Characterizing the composition of immune cells in the tumor microenvironment (TME) has shown promise in understanding variable responses to neoadjuvant treatment in rectal cancer. Despite this, no method has been established that can confidently predict the response to pre-operative chemoradiotherapy. Tumor-associated macrophages (TAMs) in the TME can be polarized by the biochemical milieu to adopt pro-inflammatory (M1-like) and anti-inflammatory (M2-like) phenotypes. Utilizing the spectrum of TAM polarization as a biomarker to predict patient response to neoadjuvant therapy in rectal cancer patients has not been fully explored. We address this using 7-plex immunofluorescence staining to quantify 16 subsets of TAMs in rectal adenocarcinoma pretreatment biopsies. Pretreatment biopsies were obtained from 128 patients with known tumor regression grades (TRG). Through quantifying the prevalence of TAM subsets, we identified a higher density of the completely M1-polarized subset and a lower density of the completely M2-polarized subset in patients with a complete pathological response, the absence of detectable tumor cells following treatment. Predictive modeling using TAM subsets showed that only the densities of two completely polarized subsets were predictors of therapeutic response in patients with rectal cancer. Significantly, we demonstrate that the full panel of markers we employed were required to define predictive populations, as total TAMs or TAM subsets defined by fewer markers were incapable of predicting treatment response. Taken together, we validate the utility of a multiplex approach to define the spectrum of TAM polarization, which can be leveraged to identify patients that will have a complete pathological response to neoadjuvant treatment.

Myeloid sarcoma is a rare solid tumour of immature myeloid precursors occurring in an extramedullary site. It often presents significant diagnostic and therapeutic challenges to clinical haematologists.

We describe a previously healthy patient who presented simultaneously with hyperleucocytic chronic myeloid leukaemia in chronic phase (CML-CP) and a pelvic myeloid sarcoma (MS). She failed to respond to conventional intensive chemotherapy meant for acute myeloid leukaemia but responded well to a combination of radiotherapy and tyrosine kinase inhibitor. She has remained well and in deep molecular response for the past 10 years.

We report the first case of MS in CML-CP that has achieved 10 years of long-term remission with a combination of radiotherapy and tyrosine kinase inhibitor, without allogeneic stem cell transplantation. We also reviewed the literature on CML-CP with simultaneous MS to determine the disease characteristics and treatment outcomes.

Suspicious calcifications in breast cancer (BC) often limit eligibility for breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NAC). This study assessed the impact of ductal carcinoma in situ (DCIS) status and post-NAC imaging changes on pathological complete response (pCR), BCS feasibility, and prognosis.

We retrospectively analyzed 163 BC patients with suspicious calcifications treated with NAC (median follow-up, 38.9 months). Logistic regression identified predictors of pCR, associations between calcification changes and pCR were assessed using Cramer's V, and OS and DFS were evaluated using Kaplan-Meier analysis.

73 patients had DCIS and 90 had non-DCIS. Calcification reduction after NAC was more frequent in non-DCIS group (56.7%; p = 0.012). pCR rates were higher in non-DCIS group than in DCIS group (73.7% vs 26.3%; p = 0.015). After adjustment, DCIS was associated with reduced pCR rates (OR: 0.26, 95% CI: 0.08-0.73). Overall BCS rate was 11%. Calcification reduction showed a weak correlation with pCR (Cramer's V = 0.321). No significant OS, DFS, or BCS differences were observed by DCIS status or calcification change within follow-up.

DCIS is associated with reduced pCR after NAC. Calcification findings alone should be interpreted cautiously, and BCS feasibility should be assessed using comprehensive surgical criteria.

Multiple myeloma (MM) remains an incurable haematological malignancy, underscoring the need for novel prognostic biomarkers and therapeutic targets. This study aimed to investigate the clinical and biological significance of peroxisome proliferator-activated receptor gamma coactivator-related protein 1 (PPRC1) in MM.

Expression and clinical data were obtained from public databases and an independent local cohort. Kaplan-Meier and Cox regression analyses were performed to evaluate prognostic value. Differential expression analysis, pathway enrichment analysis and single-cell RNA-seq data analysis were used to explore biological functions. PPRC1 was silenced in MM cell lines using siRNA to assess its effects on cell survival and oxidative phosphorylation.

PPRC1 was significantly upregulated in MM and was associated with advanced disease stage and poor overall survival. Multivariate Cox analysis identified PPRC1 as an independent prognostic factor. A nomogram incorporating PPRC1 and revised-ISS improved survival prediction. Functional analyses revealed that PPRC1 was positively correlated with oxidative phosphorylation and oncogenic signalling pathways. A potential connection between PPRC1 expression and immune cell infiltration was observed. PPRC1 knockdown inhibited cell proliferation, induced cell cycle arrest and apoptosis and impaired oxidative phosphorylation in MM.

PPRC1 acts as a prognostic biomarker and metabolic regulator in MM by sustaining mitochondrial oxidative phosphorylation. These findings highlight PPRC1 as a potential therapeutic target in MM.

Primary central nervous system lymphoma (PCNSL) alters (peri)vascular structures while increasing vasomotor and cardiorespiratory pulsations within the brain. Vasomotor pulsations may arise from amplitude modulations of respiratory (RPE) and cardiovascular (CHE) pulsations while cardiovascular fluctuations may be modulated by respiration through cardiorespiratory amplitude modulation (CREM). In this study, we examined glymphatic cerebrospinal fluid convection in brains of PCNSL patients by assessing these waves. Thirty PCNSL patients (median 66y; 9 females) and 40 healthy age-matched controls (median 62y; 29 females) were scanned using an fMRI-based MREG_BOLD sequence. Respective MREG_BOLD fluctuation amplitudes (AF_RPE; AF_CHE; AF_CREM) were compared between groups using nonparametric permutation. Regional amplitudes were compared using Mann-Whitney analysis and Cox survival analysis. Subject-specific pulsations were analyzed through Z-score mapping. AF_CREM and AF_RPE were significantly elevated across PCNSL brains, with lesser increases in AF_CHE. However, only significant increases in AF_RPE remained after correcting for sex and head displacement. AF_RPE showed a link to mortality as it was markedly elevated in deceased patients. While elevations in all pulsations were present within (peri)tumoral regions, AF_RPE elevations extended into extra-tumoral white matter and grey matter. Thus, altered cardiorespiratory fluctuations give rise to dysfunctional vasomotor and CSF pulsations in PCNSL, predicting impaired glymphatic function.

Bladder cancer is a common malignancy with a high recurrence rate, posing a significant public health burden. Beyond its role in bone health, vitamin D has been suggested to influence cancer risk, including bladder cancer.

To evaluate the association between serum vitamin D levels, dietary intake, and supplementation with bladder cancer risk.

This umbrella review included systematic reviews and meta-analyses from multiple databases, focusing on serum levels or intake of vitamin D and bladder cancer risk. Study quality was assessed using the JBI Critical Appraisal Tool. The Corrected Covered Area showed a 15.5% overlap. Considerable heterogeneity in study design, populations, and vitamin D assessment was noted. Two second-order meta-analyses were conducted for quantitative synthesis.

Eight studies met the inclusion criteria. Adequate serum vitamin D was generally defined as levels ≥ 30 nmol/L. Low serum vitamin D was significantly associated with increased bladder cancer risk (RR = 1.32; 95% CI: [1.27, 1.38]). Higher serum levels were linked to a non-significant risk reduction (RR = 0.86; 95% CI: [0.63, 1.16]). Evidence on dietary intake was inconsistent, with some analyses suggesting a modest protective effect, particularly when combined with specific dietary patterns.

Low serum vitamin D is consistently associated with increased bladder cancer risk, while maintaining levels above 30 nmol/L may provide some protection. Evidence on dietary intake and supplementation remains inconclusive. Future studies should adopt standardized methods for vitamin D measurement, explore the role of free versus total vitamin D, and clarify population-specific differences to better define vitamin D's role in bladder cancer prevention.

IntroductionFinancial hardship may undermine healthy lifestyle behaviors that are important for preventing avoidable recurrence and death during survivorship after breast cancer diagnosis. Significant research has characterized these challenges and disparities, but relatively little research has identified which strategies patients and their teams may prefer to overcome these challenges. We employ an assets lens to highlight patient-identified strategies to circumvent barriers across Social-Ecological Model (SEM) levels.MethodsWe conducted a secondary qualitative analysis of semi-structured interviews with 26 Black/Latina breast cancer survivors and 10 oncology providers recruited from a single health system (2019-2020). Transcripts (English/Spanish) were coded using deductive and inductive approaches, and these codes were subsequently organized into themes and mapped to SEM levels.ResultsSurvivors used multi-level strategies to maintain healthy behaviors while navigating financial hardship. At the individual level, women budgeted proactively, substituted canned/frozen vegetables for fresh produce, and relied on home-based exercise, often supported by emotion-focused coping. Interpersonal strategies drew on family and friends for transportation, childcare, and accountability. Community-based solutions included church-based aid, food pantries, public benefits, and transportation vouchers, frequently facilitated by social workers. Organizational solutions centered on multidisciplinary survivorship clinics that provided financial navigation, consolidated appointments, and cost-tailored lifestyle counseling. Providers corroborated these strategies and emphasized clinic-level interventions (e.g., consolidated appointment scheduling, proactive financial and nutritional screening) to reduce financial hardships.ConclusionBlack and Latina breast cancer survivors and their providers deploy pragmatic strategies across multiple SEM levels to sustain healthy behaviors under financial hardship. However, community- and organization-level solutions remain underutilized in interventions, and few trials have integrated financial navigation with lifestyle interventions. Embedding proactive financial and nutrition security screening, bilingual financial navigation, and community partnerships into lifestyle interventions and survivorship care could reduce structural barriers, improve lifestyle guideline adherence, and advance equity in cancer outcomes.

Oncology patients often experience pain, sleep problems, and discomfort during palliative care. Hand massage is a nonpharmacological method that can relax the patient and help alleviate these problems. This study aimed to examine the effect of hand massage on pain, comfort, and sleep quality in palliative oncology patients.

A randomized, controlled experimental study was conducted with a sample of 76 oncology patients treated in the palliative care clinic of a public hospital. The patients were randomly allocated to the experimental and control groups. The experimental group (n = 38) received a total of 16 sessions of hand massage, performed twice a day, 2 days per week for 4 weeks. The control group (n = 38) received no intervention. The patients' pain, sleep quality, and comfort were assessed before and at 1, 2, and 4 weeks after the start of the intervention using the Visual Analog Scale for pain, the Pittsburg Sleep Quality Index, the General Comfort Questionnaire, and a smart wristband.

Demographic characteristics and pre-intervention pain, sleep quality, and comfort scores showed no statistical differences between the groups (p > 0.05). The experimental group reported significantly lower pain intensity and greater comfort than the control group starting from week 2 (p < 0.05). In addition, subjective sleep quality assessed using the PSQI and objective sleep parameters (sleep duration and sleep score) measured by a smart wristband, including objective sleep duration and objective sleep score, were significantly better in the experimental group than in the control group from the first week (p < 0.05).

Hand massage is an effective method for reducing pain and increasing sleep quality and comfort in palliative oncology patients.

NCT06360614.

To explore the moderated mediating effect involving perceived loneliness and economic burden in the association between social support and mental health among lung cancer patients.

A total of 614 valid questionnaires were collected from December 2023 to February 2024 using convenience sampling. Social support was assessed with the Social Support Rating Scale, mental health with the General Health Questionnaire, and perceived loneliness with the Cancer Loneliness Scale. Theoretical hypotheses were tested using moderated mediation analysis.

More than half of participants were female (65.8%), and half of them were aged between 40 and 60 (53.7%). The majority had been diagnosed with adenocarcinoma (94.1%) and were classified as having stage I lung cancer (85.8%). A quarter (24.6%) of participants reported a high level of economic burden. Perceived loneliness partially mediated the relationship between social support and mental health. Economic burden moderated the relationship between perceived loneliness and mental health. For objective support, perceived loneliness served as a mediator among high-burden participants. For support utilization, perceived loneliness served as a mediator among low-burden participants. In terms of subjective support, perceived loneliness exerted a mediating effect among all patients.

Providing social support may improve mental health outcomes by alleviating feelings of loneliness among lung cancer patients. Intervention strategies should be tailored to patients' economic burden: providing supportive resources such as financial assistance, psychoeducation programs, and social activities for patients with high economic burden, while promoting resource utilization such as patient navigation programs for those with lower economic burden.

To systematically characterize the peripheral immune signature of uterine fibroids (UFs) and to develop a diagnostic model for differentiating UF patients from healthy individuals, thereby providing new insights into UF immunopathogenesis.

We performed multiparametric flow cytometry analysis on peripheral blood samples from 31 UF patients and 63 age-matched healthy controls (HCs). A total of 70 immune parameters were evaluated, encompassing T cells, B cells, natural killer (NK) cells, γδ T cells, and their functional subsets.

Comprehensive immunophenotyping revealed a distinct peripheral immune profile in UF patients. Key findings included a significant dysregulation within helper T (Th) cell compartments, characterized by elevated frequencies of functional Th and Th17 cells, alongside reduced proportions of senescent Th, T follicular helper 1 (Tfh1), and peripheral Th (Tph) cells. Concurrently, a significant expansion of the B cell compartment was observed, marked by increased total B cells, naïve B cells, immature regulatory B cells (Breg), and transformed B cells. In contrast, the frequencies and functional subsets of cytotoxic T (Tc) cells, γδ T cells, and NK cells showed no significant alterations after false discovery rate (FDR) correction. A random forest (RF) model incorporating key immune markers effectively discriminated UF patients from HCs, identifying several markers as central features with both diagnostic and mechanistic relevance.

This study presents the first systematic atlas of the peripheral immune landscape in UF, revealing a pattern of systemic immune dysregulation centered on Th and B cell pathways. These findings advance our understanding of the immunopathogenesis of UF and establish a foundation for future immune-based diagnostic and therapeutic strategies.