defined as ≥75% agreement, with strong consensus as >90%. Strong consensus was found on the use of adjuvant pembrolizumab for higher risk RCC (pathologic T2 [pT2], grade 4; pT3-pT4, any grade; pTXN1; or fully resected metastatic disease) and on neoadjuvant therapy before cystectomy for localized UTC. There was strong consensus on the use of enfortumab vedotin plus pembrolizumab as frontline therapy for metastatic UTC and the use of platinum-based chemotherapy postprogression in biomarker-negative UTC. For RCC, there was consensus on the role of single-agent vascular endothelial growth factor receptor-tyrosine kinase inhibitor therapy after progression on frontline immune checkpoint inhibitor/vascular endothelial growth factor receptor-tyrosine kinase inhibitor therapy or dual immune checkpoint inhibitor therapy. However, there was a lack of consensus on other critical areas in the management of RCC and UTC. The 2025 Advanced Urologic Cancer Consensus Conference provides evidence-informed guidance for complex clinical scenarios while identifying critical research priorities. The group recognizes that the lack of consensus across multiple areas highlights the need for improved patient selection and prospective studies enabling optimal combination and sequencing approaches. This iterative annual process will address evolving treatment paradigms to optimize outcomes.

Adolescent and young adult (AYA) cancer survivors represent a vulnerable population in cancer care and survivorship. AYA survivors are a heterogeneous group that includes people between the ages of 15 and 39 years who were treated for cancer during their childhood or AYA years, at which time they had variable agency and may have received cancer care in pediatric or adult settings. AYA survivors experience one or multiple health care transitions, moving from active oncology to posttreatment survivorship and/or from pediatric to adult care. Clinician communication that centers the needs and preferences of the AYA and their family (parent, partner, other support person) is a therapeutic tool that can support AYAs in these health care transitions and promote AYA engagement in their care. In this article, the authors review clinician communication practices through the lens of AYAs' and families' lived experiences with a focus on the initial diagnosis and treatment phase, completion of treatment, and throughout posttreatment survivorship care. Specific communication topics relevant to survivorship encompass managing uncertainty and fear of cancer recurrence, discussing treatment-related future health risks, and supporting self-management and engagement in care. Best practices for clinician communication include maintaining openness, compassion, and flexibility to re-assess and adapt communication styles as an AYA cancer survivors' needs, concerns, and preferences change over time.

This update expands the 2020 American Cancer Society (ACS) cervical cancer screening guideline for average-risk women and individuals with a cervix who are at average risk, to include self-collection for human papillomavirus (HPV) testing and revised guidance for exiting cervical cancer screening. Self-collected vaginal specimens, a method of primary HPV testing, align with the ACS cervical cancer screening guideline. When clinician-collected cervical specimens are used for HPV testing, repeat screening is recommended every 5 years for those with a negative test. For self-collected vaginal specimens, the ACS endorses the following recommendations of the Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee (of which it is a member): (1) primary HPV screening using clinician-collected cervical specimens is preferred, and self-collected vaginal specimens are acceptable for average-risk individuals aged 25-65 years; and (2) repeat testing in 3 years is recommended after a negative result on a self-collected HPV screening test. These recommendations apply only to combinations of collection devices and HPV assays approved by the US Food and Drug Administration for HPV testing in a clinical setting or at home. The rationale notes that the use of self-collected vaginal specimens can overcome barriers to screening for many patients, but most patients who test HPV-positive will require extra follow-up steps, and data on long-term, real-world effectiveness are limited. For certain high-risk individuals, clinician-collected samples are still recommended. Furthermore, in response to high rates of cervical cancer among individuals older than 65 years and with poor implementation of current exiting screening criteria, ACS has amended the 2020 guideline to recommend HPV testing at ages 60 and 65 years, with the last HPV test at an age no younger than 65 years as a requisite to exiting screening. The revised recommendation states: To qualify for discontinuation of screening, the ACS recommends an average-risk woman or an individual with a cervix at average risk have negative primary HPV tests (preferred) or negative co-testing using HPV tests and cytology (acceptable) at ages 60 and 65 years. If primary HPV tests or co-testing are not available, three consecutive negative cytology (Papanicolaou) tests at the recommended screening interval with the last test at age 65 years are acceptable. If self-collected vaginal specimens are used for HPV testing, the 3-year testing interval should be followed. Additional screening exit stipulations relate to women at higher risk because of prior abnormal test results or current immune suppression.

Interventional radiology (IR) is a rapidly evolving medical field that combines advanced imaging with minimally invasive techniques for both diagnosis and treatment. Interventional oncology (IO), a subspecialty of IR, focuses on the minimally invasive, image-guided intervention for cancer and cancer-related conditions. IR plays an important and increasingly recognized role within the multidisciplinary care of patients with cancer, contributing meaningfully to diagnosis, therapy, and palliation. IO therapies, particularly tumor ablation and transarterial embolization, aim to target tumors directly while preserving surrounding healthy tissue. These therapies are increasingly supported by clinical guidelines and have shown favorable outcomes in cancers such as hepatocellular carcinoma, renal cell carcinoma, and metastatic colorectal cancer. This review focuses on the role of minimally invasive, image-guided, locoregional IR therapies for patients who have cancer.

Radiotherapy is a cornerstone of modern oncologic care, yet its sequelae can significantly impair survivors' quality of life. Chronic radiation-induced conditions-including skin fibrosis, bone necrosis, radiation cystitis, and proctitis-pose substantial challenges for both patients and caregivers, particularly in the context of improving long-term cancer survival. Hyperbaric oxygen therapy, characterized by the promotion of angiogenesis, fibroblast activation, and tissue remodeling in hypoxic environments, has emerged as a potential adjunctive treatment for mitigating these late effects. Herein, the authors critically evaluate randomized trials, cohort studies, and real-world data while highlighting gaps in knowledge, including patient selection, optimal treatment protocols, and long-term outcomes. In addition, they discuss practical considerations and health system implications of the integration of hyperbaric oxygen therapy into survivorship care. The objective of this review is to provide clinicians with an evidence-informed framework to guide decision making in the multidisciplinary management of radiation-related late effects.

Cancers of the lip, oral cavity, and pharynx (LOCP) represent a substantial public health challenge worldwide. Using GLOBOCAN national estimates of incidence, detailed cancer registry data from Cancer Incidence in Five Continents, and population statistics from the United Nations, the authors report the distribution of new cases of LOCP cancers in 185 countries by sex in 2022. Age-standardized incidence rates were calculated. For countries lacking registry data, regional averages from high-quality registries were used to impute subsite-specific estimates. Worldwide, 758,000 people were diagnosed with LOCP cancers in 2022, with oral cavity cancer accounting for approximately 42% of cases, followed by oropharynx (19.3%), nasopharynx (15.9%), hypopharynx (11.4%), salivary gland (7.3%), and lip (4.2%) cancers. Oral cavity cancer was the most frequent LOCP subsite among women in 141 countries and among men in 93 countries, and incidence rates were highest in countries in South-Central Asia. Oropharyngeal cancer was the most frequent LOCP subsite among men in 44 countries and among women in five countries across Europe, Northern America, South America, Australia, and New Zealand. Nasopharyngeal cancer was the most common subsite among men in 39 countries and women in 23 countries, mainly in Northern Africa, Middle Africa, and Eastern and South-Eastern Asia. Rates of hypopharyngeal and salivary gland cancers were low globally, although the incidence burden was greater than that of lip cancer. The authors discuss incidence patterns in relation to disease etiology and the prospects of delivering effective cancer control measures, spanning primary prevention, early detection, cancer treatment, and survivorship.

Although poly(adenosine diphosphate-ribose) polymerase inhibitors (PARPis) and bevacizumab were approved as first-line maintenance for advanced ovarian cancer (OC), evidence comparing this combination with PARPi monotherapy, especially in BRCA-mutated/homologous recombination-deficient (HRD) patients, is lacking. This study compared combined fuzuloparib (a PARPi) plus apatinib (a vascular endothelial growth factor receptor-2 inhibitor) with either fuzuloparib or placebo as first-line maintenance in patients with advanced OC. Patients who had newly diagnosed, advanced OC and responded to first-line, platinum-based chemotherapy were randomized 2:2:1 to receive combined fuzuloparib (100 mg twice daily) plus apatinib (375 mg daily), fuzuloparib (150 mg twice daily) plus placebo, or double-placebo treatment. The primary end point was blinded independent review committee (BIRC)-assessed progression-free survival (PFS). Six hundred seventy-four patients were randomized to receive fuzuloparib plus apatinib (n = 269), fuzuloparib (n = 269), or placebo (n = 136). At the final analysis (November 1, 2024; 385 BIRC-assessed PFS events; median follow-up, 40 months), the median BIRC-assessed PFS was 26.9 months with the combination versus placebo (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.44-0.75; one-sided p < .0001) and 29.9 months with fuzuloparib monotherapy versus placebo (HR, 0.58; 95% CI, 0.44-0.75; one-sided p < .0001) compared with 11.1 months with placebo. A PFS benefit was observed regardless of germline BRCA1/2 mutation status. In homologous recombination-deficient patients (including those with BRCA1/2 mutations), combined fuzuloparib and apatinib produced a PFS similar to that of fuzuloparib (34.1 vs. 35.8 months, respectively); in homologous recombination-proficient patients, PFS had a trend favoring the combination (16.6 vs. 11.0 months; HR, 0.73; 95% CI, 0.45-1.19). Both treatments were well tolerated. Overall survival was immature. Both fuzuloparib and combination therapy improved PFS compared with placebo as maintenance therapy for patients who had newly diagnosed, advanced OC. Adding apatinib to fuzuloparib did not prolong PFS among homologous recombination-deficient patients. There was a PFS benefit trend among homologous recombination-proficient patients who received combination therapy compared with those who received monotherapy.

Prostate cancer is the most common cancer among men in the United States, and the incidence of advanced disease is increasing rapidly. This article provides an overview of prostate cancer occurrence using population-based incidence and mortality data from the National Cancer Institute and the Centers for Disease Control and Prevention. Prostate cancer incidence trends have reversed from a decline of 6.4% per year during 2007 through 2014 to an increase of 3.0% annually during 2014 through 2021. The increasing trend is confined to distant-stage disease in men younger than 55 years and to regional/distant-stage disease in men aged 55-69 years but includes early stage disease in men aged 70 years and older. Over the past decade of data, distant-stage disease has increased by 2.6% annually in men younger than 55 years, 6.0% annually in men aged 55-69 years, and 6.2% annually in men aged 70 years and older. American Indian/Alaska Native, Asian American/Pacific Islander, and Hispanic men are less likely than Black and White men to be diagnosed with localized disease (64%-67% vs. 71%-72%). Compared with White men, American Indian/Alaska Native men have 12% higher prostate cancer mortality despite 13% lower incidence, whereas Black men have double the prostate cancer mortality, with 67% higher incidence. In summary, continued increases in the diagnosis of advanced prostate cancer and persistent racial disparities underscore the need for redoubled efforts to optimize early detection while limiting overdiagnosis and to understand and address barriers to equitable outcomes.