To determine whether there is a possible link between selected preoperative systemic inflammatory markers and molecular pathological indices.

For this retrospective study, 125 patients served as subjects. Preoperative systemic inflammatory markers, namely neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR), and postoperative pathological indices, namely mitosis, Ki-67 labeling index (LI), isocitrate dehydrogenase-1 (IDH1) mutation, and 1p/19q codeletion, were obtained from the electronic database.

Results showed that NLR positively correlated with PLR (p = 0.00001), mitotic activity (p = 0.001), and Ki-67 LI (p = 0.00001). On the other hand, LMR negatively correlated with PLR (p = 0.00001), mitotic activity (p = 0.00001), Ki-67 LI (p = 0.001), and IDH1 mutation (p = 0.04).

Our results suggest a link between systemic inflammation and histopathology, and higher NLR and/or lower LMR may be a novel prognostic marker in gliomas. A prospective multicenter study with a larger patient population would be more convincing. Until such a study is published, the results of retrospective studies, including ours, should be evaluated with caution.

To evaluate the association between the preoperative pan-immune inflammation value (PIV) and prognostic factors, including stage, lymph node involvement, and metastasis, in patients who underwent radical orchiectomy for germ cell testicular tumors.

Data from 178 patients who underwent radical orchiectomy for testicular tumors between January 2014 and January 2024 were retrospectively reviewed. Preoperative serum tumor markers, hematologic parameters, and histopathological findings were recorded. Tumor staging was determined based on radiological imaging and serum tumor markers. The PIV was calculated using the formula: (monocyte count × neutrophil count × platelet count) / lymphocyte count. Optimal cut-off values for PIV were determined using ROC curve analysis. The association between the PIV score and clinicopathological variables was analyzed.

The mean age of the patients was 32.34 ± 9.62 years. The mean PIV score in patients with metastasis and retroperitoneal lymph node invasion (RPLNI) was significantly higher than in those without metastasis or RPLNI (p = 0.01 and p = 0.04, respectively). The PIV score increased progressively with higher tumor T, N, and M stages. Additionally, a statistically significant increase in PIV scores was observed among patients classified into higher International Germ Cell Cancer Collaborative Group risk groups (p = 0.01).

Higher PIV scores are significantly associated with tumor stage, lymph node involvement, and metastasis in patients with germ cell testicular tumors. The PIV score appears to be a useful and cost-effective preoperative marker for predicting advanced disease in testicular tumors at the time of diagnosis.

Nuclear protein in testis (NUT) carcinoma is an extremely rare and highly aggressive epithelial malignancy driven by NUTM1 rearrangements. Sinonasal involvement is uncommon and often presents with non-specific clinical and radiologic features, leading to delayed diagnosis. Optimal management remains undefined, and outcomes are poor when complete resection is not feasible.

A 31-year-old man developed progressive numbness and swelling of the left cheek after tooth extraction. Imaging revealed a soft-tissue mass involving the left maxillary sinus with adjacent maxillofacial soft-tissue extension. Endoscopic biopsy demonstrated a poorly differentiated carcinoma with diffuse punctate nuclear NUT expression, high proliferative index (Ki-67 ~50%), and PD-L1 expression in both tumor cells and immune cells. ^18F-FDG PET-CT showed no regional or distant metastases. Given unresectability, the patient received toripalimab (240 mg) combined with docetaxel and cisplatin every 3 weeks. MRI after three cycles showed early radiologic improvement, and further tumor regression was observed after six cycles, consistent with a partial response. The patient subsequently continued on toripalimab-based maintenance therapy with ongoing stable residual disease at the latest follow-up (approximately 5 months after therapy initiation and 6 months from diagnosis).

To our knowledge, this is the first reported case of toripalimab-based chemoimmunotherapy demonstrating an early partial response and short-term disease control in unresectable maxillary sinus NUT carcinoma. It supports the potential role of PD-1 blockade integrated with platinum-taxane chemotherapy as a component of multimodal management for sinonasal NUT carcinomas.

Over the past decade, the treatment landscape for metastatic urothelial carcinoma (mUC) has improved significantly with the introduction of immunotherapy, targeted agents, and antibody-drug conjugates. The median overall survival (mOS) reached 36.7 months in cisplatin-eligible and 25.6 months in cisplatin-ineligible patients in the first-line setting and over 10 months post-platinum failure. However, liver metastases remain a known poor prognostic factor.

We conducted a retrospective analysis of mUC patients treated at 79 global institutions. Two cohorts were defined: cohort 1 included patients who progressed after platinum-based therapy and received pembrolizumab, and cohort 2 included patients who received avelumab as maintenance therapy. Treatments were administered between 1 January 2016 and 31 October 2024.

Cohort 1 (n = 1,341) had an mOS of 17.5 months. Patients without liver metastases had significantly longer OS than those with liver involvement (20.1 vs. 9.4 months, p <0.001). Among patients with liver metastases, OS was 11.8 months in males vs. 5.8 months in females (p = 0.066). OS was longer in those with BMI ≥25 kg/m² (14.1 vs. 8.1 months, p = 0.028) and better ECOG-PS (ECOG 0: 17.0 months; ECOG 1: 9.8; ECOG ≥2: 3.1; p <0.001). Cohort 2 (n = 291) had an mOS of 25.8 months. Again, OS was longer in patients without liver metastases (27.0 vs. 16.4 months, p <0.001). Among those with liver involvement, OS was 14.7 months in males and 20.0 months in females (p = 0.310). Patients with BMI ≥25 had non-reached OS versus 17.1 months in those with lower BMI (p <0.001). ECOG-PS remained a strong prognostic factor (NR for ECOG 0; 14.7 months for ECOG 1; 4.6 months for ECOG ≥2, p <0.001).

Liver metastases are associated with significantly reduced survival in patients with mUC receiving immunotherapy. However, both pembrolizumab and avelumab demonstrated improved outcomes compared with historical chemotherapy data. These findings underscore the need for personalized treatment strategies in high-risk subgroups.

The management of advanced cholangiocarcinoma (CCA) remains a clinical challenge. Prognostic biomarkers are needed to guide treatment decisions. The C-reactive protein-albumin-lymphocyte (CALLY) index reflects nutritional, immune, and inflammatory status and has shown prognostic value in other cancers. However, its role in CCA patients receiving chemoimmunotherapy is unexplored.

We conducted a retrospective propensity score-matched (PSM) cohort study involving advanced CCA patients who were treated with chemoimmunotherapy. Participants were stratified into high- or low-CALLY groups based on an optimal cut-off value of 1.42. PSM (1:1) was applied to balance baseline covariates. Overall survival (OS) and progression-free survival (PFS) were compared between groups using Kaplan-Meier analysis, and Cox regression analysis was employed to identify prognostic factors. The prognostic models underwent comprehensive internal validation, including bootstrap resampling (1,000 iterations) for calibration and discrimination assessment. Health-related quality of life (HRQoL) was assessed using a mixed model for repeated measures.

After 1:1 propensity matching, 55 patients were retained in each group, with balanced baseline characteristics. The high-CALLY group exhibited significantly longer median OS (13.00 months vs. 11.50 months; P = 0.019) and PFS (7.50 months vs. 6.00 months; P = 0.020). Cox analysis confirmed the CALLY index as a valuable prognostic factor for both OS (hazard ratio (HR), 0.68; 95% confidence interval (CI), 0.50 to 0.93; P = 0.014) and PFS (HR, 0.70; 95% CI, 0.58 to 0.85; P < 0.001). Internal validation demonstrated good model performance, with optimism-corrected C-indices of 0.704 for OS and 0.716 for PFS. Furthermore, patients with a high CALLY index showed significantly slower deterioration in HRQoL from week 18 onward (P < 0.05).

The CALLY index is a robust prognostic biomarker for advanced CCA patients undergoing chemoimmunotherapy, associated with significantly improved survival and better-preserved quality of life. Its integration into clinical practice could enhance risk stratification and facilitate personalized treatment strategies.

This study aims to conduct a systematic review and meta-analysis to investigate how imaging parameters derived from ¹⁸F-FDG positron emission tomography/computed tomography (PET/CT) predict treatment outcomes in patients with diffuse large B-cell lymphoma (DLBCL) receiving chimeric antigen receptor T-cell (CAR-T) therapy.

A comprehensive search was conducted in PubMed, Embase, Cochrane Library, and Web of Science databases to retrieve relevant literature from their inception to December 24, 2024. This study is registered in PROSPERO (CRD42025634694). The protocol was completed in accordance with the PRISMA guidelines recommended by the EJNMMI authors' guide. Cohort studies were included that enrolled patients diagnosed with DLBCL via ¹⁸F-FDG PET/CT and who received CAR-T therapy. Fixed-effect and random-effects models were applied using Stata software to calculate pooled hazard ratios (HR) with 95% confidence intervals (CI). Heterogeneity was assessed using the I² statistic.

A total of 14 studies were included, involving 1,088 patients (aged 20 to 86 years) diagnosed with DLBCL based on ¹⁸F-FDG PET/CT imaging findings. Univariate analysis demonstrated significant associations between several PET-derived parameters and survival outcomes: SUVmax was predictive of both overall survival (OS) (HR: 1.61; 95% CI: 1.20-2.18) and progression-free survival (PFS) (HR: 1.47; 95% CI: 1.09-1.98); higher MTV levels were associated with decreased OS (HR: 2.81; 95% CI: 1.23-6.45) and PFS (HR: 2.39; 95% CI: 1.24-4.61); and TMTV and TLG were also prognostic for PFS and OS. Notably, elevated LDH was linked to inferior OS (HR: 2.76; 95% CI: 2.06-3.71) and PFS (HR: 1.95; 95% CI: 1.50-2.54). ECOG performance status (HR: 2.14; 95% CI: 1.38-3.31) and DS (HR: 6.02; 95% CI: 2.80-12.94) were significantly associated with OS, while IPI was also predictive of OS (HR: 2.04; 95% CI: 1.19-3.50). Elevated LDH and impaired ECOG performance status were independently linked to poorer OS in multivariate analysis (HRs: 3.52 and 2.58, respectively), while the IPI score remained a standalone determinant of PFS (HR: 3.07; 95% CI: 1.59-5.93).

The outcomes of DLBCL cases managed using CAR-T cells can be effectively predicted using both metabolic metrics from ¹⁸F-FDG PET/CT and conventional clinical prognostic markers.

https://www.crd.york.ac.uk/prospero, identifier CRD42025634694.

Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder affecting women of reproductive age. It frequently causes hormonal imbalance, irregular menstrual cycle, and in some cases, infertility. For centuries, traditional herbs like Shatavari (Asparagus racemosus Willd.) have been used to support women's reproductive health, and some studies suggest it may help with PCOS symptoms. Thus, this study aimed to evaluate the safety and efficacy of standardized Shatavari root extract in women with PCOS.

This prospective, randomized, double-blind, placebo-controlled trial was conducted on women aged 20-40 years for 12 weeks. Seventy participants were randomized into Shatavari root extract (SHT, n=35) and placebo (PL, n=35) groups. Sixty-six participants completed the full 12-week trial. The primary outcome was the change in ovarian and endometrial outcomes. Secondary outcomes were the change in Body Mass Index (BMI) and Perceived Stress Scale (PSS-10) scores. Assessments were performed at baseline, week 4, week 8, and week 12. Blood samples were collected at baseline and week 12 to estimate glycated hemoglobin (HbA1c), lipid profile, and serum insulin. The serum hormones, liver, renal, and thyroid functions were also assessed. For the safety assessment, adverse events were continuously monitored.

Baseline demographics and clinical parameters were comparable between groups. At 12 weeks, Ovarian volume did not differ significantly between groups (p= 0.254). SHT significantly reduced psychological stress (PSS score: -6.64 ± 3.99; p < 0.0001), decreased follicular count (p < 0.0001), and increased endometrial thickness (p = 0.028) compared to PL. No significant differences were observed in BMI, hormonal levels, or laboratory parameters. No serious adverse events occurred; mild to moderate events were reported in 11.4% (SHT) and 8.5% (PL) of participants, all manageable with standard therapy and not related to the intervention.

Shatavari root extract oral administration can be a safe and effective potential intervention for women with PCOS. The study was registered with the Clinical Trials Registry of India (CTRI) under registration number CTRI/2024/10/074660 on October 3, 2024.

https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTE0ODIy&Enc=&userName=, identifier CTRI/2024/10/074660.

Bone tumors such as osteosarcoma and Ewing sarcoma remain among the most challenging cancers to diagnose and monitor because of their biological heterogeneity and overlapping radiological features. Magnetic resonance imaging (MRI) provides detailed anatomical insights, whereas liquid biopsy offers minimally invasive access to tumor genetics through circulating DNA, RNA, and extracellular vesicles. Each modality alone is limited, but recent advances in deep learning have enabled multimodal fusion of imaging and molecular data, improving risk stratification, therapy monitoring, and prognostication in patients with osteosarcoma and Ewing sarcoma. This review highlights how multimodal AI frameworks are being applied to bone tumors, delineating evidence from sarcoma-specific studies and representative pan‑cancer models with direct methodological relevance. By integrating MRI radiomics with liquid biopsy omics, deep learning holds promise for redefining precision oncology in bone tumors, delivering earlier detection and more personalized treatment strategies.

Traditional cancer treatments such as chemotherapy and radiotherapy remain effective but lack specificity, often causing collateral damage to healthy tissues. Antibody-drug conjugates (ADCs) using monoclonal antibodies (mAbs) have been developed to achieve advanced targeted delivery; however, preclinical and pharmacokinetic studies have indicated that factors such as large size, complex conjugation processes, high production cost, and immunogenicity can limit tumor penetration, pharmacokinetics, and broader translational applicability. Nanobodies (Nbs), or single-domain antibodies (sdAbs) derived from camelid heavy-chain-only antibodies (HCAbs), represent a promising alternative with smaller size, high aqueous solubility, stability, refolding capacity, and low immunogenicity. Preclinical studies have shown that Nbs retain high affinity and specificity while providing improved access to hidden epitopes on target antigens compared to conventional antibodies. These unique features have supported the development of Nb-drug conjugates (NDCs), which have been evaluated for the selective delivery of cytotoxic drugs to antigen-expressing cancer cells in vitro and in animal models, demonstrating improved target specificity. Furthermore, Nb-attached drug delivery vehicles (NDvs) functionalized with nanoscale carriers, such as liposomes, dendrimer-based nanoparticles, upconversion nanoparticles, and polymeric micelles, have expanded the scope of Nb-based drug delivery systems. This review summarizes the current progress in Nb-mediated drug delivery, compares different strategies, and discusses their translational potential in cancer therapy, highlighting opportunities and limitations based on available experimental data.

The established method in primary care to distinguish skin cancer from benign lesions is clinical examination, with or without dermoscopy. The experience among primary care physicians in assessing skin tumours varies, as does the accessibility to teledermoscopy. To enhance diagnostic performance, improved methods for skin tumour assessment are warranted. The aim of this study was to investigate the diagnostic performance of a non-invasive method that combines near-infrared spectroscopy with skin impedance measurement (NIRIMP) to detect skin cancer in primary care.

NIRIMP measurements were collected prospectively from patients seeking primary care for skin lesion examination. The measurements were compared to the true lesion diagnosis using several machine learning methods, to determine the best machine learning methods to use and to determine the diagnostic performance of NIRIMP in distinguishing skin cancer from benign lesions.

Eighty participants with 109 lesions were included. Among these, 50 skin cancers or in situ cancers were detected: eight melanomas/in situ melanomas, four in situ squamous cell carcinomas, and 38 basal cell carcinomas. The ability of NIRIMP to distinguish any skin cancer/in situ cancer, as illustrated by the area under the receiver operating characteristics curve (AUC), was 0.776 and for melanomas/in situ melanomas alone the AUC was 0.911. When detecting any skin cancer, the AUC was slightly higher for NIR alone (0.826) compared to NIRIMP (0.776), whereas for IMP alone it was slightly lower (0.693).

Near infrared spectroscopy appears to be a promising bioengineering technique to detect skin cancer in primary care settings, of potential benefit for future skin lesion assessment. However, there was no compelling evidence supporting the benefit of adding skin impedance to improve diagnostic performance.