Integrating Traditional Chinese Medicine (TCM) with Western medical treatments enhances cancer patients' survival rates and quality of life. However, there is a lack of large-scale studies on the integration of TCM with immune checkpoint inhibitors (ICIs) or chemotherapy in cancer treatment. This retrospective cohort study analyzed data from the Taiwan National Health Insurance Research database and Taiwan Cancer Registry, including 2,512 patients treated with ICIs and 130,010 with chemotherapy between January 1, 2019, and June 30, 2021. Patients receiving TCM were classified as TCM users, while those who did not were nonusers. The primary outcome was all-cause mortality, assessed using Cox proportional hazards regression to estimate hazard ratios (HR) with 95% confidence intervals (CI), adjusting for demographics and comorbidities. Among ICI-treated patients, TCM users (n=720) had lower mortality rates than nonusers (n=1,792), with an incidence of 45.84 vs. 83.72 per 100 person-years (adjusted HR: 0.58; 95% CI: 0.51-0.66). Similarly, in chemotherapy-treated patients, TCM users (n=51,292) had reduced mortality (11.54 vs. 24.86 per 100 person-years; adjusted HR: 0.59; 95% CI: 0.57-0.60). These associations remained consistent across subgroup and sensitivity analyses. Commonly used TCM herbs included Hedyotis diffusa Willd (Bai Hua She She Cao), Scutellaria barbata (Ban Zhi Lian), and Astragali Radix (Huang Qi). These findings suggest that TCM use alongside ICIs or chemotherapy is associated with lower mortality, even after adjusting for confounders. Further prospective studies are needed to confirm these results and explore underlying mechanisms, advancing integrative cancer care.

This study evaluated the cost-effectiveness of integrating artificial intelligence (AI) into breast and lung cancer diagnostic workflows in Costa Rica, addressing the scarcity of health economic evidence for AI adoption in low- and middle-income countries and focusing on context-specific systemic barriers.

Two state-transition Markov models compared AI-assisted workflows (AI as a first reader) with conventional radiologist-only strategies over a 10-year horizon. AI-supported mammography screening was evaluated in asymptomatic women aged 50 to 70 years. For lung cancer, symptom-driven pathways were modeled using GLOBOCAN 2022 incidence data. Inputs included region-specific costs (USD), quality-adjusted life-years (QALYs), and progression probabilities, calibrated to Costa Rica's cancer registry. Methodological rigor adhered to the Consolidated Health Economic Evaluation Reporting Standards 2022 guidelines.

AI in breast cancer screening demonstrated economic dominance: it improved QALYs by 49% (10.46 vs 7.04) and reduced costs by 49% (USD 93 102 vs USD 183 278), yielding a net monetary benefit of USD 212 119 at Costa Rica's willingness-to-pay threshold. For lung cancer, the AI strategy also proved dominant: it reduced total costs to USD 1 218 507 (vs USD 1 337 640) while increasing QALYs to 6.88 (vs 4.15), driven by earlier detection that averts expensive late-stage palliative care.

AI significantly improved cost-effectiveness in both breast and lung cancer diagnostics, demonstrating economic dominance by mitigating diagnostic delays and reducing late-stage treatment burdens. These findings stress AI's context-dependent impact in low- and middle-income countries and the necessity of early detection investments and equity-focused implementation to align innovation with healthcare system realities.

Tyrosine kinase inhibitors (TKI) have transformed chronic myeloid leukemia (CML) from a life-threatening disease into a manageable chronic condition. However, 30-50% of patients require TKI switching due to resistance or intolerance, and BCR::ABL1-independent resistance mechanisms remain the most frequent and least understood cause. Non-coding RNAs (ncRNAs) - including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs) - have emerged as regulators of TKI resistance. This scoping review aimed to characterize the role of ncRNAs in TKI resistance, and to evaluate their potential as biomarkers and therapeutic targets. A systematic literature search was performed in PubMed/MEDLINE in April 2026, supplemented by manual reference searching. Of 374 identified records, 25 studies published between 2021 and 2025, plus one 2020 study identified through manual searching were included. miRNAs were the most frequently evaluated (64%), followed by lncRNAs (16%) and circRNAs (12%), with imatinib as the predominant TKI studied. Four axes were identified for miRNAs: downstream BCR::ABL1 signaling regulation, the miR-185/PAK6 axis, apoptosis and protective autophagy modulation, and drug efflux mechanisms. circRNAs and lncRNAs were found to act as competing endogenous RNAs regulating resistance via PI3K/AKT/mTOR, RAS/MAPK, and autophagy pathways. Prospective multicenter validation, particularly in countries with limited access to second- and third-generation TKIs, is a priority for future research.

The Immunotherapy of Cancer (ITOC) meeting is a leading international conference that unites immuno-oncology researchers and clinicians from around the world to present and discuss emerging research and latest developments in the field. Now in its 12th edition, the conference took place in Munich in March 2026 and spotlighted the remarkable evolution of immunotherapy from an innovative treatment modality with genuine curative potential. The highlight of ITOC12 was the Lifetime Achievement Award presented to Dr. John Haanen in recognition of his pioneering contributions to the clinical development of T‑cell-based therapies. Throughout the meeting, discussions addressed novel advances and modalities but also autoimmune and inflammatory adverse effects, as well as the relevance of financial toxicity as a critical consideration for ensuring sustainable and equitable patient access.

With its favorable profile of enhanced recovery and a reduced perioperative footprint, there is growing evidence for endoscopic spine surgery (ESS) in the management of thoracolumbar spinal malignancies. The aim of this study was to explore the conceptual framework of the endoscopic benefit zone in the management of metastatic spinal disease, and present an Australasian-first technical case series, establishing its feasibility and outcomes in this cohort.

Between 2021 and 2026, 7 patients (4 female, mean age 56) who were diagnosed with spinal metastases underwent ESS as part of multidisciplinary management. Patient selection criteria, cohort demographics, anatomical factors, and postoperative outcomes were assessed, and technical considerations of endoscopic surgical approaches were overviewed. Five patients received percutaneous posterior fixation (4 with cement augmentation), and 3 of the 4 patients with disease involving thoracic levels underwent preoperative angioembolization.

All patients successfully underwent endoscopic surgical management without conversion to an open procedure. Effective decompression, separation, and rapid symptomatic improvement were achieved in all cases, confirmed radiologically in cases of spinal cord compression, with no surgical complications recorded. Six of 7 patients were mobilized within 24 hours of surgery, and adjuvant radiation and/or systemic therapy was promptly commenced. Ambulatory status was maintained or improved in all patients during follow-up.

This Australasian-first case series demonstrates that ESS is a feasible adjunct in the management of thoracolumbar spinal metastases in selected patients, achieving effective decompression and separation, and synergizing with other minimally invasive techniques such as percutaneous fixation and angioembolization. The endoscopic anatomical corridors of the thoracolumbar spine allow direct access to pathology with preservation of normal structures, thus enabling rapid recovery and prompt commencement of adjuvant therapies.

Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in adults, with a poor prognosis despite Stupp protocol treatment. Given the substantial burden of the disease and its therapies, monitoring health-related quality of life (HRQoL) is essential. Smartphone-based approaches may enable continuous, low-burden monitoring.

This study aims to evaluate the feasibility and usability of the Lalaby-Glio app for monitoring HRQoL in patients with GBM and to explore preliminary hypothesis-generating associations between subjective global quality of life (QoL) and passive smartphone sensor data.

The study comprised four phases: (1) adaptation of Lalaby for GBM-specific monitoring by combining passive smartphone sensors (movement, step count, location, sound, light exposure, internet use, and call activity) with a clinician-designed daily 5-item questionnaire and weekly European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) and Quality of Life Questionnaire-Brain Neoplasm 20 (QLQ-BN20); (2) a 6-week feasibility study in 4 adults (aged ≥18 years) initiating Stupp treatment; (3) usability testing in patients with GBM and a complementary nonpatient sample of 103 healthy adults using either screenshot mock-ups or the installed app; and (4) exploratory Spearman correlation analyses of associations between passive sensor data and subjective global QoL using patient-level bootstrap, with no causal or predictive claims inferred due to the small sample size.

We enrolled 4 patients (3 men, 1 woman; mean age 54.3, SD 8 years), of whom 3 completed all 6 weeks, and 1 died after 2 weeks. Engagement was high, with 168 questionnaires completed (22 QLQ-C30, 19 QLQ-BN20, and 127 daily status entries). Mean app use was 1.8 (SD 2.7) minutes per day, and mean completion time for the weekly questionnaires was 7.2 (SD 3.3) minutes. Weekly patient-reported outcome measures (PROMs) revealed substantial interindividual and intraindividual variability in functioning, symptoms, and global QoL during treatment. Usability among patients with GBM was favorable (overall mean 3.7/5). Among healthy participants (mean age 20.9, SD 1.4 years; 72/103, 69.9% women), those who installed the app (n=46) achieved a mean System Usability Scale score of 72.9 (SD 10.2), above the standard benchmark, and 91.3% (94/103) judged the nature-inspired design appropriate for oncology. Passive sensing yielded 91.7 MB of data; global QoL correlated negatively with calls (ρ=-0.598; P=.01) and movement (ρ=-0.604; P<.001), while steps showed a positive but nonsignificant association (ρ=0.392; P=.63). These correlations should be interpreted as preliminary signals rather than robust evidence of digital biomarkers.

Lalaby-Glio appears feasible and usable for monitoring HRQoL in patients with GBM in an early proof-of-concept setting and can capture patient-reported fluctuations over time. Passive smartphone sensing shows promise for complementing PROM-based monitoring and generating preliminary hypotheses about objective behavioral correlates of QoL.

Cause of death is an important variable in cancer registries that supports downstream analyses, including cause-specific survival analysis. Unfortunately, in current practice, it is only available on government-issued death certificates, which are often received as scanned images. Current computer vision-based optical character recognition (OCR) methods struggle with handwriting, background noise, and blurriness, resulting in poor performance. A robust method for the cause of death ascertainment is urgently needed.

Latest vision language models (VLMs), such as Qwen3-VL and GPT-4.1, have shown promising OCR performance on poor-quality scanned documents in the general domain. We proposed two prompting methods: (1) the two-step approach, which prompts VLMs for a full-text OCR followed by a text-based information extraction and (2) end-to-end approach, which prompts VLMs with a JavaScript Object Notation schema for image-based information extraction.

We evaluated VLMs for the cause of death extraction from scanned government-issued death certificates in a major cancer center. Of 22,733 death records, 500 were manually annotated as ground truth. For the immediate cause of death, Qwen3-VL-30B-A3B-Thinking with the end-to-end approach achieved the best accuracy of 0.8625, significantly outperforming the Tesseract baseline (0.2396). For the underlying causes of death, the two-step method achieved the best F1 score of 0.7637, outperforming the baseline (0.2451).

The growing emphasis on precision medicine underscores the importance of accurate cause of death ascertainment for survival analyses. Our method demonstrated significant improvements over the current OCR approaches and provided a reliable alternative to reliance on the National Death Index.

Our VLM OCR computational framework is publicly available on GitHub. The open-weight VLMs are available for download on the Hugging Face repository.

Multi-target stool DNA (mt-sDNA) and fecal immunochemical testing (FIT) are home-based options for colorectal cancer (CRC) screening. Next-generation mt-sDNA has enhanced sensitivity for CRC and advanced precancerous lesions compared with FIT and is not subject to the same capacity constraints as colonoscopy. This analysis evaluated the economic and clinical implications of increasing the proportional utilization of next-generation mt-sDNA.

A budget impact model was developed from the validated CRC-AIM microsimulation model. The model simulated a cohort of 1 M average-risk, screen-eligible adults over a 3-year time horizon from an integrated delivery network perspective. The status quo scenario assumed an initial utilization of 20% next-generation mt-sDNA, 20% FIT, and 60% colonoscopy screening. In a hypothetical increased next-generation mt-sDNA scenario, its utilization expanded to 35% within 3 years, while FIT and colonoscopy utilization decreased to 15% and 50%, respectively. Test performance characteristics, real-world adherence, and cost inputs (i.e. screening test and programs, colonoscopy adverse events, CRC treatment) were derived from published literature. Multiple scenario analyses were conducted.

Among 1 M members, total costs in the status quo scenario were $1.058B and with increased next-generation mt-sDNA use were $1.046B, generating an estimated savings of $12.5 M (-$0.35 per member per month). Increasing next-generation mt-sDNA improved the CRC screening rate by 1.1%. Overall, 10,467 fewer screening colonoscopies and 1,912 more follow-up colonoscopies after a positive stool-based test were performed. An additional 17 CRCs were screening-detected, 11 fewer were clinically detected, and there was one less CRC-related death. Increased next-generation mt-sDNA utilization remained cost-saving with all scenario analyses.

In this budget impact model, shifting a small proportion of current FIT and colonoscopy utilization to next-generation mt-sDNA for average-risk CRC screening is estimated to be cost-saving. Increasing the next-generation mt-sDNA utilization also improves the screening rate and clinical outcomes while optimizing availability of capacity-limited colonoscopy resources.

To describe real-world treatment patterns, healthcare resource utilization (HCRU), and hospital-based non-drug direct medical costs of patients with high-risk endometrial cancer (HR-EC) from initiation of first adjuvant therapy in England.

Adult women with HR-EC (i.e. stage I/II EC with non-endometrioid histology or stage III/IVa EC with any histology) who received adjuvant therapy within 90 days after surgery were identified via England's National Cancer Registration and Analysis Service. Treatment patterns, annual rates of HCRU, and non-drug direct medical costs (in 2022 £) were described from the first adjuvant therapy.

In total, 6,036 women (mean age: 67 years, 86% White) were included. The most commonly prescribed adjuvant therapy was radiation therapy (43%), followed by chemoradiotherapy (37%), and systemic chemotherapy (19%). Across the first four lines of therapy, there were 80 unique treatment sequences. The majority of patients (79%) did not receive further treatment after the adjuvant therapy. Amongst those that did, the most common treatment across all subsequent lines was systemic chemotherapy. In the total cohort, the mean annual rate of inpatient, outpatient, and A&E visits was 2.8, 12.5, and 1.0, respectively, corresponding to a mean non-drug direct medical cost per year of £4,581. Patients who experienced recurrence exhibited higher HCRU and costs over follow-up, reflecting overall healthcare utilization trajectories among patients who ultimately recurred rather than costs directly attributable to recurrence.

Our study provides novel insights into the real-world treatment patterns, HCRU, and non-drug direct medical costs associated with HR-EC in England. The substantial clinical and economic burden underscores the need for ongoing research and optimization of treatment strategies.

Sex differences have traditionally been attributed to gonadal hormones, but accumulating evidence shows that sex chromosomes exert distinct, cell-autonomous effects on health, aging, and disease. XX and XY complements alter gene dosage, epigenetic programming, immune signaling, metabolism, and cellular stress responses, which shape aging and disease trajectories in women and men. This Review integrates mechanistic advances in sex chromosome biology-including escape from X chromosome inactivation, X reactivation, parent-of-X-origin, X-skew, X- and Y-linked gene functions, and Y loss-with aging, neurologic disease, immunity, cancer, and cardiometabolic disease. We highlight insights from mouse models, human studies, and emerging technologies that disentangle hormone-driven effects from chromosome-mediated effects and discuss translational implications for diagnostics, biomarkers, therapeutics, and clinical trial design, emphasizing the integration of sex chromosome biology into precision medicine.