Migrants in Australia experience persistent cancer-equity gaps, with later-stage diagnoses linked to low screening participation. This study aimed to co-design cancer screening interventions with migrant and refugee communities to promote equitable participation and reduce disparities in bowel, cervical and breast cancer screening in New South Wales, Australia.

Using stratified convenience sampling, 90 first-generation Middle Eastern and Sub-Saharan African migrants across five NSW regions participated in 10 face-to-face nominal group technique sessions to elicit and rank intervention priorities.

Participants identified 24 priority actions for bowel cancer screening, 11 for breast, and eight for cervical cancer, grouped into intervention domains. Bowel cancer drew the broadest response, spanning cancer literacy, policy reform, community action, and monitoring and evaluation. Breast cancer priorities centred on literacy and policy, while cervical cancer input focused on literacy and behavioural confidence. Increasing cancer literacy, shifting behaviours and enacting supportive policy reform emerged as consistent priorities across all three cancers.

Improving migrant and refugee participation across all three screening programs requires culturally grounded interventions that build cancer literacy and leverage trusted networks including peers, community champions and frontline health workers. Settlement programs, community organisations and schools provide critical infrastructure for sustained screening education, while policy reforms including age threshold reductions, incentive mechanisms and improved access support are essential to achieving equitable outcomes.

Migrants with lived experience, cancer caregivers and community champions played a central role in setting priorities and co-designing intervention options.

Acetylsalicylic acid (ASA, aspirin), derived from salicylic acid in willow bark, is known for its analgesic, anti-inflammatory, and antiplatelet properties. Beyond cardiovascular protection, increasing evidence suggests that ASA may reduce the risk of various cancers, including colorectal and prostate cancer. In this study, the effect of ASA-treated prostate epithelial cells (RWPE-1) on the proliferation and migration of prostate cancer cells was investigated. RWPE-1 cells were exposed to different ASA concentrations, and non-toxic concentrations were selected. Conditioned media (CM) from untreated and ASA-treated RWPE-1 cells were applied to PC-3 prostate cancer cells. Cell viability was assessed using the MTT assay, while migration was evaluated using the wound-healing assay, and colony formation was also assessed. ASA at 50 μM showed no cytotoxic effect on RWPE-1 cells, while CM1 (ASA 50 μM) reduced PC-3 cell viability to 60%. Moreover, CM1 (ASA 50 μM) and CM2 (ASA 25 μM) significantly inhibited PC-3 cell migration. Comparing CM groups revealed that ASA exposure alters the secretome of prostate epithelial cells, thereby reducing cancer cell viability and motility. These findings suggest that ASA may serve as a promising chemopreventive and therapeutic agent for prostate cancer.

Single-port robot-assisted nipple-sparing mastectomy (SPRNSM) has emerged as an innovative minimally invasive alternative to conventional and multi-port robotic techniques, aiming to improve cosmetic outcomes while maintaining oncologic safety. This systematic review evaluates the feasibility, safety, and current evidence supporting SPRNSM. A systematic search of PubMed, the Cochrane Library, and ClinicalTrials.gov was conducted from database inception to July 4, 2026. Studies involving adult women undergoing SPRNSM for therapeutic or prophylactic indications were included. Both clinical and cadaveric studies reporting relevant outcomes were eligible. Study selection and data extraction were performed independently by two reviewers. Risk of bias was appraised using the ROBINS-I tool. Due to heterogeneity, results were synthesized narratively. Sixteen studies were included, comprising seven retrospective studies, one prospective study, five case reports, two case series, and one cadaveric study. SPRNSM was technically feasible across all studies, with no reported conversions to conventional surgery. Operative times were significantly longer than conventional nipple-sparing mastectomy (mean differences of 54-70 min) but comparable to multi-port robotic approaches. Grade III or higher complications ranged from 1.8% to 20%, with reoperation rates from 1.4% to 7.5%. Nipple-areolar complex necrosis rates were consistently low (1.2%-2.5%) and patient-reported satisfaction and sensory preservation were favorable. Short-term oncological outcomes appeared comparable to conventional techniques, although follow-up was limited to a maximum of 36 months. Overall risk of bias was serious for 80% of clinical studies. Current evidence suggests that SPRNSM is a feasible and safe procedure with potential cosmetic and functional advantages. However, the evidence base is limited by predominantly retrospective designs, small sample sizes, selection bias toward high-volume centers, and short follow-up, preventing definitive conclusions regarding long-term oncologic safety. SPRNSM represents a promising evolution in minimally invasive breast surgery; however, until long-term oncologic data become available, its use should remain limited to controlled settings and prospective trials. Ongoing randomized trials are expected to provide higher-level evidence in the coming years.

For more than a decade after the ToGA trial, trastuzumab plus platinum-fluoropyrimidine chemotherapy remained the only established first-line HER2-targeted standard for unresectable or metastatic HER2-positive gastric or gastroesophageal junction adenocarcinoma. The treatment landscape is now changing rapidly through pembrolizumab-based chemoimmunotherapy, zanidatamab-based therapy, and antibody-drug conjugate strategies.

This narrative review summarizes pivotal and emerging evidence for first-line HER2-positive advanced gastric and gastroesophageal junction adenocarcinoma. PubMed/MEDLINE was searched through June 2026 using combinations of the terms HER2, gastric cancer, gastroesophageal junction, first-line treatment, trastuzumab, pembrolizumab, zanidatamab, tislelizumab, and trastuzumab deruxtecan. Priority was given to phase III trials, peer-reviewed reports, major conference updates, and guideline documents relevant to clinical practice.

ToGA established trastuzumab plus chemotherapy as a first-line standard, but subsequent attempts to improve outcomes by adding or substituting HER2-directed agents, including lapatinib, high-dose trastuzumab, pertuzumab, and trastuzumab emtansine, did not displace trastuzumab-based therapy. KEYNOTE-811 demonstrated that pembrolizumab added to trastuzumab and chemotherapy improves response, progression-free survival, and overall survival, particularly in PD-L1-positive disease. The phase III HERIZON-GEA-01 trial has now shown that zanidatamab plus chemotherapy, with or without tislelizumab, improves progression-free survival compared with trastuzumab plus chemotherapy, and that zanidatamab plus tislelizumab and chemotherapy improves overall survival. Trastuzumab deruxtecan is also moving from later-line therapy into first-line development through platinum-free combinations with fluoropyrimidine and immune checkpoint blockade.

First-line treatment of HER2-positive advanced gastric cancer is entering a second transformation. The central clinical question is shifting from whether HER2 blockade should be combined with chemotherapy to which HER2-targeted platform should anchor first-line therapy, how immune checkpoint inhibition should be integrated, and how HER2 heterogeneity and biomarker evolution should guide treatment sequencing.

Clonal expansions in large granular lymphocytic leukemia (LGLL) may arise in response to immune dysregulation in the context of other hematologic malignancies. This study aimed to investigate the co-occurrence of LGLL and plasma cell dyscrasias (PCDs) to assess its prevalence, features, and potential underlying mechanisms. We conducted a cross-sectional study involving 2064 PCD cases and 534 LGLL cases. Of the 534 LGLL cases, 20% co-occurred with PCD, while LGLL was present in 2% of the 2064 PCD cases. Among 117 patients with both conditions, PCDs were predominantly associated with IgM M-protein, while LGLL patients had increased NK-cell proliferation and fewer mutations in STAT3/5B. The co-occurrence was linked to a higher incidence of autoimmune conditions, B-cell neoplasms, and more severe immune-mediated cytopenias. In symptomatic PCD/LGLL patients with low plasma-cell infiltration, B-cell-targeted therapies outperformed immunosuppression, suggesting humoral involvement. Correlation with biological parameters revealed elevated interleukin-6 and inhibitory effects of sera of symptomatic PCD/LGLL patients on hematopoietic cells. Our findings suggest an association between PCD and LGLL, characterized by distinct features that may have significant implications for clinical management. These results highlight the importance of considering hematologic co-occurrences in clinical practice and warrant further investigation into the molecular mechanisms linking these conditions.

Colorectal histology classification remains challenging because subtle morphological differences, staining variability, and inappropriate model configurations can reduce generalization. This study proposes COOT-CNN, a lightweight convolutional neural network in which architectural design and training strategy are optimized jointly through the COOT metaheuristic. The search process considers network depth, convolution type, kernel size, feature width, squeeze-and-excitation attention, activation functions, pooling, regularization, loss formulation, learning-rate scheduling, data augmentation, exponential moving average, and mixed-precision training. The selected configuration is retrained independently and evaluated using accuracy, balanced accuracy, macro-F1, ROC-AUC, precision-recall analysis, confidence intervals, and paired statistical testing. Same-split comparisons are conducted against ResNet-50, EfficientNet-B0, and Swin-T under a consistent experimental protocol. COOT-CNN achieved 96.72% test accuracy and 96.71% macro-F1, while providing statistically significant improvements over the evaluated baselines. The optimized model also maintained a compact computational profile, with fewer parameters and lower inference latency than the comparison networks. These findings demonstrate that jointly optimizing architecture and training components can produce an accurate, efficient, and stable model for binary colorectal histology patch classification. The proposed framework should be regarded as a methodological proof-of-concept, with external, patient-level, and whole-slide validation required before clinical application.

This paper introduces a hybrid deep learning model combining ConvNeXt and Swin Transformer for classifying brain tumors from MRI scans. The ConvNeXt backbone is employed to obtain detailed local spatial features, whereas the Swin Transformer identifies hierarchical long-range dependencies, facilitating complementary feature representation. The proposed model is evaluated on a combined public MRI dataset of 7,023 images distributed across four categories: glioma, meningioma, pituitary, and no tumor. Experimental results demonstrate that the proposed hybrid architecture outperforms several state-of-the-art convolutional and transformer-based models, achieving an accuracy of 95.37% with competitive precision and F-score. Additionally, qualitative explainability assessment using attention-based visualization techniques offers insight into the model's decision-making by highlighting diagnostically significant regions. Furthermore, we evaluate the proposed H-ConvNeXt-Swin model on the unified dataset and also report source-stratified performance on each of the three constituent datasets: Figshare, SARTAJ, and Br35H. Future work will focus on validating the proposed framework on multi-center clinical datasets and extending it to more complex tasks such as tumor localization and segmentation.

Accurate grading of bone marrow fibrosis is essential for the diagnosis and prognostication of myeloproliferative neoplasms (MPNs). The 2017 World Health Organization (WHO) Classification recommends a trichrome stain be performed to evaluate collagen fibrosis when reticulin fibrosis grade is >1, but the inter-observer concordance in assessing collagen fibrosis in a routine diagnostic laboratory and the utility of this stain are unclear. This study assesses the inter-observer agreement in the grading of reticulin fibrosis and collagen fibrosis, and the concordance between reticulin and collagen fibrosis. Two pathologists assessed 174 consecutive bone marrow trephine biopsies with a diagnosis of an MPN at a tertiary referral centre. Reticulin fibrosis by silver impregnation and collagen fibrosis by Masson's trichrome stain were independently graded by the pathologists while blinded to clinical information. Discordant scores were reviewed to establish a final grade by consensus. Substantial inter-observer concordance was obtained for both reticulin [83%; Cohen's kappa 0.756, 95% confidence interval (CI) 0.69-0.84] and collagen fibrosis grading (81%; kappa 0.730, 95% CI 0.64-0.82). Using the final consensus scores, reticulin and collagen fibrosis grades were concordant in 60% of cases. Collagen fibrosis grade was higher than reticulin fibrosis score in 11% of cases. Inter-observer concordance in assessing the degree of collagen fibrosis using the trichrome stain is substantial. Reticulin (silver) staining alone may underestimate the degree of fibrosis. The prognostic significance where the degree of collagen fibrosis is greater than that of reticulin is uncertain and should be investigated in future studies.

We reported a case of extremely severe tuberous sclerosis complex-associated lymphangioleiomyomatosis (TSC-LAM) involving the brain, liver, kidneys, and lungs that was successfully treated with sirolimus, with a complete 17-year follow-up. The patient was diagnosed in 2008 and experienced rapid progression; by 2012, the patient had developed respiratory failure, severe anemia, renal insufficiency, and extreme abdominal distension. After 3 days of treatment with sirolimus, the aforementioned symptoms improved significantly, and respiratory failure resovled. Over the following 7 years of regular maintenance therapy, lung function declined only slightly each year, and the 6-minute walking test(6MWT) showed no decline. However, after sirolimus was discontinued from January 2020 to April 2021, the patient's lung function and 6MWT declined rapidly, with concurrent development of pneumothorax. Although sirolimus was subsequently resumed and remained effective, with no recurrence of pneumothorax or chylothorax, parameters such as lung function and 6MWT still did not recover significantly. This case suggests that TSC-LAM requires long-term maintenance therapy with sirolimus. Abrupt discontinuation of treatment may lead to rapid clinical deterioration.