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This study aimed to identify subgroups of health-related quality of life (HRQoL) and examine predictors of latent class membership among low- and high-income cancer survivors using latent class analysis (LCA). We analyzed data from the Korea National Health and Nutrition Examination Survey (2013-2020), including 1075 cancer survivors. HRQoL patterns were identified using LCA based on the EuroQol five-dimension questionnaire. Analyses were conducted separately for low- and high-income groups to examine income-stratified HRQoL patterns. Sociodemographic characteristics and chronic disease status were included as covariates in the latent class models to examine predictors of class membership within each income group. Income-stratified LCAs suggested differential HRQoL patterns. Three latent HRQoL classes were identified in the low-income group: Good HRQoL, Pain and Mobility Impairment, and Poor HRQoL. In the high-income group, two classes were identified: Good HRQoL and Pain and Mobility Impairment. While education was a common predictor in both groups, other predictors varied by income level. In the low-income group, older age, unemployment, and multimorbidity were significantly associated with impaired HRQoL classes, whereas female sex predicted membership in the Pain and Mobility Impairment class in the high-income group. These findings highlight differences in HRQoL patterns and associated factors across income-stratified groups of cancer survivors, underscoring the limitations of relying solely on average HRQoL scores in survivorship care. Survivorship strategies should be tailored to the differential HRQoL patterns and associated predictors identified within each income group, thereby promoting more targeted and equitable care for cancer survivors. Health-related quality of life (HRQoL) is a key measure for understanding cancer survivors’ well-being after cancer. However, most studies use a single total score of HRQoL, which can mask important differences across physical, psychological, and social aspects. Considering its multidimensional nature, examining patterns across HRQoL domains can provide a more comprehensive understanding of survivors’ well-being. Moreover, since socioeconomic status—especially income—strongly influences HRQoL, it is important to explore how these patterns differ by income level. Therefore, this study examined HRQoL patterns among low- and high-income Korean cancer survivors and identified factors related to each pattern. Three patterns were found among low-income survivors—Good HRQoL, Pain and Mobility Impairment, and Poor HRQoL—and two among high-income survivors—Good HRQoL and Pain and Mobility Impairment. Education was associated with better HRQoL patterns in both groups, but other predictors differed. Among low-income survivors, older age, unemployment, and multiple chronic diseases were linked to poorer HRQoL patterns. Among high-income survivors, women were more likely to belong to the Pain and Mobility pattern. These findings highlight the need for survivorship strategies that address heterogeneity across income-stratified groups, promoting equitable and comprehensive care for cancer survivors, even when overall HRQoL scores appear satisfactory.

Gallbladder cancer is one of the most aggressive malignancies in the biliary system, and there is currently no internationally recognized standardized treatment protocol. Reports on the management of rare pathological types of gallbladder cancer are particularly limited. We present 2 cases of gallbladder cancer with rare pathological subtypes and their diagnostic and therapeutic processes, aiming to further enhance clinicians' understanding of these uncommon entities. This report describes 2 cases of gallbladder cancer, both presenting with abdominal discomfort, raising concerns about the nature of the lesion and effective treatment strategies. Postoperative pathology confirmed one case as gallbladder sarcomatoid carcinoma and the other as gallbladder carcinosarcoma, both of which are clinically rare types. Both patients underwent laparoscopic cholecystectomy at our institution, with subsequent pathological and immunohistochemical examination. As of the end of follow-up (November 30, 2025), both patients recovered well postoperatively. Rare types of gallbladder cancer lack specific clinical manifestations, making early screening difficult. Most patients are diagnosed at an advanced stage. Surgical intervention should be performed as early as possible upon discovery.

The use of nanoparticles in cancer research has garnered significant interest due to their exceptional physicochemical properties. Among these, carbon nanotubes have shown potential in biomedical applications; however, their hydrophobic nature limits dispersion in aqueous environments. Therefore, surface functionalization is important to improve the dispersibility and biocompatibility of Multiwalled Carbon Nanotubes (MWCNTs). This study aimed to non-covalently functionalize MWCNTs with chitosan, characterize the resulting nanocomposites, and evaluate the in vitro cytotoxicity of oxidized MWCNTs, curcumin-loaded MWCNTs, and chitosan-functionalized MWCNTs with or without curcumin against lung, pancreatic, and colorectal cancer cell lines. The prepared samples were characterized for crystallinity, particle size, and surface charge using X-ray Diffraction (XRD) and Dynamic Light Scattering (DLS). The resulting curcumin-chitosan-MWCNT formulation demonstrated an entrapment efficiency of 99.1%, a particle size of 850 nm, and a surface area of 52.73 m²/g. The IC₅₀ of curcumin-chitosan-MWCNT was 67 μg/mL for PANC-1 cells, compared to 227.6 μg/mL for fibroblasts, 71.4 μg/mL for HCT116, and 148.6 μg/mL for A549 cells. In conclusion, the combination of curcumin, chitosan, and MWCNT significantly reduced cancer cell viability and demonstrated selective in vitro cytotoxicity, particularly against PANC-1 cells. These findings suggest that the developed formulation may warrant further investigation as a potential nanocomposite platform for anticancer applications.

In low- and middle-income countries (LMIC), Do-Not-Resuscitate (DNR) discussions are often delayed or omitted, adversely affecting the quality of end-of-life care. Despite the growing recognition of palliative care, limited evidence exists on the timing and determinants of DNR decisions in these settings. To assess the prevalence, temporal trends and predictors of DNR orders among advanced cancer patients receiving palliative care at a tertiary center in Jordan. We conducted a retrospective review of all deceased advanced cancer patients who received palliative care at the King Hussein Cancer Center between 2013 and 2022. Demographic, clinical, and code status data at referral and at death were extracted from medical records. Descriptive statistics, chi-square tests, and t-tests were used to identify patterns and associations. Among 5,264 patients were analyzed, 48.9% female, 79.9% married, and 94.6% Jordanian. The most common cancer types were gastrointestinal (26.5%), breast (16.6%), and genitourinary (14.9%). At referral, 26.4% had a DNR order, increasing to 81% at death. Cancer type was significantly associated with DNR status at death (p < .001), with breast and gastrointestinal cancers more likely to have DNR orders. The proportion of DNR orders at death demonstrated an overall upward trend across the study period. There was a substantial shift from CPR to DNR orders between referral and death primarily influenced by clinical rather than demographic factors. These findings underscore the importance of early advance care planning and targeted training in culturally sensitive end-of-life communication to promote patient-centered decision making.

Cancer remains one of the leading causes of death worldwide, and the limitations of conventional therapies such as surgery, chemotherapy, and radiotherapy underscore the urgent need for innovative therapeutic strategies. While advances in early detection and treatment have improved outcomes in some regions, challenges such as micrometastasis, tumor relapse, and multidrug resistance continue to hinder long-term success. The multifactorial nature of cancer-driven by complex genetic mutations, diverse tumor microenvironments, and adaptive cancer cell behavior- demands more precise and effective solutions. Recent breakthroughs in molecular biology and genetic engineering have led to the emergence of genome editing technologies that offer promising avenues for targeted cancer therapy. This review highlights the evolution and application of key genome editing platforms, including meganucleases, zinc finger nucleases (ZFNs), transcription activator- like effector nucleases (TALENs), and the CRISPR/CAS9 system. Meganucleases were among the earliest tools with site-specific cutting ability, but limited versatility. ZFNs and TALENs offered greater modularity and target specificity through protein-DNA interactions. The CRISPR/CAS9 system revolutionized genome editing with its RNA-guided targeting, allowing for higher efficiency, simplicity, and flexibility in gene modification. These tools have enabled researchers to disrupt oncogenes, repair tumor suppressor genes, and manipulate signalling pathways involved in tumor progression, resistance, and metastasis. Moreover, ongoing advancements in delivery systems and gene repair mechanisms have further enhanced their therapeutic potential. We also discuss their translational potential from bench to bedside and explore future perspectives on how these technologies may revolutionize precision oncology, ultimately contributing to more effective treatment outcomes.

Chronic obstructive pulmonary disease (COPD) remains substantially underdiagnosed, particularly in individuals with mild or early-stage disease. Individuals undergoing lung cancer screening represent a high-risk population due to significant smoking exposure; however, the burden of previously undiagnosed COPD in this real-world clinical setting remains insufficiently characterized. This retrospective observational study included individuals who underwent national lung cancer screening using low-dose computed tomography (LDCT) at a tertiary referral center between September 2019 and December 2022. The study population consisted of individuals referred for pulmonologist consultation after screening, reflecting real-world clinical practice. Participants without a prior diagnosis of COPD who underwent pulmonary function testing were included. Clinical characteristics, pulmonary function parameters, and CT findings were analyzed. Multivariable logistic regression analysis was performed to identify factors associated with previously undiagnosed COPD. Among 279 individuals who underwent pulmonologist consultation, 170 had available spirometry and were included in the analysis. Of these, 63 individuals (37.1%) met spirometric criteria for COPD despite having no prior diagnosis. Participants with previously undiagnosed COPD were more likely to report dyspnea and demonstrated greater physiologic impairment and structural lung abnormalities, including a trend toward lower diffusion capacity and CT-defined emphysema. In multivariable analysis, dyspnea, reduced DLCO, and CT-defined emphysema were independently associated with COPD. A substantial proportion of individuals undergoing lung cancer screening were found to have previously undiagnosed COPD. These findings highlight a gap in real-world screening workflows and support the potential value of integrating spirometry or respiratory assessment into lung cancer screening programs to facilitate early detection and timely management of COPD in high-risk populations.

Accurate lymph node assessment is crucial in early-stage endometrial cancer staging, but traditional lymphadenectomy carries significant morbidity risks. This study evaluates whether indocyanine green (ICG)-based sentinel lymph node (SLN) mapping combined with bread-loaf slicing ultrastaging optimizes lymph node metastasis detection in uterine-confined endometrial cancer. We retrospectively analyzed patients with early-stage endometrial cancer who underwent surgery with SLN mapping at Kaohsiung Chang Gung Memorial Hospital from November 2021 to December 2024. SLN mapping was performed using either ICG fluorescence imaging or patent blue dye during minimally invasive and open surgical approaches. All retrieved lymph nodes underwent ultrastaging examination using the bread-loaf slicing method. Among 131 patients, the overall SLN mapping success rate was 93.9%, and the overall detection rate was 95.9%. In exploratory subgroup analyses, bilateral mapping success was higher in the ICG group than in the patent blue group (79.2% vs. 27.3%, p&#x2009;<&#x2009;0.001). Bilateral mapping success was also higher in minimally invasive surgery than in open surgery in the overall cohort (79.1% vs. 43.8%, p&#x2009;=&#x2009;0.002). Bread-loaf slicing ultrastaging identified lymph node metastases in 4.0% of patients. No recurrence were observed among patients with pathological stage I diseases during follow-up. The combination of intraoperative ICG-based SLN mapping with bread-loaf slicing ultrastaging demonstrated high mapping success rate and detection rate, and supports a feasible, standardized surgical-pathologic workflow for lymph node assessment in uterine-confined endometrial cancer.

This systematic review synthesizes existing literature to identify the current status and key influencing factors related to death anxiety in family caregivers of cancer patients. A comprehensive search was conducted across seven databases-PubMed, Embase, PsycINFO, Scopus, Web of Science, MEDLINE, and CNKI on July 26th, 2025, with no time restrictions applied. The quality of all included studies was assessed using the Joanna Briggs Institute critical appraisal tools for cross-sectional studies. Eighteen studies were included in the systematic review. Based on our analysis, death anxiety among family caregivers of cancer patients may be influenced by the following six categories of factors: (a) personal factors, (b) disease and caregiving-related factors, (c) psychosocial factors, (d) self-regulatory factors, (e) other factors, and (f) actor and partner effects. Several specific protective and risk factors related to death anxiety were also identified. This review categorizes influencing factors, including protective factors, risk factors, and several contested personal variables, associated with death anxiety. There is a need for longitudinal research to further elucidate the dynamic nature of death anxiety over time. Future studies should adopt a dyadic perspective encompassing both cancer patients and their family caregivers to provide comprehensive insights for healthcare professionals and facilitate the development of effective interventions targeting death anxiety.

Iron oxide nanoparticles (IONPs) have proven to be of therapeutic potential against cancer. The feature of the surface coating can affect important properties of IONPs; it is therefore critical for further understanding how these materials react to physiological conditions, which is still needed to fully exploit the potential of IONPs for their theranostic applications. In this study, we explored the therapeutic potential of rutin and nisin conjugated IONPs as anticancer agents. One important hallmark of many cancers is the overexpression of the endoplasmic reticulum-resident chaperone, GRP78, and its translocation to many cellular compartments, including the cell membrane. We explored the potential binding affinity of rutin and nisin against the substrate-binding domain &#x3b2; (SBD&#x3b2;) of GRP78. The results show promising results for both nisin and rutin, with more enhanced binding capability of the former due to its extended structure (peptide in nature), forming more non-bonded interactions with the GRP78 surface. Our findings pave the way for the use of these coating agents against the cell-exposed chaperone, GRP78, to alleviate its chemoresistance characteristics in cancer.

Ovarian cancer (OC) is among the most lethal gynecological malignancies and a leading cause of cancer-related deaths in women. Significant attention has been given to the experiences of OC patients; however, the experiences of their family caregivers have been largely overlooked. The objectives of this scoping review is to characterize the scope, nature and focus of the existing literature describing the experiences of caregivers' of individuals with OC during the caregiving process and after the care recipient's death, and to identify gaps in the literature. This scoping review was guided by Arksey and O'Malley's (2005) framework. Comprehensive searches were conducted in MEDLINE, EMBASE, CINAHL, PsycINFO, and Social Work Abstracts to identify literature on caregivers of individuals living with OC. A total of 739 titles and abstracts were screened by two reviewers, 123 full-text articles were assessed, and 32 met inclusion criteria for data extraction. Themes were extracted after the reviewers carefully read through the selected articles. Main themes included (1) the well-being and mental health of caregivers, with two sub-themes (a) emotional well-being and mental health,&#xa0;(b) grief, bereavement and post-traumatic stress disorder; (2) challenges facing caregivers, with seven sub-themes (a) escalating patients needs and patient experiences, (b) interactions with doctors and medical system, (c) social isolation, (d) family responsibilities, (e) work stressors and financial burdens, (f) health behaviours and inadequate self-care, and (g) intrapersonal stressors; and (3) positive coping strategies with sub-themes (a) spirituality and (b) social support. This scoping review highlights an urgent need for tailored support for OC caregivers and may provide valuable insights for clinical practice in the field of caregiver wellbeing. Future research and greater awareness of the lived experience of OC caregivers may inform policymakers to develop policy initiatives promoting more family-centered care.

Accurate classification of endometrial pathology is clinically challenging due to the heterogeneous and focal nature of precancerous and malignant lesions. Vascular remodeling is closely linked to tumor progression and may serve as a biomarker for malignancy. We aim to characterize a label-free optical-resolution photoacoustic microscopy (OR-PAM) approach for high-resolution imaging and quantitative characterization and separability assessment of endometrial vasculature. A custom-built OR-PAM system was used to image 34 fresh uterus samples with histologically confirmed diagnoses: normal, benign, endometrial intraepithelial neoplasia (EIN), and endometrial cancer (EC). Thirty-one quantitative vascular features were extracted from structural and spectral analyses of the photoacoustic data, and five statistically significant and minimally correlated features were selected for the separability assessment framework. A pairwise cosine similarity matrix based on these features was computed to construct a weighted similarity network, which was embedded into a two-dimensional (2D) space with a force-directed layout. A logistic regression boundary was applied to the 2D embedding to evaluate separability between normal/benign and EC/EIN clusters. A logistic regression classifier was developed from a cosine similarity matrix and cross-validated using a leave-one-out strategy. The cosine-similarity network graph placed 39 of 40 images on the expected side of the separation boundary. The logistic regression classifier yielded an area under the ROC curve (AUC) of 0.943, demonstrating strong discrimination between normal/benign and EC/EIN groups. OR-PAM combined with imaging feature analysis enables robust differentiation of endometrial pathologies and demonstrates potential as a noninvasive optical biopsy tool for endometrial assessment.

The purpose of this study was to retrospectively compare the prognostic outcomes of patients with colorectal cancer (CRC) who achieved a clinical complete response (CCR) after neoadjuvant immunotherapy (NI) and those who achieved a CCR after surgery. A literature review of publications was conducted in the PubMed database. This study included 70 patients who were diagnosed with mismatch repair deficiency/microsatellite instability high (dMMR/MSI-H) colorectal cancer and who were treated with NI between 2018 and 2024. CCR patients were grouped into the "watch and wait" (W&W) method group or the radical surgery group. Afterwards, the oncological and clinical outcomes of patients who achieved a clinical complete response (CCR) were compared to those of patients who were classified as tumour free. We also conducted a literature review of publications in the PubMed database of clinical studies that compared clinical outcomes between W&W and surgery for CCR dMMR/MSI-H patients. Among the 70 NI-treated dMMR/MSI-H CRC patients, 44 (62.86%) achieved a CCR. Of these, 25 patients were managed with a watch-and-wait (W&W) strategy, while 19 underwent curative-intent surgery. In the surgery group, 16 patients (84.21%) achieved a pathological complete response (pCR). During follow-up, 2 patients (10.53%) in the surgery group developed recurrence, and both subsequently died, while the remaining 17 patients were alive at the last follow-up. No statistically significant differences were observed between the W&W and surgery groups in terms of recurrence or survival outcomes. A literature review including nine studies further demonstrated comparable oncological outcomes between W&W and surgical management in patients who achieved a CCR. Patients in the W&W group presented similar oncological outcomes to those who underwent surgery. Surgery may not be necessary for patients with dMMR/MSI-H colorectal cancer who achieve a clinical complete response after neoadjuvant immunotherapy. However, large sample sizes and multicentre investigations are needed to validate these findings.

Surgical resection, the primary treatment for locally recurrent rectal cancer (LRRC), is technically challenging. Transanal/transperineal minimally invasive surgery (Ta/Tp MIS) improves visualization and access through undisturbed planes. This study compared the short- and mid-term outcomes of Ta/Tp MIS with those of conventional non-Ta/Tp MIS for LRRC. This retrospective observational study involved 98 patients who underwent curative-intent surgery for LRRC at a single tertiary cancer center between April 2008 and March 2022. Patients were classified into Ta/Tp MIS (n&#x2009;=&#x2009;34) and non-Ta/Tp MIS (n&#x2009;=&#x2009;64) groups. Perioperative and mid-term oncologic outcomes were compared, including operative time, blood loss, intraoperative transfusion, postoperative complications, pathological R0 resection, recurrence-free survival, local recurrence, and overall survival. Ta/Tp MIS was associated with reductions in resection time (median, 225 versus 252&#xa0;min; p&#x2009;=&#x2009;0.0176), blood loss (median, 420.5 versus 1068&#xa0;mL; p&#x2009;<&#x2009;0.0001), and intraoperative transfusions (17.7% versus 48.4%, p&#x2009;=&#x2009;0.0041), and tended toward a shorter operative time (median, 366.5 versus 418.5&#xa0;min; p&#x2009;=&#x2009;0.1170). R0 resection (91.2% versus 89.1%), postoperative complications (overall Clavien-Dindo complication grade: 76.5% versus 75.0%, p&#x2009;=&#x2009;1; grade&#x2009;&#x2265;&#x2009;3: 41.2% versus 37.5%, p&#x2009;=&#x2009;0.8282), 3-year recurrence-free survival (46.3% versus 44.2%, p&#x2009;=&#x2009;0.9079), local recurrence (24.8% versus 37.7%, p&#x2009;=&#x2009;0.3130), and 3-year overall survival (89.7% versus 77.7%, p&#x2009;=&#x2009;0.2271) were comparable between groups. Ta/Tp MIS appears to be a feasible surgical approach for selected patients with LRRC, and in this retrospective analysis, was associated with shorter resection time and reduced blood loss. No clear differences were observed in postoperative complications or short- to mid-term oncologic outcomes compared with conventional approaches.

Diagnostic integration technology represents a significant advancement in cancer diagnosis and treatment. The combination of fluorescence probe-based imaging methods with photodynamic therapy (PDT) offers distinct advantages due to its high sensitivity and minimally invasive nature. However, the effective detection depth and spatial resolution of fluorescence imaging are limited by light scattering effects in biological tissues. Additionally, high concentrations of GSH in the tumor microenvironment (TME) neutralize reactive oxygen species (ROS) generated by PDT, directly inhibiting therapeutic efficacy. Therefore, developing a highly sensitive, high-resolution fluorescent probe to achieve integrated tumor diagnosis and treatment is of great significance. This study developed an activatable diagnostic-therapeutic probe, MB-2O-MB. In MB-2O-MB, methylene blue (MB) served as both the photosensitizer and signal reporting moiety, while a thiols-sensitive disulfide bond was introduced as the linker and response unit. When the probe reacted with GSH in tumor regions, the disulfide bond broke, causing structural dissociation and releasing free MB molecules. Experiments demonstrated that the probe exhibited strong interference resistance, and high sensitivity (LOD&#x202f;=&#x202f;57.99&#x202f;nM) for this reaction. Furthermore, the photoacoustic (PA) signal generated upon probe activation compensated for the limited tissue penetration depth of fluorescence imaging, enabling more precise spatial localization of tumor regions. Therapeutically, upon irradiation with 660&#x202f;nm near-infrared (NIR) laser light, the released MB efficiently generated singlet oxygen, effectively inducing 4T1 tumor cell death. In vivo data further validated the significant tumor suppression effect of MB-2O-MB via PDT. In summary, MB-2O-MB achieves precise tumor localization and complete eradication through the synergistic combination of NIR fluorescence/PA dual-modality imaging and PDT. This strategy simultaneously overcomes the drug resistance bottleneck and imaging limitations of conventional photodynamic therapy, paving a new pathway for constructing highly selective and potent smart diagnostic and therapeutic systems, and significantly advancing precision medicine.

Colorectal cancer (CRC) is one of the most significant global health concerns, necessitating innovative therapeutic strategies for its effective management. Despite advances in treatment therapies, chemotherapy remains the mainstay of CRC treatment, with 5-Fluorouracil (5-FU) as a standard first-line agent. However, its clinical effectiveness is hindered by drug resistance, rapid clearance and systemic toxicity, underscoring the need for innovative drug delivery strategies. In this context, the current work involves engineering of a bioinspired nanocomplex (NX) comprising zein and a biological macromolecule, such as chitosan, using a Quality by Design (QbD) approach. The resulting NX was characterized for particle size (186.13&#x202f;&#xb1;&#x202f;8.61&#x202f;nm), polydispersity index (0.194&#x202f;&#xb1;&#x202f;0.03), and %entrapment of 5-FU (54.39&#x202f;&#xb1;&#x202f;3.1%) and silibinin (97.44&#x202f;&#xb1;&#x202f;1.16%), respectively. SEM and TEM analysis revealed the smooth and spherical nature of NX. Thermal analysis was performed using TGA and DSC and XRD was employed for structural characterization. Subsequently, spectroscopic investigations were carried out using FTIR, Raman and fluorescence spectroscopy to examine the potential interactions between the drugs and polymers used in the formulation of the NX system. In vitro studies confirmed controlled drug release with Weibull release kinetic model. The dual-drug-loaded-NX exhibited a significant increase in cytotoxicity compared to individual 5-FU and silibinin, and achieving nearly a 5-fold increase in cytotoxicity compared to silibinin. The NX demonstrated apoptosis induction, S/G2 cell cycle arrest, and improved cellular uptake compared to control group. The current investigation suggests that QbD-engineered zein-chitosan-based-NX could be a promising therapeutic strategy for managing CRC.

Limited understanding of the biological processes that govern metastatic dissemination hinders its prevention and treatment1. Here, using 501 longitudinally collected primary and metastatic tumour samples from 24 patients with non-small cell lung cancer (NSCLC) enrolled in the TRACERx lung study and PEACE autopsy programme, we infer tumour evolution from diagnosis to death. With DNA-sequencing data encompassing 70% of the&#xa0;metastases that were radiologically detected before death and paired multi-region sampled primary tumours, we show that the genomes of metastases diverge markedly from those of their ancestral primary tumour, with additional&#xa0;driver alterations and genome doubling&#xa0;events occurring after metastatic dissemination. In 62.5% of patients, multiple primary tumour subclones disseminated, each founding a distinct metastasis. These metastases served as sources of onward spread: more than half of the metastases sampled were seeded by other metastases. The duration that metastases existed in situ influenced their likelihood of seeding further metastases. Most metastatic migrations started and ended in the same anatomical cavity. The few subclones that exited the thorax to seed metastases disseminated widely and were enriched for somatic copy-number alterations, suggesting that chromosomal instability may&#xa0;facilitate extrathoracic spread. This spatial and temporal evolutionary analysis sheds light on the extent of metastatic diversity and seeding in advanced NSCLC-which tends to be underestimated in single metastasis biopsies-and identifies genomic and clinical mediators of metastatic progression.

In metastatic castration-resistant prostate cancer (mCRPC), clinical outcomes remain highly heterogeneous despite the widespread use of next-generation androgen receptor pathway inhibitors. Reliable imaging-based biomarkers capable of reflecting whole-body tumor burden and predicting prognosis are needed. Prostate-specific membrane antigen (PSMA) PET-derived volumetric parameters have emerged as potential prognostic tools, yet their role in patients treated with abiraterone or enzalutamide remains insufficiently defined. We retrospectively analyzed 54 patients with mCRPC treated with abiraterone or enzalutamide between 2013 and 2025. Baseline 68Ga-PSMA PET/CT scans were used to derive quantitative imaging parameters, including PSMA tumor volume (PSMA-TV), total lesion PSMA expression (PSMA-TL), and SUV-based metrics. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier analyses. Receiver operating characteristic analyses identified optimal cut-off values, and Cox proportional hazards models were used to determine independent prognostic factors. Higher baseline PSMA-TV and PSMA-TL were significantly associated with inferior OS and PFS. A PSMA-TV cut-off of &#x2265;&#x2009;44.84 demonstrated good discriminatory ability for mortality prediction (AUC&#x2009;=&#x2009;0.707, p&#x2009;=&#x2009;0.010). In multivariate analysis, PSMA-TV&#x2009;&#x2265;&#x2009;44.84 emerged as an independent predictor of mortality (HR 9.48, 95% CI 1.14-78.97; p&#x2009;=&#x2009;0.037). Early PSA kinetics provided complementary prognostic information, and a PSA level&#x2009;&#x2265;&#x2009;0.20 ng/mL at 6 months was independently associated with disease progression. PSMA PET-derived volumetric parameters, particularly PSMA tumor volume, provide robust prognostic information in mCRPC patients treated with abiraterone or enzalutamide. When combined with early PSA kinetics, these imaging biomarkers enable improved risk stratification and may support more individualized treatment strategies. Prospective multicenter studies are warranted to validate these findings.

Preventive tumor vaccines exhibit substantial potential in averting tumorigenesis; nevertheless, their clinical efficacy remains constrained by challenges in eliciting potent and long-lasting immune activation, which ultimately leads to subpar overall therapeutic performance. In this study, we designed a biofilm-based hydrogel as a highly efficient single-dose prophylactic tumor vaccine. A hybrid biofilm (TMBM), which combines bacterial membrane (BM) and tumor cell membrane (TM), was modified with methacrylated hyaluronic acid-gelatin methacrylate (HAMA-GelMA) to form a gel formulation (HG-TMBM hydrogel). This hydrogel can encapsulate ginsenoside Rg3 (Rg3) within its micropores and rapidly gelate in situ following subcutaneous injection. Upon single administration of the HG-TMBM hydrogel/Rg3 vaccine, both TMBM and Rg3 are sustainably released owing to the degradable nature of the HAMA-GelMA matrix. TMBM actively targets dendritic cells (DCs) and efficiently induces their maturation. Concurrently, Rg3 modulates the immune microenvironment and enhances antigen presentation efficiency, providing robust support for subsequent antigen cross-presentation. Ultimately, the vaccine successfully elicits potent and long-lasting T lymphocyte-mediated immune responses and exhibits significant preventive efficacy against colon tumors. The present work constructs a sustained-action system for tumor prophylaxis, offering an innovative approach for the creative development of single-administration preventive tumor vaccines.

Observational studies reached conflicting results regarding the association between gestational diabetes mellitus (GDM) and breast cancer (BC), leaving the causal nature of this relationship unresolved. To clarify this, a Mendelian randomization (MR) study was performed. In brief, genetic instruments for GDM were obtained from the FinnGen project, and data for BC were obtained from previously published consortia. The primary MR analysis methods included the inverse-variance weighted method, with MR-Egger, weighted median, and weighted mode methods serving as validation. Heterogeneity, pleiotropy, and the influence of outliers were evaluated using mandatory sensitivity analyses. Additional sensitivity analyses included Steiger directionality test, radial MR analysis, and multivariable MR analysis. Genetically predicted GDM demonstrated a significant correlation with an increased risk of overall BC (OR&#x2009;=&#x2009;1.17, 95% CI: 1.03-1.32, p = 0.01) and specifically with ER-negative BC (OR&#x2009;=&#x2009;1.18, 95% CI: 1.04-1.35, p = 0.01). No such association was observed for ER-positive BC (p = 0.49). However, the causal effect of BC on GDM risk did not emerge in the reverse MR analysis. Comprehensive sensitivity analyses supported these findings. This study provides further evidence that GDM may be a risk factor for BC, particularly the ER-negative subtype, suggesting that GDM may be incorporated into personalized risk assessment models.