Peripheral immune biomarkers provide a minimally invasive approach to monitor systemic responses to cancer immunotherapy, yet their predictive value in real-world longitudinal settings remains incompletely defined.

We conducted a prospective longitudinal study in patients with advanced melanoma and non-small cell lung cancer (NSCLC) receiving immune checkpoint inhibitors. Thirteen circulating immune, inflammatory, and nutritional biomarkers were analyzed across treatment cycles, and their association with radiological response over time was assessed using Bayesian ordinal mixed-effects models.

Nine biomarkers showed significant longitudinal associations with clinical outcomes. CD4+ T cells emerged as the strongest predictor of favorable response, followed by CD3+ and CD45+ T cells, natural killer cells, albumin, and total protein, whereas elevated neutrophils, lactate dehydrogenase, and the neutrophil-to-lymphocyte ratio were associated with poor outcomes. No significant effects were observed for CD8+ T cells, B cells, total lymphocytes, or the CD4/CD8 ratio.

These findings identify circulating CD4+ T cells as the most informative peripheral biomarker associated with longitudinal response to immune checkpoint inhibitors and support the clinical utility of peripheral immune profiling as a dynamic, minimally invasive strategy for monitoring treatment efficacy in routine oncology practice.

Esophageal squamous cell carcinoma (ESCC) remains one of the most aggressive and lethal cancers, with high incidence and mortality rates in East Asia. Neoadjuvant chemotherapy (NC) has traditionally been the standard approach for improving resectability in ESCC, but its limited efficacy in achieving complete pathological responses and enhancing survival has driven interest in combining it with immune checkpoint inhibitors (ICIs), resulting in neoadjuvant chemoimmunotherapy (NIC). Based on randomized controlled trials (RCTs), this meta-analysis compares the risks and clinical benefits of NIC versus NC in resectable ESCC patients.

This meta-analysis systematically reviewed data from randomized controlled trials (RCTs) comparing NIC and NC in the treatment of resectable ESCC. Primary outcomes included pathological complete response (pCR) and major pathological response (MPR), while secondary outcomes focused on overall survival (OS), event-free survival(EFS), surgery rate, microscopically margin-negative resection(R0 resection), Intraoperative and hospitalization indicators, T Staging, Response evaluation criteria in solid tumors(RECIST), and adverse events (AEs).

Six high-quality RCTs (1070 patients) were included. NIC significantly improved major pathological response(MPR) (42.8% vs. 22.2%, Odds Ratio(OR) = 2.40, p = 0.0007) and pathological complete response(pCR) (22.2% vs. 8.0%, OR = 3.53, p < 0.00001). NIC was also associated with borderline statistically significant improvements in overall survival (OS) (HR = 0.57, p = 0.05) and R0 resection rate (OR = 2.56, p = 0.05). In addition, NIC enhanced surgical rate (OR = 1.57, p = 0.02), lymph node resection (Mean Difference (MD) = 1.76, P = 0.008), and NIC with a longer interval to surgery (MD = 4.73, p = 0.003, I2 = 95%), although this pooled estimate is less reliable because of considerable heterogeneity. However, immune-related adverse events (iRAEs) were higher in NIC (23.21% vs. 1.16%, p < 0.00001), though severe AEs were similar.

NIC significantly improves pathological response and other perioperative benefits (e.g., surgical rate and lymph node resection) in resectable ESCC compared with NC, with a trend toward improved survival, despite a higher incidence of irAEs. Further studies are needed to optimize treatment protocols and clarify the long-term impact of immune-related toxicities.

Neurofibromatosis type 1 (NF1) is a multisystemic disorder predisposing to various neoplasms and vasculopathies. While optic pathway gliomas (OPGs) are hallmarks of pediatric NF1, their incidental discovery in adults, especially when associated with persistent unidentified bright objects (UBOs), mesenchymal malignancies, and rare venous anomalies, is exceptional. A 49-year-old female with NF1 and a history of cervical synovial sarcoma underwent routine oncological surveillance. Brain MRI incidentally revealed a WHO Grade 1 OPG, multiple persistent UBOs in the brainstem and cerebellar peduncles, and a focal parietal venous aneurysm. Despite being asymptomatic, multimodal ophthalmological imaging was performed. Optical coherence tomography (OCT) showed significant asymmetric axonal loss. The left eye (OS) exhibited marked peripapillary retinal nerve fiber layer (pRNFL) thinning (69 µm, p < 0.01). Notably, while the right eye (OD) had normal pRNFL thickness (83 µm), macular ganglion cell layer (GCL) analysis detected early focal neuro-retinal suffering (54 µm minimum thickness). Automated perimetry confirmed functional correlation in both eyes. This case highlights the "multi-tumor challenge" in NF1, suggesting a high-penetrance phenotype driven by RAS/MAPK hyperactivation. The persistence of UBOs into the fifth decade and the discovery of a rare venous aneurysm likely due to medial dysplasia underscore a unique systemic vasculopathy. Unlike sporadic adult OPGs, NF1-associated forms often follow an indolent course, justifying a "watch-and-wait" strategy. Managing complex adult NF1 phenotypes requires a multidisciplinary approach. This case demonstrates that GCL-OCT can serve as a sensitive "early warning system" for axonal loss before clinical symptoms arise, facilitating non-invasive surveillance in genetically vulnerable individuals.

Neuroendocrine tumors (NETs) of the small bowel are uncommon, typically slow-growing neoplasms that may remain asymptomatic until reaching advanced stages. We present the case of a 69-year-old male with multiple comorbidities who was referred for evaluation of an incidentally identified mesenteric lesion on computed tomography (CT). Preoperative imaging revealed a 5 × 3.6 × 4.3 cm node-like mass within the mesentery. During robotic exploration, this lesion was identified along with two additional previously undetected small-bowel NETs. The patient underwent small bowel resection with en bloc removal of the mesenteric mass, and his postoperative course was uneventful. Final pathology demonstrated multifocal, well-differentiated NET with 9 of 20 lymph nodes positive for metastatic involvement. This case emphasizes important diagnostic and therapeutic considerations in the management of small-bowel NETs. Cross-sectional imaging can underestimate the true extent of disease, as multifocal tumors are common and may go undetected preoperatively. Complete surgical resection with negative margins remains the primary treatment modality and provides the best opportunity for long-term disease control. Minimally invasive and robotic approaches facilitate comprehensive intraoperative evaluation while preserving bowel length and vascular integrity. Early identification and definitive resection are critical, as untreated NETs can progress to complications such as mesenteric fibrosis, bowel obstruction, or metastatic spread despite their typically indolent course. This case highlights the importance of maintaining a high index of suspicion and performing careful intraoperative assessment when evaluating seemingly isolated mesenteric masses, given the potential for underlying multifocal disease.

Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare tumors that typically exhibit a low malignant potential and an indolent clinical course; however, up to 10-15% of cases can manifest aggressive features, including vascular invasion and synchronous distant metastases. We report the case of a patient diagnosed with an aggressive pancreatic SPN associated with extensive local invasion, a 5 cm portal vein tumor thrombus, and synchronous hepatic metastases. The patient underwent an extensive, aggressive multi-visceral resection encompassing a distal pancreatectomy, splenectomy, superior hemigastrectomy, distal esophagectomy, and a portal vein thrombectomy with primary vascular repair. Follow-up imaging demonstrated stable hepatic disease with an increase in cystic-appearing lesions, while follow-up laboratory evaluations confirmed the complete normalization of biochemical and hematological parameters. Clinically, the patient experienced a satisfactory postoperative course, presenting with no compromise in nutritional status, adequate tolerance of oral intake, and optimal functional capacity, with an Eastern Cooperative Oncology Group (ECOG) performance status of 0, performing all activities of daily living autonomously and without limitations. This case underscores that aggressive multi-visceral surgical resection with cytoreductive intent is a technically feasible and highly beneficial strategy for metastatic SPN, as it can favorably modify the disease's biological behavior, reduce overall tumor burden, and achieve remarkable clinical and functional stability.

cyclin-dependent kinase 4/6 inhibitors (CDK4/6is) are widely used to treat hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer (MBC). This study aimed to assess the real-world efficacy and tolerability of CDK 4/6i in the Egyptian population.

prospective observational study for HR+/HER2- MBC treated in the clinical oncology department of Ain Shams University Hospitals, Egypt, between July 2022 and September 2024.

sixty-two patients were included (mean age, 53.8 years; range, 29-85). Thirty-one (50%) received CDK4/6is as first-line therapy and 31 as second-line therapy. Median follow-up time was 14.2 months (range 12-24 months). Thirty patients (48.3%) started on Ribociclib, 9 (14.5%) on Abemaciclib, and 23 (37.1%) on Palbociclib, with 15 patients switched from Ribociclib and Abemaciclib to Palbociclib due to logistical causes. Median progression-free survival (PFS) was 14 months (6-27 months) and 11 months for first- and second-line therapy, respectively. Patients and treatment characteristics did not significantly impact PFS. Ribociclib and Palbociclib most frequently caused neutropenia (70.0% and 68.4%, respectively), while Abemaciclib caused diarrhea (55.6%). The rate of dose reductions was 24.6%. Age was significantly correlated with a higher incidence of hematological (p=0.03) and nephrological toxicity (p=0.02). Furthermore, medical comorbidities were associated with a significantly higher frequency of grade 3-4 hematological events (p=0.02).

our findings demonstrate that CDK4/6is are both effective and well-tolerated for HR+//HER2- MBC patients within a diverse patient population. Additionally, this prospective evaluation supports the efficacy of lower-dose levels of CDK4/6is, without negatively impacting PFS.

HPV infection is the leading cause of cervical cancer. HPV vaccination coverage among young people in China remains low. Medical students, as a high-risk group and future health educators, are critical for cervical cancer control.

A questionnaire survey was conducted among 1,244 medical students from April to May 2026. Data were analyzed using SPSS 26.0, including t-test, correlation, regression, and serial mediation analysis (PROCESS Model 6).

Among 1,203 valid participants (51.0% male, 49.0% female, 71.8% having received HPV vaccines), HPV knowledge was positively correlated with both vaccination intention and actual vaccination behavior. The serial chain mediation analysis specifically focused on vaccination intention: HPV knowledge showed a significant direct associational link with vaccination intention (β = 0.1238, p < 0.001). Perceived susceptibility and perceived severity served as significant serial mediators for intention.

HPV knowledge is correlated with vaccination intention via direct associations and serial mediating associations of perceived susceptibility and perceived severity. Based on these cross-sectional correlational findings, interventions targeting HPV knowledge improvement may correlate with elevated risk perception and stronger vaccination intention.

The association between anti-Müllerian hormone (AMH) levels, body weight and insulin resistance in women with polycystic ovary syndrome (PCOS) has been extensively discussed, yet evidence remains conflicting. Therefore, the aim of this study was to determine the relationship between AMH levels and metabolic parameters among reproductive-age women with PCOS in Poland.

This retrospective study included 156 women diagnosed with PCOS according to the Rotterdam criteria and 156 controls without PCOS. Serum AMH, fasting glucose, and fasting insulin concentrations were measured, and insulin resistance was assessed using the homeostasis model assessment (HOMA-IR). Multiple regression, interaction, and mediation analyses were performed to evaluate the relationships between BMI, insulin resistance, and AMH levels.

A negative association between AMH concentration and both fasting insulin and HOMA-IR was revealed. Subsequent analysis further demonstrated that the relationship between HOMA-IR and AMH is independent of BMI, whereas the association between BMI and AMH was weaker and likely mediated by insulin resistance.

Insulin resistance appears to represent a stronger metabolic correlate of AMH levels than BMI in women with PCOS. These findings may suggest that metabolic dysfunction, rather than excess body weight alone, is more closely associated with AMH alterations in PCOS.

Higher SES is associated with lower mortality among colorectal cancer (CRC) survivors. We performed a mediation analysis to identify factors that mediate the association between household income and CRC mortality.

Data arise from 1038 participants of the prospective Southern Community Cohort Study (SCCS) who developed incident CRC after enrollment (2002-2009); 73% self-identify as Black. Fifty-nine percent self-reported household income <$15,000/year. Mortality outcomes were determined via the National Death Index. Proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for mortality by income level. Mediation analysis was used to estimate indirect effects of stage, healthcare-access and use, comorbidities and health behaviors on mortality.

Higher income was associated with lower risk for all-cause mortality (≥$15,000 vs. <$15,000/year: HR = 0.70, 95%CI:0.58-0.84) and CRC-specific mortality (HR = 0.75, 95%CI:0.59-0.94). Differences in stage and surgical resection together explained 33% of the association with CRC-specific mortality and 16% for all-cause mortality. Smoking history explained 11% of the association with all-cause mortality and 9% for CRC-specific mortality. Diet explained 9% of the association with each outcome. Adjustment for all potential mediators explained 26% and 44% of the associations with all-cause and CRC-specific mortality, respectively. Associations between income and mortality were similar for participants with local/regional tumors only.

Differences in early detection and surgical resection are the strongest mediators of the association between income and mortality. SES-targeted health policies and patient navigation will improve CRC outcomes. Additionally, health policies to address smoking cessation and food availability will create opportunities for interventions to promote health equity.

Anti-FGFR therapies changed the treatment landscape for patients with previously treated, advanced, or metastatic cholangiocarcinoma (CCA) harbouring FGFR2 fusions/rearrangements. However, primary resistance to FGFR inhibitors remains a key challenge. In the present real-world study, we aimed to evaluate the prognostic impact of concomitant GAs in patients with FGFR2-positive CCA treated with pemigatinib.

This study included PEMIREAL-PEMIBIL patients treated with pemigatinib in second or later lines. Only patients who underwent extensive DNA- and/or RNA-based next-generation sequencing (NGS) analysis were considered. Primary endpoint was progression-free survival (PFS), with overall response rate, disease control rate and overall survival (OS) as secondary endpoint. OS and PFS were calculated by Kaplan-Meier and log-rank test. Multivariate analysis used cox-regression model. Level of statistical significance p was 0.05.

Of 72 patients of PEMIREAL-PEMIBIL, 63 patients had evaluable NGS data, with concomitant GAs identified in 28 patients (44.4%). The most frequently observed concomitant GAs involved BAP1 (7/63, 11.1%), CDKN2A (7/63, 11.1%), TP53 (6/63, 9.5%), CDKN2B (5/63, 7.9%), PTEN (3/63, 4.7%) and IDH1 (1/63, 1.5%). A significantly shorter PFS was observed in patients with CDKN2A mutations compared to CDKN2A wild-type tumours (4.79 vs. 8.66 months, p = 0.0011, HR: 3.48 95% CI: 0.91-13.24), and similarly in patients with BAP1 mutations compared to BAP1 wild-type tumours (5.97 vs. 8.52 months, p = 0.025, HR:2.55 95% CI: 0.72-9.00). No significant differences in OS were observed.

Our results support the negative prognostic role of BAP1 and CDKN2A GAs on PFS in patients with locally advanced or metastatic CCA with FGFR2 gene fusion/rearrangement treated with pemigatinib in a real-world setting.