To evaluate the real-world effectiveness of first-line niraparib maintenance therapy in Korean patients with advanced epithelial ovarian cancer (EOC) and assess outcomes across clinical and molecular subgroups.

This multicenter retrospective study included patients with newly diagnosed International Federation of Gynecology and Obstetrics stage III-IV EOC who completed first-line platinum-based chemotherapy between December 2019 and October 2022 at nine tertiary institutions in South Korea. Patients were classified according to receipt of niraparib maintenance or no maintenance therapy. Propensity score matching was performed based on age, neoadjuvant chemotherapy, and BRCA mutation status. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan-Meier analysis and Cox proportional hazards models.

A total of 554 patients were included (niraparib, n=248; no maintenance, n=306). In the unmatched cohort, niraparib was associated with significantly longer PFS (p<0.001) and OS (p=0.001). After 1:1 matching, 189 pairs were analyzed. The 3-year PFS rate was higher in the niraparib group (43.1% vs 25.7%; p<0.001), as was the 3-year OS rate (86.3% vs 74.7%; p=0.005). PFS benefit was observed in both BRCA-mutated and BRCA wild-type subgroups. OS improvement was evident in the BRCA wild-type subgroup, with minimal post-progression crossover.

First-line niraparib maintenance was associated with improved PFS regardless of BRCA status and with improved OS, particularly in BRCA wild-type patients.

ClinicalTrials.gov Identifier: NCT06086665.

Myelofibrosis (MF) is a chronic myeloproliferative neoplasm characterized by splenomegaly, systemic symptoms, and anemia, the latter being strongly associated with poor survival and reduced quality of life. Current Janus kinase (JAK) inhibitors improve symptoms and spleen size but often exacerbate anemia, leaving a significant unmet clinical need. Momelotinib, a JAK1/JAK2 and activin A receptor type 1 (ACVR1) inhibitor, has been proposed to address both splenomegaly and anemia through hepcidin suppression. This study critically evaluates the clinical benefit of momelotinib using the European Society for Medical Oncology Magnitude of Clinical Benefit Scale for Haematological Malignancies (ESMO-MCBS:H), focusing on the phase 3 trials SIMPLIFY-1 and MOMENTUM. In SIMPLIFY-1, momelotinib demonstrated non-inferiority to ruxolitinib in terms of spleen volume reduction (SVR35 26.5% vs 29.0%) and did not evaluated quality of life as a prespecified outcome, resulting in an ESMO-MCBS:H score indicating no evaluable benefit (NEB). In contrast, in MOMENTUM, conducted in symptomatic, anemic patients previously treated with JAK inhibitors, momelotinib was superior to danazol for MFSAF total symptom score response (≥50% reduction from baseline 25% vs 9%). As no improvement in global health status was observed, MOMENTUM was scored as Grade 1. Interpretation of hematologic benefits remains limited by trial design, as the anemia related outcomes were not primary endpoints and studies were not powered to robustly assess them. Furthermore, the negative SIMPLIFY-2 trial underscores uncertainty in pretreated populations. In conclusion, momelotinib demonstrates a differentiated clinical profile with consistent spleen control and potential hematologic benefits, particularly in anemic patients. However, superiority over other improved JAK inhibitors has not been demonstrated in the pivotal phase 3 trials evaluated. Future trials incorporating anemia-focused primary endpoints and biomarker stratification are warranted to better define its role in myelofibrosis management.

Embedding smoking cessation interventions into organised lung cancer screening programs can reduce smoking-related morbidity and mortality. This study sought to prioritise smoking cessation strategies for implementation into the Australian National Lung Cancer Screening Program.

We convened a national workshop of expert stakeholders to identify smoking cessation strategies that could be embedded into the proposed screening and assessment pathway. Using a modified nominal group technique, activities explored workforce, resourcing, equity, policy and research considerations to prioritise strategies and achieve consensus. Practical recommendations were devised from the priorities and mapped against a time-to-implementation matrix.

Thirty-eight participants identified 19 strategies; 12 were prioritised including: four "delivery" priorities; three "equity"; two "policy"; two "research" priorities; one priority was across delivery and policy, and one across delivery and research. Priority-based recommendations ranged from being easily implementable with appropriate community engagement to requiring systems-level change achievable only with long-term policy change.

The expert-identified priorities and recommendations can directly inform improvements to embed smoking cessation interventions into the National Lung Cancer Screening Program.

Priorities and recommendations to embed smoking cessation interventions are ready for translation into the National Lung Cancer Screening Program and may result in improved participant outcomes.

Although atypical ductal hyperplasia (ADH) and lobular carcinoma in situ (LCIS) are both high-risk breast lesions, their management differs in clinical practice. We compared subsequent breast cancer outcomes between the 2 groups.

We retrospectively reviewed patients with surgically excised ADH or LCIS treated between January 2008 and December 2025. Patients with concurrent breast cancer were excluded. ADH cases upgraded to ductal carcinoma in situ (DCIS) or invasive carcinoma at excision were analyzed separately and excluded from the primary analysis. The primary endpoint was subsequent breast cancer-free survival.

A total of 117 patients with ADH and 45 patients with LCIS were included. Four ADH cases were upgraded to DCIS and excluded from the primary analysis. No patient with pure ADH received chemoprevention, whereas chemoprevention was administered to 35 of 45 patients with LCIS (77.8%). Subsequent breast cancer developed in 14 of 113 patients (12.4%) with pure ADH and in 2 of 45 patients (4.4%) with LCIS. Subsequent breast cancer-free survival was significantly lower in the ADH cohort than in the LCIS cohort (log-rank P = .036). Among 13 evaluable subsequent breast cancers after ADH, 11 (84.6%) were hormone receptor-positive, and 6 of 14 events (42.9%) occurred more than 5 years after surgery.

Despite less intensive management, patients with ADH experienced a greater burden of subsequent breast cancer than those with LCIS. These findings support recognizing ADH as a high-risk lesion and suggest that selected patients may benefit from prolonged surveillance and chemoprevention following surgical excision.

To develop an evidence-informed imaging framework for gastric neuroendocrine neoplasms (gastric NENs) that separates pathological entity, gastric NET type, and grade and links imaging selection to management-relevant questions.

This structured narrative review used PubMed/MEDLINE and the Web of Science Core Collection through December 31, 2025, with a reproducibility rerun on August 31, 2026. Evidence was appraised at the recommendation/reporting-item level and tagged as direct gastric or gastroduodenal evidence (G-NEN), formal guidance (GL), broader gastroenteropancreatic NEN evidence (GEP-NEN), or author synthesis (AS).

The review yielded a hierarchical two-axis imaging framework, a modality-specific reporting checklist, and an evidence-uncertainty table. Type I-III classification is restricted to well-differentiated gastric NETs, with grade and adverse features treated as modifiers. Somatostatin receptor (SSTR) PET/CT and fluorodeoxyglucose (FDG) PET/CT are selected independently for defined questions, and localized NEC considered for curative-intent surgery is distinguished from unequivocally metastatic NEC.

The framework aligns imaging with pathological entity, gastric NET type, grade, disease extent, and management intent. It is an evidence-informed conceptual framework for imaging selection, reporting, and multidisciplinary decision-making rather than a prospectively validated clinical pathway.

Thermal ablation is increasingly used for pulmonary tumors, but treatment success is generally assessed by imaging rather than direct histopathology. Ablation-followed-by-resection studies provide direct evidence of residual viable tumor after ablation.

What is the rate of pathologically confirmed complete tumor necrosis after pulmonary thermal ablation, and which methodological or biological factors influence this outcome?

A systematic search of PubMed, Embase, and Web of Science (2005-2025) yielded 8 ablate-and-resect studies with 95 evaluable lesions. The primary analysis used a generalized linear mixed model (GLMM). The subgroups were sorted according to pathological assessment stringency, resection time, tumor type and ablation procedure.

The pooled complete necrosis rate was 71.4 % (95 % CI 40.1 %-90.3 %), with significant between-study heterogeneity (likelihood-ratio p < 0.0001) and a wide 95 % prediction interval (4.0 %-99.3 %). A Freeman-Tukey sensitivity analysis yielded a similar estimate of 69.0 %. Complete-necrosis rates varied numerically by pathological assessment (55.6 % vs 81.7 %), resection timing (61.1 % vs 79.7 %), tumor type (44.3 % vs 81.1 %), and ablation modality, but none of the subgroup differences was statistically significant.

Pathologic complete necrosis after pulmonary thermal ablation varies substantially across ablate-and-resect studies and is influenced by both treatment context and pathological assessment. The pooled estimate should therefore be interpreted as a descriptive summary of a heterogeneous evidence base rather than as a benchmark for contemporary definitive ablation.

Older or medically unfit patients with newly diagnosed FLT3-mutated acute myeloid leukemia (AML) have poor outcomes with hypomethylating agent (HMA) monotherapy. Venetoclax plus HMA is a modern lower-intensity standard, but FLT3-mutated AML remains biologically heterogeneous, and triplet regimens combining HMA, venetoclax, and a FLT3 inhibitor are increasingly used despite limited randomized comparative evidence. PubMed/MEDLINE, Embase, Cochrane CENTRAL, Web of Science, Scopus, and major hematology/oncology conference proceedings were searched from inception to 12 June 2026 in accordance with PRISMA 2020 and MOOSE guidance. Eligible studies reported primary clinical outcomes for newly diagnosed FLT3-ITD and/or FLT3-TKD AML treated with frontline lower-intensity HMA alone, VEN-HMA doublet, HMA/LIC plus FLT3 inhibitor, or HMA/LIC plus VEN plus FLT3 inhibitor therapy. Comparative effect estimates and single-arm proportions were synthesized only when clinical and statistical assumptions were defensible. Thirteen eligible records were retained. Direct VEN + AZA versus AZA evidence came from one FLT3-mutated pooled subgroup comparison (42 vs. 22 patients), showing CRc 67% versus 36%, RR 1.83 (95% CI 1.01-3.32), and median OS 12.5 versus 8.6 months. The randomized non-venetoclax LACEWING trial showed higher CRc with gilteritinib + AZA than AZA (58.1% vs. 26.5%; HR for OS 0.916; p = 0.753), illustrating that improved remission does not guarantee survival benefit. The principal comparative triplet evidence was one retrospective study: CR/CRi 93% versus 70%, RR 1.32 (95% CI 1.09-1.61), with median OS not reached versus 9.5 months. Prospective and long-term triplet reports described CR/CRi rates of 93%-96%, deep FLT3-ITD MRD negativity, and median OS up to 38.5 months; several reports derive from overlapping institutional series and non-randomized designs, limiting independent corroboration and causal inference. VEN + AZA improves remission compared with AZA in the FLT3-mutated subgroup, but the evidence base is underpowered for FLT3-specific survival conclusions. Triplet therapy produces the strongest remission-depth and MRD signals but has not shown superiority over VEN-HMA in a randomized frontline comparison. On current evidence, triplets are a promising biologically rational strategy requiring direct randomized validation against the contemporary VEN-HMA standard.

Pigment epithelium-derived factor (PEDF) has anti-tumour properties mediated through distinct functional peptide domains. In this study, we investigated the biological effects of PEDF-derived peptides (coded S, V, and 44-mer) in head and neck squamous cell carcinoma (HNSCC), focussing on cell viability, migration, spheroid growth, metabolism, mitochondrial function, and response to irradiation.

Cal-27 (oral squamous cell carcinoma, OSCC) and FaDu (oropharyngeal squamous cell carcinoma, OPSCC) cells treated with the 12-, 13-, and 44-mer peptides were assessed using 2D and 3D culture models, metabolic assays, JC-10 mitochondrial membrane potential analysis, and biomarker analysis.

PEDF-derived peptides reduced cell viability in a dose- and time-dependent manner in both cells. Irradiation further enhanced cytotoxicity compared to irradiation alone, suggesting a potential radiosensitizing effect. Migration was not affected, while there was a peptide-specific spheroid growth reduction in Cal-27 cells, particularly for peptide V. There was increased glucose uptake and GLUT4 expression were observed in FaDu cells, but not in Cal-27 cells. JC-10 analysis demonstrated a significant reduction in mitochondrial membrane potential in Cal-27 cells, indicating mitochondrial dysfunction, while FaDu cells exhibited less changes.

These findings suggest that these novel PEDF-derived peptides may represent promising therapeutic candidates for HNSCC, particularly in combination with radiotherapy.

Despite its growing presence in healthcare settings, research on the effectiveness of virtual reality (VR) interventions for symptom experience of patients with cancer remains varied and requires a comprehensive synthesis to reach definitive conclusions.

This systematic review and meta-analysis aimed to assess the effectiveness of VR interventions in managing anxiety among individuals diagnosed with cancer.

A comprehensive search of Ovid MEDLINE, PubMed, CINAHL, Web of Science, and Scopus databases was conducted for studies published from 2000 to November 2025. Publications were evaluated by independent reviewers for inclusion. The methodological quality of the included studies was assessed via Joanna Briggs Institute (JBI) critical appraisal tools for randomized controlled trials and quasi-experimental studies.

Twenty-one publications satisfied the requirements for review inclusion. The meta-analysis demonstrated that VR-based interventions were significantly effective in the management of patients' anxiety, yielding a moderate-to-high effect size (SMD = -0.793, 95% CI = -1.403 to -0.184; Z = -2.551; p = 0.011). Most studies reported statistically significant decreases in anxiety scores across various cancer types, including breast, prostate, and ovarian cancers. No major side effects were reported, although minor instances of cyber sickness were managed by adjusting session durations. User satisfaction was exceptionally high, with satisfaction scores reaching 4.47/5 and 7.35/10.

The results support the use of VR as an effective and safe non-pharmacological intervention for anxiety management. The findings highlight the potential for VR to be integrated into routine oncology nursing and palliative care to improve the patient experience during stressful treatments like chemotherapy.

VR-based interventions are an effective, safe, and highly acceptable approach for managing anxiety in patients with cancer. Further research is needed to support wider clinical implementation and to investigate the potential benefits of VR for other physical and psychological symptoms over longer follow-up periods.

PROSPERO International Prospective Register of Systematic Reviews CRD42022351573.

Hexokinase domain-containing protein 1 (HKDC1) has been implicated in hepatocellular carcinoma (HCC) progression, but its relationship to regulated cell death remains incompletely defined. This article presents an in vitro workflow that combines public cohort analysis, paired clinical tissues, CRISPR/Cas9-mediated HKDC1 depletion, cell growth assays, lenvatinib treatment, pharmacological rescue, and biochemical measurements of glutathione (GSH) and malondialdehyde (MDA). HKDC1 expression was higher in HCC than in non-tumor liver tissue and was associated with poorer overall and disease-free survival in public datasets. HKDC1 depletion reduced growth and colony formation in Hep3B and SNU449 cells. HKDC1 depletion also increased the response to lenvatinib and ML-162. Independent targeting with sg-HKDC1-2 reproduced the ML-162-associated viability phenotype, and ferrostatin-1 restored viability after ML-162 exposure in SNU449 cells. These results support an association between HKDC1 depletion and increased susceptibility to regulated cell-death stress in HCC cells. Because direct lipid-reactive oxygen species, GPX4/SLC7A11 activity, glucose flux, and in vivo efficacy were not measured, the downstream mechanism and therapeutic relevance require further validation.