搜索结果：Cancer research and treatment

BackgroundTraditional, complementary, and integrative medicine (TCIM) is an evolving field in oncology focused on managing cancer symptoms. Hydrogen water (HW) has gained attention for its antioxidant and anti-inflammatory properties, yet its clinical effectiveness needs further exploration. This randomized controlled trial aimed to assess the impact of gargling with HW on oral mucositis severity, pain levels, oral frailty, and quality of life in head and neck cancer patients undergoing radiotherapy or concurrent chemo-radiotherapy.MethodsIn this single-center, single-blind, parallel-group randomized controlled trial, patients were randomly assigned to receive either HW or distilled water (DW) for gargling. Oral mucositis (OM) severity, pain, oral frailty, and quality of life (QoL) were assessed using the World Health Organization Oral Mucositis Grading Criteria (WHO-OMGC), the Brief Pain Inventory-Taiwan (BPI-T), the Oral Frailty Checklist (OFC), and the EORTC QLQ-H&N35 questionnaire. Assessments were conducted at baseline (T0) and on Days 1 (T1), 3 (T2), 7 (T3), and 14 (T4) post-treatment.ResultsThe HW group showed significant OM improvement at Day 7 (p = 0.04) and Day 14 (p = 0.002). Pain decreased significantly in the HW group at Day 14 (p = 0.02). QoL improved in the HW group (p = 0.03), while OFC scores showed no significant difference between groups (p = 0.74).ConclusionHW gargling significantly alleviated OM severity and pain and improved QoL in head and neck cancer (HNC) patients undergoing radiotherapy or CCRT. HW gargling may serve as a simple, well-tolerated, and effective complementary and integrative therapy during cancer treatment.

Curative-intent surgical treatment for hepatocellular carcinoma (HCC) varies in complexity and resource requirements, potentially leading to regional disparities in access. We sought to assess the incidence of HCC and geographic variation in access to treatment (liver transplantation or resection) and outcomes across Ontario. We conducted a retrospective, population-based cohort study using ICES administrative data of patients who received a first HCC diagnosis in Ontario between 2004 and 2021. We stratified patients by Local Health Integration Network (LHIN) to evaluate regional differences in treatment and outcomes. Descriptive statistics summarized demographics, treatment patterns, and survival outcomes. We included 18 494 patients with a mean age of 63.4 (standard deviation 5.3) years, of whom 37.2% were female and 10.6% lived in rural areas. The age- and sex-standardized incidence rate of HCC was 16.8 per 100 000 people, with metabolic-associated steatotic liver disease as the leading cause (55.1%). Treatment varied by region, with most surgeries performed in urban areas. Survival differed significantly, with the top 3 LHINs located in central Ontario and the poorest outcomes in remote regions. Geographic differences in surgical treatment and survival observed across Ontario are likely multifactorial and may reflect differences in clinical presentation, patient demographics, and system-level factors influencing care pathways. These differences highlight opportunities to strengthen HCC care delivery and coordination across the province. Les traitements chirurgicaux à visée curative contre le carcinome hépatocellulaire (CHC) se présentent avec des degrés de complexité et des besoins en ressources divers, menant potentiellement à des disparités régionales en matière d'accès. Nous cherchons à évaluer l'incidence du CHC et les variations géographiques de l'accès aux traitements (transplantation ou résection hépatique) et leurs résultats en Ontario. MÉTHODES : Nous avons réalisé une étude de cohorte rétrospective de population fondée sur des données administratives de l'Institut de recherche en services de santé (IRSS) provenant de patients ayant obtenu un premier diagnostic de CHC entre 2004 et 2021, en Ontario. Nous avons regroupé les patients selon leur Réseau local d'intégration des services de santé (RLISS) afin d'évaluer les différences régionales au niveau des traitements et des résultats. Les statistiques descriptives récapitulent les données démographiques, les modalités thérapeutiques et les chances de survie. RÉSULTATS : Nous avons inclus 18 494 malades ayant un âge moyen de 63,4 (écarttype de 5,3) ans, dont 37,2 % étaient de sexe féminin et 10,6 % résidaient en milieu rural. Les taux d'incidence normalisés selon l'âge et le sexe du CHC étaient de 16,8 par 100 000 habitants, avec comme cause principale la stéatose hépatique associée à un dysfonctionnement métabolique (55,1 %). Les avenues thérapeutiques variaient selon les régions, avec la grande majorité des interventions chirurgicales réalisées en zones urbaines. Les taux de survie variaient grandement, les 3 meilleurs RLISS se situant dans le centre de l'Ontario et ceux présentant les moins bons résultats étant situés en régions éloignées. Les différences géographiques en matière de traitements chirurgicaux et de taux de survie observées à travers l'Ontario sont probablement multifactorielles et peuvent être le reflet de différences dans le tableau clinique et les caractéristiques démographiques des patients ainsi que d'autres facteurs systémiques influençant les trajectoires de soins. Ces différences mettent en lumière des occasions de renforcer la prestation des soins contre le CHC, de même que la coordination à l'échelle de la province.

Divergence from national guidelines and variations in practice patterns impact care and outcomes in patients with metastatic breast cancer (MBC). We sought to assess the quality of care in the diagnosis and treatment of real-world patients with MBC in Washington State. Data were retrospectively analyzed using a linked cancer registry and insurance claims platform for patients with recurrent or de novo MBC diagnosed between 2008 and 2019. We identified 1101 patients with MBC (median age: 66), 715 recurrent and 386 de novo. Most patients were White (89%), all were insured (Commercial [47%], Medicaid [4%], Medicare [35%], or multiple [13%]), and 15% lived in areas of high deprivation (Area Deprivation Index [ADI]: 8-10). Of the patients with recurrent MBC, less than half received a biopsy (49.5%) or biomarker reassessment (48.7%) to confirm the diagnosis of MBC. Patients treated at high- and medium-volume centers had higher rates of biopsy than low-volume clinics (51.9%, 54.3%, and 40.7%, respectively, p = 0.03). ET alone was more common in patients who did not undergo biopsy (62.3% vs. 37.7%, p < 0.001) or biomarker reassessment (62.7% vs. 37.3%, p < 0.001). Among the 677 patients with estrogen receptor (ER)+/HER2- MBC (de novo and recurrent), most received ET alone (69%), followed by CT (22%) and CDKi&#x2009;+&#x2009;ET (9%). Importantly, 40% of patients were treated before CDK4/6i approval. Most patients who received CDKi&#x2009;+&#x2009;ET were <&#x2009;65&#x2009;years old (65.2%, p < 0.02). Patients with commercial insurance were more likely to receive CDKi&#x2009;+&#x2009;ET compared to those with Medicare/Medicaid. (60.9% vs. 26.1%, p = 0.10). Our findings highlight key gaps in MBC management and serve as a launch point for patient-centered and quality-promoting initiatives.

We evaluated whether offering access to a multicomponent mHealth app improves quality of life (QoL) and psychosocial outcomes among breast cancer survivors under pragmatic, nonprescriptive conditions. In this single-center, randomized, controlled trial at Hospital Cl&#xed;nic de Barcelona, women age &#x2265;18 years, disease-free after breast cancer treatment, were recruited (December 2020-December 2021) and randomly assigned 1:1 to usual follow-up plus app access or usual follow-up alone. The app provided CTCAE v4.03-aligned symptom tracking with self-care guidance, educational content, an events calendar, and gamified smartphone-based step counting; no protocolized clinician monitoring or feedback was provided. Outcomes were assessed at baseline and 3, 6, 9, and 12 months using European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire (QLQ)-C30/BR23, Hospital Anxiety and Depression Scale (HADS), and Three-Item Loneliness Scale (TILS). The primary end point was the difference in QLQ-C30 Global Health Status/QoL at 3 months. Analyses followed intention-to-treat using mixed models for repeated measures adjusted for baseline values. Of 124 women assessed, 121 were randomized (intervention n = 60; control n = 61). Patient-reported outcome measures were available for 106 of 121 (87.6%) at 3 months and 95 of 121 (78.5%) at 12 months. At 3 months, there was no significant difference in Global Health Status/QoL (adjusted mean difference [Intervention-Control], -2.24 [95% CI, -9.29 to 4.81]; P = .53); estimates at later time points were similarly imprecise. No significant between-group difference were observed for QLQ-BR23 domains, HADS anxiety/depression, or TILS. Exploratory subgroup analyses suggested possible heterogeneity in TILS by hormonal-treatment category; this was descriptive and hypothesis-generating only. App engagement was the highest in months 0-3 (48/60 [80.0%] with any use) and declined thereafter; 12 of 60 (20.0%) never used the app. In a pragmatic, nonprescriptive survivorship trial, offering access to a multicomponent mHealth app without closed-loop clinical integration did not show a statistically significant between-group differences in QoL or psychosocial outcomes; confidence intervals were compatible with meaningful harm and did not exclude small benefit depending on the threshold used to define clinical relevance.

Background and Objectives: Quality of life (QoL) has become an essential outcome in patients with metastatic prostate cancer, particularly in the era of androgen receptor (AR)-targeted therapies. Although these agents improve survival, their differential impact on QoL and the role of psychological factors remain incompletely understood. This study aimed to evaluate QoL, functional outcomes, and psychological status, and to identify factors associated with poor QoL in a real-world cohort. Materials and Methods: This prospective cross-sectional, single-center observational study included 130 patients with metastatic prostate cancer receiving AR-targeted therapies (abiraterone, enzalutamide, or apalutamide/darolutamide). QoL was assessed using the EORTC QLQ-C30 questionnaire, and psychological status was evaluated using the Hospital Anxiety and Depression Scale (HADS). Patients were stratified according to treatment groups, and comparisons were performed using appropriate statistical tests. Logistic regression analyses were conducted to determine factors independently associated with poor QoL. Results: Exploratory differences in global QoL were observed among treatment groups (p = 0.007), with lower global QoL scores in the abiraterone group and numerically higher emotional and cognitive functioning scores in the enzalutamide group. Symptom analysis demonstrated higher nausea/vomiting scores in the abiraterone group (p = 0.022), whereas other symptom domains were comparable across treatment groups. In multivariable analysis, anxiety (odds ratio [OR]: 6.62) and depression (OR: 3.40) were independently associated with poor QoL, while treatment type was not independently associated with poor QoL after multivariable adjustment. Conclusions: Although unadjusted QoL scores differed across AR-targeted therapy groups, psychological factors-particularly anxiety and depression-were significantly associated with poorer QoL in patients with metastatic prostate cancer. These findings highlight the importance of integrating routine psychosocial assessment and supportive care strategies into clinical practice to optimize patient-centered outcomes. However, given the cross-sectional and exploratory nature of the study, the findings should be interpreted cautiously.

ALK rearrangements occur in 5.4% of Brazilian patients with non-small cell lung cancer (NSCLC). Data on treatment patterns, access to ALK inhibitors, and survival outcomes are scarce. LACOG/GBOT 1918 is a retrospective, observational study that included patients diagnosed with ALK-positive NSCLC between January 2015 and December 2020 in 12 Brazilian public and private centers. Data were extracted from patient records, including clinic-epidemiologic features, diagnosis, ALK testing methods, treatment patterns, and outcomes. Data were analyzed using descriptive statistical methods. A total of 101 patients were enrolled. The median age was 55 years (range, 18-86), and 55.4% were female. Immunohistochemistry was the most frequently used method for ALK testing. The median time from the first symptom to diagnosis was 2 months, from diagnosis to ALK testing 1.7 months, and from diagnosis to treatment initiation 1.7 months. Among patients receiving first-line treatment, only 47.9% received ALK inhibitors (53.9% private v 22.2% public), with crizotinib being the most used. For second-line treatment, 66.0% of patients received ALK inhibitors, with alectinib being the most used (50%). Most treated patients had access to ALK inhibitors in some line of treatment (83.3% private v 72.2% public); however, in the public setting, targeted treatment was restricted to first-generation and second-generation ALK inhibitors. The 3-year overall survival (OS) rate was 82.6% (95% CI, 72.6 to 89.2), with a lower 3-year OS in the public setting (61.4% public v 87.2% private; P = .0279). Access to targeted ALK therapy is limited in the public health care system, reflecting poor clinical outcomes. Public health measures are necessary to minimize the differences between these two systems.

Background and Objectives: Quality of life (QoL) is an important issue for breast cancer (BC) survivors. The objective of this study was to assess health-related QoL (HRQoL) of BC patients and investigate the impact of different demographic and clinical factors on physical and social functioning and BC-related symptoms. Materials and Methods: In this cross-sectional study, 107 BC patients undergoing chemotherapy in Greece completed a questionnaire collecting sociodemographic and clinical information and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) in order to assess HRQoL. Descriptive statistics and multiple linear regression analyses were used to identify factors linked to HRQoL outcomes. Results: Overall, participants reported moderate HRQoL, with high physical and social functioning and moderate emotional, cognitive, and role functioning. Fatigue was the most common symptom, whereas other symptoms were generally uncommon. Multiple regression analyses showed that marital status, place of residence, time since diagnosis, and type of surgery were significantly associated with the global QLQ-C30 score (R2 = 0.337, p < 0.001). Physical functioning was associated with comorbidity burden, time since diagnosis, and employment status (R2 = 0.155, p = 0.035), and social functioning with marital status and type of surgery (R2 = 0.171, p = 0.011). Emotional functioning showed exploratory associations with place of residence and type of surgery; however, the overall regression model for emotional functioning did not reach statistical significance. No symptom model reached overall significance, but time since diagnosis, treatment type, and surgery were linked to distinct symptoms. Conclusions: BC patients undergoing chemotherapy in Greece report an overall moderate level of HRQoL, which is significantly influenced by a combination of demographic and clinical factors; physical and social functioning were high, with moderate emotional, cognitive, and role functioning. These findings highlight the importance of individualized supportive care strategies in order to improve QoL of BC patients.

Preclinical studies suggest that sodium-glucose cotransporter-2 inhibitors (SGLT-2is) may have cancer-preventive effects; however, clinical evidence remains inconclusive. Therefore, this study aimed to evaluate the association between the use of SGLT-2is (empagliflozin or dapagliflozin) and the incidence of new-onset cancer in patients with type 2 diabetes. This nationwide retrospective cohort study used Korean national health claims data. Patients with type 2 diabetes who started empagliflozin, dapagliflozin, or other glucose-lowering drugs (oGLDs) between 2016 and 2019 were included, and propensity score matching between the SGLT-2is users and oGLDs users was applied. The primary outcome was overall cancer incidence, and the secondary outcomes were the incidence of 11 site-specific cancers. Hazard ratios (HRs) and confidence intervals (CIs) for cancer incidence adjusted for covariates were estimated using a Cox proportional hazards model. After propensity score matching, each group comprised 20,456 patients. There was no significant difference in the overall incidence of new-onset cancer in either the empagliflozin or dapagliflozin groups when compared to the oGLDs user group (adjusted HR 0.85, 95% CI 0.65-1.12; adjusted HR 0.87, 95% CI 0.66-1.14, respectively). Similar results were observed in site-specific cancer incidence. Furthermore, there were no significant differences in overall or site-specific cancer incidence between the empagliflozin and dapagliflozin user groups. The results were consistent across subgroup analyses and various sensitivity analyses. In this large-scale national cohort study, the use of empagliflozin or dapagliflozin did not show a significant difference in the incidence of new-onset cancer in patients with type 2 diabetes. These results provide evidence supporting the association between SGLT-2i use and cancer risk in this population, based on real-world clinical data. Longer-term follow-up studies would be helpful in strengthening the validity of these findings.

This study aims to explore the lived experiences of families caring for breast cancer patients undergoing chemotherapy, focusing on the multidimensional impacts and coping mechanisms in the Indonesian cultural context. Using Van Manen's hermeneutic phenomenological approach, this qualitative study involved 20 family members of breast cancer patients undergoing chemotherapy at a government hospital in Semarang, Indonesia. Data were collected through in-depth, semi-structured interviews, supported by field notes and demographic questionnaires. Thematic analysis was conducted using NVivo software and Colaizzi's method to extract key themes and subthemes. Four major themes emerged: (1) information on the impact of chemotherapy, which included physical, psychological, and socioeconomic changes experienced by patients and observed by families; (2) unpreparedness to face side effects, revealing families' confusion and emotional responses due to a lack of knowledge; (3) The need for adequate information and support, highlighting the demand for clear communication and psychological guidance from healthcare providers; and (4) Hope and the meaning of being a caregiver, in which families found renewed strength, spiritual growth, and purpose throughout the caregiving journey. These findings highlight the complex emotional and social dynamics that families encounter during the cancer treatment process. Chemotherapy has a profound impact not only on patients but also on their families. A lack of preparedness and insufficient support intensify emotional and practical burdens. Therefore, a culturally sensitive, family-centered nursing intervention is crucial to enhance family resilience, ensure effective caregiving, and improve overall quality of life during cancer treatment in developing countries. Such culturally sensitive, family-centered nursing support is essential to strengthen caregiver resilience, reduce burden, and improve the quality of life for both patients and families during chemotherapy.

This study evaluated the safety and effectiveness of an intraoral light-emitting diode (LED)-based photobiomodulation (PBM) device to reduce the incidence and severity of oral mucositis (OM) from intensity modulated radiation therapy (IMRT) for head and neck cancer (HNC). This randomized, double-blind, sham-controlled trial enrolled patients with HNC undergoing high-dose IMRT over 6-8&#xa0;weeks, with or without concurrent chemotherapy. Participants received daily 10-min PBM or sham treatments immediately before IMRT sessions. Assessments were conducted at baseline, daily and weekly during IMRT, and two weeks post-IMRT. Eighty-five participants (42 PBM; 43 sham) were enrolled across 12 US sites. No device-related adverse events were observed, and 99.5% of initiated sessions were completed. In the intent-to-treat population, severe OM (WHO Grade&#x2009;&#x2265;&#x2009;3) incidence was significantly lower with PBM across six weeks of IMRT (36.8% vs 57.1%; p&#x2009;=&#x2009;0.046) and at two weeks post-treatment (10.8% vs 36.4%; p&#x2009;=&#x2009;0.042). In the per-protocol population, the PBM arm reported significantly greater taste preservation (p&#x2009;=&#x2009;0.034), lower increases in mouth/throat soreness (p&#x2009;=&#x2009;0.029) and throat pain (p&#x2009;=&#x2009;0.028) and needed fewer feeding tube placements (p&#x2009;=&#x2009;0.073) than the control arm. Daily intraoral PBM therapy using an LED-based device was safe, well tolerated, and significantly reduced the incidence of severe OM and associated complications in HNC patients undergoing IMRT with or without concurrent chemotherapy. These findings align with guidelines recommending daily intraoral PBM therapy for preventing cancer therapy-related OM, a dose-limiting toxicity for which effective preventive interventions are needed. Clinical Trials.gov Registration Number NCT03972527. Registered on June 3, 2019. Daily intraoral PBM therapy using an LED-based device was safe, well tolerated, and significantly reduced the incidence of severe OM and associated complications in HNC patients undergoing IMRT with or without concurrent chemotherapy. These findings align with guidelines recommending daily intraoral PBM therapy for preventing cancer therapy-related OM, a dose-limiting toxicity for which effective preventive interventions are needed.

The present study aimed to extract and purify the glycoprotein (DeGP-4) from Dioscorea esculenta (Lour.) Burkill, investigate its antitumor activity and molecular mechanism against MDA-MB-231 and BT-549 breast cancer cell lines. The glycoprotein DeGP-4 was isolated, which contained 48.35% carbohydrates and 50.20% proteins. DeGP-4 was identified as glycoprotein around 23.28 kDa, a purity of 93.20%, and contained 16 different amino acids, in which the Asp and Glu were predominant. The carbohydrate chain composition was predominantly mannose (53.84%), glucose (43.38%), galactose (2.08%), and arabinose (0.99%), and two O-glycosylation sites were identified at positions 94 and 146. DeGP-4 demonstrated potent inhibitory effects on the proliferation of MDA-MB-231 and BT-549 breast cancer cells, with IC50 values of 1.2 and 2.5 &#xb5;g/mL. The inhibitory effect of DeGP-4 on MDA-MB-231 is better than cisplatin, and the inhibitory effect on BT-549 is comparable to cisplatin. DeGP-4 may suppress tumor cell migration and induced apoptosis by promoting reactive oxygen species (ROS) production and modulating the expression of key apoptotic proteins, including downregulation of Bcl-2 and upregulation of Bax and Caspase-3. Furthermore, in vivo experiments conducted the mouse tumor model, supported by histological and immunohistochemical analyses, confirmed the significant antitumor activity of DeGP-4.

Caffeic acid phenethyl ester (CAPE) and deuterium oxide (D2O), known as heavy water, have anticancer properties. However, their combined effects in colon cancer have not been addressed yet. This study aimed to evaluate the synergistic effects of CAPE and D2O in colon cancer using in vitro techniques. The cancer cells (HCT-116) were treated with CAPE and D2O alone and in combination to evaluate their cell viability (CV), induction of apoptosis, expression levels of tumor proliferative (AKT, NF-&#x3ba;B, CCND1), tumor suppressor (p16, BAX, TP53, p21) genes, and colony-forming ability, respectively. The combined treatment of 10 &#xb5;M CAPE and 30% D&#x2082;O in human colon cancer cells (HCT-116) were significantly: (i)cytotoxic on the CV; (i)induced apoptosis, (iii)downregulated the expression of AKT, NF-&#x3ba;B and CCND1 while upregulated the expression of p16, BAX, and TP53, without altering p21 level, and (iv)suppressed the cells' colony forming ability, respectively (p<0.05). Overall, CAPE and D&#x2082;O may be an effective adjuvant for enhancing therapeutic efficacy in colon cancer. However, further research is needed to determine whether their synergistic effects are also selective in other malignancies, as well as with their toxicokinetic potential.

Relapsed/metastatic anaplastic thyroid carcinoma (R/M ATC) is associated with poor prognosis. Approximately 40% of ATCs harbor the BRAFV600E mutation, for which targeted therapy is available. However, the clinical characteristics of BRAFV600E-mutant versus wild-type ATC and the role of liquid biopsy (LB) for molecular assessment and monitoring remain incompletely defined. Consecutive patients with R/M ATCs treated at a tertiary referral center were stratified as BRAF wild-type (Cohort A) or BRAFV600E-mutant (Cohort B). Patients received chemotherapy, dabrafenib and trametinib (BRAF/MEKi), immune checkpoint inhibitors (ICI) or best supportive care. Tumor tissue (TB) was analyzed by RT-PCR and/or next-generation sequencing (NGS). Circulating cell-free DNA was assessed by droplet digital PCR (ddPCR) and/or a 52-gene NGS panel on LB at baseline in both cohorts and longitudinally in Cohort B. Clinical characteristics, treatment outcomes, and concordance between TB and LB were evaluated. Between 2018 and 2021, 24 patients were included (13 Cohort A, 11 Cohort B). BRAFV600E tumors more frequently presented with metastatic disease at diagnosis (81.8% vs. 15.4%, p&#x2009;=&#x2009;0.003). Overall, 79% received first-line therapy and 41.6% second-line treatment. All patients in Cohort B received BRAF/MEK inhibitors, achieving a median progression-free survival of 3.2 months (95% CI 1.2-17.5). Concordance for BRAFV600E status between TB and LB assessed by ddPCR was 93.7% (specificity 100%, sensitivity 85.7%). Among 12 paired TB/LB NGS analyses, overall mutation concordance was 30%. In longitudinal assessment, LB anticipated disease progression in 3 of 6 cases and, in one case, identified emerging secondary alterations during BRAF/MEK inhibitor therapy. BRAFV600E-mutant ATC displays distinct clinical features and improved survival when treated with targeted therapy; ddPCR-based liquid biopsy provides a rapid and sensitive method for BRAFV600E detection and may support timely therapeutic decision-making. Serial LB analysis may contribute to disease monitoring and detection of resistance mechanisms in selected patients.

Rare diseases (RDs), affecting fewer than 5 people per 10,000, present unique challenges to usual care pathways due to their unique characteristics: rarity and large number of disease entities, heterogeneous clinical manifestations and genetic causes, multisystemic involvement, and high complexity of diagnosis and treatment. This complexity often hampers the setting of appropriate pathways of care, which are not easily identifiable by patients and stakeholders. This ultimately leads to significant delays in diagnosis, lack of timely access to RD treatments and profound inequalities across countries. To overcome these difficulties, European Reference Networks (ERNs) were established in 2017 to facilitate patients' referral to expertise and excellent services, aiming to reduce disparities and expedite diagnosis, standard of care, and treatment for people living with rare diseases (PLWRDs). Since 72% of rare diseases are of genetic in origin and mostly affect children, genomic newborn screening (gNBS) offers a powerful tool to overcome diagnostic barriers by providing early and accurate genetic diagnoses for a wide range of treatable pediatric RDs. Several gNBS initiatives have been implemented across Europe and worldwide. Screen4Care (S4C) is an EU-IHI funded research project integrating gNBS with artificial intelligence (AI)-based tools to improve care for PLWRDs in the EU. The project will offer gNBS to up to 18,000 infants using a capture-based panel (TREAT-panel) targeting 245 genes associated with treatable genetic disorders [ClinicalTrials.gov NCT06549218]. Within this framework, an operational pipeline and a comprehensive step-by-step process in collaboration with ERNs were developed to refer gNBS-positive newborns to the appropriate ERN, ensuring timely access to optimal standards of care and available treatments. We suggest that this organisational and structured health model might be adopted by EU Member States (MS), as it provides a defined clinical framework for identifying newborns with RDs at birth and ensuring they receive the correct care, thereby promoting patient-centred and equitable disease management.

The urgent need for innovative cancer therapies has driven increasing interest in repurposing drugs originally developed for non-oncological diseases. Several FDA-approved and clinically investigated agents, including mesalamine, celecoxib, gliclazide, metformin, itraconazole, and doxycycline, have shown anticancer potential through diverse mechanisms. However, despite their therapeutic potential, many of these drugs suffer from limited tumor selectivity, suboptimal bioavailability, and off-target toxicity when used in oncology. Nanocarrier-based delivery systems offer a promising strategy to address these limitations by improving drug solubility, enhancing tumor accumulation, and enabling more selective delivery to cancer cells and the tumor microenvironment. In this context, nanocarriers not only serve as delivery vehicles but also provide opportunities for controlled release, combination therapy, and stimulus-responsive treatment strategies. This review summarizes recent progress in repurposing non-oncologic drugs for cancer therapy with a particular focus on nanocarrier-enabled delivery approaches. We discuss the molecular mechanisms underlying the anticancer activity of repurposed drugs, as well as their targeting of tumor cells, the tumor microenvironment, and cancer stem cells. In addition, we highlight advances in integrating these agents into nanocarrier platforms for combination therapy, photodynamic therapy, dual-drug delivery, and stimuli-responsive systems. Finally, we address translational challenges, including regulatory and intellectual property considerations, and discuss future perspectives involving artificial intelligence and personalized medicine to accelerate clinical implementation.

Research on the impact of integrative oncology (IO) programs on quality of life (QoL) among young adults with cancer is limited. The present study explored the impact of a patient-tailored IO program for young patients undergoing active oncology care. This pragmatic, prospective and preference-controlled study examined patients aged 18-45 referred by oncology healthcare providers to an IO consultation and 6 weekly treatments addressing QoL-related concerns. High adherence to integrative care (high-AIC, vs. low-AIC) was defined as attending&#x2009;&#x2265;&#x2009;4 IO sessions, with baseline and 6-week symptoms assessed using ESAS (Edmonton Symptom Assessment Scale); EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) and MYCAW (Measure Yourself Concerns and Wellbeing) tools. Of 180 patients, 137 (76%) were high-AIC, with similar baseline demographic, cancer-and QoL-related characteristics in both groups. At 6 weeks, high-AIC patients reported greater improvement on ESAS (p&#x2009;=&#x2009;0.046) and MYCAW (p&#x2009;=&#x2009;0.008) wellbeing; ESAS nausea (p&#x2009;=&#x2009;0.027); EORTC dyspnea; and EORTC role functioning (p&#x2009;=&#x2009;0.031). Significant within-group improvement was observed in older high-AIC patients (aged 40-45, n&#x2009;=&#x2009;72), as opposed to no improvement in young high-AIC patients (aged 18-39, n&#x2009;=&#x2009;65) on ESAS fatigue (p&#x2009;=&#x2009;0.033), anxiety (p&#x2009;=&#x2009;0.001), and breathing (p&#x2009;=&#x2009;0.016); and wellbeing on ESAS (p&#x2009;=&#x2009;0.006) and MYCAW (p&#x2009;<&#x2009;0.001). Young patients with cancer highly adherent to a 6-week IO program reported significantly improved wellbeing, more significantly among older patients. Further research is needed to explore the impact of IO programs on young patients with cancer, addressing their unique psychological, social, and spiritual needs.

Primary bone cancer is a relatively rare malignant tumor that manifests in the bone and affects the normal functioning of the bone tissue. Primary bone cancer can be characterized into three subtypes, which are osteosarcoma, chondrosarcoma, and Ewing sarcoma. Notably, the treatment of primary bone cancer with conventional modalities, like chemotherapy and surgical interventions, has been overwhelmed with dismal clinical outcomes. The conventional therapies are challenged with non-specificity, resulting in off-target effects and ultimate harm to healthy tissue. Particularly, chemotherapy as a first-line treatment option is riddled with poor drug bioavailability, limited tumor accumulation, and increasing drug resistance. Several innovative drug delivery systems, including nano-based carriers, have been investigated to overcome the systemic drug delivery challenges in primary bone cancer. Accordingly, with most reviews focusing on bone metastasis (secondary bone cancer), this current narrative review aims to provides critical insights on nanocarrier strategies for drug delivery in primary bone cancer, comprehensively expounding on the epidemiology, cellular mechanisms, and etiological effects of primary bone cancer, as well as the current therapies and new drug nanocarriers prototyped to optimize the clinical outcomes in bone cancer management.

Lectins are carbohydrate-binding proteins, some of which exhibit significant anti-tumor activity. Siye is a lectin derived from the red alga Kappaphycus alvarezii that was previously discovered using an artificial intelligence-guided genome mining strategy and shown to exert cytotoxic effects against several human cancer cell lines, including breast adenocarcinoma HCC1937. Based on the presence of shared glycopatterns between breast and colon cancers, we hypothesized that Siye may also exhibit anti-tumor activity against colon cancer cells. The cytotoxic effect of Siye on human colon cancer HCT116 cells was evaluated using the CCK-8 assay. Apoptosis was assessed by flow cytometry with Annexin V-FITC/PI staining. Expression levels of apoptosis-related genes (Bax, Bcl-2, Casp3, Casp8, Casp9, and TP53) were determined by qRT-PCR. Competitive inhibition assays using mannan were performed to assess the role of cell surface glycan binding. Siye significantly reduced the viability of HCT116 cells in a dose-dependent manner, with an IC50 value of 14.065 &#x3bc;g/mL (=0.488 &#x3bc;M). Flow cytometry revealed that Siye promoted both early and late apoptosis in HCT116 cells, whereas in HCC1937 cells, the effect was primarily on early apoptosis. Mechanistically, Siye significantly upregulated the expression of the pro-apoptotic genes Bax (p < 0.05) and Casp9 (p < 0.001) in HCT116 cells, while in HCC1937 cells, Casp9 expression was significantly increased (p < 0.001). Morphological changes, including cell rounding and agglutination, were observed within 4 h of Siye treatment in both cell lines and were attenuated by co-treatment with mannan, suggesting that Siye-induced morphological changes are associated with binding to cell surface glycans. This study suggests that the red algal lectin Siye exerts anti-tumor effects against colon cancer HCT116 cells by inducing caspase-associated apoptosis. The differential apoptotic response between HCC1937 and HCT116 cells suggests cell-type-specific mechanisms. These findings extend the known anti-tumor activity spectrum of AI-discovered red algal lectin Siye and provide a basis for further investigation of its glycan-associated cellular effects and marine drug discovery potential.

To explore the preirradiation dental screening experiences of patients with head and neck cancer and how this understanding can contribute to the enhancement of nursing practice. In 2022 and 2023, patients diagnosed with head and neck cancer with planned radiation therapy were recruited. The study was conducted at a university hospital in Denmark, where preirradiation dental screening is an integrated component of the fast-track cancer pathway. A qualitative, phenomenologic-hermeneutic design was applied, employing semistructured telephone interviews with 10 patients. Detailed field notes were used to construct individual patient narratives. Data were analyzed using reflexive thematic analysis to capture the depth and variation in patients' lived experiences. Four main themes were identified: anxiety for the future and the dentist, information overload, the stressful day, and confidence in efficiency. Overall, patient experiences clustered into two overarching patterns: compromised course and successful course. Patients' experiences vary widely. Anxiety, information overload, and stressful logistics may compromise the patient's experience, whereas clear information and supportive interactions may result in confidence. It is recommended that nursing practice prioritize individual support using Henderson's model, ensuring that needs are addressed and managing information overload throughout the complex treatment process of preirradiation dental screening.