Knowledge about the patient’s experience and perception of side effects and their impact on daily life is crucial for the adequate planning of interventions to provide the highest attainable levels of quality of life during oncology treatment. We conducted a study on consecutive samples of 69 early breast cancer patients treated with four cycles of neoadjuvant or adjuvant anthracycline-based chemotherapy. Patients completed the questionnaire about side effects experienced after the previous cycle of chemotherapy. The questionnaire was a modified PRO for the evaluation of treatment toxicity consisting of 18 questions related to the very common and common side effects of doxorubicin and cyclophosphamide, valued from 0 to 3 according to the subjective assessment of the patient. During the same cycles of therapy, data were also collected by the physician who completed a questionnaire consisting of the same questions as the questionnaire for patients, on the same scale. Most of the side effects reported by patients were mild to moderate in intensity, while physicians reported side effects much less frequently. The results also indicated a disproportionate reporting, in which physicians reported statistically significantly fewer side effects than patients. This study reported a level of disagreement between patients and physicians in the experience of therapy toxicity. In conclusion, use of PRO in clinical practice can help us avoid physician subjectiveness in the estimation of side effects and determine the group of patients who can benefit from additional and individualized supportive care measures, which could lead to better adherence to therapy and ultimately best outcomes.

“Basal-like” (BL) morphology and the expression of cancer testis antigens (CTA) in breast cancer still have unclear prognostic significance. The aim of our research was to explore correlations of the morphological characteristics and tumor microenvironment in triple-negative breast carcinomas (TNBCs) with multi-MAGE-A CTA expression and to determine their prognostic significance. Clinical records of breast cancer patients who underwent surgery between January 2017 and December 2018 in four major Croatian clinical centers were analyzed. A total of 97 non-metastatic TNBCs with available tissue samples and treatment information were identified. Cancer tissue sections were additionally stained with programmed death-ligand 1 (PD-L1) Ventana (SP142) and multi-MAGE-A (mAb 57B). BL morphology was detected in 47 (49%) TNBCs and was associated with a higher Ki-67 proliferation index and histologic grade. Expression of multi-MAGE-A was observed in 77 (79%) TNBCs and was significantly associated with BL morphology. Lymphocyte-predominant breast cancer (LPBC) status was detected in 11 cases (11.3%) and significantly correlated with the Ki-67 proliferation index, increased number of intratumoral lymphocytes (itTIL), and PD-L1 expression. No impact of BL morphology, multi-MAGE-A expression, histologic type, or LPBC status on disease-free survival was observed. Our data suggest that tumor morphology could help identify patients with potential benefits from CTA-targeting immunotherapy.

Background: Systemic inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) have demonstrated prognostic relevance in metastatic colorectal cancer (mCRC). However, most available evidence relies on single baseline measurements, while the longitudinal dynamics of these biomarkers in relation to immunonutritional status remain insufficiently explored. Methods: This retrospective longitudinal study included 86 patients with previously untreated mCRC receiving first-line chemo-biological therapy. NLR, PLR, and SII were assessed at three predefined time points: before treatment initiation, after completion of induction therapy, and at radiologically confirmed disease progression. Nutritional and sarcopenia risk were evaluated using the NRS-2002 and SARC-F tools. Longitudinal differences were analyzed using the Friedman test with post hoc comparisons. Results: In nutritionally preserved patients, significant longitudinal changes were observed for NLR (χ²(2) = 16.72, p < 0.001), PLR (χ²(2) = 6.36, p = 0.003), and SII (χ²(2) = 24.57, p < 0.001), characterized by a marked decline following induction therapy and re-elevation at disease progression. In high nutritional risk patients, significant dynamics were observed only for SII (χ²(2) = 5.60, p = 0.007). Similarly, in the low SARC-F subgroup, all three indices demonstrated significant modulation over time, whereas no statistical analysis was feasible in the high SARC-F subgroup due to limited sample size. Among the evaluated parameters, SII showed the most consistent and pronounced longitudinal variation. Conclusions: The clinical value of inflammatory hematologic indices in mCRC appears to derive primarily from their longitudinal dynamics rather than single absolute measurements. SII, in particular, may serve as a marker of therapy-induced modulation of systemic inflammation, especially in patients with preserved immunonutritional reserve. Integration of dynamic inflammatory indices into routine clinical monitoring could enhance early identification of biological progression and improve risk stratification in mCRC.