INTRODUCTION: Sarcomas are rare, molecularly diverse malignancies that challenge accurate diagnosis and effective therapy. Japan has implemented nationwide comprehensive cancer genomic profiling (CGP) since 2019, creatin...INTRODUCTION: Sarcomas are rare, molecularly diverse malignancies that challenge accurate diagnosis and effective therapy. Japan has implemented nationwide comprehensive cancer genomic profiling (CGP) since 2019, creating an integrated framework that enables precision oncology in routine care. AREAS COVERED: This review synthesizes the status of cancer genomic medicine in Japan, delineates the genomic landscape of sarcomas, and summarizes clinically actionable alterations. We describe the diagnostic value of CGP - particularly the contribution of RNA sequencing for fusion detection - and outline national infrastructures (expert panels, registries) and platform trials that operationalize genome-matched therapy access. We also examine emerging directions, including liquid biopsy, multi-omics integration, whole-genome approaches, and artificial intelligence, and discuss practical barriers (tissue quality, turnaround time, drug access) with potential solutions. EXPERT OPINION: Japan's coordinated model - CGP embedded in care, centralized data, and adaptive trial platforms - offers a blueprint for rare cancer precision medicine. Over the next five years, earlier CGP use, broader RNA-enabled diagnostics, and trial-mediated access to targeted agents should expand; coupling liquid biopsy with multi-omics and AI will refine classification and treatment selection. Addressing access and implementation gaps will be critical to translate genomic insights into better outcomes.
INTRODUCTION: The rapid progress of immuno-oncology has transformed cancer pharmacotherapy through immune checkpoint inhibitors (ICIs); however, only a minority of patients experience durable benefits. Recent evidence su...INTRODUCTION: The rapid progress of immuno-oncology has transformed cancer pharmacotherapy through immune checkpoint inhibitors (ICIs); however, only a minority of patients experience durable benefits. Recent evidence suggests that concomitant administration of H1 antihistamines may synergistically enhance ICI efficacy by modulating the tumor immune microenvironment. This meta-analysis evaluated the association between H1 antihistamine use and outcomes in cancer patients undergoing ICI therapy. METHODS: Comprehensive searches were conducted in PubMed, Embase, and Web of Science to identify studies comparing overall survival (OS) and progression-free survival (PFS) between ICI users with and without H1 antihistamines. Pooled hazard ratios (HRs) were calculated using a random-effects model (REML) in R software (v4.4.2). RESULTS: Six retrospective cohort studies encompassing 2166 patients (417 antihistamine users and 1749 non-users) were included, primarily involving lung cancer (34.5%) and melanoma (13%). H1 antihistamine use was significantly associated with improved OS (HR = 0.64; 95% CI 0.42-0.97; = 0.035) and PFS (HR = 0.54; 95% CI 0.44-0.66; < 0.001). CONCLUSIONS: These findings indicate that H1 receptor blockade may potentiate the therapeutic efficacy of ICIs, resulting in better survival and delayed disease progression. The integration of antihistamines with ICIs may represent a promising and cost-effective adjunct strategy in cancer immunotherapy. REGISTRATION: PROSPERO (CRD420251207396).
INTRODUCTION: Zolbetuximab is a first-in-class monoclonal antibody targeting claudin 18.2 (CLDN18.2) demonstrating clinical benefit in gastroesophageal adenocarcinomas. CLDN18.2 is a gastric lineage-restricted tight-junc...INTRODUCTION: Zolbetuximab is a first-in-class monoclonal antibody targeting claudin 18.2 (CLDN18.2) demonstrating clinical benefit in gastroesophageal adenocarcinomas. CLDN18.2 is a gastric lineage-restricted tight-junction protein normally concealed in healthy gastric mucosa but aberrantly exposed on tumor cells due to polarity loss following malignant transformation. Unlike canonical oncogenic drivers, CLDN18.2 has no known oncogenic signaling role and serves as a therapeutic anchor rather than a target for tumor growth inhibition. AREAS COVERED: This review synthesizes preclinical, translational, and clinical evidence to clarify zolbetuximab's mechanism of action. Preclinical studies demonstrated that antitumor efficacy is mediated through immune effector pathways - antibody-dependent cellular cytotoxicity (ADCC) via NK cells and complement-dependent cytotoxicity (CDC). The effect requires high antigen density and is enhanced by chemotherapy-induced CLDN18.2 upregulation. Phase I pharmacodynamic studies confirmed that (i) patients retain intact NK and complement function, (ii) ADCC and CDC are rapidly engaged following infusion, and (iii) activity persists across the dosing interval. EXPERT OPINION: Zolbetuximab exemplifies a novel therapeutic class which can be classified as targeted cytolytic antibodies. Future work should test combinations with checkpoint blockade, refine biomarkers, and define resistance mechanisms.
BACKGROUND: This study evaluated the cost-effectiveness of repotrectinib as first-line versus second-line therapy compared with chemotherapy for advanced ROS1 fusion - positive non-small cell lung cancer (NSCLC) from a U...BACKGROUND: This study evaluated the cost-effectiveness of repotrectinib as first-line versus second-line therapy compared with chemotherapy for advanced ROS1 fusion - positive non-small cell lung cancer (NSCLC) from a U.S. healthcare payer perspective. METHODS: A partitioned survival model was developed to estimate lifetime costs and health outcomes for three treatment strategies. Outcomes included costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs), using a willingness-to-pay threshold of USD 150,000 per QALY One-way, probabilistic sensitivity analyses and scenario analyses were conducted to assess model uncertainty. RESULTS: Compared with chemotherapy, first-line repotrectinib yielded an additional 3.61688 QALYs at an incremental cost of $1,529,475, resulting in an ICER of $422,871 per QALY. As second-line therapy, repotrectinib provided 1.69511 additional QALYs at an incremental cost of $1,174,738, yielding an ICER of $693,016 per QALY. Both ICERs exceeded the willingness-to-pay threshold. Drug price and utility values were the main drivers of cost-effectiveness. Scenario analyses showed that reducing the price of repotrectinib to 31.843% of the base-case value lowered the ICER for first-line treatment to the WTP threshold. CONCLUSIONS: Repotrectinib is not cost-effective at current prices; however, it demonstrates a more favorable cost-effectiveness profile when used as first-line therapy. Price reductions or shorter treatment durations could improve its cost-effectiveness.
Mutlu Ozkan E, Karadağ I, Sahın E
… +33 more, Nuransoy Cengiz A, Cengız M, Can Guven D, Bozkurt O, Inanç M, Ozkan M, Kefelı U, Cabuk D, Erman M, Kılıckap S, Kosecı T, Bayır D, Demir H, Yıldız S, Urun M, Sakalar T, Majidova N, Akosman C, Ersoy M, Can Sancı P, Kolemen E, Agdas G, Kocaaslan E, Turkoğlu E, Yıldırım S, Mermıt Ercek B, Karakayalı A, Arvas H, Kıdı MM, Biter S, Cınkır HY, Karahan L, Apaydın Rollas AE
BACKGROUND: The objective of this study is to evaluate the correlation between survival outcomes and renin angiotensin system inhibitors (RASI) use in patients treated nivolmab with metastatic non-small cell lung cancer...BACKGROUND: The objective of this study is to evaluate the correlation between survival outcomes and renin angiotensin system inhibitors (RASI) use in patients treated nivolmab with metastatic non-small cell lung cancer (mNSCLC). METHODS: This retrospective cohort multicentre study was conducted on patients with mNSCLC patients treated Nivolumab monotherapy as second line therapy. Factors affecting the survival of patients receiving concurrent RASI therapy with nivolumab were analyzed. RESULTS: 614 patients were included. A total of 288 patients (46.9%) were using concurrent RASI. Patients using RASIs had a median progression free survival (PFS) of 10 months compared to 7 months in non-users. In the multivariate analysis, RASI use (HR: 0.747, 95% CI: 0.594-0.941; p: 0.013) was associated with improved PFS. RASI use was also significantly associated with overall survival (OS), median OS of 20 months in users and 12 months in non-users. In the multivariate analysis, RASI use (HR: 0.600, 95% CI: 0.458-0.787; < 0.001) was associated with improved OS. CONCLUSIONS: In this multicenter real-world study of patients with mNSCLC receiving second-line nivolumab, concomitant use of RASIs was associated with PFS and OS. The integration of RAS blockade into immunotherapy regimens could represent a promising strategy to enhance treatment efficacy.
INTRODUCTION: Acute Myeloid Leukemia (AML) is a challenging blood cancer characterized by a high rate of relapse and often unfavorable outcomes. Immunotherapies can pave the way for a changing paradigm in AML treatment a...INTRODUCTION: Acute Myeloid Leukemia (AML) is a challenging blood cancer characterized by a high rate of relapse and often unfavorable outcomes. Immunotherapies can pave the way for a changing paradigm in AML treatment and improve therapeutic outcomes, ultimately leading to a possible cure for this challenging disease. This narrative review aims to summarize the progress of immunotherapy and highlight the future landscape of these measures in the context of AML. AREA COVERED: By searching English-language literature and querying the PubMed database using pertinent Medical Subject Headings, this review traces the development of AML immunotherapy, from the first antibody-drug conjugate, gemtuzumab ozogamicin, to newer approaches, including other monoclonal antibody formats, immune checkpoint inhibitors, chimeric antigen receptor T-cell therapy, and vaccinations. EXPERT REVIEW: Although there have been significant advances, the outcomes of both traditional and novel therapies are still unsatisfactory. Immunotherapies could eliminate leukemia stem cells, which contribute to treatment resistance and disease relapse in AML. The positioning of these new therapeutic measures in development within the management algorithm for AML and their precise place in each patient's therapeutic plan are future challenges for enhancing targeted, personalized clinical programs.
BACKGROUND: Immune checkpoint inhibitors (ICIs) improve survival in solid tumors but can cause immune-related adverse events (irAEs) that often require systemic steroids. The impact of steroid dose and timing on ICI effi...BACKGROUND: Immune checkpoint inhibitors (ICIs) improve survival in solid tumors but can cause immune-related adverse events (irAEs) that often require systemic steroids. The impact of steroid dose and timing on ICI efficacy remains unclear. METHODS: We conducted a single-center retrospective study of 466 patients with metastatic solid tumors treated with ICIs between June 2016 and September 2024. Steroids for irAEs were categorized as high dose (≥1 mg/kg prednisolone-equivalent) or low dose (≤0.5 mg/kg). Overall survival (OS), progression-free survival (PFS), and post-irAE OS/PFS were evaluated. RESULTS: IrAEs occurred in 182 (39.1%) patients, and 81 (17.4%) received systemic steroids. IrAE occurrence was associated with reduced mortality risk. Among patients with irAEs, steroid use increased mortality ( = 0.035) without significantly affecting PFS. High-dose steroids were linked to worse post-irAE OS ( = 0.002) and PFS ( = 0.034), while low-dose steroids showed no detrimental effect. Early initiation ( < 2 months) of high-dose steroids demonstrated the strongest negative association. CONCLUSIONS: High-dose steroids, particularly when started early, are associated with significantly worse survival after irAEs in metastatic solid tumors. These findings support managing irAEs with the lowest effective steroid dose and encourage exploration of steroid-sparing strategies. Subtype-specific analyses were limited by small sample sizes and should be interpreted cautiously.
BACKGROUND: This study aimed to evaluate the clinical characteristics and identify prognostic variables affecting overall survival (OS) in children with undifferentiated embryonal sarcoma of the liver (UESL) using data f...BACKGROUND: This study aimed to evaluate the clinical characteristics and identify prognostic variables affecting overall survival (OS) in children with undifferentiated embryonal sarcoma of the liver (UESL) using data from the SEER database. RESEARCH DESIGN AND METHODS: We performed a retrospective cohort analysis of 101 patients aged ≤19 years diagnosed with UESL between 2000 and 2022 from the SEER database. Kaplan - Meier survival analysis and Cox proportional hazards regression were applied to determine independent prognostic factors. A nomogram was constructed based on significant predictors. RESULTS: Tumor size, surgical resection, and chemotherapy emerged as independent prognostic factors. Patients with tumors larger than 15 cm had a markedly increased risk of mortality. Surgical resection and chemotherapy were associated with improved survival outcomes. A nomogram incorporating these factors was developed to predict OS. Larger tumor size was linked to higher mortality, whereas chemotherapy significantly reduced death risk. CONCLUSIONS: Tumor size, surgery, and chemotherapy are crucial determinants of survival in pediatric UESL. Surgical intervention combined with chemotherapy appears essential for improving prognosis. Further external validation is warranted to refine treatment strategies.
INTRODUCTION: Synovial sarcoma (SyS) and myxoid round-cell liposarcoma (MRCL) are rare, aggressive soft tissue sarcomas with poor outcomes at the advanced and metastatic stage. Novel therapeutic strategies are urgently n...INTRODUCTION: Synovial sarcoma (SyS) and myxoid round-cell liposarcoma (MRCL) are rare, aggressive soft tissue sarcomas with poor outcomes at the advanced and metastatic stage. Novel therapeutic strategies are urgently needed. Afamitresgene autoleucel (afami-cel) is the first Food and Drug Administration (FDA)-approved, affinity-enhanced T-cell receptor (TCR) therapy targeting the cancer-testis antigen MAGE-A4 in HLA-A*02-positive patients. AREAS COVERED: This review summarizes clinical evidence from one early-phase study and the pivotal phase 2 SPEARHEAD-1 trial. Afami-cel achieved objective response rates of 39% in SyS and 25% in MRCL, with durable responses exceeding 11 months in SyS. The safety profile is manageable, with hematological toxicities from lymphodepletion and predominantly low-grade cytokine release syndrome; no treatment-related deaths occurred in SPEARHEAD-1. EXPERT OPINION: Afami-cel represents a milestone in sarcoma therapy, establishing proof of concept for engineered TCR T-cell therapies in solid tumors. However, challenges remain regarding HLA restriction, tumor microenvironment resistance, manufacturing delays and cost. Future efforts should focus on broadening applicability, optimizing combinations, and ensuring equitable access.
INTRODUCTION: Hormone receptor-positive and HER2-negative advanced breast cancer is the most prevalent subtype and poses therapeutic challenges. While endocrine therapy remains the cornerstone of management, acquired res...INTRODUCTION: Hormone receptor-positive and HER2-negative advanced breast cancer is the most prevalent subtype and poses therapeutic challenges. While endocrine therapy remains the cornerstone of management, acquired resistance, particularly stemming from ESR1 mutations, limits long-term efficacy. Consequently, novel endocrine agents with enhanced potency, oral bioavailability, and favorable tolerability are crucial for overcoming resistance and improving patient outcomes. AREAS COVERED: This review provides a comprehensive evaluation of elacestrant, an orally active selective estrogen receptor degrader that has transformed the treatment paradigm for endocrine resistant disease. The pharmacologic properties, antitumor activity, and clinical outcomes associated with elacestrant are discussed in detail, along with ongoing research exploring its integration into combination regimens and in earlier disease settings. EXPERT OPINION: Elacestrant has become an important therapeutic option for patients with ESR1-mutated disease, offering durable estrogen receptor suppression and favorable tolerability. Combination therapies targeting CDK4/6 and PI3K-AKT-TOR signaling pathways represent promising directions for extending endocrine sensitivity. With the growing integration of liquid biopsy technologies and molecular monitoring into clinical practice, dynamic treatment adaptation guided by real time molecular profiling is expected to refine therapy selection. Elacestrant is a benchmark in the shift toward individualized endocrine therapy in metastatic breast cancer, bridging molecular precision with clinical practicality.
INTRODUCTION: Bevacizumab and poly (ADP-ribose) polymerase inhibitors (PARPi) administered as maintenance therapies after platinum-based chemotherapy have shown a progression-free survival benefit in patients with ovaria...INTRODUCTION: Bevacizumab and poly (ADP-ribose) polymerase inhibitors (PARPi) administered as maintenance therapies after platinum-based chemotherapy have shown a progression-free survival benefit in patients with ovarian cancer. However, there is no head-to-head trial comparing the quality of life (QOL) between bevacizumab and PARPi. We conducted a Bayesian network meta-analysis to compare the QOL between bevacizumab and PARPi. METHODS: PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. were searched for trials reporting QOL in ovarian cancer treated with bevacizumab or PARPi. The primary outcome was the difference in QOL change between bevacizumab and PARPi. RESULTS: Eight RCTs with a total of 5822 participants were included in our analyses. We found no significant difference in QOL change between patients treated with bevacizumab and those treated with PARPi (SMD = -0.058, 95% CrI -0.431 to 0.331). Subgroup analyses stratified by treatment setting and BRCA status showed no significant influence on the network estimates. CONCLUSIONS: Both bevacizumab and PARPi demonstrated no significant adverse effects on QOL when compared to standard chemotherapy. There was no clear superiority of one treatment over the other in terms of QOL. The acceptable QOL further supports the benefit of these maintenance treatments for ovarian cancer. REGISTRATION: PROSPERO (CRD42024607491).
INTRODUCTION: Autophagy is a highly conservative self-degradative process. Previous research confirmed its importance in cancer pathogenesis. PubMed and Google Scholar databases were searched, analyzing studies on the ro...INTRODUCTION: Autophagy is a highly conservative self-degradative process. Previous research confirmed its importance in cancer pathogenesis. PubMed and Google Scholar databases were searched, analyzing studies on the role of autophagy in the development of multiple myeloma. The manuscript focuses on meta-analyses, case-control studies, and observational studies involving people with multiple myeloma. AREAS COVERED: This article explores the role of autophagy in the development of MM. Autophagy can either promote or inhibit carcinogenesis. Autophagy is crucial in determining the fate of B cells, either supporting their survival or triggering cell death. Drugs that target autophagy may be the focus of 'molecular targeted therapy.' Autophagy mechanisms potentially effective in MM cells are discussed within the context of the unfolded protein response (UPR), the bone marrow microenvironment (BMME), drug resistance, hypoxia, and DNA repair. The genes and pathways involved in MM cell survival and drug resistance, which could serve as new targets for effective treatment, are highlighted. EXPERT OPINION: The analysis of autophagy gene expression in MM could be a important factor in the diagnostic process and treatment individualization. The autophagy modulation seems to be a relevant target in oncological therapy, it could limit disease progression and increase the effectiveness of treatment.
INTRODUCTION: There is limited research on the real-world use of medicines for the management of pediatric cancers, with insufficient understanding of the varied approaches toward treatment across the globe. This scoping...INTRODUCTION: There is limited research on the real-world use of medicines for the management of pediatric cancers, with insufficient understanding of the varied approaches toward treatment across the globe. This scoping review aimed to identify publications focusing on systematic anti-cancer therapy (SACT), along with supplementary medicines, for pediatric patients with hematological malignancies in routine clinical practice globally to provide insights into current practice and identify gaps in the literature. AREAS COVERED: A scoping review methodology, following the Joanna Briggs Institute guidance, was used to identify observational studies, published between January 2013 and February 2023 in PubMed, Embase, and Scopus databases. A total of 82 studies were identified, describing the use of 50 SACT agents and 74 supplementary care medicines. Findings highlighted the implementation of multi-drug therapeutic plans to treat hematological malignancies and the diversity of treatments across settings. Cancer treatment was commonly complemented by the administration of various supplementary medicines. EXPERT OPINION: Further observational studies should be conducted to provide additional insights into pharmacological interventions in under-researched therapeutic areas; in addition, descriptive drug utilization studies would be beneficial from clinical settings where pediatric cancer patients are commonly included in clinical trials to address knowledge gaps on treatments in these settings.
INTRODUCTION: CRISPR-based genome editing and mRNA vaccine technologies have recently converged to offer new opportunities for precise and adaptable cancer immunotherapy. Their combined use may improve tumor antigenicity...INTRODUCTION: CRISPR-based genome editing and mRNA vaccine technologies have recently converged to offer new opportunities for precise and adaptable cancer immunotherapy. Their combined use may improve tumor antigenicity while enabling rapid induction of tailored immune responses. AREAS COVERED: This review examines how CRISPR-mediated modulation of oncogenic pathways, immune evasion mechanisms, and antigen presentation can enhance the efficacy of mRNA neoantigen vaccines. A structured literature search using PubMed, Web of Science, and Scopus (2013-2025) was conducted to identify preclinical and clinical studies evaluating CRISPR editing, mRNA cancer vaccines, and integrated combination strategies. Evidence from preclinical models demonstrates that CRISPR-driven tumor sensitization such as checkpoint disruption or antigen restoration amplifies T-cell responses elicited by mRNA vaccination. Early-phase clinical trials in melanoma, non - small-cell lung cancer, and pancreatic cancer indicate that sequential CRISPR editing followed by individualized mRNA vaccination is technically feasible and capable of inducing durable immune activity. Challenges related to delivery systems, safety oversight, and ethical considerations are also evaluated. EXPERT OPINION: CRISPR - mRNA integration represents a promising path toward adaptive, evolution-aware oncology. As delivery and regulatory frameworks advance, combined genome editing and programmable RNA immunotherapy is likely to become a key pillar of future personalized cancer treatment.
INTRODUCTION: Angiogenesis, the formation of new blood vessels from existing ones, plays a critical role in cancer development and progression. Given its significance, inhibiting angiogenesis has emerged as a key strateg...INTRODUCTION: Angiogenesis, the formation of new blood vessels from existing ones, plays a critical role in cancer development and progression. Given its significance, inhibiting angiogenesis has emerged as a key strategy in anticancer therapy. AREAS COVERED: This review outlines the biological process of angiogenesis and explores the clinical development of anti-angiogenic therapies across various cancer types. A comprehensive literature search was conducted focusing on approved therapies, emerging agents, combination strategies, and clinical outcomes. The review highlights current limitations, including variable efficacy, drug resistance, and associated toxicities. It also examines recent advances such as biomarker discovery, synergistic combinations with immunotherapy, and novel therapeutic targets. EXPERT OPINION: Although anti-angiogenic agents have transformed certain aspects of cancer therapy, their full potential remains unrealized. Future strategies should focus on personalized approaches aided by predictive biomarkers, and rational combinations to enhance efficacy and reduce resistance.
INTRODUCTION: Breast sarcomas (BS) are considerably less prevalent than breast carcinomas. Nevertheless, they are often aggressive, resulting in substantial morbidity and mortality. Despite advances and the introduction...INTRODUCTION: Breast sarcomas (BS) are considerably less prevalent than breast carcinomas. Nevertheless, they are often aggressive, resulting in substantial morbidity and mortality. Despite advances and the introduction of targeted therapies, the treatment continues to rely on cytotoxic chemotherapy. Given their rarity, this review comprehensively examines recent developments in BS therapies and explores how novel treatments may be integrated into the current standard of care. It also highlights emerging trends in adjuvant treatment for localized disease and targeted therapies for specific histologic subtypes in metastatic cases. AREAS COVERED: This review synthesizes recent developments in BS and integrates novel therapies into the existing treatment paradigm. It underscores the heterogeneity among BS subtypes and discusses emerging trends in adjuvant therapies and targeted agents. Current literature was reviewed by a systematic search using PubMed, focusing on high-impact clinical trials, guidelines, and recent reviews published up to January 2025. EXPERT OPINION: Although there is a growing understanding of genomic abnormalities associated with specific sarcoma subtypes, this knowledge has yet to be fully applied to personalized treatment strategies. Future research should focus on integrating genomic insights, enhancing trial design to improve patient's outcome. Robust interdisciplinary collaboration - combined with real-world data collection - is critical in improving treatment outcomes.
INTRODUCTION: The CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) gene-editing tool provides novel therapeutic alternatives by promoting the gene alteration in adaptive T cells or malignant cells to co...INTRODUCTION: The CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) gene-editing tool provides novel therapeutic alternatives by promoting the gene alteration in adaptive T cells or malignant cells to combat Hepatocellular Carcinoma (HCC). More successful cancer treatments are now possible due to the capacity of precisely locating and modifying particular genetic abnormalities that promote malignancy growth and metastasis. AREAS COVERED: In this review, we address ongoing clinical trials, the possible similarities between CRISPR-based cancer treatments and current therapeutic choices, and how CRISPR technology can improve treatment outcomes for HCC while using the latest safety measures. Additionally, this analysis sheds light on the existing obstacles and potential future possibilities of applying CRISPR technology to the management of HCC, with a final objective of enhancing patient results and completely changing the field of HCC therapies. EXPERT OPINION: The urgent need for innovative therapies is underscored by the poor prognosis associated with severe hepatocellular carcinoma, despite recent advancements in clinical therapies. Through a special emphasis on invivo cancer cell targeting along with the generation of chimeric antigen receptor (CAR) T cells, including T cell receptor (TCR) T cells, this review analyses the uses of CRISPR methods in the therapy of HCC.
INTRODUCTION: Thyroid cancer management is shifting from morphology-based assessment to precision oncology driven by integrated molecular profiling and computational analytics. This review examines how these advances add...INTRODUCTION: Thyroid cancer management is shifting from morphology-based assessment to precision oncology driven by integrated molecular profiling and computational analytics. This review examines how these advances address overdiagnosis, indeterminate cytology, and radioiodine-refractory disease. AREAS COVERED: We synthesize recent evidence on multi-analyte next-generation sequencing panels, the prognostic impact of co-occurring mutations, characterization of the tumor immune microenvironment, and therapeutic innovations (targeted agents and immunomodulatory strategies). We also summarize applications of artificial intelligence in ultrasound, cytology, and text mining. Literature was identified through structured searches of PubMed/MEDLINE, Scopus, and Web of Science for English-language studies published between January 2020 and June 2024, prioritizing original research, clinical trials, meta-analyses, and high-quality reviews. EXPERT OPINION: The field is converging toward an integrated framework that combines genomic architecture, immune contexture, and AI-derived features to refine surgical decisions, guide radioactive iodine use, and select systemic therapy. Near-term priorities include standardizing multi-omic pipelines, validating AI across diverse populations, and expanding access to testing, while emerging tools such as liquid biopsy and patient-derived organoids are poised to enable adaptive, patient-specific management.