Computational predictions of magnetic resonance acoustic radiation force imaging for breast cancer focused ultrasound therapy

PURPOSE

In magnetic resonance-guided focused ultrasound (MRgFUS) breast therapies, the focal location must be characterized to guide successful treatment. Focal characterization is difficult because heterogeneous breast tissues introduce phase aberrations that blur and shift the focus and traditional guidance methods do not work in adipose tissues. The purpose of this work is to evaluate numerical simulations of MRgFUS that predict the focal location. Those simulations are compared to clinical magnetic resonance acoustic radiation force imaging (MR-ARFI) data collected during in vivo treatment of breast tumors.

METHODS

The focal location was evaluated before MRgFUS treatment with MR-ARFI in five patients. The hybrid angular spectrum method (HAS) was applied to simulate pressure fields which were converted to forces, then convolved with a 3D Green's function (with time-of-arrival weighting) to produce a simulation of the MR-ARFI tissue displacement.

RESULTS

The focal locations found by the simulations and the MR-ARFI measurements were on average separated by 3.7 mm (SD: 0.9 mm). Characterization of the focal zone spatial distributions had a normalized root mean squared difference of 8.1% (SD: 2.5%). The displacement magnitudes of the simulations underestimated the MR-ARFI measurements by 82% (SD: 5.6%).

CONCLUSIONS

The agreement between MR-ARFI measurements and simulations demonstrates that HAS can predict the in vivo focal location in heterogeneous tissues, though accurate patient-specific properties are needed to improve predictions of tissue displacement magnitude. Tools developed in this study could be used to streamline MRgFUS treatment planning and optimization, for biomechanical property estimation, and in developing phase aberration correction techniques.

The clinical value of Delphian and pre-tracheal lymph nodes in predicting lateral lymph nodes metastasis of papillary thyroid carcinoma

BACKGROUND

Occult lymph node metastasis of papillary thyroid carcinoma is common. However, whether undergoing prophylactic lateral lymph node dissections is still controversial. This cross-sectional study with large cohort of patients aims to investigate the clinical value of Delphian and pre-tracheal lymph node in predicting lateral lymph node metastasis of papillary thyroid carcinoma.

MATERIALS AND METHODS

A retrospective analysis was conducted on 865 papillary thyroid carcinoma patients with Delphian and pre-tracheal lymph node data who underwent thyroidectomy plus central and lateral lymph node dissection. Data on clinicopathological characteristics were collected. Subsequently, a predictive model was established based on the results of the univariate and multivariate analyses.

RESULTS

The rates of Delphian and pre-tracheal lymph node metastasis and lateral lymph node metastasis were 54.7% and 39.1%, respectively. Having ≥ 3 or 1-2 Delphian and pre-tracheal lymph node metastasis dramatically increased the risk of lateral lymph node metastasis (OR = 8.5, 95% CI 5.3-13.4 and OR = 3.9, 95% CI 2.7-5.7, respectively). The upper tumour had a 3.7 times higher risk of lateral lymph node metastasis than other locations. Patients ≤ 42 years or tumour size >8 mm had a higher risk of lateral lymph node metastasis.

CONCLUSIONS

Delphian and pre-tracheal lymph node metastasis was associated positively with the risk of lateral lymph node metastasis. For patients without clinical lateral lymph node metastasis, the Delphian and pre-tracheal lymph node could be considered to harvest as the first step in a thyroidectomy to facilitate further conduct of the operation.

Correlation between ultrasonography and elastography parameters and molecular subtypes of breast cancer in young women

OBJECTIVE

To explore the differences of conventional ultrasound characteristics, elastic imaging parameters and clinicopathological characteristics of distinct molecular subtypes of breast cancer in young women, and to identify imaging parameters that exhibited significant associations with each molecular subtype.

METHODS

We performed a retrospective analysis encompassing 310 young women with breast cancer. Observations were made regarding the ultrasonography and elastography characteristics of the identified breast lesions. Subsequently, based on immunohistochemistry results patients were classified into five distinct molecular subtypes: luminal A, luminal B (HER2-), luminal B (HER2+), HER2+, and triple-negative breast cancer (TNBC). Clinical, pathological, and ultrasound imaging features were compared among these subtypes using binary logistic regression analysis.

RESULTS

Statistically significant differences were observed in various parameters across the five molecular subtypes (p < 0.05), including tumor size, morphology, margins, calcification, posterior echo features, blood flow (Adler grading), and tumor hardness. Specifically, luminal A subtype exhibited propensity for spiculated margins, lower blood flow grading, and decreased hardness; luminal B subtype was characterized by angular margins; HER2+ subtype manifested higher blood flow grading, calcification, and elevated hardness. Conversely, TNBC subtype displayed smooth margins, absence of calcification, and heightened hardness.

CONCLUSION

Specific molecular subtypes of breast cancer have unique ultrasonic and elastic imaging characteristics.

Efficacy of first-line radiofrequency ablation combined with systemic chemotherapy plus targeted therapy for initially unresectable colorectal liver metastases

BACKGROUND/OBJECTIVE

The optimal strategy for patients with colorectal liver metastases is still controversially discussed. This study aimed to evaluate the efficacy of radiofrequency ablation (RFA) combined with systemic chemotherapy plus targeted therapy as first-line treatment in patients with initially unresectable colorectal liver metastases (CRLM), to identify prognostic factors and construct nomograms predicting survival.

METHODS

This retrospective study included patients with initially unresectable CRLM treated with (study group n = 74) or without (control group n = 83) RFA at the National Cancer Center from January 2018 to January 2021. Survival curves were assessed using the Kaplan-Meier method and log-rank test. Univariate and multivariate Cox regression analyses were used to determine prognostic factors and include these factors in the nomograms to predict progression-free survival (PFS) and overall survival (OS).

RESULTS

The study group had significantly better median PFS (17.16 months vs. 8.35 months, p < 0.01) and OS (34.9 months vs. 21.1 months, p < 0.01) than the control group after propensity score matching. Cox regression analyses identified RFA treatment and clinical risk score (CRS) as independent prognostic factors for PFS. The largest diameter of liver metastases, RFA treatment, and CRS were independent prognostic factors for OS. Based on this finding, nomograms with good discrimination and calibration were constructed.

CONCLUSION

RFA combined with systemic chemotherapy plus targeted therapy as first-line treatment could significantly prolong PFS and OS in patients with initially unresectable CRLM compared with systemic chemotherapy plus targeted therapy. The nomograms predicting PFS and OS might help clinicians select personalized treatment.

Machine learning-based integration develops a disulfidptosis-related lncRNA signature for improving outcomes in gastric cancer

Gastric cancer remains one of the deadliest cancers globally due to delayed detection and limited treatment options, underscoring the critical need for innovative prognostic methods. Disulfidptosis, a recently discovered programmed cell death triggered by disulphide stress, presents a fresh avenue for therapeutic exploration. This research examines disulfidptosis-related long noncoding RNAs (DRLs) in gastric cancer, with the goal of leveraging these lncRNAs as potential markers to enhance patient outcomes and treatment approaches. Comprehensive genomic and clinical data from stomach adenocarcinoma (STAD) were obtained from The Cancer Genome Atlas (TCGA). Employing least absolute shrinkage and selection operator (LASSO) regression analysis, a prognostic model was devised incorporating five key DRLs to forecast survival rates. The effectiveness of this model was validated using Kaplan-Meier survival plots, receiver operating characteristic (ROC) curves, and extensive functional enrichment studies. The importance of select lncRNAs and the expression variability of genes tied to disulfidptosis were validated via quantitative real-time PCR (qRT-PCR) and Western blot tests, establishing a solid foundation for their prognostic utility. Analyses of functional enrichment and tumour mutation burden highlighted the biological importance of these DRLs, connecting them to critical cancer pathways and immune responses. These discoveries broaden our comprehension of the molecular framework of gastric cancer and bolster the development of tailored treatment plans, highlighting the substantial role of DRLs in clinical prognosis and therapeutic intervention.

Research trends of neoadjuvant therapy for breast cancer: A bibliometric analysis

The approach of neoadjuvant therapy for breast cancer, which involves administering systemic treatment prior to primary surgery, has undergone substantial advancements in recent decades. This strategy is intended to reduce tumor size, thereby enabling less invasive surgical procedures and enhancing patient outcomes. This study presents a comprehensive bibliometric analysis of research trends in neoadjuvant therapy for breast cancer from 2009 to 2024. Using data extracted from the Web of Science Core Collection, a total of 3,674 articles were analyzed to map the research landscape in this field. The analysis reveals a steady increase in publication output, peaking in 2022, with the United States and China identified as the leading contributors. Key institutions, such as the University of Texas System and MD Anderson Cancer Center, have been instrumental in advancing the research on neoadjuvant therapy. The study also highlights the contributions of influential authors like Sibylle Loibl and Gunter von Minckwitz, as well as major journals such as the Journal of Clinical Oncology. Emerging research topics, including immunotherapy, liquid biopsy, and artificial intelligence, are gaining prominence and represent potential future directions for clinical applications. This bibliometric analysis provides critical insights into global research trends, key contributors, and future developments in the field of neoadjuvant therapy for breast cancer, offering a foundation for future research and clinical practice advancements.

Enhancing cancer subtype classification through convolutional neural networks: a deepinsight analysis of TCGA gene expression data

Purpose

This study investigates the adaptation of DeepInsight for cancer subtype classification using high-dimensional gene expression data. Originally designed for non-image data, DeepInsight has been adapted for cancer classification.

Methods

We evaluated DeepInsight's performance against several models, including support vector machines, LightGBM, neural networks, and decision trees, with and without the application of the Synthetic Minority Oversampling Technique. The study utilized gene expression data from breast, lung, and colon cancers. A novel multi-class feature selection method was introduced, using modified aggregated class activation maps to identify key genes across different cancer subtypes. These critical genes were further analyzed through Gene Ontology to explore their roles in significant biological processes.

Result

DeepInsight consistently outperformed traditional models in terms of F1 score across breast, lung, and colon cancer datasets, effectively addressing multi-class classification challenges. Notably, several top genes were identified as significant across multiple methods. Furthermore, we conducted a Gene Ontology analysis on the critical genes, including the top genes identified by DeepInsight and the common genes recognized through multiple methods.

Conclusion

The adaptation of DeepInsight provides an approach to cancer subtype classification by transforming high-dimensional gene expression data into image representations. Utilizing aggregated class activation maps, it effectively identifies critical pixels within these images, enabling the discovery of distinct genes that may not be highlighted by other methods. DeepInsight demonstrates potential as a valuable tool for classifying cancer subtypes and critical genes.

Multidisciplinary management of pituitary macroadenoma

BACKGROUND

Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations. This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas, integrating neurosurgery, endocrinology, radiology, and pathology perspectives.

AIM

To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis, management, and rehabilitation of individuals with pituitary adenomas, to add to already preexisting knowledge, in managing these cases enhancing better ocular and systemic outcomes.

METHODS

A search was conducted on an online publication database (PubMed) using the term “pituitary adenoma” including all results published over twenty years (2004-2024). Results were sorted for relevance, language, and completeness.

RESULTS

A total of 176 records were returned. The guidelines of the PRISMA 2020 statement were followed in this study. A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates. Another 17 records were not available as full-length articles and were also excluded. The references of each included record was further searched for relevant publications. A total of 141 records were therefore used in this minireview.

CONCLUSION

Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact, modern therapeutic strategies offer effective management options. Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life. Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future

Liver Transplantation for Non-hepatocellular Carcinoma: The Role of Immune Checkpoint Inhibitors

Colorectal cancer (CRC), gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN), and cholangiocarcinoma (CCA) exhibit high rates of morbidity and mortality once metastasized to the liver. Liver transplantation (LT) is a viable therapeutic approach for these cancers in highly selected patients; however, their invasive nature at late stages causes many patients to be delisted from transplantation or to require further downstaging. Immunotherapy with immune checkpoint modulators has revolutionized cancer research. Immune checkpoint inhibitors (ICI) leverage the chronic inflammatory state and the overexpression of cytotoxic T lymphocyte antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1)/programmed cell death-ligand 1 (PD-L1) by malignant cells and regulatory T cells, to block immune checkpoints and counteract tumor's ability to evade the immune system. However, the interaction between allograft PD-L1 and PD-1 on infiltrating T cells functions as a means of graft tolerance in cases of LT. Therefore, the application of ICIs might block this protective effect and induce graft rejection, a phenomenon particularly observed in PD-1/PD-L1 inhibiting ICIs. The risk of post-LT graft rejection can be mitigated by applying advanced biomarkers and specifying certain mutations that enhance patient selection criteria for pre-LT ICI use. Furthermore, the determination of optimal intervals of ICI administration pre- and post-LT, identification of ICI indications in de novo malignancies occurring after LT, and investigation of biomarkers for early rejection detection, pave the way for more promising LT outcomes in patients with CRC, GEP-NEN, or CCA. Therefore, this review aims to illustrate a comprehensive overview of the role of ICI therapy in the management of non-hepatocellular carcinoma transplant oncology cancers by demonstrating the potential for its application in both pre-and post-LT states, and pathways to reduce or timely detect ICI-associated graft rejection.

Immunity/metabolism dual-regulation via an acidity-triggered bioorthogonal assembly nanoplatform enhances glioblastoma immunotherapy by targeting CXCL12/CXCR4 and adenosine-A2AR pathways

Blocking the C-X-C motif chemokine ligand-12/C-X-C motif chemokine receptor-4 (CXCL12/CXCR4) signal offers the potential to induce immunogenic cell death (ICD) and enhance immunotherapy of glioblastoma (GBM). However, traditional intracellular targeted delivery strategies and adenosine-mediated tumor immunosuppression limit its therapeutic efficacy. Herein, we present an acidity-triggered self-assembly nanoplatform based on bioorthogonal reaction to potentiate GBM immunotherapy through dual regulation of metabolism and immune pathways. AMD3100 (CXCR4 antagonist) and CPI-444 (adenosine 2A receptor inhibitor) were formulated into micelles, denoted as AMD@iNPDBCO and CPI@iNPN3, respectively. Upon administration, the pH-sensitive poly(2-azepane ethyl methacrylate) group of AMD@iNPDBCO responds to the acidic tumor microenvironment, exposing the DBCO moiety, resulting in highly efficient bioorthogonal reaction with azide group on CPI@iNPN3 to form large-sized aggregates, ensuring extracellular drug release. The combination of AMD3100 and CPI-444 contributes to ICD induction, dendritic cell maturation, and immunosuppressive milieu alleviation by reducing tumor-associated macrophages, myeloid-derived suppressor cells, and regulatory T cells, leading to a robust antitumor response, thereby significantly prolonging survival in orthotopic GBM-bearing mice. Furthermore, the nanoplatform remarkably amplifies immuno-radiotherapy by potently evoking cytotoxic CD8+ T cell priming, and synergized with immune checkpoint blockade by delaying CD8+ T cell exhaustion. Our work highlights the potential of the in situ assembly nanoplatform tailored for delivery of extracellular-targeted therapeutic agents for boosting GBM immunotherapy.

MCC in the spotlight: Its dual role in signal regulation and oncogenesis

The mutated in colorectal cancer (MCC) gene is closely associated with the onset and progression of colorectal cancer. MCC plays a critical role in regulating the cell cycle and various signaling pathways and is recognized to inhibit cancer cell proliferation via the β-catenin signaling pathway. β-catenin is a key component of the WNT signaling pathway that influences cell growth, differentiation, survival, and migration, thereby positioning MCC as an important tumor suppressor. Notably, MCC has also been implicated in other cancer types, including lung, liver, and brain cancers. However, the precise mechanisms by which MCC functions in these malignancies remain inadequately understood. Comprehensive investigations into the interactions among MCC, various signaling pathways, and metabolic processes are essential for uncovering the molecular mechanisms of cancer and the pathological features characteristic of different cancer stages. This review presents the structural characteristics of MCC and its cell growth regulation mechanisms and functional roles within tissues, with the aims of enhancing our understanding of the role of MCC in cancer biology and highlighting potential therapeutic strategies targeting this gene.

Circadian clock regulation of myofibroblast fate

Fibrosis-related disorders represent an increasing medical and economic burden on a worldwide scale, accounting for one-third of all disease-related deaths with limited therapeutic options. As central mediators in fibrosis development, myofibroblasts have been gaining increasing attention in the last 20 years as potential targets for fibrosis attenuation and reversal. While various aspects of myofibroblast physiology have been proposed as treatment targets, many of these approaches have shown limited long-term efficacy so far. However, ongoing research is uncovering new potential strategies for targeting myofibroblast activity, offering hope for more effective treatments in the future. The circadian molecular clock is a feature of almost every cell in the human body that dictates the rhythmic nature of various aspects of human physiology and behavior in response to changes in the surrounding environment. The dysregulation of these rhythms with aging is considered to be one of the underlying reasons behind the development of multiple aging-related chronic disorders, with fibrotic tissue scarring being a common pathological complication among the majority of them. Myofibroblast dysregulation due to skewed circadian clockwork might significantly contribute to fibrotic scar persistence. In the current review, we highlight the role of the circadian clock in the context of myofibroblast activation and deactivation and examine its dysregulation as a driver of fibrogenesis.

The role of ICG NIRL fluorescence imaging in the surgical treatment of digestive system tumors (Review)

Indocyanine green (ICG) is a relatively non‑toxic fluorescent dye with a history of safe use, which has fueled the development of new applications for ICG. Research on the use of ICG near‑infrared light (NIRL) fluorescence imaging during oncologic surgery has increased, revealing its role in tumor identification and localization, lymph node navigational resection and blood perfusion assessment. The purpose of the present review was to provide a comprehensive overview of advances in the clinical application of ICG NIRL fluorescence imaging during gastrointestinal tumor surgery. The present review discusses the techniques, outcomes, limitations and key considerations necessary for clinical practice, aiming to provide a valuable resource for professionals in the field.

The arginine metabolism and its deprivation in cancer therapy

Arginine deprivation has emerged as a promising therapeutic strategy in cancer treatment due to the auxotrophy of certain tumors. Many cancers, such as pancreatic, colorectal, and hepatocellular carcinoma, exhibit downregulated argininosuccinate synthetase, making them reliant on external arginine sources. This dependency allows targeted therapies that deplete arginine, inhibiting tumor growth while sparing normal cells. Arginine is crucial for various cellular processes, including protein synthesis and immune function. Its deprivation affects both tumor metabolism and immune responses, potentially enhancing cancer therapy. Studies have explored using enzymes like arginine deiminase and arginase, often modified for increased stability and reduced immunogenicity, to effectively lower arginine levels in the tumor microenvironment. These approaches show promise, particularly in tumors with low argininosuccinate synthetase expression. However, the impact on immune cells and the potential for resistance highlight the need for further research. Combining arginine deprivation with other treatments might improve outcomes, offering a novel approach to combat arginine-dependent cancers.

Shared neoantigens for cancer immunotherapy

Exploration of neoantigens holds the potential to be productive in immuno-oncotherapy. Among tumor-specific antigens, neoantigens result from genetic instability that gives rise to non-synonymous somatic mutations, highly specific to tumor cells. In addition to point mutations, gene rearrangements, indels leading to frameshifts, chromosomal translocations or inversions that may lead to fusion proteins, alternative mRNA splicing, and integration of genetic material of oncogenic viruses into the host genome provide consistent sources of neoantigens that are absent in healthy tissues. Out of these alterations, 2%-3% may generate T cell neoepitopes, possibly detectable by TCRs. Neoantigens are absent in healthy tissues and are thus at low risk of triggering autoimmunity. In addition, the host lymphocytes have not been rendered tolerant toward them and it is possible to induce immune responses against them. Here, we overview the two categories of neoantigens, i.e., private and shared, and their use in immuno-oncotherapy in selected pre-clinical and clinical studies. The vast majority of commonly occurring tumor-specific mutations are cancer causing and are permanently expressed by all malignant tumor cells, preventing the latter from escaping vaccine-induced anti-neoantigen immunity. The use of public neoantigens combined with efficient vaccine platforms can provide non-personalized "off-the-shelf" therapeutic vaccine candidates for broad-spectrum immunotherapy purposes.

miR-660: A novel regulator in human cancer pathogenesis and therapeutic implications

MicroRNAs (miRNAs) are non-coding RNAs that regulate gene expression. Among these, miR-660, located on chromosome Xp11.23, is increasingly studied for its role in cancer due to its abnormal expression in various biological contexts. It is regulated by 8 competing endogenous RNAs (ceRNAs), which adds complexity to its function. miR- 660 targets 19 genes involved in 6 pathways such as PI3K/AKT/mTOR, STAT3, Wnt/β-catenin, p53, NF‑κB, and RAS, influencing cell cycle, proliferation, apoptosis, and invasion/migration. It also plays a role in resistance to chemotherapies like cisplatin, gemcitabine, and sorafenib in lung adenocarcinoma (LUAD), pancreatic ductal adenocarcinoma (PDAC), and hepatocellular carcinoma (HCC), thus highlighting its clinical importance. Additionally, leveraging liposomes as nanocarriers presents a promising avenue for enhancing cancer drug delivery. Our comprehensive study not only elucidates the aberrant expression patterns, biological functions, and regulatory networks of miR-660 and its ceRNAs but also delves into the intricate signaling pathways implicated. We envisage that our findings will furnish a robust framework and serve as a seminal reference for future investigations of miR-660, fostering advancements in cancer research and potentially catalyzing breakthroughs in cancer diagnosis and treatment paradigms.

Nano biosensor unlocks tumor derived immune signals for the early detection of ovarian cancer

Ovarian cancer is a critical health issue for women nowadays. Its impact is significant because of its high mortality rate (324,603 worldwide), late-stage diagnosis and poor survival rate. Lack of screening tests, vague symptoms, misdiagnosis, and age factor makes it even more difficult to detect. Neutrophils, a subset of immune cells, undergo tumor-specific changes as ovarian cancer progresses inside ovarian tumour microenvironment. Therefore, monitoring the time-specific activity of neutrophils in circulation has the potential to aid in the diagnosis of ovarian cancer. Most ovarian tumor-specific antigens are unknown, making it difficult to identify neutrophils associated with ovarian tumor. We present ovarian tumor-associated circulating neutrophil cell profiling as a stand-alone cancer diagnostic method using a liquid biopsy. Using a SERS-functionalized nano probe, the metabolic profiles of neutrophils from ovarian tumor interaction are detected. We demonstrate that neutrophils associated with cancer stem cells have a distinct metabolic profile and are useful in the diagnosis of early ovarian cancer. Using 5 μL of peripheral blood and an artificial neural network, the characteristics of neutrophil profiles in patient blood could distinguish cancer cohort from non-cancer (healthy) with a 90 % sensitivity and 100 % specificity. Our results demonstrate the viability of using circulating neutrophils for non-invasive cancer diagnostics.

Mechanistic study of cancer drug delivery: Current techniques, limitations, and future prospects

Cancer drug delivery remains a critical challenge with systemic toxicity, poor drug bioavailability, and a lack of effective targeting. Overcoming these barriers is essential for improving treatment efficacy and patient outcomes. This review discusses current drug delivery techniques that reshape cancer therapy by offering precise, controlled-release tailored to tumor-specific features. Innovations in nanotechnology, immunotherapy, and gene therapy enable interventions at molecular and cellular levels. Radiomics and pathomics integrate high-dimensional data to optimize diagnostics and treatment planning. Combination therapy addresses the complexities of tumor heterogeneity by synergizing multiple agents within a single therapeutic framework, while peptide-drug conjugates enhance specificity and potency. Hydrogel-based systems and microneedle arrays offer localized, sustained release, significantly improving therapeutic outcomes. However, clinical translation of these advancements faces significant barriers such as drug resistance, off-target effects, scalability, cost, and ethical concerns. Moreover, regulatory complexities and the economic feasibility of these therapies highlight the need for innovative frameworks to make them accessible globally. Therefore, there is a need for innovation in gene and cell therapy, next-generation drug delivery platforms, and personalized medicine. This review focuses on recent advancements in drug delivery techniques over the past decade, evaluating their limitations and exploring potential future directions for transforming cancer treatment.

Eco-friendly nanotherapeutics: Metallic nanoparticles for targeting breast cancer

Breast cancer continues to be a major cause of death among women globally, with triple-negative breast cancer (TNBC) presenting a particularly difficult challenge due to its aggressive behaviour and the lack of effective treatment options. Nanotechnology, particularly the use of silver nanoparticles (AgNPs), has emerged as a promising avenue in oncological research. This review explores into the escalating field of green synthesis of nanoparticles, emphasizing sustainable approaches utilizing plant-based resources. Critical factors influencing nanoparticle synthesis, including reaction conditions, precursor types, and plant phytochemicals, are explored alongside advanced characterization techniques essential for evaluating nanoparticle properties. Special focus is given to the phytofabrication of silver nanoparticles and their multifaceted roles in breast cancer treatment, with detailed insights into their mechanisms, such as inducing apoptosis, generating reactive oxygen species (ROS), and disrupting mitochondrial function, particularly in TNBC cells. The review further highlights the advantages of plant-derived AgNPs, such as biocompatibility and reduced toxicity, while addressing challenges like scalability, reproducibility, and regulatory hurdles. Concluding with future prospects, this paper reflects the potential of green-synthesized AgNPs as a keystone in next-generation cancer therapeutics, paving the way for innovative and eco-friendly approaches in oncology.

Anti-cancer efficiency of Campylobacter jejuni secretome loaded chitosan nanoparticles on colorectal cancer signaling pathways

Colorectal cancer (CRC) remains as a major health problem with high lethality rate in the world. The innovate therapeutic strategies are essential in CRC management. The purpose of this research was to evaluate the effect of chitosan nanoparticle containing Campylobacter jejuni culture supernatant (CNP/Cj-sup) on genes involved in CRC signaling pathways. CNP/Cj-sup was fabricated via ionotropic gelation method. Dynamic light scattering and transmission electron microscopy (TEM) techniques were employed to characterize of the CNP/Cj-sup including the electrical charge, size distribution, and morphological properties. The loaded protein, released protein, and entrapment efficacy (EE) were assayed utilizing a BCA assay kit. After the evaluation of the viability of Caco-2 (colon adenocarcinoma) and HDF (human dermal fibroblasts) cells against CNP/Cj-sup by MTT assay, subsequently anti-tumor effect of CNP/Cj-sup on genes associated with CRC signaling pathways was assessed via real-time PCR method. The size dispersion of CNP/Cj-sup was 400.6 ± 24.4 nm with an electrical charge of + 4.5 mV. The loaded protein was calculated 1100 µg. The release rate of protein from CNP/Cj-sup was 78% at pH of 6.8 after 48 h, with EE of 74.62%. The viability of Caco-2 and HDF cells against CNP/Cj-sup (1100 µg + 0.05%) was measured 75.8 and 96.5%, respectively after 48 h. CNP/Cj-sup exhibited the highest efficacy in inhibiting the expression of oncogenes TGF-α, Bcl2, TLR4, CEA, TGF-β, and PI3K by to 0.06, 0.34, 0.14, 0.13, 0.08, and 0.14-fold (p value < .0001). Moreover, it led to a significant increase in the expression of the suppressor genes caspase9 and PTEN by to 55.7 and 1.8- fold (p value < .0001). CNP/Cj-sup demonstrated the highest efficiency in suppressing TGF-α and enhancing caspase9 compared to CNP and Cj-sup. In conclusion, CNP/Cj-sup as an innovative potential anticancer agent, with the ability to modulate genes involved in CRC progression, represents a promising approach to CRC treatment.

Graphical abstract

The effect of CNP/Cj-sup on different colorectal cancer signaling pathways.

The function of microRNA related to cancer-associated fibroblasts in pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignant tumor characterized by a poor prognosis. A prominent feature of PDAC is the rich and dense stroma present in the tumor microenvironment (TME), which significantly hinders drug penetration. Cancer-associated fibroblasts (CAFs), activated fibroblasts originating from various cell sources, including pancreatic stellate cells (PSCs) and mesenchymal stem cells (MSCs), play a critical role in PDAC progression and TME formation. MicroRNAs (miRNAs) are small, single-stranded non-coding RNA molecules that are frequently involved in tumorigenesis and progression, exhibiting either oncolytic or oncogenic activity. Increasing evidence suggests that aberrant expression of miRNAs can mediate interactions between cancer cells and CAFs, thereby providing novel therapeutic targets for PDAC treatment. In this review, we will focus on the potential roles of miRNAs that target CAFs or CAFs-derived exosomes in PDAC progression, highlighting the feasibility of therapeutic strategies aimed at restoring aberrantly expressed miRNAs associated with CAFs, offering new pathways for the clinical management of PDAC.

Machine learning predictions of tumor progression: How reliable are we?

BACKGROUND

Cancer continues to pose significant challenges in healthcare due to the complex nature of tumor progression. In this digital era, artificial intelligence has emerged as a powerful tool that can potentially transform multiple aspects of cancer care.

METHODS

In the current study, we conducted a comprehensive literature search across databases such as PubMed, Scopus, and IEEE Xplore. Studies published between 2014 and 2024 were considered. The selection process involved a systematic screening based on predefined inclusion and exclusion criteria. Studies were included if they focused on applying machine learning techniques for tumor progression modeling, diagnosis, or prognosis, were published in peer-reviewed journals or conference proceedings, were available in English, and presented experimental results, simulations, or real-world applications. In total, 87 papers were included in this review, ensuring a diverse and representative analysis of the field. A workflow is included to illustrate the procedure followed to achieve this aim.

RESULTS

This review delves into the cutting-edge applications of machine learning (ML), including supervised learning methods like Support Vector Machines and Random Forests, as well as advanced deep learning (DL). It focuses on the integration of ML into oncological research, particularly its application in tumor progression through the tumor microenvironment, genetic data, histopathological data, and radiological data. This work provides a critical analysis of the challenges associated with the reliability and accuracy of ML models, which limit their clinical integration.

CONCLUSION

This review offers expert insights and strategies to address these challenges in order to improve the robustness and applicability of ML in real-world oncology settings. By emphasizing the potential for personalized cancer treatment and bridging gaps between technology and clinical needs, this review serves as a comprehensive resource for advancing the integration of ML models into clinical oncology.

Pictorial essay on selected new, emerging, and reclassified entities in the 2020 WHO classification of soft tissue tumors

The 2020 WHO classification of soft tissue tumors includes major updates, incorporating new and emerging tumor entities, along with reclassified tumor types, supported by advances in immunohistochemistry and genetic data. This pictorial essay provides an overview of the selected new, "emerging," and reclassified soft tissue tumors, highlighting their imaging characteristics. Given the rarity of many of these entities, familiarity with their imaging features will aid in accurate diagnosis, ultimately contributing to improved patient care and management of these tumors.

Posttransplant EBV-Positive Smooth Muscle Tumors in Children, Adolescents, and Young Adults: A Multi-Institution Experience

Epstein-Barr virus (EBV)-positive smooth muscle tumors (SMTs) are rare tumors seen in immunocompromised patients. There is no clear standard of care for the management and treatment of EBV-SMTs. Patients are often treated with chemotherapy, surgery, and/or radiation. Additional options include antiretroviral treatment, reduction in immunosuppression, and EBV-directed virus-specific T cells (VSTs). This report describes the treatment regimens and outcomes of eight patients with EBV-associated SMTs. Although no consensus treatment for EBV-SMTs has been identified, VSTs show promise in providing a period of stable disease or partial response and surgical removal may offer long-term benefits in cases of localized disease.

High CCR6 expression increases the risk of pediatric Langerhans cell histiocytosis

Langerhans cell histiocytosis (LCH) is a rare disorder that primarily affects children. Considering the intricate clinical presentation of this disease, the identification of specific biomarkers associated with susceptibility to LCH is essential for timely diagnosis and risk stratification. In this study, we examined the skin specimens from pediatric patients with LCH using RNAscope, immunohistochemistry, and sequencing techniques. We observed a notable correlation between elevated CCR6 expression in pathological tissues and LCH risk classification. Therefore, CCR6 expression may serve as an independent predictor of risk in clinical cases of LCH. Furthermore, the frequency of BRAF V600E mutations correlated with risk stratification. We discovered new mutations-H119Y and R108Q-in MAP2K1 in specimens with BRAF V600E mutations. Moreover, CCR6-positive tumors may exhibit an enhanced recruitment of lymphocytes expressing high CCR7 levels.

Antibody-drug conjugates and radioconjugates targeting carbonic anhydrase IX and XII in hypoxic tumors: Bench to clinical applications

Treating hypoxic tumors is challenging due to their aggressive nature, resistance to standard treatments, often leading to poor outcomes. Hypoxic tumors create a unique environment that reduces the effectiveness of traditional treatments such as chemotherapy and radiotherapy. Human carbonic anhydrases (hCA IX and hCA XII) are involved in tumors survival and metabolism by regulating pH homeostasis, ferroptosis, metastatization, and other processes. Developing drugs that specifically target these enzymes has been demonstrated to disrupt the tumor survival mechanisms, leading to significant antitumor effects. This review discusses recent developments on antibody-drug conjugates (ADCs) and radioconjugates targeting hCA IX and hCA XII in hypoxic tumors. New approaches based on small molecule inhibitors and monoclonal antibodies such as girentuximab provided encouraging results in preclinical research and clinical trials. These advances highlight the potential of hCA-targeted therapies to improve cancer treatment for hypoxic tumors.

A joint photoacoustic imaging and broadband spectral analysis for early-stage intraoperative pathology assessment: A case study with colorectal cancer

Accurate and rapid intraoperative diagnosis of micro-infiltration in early-stage tumors presents a formidable challenge for decades. Here, we propose a novel diagnostic approach, that combines Photoacoustic Morphological Imaging (PAMI) with an in situ broadband Photoacoustic Spectral Analysis (PASA), to implement intraoperative assessment of early-stage tumor while its high-frequencies between 50 and 150 MHz respond to various nuclei specifically. Our system, a broadband Ultraviolet Photoacoustic Microscopy (bUV-PAM), uniquely integrates ultraviolet laser-induced nucleus-specific photoacoustic excitation with broadband photoacoustic detection (up to 176 MHz at -6 dB) via an optical surface wave sensor. This approach facilitates the simultaneous acquisition of morphological and spectral information from unstained tissue sections, yielding a comprehensive dual-modality virtual slice within a single raster scan. Using human colorectal tissue samples, we applied the joint PAMI and in situ PASA approach across 6 case groups. Morphological features in PAMI showed a high concordance with Hematoxylin and Eosin (H&E) staining, whereas micro-infiltrative features were too indistinct to be identified in both PAMI and H&E images. In contrast, the PASA effectively distinguishes between micro-infiltrated and non-infiltrated tissues, a finding validated by subsequent Immunohistochemical (IHC) assessments. The preliminary results suggest that the joint approach holds potential to enhance intraoperative detection of micro-infiltration, thereby offering a promising avenue for accurate and rapid surgical margin assessment.

A Descriptive Phenomenological Study of the Women's Experiences From the Suspicion of Breast Cancer to the Initiation of Treatment

INTRODUCTION

Breast cancer is the most common malignancy among women worldwide. However, scientific research has paid little attention to the lived experiences of these women, from the onset of concerning symptoms to the initiation of curative treatment. This study aimed to explore and understand the experiences of Tunisian women, from the appearance of the first symptoms of suspected breast cancer to the initiation of curative treatment.

METHOD

This descriptive phenomenological qualitative study, inspired by Husserl's philosophy, is the first of its kind in Tunisia to explore the feelings and experiences of women with breast cancer during the early stages of care. Individual interviews were conducted with 13 women diagnosed with breast cancer who had visited the Farhat Hached University Hospital in Sousse. Participants were selected through purposive sampling. Data collection was carried out in September and October 2022. The Giorgi analysis method was used, allowing for the emergence of three main themes.

RESULTS

The analysis of the interviews revealed three themes: Waiting for diagnostic test results, the announcement of the diagnosis, and waiting for treatments. Together, these themes encapsulated the essence of the phenomenon: a balance between vulnerability to various challenges and resilience in managing the journey from diagnosis to treatment, reflecting a life of both struggle and strength. Participants highlighted the psychological, physical and economic challenges they faced and expressed specific needs related to their condition. These needs were particularly evident during the pre-diagnosis phase, the moment of diagnosis disclosure and the waiting period before treatment began.

CONCLUSION

The practical implications derived from the results of this study could help inform medical and nursing practices and guide the development of care delivery strategies to better support women with breast cancer.

Leveraging self-signal amplifying poly(acrylic acid)/polyaniline electrodes for label-free electrochemical immunoassays in protein biomarker detection

Accurate quantification of specific biomarkers is essential for clinical diagnosis and evaluating therapeutic efficacy. A self-signal-amplifying poly(acrylic acid) (PAA)/polyaniline (PANI) film-modified disposable and cost-effective screen-printed carbon electrode (SPCE) has been developed for constructing new label-free immunosensors targeting two model biomarkers: human immunoglobulin G (IgG) and alpha-fetoprotein (AFP). The electrochemically deposited PAA/PANI film on the SPCE serves a dual function: both a bio-immobilization support and a signal amplifier, enhancing biomarker detection sensitivity and efficiency. The self-signal amplification properties of PANI streamline the detection process. At the same time, the high-density surface carboxyl groups from embedded PAA enable covalent conjugation with capture antibodies (anti-IgG and anti-AFP). Subsequently, antibody-immobilized PAA/PANI film-modified SPCEs, as immunosensors, successfully detect IgG and AFP without the need for external redox probes. The reductions in the electrochemical PANI signals of the immunosensors are linearly proportional to the logarithm of IgG and AFP concentrations. The proposed immunosensors exhibit sufficiently wide ranges of calibration curves from 0.10 to 50 ng mL-1, with limits of detection of 0.080 ng mL-1 for IgG and 0.090 ng mL-1 for AFP. The sensors exhibit satisfactory sensitivity and selectivity, indicating their potential for accurate and reliable detection.

The current landscape of aromatase inhibitors for the treatment of estrogen receptor-positive breast carcinoma

Estrogen receptor-positive (ER+) breast carcinoma represents a significant portion of breast cancer cases and is characterized by the presence of estrogen receptors that promote tumor growth upon estrogen binding. ER + breast cancer progression involves hormonal influences, interactions within the tumor microenvironment, and genetic mutations that may lead to treatment resistance. Successful therapeutic options include hormonal therapies, particularly aromatase inhibitors (AIs), which aim to block the effects of estrogen or reduce its synthesis. With higher efficacy than tamoxifen, AIs such as anastrozole, letrozole, and exemestane have become widely employed in adjuvant and first-line treatments for advanced breast cancer. AIs function by inhibiting the enzyme aromatase, which converts androgens into estrogens in the peripheral tissues. Because too much estrogen might promote tumor growth, this decrease in estrogen levels is essential for treating ER+ malignancies. To provide a comprehensive overview of AIs in the treatment of ER+ breast cancer, this study examined the pharmacokinetics, clinical uses, mechanisms of action, and problems with treatment resistance. To maximize therapeutic approaches and enhance patient outcomes in the treatment of ER breast cancer, it is imperative to understand these characteristics.

A Survey of Clinical Practices for Hepatocellular Carcinoma Among Experts at Tertiary Hospitals in China From 2020 to 2021

Background

Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death in China. The rapid progress in systemic therapies has led to the approval of many therapeutic methods that have quickly changed clinical guidelines and practices. Because of the high heterogeneity of HCC, there are still some gaps between the guidelines and real-world clinical practice. The present study surveyed experts in China to investigate the current treatment concepts and clinical practice regarding HCC.

Methods

A questionnaire survey on the treatment concepts and clinical practice of HCC was administered to 310 experts with senior professional titles in 2020 and 312 experts in 2021. The results were analyzed and compared.

Results

For treating patients with resectable HCC, 28% of hepatobiliary surgeons indicated neoadjuvant therapy, and 7% chose systemic therapy ± locoregional therapy as 1 L therapy in 2021 compared with 20% and 1% in 2020. More experts chose adjuvant treatment within 1 month in 2021 compared with 2020, and 6 months and 12 months were the leading choices for the duration of adjuvant treatment. In 2021, 79% of surgeons and 19% of interventionalists were willing to conduct downstaging/conversion therapy for patients with potentially resectable HCC, and 78% chose tyrosine kinase inhibitors (TKI) + immunotherapy (IO) + locoregional therapy for cases in which R0 resection could not be achieved. For completely unresectable HCC, more experts preferred TKI + IO-based therapy as 1 L therapy in 2021 compared with 2020 (78% vs. 55%). The proportion of experts who indicated TKI + IO-based therapy as 2 L therapy increased from 32% in 2020 to 40% in 2021.

Conclusion

The survey results indicated that in 2021, compared with 2020, more experts opted to administer IO + TKI for the treatment of liver cancer, and more experts and patients were willing to participate in clinical research.

Blood-oxygenation-level-dependent (BOLD) MRI responses to CO2 and O2 inhalation in brain gliomas

PURPOSE

Cerebrovascular abnormalities are intricately involved in gliomas. While static cerebrovascular properties such as cerebral blood flow, volume, and permeability have been extensively studied, dynamic vascular parameters have not been fully understood. This study aimed to characterize the vascular responses to CO2 and O2 inhalation in brain gliomas.

METHODS

In 15 glioma patients, concomitant CO2 and O2 inhalation was applied while BOLD MR images were continuously acquired for nine minutes, resulting in the measurement of O2-reactivity, CO2-reactivity, and bolus arrival time (BAT). Vascular parameters were compared between the tumor regions and contralateral healthy tissue using Student t-tests. The dependence of vascular parameters on glioma grade, glioma subtypes, and molecular biomarkers were assessed using a multiple linear regression.

RESULTS

Visual inspection suggested that reliable O2-reactivity, CO2-reactivity, and BAT maps could be obtained in every patient. Compared to the contralateral healthy tissue, glioma regions on average revealed a diminished O2-reactivity (p < 0.001) and CO2-reactivity (p < 0.001), but a lengthened BAT (p < 0.001). Intra-tumoral heterogeneity in the vascular parameters between core and periphery was also observed. Astrocytomas had a lower CO2-reactivity (p = 0.014) and a longer BAT (p = 0.012) relative to oligodendrogliomas. Glioma grade had no association with O2-reactivity, CO2-reactivity, or BAT. Patients who lost ATRX expression had a lower CO2- and O2-reactivity (p = 0.005 and p = 0.035) compared to patients who retained ATRX expression.

CONCLUSIONS

Gliomas are associated with abnormal CO2- and O2-reactivity measured with MRI. These dynamic parameters may provide new insights into the vascular pathophysiology in gliomas.

Comparative proteomic profiling of glioblastoma and healthy brain cell-derived extracellular vesicles reveals enrichment of cancer-associated proteins

Extracellular vesicles (EVs)-mediated cellular communication plays a role in cancer development and progression. This study focuses on identifying glioblastoma-specific EV protein markers through a comparative mass spectrometry bottom-up proteomic analysis of the LN-229 cell line and human neurons, astrocytes, and endothelial brain cells (HEBCs) using timsTOF Pro 2 instrument. The statistically significant upregulated proteins with fold change greater than 2 in the glioblastoma-derived EVs were clustered based on physical and functional interactions using the STRING database and analyzed using Gene Ontology enrichment. LN229-derived EVs contained an average of 2635 proteins, while human astrocytes, neurons, and HEBC encapsulated 2647, 716, and 2285 proteins, respectively. NanoParticle Tracking Analysis indicated that glioblastoma-derived EVs exhibited greater size variability compared to EVs from healthy cells. Statistical analysis identified 25 statistically significant proteins with increased levels in LN229 EVs relative to at least two healthy cell lines suggesting their potential as glioblastoma markers. Functional clustering using the STRING database and GO analysis indicated involvement in epigenetic regulation, metastasis, angiogenesis, and protein folding. Post-translational modification analysis identified a subset of 17 proteins unique to the cancer-derived EVs involved in chromatin regulation, extracellular matrix remodeling, and basement membrane organization pathways, highlighting their role in tumor progression.

Phytochemical composition, antimicrobial, antioxidant, and wound healing activities of Thermopsis turcica

The antioxidant, antimicrobial, anticarcinogenic, wound healing activities and phenolic substance profile of aqueous extracts prepared using branch, leaf, flower parts and above-ground parts of Thermopsis turcica were determined in the study. The analyses indicate that the total phenolic substance contents and total antioxidant status are higher in the mix, flower, and leaf extracts. The extracts reduced cell viability in HGF cells more than in A549 cells. It shows that the extract has low anticarcinogenic activity in A549 cells. Flower extract had the highest wound closure rate. Quinic acid, cyranoside and luteolin were found in high concentrations in all extracts with LC/ESI-MS/LC analysis. It has been determined that the flower extract of the species is the most critical part showing antioxidant, antimicrobial, cytotoxic and wound healing properties. While the leaf and mix extracts stand out with their antioxidative and antimicrobial properties, the branch extract is effective in wound healing.

Evaluating the detection rate and pathological features of polyps in patients with upper gastrointestinal endoscopy

BACKGROUND

The incidence of gastric polyps (GPs) has ranged from 0.30% to 6.8% in various studies. Most GPs include hyperplastic polyps (HPs), fundic gland polyps (FGPs), and adenomatous polyps (APs). Although APs have a high malignant potential, HPs have a low risk of potential harm, whereas sporadic FGPs have no malignant potential. It is not enough to determine the type and displacement of a polyp by biopsy alone; therefore, some polyps may require an extensive biopsy or complete resection.

AIM

To evaluate the detection rate and pathological features of polyps in patients undergoing upper gastrointestinal endoscopy.

METHODS

This retrospective study included patients with GPs or polyphenic lesions with polyps or malignant histology found in polyps or by gastroscopy at the Department of Gastroenterology at the Shaanxi Provincial Hospital of Traditional Chinese Medicine from 2019 to 2023.

RESULTS

In a series of 10000 patients who underwent upper gastrointestinal endoscopy, 384 (3.84%) had GPs. There were 98 males (25.5%) and 286 females (74.5%). The mean age of patients was 62.8 ± 10.4 (36-75) years. The frequencies of HPs, APs, and FGPs were 88.5%, 5.2%, and 2.1%, respectively. The polyp size of 274 patients (71.3%) was ≤ 1 cm. Polyps were found in 262 cases (68.2%). The most common sites for polyps were the lumen and body of the intestine. Endoscopic polypectomy was performed in 128 patients. Bleeding events were observed and endoscopic treatment was required after endoscopic polypectomy.

CONCLUSION

The incidence of GPs was low. HPs were the most common types of GPs. Of note, as GPs have the potential to develop into adenocarcinoma or precancerous lesions, we suggest that appropriate GP resection technology (e.g., biopsy forceps or mesenchymal resection) be applied.

EYA3 regulation of NF-κB and CCL2 suppresses cytotoxic NK cells in the premetastatic niche to promote TNBC metastasis

Triple-negative breast cancer cells must evade immune surveillance to metastasize to distant sites, yet this process is not well understood. The Eyes absent (EYA) family of proteins, which are crucial for embryonic development, become dysregulated in cancer, where they have been shown to mediate proliferation, migration, and invasion. Our study reveals an unusual mechanism by which EYA3 reduces the presence of cytotoxic natural killer (NK) cells in the premetastatic niche (PMN) to enhance metastasis, independent of its effects on the primary tumor. We find that EYA3 up-regulates nuclear factor κB signaling to enhance CCL2 expression, which, in contrast to previous findings, suppresses cytotoxic NK cell activation in vitro and their infiltration into the PMN in vivo. These findings uncover an unexpected role for CCL2 in inhibiting NK cell responses at the PMN and suggest that targeting EYA3 could be an effective strategy to reactivate antitumor immune responses to inhibit metastasis.

Liquid Biopsy in Hepatocellular Carcinoma: ctDNA as a Potential Biomarker for Diagnosis and Prognosis

PURPOSE OF REVIEW

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, with rising incidence and mortality. Early-stage HCC is often asymptomatic, and the lack of reliable early diagnostic markers leads to late-stage diagnosis with limited treatment options. Current treatment relies on tumour staging and patient status, but accurate staging requires invasive procedures that fail to capture tumour heterogeneity and progression. There is an urgent need for less invasive diagnostic strategies, such as liquid biopsy technologies, which allow for repeated sampling and real-time analysis of tumour dynamics. Liquid biopsies, including circulating tumour cells (CTCs) and circulating tumour DNA (ctDNA), offer the potential to monitor recurrence, metastasis, and treatment responses, potentially transforming HCC clinical management by enabling earlier intervention and personalised treatment strategies.

RECENT FINDINGS

Recent studies emphasise the potential of ctDNA as a non-invasive biomarker by targeting DNA methylation for early HCC detection, enabling timely intervention and personalised treatment to improve patient outcomes. Comparative analyses have shown that ctDNA mutation testing outperforms alpha-fetoprotein (AFP), with a sensitivity of 85% and a specificity of 92%, compared to 60% sensitivity and 80% specificity for AFP. Additionally, profiling the ctDNA mutation landscape of 100 HCC patients has identified recurrent mutations in genes such as TP53, CTNNB1, and AXIN1. ctDNA appears to be a promising non-invasive biomarker in the clinical management of HCC patients, with the sensitivity and specificity improving by 41.67% and 15% respectively. The ctDNA mutations, particularly those targeting DNA methylation, highlight great potential for precision medicine, critical for early diagnosis and prognosis of HCC.

Prediction of Drug-Induced Nephrotoxicity Using Chemical Information and Transcriptomics Data

Prediction of drug-induced nephrotoxicity is an important task in the drug discovery and development pipeline. Chemical information-based machine learning models are used in general for nephrotoxicity prediction as a part of computational modeling. Currently, gene expression data are being considered increasingly for prediction of different toxicities, as they can provide mechanistic understanding by which the drug causes specific organ toxicity. Here, we demonstrate the use of gene expression data for nephrotoxicity prediction using multiple machine learning methods such as LightGBM, random forest, support vector machine, and XGBoost. Apart from the models built with all the gene expression profiles for selected compounds, the sample selection technique is used to select three different subsets of gene expression profiles of sizes 6000, 9000, and 12,000 and models are generated using them also. Considering the imbalanced class distribution in gene expression data, different techniques such as optimal probability thresholds determination, data balancing, and cost-sensitive learning are considered during model generation. We have also generated chemical information-based models to compare the performance of gene expression-based models. Multiple data division techniques are applied to enhance the performance of chemical information-based models. The best chemical information-based model (CIM19) and best gene expression-based model (GEM9) (generated without any data balancing techniques) have similar AUC values of 0.89 and 0.9, respectively. To further enhance the performance of gene expression-based models, we have developed a model GEM20 with all the 6162 toxic gene expression profiles and the same number of nontoxic profiles selected using the SPXY method from 18,825 nontoxic profiles. This model provides the highest AUC score of 0.94 among all of the chemical information- and gene expression-based models. Additionally, SHAP analysis has been performed on a gene expression-based model and identified several genes such as cell division cycle 20, RPS6, DNA damage-inducible transcript 4, GAPDH, CCNF, and MRPL12, which could be associated with nephrotoxicity.

Prognostic impact of lymph node and surgical margin in patients with perihilar cholangiocarcinoma

BACKGROUND

The study aimed to assess the prognostic impact of lymph node (LN) metastasis combined with surgical margin status on the 5-year overall survival (OS) of patients after radical resection perihilar cholangiocarcinoma (PHCC).

METHODS

Clinicopathological data of patients with PHCC who underwent curative resection between June 2014 and June 2022 were analyzed retrospectively. Cox regression analyses were performed to evaluate the risk factors for OS and LN metastasis. Kaplan-Meier method with log-rank test was performed for OS curves.

RESULTS

71 patients were enrolled and the 5-year OS rate was 52.4%. Poor differentiation grade, R1/2 resection, and the presence of LN metastasis were the independent prognostic factors of poor OS. In patients without LN metastasis, the 5-year OS rate was significantly higher in patients with negative surgical margin than patients with positive surgical margin. In LN metastasis positive patients, a comparable 5-year OS rate was found between patients with and without positive surgical margin (P = 0.185).

CONCLUSIONS

In patients with curatively resected for PHCC, R1 resection margin does not influence OS in patients with LN metastasis even when radical resection was achieved. Consequently, the risk of highly invasive procedures aimed at achieving R0 margins should be judiciously weighed against potential morbidity risk in patients with LN metastasis, as aggressive surgical strategies may not translate to survival benefits.

Real-world treatment and outcomes for EGFR WT advanced/metastatic non-squamous non-small cell lung cancer: pooled analysis from project LUMINATE-101

BACKGROUND

Lung cancer is the leading cause of cancer-related deaths in North America. Non-small cell lung cancer (NSCLC) is the most common type; most cases are advanced/metastatic at diagnosis. Available first and second lines of treatment include platinum-based chemotherapeutics, therapies targeting driver oncogene mutations, and immune checkpoint inhibitors, with limited options at later lines. Understanding the current treatment landscape to define unmet needs will benefit research and development of novel therapies for advanced/metastatic NSCLC.

METHODS

The LUMINATE-101 retrospective cohort study evaluated real-world treatment patterns and outcomes for patients with non-squamous epidermal growth factor receptor (EGFR) wild type (WT) advanced/metastatic NSCLC diagnosed 1 January 2017 to 31 August 2022 that progressed on previous therapies. Patient data were pooled from US-based electronic health records-derived databases: Flatiron Health NSCLC real-world, ConcertAI Patient360 Lung Cancer, and ConcertAI RWD360NLP; redundant records were removed using tokenization.

RESULTS

Overall, 620 patients were included; median age 67 years, >34% ECOG performance status ≥2, 19% had brain metastasis, 10% had liver metastasis, and 91% were current/ex-smokers. Most patients (54%) received a first-line platinum-based regimen ± immunotherapy and second-line docetaxel + ramucirumab/bevacizumab. Real-world outcomes included median overall survival (OS) = 6.4 months, median time to next treatment/death = 5.0 months, median time to treatment discontinuation = 2.3 months, and median progression-free survival = 3.5 months. ECOG performance status ≥2 correlated with poorer real-world outcomes overall; males had poorer survival and greater progression risk.

CONCLUSION

Real-world median OS of second-line patients on the current standard of care was < 7 months, highlighting an unmet need for more effective therapeutics in non-squamous EGFR WT advanced/metastatic NSCLC.

[Prehabilitation and enhanced recovery after surgery protocols for head and neck cancer : Value and application of these concepts]

Prehabilitation is gaining traction in complex oncological interventions and treatments. This CME article is focused on the basic principles of prehabilitation. We discuss the objective evaluation of physical fitness and how to improve it by physio- and speech therapy. Thereafter, we explain how to judge nutritional status, especially in oncological patients, and discuss modes of nutritional supplementation. Finally, the enhanced recovery after surgery concept is briefly explained and its current value in head and neck cancer patients discussed.

A Meta-Analysis: Anti-Inflammatory Medicinal Plants for Age-Related Menopause-Like Symptoms and Psychological Problems in Breast Cancer and Healthy Perimenopausal Women

BACKGROUND

Medicinal plant supplements (MPS) have benefits in improving menopause-like symptoms (MLS).

OBJECTIVES

To investigate the effectiveness of MPS in reducing MLS in healthy women and those with breast cancer (BC).

SEARCH STRATEGY

PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang database and Chinese Scientific Journals Database were searched from the date of library construction until 30 January 2024.

SELECTION CRITERIA

Randomised controlled trials were selected that involved healthy perimenopausal women, BC patients treated with herbal medicines, and the effects of plant-based compounds on MLS.

DATA COLLECTION AND ANALYSIS

The review included 12 studies with 917 patients with BC and 15 studies with 2104 healthy perimenopausal women. The data were analysed using the Meta-mar tool.

MAIN RESULTS

MPS improved Kupperman's Index (KMI) and menopause rating scale (MRS) scores compared with the comparator. Patients with BC experienced a greater reduction in KMI and MRS because of treatment than healthy perimenopausal women. Patients with BC had a more significant reduction in KMI than women who received hormone therapy. In both healthy perimenopausal women and women with BC, MPS treatment resulted in significantly higher response rates and fewer psychological problems. Women with BC experienced a decrease in anxiety and insomnia by MPS. Network analysis showed that the response rate was the factor most associated with MPS use.

CONCLUSIONS

Anti-inflammatory MPS may assist women with BC or healthy perimenopausal women experience less MLS.

Current Concepts in Histiocytic Neoplasms

Histiocytic neoplasms are a diverse group of disorders arising from macrophages, dendritic cells, and monocytes of the mononuclear phagocyte system. These neoplasms encompass a clinical spectrum from indolent, self-limited, and localized conditions to highly aggressive malignancies. Since the publication of the Revised Fourth Edition of the World Health Organization (WHO) classification, advances in molecular diagnostics have improved our understanding of the pathogenesis and classification of these disorders. In contrast to the Revised Fourth Edition, the International Consensus Classification (ICC) now recognizes Rosai-Dorfman-Destombes disease as a neoplastic disorder and introduces ALK-positive histiocytosis as a distinct entity. This manuscript reviews the current concepts regarding histiocytic neoplasms, focusing on the diagnostic criteria recommended by the ICC based on histopathology, immunophenotype, molecular alterations, as well as clinical and imaging characteristics.

The role and significance of the oncobiota in selected cancers: a review

This review provides an overview of research evidence focused on the microbial components essential to clinical cancer care, called the oncobiota (the interaction of human microbiota and cancer cells). It specifically examines the oncobiota in central nervous system cancer,breast cancer, pancreatic cancer, liver cancer, lung cancer, and cervical cancer. The literature review reveals insufficient knowledge about the oncobiota of organs once considered sterile. Many studies on oncobiota focus on small, geographically specific patient groups, and the absence of a reference (control) group complicates the development of microbial profiles for selected cancers. Consequently, this review aims to analyze the literature data and reports on the role of oncobiota in selected "sterile" organs and the resulting therapeutic or preventive implications. All relevant publications on oncobiota in patients with the selected cancers were considered to provide the most thorough analysis possible. Understanding the significance and role of oncobiota in the pathomechanisms of carcinogenesis may pave the way for targeted cancer prevention methods. Furthermore, therapeutic strategies based on oncobiota could represent a novel area of ​​personalized cancer treatment. Additionally, oncobiota may serve as an additional diagnostic tool in oncology.

A Cytotoxic T Lymphocyte-Inspiring Microscale System for Cancer Immunotherapy

Adoptive T cell therapy (ACT) is an emerging cancer immunotherapy undergoing clinical evaluation, showing significant promise in the treatment of solid tumors. However, the clinical translation of ACT is hindered by its time-, labor-, and financial-consuming procedures, heterogeneity of cytotoxic T lymphocytes (CTLs), and immunosuppressive tumor microenvironment. Herein, we have developed a bionic cytotoxic T lymphocyte-inspiring microscale system (CTLiMS) composed of mesoporous silica dioxide microspheres containing membrane-disrupting boron clusters (BICs) and proapoptotic monomethyl auristatin E (MMAE) peptides. The BICs were found to disrupt the integrity of cancer cell membranes and enhance the internalization of MMAE, effectively mimicking the biological functions of perforin and granzymes released by CTLs to destroy cancer cells. As expected, the CTLiMSs demonstrated exceptional in vitro anticancer activity, inducing cancer cell apoptosis and exhibiting strong antiproliferative effects. Notably, CTLiMS treatment was demonstrated to induce immunogenic cell death of cancer cells as a result of Ca2+ and MMAE influx and subsequent production of reactive oxygen species. The animal studies demonstrated that the CTLiMS treatment led to efficient repression of the tumor growth. Furthermore, the CTLiMS administration resulted in favorable antitumor immunotherapeutic effects, as shown by significant inhibition of distant tumors, increased immune cell infiltration, and elevated plasma levels of pro-inflammatory cytokines. This pilot study using CTLiMSs for cancer immunotherapy offers an innovative bionic strategy for the future advancement of adoptive T cell therapy.

NEDD4 signaling: a new frontier in the diagnosis and treatment of breast and ovarian cancers

Currently, breast cancer (BC) and ovarian cancer (OC) are the most prevalent forms of cancer among women worldwide. Even though BC has a favorable outlook when detected early and managed appropriately compared to OC, the spread of BC and OC to other parts of the body, known as metastasis, is a significant cause of death. A robust association exists between genetic and protein alterations and post-translational modifications (PTMs), significantly impacting tumor formation, advancement, and prognosis. Ubiquitination, a crucial PTM, regulates almost all aspects of cellular function, and E3-ligase-mediated ubiquitination is a pivotal process that controls the speed of the protein ubiquitination cascade. NEDD4-1, a neural developmentally downregulated protein 4-1, is a crucial E3 ligase that plays a significant role in regulating several proteins that have important functions in the development and progression of BC and OC, thus controlling BC and OC cells' movement, infiltration, and multiplication. This review discusses the latest developments in comprehending NEDD4-1 substrates and their involvement in signal transduction pathways in BC and OC. NEDD4-1 likely serves as a novel diagnostic indicator and a target for therapy in the battle against both cancers.

Efficient Assembly of Cytochrome-Based Protoporphyrin IX Composite and Its Characterization as a Photosensitizer

Apo-rC552 C14A/M69F, a heme-deficient mutant of cytochrome c552 from Thermus thermophilus HB8, forms a thermally stable composite with protoporphyrin IX (PPIX). However, the apoprotein yield was compromised because of contamination of the purified protein with the holo-protein bearing a covalently attached heme moiety, impeding efficient composite preparation and subsequent studies on the composite. A newly prepared rC552 mutant involving quadruple mutations, C11A, C14A, H15F, and M69F (rC552-qm), addressed this problem while preserving the inherent thermal stability of a thermophilic bacterial protein. The results obtained for the R125A mutant of rC552-qm corroborated the hypothesis that PPIX occupies the cavity of rC552-qm with an orientation similar to that of heme c in the wild-type protein. The PPIX composite with rC552-qm (PPIX@rC552-qm) exhibited superior singlet oxygen (1O2) production activity compared to the PPIX composite with human serum albumin (PPIX@HSA). Stern-Volmer quenching analysis suggested that the enhanced 1O2 production of PPIX@rC552-qm stems from the facilitated access of O2 to photoexcited PPIX within PPIX@rC552-qm relative to PPIX@HSA. Photoexcitation of PPIX@rC552-qm induced the self-oxidation of PPIX in an aqueous medium, yielding a composite containing a particular chlorin derivative (photo-PPIX) as the degradation intermediate. The photo-PPIX@rC552-qm composite was stable in the solution and showed 1O2 production activity upon exposure to red light because of the characteristic of an absorption band of the chlorin ring. This study proposes the rC552-qm mutant as a platform for readily creating a stable cytochrome-based photosensitizer responsive to visible and red light in combination with readily available PPIX.

Self-administered versus lymphedema therapist-administered complex decongestive therapy protocol in breast cancer-related lymphedema: a non-inferiority randomized controlled trial with three-month follow-up

PURPOSE

The aim of this study was to demonstrate that a self-administered complex decongestive therapy (CDT) protocol is not inferior to certified lymphedema therapist (CLT)-administered CDT in the management of lymphedema and health-related outcomes in patients with breast cancer-related lymphedema (BCRL).

METHODS

Fifty patients with BCRL were randomly assigned to two experimental groups: (1) a CLT-administered CDT group (n = 25) or a self-administered CDT group (n = 25). CDT was a multimodal approach in two experimental conditions consisting of patient education, manual lymph drainage, multi-layer bandaging, therapeutic exercises and skin/nail care. Lymphedema severity was assessed using circumference measurement, and BCRL-related symptoms were assessed using a numerical rating scale. The following measurement methods were used to assess health-related outcomes: universal goniometer for range of motion (ROMs), hand grip dynamometer for peripheral muscle strength, disabilities of the arm, shoulder and hand (DASH) questionnaire for disability level, International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity level, the checklist for individual strength (CIS) for fatigue and upper limb lymphedema quality of life questionnaire (ULL-27) for quality of life.

RESULTS

Following CDT, there was a significant decrease in lymphedema severity and lymphedema-related symptoms in both groups (p < 0.001). There was no significant difference between the groups regarding the mean difference in health-related outcomes following CDT (post-treatment-baseline) (p < 0.05). Lymphedema severity and symptoms remained stable during the 3-month follow-up periods in the CLT-administered CDT group (p > 0.05). There was a decrease in the severity of lymphedema, stiffness, heaviness and fatigue in the self-administered CDT group at 3-month follow-up (p < 0.05), while pain and tingling remained unchanged (p > 0.05).

CONCLUSION

The present findings demonstrated self-administered CDT protocol is not inferior to CLT-administered CDT in the management of lymphedema and reduction of lymphedema-related disabilities.

The dual effect of interferon-γ in acute myeloid leukemia: A narrative review

Acute myeloid leukemia (AML) is a hematological malignancy representing a very rapid, uncontrolled growth of myeloid precursors in the BM and peripheral circulation. Studies on AML have highlighted the crucial role of IFN-γ therapy in immune surveillance, both promotive and inhibitory effects on leukemic cells, and regulation of the tumor microenvironment. However, there is a need for a comprehensive understanding of the dual effects of IFN-γ in AML. Thus, this review aimed to assess the dual effects of IFN-γ in AML. Literature searches were conducted in Pub Med, Google Scholar, and direct Google Search. The data was presented in tables and figures, with findings summarized through a narrative synthesis. Depending on the circumstances and stage of the disease IFN-γ shows two different activities in AML patients. First, IFN-γ enhances NK cells and CD8+T lymphocyte functions, which collectively evoke antileukemic immunity. Another promising effect of IFN-γ includes the differentiation of myeloid cells, thereby possibly reducing the severity of leukemia. However, prolonged exposure to IFN-γ can activate Treg cells and inhibitory immunological checkpoints, which can help leukemia evade immune surveillance and encounter an immunosuppressive environment. Our review highlights IFN-γ's critical role in the complex interplay between the immune system and AML pathogenesis. Its dual role in both inhibiting and promoting leukemic processes has been highlighted. However, future pre-clinical and clinical studies should focus on the specific mechanisms by which IFN-γ impacts AML progression and treatment outcomes, with the goal of achieving curative results for patients.