Melanoma is the leading cause of skin-cancer-related mortality worldwide. Anti-programmed cell death protein-1 therapies, including pembrolizumab, play a critical role in treating advanced melanoma. However, the optimal treatment duration remains undetermined.

To evaluate whether longer durations of pembrolizumab therapy improve overall mortality in stage III and stage IV melanoma.

We conducted a retrospective cohort study using the TriNetX platform, including 234 patients who received 24+ months of therapy (long-term) and 796 patients who received 12 to 24 months (intermediate-duration). A cohort of 746 patients who received pembrolizumab for 7 to 10 months (short-term) served as the comparison group. Mortality, hospitalizations, serum lactate dehydrogenase (LDH) levels, and adverse events were analyzed over 10 years using Cox proportional hazards regression with propensity score matching.

Long-term therapy significantly reduced overall mortality (HR = 0.41, 95% CI: 0.27-0.62) compared with short-term therapy. Intermediate-duration therapy also reduced mortality (HR = 0.47, 95% CI: 0.37-0.60) and hospitalizations (HR = 0.74, 95% CI: 0.68-0.93). Differences in LDH levels and adverse events did not reach statistical significance.

Longer durations of pembrolizumab therapy reduces overall mortality in stage III and stage IV melanoma, reinforcing its safety and utility. Prospective studies are needed to confirm these findings.

Confluent and reticulated papillomatosis (CARP) is a rare, non-systemic disease usually treated using oral antibiotics.

We present a 15-year-old male with CARP for whom initial treatment with doxycycline, ketoconazole shampoo, and topical minocycline was ineffective. He was subsequently treated with a combination of fixed-dose triple-combination clindamycin phosphate 1.2% / adapalene 0.15% / benzoyl peroxide 3.1% (CAB) gel and a sodium hypochlorite-based body wash, resulting in complete clearance after 3 months.

CARP is most often treated with oral or topical antibiotics. This case highlights the successful use of topical combination therapy with CAB, which is FDA approved for acne, plus a sodium hypochlorite-based body wash as a safe and effective alternative.

This case supports the potential role of CAB in CARP management and highlights the value of non-systemic options for treatment-resistant cases.

of Case: We report an atypical case of cutaneous angiosarcoma presenting as unilateral nasal swelling in an elderly male. The lesion was unresponsive to topical and antibiotic therapy. Diagnosis was confirmed after surgical excision, and disease control was ultimately achieved through radiation and off-label use of pembrolizumab. Patient Info: A 79-year-old male with a history of squamous cell carcinoma presented with a 1–2 month history of erythematous, scaly swelling of the left nasal tip and ala. Family history was notable for nonmelanoma skin cancer.

Initial differential diagnoses included contact dermatitis, rosacea, and rhinophyma. A shave biopsy revealed actinic damage but no malignancy. Following persistent symptoms and referral to plastic surgery, debulking surgery was performed. Histopathology confirmed cutaneous angiosarcoma.

The patient declined wide local excision and instead underwent a 4-week course of hypofractionated radiation. Subsequent imaging showed regional lymph node recurrence. He declined biopsy and surgery, and was started on off-label pembrolizumab immunotherapy for disease control.

Following immunotherapy, the patient experienced sustained remission with no clinical or radiographic evidence of disease four years post-treatment.

Cutaneous angiosarcoma is a rare, aggressive malignancy with a poor prognosis. This case illustrates the importance of considering angiosarcoma in atypical facial lesions and demonstrates disease control using a non-traditional, patient-centered treatment strategy. Immunotherapy with pembrolizumab may offer a promising option in select patients, particularly those with contraindications to extensive surgery.

To explore the intervention effect of preoperative visit nursing based on the Health Belief Model (HBM) on the perception of preoperative anxiety and pain-related stress in patients with lung cancer (LC). This retrospective study included 110 LC patients who underwent surgery at our hospital from June 2022 to June 2024. Based on the preoperative nursing protocol received, patients were assigned to a control group (routine preoperative care, n = 55) or a study group (HBM-based preoperative visit nursing, n = 55). Primary outcomes were preoperative anxiety (Amsterdam Anxiety and Information Scale [APAIS]; higher scores indicate greater anxiety), pain sensitivity (Pain Sensitivity Questionnaire [PSQ]; higher scores indicate greater sensitivity), perceived stress (Perceived Stress Scale [PSS]; higher scores indicate greater stress), and postoperative pain (Visual Analogue Scale [VAS]; higher scores indicate greater pain). Secondary outcomes included preoperative physiological parameters (systolic/diastolic blood pressure, heart rate), sleep quality (Pittsburgh Sleep Quality Index [PSQI]; higher scores indicate poorer sleep), and postoperative complications.No significant baseline differences existed between groups (P > 0.05). Between-group comparisons used independent t-tests or chi-square tests; repeated-measures ANOVA was used for longitudinal data. After intervention, APAIS, PSQ, and PSS scores decreased in both groups, with significantly lower scores in the study group (P < 0.05). Except at 6 h postoperatively, VAS scores at 12 h, 24 h, and 48 h were significantly lower in the study group (P < 0.05). Preoperative physiological parameters increased less in the study group (P < 0.05); PSQI scores decreased more in the study group (P < 0.05). The study group had a lower postoperative complication rate (3.64% vs. 16.36%, P < 0.05). HBM-based preoperative visit nursing may alleviate preoperative anxiety, pain sensitivity, and stress perception, reduce postoperative pain and physiological stress, improve sleep quality, and lower postoperative complications in LC patients.

Adoption of enhanced recovery pathways in proctectomy has gained attention due to its potential to reduce resource utilization and optimize recovery. Using a nationally representative cohort, we examined the association between early discharge (within 3 days) and 30-day readmissions, perioperative complications, and hospitalization costs.

Adult (≥18 years) patients with rectal cancer undergoing proctectomy were identified using the 2016-2021 Nationwide Readmissions Database. Patients were classified as Early if they were discharged within 3 days of proctectomy and otherwise were classified as Routine. Multivariable regression models were developed to assess associations between early discharge and 30-day outcomes, as well as associated readmission, costs, and mortality. Entropy balancing was employed to obtain a weighted comparison to adjust for intergroup differences.

Of an estimated 39,505 patients, 25.8% were discharged early. Early was younger (59 [51-68] vs 62 years [53-71], p < 0.001), had lower comorbidity burden (2 [1 -3] vs. 3 [2 -4] unit, p < 0.001), and more frequently received laparoscopic proctectomy (60.9 vs. 39.0%, p < 0.001). Following entropy balancing, early discharge was associated with lower readmission rates (adjusted odds ratio [AOR], 0.77; 95% confidence interval [CI], 0.69-0.86) and decreased cumulative hospitalization costs (β: - $6.2K; 95% CI, - 8.6k to -3.7k). Mortality at readmission was similar between the two groups (AOR, 0.69; 95% CI, 0.33-1.45).

Early discharge after proctectomy is feasible for rectal cancer patients when clinically appropriate and is associated with reduced readmissions and hospitalization costs without compromising patient safety compared to routine. Broader implementation of early discharge protocols may optimize outcomes for rectal cancer patients undergoing proctectomy.

Human papillomavirus (HPV) vaccination is a critical yet underutilized strategy for preventing HPV-related cancers in young adults. University students represent a key demographic for catch-up vaccination owing to their risk profile and transitional healthcare access. This review synthesized data from January 2015 to February 2026 to examine the trends, disparities, and determinants of HPV vaccine uptake in this population. Vaccination rates remain suboptimal worldwide, with pronounced disparities across sex, race/ethnicity, socioeconomic status, and geographic regions. Key barriers operate at multiple levels: individual (knowledge gaps, low perceived risk, hesitancy), interpersonal (lack of provider recommendations), and structural (cost, healthcare access). Promising evidence-based interventions include proactive campus health services, digital campaigns tailored to Generation Z, healthcare provider recommendations, and supportive policies. An integrated socioecological approach coordinating strategies across these levels is essential. This review highlights the urgent need for equity-focused multichannel interventions and policies to improve HPV vaccination coverage among university students worldwide.

To enhance the effectiveness of radioligand therapy (RLT), new prostate-specific membrane antigen (PSMA) targeting radiopharmaceuticals utilizing alternative radionuclides are under active investigation. One promising alternative to the established 177 Lu is the use of 161 Tb. A key advantage of 161 Tb is its emission of a higher proportion of low-energy conversion and Auger electrons, which may contribute to enhanced therapeutic effectiveness. This study provides a first exploratory evaluation of the efficacy and safety of [ 161 Tb]Tb-PSMA-617 in patients with progression after [ 177 Lu]Lu-PSMA-617, aiming to generate early clinical insights.

The study included 15 patients with mCRPC, who were enrolled in the "prospective registry to assess outcome and toxicity of targeted radionuclide therapy in patients with mCRPC in clinical routine" (REALITY Study; NCT04833517). All patients had received conventional PSMA RLT using [ 177 Lu]Lu-PSMA-617, which resulted in initial biochemical response (PSA decline ≥50%), followed by a biochemical relapse, prompting the re-initiation of PSMA RLT using [ 161 Tb]Tb-PSMA-617. Patients received a median of 3 (range: 2-7) cycles with mean administered activity of 5.4 ± 1.1 GBq and mean cumulative activity of 19.2 ± 6.4 GBq [ 161 Tb]Tb-PSMA-617. Treatment response was assessed both biochemically by serum PSA levels and through molecular imaging by total lesion PSMA (TLP) on [ 68 Ga]Ga-PSMA-11 PET/CT scans. Adverse events were assessed at baseline and follow-up using the "Common Terminology Criteria for Adverse Events" (Version 5.0).

[ 161 Tb]Tb-PSMA-617 RLT showed response rates of 66.7% (10/15 patients) based on biochemical assessment and 86.7% (13/15 patients) based on molecular imaging assessment. Beginning with the initiation of [ 161 Tb]Tb-PSMA-617 RLT, the median progression-free survival (PFS) was 6.4 months, and the median overall survival (OS) was 15.5 months. In total, 6 CTCAE grade deteriorations from grade 2 to grade 3 or from grade 3 to grade 4 were observed. No discontinuation of PSMA RLT due to adverse events was reported.

[ 161 Tb]Tb-PSMA-617 RLT emerges as a promising treatment option, demonstrating encouraging response rates, preliminary clinical outcomes, and a favorable safety profile as second-line RLT in progressing patients who previously benefited from [ 177 Lu]Lu-PSMA-617 RLT.

Accurate classification of renal masses before treatment is crucial for therapeutic decision-making and patient outcome. This study developed and validated Multi-Phase Attention Network (MPANet), a multimodal deep learning model integrating multiphase contrast-enhanced CT and clinical information, which can utilize both complete-phase and missing-phase CT data for multiclass classification of four common and easily confusable renal tumors-clear cell renal cell carcinoma (ccRCC), papillary renal cell carcinoma (pRCC), oncocytic neoplasms (including chromophobe renal cell carcinoma (chRCC) and renal oncocytoma (RO)), and fat-poor angiomyolipoma (fpAML). A total of 1688 multi-center cases were enrolled. Across all test sets, MPANet consistently outperformed single-phase models. In the internal test set, MPANet achieved a macro-average AUC of 0.850, a micro-average AUC of 0.865, and an accuracy of 73.3%. These results compared favorably to assessments by four radiologists based on CT (accuracies 43.6-62.4%) and two radiologists using MRI with clear cell likelihood score (ccLS) system (accuracies 52.5% and 49.5%). The net improvement rate of MPANet over radiologist assessment ranged from 10.9% to 29.7%. In the two external test sets, macro-average AUCs were 0.811 and 0.813, and micro-average AUCs were 0.867 and 0.909, respectively. MPANet shows potential as a clinical decision-support tool for personalized renal tumor diagnosis.

Improved treatment techniques in locally advanced rectal cancer (LARC) with neoadjuvant chemoradiation and total mesorectal excision have resulted in higher rates of tumor downstaging and complete pathologic response (pCR). We aimed to explore the association of pCR with survival outcomes and its predictors.

We retrospectively enrolled 478 LARC patients referred to a tertiary cancer center from July 2008 to October 2023 who had received neoadjuvant long-course chemoradiation followed by definitive surgery. The patients were followed up, and the association of pCR with disease-free survival (DFS) and overall survival (OS), as well as its predictors, was analyzed.

Ninety-one (22.5%) patients achieved a pCR and 167 (39.9%) patients were downstaged to ypT_0-2ypN₀. The 5-year OS and DFS rates were 64.1% and 56% in patients without a pCR and 90.3% and 91.8% in patients with a pCR, respectively (p-value < 0.001). Receipt of adjuvant chemotherapy in patients who did not achieve a pCR did not improve either DFS or OS (p-value 0.44 and 0.73, respectively). Clinical N2 and preoperative carcinoembryonic antigen (CEA) > 5ng/mL independently predicted for pCR.

Our study underscores the importance of pCR as an independent predictor of survival in LARC. Patients with higher nodal burden as well as an abnormal preoperative CEA are less likely to achieve a pCR.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal and aggressive tumor types, with a dismal 5-year survival rate of less than 15%. Despite major advances in understanding PDAC biology, therapeutic progress has been limited. Numerous preclinical studies have provided encouraging evidence that immune-based therapies may be effective. However, the clinical translation of immunotherapies for PDAC treatment has proven difficult with a lack of favorable tumor responses outside of a very select group of patients such as patients with MSI high tumors. Immune checkpoint inhibitors, as well as combination strategies with targeted radiotherapy or chemotherapy, have largely failed to demonstrate meaningful survival benefits for the majority of PDAC patients. Increasing evidence indicates that PDAC harbors a uniquely complex and multifaceted immunosuppressive microenvironment, which plays a central role in shielding malignant cells from effective antitumor immunity. Overcoming this barrier requires the development of rational and effective combination regimens that simultaneously target both the tumor and its surrounding immune microenvironment. Novel strategies, including the use of natural killer cell-based therapies, reprogramming of cancer-associated fibroblasts, and integration of predictive or prognostic biomarkers, hold promise for enhancing therapeutic efficacy. This review summarizes recent progress in PDAC immunotherapy, highlights key challenges, and discusses emerging approaches designed to improve patient outcomes.