IntroductionSOX2, a key pluripotency gene, plays a central role in breast cancer stem cell (BCSC) biology, driving tumor aggressiveness. Although SOX2 dysregulation has been widely studied across various cancers, its specific regulatory mechanisms in breast cancer (BC) remain incompletely elucidated. This study examined the regulatory axis of the SOX2 gene and associated molecular mechanisms underlying BCSC maintenance and prognosis.MethodsThis retrospective cross-sectional study analyzed breast tumor tissues and adjacent normal controls collected consecutively from two tertiary hospitals. SOX2 promoter methylation was assessed using methylation-Specific PCR, and expression of SOX2, DNMT3b, TET3, miR-200b-3p, and TGFβ1 was quantified by qPCR.ResultsAberrant methylation of the SOX2 promoter, linked to increased expression, was observed in the BC cohort. Notably, several samples exhibited a poised promoter state, reflecting an epigenetic configuration associated with stemness. Upregulation of DNMT3b in miR-200b-reduced cells was significantly associated with SOX2 promoter methylation, suggesting a feedback loop modulating methylation dynamics. Additionally, a positive association between deregulated TET3 and TGFβ1 highlights a positive feedback loop in the dynamic tumor microenvironment. SOX2 methylation emerged as a strong prognostic marker, characterized by a low hazard ratio and high diagnostic sensitivity. Its combination with DNMT3b improved specificity (SE = 90%, SP = 79%). Reduced TET3 and miR200b expression correlated with poor outcomes, and their integration with SOX2 formed a tri-gene signature that enhanced patient stratification. Correlation analyses revealed coordinated expression among SOX2, TET3, and TGFβ1, supporting their role in methylome regulation.ConclusionThe findings underscore the clinical significance of this axis and its embedded feedback circuits in shaping BC progression and therapeutic response.

IntroductionThe Cancer Genome Atlas (TCGA) data has been extensively used for differentially expressed genes (DEGs) discovery and validation in high-grade serous ovarian cancer (HGSOC), however platinum-sensitivity biomarkers have not yet reached clinical application. We aimed to propose a robust analytical framework for TCGA platinum sensitivity studies and systematically demonstrate how patient characteristics influence DEG analyses between platinum-sensitive and resistant groups, while also considering experimental platforms and analysis pipelines, as their impact is recognized but not comprehensively evaluated.MethodsThis retrospective TCGA cohort study used publicly available microarray and RNA-seq gene expression data. TCGA-derived datasets were identified through a literature review, including only studies enabling unambiguous patient identification. Three TCGA-based cohorts were assembled-two directly from published studies and one curated through own selection-differing in patient numbers (230, 201 and 142 patients, respectively) and stage distribution. Data were analyzed using DESeq2, edgeR, limma-voom, and Wilcoxon rank-sum test to compare the impact of patient selection and pipeline choice on DEGs outcome. Genes with an adjusted p-value < 0.05 and an |log₂ fold change| > 2 were considered differentially expressed.ResultsThe three cohorts showed partial overlap of DEGs across platforms and pipelines. Both patient selection and analytical workflow influenced which genes were identified, highlighting findings variability even when using the same TCGA dataset. We establish a robust analytical framework for TCGA HGSOC biomarker studies, including the provision of patient barcodes and openly shared workflows that enable straightforward replication of our analyses from data download to DEG analysis.ConclusionsReproducibility of TCGA studies is limited by variability in patient selection, platinum sensitivity definitions, data sources, and analysis pipelines. We addressed these factors by providing a robust framework that can serve as a template for data analysis and transparent reporting when identifying and validating predictive signatures of platinum sensitivity in HGSOC patients.

Uveal melanoma is a rare cancer that can metastasize to the liver. Percutaneous hepatic perfusion (PHP) is a minimally invasive technique that delivers melphalan directly to the liver to treat metastatic uveal melanoma.

This article presents nursing care and safety recommendations across all phases of the PHP procedure for patients with metastatic uveal melanoma.

A multidisciplinary team of subject matter expert nurses, along with a clinic-based physician assistant, reviewed current literature, clinical guidelines, and trial protocols. The team identified best practices for nursing care during clinic visits, preprocedure preparation, intraprocedure monitoring, hazardous drug safe handling, postprocedure care, critical care and recovery, and follow-up.

Collaborative nursing care across specialties is essential for the safe and effective delivery of melphalan via PHP. These recommendations provide guidance on patient assessment, monitoring, management of adverse events, and patient education. As PHP becomes more widely used nationally, nurses unfamiliar with this specialized procedure will benefit from structured, evidence-informed care protocols.

Oncology nurses educate patients and caregivers about treatment. At one cancer center, treatment education was previously delivered via an in-person group class offered twice weekly to adults. This educational approach strained available resources, prompting the team to identify a new method for educating patients.

This quality improvement initiative aimed to implement a longer interval between patient education and first treatment to enhance patients' retention of educational content and maintain resource-neutral workflows.

Educational videos were developed and made available in the patient portal, via email, or for in-clinic viewing by the patient or caregiver. Scripting was developed for nurses to conduct teach-back during follow-up calls, which standardized content and teach-back delivery. The time from patient education to treatment initiation was compared for different educational methods.

This quality improvement project increased the length of time between patient education delivery and cancer treatment initiation. Patients and nurses reported satisfaction with the new process, and patients appreciated the opportunity to directly ask a nurse questions.

Palliative care (PC) is specialized health care that can improve quality of life for patients with cancer. However, PC tends to be underutilized or relegated to end-of-life care, limiting patients' ability to benefit from patient-centered, goal-concordant care. Patients with pancreatic cancer, who are often diagnosed at an advanced stage and with high symptom burdens, could benefit from PC. A chart review conducted in 2022 at a southern New Jersey academic medical center and cancer center found that among 77 patients diagnosed with cancer, only 26 were referred to palliative care services. Of those referred, just 6 received referrals for goal-concordant care discussions; the remaining 20 were referred primarily for cancer-related pain and symptom management or hospice care.

This pilot observational quality improvement study sought to increase PC referrals for patients with pancreatic cancer, and to determine whether the PC received was goal concordant.

Patients (N = 19) received referrals to PC and completed pre- and postvisit surveys.

All patients who completed the postvisit survey (N = 9) expressed satisfaction with care received from the PC team. However, there were significant delays from diagnosis to the PC visit. Nurses support oncology care and tend to be aware of patients' needs; including nurses in discussions about PC may be a mechanism to increase referrals for this patient population.

The landscape of multiple myeloma (MM) treatment has been revolutionized by the emergence of quadruplet therapies and T-cell-redirecting immunotherapies. Although these advancements offer unprecedented responses and lengths of remission, they simultaneously create a profound state of immune compromise. Infection is a leading cause of death and a significant cause of morbidity in patients living with MM.

This article explores the complex landscape of infection in patients with MM, highlighting nurse responsibilities in early detection and management. Through targeted prevention and treatment strategies, nurses improve the longevity and the daily lived experiences of their patients.

This article is a narrative review of risk factors for infection and current practices for the prevention and management of infections in patients with MM, highlighting updated guidelines for nurses.

Risk factors for infection in MM include MM-related immune system dysfunction, disease-related factors such as renal failure, comorbid conditions, and treatment-related immunosuppression or cytopenias. By fostering competence through education, supporting autonomy through structured transitions of care, and maintaining relatedness through the patient-nurse relationship, oncology nurses can mitigate the infection risks associated with modern MM therapy.

Background and objectives Despite substantial research on immunotherapy, its efficacy and safety in treating advanced non-small cell lung cancer (NSCLC) without identifiable driver mutations remain unclear. The objective of this review was to examine the efficacy and safety of immunotherapy, used as monotherapy or alongside chemotherapy, vs. chemotherapy alone in patients with advanced driver mutation-negative NSCLC. Methods A comprehensive literature search of PubMed, Embase, Scopus, and CENTRAL databases was conducted until December 2024. The protocol was registered in PROSPERO (CRD42024585050). Randomised controlled trials (RCTs) evaluating the efficacy and safety of immunotherapy, either as monotherapy or in combination with chemotherapy, compared with chemotherapy alone, were included. A random-effects meta-analysis was performed. Risk of bias was assessed using the Cochrane RoB 2 tool, and the certainty of evidence was evaluated using the GRADE framework. Results Twenty-three RCTs (n=14605 participants) were included. Immunotherapy (± chemotherapy) significantly improved overall survival [22 RCTs; 14,375 participants, hazard ratio (HR): 0.77; 95% Confidence interval (CI): 0.72-0.83] and progression-free survival (22 RCTs; 14,003 participants, HR: 0.67; 95% CI: 0.58-0.76) compared with chemotherapy alone. The objective response rate was also higher with immunotherapy (23 RCTs; 12,967 participants, RR 1.38, 95% CI: 1.24-1.54). No statistically significant differences were observed between the groups in terms of overall adverse event rates. Interpretation and conclusions Immunotherapy, whether administered alone or in combination with chemotherapy, provides significant survival benefits in patients with advanced driver mutation-negative NSCLC.

In Ghana, traditional medicine practitioners (TMPs) are often the first point of contact for women with breast health concerns. However, they operate independently of formal healthcare services. While their embeddedness within communities grants them cultural legitimacy, their perceptions of breast cancer remain underexplored. Understanding TMPs' explanatory models, recognition of signs, and diagnostic practices is crucial for improving early detection of breast cancer and reducing delays in accessing treatment that lead to poor outcomes.

We conducted a qualitative exploratory descriptive study using semi-structured interviews with 14 non-formally trained TMPs involved in breast care services in Ghana. Interviews were transcribed, translated, and thematically analyzed to understand how they recognize and interpret symptoms, their beliefs about the causes and risks of breast cancer, and how they diagnose and treat breast-related problems.

Our analysis generated four major themes: sources of knowledge, multi-dimensional explanations of breast cancer causation, cardinal signs defining breast cancer recognition, and experiential and practice-based approaches to diagnosis. TMPs relied on inherited ancestral traditions but also sought to improve their skills through workshops, professional associations, and occasional biomedical collaborations, showing a willingness to learn and adapt to new information. However, significant misconceptions remained, including beliefs that spiritual or social disharmony and reproductive and lifestyle factors cause breast cancer. While TMPs identified key signs such as lumps, nipple changes, and skin alterations, their dependence on experiential and intuitive diagnostic practices risked both over- and under-diagnosis.

TMPs are central actors in Ghana's breast cancer pathway, representing both opportunities for early recognition and risks of misinformation. Correcting misconceptions and embedding TMPs into structured training and referral systems could reduce diagnostic delays, enhance early detection, and support Ghana's National Cancer Control Plan and Sustainable Development Goal 3.

This study examined whether theory-based education increases cervical cancer screening among underserved women.

Seven databases (PubMed, Embase, Scopus, Web of Science, Cochrane Library, CINAHL, and PsycINFO) were systematically searched for studies published between January 2005 and November 2025. A total of 1,200 records were identified; after duplicate removal, 900 titles and abstracts were screened, and 200 full-text articles were assessed. Fourteen studies met inclusion criteria for qualitative synthesis, and 12 trials contributed extractable binary outcome data for meta-analysis, including one study with two distinct intervention arms. The primary outcome was screening uptake (Pap smear, visual inspection with acetic acid [VIA], or human papillomavirus [HPV] testing). Data extraction and quality appraisal followed PRISMA 2020 and Joanna Briggs Institute guidance. Pooled odds ratios (ORs) were calculated using DerSimonian-Laird random-effects models with Hartung-Knapp adjustment, and heterogeneity, prediction intervals, small-study effects, and certainty of evidence (GRADE) were evaluated.

Structured educational interventions significantly increased screening uptake compared with usual care or minimal information (OR = 4.41; 95% confidence interval [CI]: 2.21-8.80). Subgroup analyses showed substantial effects in both high-income (OR = 3.46; 95% CI: 1.43-8.36) and middle-income settings (OR = 6.55; 95% CI: 2.74-15.63). Interventions frequently incorporated behavioral frameworks, such as the Health Belief Model, Protection Motivation Theory, and BASNEF model, and were often culturally tailored or delivered through community-embedded formats.

Integrating such interventions into national and local screening programs represents an effective and equitable strategy to reduce disparities in cervical cancer prevention.

Dostarlimab in combination with carboplatin-paclitaxel was approved for primary advanced or recurrent endometrial cancer (pA/rEC). The first interim analysis (IA1) of RUBY Part 1 (NCT03981796) showed no significant exposure-response (ER) relationship for progression-free survival or for the five most common dostarlimab-related adverse events (AEs), except rash. Herein, we report the ER relationship between dostarlimab exposure and overall survival (OS) and between dostarlimab exposure and dostarlimab-related AEs. Population pharmacokinetic model was based on IA1, and the predicted exposure metrics from Cycle 1 were used to perform ER analysis at the second interim analysis (IA2). AE analysis was completed for three periods: Cycles 1-6 (chemotherapy phase), Cycle 7 and beyond (monotherapy phase), and all cycles. Included in the OS analysis were 232 patients treated with dostarlimab + carboplatin-paclitaxel. Cox regression of OS showed no significant ER relationship based on dostarlimab Cycle 1 exposure, except for rash and arthralgia. The increase in predicted probabilities for rash and arthralgia for patients with high versus low exposure was limited, ranging from 5.6% to 10.4% for rash and 4.3% to 17.7% for arthralgia (deemed not clinically relevant). These data support the risk/benefit profile at the selected dose of dostarlimab + carboplatin-paclitaxel as standard of care in patients with pA/rEC.