BACKGROUND A durable complete response, or sustained disappearance of measurable malignancy, can occur in selected patients with metastatic renal cell carcinoma after systemic therapy. Clear cell renal cell carcinoma is the most common renal cell carcinoma subtype. Lenvatinib is a multikinase inhibitor with antiangiogenic activity, and pembrolizumab is an anti-programmed death-1 immune checkpoint inhibitor. Although this combination can induce deep extracranial responses, central nervous system relapse after prolonged complete response remains incompletely characterized. This report describes a 73-year-old man with late isolated brain metastasis of clear cell renal cell carcinoma after durable complete response to lenvatinib-pembrolizumab and deferred cytoreductive nephrectomy. CASE REPORT A 73-year-old man presented with right flank pain. Computed tomography showed a right renal tumor, level II inferior vena cava tumor thrombus, and multiple pulmonary metastases. Baseline brain computed tomography showed no intracranial metastasis. He received lenvatinib plus pembrolizumab, resulting in marked regression of the primary tumor, inferior vena cava thrombus, and lung metastases. Deferred cytoreductive nephrectomy with thrombectomy was then performed, and pathology confirmed clear cell renal cell carcinoma with extensive treatment effect. Lenvatinib was discontinued because of renal dysfunction, and pembrolizumab monotherapy was continued. The patient maintained complete extracranial radiographic remission for more than 2 years. He later developed headache, and brain magnetic resonance imaging revealed a solitary left occipital metastasis without systemic recurrence. Stereotactic body radiotherapy achieved local control. CONCLUSIONS This case shows that late isolated central nervous system relapse can occur despite durable extracranial complete response after lenvatinib-pembrolizumab and deferred cytoreductive nephrectomy. New neurological symptoms in long-term responders should prompt brain magnetic resonance imaging, because intracranial progression may occur even when systemic imaging remains negative.

No head-to-head trials have compared the efficacy of zanubrutinib versus ibrutinib in relapsed/refractory mantle-cell lymphoma (R/R MCL).

Following a systematic literature review, individual patient data from trials of zanubrutinib (n = 118) and aggregate data from a pooled analysis of ibrutinib trials (n = 370) were analyzed using an unanchored matching-adjusted indirect comparison (MAIC).

After matching selected covariates, statistically significant differences were observed with zanubrutinib versus ibrutinib for progression-free survival (hazard ratio [HR] = 0.63; 95% confidence interval [CI] 0.46-0.87, p = .0044) and overall survival (HR, 0.46; 95% CI 0.30-0.71, p = .0005).

These MAIC analyses demonstrate that zanubrutinib may be more effective than ibrutinib at delaying disease progression and death in R/R MCL.

Animal venoms represent an extraordinary, yet largely untapped, biochemical reservoir for oncological drug discovery. This review provides a comprehensive analysis of venom-derived enzyme inhibitors as emerging anticancer agents, emphasizing their chemical diversity, structure-activity relationships (SAR), molecular targets, and mechanistic pathways. Venom-derived peptides and proteins exhibit exceptional binding affinity and structural rigidity, characteristics frequently enforced by conserved disulfide networks. This specific architecture allows them to selectively modulate critical cancer-associated enzymes, including matrix metalloproteinases, phospholipases A₂, serine proteases, and kinases. Inhibiting these highly specific targets successfully disrupts tumour angiogenesis, extracellular matrix remodelling, and metastatic dissemination, while simultaneously inducing apoptosis through unique pathways such as reactive oxygen species generation. Modern computational approaches, encompassing deep learning algorithms, molecular docking, and molecular dynamics simulations, are substantially accelerating and transforming the discovery pipeline by rapidly mapping intricate peptide-receptor interactions and guiding rational drug design. Translating these potent molecules into clinical therapeutics remains heavily challenged by pharmacokinetic instability, rapid proteolytic degradation, and systemic toxicity. The integration of computationally optimized scaffolds with advanced targeted delivery platforms, such as nanocarriers and liposomal encapsulation, offers a highly viable strategy to overcome these barriers, ultimately paving the way for next-generation, venom-inspired cancer therapies.

Evidence on the effects of palliative care team interventions on cachexia remains limited. We examined the effects on nutrition impact symptoms (NISs), dietary intake, and eating-related distress (ERD) among advanced cancer patients.

This was a multicenter prospective observational study. Participants completed the baseline survey and the follow-up survey one week later. They evaluated NISs, dietary intake, and ERD. We compared the patient-reported outcomes between the two surveys. We categorized the participants having four or more NISs with a score ≥ 4 into the High-NIS group (otherwise, the Low-NIS group) using their baseline scores. Changes in the number of symptoms with a score ≥ 4, the dietary intake, and the ERD scores were calculated. Multiple regression analyses were performed to identify the factors influencing the improvements in dietary intake and ERD.

A total of 123 patients were included. In all patients, pain, fatigue, lack of appetite, sadness, and ERD significantly improved (p = 0.001, 0.023, 0.043, 0.037, <0.001). In the High-NIS group, the number of symptoms with a score ≥ 4 significantly decreased (p = 0.009), dietary intake scores significantly increased (p = 0.037), and ERD scores significantly decreased (p = 0.001). The number of symptoms with a score ≥ 4 at baseline (B = 1.08, p = 0.044, 95% confidence interval 0.03 to 2.14) was the only independent factor influencing the improvements in dietary intake.

NISs and ERD improvements were associated with the interventions. Dietary intake improvement was associated with a high baseline symptom burden.

Background/Objectives: Dietary habits are important modifiable factors influencing survival among cancer patients. The dietary quality among cancer survivors may differ from those of the general population and may vary according to age at cancer diagnosis. This study aimed to compare dietary quality between cancer survivors and the general population and to examine whether age at diagnosis is associated with dietary quality. Methods: This retrospective cross-sectional study used data from 8706 adults aged ≥ 30 years (641 cancer survivors and 8065 controls) from the 2019-2021 Korea National Health and Nutrition Examination Survey. Dietary quality was assessed using the Diet Quality Index-International (DQI-I; range 0-100). Survey-weighted multiple linear regression models were used to compare DQI-I scores between cancer survivors and controls. Subgroup analyses were stratified by age at diagnosis, and quadratic age terms were included to assess nonlinear associations. All analyses accounted for the complex survey design. Results: Cancer survivors had significantly higher mean DQI-I scores than controls (69.1 ± 0.4 vs. 66.1 ± 0.2; p < 0.001). Among survivors diagnosed before age 50, dietary quality was significantly higher in those currently under 65 years than in controls (mean difference +3.02, 95% CI 1.44-4.60), but notably lower in those aged ≥ 65 years (-3.18, 95% CI -6.16 to -0.20). In contrast, survivors diagnosed at age ≥ 50 consistently showed higher dietary quality than controls across all age groups (+3.76, 95% CI 2.83-4.68). Conclusions: While cancer survivors generally exhibit better dietary quality than the general population, this positive trend was not observed among younger-onset survivors in older age groups. These findings suggest that age at cancer diagnosis may be associated with dietary quality and highlight the need for sustained, age-specific nutritional support strategies in cancer survivorship.

Cancer remains a major public health challenge among women worldwide, and diet quality may play an important role in cancer prevention. This narrative review synthesized evidence on the association between standardized diet quality indices-the DASH Score, Mediterranean Diet Score, and plant-based diet indices-and the risk of selected cancers in women, focusing on breast, colorectal, and ovarian cancer. English-language publications from 2020 to 2026 were reviewed, supplemented by key earlier methodological and epidemiological sources. The most consistent inverse associations were observed for colorectal cancer in relation to the DASH and Mediterranean dietary patterns, and for breast cancer in relation to healthful plant-based diets assessed using the hPDI. Evidence for ovarian cancer remains limited and inconclusive. Across dietary patterns, the findings indicate that overall diet quality, including the quality and processing level of plant-based foods, may be more relevant than the proportion of plant foods alone. The available evidence is limited mainly by heterogeneity in index definitions, predominance of observational designs, dietary assessment errors, and residual confounding. Overall, high-quality dietary patterns may be relevant to cancer prevention in women, although the strength and consistency of associations vary by cancer site and dietary assessment approach.

Background/Objectives: We examined whether guidance on dietary habits or nutrition-related problems from healthcare professionals during cancer treatment was associated with quality of life, after treatment. Methods: Cross-sectional data were drawn from the Icelandic Compass study, conducted in 2020-2021 among adults diagnosed with cancer in 2015-2019. The analysis included participants who had completed treatment for breast cancer (n = 341), prostate cancer (n = 137), or colorectal cancer (n = 132), for a total sample of 610 participants. Quality of life (QL) was assessed using the EORTC QLQ-C30 global health status/quality of life scale. Associations were examined using regression models adjusted for age, marital status, education, number of cancer treatments, stage at diagnosis, body mass index, tobacco and alcohol use, and comorbidities. Results: Overall, 26% of participants reported receiving sufficient guidance on general dietary habits during treatment and 19% on nutrition-related problems. On average, three years had passed since diagnosis. Among all participants, guidance on general dietary habits was associated with higher QL scores (β = 5.6; 95% CI: 0.8 to 10.5), as was guidance on nutrition-related problems (β = 5.7; 95% CI: 0.3 to 11.1). In subgroup analyses, statistically significant associations were observed among prostate cancer survivors for both dietary guidance (β = 12.4) and guidance on nutrition-related problems (β = 14.0), and among breast cancer survivors for guidance on nutrition-related problems (β = 8.4). Conclusions: Patient-reported sufficient discussions about dietary habits or nutrition-related problems during treatment were associated with slightly higher post-treatment QL scores.

Background/Objectives: Human papillomavirus (HPV) is a well-established prognostic marker in oropharyngeal squamous cell carcinoma (OPSCC); however, the short-term treatment response remains heterogeneous, particularly among HPV-positive patients. Given the high prevalence of malnutrition in head and neck cancer, this study examined whether baseline nutritional status, body composition and functional status were associated with early treatment response in OPSCC according to HPV status. Methods: A prospective observational multicenter cohort study of newly diagnosed OPSCC patients eligible for curative-intent treatment was conducted at three tertiary hospitals in Barcelona, Spain. Baseline assessments comprised anthropometry, computed tomography (CT)-based body composition at L3, functional performance tests, systemic inflammatory biomarkers and nutritional diagnosis by the Patient-Generated Subjective Global Assessment (PG-SGA). Early treatment response, assessed around 12 weeks post-therapy, was classified as complete remission (CR) or non-complete remission (NCR). Classification tree analyses were performed separately by HPV status. Results: Of 101 enrolled patients, 97 completed post-treatment assessment, of whom 51% were HPV-positive. Among HPV-positive patients, PG-SGA score was the main discriminating variable for early response within the classification tree model, with CR achieved in 74% of patients scoring <6 versus 33% of those scoring ≥6 (AUC 0.68, 95% CI 0.55-0.82). Conversely, Eastern Cooperative Oncology Group Performance Status (ECOG PS) and age were the primary discriminating variables in HPV-negative patients (AUC 0.81, 95% CI 0.70-0.93). In both HPV subgroups, body composition and inflammatory markers were not retained in the analysis once nutritional and functional status were considered. Conclusions: PG-SGA-defined nutritional status was associated with early treatment response in HPV-positive patients, while functional status was the main variable retained in HPV-negative patients. These findings support the potential clinical value of standardized nutritional assessment in OPSCC and suggest that early identification of poor nutritional status or functional impairment may help refine supportive care planning at treatment initiation.

High-grade serous ovarian carcinoma (HGSOC) shows limited benefit from immune checkpoint blockade, partly because stromal barriers impair antitumor immunity. We developed a cancer-associated fibroblast (CAF)-associated mitochondrial metabolic and matrix-remodeling signature, termed CMMS, to characterize this immune-suppressive stromal state. CMMS integrated contractile/myCAF, extracellular matrix (ECM), and mitochondrial metabolic genes. Its clinical, metabolic, and immune relevance was evaluated in TCGA-HGSOC, independent GEO cohorts, single-cell RNA-seq datasets, and an anti-PD-L1-treated cohort, followed by cell-cell communication and experimental validation. LASSO-weighted CMMS stratified overall survival, with high CMMS indicating poorer prognosis. CMMS-high tumors exhibited ECM/TGFβ activation; associations with COL1A1, POSTN, and LOX; and a hypoxia-dominant metabolic phenotype. Mediation analysis suggested that hypoxia largely linked CMMS to glycolytic remodeling. Immune profiling revealed stromal-rich immune exclusion, checkpoint activation, and exhaustion-prone T-cell dysfunction. Single-cell analysis localized CMMS mainly to myCAF-like ECM-remodeling CAFs. In validation datasets, CMMS-high CAFs were associated with reduced CD8 abundance, increased CD8 exhaustion, and stronger matrix- and chemokine-related communication with T cells. Experiments further supported a link between TGFβ-related fibroblast activation, ECM-remodeling features, and impaired CD8⁺ T-cell effector function. Overall, CMMS defines a CAF-enriched fibrotic-hypoxic stromal program associated with immune exclusion-related features, exhaustion-prone T-cell dysfunction, and poor outcome in HGSOC.

Prostate cancer (PCa) exhibits marked biological heterogeneity, complicating accurate identification of aggressive disease at initial diagnosis. This study investigated whether circulating tumour DNA (ctDNA) methylation markers enhance detection and risk stratification across the PCa disease continuum. Plasma samples from the initial hospital visit were obtained from 280 participants in the PerPros prostate biobank (Vejle, Denmark), all referred with suspected PCa. Following diagnostic work-up, participants were classified across the PCa disease spectrum or as biopsy-confirmed PCa-free controls. Five methylated CpG regions (DOCK2, HAPLN3, ACTRT2, EVX1, HOXD13) were analysed using multiplex ddPCR. Performance was assessed using ROC analysis and logistic regression and compared with prostate-specific antigen (PSA). Methylation markers were detectable across the PCa disease spectrum, most frequently in metastatic castration-sensitive PCa (mCSPC) (85/97; 88%). The ctDNA methylation panel discriminated mCSPC from controls with an AUC (area under the curve) of 0.88 (95% CI: 0.83-0.93). In this cohort, combining PSA (cut-off 20 µg/L) with the ctDNA methylation panel significantly improved discrimination between patients with mCSPC and locally advanced PCa compared with PSA alone (AUC 0.88; 95% CI 0.83-0.94; p < 0.001) vs. 0.78 (95% CI 0.71-0.84). In contrast, discrimination between localised/locally advanced PCa and patients with biopsy-confirmed controls was limited (AUC 0.56; 95% CI: 0.51-0.61). The ctDNA methylation panel demonstrates robust identification of metastatic PCa and can effectively differentiate mCSPC from locally advanced PCa. However, its diagnostic abilities in localised disease appear limited.