Cancer prehabilitation is the process between the time of cancer diagnosis and the beginning of the active acute treatment; prehabilitation consists of various need-based interventions, e.g., physical activity, a nutritional program, and psychological support. It can be delivered as unimodal or multimodal interventions. Physical activity, including resistant exercise and aerobic activities, has to be tailored according to the patient’s characteristics; nutritional support is aimed at preventing malnutrition and sarcopenia; while psychological intervention intercepts the patient’s distress and supports specific intervention to address it. In addition, multimodal prehabilitation could have a potential impact on the immune system, globally reducing the inflammatory processes and, as a consequence, influencing cancer progression. However, many challenges are still to be addressed, foremost among them the feasibility of prehabilitation programs, the lack of adequate facilities for these programs’ implementation, and the fact that not all prehabilitation interventions are reimbursed by the national health system.

Head and neck squamous cell carcinomas (HNSCCs) are the eighth most common cancer worldwide with approximately 875,000 new cases and 440,000 deaths in 2020 [1]. Despite advances in multimodality tr...

Clear cell renal carcinoma (ccRCC) can occur in young people and could be associated with an aggressive behavior. While for the first-line treatment in metastatic disease, there is an agreement to rely on an immunotherapy (IO)-based combination regimen, no standard second-line regimens exist. Generally, tyrosine kinase inhibitors (TKIs) are employed, even in sequence, although no trials have demonstrated yet the best succession. Herein, we present the case of a 39-year-old male, with a very aggressive ccRCC with somatic VHL mutation and distant metastases at diagnosis. He was treated with four different lines of therapies, including TKIs, with progressive multiple tumor deposits. Lenvatinib alone as the fifth line was able to induce a remarkable and prolonged tumor shrinkage with manageable toxicities.

BACKGROUND The CAPABLE (Cancer Patients Better Life Experience) project developed an application for remote monitoring and management of treatment-related symptoms, as well as for delivering a set of supplementary nonpharmacological interventions, with the aim of improving patients’ quality of life. Clinical studies were conducted to evaluate the effectiveness of CAPABLE, yielding encouraging results. However, these studies did not explore individual patients’ perspectives. OBJECTIVE Following the evaluation of the CAPABLE intervention’s efficacy, this study aims at exploring end users’ overall experience with the telemonitoring system, identifying strengths and weaknesses in relation to users’ needs and expectations, in order to inform future developments. METHODS Toward the end of the clinical study, a focus group was conducted with a subset of enrolled patients. The discussion was led by a psycho-oncologist using a predefined framework of topic-related questions, which served as prompts to encourage open discussion. Patients freely shared their experiences, and a thematic analysis was performed on the collected statements. RESULTS The findings showed that the tool primarily served a dual function of support and reassurance. Patients reported psychological relief and a sense of security, driven by the perception of being closely monitored and supported by a multidisciplinary hospital team. CAPABLE was perceived as easy to use, effective, and useful. Nevertheless, several weaknesses also emerged. Suggestions for improvement focused on a closer alignment between CAPABLE functionalities and patients’ individual treatments and preferences, as well as concerns regarding application maintenance after the end of the project. CONCLUSIONS The focus group provided valuable insights to inform the future development of telemonitoring applications for cancer patients.

Background: Adverse events (AEs) related to cancer treatment represent a valuable source of information that can be used to adjust therapy for individual patients. The National Institutes of Health developed the Common Terminology Criteria for Adverse Events (CTCAE), a comprehensive standardized terminology for health care providers to consistently report AEs during patient visits. Mobile health technologies, in principle, also allow AEs to be self-reported by patients in between visits; however, the terminology poses challenges for them, both in selecting the correct symptom to report and in rating its severity. The National Institutes of Health developed the Patient-Reported Outcomes–CTACE as the patient-oriented companion of the CTCAE. However, it shows some weaknesses in completeness and precision when used for continuous home patient monitoring and for decision support. Objective: The aim of this paper is to propose a new terminology for reporting AEs that is easy for patients to use while also being clinically meaningful for health care providers and easily exploitable by decision support systems. Moreover, we aim to demonstrate its implementation and validation within the CAPABLE (Cancer Patients Better Life Experience) EU project. Methods: The development of the new terminology starts from the CTCAE, which includes a comprehensive list of signs and symptoms along with guidance for accurately grading their severity. Through a multistep, participatory approach involving both patients and health care providers, we reduced and adapted the AE list for patient-oriented apps. During the CAPABLE project, the proposed terminology was integrated into a mobile app and evaluated within a clinical pilot study involving 86 patients who were monitored through the app for at least 6 months, and a control cohort of 133 patients monitored using standard care practices. Results: The final terminology includes 124 AEs, 49 expressed as “present or absent,” and 77 associated with 4 description levels. A mapping between the description levels and the original CTCAE grades enables running the decision support system embedded in the CAPABLE app. The pilot study demonstrated that the majority of the patients used the symptoms reporting functionality, sharing also 24 unique AEs that are not present in the Patient-Reported Outcomes–CTCAE. Symptoms reported using the proposed terminology allowed the enactment of the clinical practice guidelines included in the CAPABLE decision support tool, triggering 11 distinct recommendations. Conclusions: The results obtained from the clinical study support our claim regarding the need for a novel terminology for the self-reporting of AEs, characterized by ease of use, completeness, and clinical meaningfulness. Finally, by mapping our terminology to the CTCAE, we demonstrated that it is possible to exploit self-reported data to trigger decision support rules consistent with clinical practice guidelines.