Faecal immunochemical test (FIT) is widely used in colorectal cancer (CRC) screening, but the impact of antithrombotic therapy on colonoscopy outcomes remains unclear. This study aimed to compare polyp detection rate (PDR) and prevalence of non-neoplastic findings in FIT-positive patients undergoing colonoscopy, stratified by antithrombotic therapy.

We conducted a retrospective, multicentre cohort study of 26 280 FIT-positive colonoscopies performed between 2016 and 2023 across seven gastroenterology centres in Israel. The FIT positivity threshold was 75 ng/mL. Patients were grouped by therapy: antiplatelets (n=1904), anticoagulants (n=262) or no antithrombotic treatment (n=24 079). Using crude and matched analyses, we assessed PDR, adenoma detection rate (ADR), CRC detection and diverticulosis prevalence.

Patients on antithrombotics were older (mean 65.9±7 vs 61.0±8 years; p<0.001), more often men (65.2% vs 50.1%; p<0.001) and had higher comorbidity rates. Crude PDR was higher in antithrombotic users (55.5% vs 51.9%; p=0.001), but ADR was similar (28.2% vs 28.3%; p=0.950). Diverticulosis was more prevalent in the antithrombotic group (24.0% vs 17.4%; p<0.001). After matching for age and sex (n=2201 pairs), all previously significant associations were eliminated: PDR were no longer different (55.5% vs 53.1%; p=0.112), diverticulosis prevalence became identical (24.0% vs 24.3%; p=0.799) and normal colonoscopy rates were similar (27.5% vs 29.6%; p=0.123). ADRs remained comparable (28.2% vs 26.7%; p=0.269), and CRC detection rates were identical (2.0% vs 2.0%; p=0.998).

Demographic confounding, rather than antithrombotic therapy per se, explains the crude associations in colonoscopy outcomes. The matched analysis demonstrates that antithrombotics do not independently affect polyp detection, diverticulosis prevalence or adenoma detection when age and sex are controlled for. These findings support the continued use of antithrombotics during CRC screening, shifting clinical interpretation from medication-based to demographic-based risk stratification.

This study developed a multiomics model combining radiomics, pathomics, and temporal imaging to predict major pathological response in patients with locally advanced non-small cell lung cancer (NSCLC) undergoing neoadjuvant immunochemotherapy.

A retrospective, multicenter study was conducted, enrolling 271 patients with stage IB-III NSCLC who received neoadjuvant immunochemotherapy. High-resolution CT images were enhanced using a generative adversarial network-based super-resolution technique. Radiomics features were extracted from multi-sequence CT scans at multiple time points, while pathomics features were derived from whole-slide imaging of surgical specimens. A transformer-based attention mechanism was used to integrate radiomics, pathomics, and temporal imaging data. The model was trained and validated on data from one center and tested on external cohorts. Performance was evaluated using area under the curve (AUC), net reclassification improvement, integrated discrimination improvement, and decision curve analysis.

The Trans-Model demonstrated superior predictive performance, achieving an AUC of 0.858 (95% CI 0.783 to 0.933) in the external test cohort. It outperformed Rad-Model (AUC: 0.839) and Patho-Model (AUC: 0.753). The Trans-Model effectively stratified patients by survival outcomes, with major pathological response (MPR)-positive patients exhibiting significantly improved 3-year overall survival (87.3% vs 76.1%, p=0.034) and 5-year progression-free survival (45.8% vs 34.7%, p=0.033) compared with MPR-negative patients. Decision curve analysis confirmed the model's clinical utility across a wide range of threshold probabilities.

The multiomics model, integrating multi-temporal, multi-sequence data with attention-based feature fusion, improves MPR prediction in patients with NSCLC receiving neoadjuvant immunochemotherapy, enabling personalized treatment by identifying responders and optimizing outcomes.

Immune checkpoint blockade (ICB) therapy has demonstrated significant clinical potential in a variety of cancers; however, its efficacy in clear cell renal cell carcinoma (ccRCC) remains suboptimal. In ccRCC, an increased infiltration of CD8⁺ T cells does not necessarily correlate with improved prognosis, indicating the presence of unique immune evasion mechanisms within the tumor microenvironment (TME).

Tripartite motif-containing 28 (TRIM28) was identified as a potential therapeutic target through single-cell transcriptomics (GSE159115) and Geneformer-based perturbation screening. Functional validation was performed by constructing shTRIM28 and overexpression cell models to assess tumor proliferation, CD8⁺ T cell co-cultures, flow cytometry, and patient-derived xenograft models. Co-immunoprecipitation and GST pull-down assays were used to analyze the TRIM28-poly (ADP-ribose) polymerase 1 (PARP1) interaction. SUMOylation/ubiquitination studies elucidated the mechanism regulating PARP1 stability, and chromatin immunoprecipitation-quantitative PCR identified the transcriptional regulation of programmed death-ligand 1 (PD-L1). High-throughput screening was conducted with RNA-seq, liquid chromatography-tandem mass spectrometry, and metabolomics. Virtual screening identified the TRIM28 inhibitor Eltrombopag, which was tested in combination with anti-programmed cell death protein-1 (PD-1) therapy for in vivo efficacy and metabolic reprogramming.

We identified TRIM28 as a central regulator of immune evasion in ccRCC. Using high-throughput gene knockout screening, we demonstrated that TRIM28 depletion reprograms malignant epithelial cells toward a less aggressive phenotype and significantly enhances tumor cell susceptibility to cytotoxic T lymphocyte killing. Mechanistically, TRIM28 promotes immune resistance through dual immunometabolic mechanisms: first, by stabilizing PARP1 and promoting its SUMOylation, which in turn amplifies PD-L1 expression via NAD⁺-SIRT1-p65 signaling; second, by depleting NAD⁺ in the TME, limiting NAD⁺ availability for CD8⁺ T cells and impairing their respiration and effector function. These findings provide a novel mechanistic framework for TRIM28-driven immune suppression, integrating tumor-intrinsic metabolic reprogramming with CD8⁺ T cell dysfunction. Notably, we identified Eltrombopag as a candidate TRIM28 inhibitor, which synergized with anti-PD-1 therapy to enhance antitumor immunity and overcome ICB resistance in murine models.

This study reveals that TRIM28 is a key regulator of PD-L1 expression and T cell dysfunction in ccRCC through PARP1 stabilization and NAD⁺ metabolic reprogramming. Targeting TRIM28/PARP1/PDL1 with Eltrombopag reshapes the immunosuppressive TME and enhances checkpoint blockade efficacy, providing a novel combinatorial strategy for ccRCC immunotherapy.

Metastasis is the primary cause of poor prognosis and high mortality in lung cancer. Surgery with postoperative adjuvant chemotherapy is the standard treatment for patients with stage IIA-IIIA lung cancer with negative driver genes. However, recurrence rates remain significant. In China, traditional Chinese medicine shows potential as an adjuvant therapy to reduce treatment toxicity and improve clinical efficacy.

This study aimed to evaluate its efficacy and safety in preventing postoperative metastasis in driver gene-negative stage IIA-IIIA lung cancer, based on the promising preclinical results of Fuzheng Quxie Formula against lung cancer metastasis. In this trial, we hypothesize that the treatment group will have better efficacy and safety than the control group.

A multicenter, double-blind, randomized, placebo-controlled parallel group trial will be conducted. Eligible patients will be randomized into a treatment group (daily Fuzheng Quxie Formula granules+regular chemotherapy) and a control group (daily Chinese medicine placebo granules+regular chemotherapy) in a ratio of 1:1. Fuzheng Quxie Formula will be administered orally, twice a day, in the morning and evening, for 6 months. Patients will be followed up after the end of treatment for 18 months. After the end of the program, follow-up will be continued for 5 years or until the patient dies (or progressed). The primary efficacy endpoint is disease-free survival, and the secondary efficacy endpoints are overall survival, minimal residual disease, circulating tumor cells, Chinese medicine symptom score, quality-of-life assessment, immune indicators, tumor markers, peripheral blood systemic immune-inflammation index, and prognostic nutritional index. We will conduct per-protocol analyses on these outcomes. In addition, we will also evaluate the safety of the Fuzheng Quxie Formula.

This study began screening and recruitment in March 2023. Recruitment is ongoing; by the end of 2024, a total of 180 eligible participants will be enrolled. Recruitment will continue until the end of June 2025 or until the target sample is reached. We estimate that the results will be published by March 2026.

This study is a high-quality, large-scale, multicenter, double-blind, randomized controlled trial. This will be the first trial to evaluate the efficacy and safety of Fuzheng Quxie Formula in inhibiting metastasis after surgery in stage IIA-IIIA lung cancer with negative driver genes. Provide a basis for the clinical application of Fuzheng Quxie Formula.

ClinicalTrials.gov NCT06381960; https://clinicaltrials.gov/study/NCT06381960.

DERR1-10.2196/66342.

Breast cancer diagnosis using implantable biomedical antennas offers a promising alternative to conventional imaging techniques due to their potential for continuous monitoring and minimal invasiveness. This paper presents a miniaturized antenna with dimensions of 3 ȕ 3 ȕ 1.27 mm3, specifically designed for implantation in breast tissue to detect the presence of tumors. The objective is to evaluate the antenna's ability to detect breast tumors by first analyzing its reflection behavior (S11) in implanted conditions, both with and without tumors. Subsequently, a second external antenna is introduced in free space to assess transmission performance at varying distances. To further assess transmission performance, a second external antenna is introduced, and the system is tested at varying distances and orientations (face-to-face and side-by-side). The antenna operates at 2.45 GHz and is tested in both skin and breast tissue phantoms with embedded tumors of different sizes and positions. Key performance metrics such as S-parameters, gain, transmission coefficient, and group delay are analyzed. Simulation results show gain values of -31.28 dB in skin and -17.78 dB in breast tissue. Patient safety is confirmed through specific absorption rate (SAR) analysis, with a maximum input power of 2.3 mW. The proposed design shows strong potential for breast cancer detection due to its small size, consistent performance in various antenna positions, and compliance with SAR safety standards.

Over the past 5 years, large language models (LLMs) have emerged and continued to improve in their generative abilities and are now capable of generating human-understandable text and performing complex data analyses. As these models continue to improve in their capabilities, they are increasingly used to support population oncology, including clinical information extraction, cancer care education, and clinical decision support. This narrative review provides a high-level description of the use of LLMs in cancer with an overview of the current literature, along with research gaps. Despite increasing interest in using LLMs for cancer care, prevention, and research, applied methods in cancer still lag advancements published in the computer science literature. Therefore, we recommend that cancer-focused LLM research and applications better incorporate technical advancements and techniques found in the computer science literature. Additionally, standardized evaluation metrics and approaches need to be better studied and adopted in oncology, along with data governance and computational infrastructure to support state-of-the-art model integration and the use of real-world data. Finally, we describe the need for researchers to incorporate principles and frameworks from implementation and dissemination science to promote LLM-based tool adaptation, effectiveness, fit, and sustainability.

Breast cancer is the most common malignancy among women, and patients require rapid transition to adjuvant therapy post-surgery. Opioid-based anesthesia (OBA) is widely used but carries risks such as postoperative nausea and vomiting (PONV), immunosuppression, and hyperalgesia, which may delay recovery. Opioid-sparing anesthesia (OSA) and opioid-free anesthesia (OFA) may reduce these risks, but their effects on postoperative quality of recovery (QoR) are unclear. This study compares the effects of these three anesthetic strategies on early postoperative QoR in breast cancer surgery using a Bayesian network meta-analysis.

Following PRISMA guidelines (PROSPERO ID: CRD420251065588), a systematic search was conducted in PubMed, Cochrane Library, EMBASE, and Web of Science from inception to June 1, 2025. Included were randomized controlled trials (RCTs) comparing OSA, OFA, and OBA in adult breast cancer surgery that reported QoR scores. Risk of bias and evidence quality were assessed using the Cochrane tool and GRADE system. Bayesian random-effects analysis was performed with the R package gemtc. Continuous data were reported as mean differences, and categorical data as odds ratios.

Seventeen RCTs with 1,254 patients were included. Bayesian network meta-analysis showed that OSA significantly outperformed OBA in 24-hour postoperative QoR (d = 0.050, 95% CrI: 0.038-0.062; SUCRA = 85.3%), and OFA was also superior to OBA (d = 0.044, 95% CrI: 0.020-0.068; SUCRA = 64.7%). No significant difference was found between OSA and OFA (d = -0.006, 95% CrI: -0.029-0.018). Secondary outcomes SUCRA showed that OFA was most effective in controlling postoperative nausea and vomiting (99.4%) and pain management (81.4%), while OSA excelled in emotional well-being (96.2%) and physical comfort (76.6%). For physical independence, OFA (85.1%) outperformed OSA (63.5%), with no differences in psychological support. Intraoperative opioid reduction showed an inverted U-shaped relationship with QoR improvement (p = 0.0004).

OSA is the optimal strategy for enhancing overall quality of recovery within 24 hours after breast cancer surgery. Although OFA excels in PONV reduction and pain control, OSA offers more balanced benefits across multiple QoR dimensions. An individualized anesthetic approach is recommended, aiming for opioid minimization rather than complete elimination.

Breast cancer is the leading cause of cancer-related mortality among women worldwide, and it has poor prognosis if diagnosed at late stages. Common breast cancer detection methods include mammography, clinical breast exams (CBE), and breast self-examination (BSE). Breast self-examination is the most cost-effective strategy for early detection in low- and middle-income countries.

To evaluate the knowledge and practice of breast self-examination, along with associated factors, among women with breast cancer visiting Ali Abad Teaching Hospital in Kabul, Afghanistan in 2025.

This cross-sectional study was conducted among 290 Afghan women aged 20-80 who were either currently or previously admitted to the Oncology department of Ali Abad Teaching Hospital for regular follow-ups or treatment. Data was collected using an interviewer-administered questionnaire between January and February 2025. Chi-square tests were conducted to examine the associations between BSE knowledge, BSE practice, and potential explanatory factors. Those that showed significant associations in the bivariate analyses were considered potential confounders and included in multivariable logistics regression analysis.

The mean age of participants was 42.9 ± 14.7. Majority of the participants were illiterate (83.8%) and unemployed (95.9%). Women with education of secondary level or higher were more likely to practice BSE than those who were illiterate (AOR: 3.65, 95% CI: 1.06-12.76). Participants with good knowledge level were more likely to practice BSE than those who had a poor knowledge of BSE (AOR: 5.28, 95% CI: 2.45-12.48). In addition, women who had heard of BSE were more likely to practice it compared to those who had not (AOR: 4.31, 95% CI: 1.37-19.25).

In this study, education, knowledge score, and awareness of BSE (i.e., having heard of BSE) were selected as important predictors for practice of BSE via both bivariate and multivariate logistic regression analysis. While about 50% of participants demonstrated good knowledge of BSE, only 18% were practicing it, and among those who did, only about 30% were performing it at the right time and frequency. These findings highlight the importance of educational programs with an aim to increase breast cancer awareness among women in Afghanistan, and to promote breast self-examination as a low-cost, accessible tool for early detection - helping to alleviate cancer burden in the country.

This study aims to assess the performance of the Xpert HPV test for the detection and genotyping of high-risk HPVs (HR-HPV) on FFPE cervical cancer (CC) tissues and to determine the distribution of HR-HPV genotypes in a CC Tunisian series.

The Xpert HPV test was conducted on purified DNA from 134 FFPE CC tissues. A single-tube multiplex polymerase chain reaction (PCR) served as a comparator assay to evaluate Xpert HPV performance in detecting and genotyping HR-HPVs. Discordant cases were tested using uniplex PCR.

The Xpert HPV test generated valid results in 131/134 (97.8%) samples. Sensitivity, specificity, positive and negative predictive values of Xpert HPV for HR-HPV detection among valid samples were 99.16%, 100%, 100%, and 92.31%, respectively. Agreement between Xpert HPV and multiplex PCR for HPV detection was observed in 131/134 cases (97.8%), with a kappa value of 0.892. Agreement between Xpert HPV and Multiplex PCR for HR-HPV genotyping was 96.6%. Combining assays results and after confirmation with uniplex PCR, HR-HPVs were detected in 119/134 (88.8%) samples and 11 HR-HPV genotypes were detected with a predominance of HPV 16 (71%), followed by HPV 31 (8%) and HPV 18 (5%).

This study demonstrated a high accuracy of the Xpert-HPV test for HR-HPVs detection and genotyping in FFPE CC tissues and revealed a distinct distribution of HR-HPVs in Tunisia.

Pediatric hematopoietic stem cell transplantation (HSCT) is a complex process that impacts the entire family. The traumatic nature of the pediatric HSCT period makes this a particularly vulnerable time for parents, leading to coping challenges. This study aimed to explore parents' experiences regarding the obstacles and facilitators of coping with their child's HSCT.

This qualitative study used a conventional content analysis method. The study took place at largest Children's Medical Center in Iran from February to November 2023. The study utilized purposive sampling for selecting participants. Data collection began with unstructured interviews, followed by in-depth semi-structured interviews with open-ended questions. Sampling continued until data saturation was achieved after examining qualitative data from 20 participants.

The qualitative analysis identified eight subcategories grouped into two main categories: "variable support" and "beliefs and individual situation". Support varied widely, with significant roles played by family, friends, healthcare providers, non-governmental organizations, and desirable beliefs and individual situation. However, inadequate family support, financial stress, and conflicts with healthcare teams were notable barriers.

The findings underscore the need for comprehensive support systems and targeted interventions to address the emotional and practical challenges families face during their child's HSCT vulnerable period. Future efforts should focus on enhancing support structures and addressing barriers to improve the overall coping experience for parents.