Cancer[JOURNAL]
Sun
200 papers
Comparative efficacy and harms of adjuvant whole breast hypofractionation or external beam accelerated partial breast irradiation for treatment of breast cancer: a systematic review.
Sowerby C, Lemu K, Landsteiner A … +7 more , Ullman K, Anthony M, Kalinowski C, Ester E, Dahm P, Wilt TJ, Duan-Porter W
BMC Cancer · 2026 Jun · PMID 42343211 · Full text
BACKGROUND: Whole breast moderate hypofractionation is recommended for most breast cancer populations to improve survival and reduce recurrence. Whole breast ultra-hypofractionation and external beam accelerated partial...
BACKGROUND: Whole breast moderate hypofractionation is recommended for most breast cancer populations to improve survival and reduce recurrence. Whole breast ultra-hypofractionation and external beam accelerated partial breast irradiation (APBI) may reduce toxicity while maintaining benefits. METHODS: MEDLINE and Embase searches through March 2024 identified randomized controlled trials (RCTs) evaluating adjuvant external beam hypofractionated radiation therapy for breast cancer. Eligibility and risk of bias (RoB) were assessed by two reviewers and required consensus. For prioritized outcomes (e.g., overall survival, acute toxicity), certainty of evidence was assessed using GRADE. RESULTS: Thirty-nine RCTs compared whole breast moderate hypofractionation vs. conventional radiation (CFRT; k = 25); whole breast ultra-hypofractionation vs. moderate hypofractionation or CFRT (k = 8); or external beam APBI vs. whole breast radiation (k = 6). For all comparisons, there were low RoB, large trials (N > 2,000) with 5-10 year outcomes. Trials on ultra-hypofractionation and APBI focused on early stage cancer, some also including ductal carcinoma in situ (DCIS). High survival (> 90%) and low recurrence were found across all treatments. Moderate hypofractionation probably results in less overall acute toxicity, but makes little to no difference in specific adverse events. No trial on ultra-hypofractionation reported overall toxicity; evidence on acute skin toxicity is very uncertain. APBI probably results in less overall acute toxicity, but may result in more overall late toxicity; evidence was very uncertain or showed no difference for specific events. CONCLUSION: Radiation treatments had similar survival and recurrence. Moderate hypofractionation and APBI result in lower overall acute toxicity, but evidence is lacking for ultra-hypofractionation. For ultra-hypofractionation and APBI, future research is needed to better understand late toxicity outcomes, and whether effects may vary across settings and subgroups.
How to give a bad talk.
Yanai I
Nat Rev Cancer · 2026 Jun · PMID 42342955 · Publisher ↗
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"Protected time" for clinical investigators in medical oncology: The persistent gap between expectation and reality.
Sedrak MS, Ramalingam SS, Sparano JA
Cancer · 2026 Jul · PMID 42340000 · Full text
“Protected time” in academic oncology is essential for clinical investigators, yet its prevailing definition as “time away from clinic” may no longer reflect the realities of modern cancer research. This commentary exami...
“Protected time” in academic oncology is essential for clinical investigators, yet its prevailing definition as “time away from clinic” may no longer reflect the realities of modern cancer research. This commentary examines the growing tension between clinical productivity demands and the operational work of clinical investigation, highlighting the need for broader discussion regarding how protected effort for clinical investigators should be conceptualized, structured, and sustained within academic oncology.
Postoperative anlotinib plus radiotherapy in patients with newly diagnosed, unmethylated O-methylguanine-DNA methyltransferase glioblastoma: A single-arm, phase 2 study.
Wu B, Zhang Z, Ma H … +29 more , Huang J, Liu X, Shi L, Dong X, Lei D, Wang X, Zhang F, Zhao H, Lin H, Fu R, Zou Z, Qin Y, Wang H, Hu X, Yao D, Yang L, Yang J, Hong X, Wang J, Wen L, Zhang C, Liang Z, Yang Z, Nie X, Liu G, Hu F, Peng G, Jiang X, Yang K
Cancer · 2026 Jul · PMID 42339996 · Publisher ↗
BACKGROUND: Patients with unmethylated O-methylguanine-DNA methyltransferase (MGMT) glioblastoma derive minimal benefit from the standard temozolomide chemoradiotherapy, leaving an urgent need for more effective therapie...
BACKGROUND: Patients with unmethylated O-methylguanine-DNA methyltransferase (MGMT) glioblastoma derive minimal benefit from the standard temozolomide chemoradiotherapy, leaving an urgent need for more effective therapies. The objective of this phase 2 study was to evaluate the efficacy of anlotinib plus radiotherapy in this disease. METHODS: In this single-arm, phase 2 study, patients with newly diagnosed, unmethylated MGMT glioblastoma were recruited after surgical resection. Patients received standard radiotherapy (60.0 grays) and concomitant with anlotinib (12 mg once daily, 2 weeks on/1 week off), followed by six cycles of anlotinib maintenance. The primary end point was overall survival (OS). Secondary end points were progression-free survival (PFS), OS rates at 12 and 24 months, PFS rates at 6 and 12 months, and safety. RESULTS: Between October 12, 2020, and August 1, 2022, 32 patients were enrolled and received protocol therapy, and all were evaluable for efficacy and safety analyses. At a median follow-up of 18.6 months (range, 8.3-50.3 months), the median OS was 19.1 months (95% confidence interval, 14.4-22.4 months), with 12-month and 24-month OS rates of 90.6% and 30.0%, respectively. The median OS did not reach the prespecified threshold of 20.1 months. The median PFS was 11.1 months (95% confidence interval, 9.6-12.9 months), with 6-month and 12-month PFS rates of 96.9% and 37.5%, respectively. Four patients (12.5%) experienced grade 3 or worse treatment-related adverse events, two of which (6.3%) were serious. No treatment-related deaths occurred. CONCLUSIONS: Postoperative anlotinib plus radiotherapy demonstrated clinically meaningful activity with a manageable safety profile in patients with unmethylated MGMT glioblastoma (Chinese Clinical Trials Registry identifier: ChiCTR2000040116).
Magnetic resonance imaging radiomic phenotypes stratify response and define immune states in very high-risk, nonmuscle-invasive bladder cancer treated with tislelizumab plus nanoparticle albumin-bound paclitaxel.
Huang S, Jia K, Liang S … +18 more , Ma B, Chen H, Zhang Z, Kang N, Wu Z, Lin Y, Li P, Xue Z, Chen H, Zhao Y, Guo J, Li C, Chai W, Cui J, Xu G, Qie Y, Shen C, Hu H
Cancer · 2026 Jul · PMID 42339693 · Publisher ↗
BACKGROUND: Patients with very high-risk (VHR), nonmuscle-invasive bladder cancer (NMIBC) who are ineligible for or decline radical cystectomy face limited treatment options. Immune checkpoint inhibitor-based regimens ha...
BACKGROUND: Patients with very high-risk (VHR), nonmuscle-invasive bladder cancer (NMIBC) who are ineligible for or decline radical cystectomy face limited treatment options. Immune checkpoint inhibitor-based regimens have demonstrated promise but lack reliable biomarkers to guide patient selection. The objective of this study was to identify magnetic resonance imaging-derived radiomic phenotypes predictive of treatment response to immune checkpoint inhibitor-based therapy. METHODS: The authors retrospectively analyzed two prospective cohorts of patients with extensive VHR NMIBC: a single-center derivation cohort from the TRUCE-02 trial (n = 59) and a multicenter validation cohort from the TRUCE-22 trial (n = 37). All patients received tislelizumab and nanoparticle albumin-bound paclitaxel every 3 weeks. Complete response (CR) was assessed at 3 months. Radiomic features were extracted from baseline, T2-weighted images, and a hybrid framework integrating supervised feature selection with unsupervised clustering was used to identify imaging phenotypes. Associations with CR, progression-free and overall survival, and immune-related transcriptional signatures were evaluated. RESULTS: Three radiomic clusters were identified: immune-excluded (cluster 0), immune-intermediate (cluster 1), and immune-inflamed (cluster 2). In the derivation cohort, cluster 2 had a significantly higher CR rate (82.8%) than cluster 0 (21.4%; p = .001), a pattern that was validated in TRUCE-22 (83.3% vs. 22.2%; p = .008). The cluster-only model achieved the highest predictive performance for CR in both the derivation (area under the receiver operating characteristic curve, 0.77) and validation (area under the receiver operating characteristic curve, 0.78) cohorts. Cluster 2 had better progression-free and overall survival. Transcriptomic and immunofluorescence analyses revealed functional immune suppression in cluster 0, including reduced CD8-positive, phosphorylated STAT1-positive T cells. CONCLUSIONS: In patients with very high-risk NMIBC, magnetic resonance imaging-derived radiomic phenotypes can be used to stratify responses to immunochemotherapy and capture functional immune states. Noninvasive radiomic profiling may guide precision treatment selection in patients who are unfit for radical cystectomy, and prospective validation is warranted before clinical adoption.
Clinical trial enrollment processes and strategies to enhance clinical trial participation at rural National Cancer Institute Community Oncology Research Program sites.
Okado I, Chang S, Fukaya EM … +2 more , Braun-Inglis CM, Berenberg JL
Cancer · 2026 Jul · PMID 42339593 · Publisher ↗
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Abnormal body weight and risk of gallbladder cancer: an updated meta-analysis incorporating recent evidence.
Chung W, Kang M, Sung JM … +4 more , Kim KN, Choi JY, Jung YK, Choi D
BMC Cancer · 2026 Jun · PMID 42337712 · Full text
BACKGROUND: To update previous meta-analyses by evaluating the association between body mass index (BMI) categories (underweight, overweight, and obesity) and gallbladder cancer (GBC) risk, and to compare findings betwee...
BACKGROUND: To update previous meta-analyses by evaluating the association between body mass index (BMI) categories (underweight, overweight, and obesity) and gallbladder cancer (GBC) risk, and to compare findings between earlier and more recent studies. METHODS: A systematic search of PubMed and Web of Science identified 10 observational studies published between January 2017 and May 2025. Studies reporting risk ratios (RRs), hazard ratios, or odds ratios with 95% confidence intervals (CIs) for GBC by BMI category were included. Pooled RRs were calculated using fixed- and random-effects models, and heterogeneity was assessed using I statistics. Subgroup analyses compared older with newer studies, and men with women. RESULTS: Twenty-four studies (14 previous, 11 new) were included. The underweight group showed a a 5% increased possible risk of GBC (fixed-effects RR = 1.05, 95% CI: 0.89-1.24), but there was no clear evidence as statistical significance was not demonstrated. The overweight group was associated with a 19% increased risk (random-effects RR = 1.19, 95% CI: 1.11-1.27), and obesity with a 69% increased risk (random-effects RR = 1.69, 95% CI: 1.51-1.88). Recent studies reported higher RRs for the overweight and obesity groups compared with earlier studies. CONCLUSIONS: Excess body weight is significantly associated with increased GBC risk, with stronger associations reported in recent studies. Underweight also suggests a possible positive association. These findings emphasize the importance of weight management in GBC prevention strategies. TRIAL REGISTRATION: Prospero registration ID: CRD420251089832.
Over-presentation of apolipoprotein E gene variants E3/E4 and cardiovascular disease risk factors among Ghanaian breast cancer patients.
Antonio DNM, Annani-Akollor M, Fondjo LA … +6 more , Anang-Quartey Y, Owusu H, Arko-Boham B, Santa S, Quaye O, Tagoe EA
BMC Cancer · 2026 Jun · PMID 42337705 · Full text
BACKGROUND: Apolipoprotein E (APO E), a member of the apolipoprotein family, plays a crucial role in lipid metabolism. The association between dyslipidaemia and breast cancer remains inconclusive, and the relationship be...
BACKGROUND: Apolipoprotein E (APO E), a member of the apolipoprotein family, plays a crucial role in lipid metabolism. The association between dyslipidaemia and breast cancer remains inconclusive, and the relationship between APO E gene variants and breast cancer is not well established. This study aimed to determine the distribution of APO E gene variants and assess dyslipidaemia as cardiovascular disease risk factor among Ghanaian breast cancer patients. METHODS: A case-control approach was used, involving 140 participants comprising 70 breast cancer patients and 70 age-matched non-cancer individuals. Socio-demographic and clinicopathological data were collected using a structured questionnaire. Polymerase chain reaction-restriction fragment length polymorphism analysis was performed on the extracted DNA to determine APO E variants. Serum lipid profiles were assessed using an automated chemistry analyser, and serum lipids indices as cardiovascular diseases risk factors including atherogenic index of plasma were calculated. STATA version 19.0 was used for statistical analysis. RESULTS: The APO E3/E4 variant was significantly associated with breast cancer (OR = 2.9; p < 0.001). Breast cancer patients showed elevated levels of triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-c), while high-density lipoprotein cholesterol (HDL-c) levels were lower, suggesting a higher risk of cardiovascular diseases among breast cancer patients compared to the control group (p < 0.001). Also, MDA levels were found to be significantly lower among breast cancer patients compared to the healthy control group (p < 0.01). CONCLUSION: APO E, E3/E4 variant was associated with breast cancer and may contribute to the increased cardiovascular disease risk among the breast cancer patients.
Correction: Hospital-based patterns of esophageal and gastric cancer cases at a major tertiary referral center in Kabul, Afghanistan: a retrospective case series.
Tawakoli MF, Salihee H, Rahmati A … +1 more , Hatami MN
BMC Cancer · 2026 Jun · PMID 42337494 · Full text
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Integrated pan-cancer multi-omics profiling and experimental validation identify LSM12 as a prognostic biomarker and candidate therapeutic target in human cancers.
Eldeen MA, Refaat AM, Ahmed HEM … +9 more , Hassan HM, Alshehri M, Fayad E, Jafri I, Alshaya DS, Babteen NA, Sait LM, Alqahtani LS, Kim B
BMC Cancer · 2026 Jun · PMID 42337485 · Full text
BACKGROUND: RNA metabolism regulators remain insufficiently characterized across tumor types, despite the substantial expansion of multi-omics datasets. LSM12, a member of the Like-Sm (LSM) protein family involved in RNA...
BACKGROUND: RNA metabolism regulators remain insufficiently characterized across tumor types, despite the substantial expansion of multi-omics datasets. LSM12, a member of the Like-Sm (LSM) protein family involved in RNA processing, has not been systematically evaluated in a pan-cancer context. Accordingly, this study aimed to investigate the oncogenic and immunomodulatory roles of LSM12 across multiple cancer types through an integrated multi-omics framework. METHODS: We conducted an integrative pan-cancer analysis using publicly available multi-omics platforms, including TIMER2, GEPIA2, TISIDB, cBioPortal, and CPTAC (accessed via UALCAN), to assess LSM12 expression patterns, genomic alterations, epigenetic regulation, and clinical relevance. Immune infiltration was evaluated using partial Spearman correlation adjusted for tumor purity. Structure-based virtual screening and Density Functional Theory (DFT) calculations were performed to assess the druggability of LSM12. In vitro functional validation was conducted in HepG2 and TE-8 cancer cell lines using siRNA-mediated knockdown. RESULTS: LSM12 was significantly upregulated in multiple malignancies at both mRNA and protein levels and was positively correlated with advanced tumor stage and grade. Increased expression was associated with promoter hypomethylation and copy-number amplification, and was predictive of unfavorable overall survival (OS) and disease-free survival (DFS) in univariate analyses. Immune infiltration analyses indicated that elevated LSM12 expression corresponded to an immunosuppressive tumor immune microenvironment (TIME), characterized by enrichment of myeloid-derived suppressor cell (MDSC) signatures and diminished natural killer (NK) cell infiltration. In vitro siRNA-mediated LSM12 silencing suppressed proliferation, migration, colony formation, and cell-cycle progression in cancer cells. Structure-based virtual screening coupled with DFT identified an isoindolinone derivative (Compound 1) as a potential LSM12 binder with favorable in silico drug-like properties. CONCLUSIONS: These hypothesis-generating findings position LSM12 as a candidate prognostic biomarker and potential therapeutic target in pan-cancer precision oncology, warranting further experimental and clinical validation.
Betel nut chewing influences pathologic response in oral squamous cell carcinoma treated by neoadjuvant immunochemotherapy.
Gao R, Zhang X, Li G … +2 more , Li P, Du W
BMC Cancer · 2026 Jun · PMID 42337483 · Full text
BACKGROUND: Betel nut chewing (BNC) is a prevalent risk factor for oral squamous cell carcinoma (SCC) in South and Southeast Asia, yet its influence on response to neoadjuvant immunochemotherapy remains unexplored. This...
BACKGROUND: Betel nut chewing (BNC) is a prevalent risk factor for oral squamous cell carcinoma (SCC) in South and Southeast Asia, yet its influence on response to neoadjuvant immunochemotherapy remains unexplored. This study aimed to evaluate the association between BNC and pathologic response in oral SCC patients receiving neoadjuvant immunochemotherapy. METHODS: We retrospectively reviewed 192 patients with primary oral SCC who received neoadjuvant immunochemotherapy (docetaxel, cisplatin, and PD-1 inhibitors) followed by surgery between January 2020 and October 2024. Pathologic complete response (pCR), major pathologic response (mPR), objective response rate (ORR), clinical to pathological downstaging, adverse pathologic features, and disease-free survival (DFS) were compared between BNC (n = 42) and no-BNC (n = 150) groups. RESULTS: BNC patients demonstrated significantly lower pCR (16.7% vs. 34.0%; OR = 2.55, p = 0.031) and mPR rates (54.8% vs. 74.7%; OR = 3.17, p = 0.013) compared to no-BNC patients. Multivariable analysis confirmed absence of BNC as an independent predictor of both pCR (adjusted OR = 2.55, 95% CI: 1.20-7.65) and mPR (adjusted OR = 3.17, 95% CI: 1.32-8.53). BNC was also associated with lower ORR (73.8% vs. 86.7%, p = 0.045), reduced downstaging (71.4% vs. 90.0%, p = 0.002), and higher prevalence of adverse pathologic features (19.0% vs. 4.7%, p = 0.005). The poorest outcomes occurred in well/moderately differentiated tumors with BNC history. BNC did not significantly impact DFS (3-year DFS: 71.2% vs. 78.4%, p = 0.194). Number of neoadjuvant cycles did not influence pathologic response. CONCLUSIONS: BNC is an independent predictor of suboptimal pathologic response to neoadjuvant immunochemotherapy in oral SCC, although it does not adversely affect DFS. These findings may inform patient selection and treatment stratification.
Symptom associations during early recovery after pancreatic cancer surgery: an exploratory cross-sectional network analysis.
Xia N, Shi N, Song Y … +2 more , Miao Y, Yan H
BMC Cancer · 2026 Jun · PMID 42337482 · Full text
BACKGROUND: Patients undergoing pancreatic cancer surgery often experience multiple symptoms during early recovery, but the structural relationships among these symptoms remain unclear. METHODS: A cross-sectional network...
BACKGROUND: Patients undergoing pancreatic cancer surgery often experience multiple symptoms during early recovery, but the structural relationships among these symptoms remain unclear. METHODS: A cross-sectional network analysis was conducted on 213 patients after pancreatic cancer surgery. Symptoms during the first postoperative week were retrospectively assessed on day 7 using the M.D. Anderson Symptom Inventory gastrointestinal cancer module. Symptom prevalence, severity, centrality, bridge strength, and network stability were examined. RESULTS: Of the 22 symptoms, 17 occurred in more than 30% of patients. The most prevalent symptoms were lack of appetite, disturbed sleep, distress, pain, and fatigue. Lack of appetite, vomiting, and fatigue had the highest mean severity scores. Within the symptom network, vomiting, distress, and sweating showed the highest strength centrality, with vomiting occupying the most central position. Swelling, fatigue, and irritability showed relatively high bridge strength. The correlation stability coefficient for strength was 0.516. CONCLUSIONS: Symptoms were common but generally mild during the first postoperative week. Network analysis provided a structured description of symptom associations and may inform future longitudinal studies on postoperative symptom trajectories and patient-centered outcomes.
The clinical value of the combined detection of circulating low ⁃ density neutrophils and inflammatory markers in breast cancer with lymph node metastasis.
Mo D, Li C, Mao X … +2 more , Zheng L, Yan F
BMC Cancer · 2026 Jun · PMID 42337476 · Full text
BACKGROUND: Breast cancer (BC) is the most prevalent cancer in women globally, with axillary lymph node metastasis (LNM) and distant metastasis being key prognostic factors linked to survival. Circulating low-density neu...
BACKGROUND: Breast cancer (BC) is the most prevalent cancer in women globally, with axillary lymph node metastasis (LNM) and distant metastasis being key prognostic factors linked to survival. Circulating low-density neutrophils (LDNs) in cancer patients are associated with tumor-supportive role. This study assessed the clinical relevance of combining circulating LDNs with hematological indicators in BC patients with LNM. METHODS: Peripheral blood samples from 184 BC patients were analyzed using flow cytometry to measure the LDNs levels. Lasso logistic regression was used for variable selection, and univariate and multivariate logistic regression identified independent risk factors. A predictive nomogram was developed and validated with an external cohort. RESULTS: LDNs were elevated in BC patients, especially those with LNM. Seven variables-LDNs, CEA, CA153, PLR, SIRI, NMLR, and NHR-were identified for further analysis. Multivariate logistic regression identified five of these as independent risk factors for LNM: LDNs (OR = 2.307, P = 0.032), CEA (OR = 4.027, P < 0.001), CA153 (OR = 2.440, P = 0.016), PLR (OR = 2.563, P = 0.014), and SIRI (OR = 4.617, P = 0.003). The nomogram model based on these factors demonstrated good predictive performance with an optimism-corrected C-statistic of 0.780, consistent in the external validation set (AUC = 0.762). The calibration curve confirmed good clinical applicability. CONCLUSION: This study suggests circulating LDNs levels may be potential biomarkers for BC progression, and a nomogram combing LDNs with other hematological indicators shows potential for identifying patients with LNM.
The 30% reduction of baseline CA19-9 could stratify the prognosis of advanced pancreatic ductal adenocarcinoma with RECIST stable disease after first-line chemotherapy.
Zhang X, Huang XT, Fu AQ … +5 more , Huang CS, Xu QC, Lai JM, Liang LJ, Yin XY
BMC Cancer · 2026 Jun · PMID 42337456 · Full text
BACKGROUND: Radiological assessment based on RECIST criteria has limited accuracy in evaluating chemotherapy response in advanced pancreatic ductal adenocarcinoma (PDAC), particularly in patients classified as stable dis...
BACKGROUND: Radiological assessment based on RECIST criteria has limited accuracy in evaluating chemotherapy response in advanced pancreatic ductal adenocarcinoma (PDAC), particularly in patients classified as stable disease. Additional clinically accessible biomarkers are needed to better stratify treatment response and prognosis in this population. METHODS: This study retrospectively included patients with advanced PDAC who received first-line chemotherapy and completed an 8-week response assessment. Contrast-enhanced CT and serum CA19-9 were evaluated every 8 weeks for disease surveillance. The primary endpoints were progression-free survival (PFS) and overall survival (OS). RESULTS: Of 182 patients included, 117 (64.3%), 21 (11.5%), and 44 (24.2%) patients were classified into SD, partial response (PR), and progressive disease (PD) at the first radiological evaluation. The SD cohorts presented OS similar to the PR cohort (P = 0.348). In SD patients with elevated baseline CA19-9 levels, the cohort with a 30% reduction of baseline CA19-9 levels was defined as the CA19-9 response group. Compared with the nonresponse group (decreased < 30% or increased CA19-9 cohorts), the response group presented significantly better PFS (P < 0.001) and OS (P = 0.010). CONCLUSIONS: After 8 weeks of first-line chemotherapy, most patients with advanced PDAC were classified as SD and exhibited survival outcomes comparable to those with partial response. In patients with stable disease and elevated baseline CA19-9 levels, a ≥ 30% reduction in CA19-9 provided additional prognostic stratification.
Using machine learning algorithms based on laboratory indicators to establish a diagnostic model for lung cancer.
Wu J, Zhang L, Zhang Z … +7 more , Gao S, Wang S, Zheng X, Xu X, Ding H, Shen H, Yan H
BMC Cancer · 2026 Jun · PMID 42337448 · Full text
BACKGROUND: Lung cancer remains one of the leading causes of cancer-related mortality worldwide. Current diagnostic strategies rely primarily on imaging examinations and histopathological biopsy, which are invasive and u...
BACKGROUND: Lung cancer remains one of the leading causes of cancer-related mortality worldwide. Current diagnostic strategies rely primarily on imaging examinations and histopathological biopsy, which are invasive and unsuitable for longitudinal monitoring. Therefore, there is an urgent need for non-invasive and efficient predictive models to facilitate early detection and disease staging. This study aimed to compare multiple machine learning algorithms and identify the optimal model for distinguishing benign pulmonary nodules from early- and advanced-stage lung cancer. METHODS: Between January 2024 and September 2025, a total of 1,238 patients with pulmonary nodules were registered at Nanjing Drum Tower Hospital, including 951 patients with lung cancer and 287 patients with benign pulmonary nodules. In addition, 250 healthy individuals were enrolled as a control group. Clinical characteristics, including age, sex, and routine laboratory indicators, were collected for model development. Five machine learning algorithms were constructed and evaluated. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and precision. Model interpretability was further explored using SHapley Additive exPlanations (SHAP). RESULTS: Among the evaluated algorithms, the eXtreme Gradient Boosting (XGBoost) model demonstrated the best overall performance and was selected as the final predictive model. Correlation and differential analyses identified 60, 37, 25, 17, 12, and 17 informative features across six comparison groups: healthy vs. benign, healthy vs. early-stage lung cancer, healthy vs. advanced-stage lung cancer, benign vs. early-stage lung cancer, benign vs. advanced-stage lung cancer, and early vs. advanced-stage lung cancer, respectively. The corresponding AUC values were 0.999, 0.962, 0.970, 0.663, 0.926, and 0.713. SHAP analysis further elucidated the relative importance and directional effects of individual clinical features on model predictions. CONCLUSION: The XGBoost-based models demonstrated comparatively better performance in comparisons involving healthy controls and in distinguishing benign pulmonary disease from advanced-stage lung cancer. This approach may assist clinicians in early identification, risk stratification, and timely intervention for patients with pulmonary nodules, potentially contributing to reduced lung cancer-related mortality.
Fertility preservation access among female adolescents and young adults with cancer: A systematic review.
Algave M, Junak S, Schnall R … +1 more , Beauchemin MP
Cancer · 2026 Jul · PMID 42334857 · Full text
Adolescents and young adults (AYAs; aged 15-39 years) with cancer face significant threats to future fertility. Despite fertility preservation (FP) guidelines, disparities in access persist, particularly among female AYA...
Adolescents and young adults (AYAs; aged 15-39 years) with cancer face significant threats to future fertility. Despite fertility preservation (FP) guidelines, disparities in access persist, particularly among female AYAs. This systematic review aims to describe FP access and explore disparities by sociodemographic and clinical factors among female AYAs with cancer in the United States. This systematic review was registered in PROSPERO (CRD420251077846) and conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Embase were searched from May 1, 2006, through July 17, 2025. Eligible studies were US-based, peer-reviewed observational or interventional studies examining FP access among female AYAs with cancer. Two reviewers independently screened articles, extracted data, and appraised methodological quality with Joanna Briggs Institute tools. Among 10,151 records, 25 studies met the inclusion criteria. All included studies demonstrated high methodological quality and low risk of bias. Reported rates of FP discussions ranged from 9% to 75%, referrals or consultations with fertility specialists ranged from 0.9% to 57%, and completion of FP procedures ranged from 0.56% to 70.3%. Facilitators of access included younger age, private insurance, nulliparity, higher socioeconomic status, certain cancer types, and more recent diagnosis year. Barriers included non-Hispanic Black or Hispanic race/ethnicity, lower income, public insurance, and residence in rural or low-resource areas. Institutional interventions improved access but did not eliminate the underlying disparities. Substantial inequities in FP access persist for female AYAs with cancer in the United States, which underscores the need for routine integration of FP into oncology care and for interventions that address structural and geographic barriers.
Exploring the relationship between potential hepatotoxicity and novel hormonal therapies in prostate cancer: a systematic review and meta-analysis.
Ma L, Fan L, Luo X … +4 more , Huang Z, Dai J, Wu Y, Zhang W
BMC Cancer · 2026 Jun · PMID 42332688 · Full text
BACKGROUND: Novel hormonal therapies (NHTs) have substantially improved outcomes in prostate cancer across multiple disease states. However, their hepatic safety remains clinically relevant because treatment is often pro...
BACKGROUND: Novel hormonal therapies (NHTs) have substantially improved outcomes in prostate cancer across multiple disease states. However, their hepatic safety remains clinically relevant because treatment is often prolonged and may be combined with androgen-deprivation therapy, corticosteroids, or chemotherapy. We performed a systematic review and meta-analysis to quantify the risk of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevations associated with NHT-based therapy. METHODS: This study was conducted in accordance with PRISMA guidelines. Randomized controlled trials comparing NHT-containing regimens with control regimens in patients with prostate cancer were eligible if they reported extractable ALT and/or AST adverse-event data. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for four prespecified outcomes: all-grade ALT elevation, grade ≥ 3 ALT elevation, all-grade AST elevation, and grade ≥ 3 AST elevation. RESULTS: Ten randomized studies reported in 11 publications were included, involving 10,173 participants treated with abiraterone, enzalutamide, darolutamide, or abiraterone plus enzalutamide combination regimens. Compared with controls, NHT-based therapy significantly increased the risk of all-grade ALT elevation (RR 1.49, 95% CI 1.12-2.00; I = 82.8%), grade ≥ 3 ALT elevation (RR 5.91, 95% CI 2.86-12.20; I = 67.5%), all-grade AST elevation (RR 1.58, 95% CI 1.02-2.45; I = 84.5%), and grade ≥ 3 AST elevation (RR 3.32, 95% CI 2.13-5.18; I = 0%). Subgroup analyses suggested that the hepatic safety signal was more evident for abiraterone-containing and abiraterone plus enzalutamide combination regimens, whereas estimates for enzalutamide and darolutamide varied across outcomes and should be interpreted cautiously because of the limited number of available comparisons. CONCLUSIONS: NHT-based therapy for prostate cancer was associated with an increased risk of hepatic enzyme abnormalities, particularly severe ALT elevation. The hepatic safety signal appeared more evident for abiraterone-containing and combination regimens, whereas drug-specific estimates for enzalutamide and darolutamide remained limited. Because this analysis focused on laboratory-defined ALT and AST elevations, careful liver function monitoring remains warranted during NHT-based therapy, especially in patients receiving abiraterone-containing or prolonged combination regimens.
Evaluation of tumor-infiltrating lymphocytes across breast cancer stages at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.
Getnet E, Adane G, Awoke Shiferaw E … +8 more , Ayelegn Nibret T, Maru Yemru G, Mengstu MK, Birhanu A, Habtamu A, Debash H, Wondmagegn T, Lemma M
BMC Cancer · 2026 Jun · PMID 42332664 · Full text
BACKGROUND: Tumor-infiltrating lymphocytes (TILs) are recognized as prognostic biomarkers. However, inconsistent TIL scores across breast cancer stages, and data are scarce for Ethiopian patients. Thus, this study evalua...
BACKGROUND: Tumor-infiltrating lymphocytes (TILs) are recognized as prognostic biomarkers. However, inconsistent TIL scores across breast cancer stages, and data are scarce for Ethiopian patients. Thus, this study evaluated TIL scores across breast cancer stages in Northwest Ethiopia. METHODS: A cross-sectional study was conducted from 20 June 2024 to 19 June 2025. Using consecutive sampling, 62 breast cancer patients were enrolled, and their socio-demographic and clinicopathological data were collected using questionnaires and chart reviews. Formalin-fixed, paraffin-embedded tissue sections were stained with hematoxylin and eosin, and stromal TILs were evaluated according to the International TIL Working Group guidelines. Data were analyzed using SPSS version 27. Median TILs across clinicopathological variables were assessed using Kruskal-Wallis and Mann-Whitney U tests. Spearman correlation assessed the association of TIL scores and clinicopathological variables. P ≤ 0.05 was considered statistically significant. RESULTS: Low TIL scores were observed in 76.5% of stage II cases, whereas high TIL scores were observed in 54.5% of stage IV cases. Median TIL percentages in stage IV (48%) and III (33%) were significantly higher than in stage II (7%), and in N2-N3 (33%) than in N0-N1 (9%) (p < 0.001). Moreover, the median TIL percentage in grade III (48%) was higher than in grade I (9%) (p = 0.028). TILs were positively correlated with TNM stage, lymph node stage, and grade. CONCLUSIONS: A positive correlation was found between TIL score and TNM stage. Intermediate and high TIL scores were common in advanced stages, whereas low TIL scores were prevalent in early stages. The findings suggest that advanced tumors may harbor higher mutation burdens and immunogenicity. Future research should explore the molecular subtypes of immune profiles.
A stratified urine-based molecular diagnostic and prognostic model for non-muscle-invasive bladder cancer management.
Yi L, Ma Z, Zhang J … +9 more , Zhan Y, Xiao H, Dai K, Liu Y, Gao Y, Yang X, Cao D, Xu D, Huang H
BMC Cancer · 2026 Jun · PMID 42332658 · Full text
BACKGROUND: Non-muscle-invasive bladder cancer (NMIBC) is characterized by a high recurrence rate requiring lifelong cystoscopic surveillance. Existing urine-based molecular assays mainly rely on mutations or methylation...
BACKGROUND: Non-muscle-invasive bladder cancer (NMIBC) is characterized by a high recurrence rate requiring lifelong cystoscopic surveillance. Existing urine-based molecular assays mainly rely on mutations or methylation, which fail to capture large-scale genomic instability. Copy number variation (CNV) profiling offers complementary information on tumor evolution and aggressiveness, but its application in urinary diagnosis remains limited. We aimed to integrate CNV and DNA methylation signals from urinary DNA to establish a noninvasive and biologically informed stratified diagnostic model for NMIBC recurrence surveillance and risk stratification. METHODS: Urine samples were prospectively collected from 91 patients (75 evaluable) between June 2021 and August 2023. Shallow whole-genome sequencing (sWGS) was used to detect CNVs at chromosomal arm and focal gene levels, while ONECUT2 promoter methylation was quantified by qPCR. Diagnostic and prognostic performance was evaluated by ROC analysis, Kaplan-Meier survival, and stratified recurrence assessment. RESULTS: We evaluated a stratified diagnostic model combining CNV and ONECUT2 methylation testing in a cohort of 79 patients. CNV analysis alone showed high specificity (0.923) for NMIBC diagnosis. A combined model, using CNV as an initial screen followed by ONECUT2 methylation testing in CNV-positive cases, achieved a sensitivity of 0.783, specificity of 0.981, and a negative predictive value (NPV) of 0.911. This approach reduced the number of required ONECUT2 tests by 35% and identified a high proportion of true-negative patients (98.1%), which may help reduce unnecessary cystoscopy procedures. The model also demonstrated significant prognostic value, with the molecularly defined high-risk group showing significantly shorter recurrence-free survival (RFS) than the low-risk group (median RFS: 4.33 months vs. not reached; p < 0.001). Additional, in patients with initially negative cystoscopy after urine sample collection, the model demonstrated a predictive accuracy of 0.922 for recurrence, with molecular positivity observed a median of 9.6 months prior to clinical diagnosis. CONCLUSIONS: Integrating CNV and DNA methylation profiling from urinary DNA provides a powerful and noninvasive molecular framework for NMIBC surveillance. By combining early epigenetic changes with genomic instability signals, this approach enhances recurrence risk assessment and enables earlier detection compared with conventional cystoscopy. It offers a practical route toward personalized and adaptive post-treatment monitoring of NMIBC. TRIAL REGISTRATION: NCT04994197.
A single-center retrospective study of short-term efficacy and safety of blinatumomab in the treatment of high-risk acute lymphoblastic leukemia.
Ma Y, Chang L, Wang L … +3 more , Chen L, Wei X, Mi R
BMC Cancer · 2026 Jun · PMID 42332648 · Full text
BACKGROUND: Treatment outcomes for high-risk B-ALL remain suboptimal. Blinatumomab, a CD19/CD3 bispecific T-cell engager, has shown efficacy in trials, but real-world data in Chinese high-risk patients are limited. METHO...
BACKGROUND: Treatment outcomes for high-risk B-ALL remain suboptimal. Blinatumomab, a CD19/CD3 bispecific T-cell engager, has shown efficacy in trials, but real-world data in Chinese high-risk patients are limited. METHODS: This single-center retrospective study analyzed 29 high-risk B-ALL patients treated with blinatumomab (7-28 days/cycle). We assessed short-term efficacy (MRD negativity rate), safety, and the impact of genetic factors and treatment duration. RESULTS: The overall MRD negativity rate after one cycle of blinatumomab was 82.8% (24/29). All patients with the Ph-like subtype (3/3, 100%) and 71.4% (10/14) of Ph+ patients achieved MRD negativity. However, clinical outcomes were inferior in patients harboring specific genetic alterations: 50% (2/4) of patients with the BCR::ABL1 T315I mutation experienced early relapse, and only one of two patients with E2A::PBX1 rearrangement achieved transient MRD negativity. The median event-free survival (EFS) was 9.6 months (95% CI: 6-16.75). Grade ≥ 3 hematologic toxicity occurred in 48.3% (14/29) of the patient cohort. CONCLUSION: Blinatumomab achieved high short-term MRD response rates in high-risk B-ALL. Inferior outcomes appeared to be associated with the presence of BCR::ABL1 T315I mutations and E2A::PBX1 rearrangements.
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