Korobeinikova, Erika
Item type:Publication, conference output[2026][T1e][M001,N010][2]; ; ; ; ; ; ; 11th Kaunas/Lithuania International Hematology/Oncology Colloquium : 8 May 2026 : Online poster abstract book / Editor Prof. Elona Juozaitytė, 2026-05-08, p. 42-43Background and Objectives Breast cancer (BC) is a heterogenous disease characterized by substantial variability in tumor biology and clinical behavior. This heterogeneity is reflected in clinicopathological features, including hormone receptor status, human epidermal growth factor receptor 2 (HER2) expression, tumor histological grade, tumor size, and disease stage, which describe tumor features and are key determinants of prognosis. Single nucleotide polymorphisms (SNPs) have been proposed as potential contributors to inter-individual differences in these tumor features and clinical outcomes; however, their role in early-stage BC remains insufficiently defined. In this study, polymorphisms in the RRP1B gene, specifically rs2838342 and rs2051407, were investigated for their potential associations with BC features and outcomes. Material and Method Study population. A total of 191 adult female patients with primary stage I-II BC were enrolled. All participants provided written informed consent, and the study was approved by the Kaunas Regional Ethics Committee for Biomedical Research (nos. BE-2-10 and P1-BE-2-10/2014). Peripheral blood samples were collected for genetic analysis. DNA extraction and genotyping. Genomic DNA was extracted from peripheral blood using a spin column-based extraction method with a commercially available kit. SNP genotyping was performed using TaqMan allelic discrimination assays on a Quanstudio 3 Real-Time PCR System. Statistical analysis. Associations between SNPs and clinicopathological features as well as binary clinical outcomes (disease progression, metastasis status, and mortality status) were evaluated using logistic regression under an additive genetic model. Both univariate and age-adjusted multivariable analyses were performed. Sensitivity analyses using alternative genetic models were conducted for selected SNPoutcome associations showing non-linear patterns in genotype distributions. Progression-free, overall, and metastasis-free survival (MFS) were analyzed using Kaplan-Meier with log-rank tests and Cox proportional hazards regression models under an additive genetic model. Multivariable Cox models were adjusted for established clinicopathological prognostic factors. To account for multiple testing, the Benjamini-Hochberg false discovery rate (FDR) correction was applied separately for clinicopathological features (n = 12), binary clinical outcomes (n = 6), and Cox models (n = 6), using p-values from fully adjusted additive models. Kaplan-Meier analyses were considered descriptive and were not included in correction. Adjusted p-values (q-values) < 0.05 were considered significant. All statistical analyses were performed using IBM SPSS Statistics 30.0.0.0. Results Genotype distributions were as follows: for rs2838342, AA 30.9% (n = 59), AG 51.8%, (n = 99), and GG 17.3% (n = 33); for rs2051407, CC 36.6% (n = 70), CT 45.5 % (n = 87), and TT 17.8% (n = 34). The minor allele frequencies were 43.2% for rs2838342 and 40.6% for rs2051407. Genotype frequencies for both SNPs were consistent with Hardy-Weinberg equilibrium (p > 0.05). In age-adjusted additive logistic regression models, rs2838342 was associated with tumor size (p = 0.022) and histological grade (p = 0.032), although neither association remained significant after correction for multiple testing. Under a recessive genetic model, rs2838342 was associated with estrogen receptor (ER) status after adjustment for age group (OR = 0.38, 95% CI 0.17-0.85, p = 0.018), suggesting a lower likelihood of ER positivity among GG homozygotes. A similar nonsignificant trend under the same genetic model was observed for rs2051407 (p = 0.072). Kaplan-Meier analyses showed no statistically significant differences in survival outcomes across genotype groups. Consistently, no associations were observed in Cox regression analyses under unadjusted or multivariable-adjusted models accounting for age and clinicopathological variables. All results remained non-significant after Benjamini-Hochberg FDR correction. Conclusions and Recommendations No statistically significant associations were observed between the studied SNPs and clinicopathological or survival outcomes after multiple testing correction. However, nominal and model-specific associations for rs2838342 indicate a potential role in tumor biology requiring validation in larger, independent cohorts.
4 Item type:Publication, conference output[2026][T1e][M001,N010][2]; ; ; ; ; ; 11th Kaunas/Lithuania International Hematology/Oncology Colloquium : 8 May 2026 : Online poster abstract book / Editor Prof. Elona Juozaitytė, 2026-05-08, p. 50-51Background and Objectives Breast cancer (BC) is a biologically heterogeneous disease with diverse molecular subtypes and clinical outcomes, strongly influenced by genetic factors. ATP-binding cassette (ABC) transporters play an important role in transmembrane processes, including drug efflux, cellular detoxification, and the maintenance of intracellular homeostasis. Variants in genes such as ABCB1 and ABCB8 may contribute to interindividual differences in tumor behavior, influencing clinicopathological characteristics and potentially affecting disease progression and treatment response. This study evaluated the association of two single nucleotide polymorphisms (SNPs), ABCB1 rs1128503 and ABCB8 rs56198402, with BC clinicopathological features. The findings aim to clarify their role in tumor biology and assess their potential as prognostic biomarkers, contributing to a better understanding of the genetic background of BC heterogeneity. Material and Method The study population comprised 170 female patients with histopathologically confirmed early-stage primary BC, aged 30 to 74 years (median age: 46 years). Clinical and tumor pathomorphological data, including tumor size, lymph node involvement, presence of metastases, degree of differentiation, estrogen (ER) and progesterone (PR) receptor status, human epidermal growth factor receptor 2 (HER2) status, disease progression, and mortality, were obtained from oncologists and the follow-up period extended until November 30, 2024. Genomic DNA was extracted from peripheral blood leukocytes using a column-based commercial DNA isolation kit in accordance with the manufacturer’s instructions. Genotyping of ABCB1 rs1128503 and ABCB8 rs56198402 was performed using TaqMan probe-based assays on the QuantStudio™ 3 Real-Time PCR System. The strength of associations between SNPs and BC clinicopathological characteristics was estimated using crude odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Survival outcomes were assessed using Kaplan-Meier analysis. Statistical analysis was conducted using IBM SPSS Statistics, version 30.0.0.0, and a p-value < 0.05 was considered statistically significant. The study protocol was approved by the Kaunas Regional Biomedical Research Ethics Committee (approval numbers BE-2-10 and P1-BE-2-10/2014). Results Significant associations were identified between ABCB1 rs1128503 and PR status, metastatic disease, disease progression, and mortality. Specifically, GA genotype carriers had higher odds of progesterone receptor positivity than GG (OR=2.038; 95% CI 1.016–4.091; p=0.045), which was corroborated by allele-based analysis, showing similarly increased odds among A allele carriers (OR=1.986; 95% CI 1.034–3.816; p=0.039). Conversely, GA carriers demonstrated reduced odds of metastasis (OR=0.301; 95% CI 0.122–0.742; p=0.009), disease progression (OR=0.387; 95% CI 0.171–0.877; p=0.023), and mortality (OR=0.361; 95% CI 0.144–0.907; p=0.030). Furthermore, tumor size and lymph node involvement were also significantly associated (p-value < 0.05) with the studied genotype, indicating a protective effect against more advanced disease features. A significant difference in progression-free survival was observed across ABCB1 rs1128503 genotypes, with the GA genotype associated with more favorable outcomes (p-value < 0.05). No significant associations were found between the ABCB8 rs56198402 and clinicopathological characteristics of BC. Conclusions and Recommendations The ABCB1 rs1128503 was significantly associated with several breast cancer clinicopathological features, including progesterone receptor status, metastasis, disease progression, and progression-free survival, suggesting a potential protective effect of the GA genotype. In contrast, no significant associations were found for the ABCB8 rs56198402 variant. Further studies with larger cohorts are needed to confirm these findings and clarify the biological role of ABCB1 variants in breast cancer progression and prognosis.
4 Item type:Publication, conference output[2026][T1e][M001,N010][2]; ; ; ; ; ; ; 11th Kaunas/Lithuania International Hematology/Oncology Colloquium : 8 May 2026 : Online poster abstract book / Editor Prof. Elona Juozaitytė, 2026-05-08, p. 23-24Background and Objectives Germline pathogenic or likely pathogenic (P/LP) variants account for 5–10% of all breast cancer (BC) cases, with a higher prevalence of 10–20% observed in specific BC molecular subtypes, such as triple-negative breast cancer (TNBC). P/LP variants in established BC susceptibility genes are associated with an increased risk of BC and may contribute to distinct tumor phenotypes and clinical outcomes. This study aimed to evaluate the distribution of germline P/LP variants and their associations with clinicopathological features and clinical outcomes in BC patients. Material and Method A total of 85 female patients with stage I-II BC, including hormone receptor-positive (HR+)/HER2-negative (HER2−) (n=60) and TNBC (n=25), were included. Inclusion criteria required complete clinicopathological data (age at diagnosis, tumor size, tumor histological grade, lymph node involvement, and clinical outcomes) and absence of clinically significant comorbidities. Exome sequencing of germline DNA from peripheral blood was performed to identify variants in 13 BC susceptibility genes (BRCA1, BRCA2, CDH1, PTEN, STK11, TP53, ATM, CHEK2, PALB2, RAD51C, RAD51D, BARD1, and NF1). Variant analysis was conducted using the Franklin platform (Qiagen), and pathogenicity was re-evaluated according to current ENIGMA, ClinGen, and CanVIG guidelines. For statistical analysis, patients were stratified into P/LP variant carriers and non-carriers. Associations with clinicopathological features and clinical outcomes were assessed, with age included as a continuous covariate for adjustment. The study was approved by the Kaunas Regional Biomedical Research Ethical Committee (Nos. BE-2-10 and P1-BE-2-10/2014). Results Overall, 11 distinct P/LP variants were identified (six in BRCA1, three in CHEK2, and one each in BRCA2 and ATM). These variants were detected in 20/85 patients (23.5%), including 10/60 (16.7%) with HR+/HER2− BC and 10/25 (40%) with TNBC. Only one HR+/HER2− BC patient carried two variants; all others had a single variant. P/LP variants were significantly associated with BC molecular subtype (p=0.021), with carriers more likely to have TNBC (OR=3.33, 95% CI 1.17−9.52, p=0.025), although this was not significant after age adjustment (p=0.158). Carrier status was also associated with tumor grade (p=0.039), disease progression (p=0.007), and distant metastasis (p=0.035), but only the association for increased risk of disease progression for patients carrying P/LP variants remained significant after age adjustment (OR=3.09, 95% CI 1.01–9.43, p=0.048). In the TNBC subgroup, P/LP variant carrier status was statistically associated with lymph node involvement (p=0.009), with carriers having higher odds of lymph node involvement, even after age adjustment (OR=15.18, 95% CI 2.01–113.35, p=0.008), although this finding should be interpreted cautiously due to the small sample size. Survival analysis showed a significant association between P/LP variant carrier status and progression-free survival (PFS) in the overall cohort (p=0.011), which was likely driven by the HR+/HER2− BC subgroup (p=0.030) but not TNBC (p=0.154). In HR+/HER2− patients, carriers had a higher risk of shorter PFS in univariate analysis (HR=2.8, 95% CI 1.05–7.54, p=0.039), which was not significant after age adjustment (p=0.084). For metastasis-free survival (MFS), a significant difference was observed in the overall cohort (p = 0.039), but not in subtype-specific analyses. Although carriers showed a higher risk of shorter MFS in univariate analysis (HR=2.41, 95% CI 1.02– 5.72, p=0.046), this did not remain significant after adjustment for age (p=0.073). Conclusions and Recommendations Germline P/LP variants were identified in a substantial proportion of BC patients, with a higher prevalence in TNBC. Although carrier status was associated with more aggressive disease features, particularly disease progression, most associations did not remain significant after adjustment for age. These findings suggest that P/LP variants may contribute to BC heterogeneity, although their independent prognostic value appears limited and requires further investigation in larger cohorts.
3 Item type:Publication, conference output[2026][T1e][M001,N010][2]; ; ; ; ; 11th Kaunas/Lithuania International Hematology/Oncology Colloquium : 8 May 2026 : Online poster abstract book / Editor Prof. Elona Juozaitytė, 2026-05-08, p. 27-28Background and Objectives Breast cancer is a leading cause of cancer-related deaths globally. According to WHO data, in 2022, BC accounted for 6.8% of cancer-related deaths worldwide and 6.2% of such deaths within the Lithuanian population. One of the mechanisms underlying BC is the influence of genetic variants. High-frequency, low-penetrance genetic variants, including single nucleotide polymorphisms (SNPs), are more frequently linked to sporadic breast cancer. The epithelial-to-mesenchymal transition (EMT) is a cellular process that plays a role in embryonic development, wound healing, and tumor formation. EMT is crucial in invasion and subsequent metastasis. Snail1, encoded by the SNAI1 gene, is one of the key factors triggering EMT. In this study, we focused on SNAI1 rs8120550, rs1543442, and rs73113648 polymorphisms and their impact on various pathomorphological features and patients’ prognosis within the Lithuanian breast cancer cohort. Material and Method A total of 199 breast cancer patients were studied. The inclusion criteria were as follows: confirmed diagnosis, early BC stage (I–II), and complete medical documentation. Clinicopathological information was collected from medical records in collaboration with oncologists. Polymorphisms of interest were analyzed with real-time PCR-based genotyping. Statistical analysis was performed using SPSS (31.0.0.0). A pvalue < 0.05 was considered statistically significant. The study received approval from the Kaunas Regional Biomedical Research Ethical Committee (no. BE-2-10, no. P1- BE-2-10/2014,), and written informed consent was obtained from all participants. Results Pearson’s chi‑square analysis revealed significant associations between SNAI1 rs8120550 and disease progression (p = 0.011) and metastasis (p = 0.008). Additionally, rs73113648 was significantly associated with age group (p = 0.041), disease progression (p = 0.002), and metastasis (p = 0.002). In univariate logistic regression analysis, for SNAI1 rs73113648, the TT genotype was significantly associated with older age at diagnosis, showing lower odds compared with the CC genotype (OR = 0.247, p = 0.036). In the analysis of clinical outcomes for rs73113648, the TT genotype was statistically associated with higher odds of progression and metastasis compared with CC genotype (OR = 6.207, p = 0.001; OR = 5.952, p = 0.002, respectively). Rs8120550 demonstrated significant associations with disease progression and metastasis, where the AG genotype was associated with significantly higher odds than the AA genotype (OR = 2.718, p = 0.005; OR = 2.872, p = 0.005, respectively). The following are results after Kaplan-Meier method, which was used to evaluate the association between SNPs and PFS, MFS and OS: rs8120550 showed significant results for PFS (p = 0.012) and for MFS (p = 0.009), while rs73113648 demonstrated statistically significant associations with PFS (p = 0.001) and MFS (p = 0.004). Rs1543442 demonstrated no significant associations with any survival outcomes. In univariate Cox regression analysis, rs8120550 (AG versus AA) were associated with shorter PFS (HR = 2.323, p = 0.006) and MFS (HR = 2.529, p = 0.006), while rs73113648 (TT versus CC) was linked to even shorter PFS (HR = 3.650, p < 0.001) and MFS (HR = 3.567, p = 0.002). Conclusions and Recommendations The study revealed that SNAI1 rs8120550 and rs73113648 were significantly associated with an increased risk of disease progression and metastasis. Both SNPs were also associated with poorer PFS and MFS, with rs73113648 showing the strongest effect. These findings suggest that SNAI1 polymorphisms may have prognostic value for clinical outcomes in early-stage BC, but further studies involving a larger, independent cohort, are recommended to confirm our findings.
4 Item type:Publication, conference output[2026][T1e][M001][2]; ; ; 11th Kaunas/Lithuania International Hematology/Oncology Colloquium : 8 May 2026 : Online poster abstract book / Editor Prof. Elona Juozaitytė, 2026-05-08, p. 9-10Background and Objectives Electroporation is a method that applies controlled electrical pulses to enhance the permeability of the cell membrane, thereby enabling improved intracellular delivery of therapeutic agents or inducing direct cytotoxic effects. Checkpoint inhibitor therapy, a form of immunotherapy, targets inhibitory signaling pathways exploited by cancer cells to evade immune detection, thereby restoring and amplifying the host’s antitumor immune response. Recent studies suggest that combining electroporation-based therapies with immunotherapy may further enhance antitumor efficacy [1]. This study aims to determine whether a multimodal treatment strategy provides greater tumor control than single-modality interventions. Specifically, we investigated the therapeutic efficacy of combining cytotoxic drugs (Cisplatin or Oxaliplatin) with electroporation and checkpoint inhibitor therapy in the treatment of tumors in mouse models. Results Experiments were performed using the 4T1 murine breast cancer cell line (ATCC). Cells were cultured in RPMI medium (Sigma-Aldrich, St. Louis, MO, USA) supplemented with 1% penicillin–streptomycin and 10% fetal bovine serum. Experimental scheme Eight- to twelve-week-old female BALB/c mice were used in this study. Tumors were induced by a single 100 μL subcutaneous injection of 4T1 cells (20 × 10⁶ cells/mL), resulting in one tumor per mouse. Tumors were allowed to develop until they reached a volume of approximately 150–500 mm³, after which treatment was initiated (~10 days post-injection), depending on tumor growth rate. Mice were assigned to experimental groups based on tumor volume to ensure balanced distribution across groups. A total of ten groups were included: untreated control (CTRL) (n = 8), Oxaliplatin (Ox) (n = 8), Ox + EP (n = 8), Cisplatin (Cis) (n = 8), Cis + EP (n = 8), EP (n = 8), checkpoint inhibitor therapy (Nivolumab, Ch.P) (n = 8), Ch.P + EP (n = 4), Ch.P + EP + Ox (n = 8), and Ch.P + EP + Cis (n = 8). Prior to treatment, the tumor-bearing area was shaved and depilated. Mice were anesthetized with ketamine (80 mg/kg) and xylazine (7.5 mg/kg, i.p.) to ensure adequate sedation during procedures. Electroporation Electroporation was performed using a BTX T820 electroporator (Harvard Apparatus, San Diego, CA, USA). Reversible electroporation (EP) was applied to groups 3, 5, 6, 8, 9, and 10 using the following parameters: 1.5 kV/cm × 8 pulses, 99 µs, 1 Hz. Treatment with drugs Cisplatin (88 μL, 1 mg/mL) was administered as a single dose via the tail vein (groups 4, 5, and 10). Oxaliplatin (33 μL, 5 mg/mL) was administered in the same manner (groups 2, 3, and 9). As a checkpoint inhibitor therapy, Nivolumab (200 μg) was administered intraperitoneally (i.p.) every two days for a total of four injections (groups 7, 8, 9 and 10). Evaluation of tumor sizes Tumors were measured every 2 days, starting on day 1 (the day of treatment) and continuing until day 19. Tumor dimensions were determined using a digital caliper. Tumor volume (mm³) was calculated according to the formula: V = (π × l × w × h) / 6, where l denotes length, w width, and h height of the tumor [2]. Tumor growth analysis revealed time-dependent differences between treatment groups. In the early phase (days 2–6), statistically significant reductions in tumor volume compared to CTRL (Dunnett test, p < 0.05) were observed in the Cis + EP, EP, and Ch.P + EP + Cis groups, indicating an early therapeutic response. Due to technical limitations (insufficient reliable measurements), the Ch.P + EP group was excluded from comparative analysis. By the intermediate phase (day 10), the Ch.P + EP + Cis combination demonstrated the strongest and most consistent antitumor effect, achieving nearly a 2-fold reduction in tumor volume compared to CTRL. A strong but less consistent effect was also observed in the Ch.P + EP + Ox + Cis group. In the late phase, these groups maintained approximately 2.0–2.2-fold lower tumor volumes compared to control; however, differences were not statistically significant, likely due to increased variability. EP alone also showed a consistent ~2-fold inhibitory effect. Notably, the addition of Oxaliplatin, a chemotherapeutic agent with reported immunomodulatory properties, appeared to reduce treatment efficacy in combination regimens (~1.2–1.3-fold reduction), suggesting a potential antagonistic interaction. These findings indicate that while electroporation enhances checkpoint inhibitor therapy, certain drug combinations may attenuate this effect and require further investigation. Conclusions and Recommendations Ch.P + EP demonstrated the strongest antitumor effect, achieving ~2-fold tumor reduction compared to control, while the addition of Oxaliplatin reduced efficacy, suggesting a potential antagonistic interaction. Further studies are needed to clarify underlying mechanisms and optimize combination strategies.
6 Item type:Publication, research article[2026][S1][M001][8]; ; ; Background and purpose: Cancer mortality rates in the Baltic States (Estonia, Latvia, and Lithuania) exceeds the European Union (EU) average, in part due to limited access to radiation therapy (RT). We updated RT capacity and utilization to inform regional planning. Patient/material and methods: We conducted a census of all 11 RT centres (2016–2023) via a standardized questionnaire, cross-validated with national registries and international databases. We compared technology availability, workforce, and utilization with EU countries in relation to the present cancer burden and projections to 2050. This multicentre observational study adhered to STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE) guidelines. Results: Only 35–42% of cancer patients received RT, below the 50% recommendation. Linear accelerator availability ranged from 3.8 to 5.1 per million inhabitants, figures that are almost half those seen in EU countries with higher Gross Domestic Product (GDP) per capita. While the use of intensity modulated RT, volumetric modulated arc therapy and stereotactic RT increased, staffing levels has remained static in recent years. Mortality-to-incidence ratio correlated negatively with GDP (r = –0.7) and RT capacity (r = –0.7). Interpretation: Despite technological progress in the Baltic States, major gaps persist in RT access and workforce levels. Baltic States still underperform compared to EU countries with higher GDP per capita in terms of equipment availability, workforce capacity, and overall cancer outcomes. Future-oriented strategic investments, based on regional collaboration and shared infrastructure are urgently needed, including the development of a regional particle therapy centre, to ensure equitable access to state-of-the art advanced cancer care across the Baltic States.
15 Item type:Publication, book[2026][K2b][M001][140]; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; Kaunas : Lietuvos pulmonologų ir alergologų draugija, 2026-04-23Plaučių vėžys vis dar tebėra didžiulė grėsmė ne tik pasaulio, Europos Sąjungos, bet ir Lietuvos gyventojams. Siekiant pagerinti pagalbą plaučių vėžiu sergantiems ligoniams, suvienodinti specialistų požiūrį į šios ligos diagnostikos ir gydymo standartus, Lietuvos sveikatos mokslų universiteto ir Lietuvos sveikatos priežiūros specialistų draugijų iniciatyva bei bendru darbu nuo 2007-ųjų kas kelerius metus išleidžiamos „Plaučių vėžio diagnostikos ir gydymo rekomendacijos“. Išlaikydami tradicijas ir tęstinumą pristatome aštuntąsias atnaujintas ir papildytas „Plaučių vėžio diagnostikos ir gydymo rekomendacijas“, kurios yra gausaus autorių, savo srities ekspertų ir pagrindinių Lietuvos sveikatos priežiūros specialistų draugijų atstovų, kolektyvo ilgametės patirties, bendro nuolatinio darbo rezultatas. Plaučių vėžio gydymas išlieka viena dinamiškiausių onkologijos sričių, todėl ankstesnes rekomendacijas buvo būtina atnaujinti apžvelgiant svarbiausias prigijusias naujoves. Plaučių vėžio profilaktika, ankstyva diagnostika ir atrankinė patikra yra viena iš prioritetinių sričių naujame Europos Sąjungos kovos su vėžiu plane. Kai kuriose Europos Sąjungos šalyse jau yra įdiegtos nacionalinės plaučių vėžio patikros programos, kitose, taip pat ir Lietuvoje, vykdomos ar jau atliktos bandomosios programos. Tačiau, kol nėra patvirtinta nacionalinė plaučių vėžio patikros programa Lietuvoje, šiose rekomendacijose paliekame tikslinės plaučių vėžio atrankinės patikros gaires, kurios sėkmingai pritaikytos daugelyje Europos Sąjungos šalių ir yra patvirtintos Lietuvoje Plaučių vėžio metodiniame dokumente. Tikimės, kad netolimoje ateityje galėsime pristatyti ir nacionalinę plaučių vėžio atrankinės patikros programą. [...].
10 Item type:Publication, journal article[2026][S1][M001][13]; Cancer screening is a cornerstone of effective cancer prevention. The 2022 European Council Recommendation on cancer screening encourages risk-based approaches, including risk stratification, when appropriate, to improve the balance of screening benefits, harms, and resource use. To address conceptual heterogeneity and fragmented guidance across cancer sites and countries, the EUCanScreen Joint Action convened a multidisciplinary working group from 22 European countries to develop a shared conceptual framework for risk-stratified cancer screening, as a specific operational approach.
26 Item type:Publication, research article[2026][S1][M001][18]; ; ; ; ; Complications are frequent in cancer patients and contribute to adverse outcomes and higher healthcare costs, underscoring the need for earlier identification and prediction. This study evaluated the feasibility of using passively generated smartphone sensor data to explore early-warning signals of complications and symptom worsening during cancer treatment. A total of 108 patients were continuously monitored using accelerometer, GPS, and screen on/off data collected through the LAIMA application, while symptoms of depression, fatigue, and nausea were assessed every two weeks and complications were confirmed during clinic visits or emergency presentations. Smartphone data streams were aggregated into variables describing activity and sociability patterns. Machine learning models, including Decision Tree, Extreme Gradient Boosting, K-Nearest Neighbors, and Support Vector Machine, were used for complication prediction, and time-series models such as Autoregressive Integrated Moving Average, Holt–Winters, TBATS, Long Short-Term Memory neural network, and General Regression Neural Network were applied to identify early behavioral changes preceding symptom reports. In this exploratory analysis, the ensemble model demonstrated high sensitivity (89%) for identifying complication events. Smartphone-derived behavioral indicators enabled earlier detection of depression, fatigue, and vomiting by about nine days in a subset of patients. These findings demonstrate the feasibility of passive smartphone sensor data as exploratory early-warning signals, warranting validation in larger cohorts.
13 Item type:Publication, research article[2025][S1][M001][21]; ; ; ; ; ; ; ; ; ; Medicina, 2025-11-03, vol. 61, no. 11, p. 1-21Background and Objectives: Lung cancer and pulmonary metastases are major causes of cancer-related mortality. Surgery is a standard curative approach, but many patients are ineligible due to age, comorbidities, or treatment preference. This study aimed to evaluate the safety, effectiveness, and quality-of-life outcomes of thermal ablation versus surgery and stereotactic body radiotherapy (SBRT) for malignant lung lesions. Materials and Methods: A prospective, non-randomized study was conducted on 68 patients with primary or metastatic lung tumours treated by surgery (n = 19), SBRT (n = 29), or thermal ablation (n = 20). The key outcomes included recurrence rates and patterns, disease-free and overall survival, complications, hospitalization, and health-related quality of life (HRQoL). Results: Surgery demonstrated the lowest total and regional recurrence rates (21.1% and 10.5%, respectively), significantly lower than SBRT (57.1% and 42.9%, respectively; p < 0.05). Additionally, surgery led to the longest disease-free survival but was associated with the highest complication rate (78.9%) and the greatest HRQoL decline. SBRT had fewer complications (17.2%) and moderate HRQoL outcomes. Thermal ablation showed no significant differences in recurrence (45.0% of total recurrence) or survival compared to surgery or SBRT, with a moderate complication rate (45.0%) and the most favorable HRQoL outcomes. Major complications were rare and comparable across all groups. Conclusions: Thermal ablation demonstrated comparable disease control and quality-of-life outcomes to SBRT, with lower complication rates. While surgery remains superior in local disease control, its invasiveness and impact on quality of life underscore the importance of minimally invasive treatments in multidisciplinary management of malignant lung lesions.
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