ASIDE Oncology Journal is a peer-reviewed, open-access journal published and owned by PubPorta Publishing LLC, 16192 Coastal Highway, Lewes, Delaware 19958, USA. Academic oversight and scholarly guidance are provided by the American Society for Inclusion, Diversity, and Equity in Healthcare (ASIDE). The journal is dedicated to advancing oncology through the publication of high-quality scholarly work spanning cancer prevention, diagnosis, treatment, survivorship, and supportive care. It promotes diversity, equity, inclusion, and accessibility in healthcare by highlighting disparities in cancer outcomes, inclusive approaches to cancer care, the impact of social determinants of health, and strategies to improve access and outcomes for underserved and marginalized populations. It serves as an international platform for oncologists, researchers, educators, and healthcare professionals to share knowledge, foster innovation, and advance more equitable oncology practice, research, and policy.
Divergent Temporal Trends in Site-Specific Sarcoma Mortality in the United States, 1999–2020: A Population-Based Analysis
Background: Sarcomas are heterogeneous malignancies with prognoses that vary markedly by anatomical site. Whether population-level mortality trends differ across anatomical locations remains unclear. Methods: Sarcoma-related deaths in the United States from 1999 to 2020 were analyzed using the CDC WONDER Underlying Cause of Death database. ICD-10 codes classified deaths into six anatomical categories: bone, retroperitoneal/peritoneal, trunk soft tissue, extremity soft tissue, head and neck, and unspecified. Negative binomial regression models with a population offset estimated site-specific trends, and an interaction model tested heterogeneity across sites. Sensitivity analyses excluded 2020 and recalculated proportions among specified-site deaths only. Results: Nearly half of the deaths were coded to unspecified sites (49.8%), with no improvement over time. Among specified sites, bone accounted for the largest share (22.6%), followed by retroperitoneal/peritoneal sarcomas (15.1%). Overall mortality increased by 1.32% annually (IRR 1.013, 95% CI 1.012–1.014), with significant increases across all specified sites. Decomposition showed that retroperitoneal/peritoneal (43.5%) and bone (29.7%) sarcomas contributed the largest shares of the overall increase. Trend heterogeneity was significant (p < 0.001), with trunk soft-tissue and head-and-neck sarcomas increasing the fastest. Findings were robust after excluding 2020 and in specified-site–only analyses. Conclusions: Mortality coded to sarcoma-related ICD-10 underlying-cause categories increased across all anatomically specified sites, with heterogeneous site-specific trends. Retroperitoneal/peritoneal and bone categories contributed most to the absolute increase, while trunk soft tissue and head and neck categories showed the steepest relative increases.
Copyright (c) 2026 Muhanad Alzahrani, Abdullah Alabbasi, Mohammed Sayes, Rayyan Fahad H Altemani, Ziyad Alzahrani https://creativecommons.org/licenses/by/4.0
Long-Term Shifts and Disparities in Colorectal Cancer Mortality in the United States: A Population-Based Analysis (1999–2023)
Background: Colorectal cancer (CRC) remains a leading cause of cancer-related mortality in the United States despite advances in screening and treatment. Prior national studies have documented long-term declines in CRC mortality; however, emerging demographic and disparities warrant updated evaluation. Methods: We conducted a retrospective, population-based analysis of CRC mortality in the United States from 1999 to 2023 using the CDC WONDER database. Adults aged ≥25 years with CRC were identified using ICD-10 codes C18–C20. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Trends were assessed using Joinpoint regression. Results: From 1999 to 2023, a total of 1,551,550 CRC deaths were recorded among U.S. adults aged ≥25. The overall AAMR declined from 38.23 per 100,000 in 1999 to 22.93 in 2023 (AAPC: –2.14; 95% CI: –2.39 to –1.88; p < 0.001). Overall, the AAMR declined in both sexes between 1999 and 2023; 31.98 to 19.09 (AAPC: -2.16; p < 0.01) among women, as compared to 47.46 to 27.43 (AAPC: -2.31; p < 0.01) among men. Racial disparities persisted, with non-Hispanic Black individuals showing the highest overall AAMR (37.34). Regionally, the Midwest has the highest overall AAMR (30.05). Urban–rural comparisons (1999–2020) showed higher AAMRs in rural areas (32.08) than in metropolitan areas (27.81). Older adults (≥65 years) accounted for most deaths. The most common place of death was home (40.7%). Conclusions: CRC mortality in the U.S. has declined substantially over the past 25 years; however, significant disparities persist by race, geography, and age.
Copyright (c) 2026 Mahmoud Tablawy, Alyaa Ahmed Ibrahim, Salma Ehab, Mohammad Rayyan Faisal , Maryam Saghir, Eshal Saghir, Abdelrhman H. Mohamed, Rodina Sharaf, Ahmed Atef Mohamed , Humam Al-Machtomi, Mina Nageh, Mohaimen Mohammed Al-Machtomi, Ahmed Tharwat Emara, Safeya Fawzi, Ahmed Ebrahim , Mahdi Ahmed, Amro Ali, Mohamed Fawzi Hemida https://creativecommons.org/licenses/by/4.0
The Relationship Between pks+ Escherichia coli and Colorectal Cancer: A Review
Introduction: According to GLOBOCAN estimates, colorectal cancer (CRC) was the third most common cancer worldwide in 2020, comprising 11% of all cancer diagnoses. Researchers’ interest in CRC development has shifted toward the gastrointestinal microbiome, especially the mutagenicity of pks+ E. coli. Therefore, we aimed to review the current evidence on the relationship between pks+ E. coli and CRC. Method: We reviewed the literature reporting the association between pks+ E. coli and CRC, which was obtained from three databases: PubMed, Google Scholar, and the Cochrane Library, published between January 2021 and January 2026. We used the following keywords for our search strategy: pks, Escherichia coli, and colorectal cancer. Result: As stated in the original studies, the contribution of pks+ E. coli to CRC development was associated with a higher prevalence in the CRC group than in the healthy group. However, these results are inconsistent across the studies. Conclusion: Given the limited evidence, researchers should conduct larger cohort studies to clarify this relationship and identify other factors contributing to the presence of pks+ E. coli, particularly across diverse clinical settings. Furthermore, clinical translation, such as the utilization of screening or therapeutic biomarkers, requires prospective validation and standardized detection methods.
Copyright (c) 2026 Bolor Ulziitsogt, Chuluunbileg Batbold, Tsogdulam Sumiyabazar, Gantogtokh Dashjamts, Yumchinsuren Tsedendorj, Tegshjargal Badamjav, Ganchimeg Dondov, Tulgaa Lonjid, Batbold Batsaikhan https://creativecommons.org/licenses/by/4.0
Late Gastrointestinal and Genitourinary Progression of Metastatic Invasive Lobular Breast Carcinoma: A Case Report
Gastrointestinal (GI) and genitourinary (GU) metastases from breast cancer are uncommon and are most frequently associated with invasive lobular carcinoma (ILC). These metastases may occur many years after initial diagnosis and can closely mimic primary colorectal or urothelial malignancies, posing significant diagnostic challenges. We report the case of a 64-year-old woman with hormone receptor–positive, HER2-negative bilateral ILC diagnosed in 2010 and treated with neoadjuvant chemotherapy, bilateral mastectomy, radiation, and prolonged endocrine therapy. Microscopic ovarian involvement identified at prophylactic bilateral salpingo-oophorectomy in 2011 established stage IV disease, followed years later by biopsy-confirmed adrenal metastasis treated with radiation and systemic therapy. More than a decade after initial diagnosis and in the setting of established metastatic disease, surveillance imaging identified lesions in the sigmoid colon and left urinary bladder wall. Biopsies from both sites demonstrated metastatic ILC on histomorphology and immunohistochemical (IHC) profiling, supporting metastatic rather than new primary malignancy. The bladder wall lesion demonstrated minimal metabolic activity on PET/CT despite histologic confirmation, highlighting the limited sensitivity of functional imaging in ILC. The patient was treated with fulvestrant and everolimus, with subsequent radiographic stability and decline in tumor markers CA 15-3 and CA 27.29; these findings represent an individual clinical course rather than evidence of treatment efficacy. This case underscores the importance of maintaining diagnostic vigilance for late GI and GU metastases with ILC. It highlights the role of tissue diagnosis and panel-based IHC interpretation in guiding management.
Copyright (c) 2026 Navin Roger Prasad, Stanley M Nwabudike, David Brian Meredith, Vipin Mittal https://creativecommons.org/licenses/by/4.0
Antibody-Drug Conjugates in Solid Tumors: Mechanisms, Clinical Advances, and Emerging Resistance Patterns
Introduction: Antibody-drug conjugates (ADCs) represent a transformative therapeutic modality in oncology, combining targeted antibody delivery with potent cytotoxic payloads. This narrative literature review examines ADC development for solid tumors, emphasizing advances from 2022-2025 while incorporating foundational trials from 2017-2021. Methods: We conducted comprehensive searches of PubMed, Embase, and major oncology conference proceedings (ASCO, ESMO, AACR) from January 2020 through December 2025, with emphasis on literature published since 2022. Search terms included: antibody-drug conjugates, ADC, solid tumors, specific agent names (trastuzumab deruxtecan, sacituzumab govitecan, enfortumab vedotin, tisotumab vedotin, datopotamab deruxtecan), resistance mechanisms, and combination therapy. We prioritized phase 2 and 3 clinical trials, mechanistic studies, and high-quality systematic reviews, clearly distinguishing phase 2 response data from comparative survival outcomes. Results: Topoisomerase inhibitor-based ADCs demonstrated substantial activity across multiple tumor types. In HER2-positive breast cancer, trastuzumab deruxtecan achieved superior outcomes compared to trastuzumab emtansine in DESTINY-Breast03. HER2-targeted ADCs achieve higher response rates than tissue antigen-targeted ADCs, though comparisons are limited by population heterogeneity. Multiple resistance mechanisms include antigen downregulation, impaired internalization, and payload efflux. Established targets (HER2, TROP2, Nectin-4) have FDA-approved ADCs, while emerging targets (B7H3, CEACAM5) are under investigation. Combination strategies with immunotherapy show promising synergy. Conclusions: ADCs have established clinical utility across solid tumors, with ongoing innovation in linker technology, payload selection, and target identification. Next-generation ADCs incorporating bispecific antibodies and dual payloads represent promising directions. Definitive evidence of improved long-term outcomes is needed before widespread adoption in curative-intent settings.
Copyright (c) 2026 Hassan A. Abdou, Shadi Awny https://creativecommons.org/licenses/by/4.0
Sepsis Mortality Among Patients with Myeloid Leukemia in the United States, 1999–2023: Insights, Trends, and Disparities
Background: Sepsis is a life-threatening condition that complicates major diseases like myeloid leukemia. Both conditions can lead to morbidity and mortality. Despite its clinical significance, trends in sepsis among myeloid leukemia patients remain understudied. Methods: Nationwide mortality records were obtained from the CDC-WONDER database for U.S. adults aged ≥25 with myeloid leukemia (ICD-10 code C92) and sepsis (ICD-10 codes A40, A41) from 1999 to 2023. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated for variables. Joinpoint analysis was utilized to evaluate annual percent changes (APCs). Results: From 1999 to 2023, a total of 35,075 deaths were recorded. The overall AAMR showed a modest but statistically significant increase (0.62) per 100,000 (AAPC 0.31; 95% CI 0.09 to 0.53; p = 0.007). Males experienced higher AAMRs (AAPC: 0.17, 95% CI: -0.05 to 0.40; p = 0.113) than females (0.82 vs.0.48) (AAPC: 0.33, 95% CI: -0.01 to 0.67; p = 0.056). Time trends within each sex were not statistically significant. The highest overall AAMR was recorded among NH Blacks (0.68), followed by NH Whites (0.64). Regional AAMRs were similar; the Northeast showed the largest decline, while the West increased modestly. The overall AAMR was slightly higher in metropolitan areas (0.64) compared to non-metropolitan areas (0.60). Older adults aged ≥ 65 years consistently exhibited the highest CMRs (1.86). Most deaths occurred in inpatient medical facilities (88.80%). Conclusion: Trends in sepsis mortality among myeloid leukemia patients increased modestly. Higher trends observed in urban areas and NH Blacks. Declines were observed in the Northeast region.
Copyright (c) 2026 Alyaa Ahmed Ibrahim, Mahmoud Tablawy, Mohamed Fawzi Hemida, Anika Goel, Raveen Mujeeb, Krish Patel, Sahil Jairamani, AbdAllah Dewair, Mirna Hussein, Maryam Saghir, Eshal Saghir , Safeya Fawzi, Ehsanullah Alokozay, Amro Ali https://creativecommons.org/licenses/by/4.0
Early clinical signals for Placental Mesenchymal Stem Cell Hydrogel in Radiation-induced Skin Injury
Background: Radiation-induced skin injury (RSI) affects 85-90\% of radiotherapy patients, with limited effective treatment options available. A recent Phase II randomized controlled trial investigated the efficacy of placental mesenchymal stem cell (PMSC)-embedded alginate hydrogel for treating moderate-to-severe RSI. Methods: This commentary analyzes the double-blinded, placebo-controlled trial by Tian et al. (N= 66), which evaluated once-daily PMSC hydrogel application (1× viable PMSCs) for six days in patients with grade II or higher RSI. Primary endpoints included overall recovery rate, wound regression, and dermatitis severity scores. Results: The PMSC hydrogel group demonstrated statistically significant improvement in healing rates (p ˂ 0.001), with 64% relative risk reduction in wound progression compared to placebo. Radiation-Induced Skin Reaction Assessment Scale scores and pain relief showed significant benefits by Day 6. TGF-β1 biomarker elevation suggested native tissue repair mechanisms. No serious adverse events were reported during the study period. Key constraints include a single-center design, a small sample size, a 15-day follow-up duration, the absence of quality-of-life improvements on the EORTC QLQ-C30, and the lack of reported cancer types or radiation regimen details, limiting generalizability. Conclusion: The trial presents encouraging preliminary evidence supporting PMSC hydrogel’s potential in accelerating the RSI healing process. However, definitive conclusions regarding practice-change efficacy require confirmation through larger, multicenter Phase III trials with extended follow-up (3-6 months), comprehensive patient-centered outcomes, cost-effectiveness analysis, and through assessment of late effects, including fibrosis.
Dermatologic complications of cancer therapy
Copyright (c) 2025 Fatma A. Rikabe, Abdelrhman Gouda, Abdelrhman H. Mohamed, Sampana Fatima (Author) https://creativecommons.org/licenses/by/4.0
Federated Hybrid CNN Vision Transformer Framework for Breast Cancer Classification Under Simulated Non-IID Settings
Background: Breast cancer diagnosis increasingly relies on data-driven learning from heterogeneous medical imaging sources. However, centralized deep learning approaches face major limitations, including privacy risks, institutional data silos, and limited generalization across imaging modalities. Methods: This study proposes a privacy-aware federated learning framework integrating a hybrid CNN–Vision Transformer architecture for breast cancer classification under simulated non-identically distributed (non-IID) conditions. Public datasets representing different imaging modalities, BreakHis (histopathology), INbreast and CBIS-DDSM (mammography), and BUSI (ultrasound) are treated as independent federated clients to emulate multi-institutional collaboration. Each client trains a local model, and only the model parameters are aggregated via Federated Averaging, thereby preserving data locality. The hybrid architecture combines a ResNet-18 convolutional branch for local feature extraction with a Vision Transformer branch for global contextual representation. Results: Across ten federated communication rounds, the global model demonstrates stable convergence under heterogeneous client distributions. The final global validation performance reaches 72.43% accuracy, AUC 0.7475, and F1-score 0.718. Evaluation on the pooled test cohort achieves approximately 84% overall accuracy with a weighted F1-score of 0.82, while malignant recall approaches 96%, prioritizing clinically critical cancer detection. Qualitative explainability analysis indicates that the model focuses on diagnostically relevant tissue regions. Conclusion: The results demonstrate the feasibility of hybrid CNN–Vision Transformer training in a federated setting for privacy-aware breast cancer classification across heterogeneous imaging domains.
Copyright (c) 2026 Bandhan Panda, Bibek Kumar Patro, Siba Sundar Das, Santosh Kumar Kar https://creativecommons.org/licenses/by/4.0