Objective: To analyze the disease burden of malignant neoplasms of bone and articular cartilage (MNBAC) in the East Asian (China, Democratic People's Republic of Korea, Japan, Mongolia, and South Korea) from 1990 to 2023, so as to formulate and adjust prevention and treatment strategies for MNBAC. Methods: The average annual percentage change (AAPC) was used to comprehensively evaluate the changing trend of MNBAC disease burden from 1990 to 2023. Decomposition analysis was conducted on the corresponding burden of MNBAC in Ease Asian countries, along with subgroup analyses by age and gender. Based on the autoregressive integrated moving average (ARIMA) model, the future standardized rates of MNBAC in China were predicted. Results: In 2023, there were significant differences in the disease burden of MNBAC among East Asia countries, with China, Democratic People's Republic of Korea, and Mongolia bearing the heavier burden. From 1990 to 2023, the standardized prevalence, disability-adjusted life years (DALYs) rate, and mortality rate of MNBAC in China and Democratic People's Republic of Korea all showed upward trends (AAPC value of 2.86%, 1.74%, 1.96% for China; and 1.15%, 0.84%, 1.26% for Democratic People's Republic of Korea, respectively), whereas those in Japan and Mongolia showed downward trends (AAPC values of -0.36%, -1.40%, -1.37% for Japan; and -0.58%, -0.77%, -0.82% for Mongolia, respectively). The standardized prevalence, DALYs rate, and mortality rate in South Korea remained relatively stable (AAPC=0.12%). Decomposition analysis indicated that epidemiological changes were the main drivers of the increases in prevalence and DALYs burden in China and Democratic People's Republic of Korea, but were negative contributors to the prevalence, DALYs and mortality burden in Mongolia. Gender subgroup analysis showed that the overall burden of MNBAC in males was significantly higher than that in females in East Asia. Age subgroup analysis indicated that the prevalence and DALYs rate exhibited an M-shaped pattern with increasing age, while the mortality rate increased with age. Additionally, over the next the corresponding burden of MNBAC in China is projected to show a downward trend. Conclusions: The disease burden of MNBAC varies significantly cross countries, genders, and age groups. It is necessary to further develop more targeted prevention and treatment measures based on the distribution characteristics of the disease burden, so as to effectively reduce the burden of MNBAC.

Developing effective nursing support for cancer therapy-related cardiac dysfunction (CTRCD) in patients with breast cancer requires understanding nurses' knowledge and nursing practices regarding CTRCD. This study elucidated these aspects among Certified Nurse Specialists (CNSs) and Certified Nurses (CNs) in Japan.

A web-based survey was administered to 1490 nurses, including CNSs in cancer nursing and CNs in cancer chemotherapy, breast cancer, and heart failure. The survey assessed participants' characteristics, knowledge of CTRCD, nursing practices, consultation experiences, and interprofessional collaboration. We calculated descriptive statistics and conducted group comparisons between oncology nurses specializing in cancer nursing and cardiology nurses specializing in heart failure nursing.

We obtained 261 responses, including 214 (82.0%) from oncology nurses and 47 (18.0%) from cardiology nurses. These two groups exhibited significant differences in their knowledge of CTRCD definitions, risk factors, and related agents (p < 0.01). Among oncology nurses, 88 (56.8%) provided patient education on CTRCD risk and 94 (63.9%) monitored CTRCD symptoms; thus, practice implementation remained around half. A higher proportion of cardiology nurses reported having received questions or consultations regarding CTRCD from patients or staff (p < 0.05). Only 27 participants (10.3%) reported access to onco-cardiology educational opportunities at their respective institutions.

Differences in knowledge and practices regarding CTRCD were identified between oncology and cardiology nurses. Improving nursing practices, particularly patient education and symptom observation, is essential for early CTRCD detection and treatment. Furthermore, systematic educational programs and structured collaborative frameworks, including interprofessional collaboration, are needed at both the institutional and national levels.

The FDA's Project Optimus CALLS for randomized exploration of multiple doses to better refine selection of the optimal biologic dose (OBD). Project FrontRunner encourages the use of randomized controlled trials earlier in the drug development process. We propose a seamless three-stage trial design that addresses both goals by incorporating biomarker-subgroup stratified randomization in both the dose-ranging and efficacy stages. Stratification in the dose-ranging stage allows for possibly different OBDs within each biomarker subgroup. A Bayesian optimal interval design guides dose escalation, followed by a one-sample Bayesian optimal efficiency predictive probability design in the dose-ranging stage. A Bayesian optimal efficiency stratified control arm design is employed in the efficacy stage. The components are linked by two novel decisions: (1) selecting sufficiently safe doses to advance from escalation to dose-ranging, and (2) ranking doses based jointly on safety and efficacy to choose an OBD for the efficacy stage. In simulation studies of three potential dose levels, correct selection of the true OBD in the dose-ranging stage was challenging in some settings, with rates of correct selection ranging from 12% when the true OBD was the same as the true MRD to 80% when the true OBD was below the MTD. In many settings the proposed design outperformed BOIN12 and DROID in selection of the true OBD. Over the entire seamless study, adequate power of at least 80% was never achieved and the Type I error was controlled at too low rates, below the target of 10%. This novel design provides an important option for both settings with well-defined molecularly targeted subgroups and in settings where the molecular target is still being refined. By gathering multifaceted information across both dose levels and targeted subgroups, more efficient and better-informed decisions can be made about targeted dosing.

Robotic gastrectomy (RG) for gastric cancer reduces morbidity and achieves long-term outcomes comparable to laparoscopy. However, RG is typically a solo-surgeon procedure performed by expert console surgeons, limiting trainees' operative experience. To address this issue, we developed Laparoscopic and Robotic procedures Combined Surgery (LARCS), in which the patient-side surgeon (PSS) performs selected surgical maneuvers, including dissection, clipping, and stapling, using laparoscopic instruments under the supervision of the console surgeon.

We retrospectively analyzed 96 patients who underwent robotic distal or subtotal gastrectomy at Kitasato University Hospital between January 2019 and December 2023. Patients were divided into a conventional RG group (CRG; n = 60) and a LARCS group (n = 36). Propensity scores were estimated based on age, sex, body mass index, American Society of Anesthesiologists status, and clinical T and N categories. Cardinality matching within a 0.2-standard-deviation caliper of the logit of the propensity score yielded 23 matched pairs, with all absolute standardized mean differences for the matching covariates < 0.1. Perioperative outcomes and PSS participation were compared.

After matching, adequate balance was achieved for all matching covariates, with absolute standardized mean differences ranging from 0 to 0.062. Operative time was 406 min in the LARCS group and 373 min in the CRG group (p = 0.110). Estimated blood loss tended to be greater with LARCS (51 vs. 6 mL, p = 0.070). Any postoperative complication occurred in 6 and 5 patients, respectively (p = 1.000), and major complications occurred in 2 and 0 patients, respectively (p = 0.500). Median PSS operative time was 108 min, corresponding to 26.6% of the total operative time in LARCS, versus 0 min in CRG (p < 0.001).

LARCS provided patient-side trainees with supervised, instrument-based first-operator participation for approximately one-quarter of the operative time, supporting its feasibility as a complementary approach to trainee participation during robotic gastrectomy. Further prospective studies incorporating objective competency-based assessments are required to determine its educational effectiveness and safety.

To identify factors contributing to the known increased age-standardised incidence and mortality rates for lung cancer for Aboriginal and Torres Strait Islander people in Victoria, Australia.

Retrospective, population-based, case-control study using Victorian Cancer Registry (VCR) data and linked health administrative datasets.

Self-identified Aboriginal and Torres Strait Islander people (respectfully referred to hereon as Aboriginal) and non-Aboriginal people (aged > 18 years) diagnosed with lung cancer from 1 January 2008 to 31 December 2022.

Clinical, pathological, demographic, socio-economic factors and biomarkers (programmed cell death-ligand 1 [PD-L1], anaplastic lymphoma kinase [ALK] and c-ros oncogene [ROS1]) were assessed. Endpoints were all-cause and lung cancer-specific mortality. Survival analyses were conducted using Cox regression.

Aboriginal people (N = 512) were younger (p < 0.001), more likely to live outside a major city (p < 0.001) and in areas of greatest disadvantage (p < 0.001) than non-Aboriginal people (N = 43,468). More Aboriginal females had small cell lung cancer compared with non-Aboriginal females (17% vs. 10%), more Aboriginal males had adenocarcinomas (41% vs. 36%) and squamous cell carcinomas (26% vs. 20%), compared with non-Aboriginal males. There were no differences in the proportions of PD-L1-positive disease nor ALK or ROS1 gene rearrangements. A higher risk of all-cause mortality (hazard ratio, 1.12; 95% CI, 1.01-1.24; p = 0.03) for Aboriginal people after stratification for age, sex and lung cancer subtype was identified.

This study identified that Aboriginal people were younger, more likely to be living outside of major cities and in areas of greatest inequity than non-Aboriginal people, which is an ongoing manifestation of colonisation. Aboriginal people diagnosed with lung cancer had an increased all-cause mortality compared with non-Aboriginal people.

Myxoma is the most common benign cardiac tumor. We reported a rare variant of balloon-like cystic cardiac myxoma.

A 54-year-old woman presented with exertional dyspnea, chest tightness, and intermittent dizziness. Electrocardiogram and laboratory studies were unremarkable. Transthoracic echocardiography(TTE) revealed a balloon-like cystic mass in the left atrium mimicking a blood-filled cyst. Contrast echocardiography demonstrated a contrast-filled lesion with iso-myocardial enhancement. Transesophageal echocardiography(TEE) identified a distinct arterial inflow at the cyst base and an outflow orifice, which was further confirmed during surgery by the administration of cardioplegic solution. The mass was successfully resected and confirmed a cystic cardiac myxoma.

Cystic myxoma is a rare variant with only few cases reported. The presented balloon-like variant of myxoma exhibited unique anatomical and hemodynamic features that elucidate its formation mechanism.

Acquired radioresistance limits effective radiotherapy. Cuproptosis is a copper-dependent form of cell death driven by mitochondrial copper accumulation and lipoylated protein aggregation. Building on evidence that radioresistant cancer cells exhibit increased cuproptosis susceptibility, here we combine a radiation-responsive, copper-incorporated covalent organic framework (COF‑Tpy‑Se‑Cu) with an oncolytic adenovirus to target this vulnerability. X-ray irradiation triggers copper release from COF‑Tpy‑Se‑Cu and induces FDX1-dependent cuproptosis, while the oncolytic adenovirus depletes intracellular glutathione and stabilizes FDX1 by limiting its mitochondrial protease-mediated degradation. The combination enhances tumor cell death and remodels the immunosuppressive tumor microenvironment into a T-cell-inflamed state. In models of radioresistant tumors in female mice, this regimen improves tumor control and elicits CD8⁺ T cell-dependent systemic antitumor immunity and durable immunological memory. These findings support the combined use of radiation-responsive copper delivery and oncolytic virotherapy as a strategy for exploiting cuproptosis susceptibility and improving radiotherapy responses.

The phase III ADVANCE study prospectively assessed a chemotherapy-free strategy combining aumolertinib with definitive radiotherapy (RT) in patients with unresectable stage III non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations (ChiCTR.org: ChiCTR2000040590). Participants were assigned in a 1:1 ratio to either the experimental arm (110 mg daily aulomertinib plus RT) or the control arm (cisplatin/pemetrexed with RT). The primary endpoint was progression-free survival (PFS). Planned enrollment was 98 patients to detect a hazard ratio (HR) of 0.5. A protocol-prespecified real-world cohort (n = 125) was used for validation. 43 eligible patients were randomized (24 experimental, 19 control). The trial was terminated early following the prespecified interim analysis because of loss of equipoise in an open-label setting, slow accrual, and a large observed PFS difference. At a median follow-up of 25.5 months, the experimental arm had significantly longer PFS (median 34.0 vs. 7.4 months; HR 0.15; P < 0.001). Median overall survival (OS) was not reached vs. 30.5 months (HR = 0.32; P = 0.09). Neutropenia and nausea were more frequent in the control arm; quality of life favored the experimental arm. These findings were supported by real-world validation (n = 125, median follow-up 32.7 months), in which EGFR tyrosine kinase inhibitors (TKIs) + RT and TKIs+cCRT showed similar outcomes, both superior to cCRT (P < 0.001) (ClinicalTrials.gov: NCT04304638). The ADVANCE trial establishes a novel chemo-free strategy incorporating TKI and RT, which prolongs PFS and demonstrates promising OS in unresectable stage III EGFR-mutant NSCLC versus cCRT.

Storiform collagenoma is a rare benign dermal neoplasm recently shown to harbor concurrent PTEN and PDGFRB mutations. While most are sporadic, a subset occurs in the context of Cowden syndrome. We describe two storiform collagenomas with unusual morphology including infiltrative growth pattern and perivascular myoid differentiation. Confirmation of concurrent PTEN and PDGFRB mutations in both cases allowed for a more confident diagnosis of storiform collagenoma in these cases and their distinction from dermatofibrosarcoma protuberans.

Objective: To assess the clinical value of differential expression of BBOX1-AS1 in non-small cell lung cancer (NSCLC), and to explore its function and mechanism in disease progression through regulating tumor cells. Methods: Reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR) was used to detect the expression of BBOX1-AS1. The chi-square test was used to analyze the relationship between BBOX1-AS1 and clinicopathological characteristics of patients (patients diagnosed with NSCLC at Pangang Group General Hospital from January 2018 to January 2021). The clinical diagnostic value of BBOX1-AS1 and miR-3940-3p was evaluated by receiver operating characteristic (ROC) curve. Kaplan-Meier survival curve and Cox regression analysis were used to evaluate the prognostic value of BBOX1-AS1. Cell counting kit-8 (CCK-8) assay was used to analyze the effect of BBOX1-AS1 on the biological function of tumor cells. Bioinformatics tools and dual luciferase reporter system were used to investigate the downstream miRNAs and target genes mediating the function of BBOX1-AS1. Results: BBOX1-AS1 expression was significantly upregulated in NSCLC tumor tissues, serum, and cell lines (all P＜0.05). High BBOX1-AS1 expression was significantly correlated with larger tumor diameter, lymph node metastasis, and advanced TNM stage (all P＜0.05). NSCLC patients with high BBOX1-AS1 expression had a significantly lower 5-year survival rate (36.7%) than those with low expression (61.1%), and high BBOX1-AS1 expression was identified as an independent prognostic factor for NSCLC (HR=0.496, 95% CI: 0.272, 0.904, P=0.022). MiR-3940-3p expression was downregulated in NSCLC serum (P＜0.05) and negatively correlated with BBOX1-AS1 levels (r=-0.646,P＜0.001). Both BBOX1-AS1 [area under the curve (AUC)=0.858] and miR-3940-3p (AUC=0.852) exhibited high diagnostic value for NSCLC. Knockdown of BBOX1-AS1 inhibited A549 cell proliferation [the absorbance value of the BBOX1-AS1-siRNA group at 72 hours was 0.67±0.05, which was lower than those of the Mock group (1.17±0.06) and the siRNA-NC group (1.06±0.03), P＜0.001]. MiR-3940-3p directly interacted with BBOX1-AS1 and might be involved in mediating the function of BBOX1-AS1. Bioinformatics analysis predicted 10 potential target genes of miR-3940-3p: MOV10, TP53, PABPC1, TIAL1, STAU1, IGF2BP1, FMR1, ELAVL1, CPEB1, and PABPN1. Conclusions: BBOX1-AS1 is highly expressed in NSCLC patients, and its high expression indicates a poor prognosis. Knockdown of BBOX1-AS1 leads to a decrease in tumor cell proliferation. This study screens potential functional target genes and prognostic biomarkers for NSCLC.