The lancet oncology
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Technological innovations in genomics and related fields have facilitated large sequencing efforts, supported new biological discoveries in cancer, and spawned an era of liquid biopsy biomarkers. Despite these advances, precision oncology has practical constraints, partly related to cancer's biological diversity and spatial and temporal complexity. ⋯ We discuss key areas of advanced imaging for improving cancer outcomes and survival. Finally, we discuss practical challenges to the broader adoption of precision imaging in the clinic and the need for a robust translational infrastructure.
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The lancet oncology · Jan 2025
ReviewPulmonary neuroendocrine neoplasms: the molecular landscape, therapeutic challenges, and diagnosis and management strategies.
Lung neuroendocrine neoplasms are a group of diverse, heterogeneous tumours that range from well-differentiated, low-grade neuroendocrine tumours-such as typical and atypical carcinoids-to high-grade, poorly differentiated aggressive malignancies, such as large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC). While the incidence of SCLC has decreased, the worldwide incidence of other pulmonary neuroendocrine neoplasms has been increasing over the past decades. In addition to the standard histopathological classification of lung neuroendocrine neoplasms, the introduction of molecular and sequencing techniques has led to new advances in understanding the biology of these diseases and might influence future classifications and staging that can subsequently improve management guidelines in the adjuvant or metastatic settings. ⋯ This Review explores the epidemiology, diagnosis, and staging of lung neuroendocrine neoplasms to date. In addition, we focus on the evolving molecular landscape and biomarkers, ranging from tumour phenotypes to functional imaging studies and novel molecular biomarkers. We outline the various clinical outcomes, challenges, the treatment landscape, ongoing clinical trials, and future directions.
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The lancet oncology · Jan 2025
ReviewIntegrating cancer into crisis: a global vision for action from WHO and partners.
More than a billion people live in fragile, conflict-affected, and vulnerable settings requiring humanitarian support, where cancer is a substantial health issue. Despite its substantial effect on populations, cancer care remains underprioritised in emergency preparedness and response frameworks and humanitarian operational planning. This Policy Review summarises the perspectives and actionable recommendations from the First Global High-Level Technical Meeting on Non-communicable Diseases in Humanitarian Settings, with a focus on cancer. ⋯ Key solutions include: integrating the cancer care continuum into national preparedness and response plans to enhance health-care system resilience; integrating cancer into humanitarian responses efforts; addressing the specific needs of paediatric patients with cancer; improving cancer intelligence and surveillance systems; and developing strategies to navigate the logistical and financial challenges of providing cancer care during crises. Additionally, the paper outlines practical actions and next steps for international cooperation needed to drive a shift in global health priorities and elevate cancer in the global health security agenda. We hope the presented notions will help prevent millions of avoidable deaths among people with cancer.
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The lancet oncology · Dec 2024
ReviewCancer care and outreach in the South Asian Association for Regional Cooperation (SAARC) region: overcoming barriers and addressing challenges.
Cancer care in countries in the South Asian Association for Regional Cooperation (SAARC) is hindered by many challenges, including inadequate infrastructure, a shortage of skilled health-care professionals, and economic constraints. These factors contribute to disparities in timely diagnosis and treatment, leading to poorer health outcomes. Health-care systems within the region vary considerably, ranging from free public health care in Sri Lanka to predominantly out-of-pocket expenses in Bangladesh, highlighting inequities in financial access and service delivery for patients within this region. ⋯ Despite progress in India and Sri Lanka, gaps in specialised training and holistic care for older patients remain. Addressing these disparities requires coordinated efforts, including improving health-care infrastructure, expanding insurance coverage, and fostering regional collaborations. Implementing comprehensive national cancer control programmes across SAARC nations, leveraging intercountry networks, and ensuring political commitment are essential to achieving equitable cancer care and advancing Sustainable Development Goals in the region.
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The lancet oncology · Dec 2024
ReviewCancer education and training within the South Asian Association for Regional Cooperation (SAARC) countries.
The education and training of the oncological health-care workforce is vital for building effective health-care systems that deliver optimal care to patients with cancer. In the South Asian Association for Regional Cooperation (SAARC) nations, there is a notable shortage of both physician and non-physician oncology professionals, including oncologists, medical physicists, radiotherapy technologists, and oncology nurses. This shortage is primarily caused by inadequate education and training programmes. ⋯ In the long term, the goals are to establish self-sufficient cancer care systems, promote regional collaboration, and strengthen research infrastructure. Achieving these objectives will require comprehensive approaches, increased financial resources, advanced cancer care infrastructure, and innovative educational models. Regional and international collaborations are essential to raise awareness of cancer as a major public health concern, advance prevention and early detection efforts, and bolster research initiatives.