Pathogenic bacteria adapt to distinct disease environments, but whether these adaptations create therapeutic vulnerabilities remains unclear. Fusobacterium nucleatum has emerged as a key microbial player in colorectal cancer (CRC), yet its strain-specific virulence mechanisms remain poorly defined. In this pilot study of 16 clinical F. nucleatum isolates from CRC patients (n=6), Crohn's disease patients (n=6), colon of healthy individuals (n=3) and an oral lesion (n=1), a subset of CRC-derived strains produced three- to fourfold higher levels of endogenous indole. Exogenous indole treatment differentially affected growth and biofilm formation, with some strains increasing biofilm despite growth inhibition. Notably, sensitivity to exogenous indole was independent of endogenous production and revealed that isolate 7-1 (EAVG002), a member of the tumourigenic Fna C2 clade, was uniquely hypersensitive to I3CA- and IPA-mediated stress. Invasion assays further showed that indole and its derivatives (I3A, I3CA) reduced the invasion of a highly indole-tolerant CRC-derived isolate (SB-CTX3Tcol3) into CRC cells by ~50%, comparable to antibiotic treatment. Furthermore, in two CRC cell lines, exposure to indole or indole derivatives resulted in substantial variability in adherens junction and tight junction transcript levels, with I3A having the strongest effect on tight junction (CLDN1, CLDN7) transcripts. Collectively, these findings reveal profound strain-level heterogeneity and indole derivative effects, highlighting vulnerabilities that could enable precision therapeutic targeting of pathogenic F. nucleatum populations within the host environment while preserving beneficial commensals.

Understanding trends among screening program cancers (breast, cervical, and colon) equips researchers, policymakers, and First Nations communities with evidence to inform cancer system improvements.

To examine cancer incidence, mortality, and survival trends for screening program cancers among First Nations people in Ontario, Canada, compared with other Ontario residents.

This retrospective cohort study examined incidence (1994-2018), mortality (1994-2017), and survival (2007-2019) of breast, cervical, and colon cancers among First Nations people identified from the Indian Registry System linked to the Registered Persons Database and other Ontario residents identified from the Registered Persons Database. The data were analyzed between July 2020 and March 2022.

Baseline characteristics between the First Nations and other Ontario cohorts were compared. Negative binomial regression adjusting for age and sex was used to model annual incidence and mortality. Crude rates were plotted using 3-year moving averages. Cox proportional hazards regression, adjusting for age, sex, comorbidity, and cancer stage, was used to model survival. Interactions were tested for all models.

The largest annual cohort included 146 498 First Nations people (median [IQR] age, 41 [28-55] years; 50.7% male) and 11 840 783 other Ontario residents (median [IQR] age, 48 [33-62] years; 51.1% female). Compared with other Ontario females, First Nations females had lower breast cancer incidence (rate ratio [RR], 0.77 [95% CI, 0.73-0.82]) and mortality (RR, 0.79 [95% CI, 0.70-0.90]). Cervical cancer incidence and mortality were higher in First Nations females (RR, 1.47 [95% CI, 1.23-1.70] and 2.26 [95% CI, 1.78-2.88], respectively); however, over time, both rates declined more rapidly among First Nations females. Colon cancer incidence was higher for First Nations people; those aged 40 to 49 years had a similar elevated risk to those aged 50 to 74 years (incidence RR, 1.27 [95% CI, 1.06-1.51] and 1.29 [95% CI, 1.20-1.40], respectively). First Nations people had higher colon cancer mortality (RR, 1.18 [95% CI, 1.07-1.31]). Once diagnosed, First Nations people were more likely to die compared with other Ontario residents (breast cancer: hazard ratio, 1.51 [95% CI, 1.28-1.76]; cervical cancer: hazard ratio, 1.60 [95% CI, 1.12-2.27]; colon cancer: hazard ratio, 1.19 [95% CI, 1.07-1.32]).

This cohort study of First Nations people in Ontario and other Ontario residents suggests that clear disparities persist despite progress over time. Cancer prevention, screening programs, and care systems for Indigenous peoples in Ontario need optimization.

Prostate cancer (PCa) is the most common nonskin cancer among men. Although treatments achieve excellent survival for localized PCa, long-lasting complications significantly diminish patients' quality of life (QOL) across physical, sexual, psychosocial, and general symptom domains. Because these effects also profoundly impact intimate partners, often reducing partners' QOL as much as or more than patients' QOL, supportive care must address the needs of both members of the couple.

This study evaluated the efficacy of the Prostate Cancer Education and Resources for Couples (PERC) eHealth intervention in improving outcomes for patients and their partners.

We enrolled 280 dyads (560 individuals) consisting of patients with localized PCa who recently completed treatment and their partners through the North Carolina Cancer Registry. Dyads were randomized to PERC or a control group that received access to the National Cancer Institute prostate cancer website. PERC dyads completed a nurse-led orientation and received monthly follow-ups. The platform has the following three components: (1) 11 interactive modules with postsession assignments on QOL, symptom management, and cancer communication; (2) a moderated online forum providing professional and peer support; and (3) a resource toolbox containing scientific publications related to PCa care. PERC development was guided by an adapted stress-coping theory and informed by evidence and stakeholder input. Validated questionnaires assessed QOL (Functional Assessment of Chronic Illness Therapy-General [FACT-G] total; primary outcomes), FACT-G subdomains, and symptom and psychosocial measures (secondary outcomes) at baseline and at 4, 8, and 12 months. Multilevel linear mixed models tested intervention effects.

The trial was conducted during the COVID-19 pandemic. Among PERC (n=141) and control (n=139) dyads who completed baseline assessments, 221 (78.9%) dyads completed the 12-month follow-up (PERC=106 and control=115). FACT-G total score, subdomains, and overall psychosocial outcomes did not differ significantly between groups over time. Patients assigned to PERC reported better physical QOL (mean difference 0.9, 95% CI -0.1 to 1.9; Cohen d=0.33), less negative illness appraisal (mean difference 0.2, 95% CI 0.0-0.4; Cohen d=0.38), lower pain (mean difference -2.7, 95% CI -5.3 to -0.2; Cohen d=-0.38) at 12 months, and less frequent fatigue across time (mean difference -2.1, -95% CI -3.9 to -0.4; Cohen d=-0.23). PERC partners reported less urinary symptom bother at 8 months (mean difference 6.5, 95% CI -1.0 to 14.1; Cohen d=0.44).

Although no significant between-group difference was observed in the FACT-G total score, PERC demonstrated exploratory benefits, including improved physical QOL, less fatigue, lower pain, and improved illness appraisal among patients, as well as less urinary bother among partners. These findings suggest that the COVID-19 pandemic may have adversely affected participants' overall QOL, potentially obscuring changes in the primary outcome, while highlighting targeted benefits that warrant evaluation in larger studies.

Large symptomatic brain metastases require initial surgical resection. However, local control (LC) after Gamma Knife radiosurgery (GKRS) to resection cavities remains variable. Quantitative risk stratification using routinely available treatment-time variables could inform surveillance and multidisciplinary decision-making.

We performed a retrospective study of post-resection cavities treated with GKRS at a single institution (2014-2024). The primary endpoint was LC. The cohort comprised of 401 post-resection cavities. A gradient boosting classifier was trained using eight routine treatment-time features: age, sex, pre-treatment Karnofsky Performance Status, primary tumor category, single vs. multiple metastases, lobe/structure, eloquence, and cavity volume. Performance was estimated using five-fold stratified cross-validation with out-of-fold predictions and compared with a prevalence-only baseline. Discrimination and calibration were assessed using the receiver operating characteristic area under the curve (ROC-AUC), and Brier score; operating characteristics were reported at a prespecified probability threshold of 0.50.

We compared the performance of two different AI models for predicting LC. The prevalence baseline demonstrated chance-level discrimination (ROC-AUC 0.494). The gradient boosting model improved performance with ROC-AUC 0.735 and PR-AUC 0.802 with acceptable calibration (Brier 0.208). At threshold 0.50, accuracy was 0.701 with sensitivity 0.783 and specificity 0.566. A feedforward neural network trained on the same features performed worse (ROC-AUC 0.672; PR-AUC 0.768; Brier 0.219).

A machine learning model using routine treatment-time variables can meaningfully stratify LC after GKRS to post-resection cavities. The gradient boosting model showed the best performance supporting further external validation and prospective evaluation.

Not applicable.

To assess the incidence and determinants of early first-line systemic anticancer therapeutic attrition after metastatic recurrence in triple-negative breast cancer (TNBC) treated with neoadjuvant chemo-immunotherapy.

We conducted a retrospective multicenter analysis of 209 consecutive patients with early-stage TNBC treated with neoadjuvant chemo-immunotherapy. After a median follow-up of 24 months, 54 developed metastatic recurrence. Early first-line systemic anticancer therapeutic attrition was defined as failure to initiate systemic anticancer therapy within 90 days of documented recurrence. Associations were evaluated using univariate and multivariable logistic regression.

Among patients who developed metastatic recurrence, 17 of 54 evaluable patients (32.7%) experienced early first-line systemic anticancer therapeutic attrition. Patients who did not initiate treatment had a significantly shorter disease-free interval compared with those who received first-line therapy (median 7.4 vs. 14.3 months; p = 0.011). PD-L1 positivity was more frequent in the attrition group (64.7% vs. 28.6%; p = 0.021), and central nervous system metastases were more commonly observed (41.2% vs. 20.0%). Median overall survival from metastatic recurrence was 3.4 months in the attrition group compared with 12.4 months in the no-attrition group. In multivariable analysis, shorter disease-free interval (OR 0.87 per month; 95% CI 0.78-0.97), PD-L1 positivity (OR 8.73; 95% CI 1.81-42.04), and presence of central nervous system metastases (OR 7.09; 95% CI 1.41-35.57) were independently associated with early first-line therapeutic attrition.

In this real-world multicenter cohort, nearly one-third of patients with TNBC experiencing metastatic recurrence after neoadjuvant chemo-immunotherapy did not initiate first-line systemic therapy within a clinically relevant timeframe. Early first-line systemic anticancer therapeutic attrition represents a meaningful gap in the care continuum and warrants improved surveillance and multidisciplinary management strategies.

Not applicable.

Low anterior resection syndrome (LARS) is a prevalent and often persistent consequence of sphincter-preserving rectal cancer surgery that substantially disrupts daily functioning and long-term adaptation. Beyond bowel dysfunction, patients frequently experience psychosocial distress and lifestyle limitations that require comprehensive supportive care. This study aimed to explore how patients live with LARS, the challenges they encounter, and the self-management strategies they develop, in order to identify priorities for supportive care across the survivorship trajectory.

A qualitative descriptive design was employed. Sixteen adults diagnosed with minor or major LARS following rectal cancer surgery were purposely recruited from a surgical outpatient clinic. Data were collected through face-to-face, semi-structured interviews and analysed using inductive thematic analysis.

Five interrelated themes emerged: changes in bowel habits, non-defecation-related difficulties, impacts on daily life, coping strategies, and patient recommendations for care. Participants described persistent bowel dysfunction, nutritional intolerance, psychological distress, sexual problems, and social restrictions that shaped everyday life. In response, they developed individualised coping strategies, largely through trial and error, including dietary regulation, behavioural adaptations, emotional coping, and reliance on family support. Participants consistently emphasised the importance of anticipatory information, continuity of follow-up, and accessible professional guidance throughout the survivorship trajectory.

Living with LARS involves a multidimensional adaptation process extending well beyond the immediate postoperative period. Findings highlight key priorities for supportive care, including structured preoperative education, symptom-oriented guidance, and sustained , person-centred follow-up. Integrating these elements into survivorship care pathways may enhance patients' capacity for self-management and long-term quality of life after rectal cancer surgery.

Although prognostic biomarkers in patients with oral squamous cell carcinoma (SCC) have previously been explored, none have yet been established for clinical use for oral SCC. This study evaluated plasma inflammatory cytokines using the proximity extension assay (PEA) in patients with tongue SCC before and after surgery to investigate relationships between disease status and cytokine levels.

Plasma samples from 19 patients who underwent surgery for tongue SCC were collected pre- and postoperatively. Inflammatory cytokine levels were quantified by PEA. Cytokine levels were compared between preoperative patients with early- and advanced-stage cancer, patients with recurrence after surgery and with no recurrence, and as well as between patients of each stage grouped by prognosis.

No difference in preoperative cytokine levels was found between early- and advanced-stage patients. Levels of fms-related receptor tyrosine kinase 3 ligand (FLT3LG) were significantly lower in the postoperative recurrent group as compared with the nonrecurrent group (p = 0.049). Amongst the advanced-stage patients with recurrence or metastasis in postoperative, the reduction in interleukin-6 (IL-6), hepatocyte growth factor (HGF), and tumor necrosis factor (TNF) levels following surgery was less pronounced compared with the patients with no evidence of disease. (IL-6: p = 0.037, HGF: p = 0.020, TNF: p = 0.037).

This pilot study indicates that FLT3LG, IL-6, HGF, and TNF may serve as promising biomarker candidates for evaluating disease status and prognosis in patients with tongue SCC using PEA technology, though validation in larger and adequately powered cohorts is warranted.

The Traditional Mexican Diet (TMexD) is a culturally rooted, plant-forward dietary pattern derived from Mesoamerican agriculture and culinary practice, built on minimally processed staples-maize-based preparations, legumes, vegetables, fruits, and herbs. Characteristic techniques such as nixtamalization and fermentation alter starch structure, mineral availability, and gut microbial activity. Through these effects, the pattern shapes metabolic responses relevant to carcinogenesis. This narrative review clarifies defining features of the TMexD across Mexico's regional diversity and synthesizes epidemiologic evidence from Mexican and Mexican-heritage populations linking closer alignment with the TMexD to favorable lipid and insulin profiles and lower markers of inflammation. Site-specific observations suggest inverse associations for multiple cancers, with the most direct evidence for breast and colorectal cancer, supportive component-level evidence for gastric cancer, and indirect evidence for lung and prostate cancer. Convergent mechanistic pathways include improved insulin/IGF signaling, modulation of oxidative stress and bile-acid metabolism, short-chain fatty acid production that reinforces mucosal integrity, and enhanced immune surveillance; traditional dishes contribute additional phytochemicals with antioxidant and anti-inflammatory activity. We also examine how globalization, migration, acculturation, and urban food environments influence access to heritage staples and day-to-day practice of the pattern, noting that some regional staples remain robust while others are declining. Although definitions of "traditional" vary and measurement of preparation methods is inconsistent across studies, the convergent epidemiologic and mechanistic evidence positions the TMexD as a credible, culturally concordant framework for cancer prevention in contemporary Mexican and diaspora settings.

To identify risk factors for development of leptomeningeal disease (LMD) in patients with resected brain metastases (BM) based on the multicentric SUBARoMA study-cohort.

The SUBARoMA study included patients undergoing surgery as initial treatment for BM. LMD was diagnosed based on MR imaging or lumbar puncture. Risk factors were identified from univariate Kaplan-Meier and multivariate Cox Regression analysis.

We analyzed 2,673 patients. In total, 148 developed LMD (11.1% of recurrences, 5.5% of all patients, 104 at first recurrence). Median time to LMD after surgery was 5.5 months (range: 0.2-129.3). Risk-factors for development of LMD were primary tumor type (PT) breast cancer and melanoma (p = 0.003), interval between BM and PT diagnosis ≥ 3 months, and incomplete resection (p = 0.002), while postoperative systemic therapy (p < 0.001) represented a protective factor. Incomplete resection (p = 0.003; HR 1.810; 95%CI 1.218-2.690) and postoperative systemic therapy (p = 0.028; HR 0.641; 95%CI 0.431-0.952) remained independent risk/ protective factors in multivariate analysis. Postoperative radiation-therapy and anatomical location did not relate to LMD-frequency. Over the study period, diagnosis of LMD, application of local radiation, targeted and immunotherapies increased while whole brain radiation decreased.

Breast cancer, melanoma, incomplete resection and BM occurrence ≥ 3months after PT are risk-factors for LMD-development after BM resection, while postoperative systemic therapy represents a protective factor.

Purpose To identify a panel based on circulating proteins to predict clinical outcomes after local ablation across patients with primary and metastatic liver cancer to improve patient selection. Materials and Methods This exploratory post hoc analysis is derived from ESTIMATE, a prospective controlled trial (DRKS registration no. 00010587) evaluating progression-free survival and overall survival (OS) after local ablation of liver malignancies between 2017 and 2023. Baseline plasma samples from patients with hepatocellular carcinoma, intrahepatic cholangiocarcinoma, or metastatic breast or colorectal cancer treated with interstitial brachytherapy were profiled using an immunoassay panel. Group comparisons used t tests or Mann-Whitney U tests. Survival was assessed using Kaplan-Meier, log-rank, and Cox regression analyses. Multivariable Cox models were adjusted for tumor type, number of lesions, and treatment response. Model discrimination was assessed using time-dependent areas under the receiver operating characteristic curves (AUCs) for OS, with bootstrap resampling used to estimate optimism-corrected performance. Results In total, 103 patients (62 male; mean age, 67.5 years; range, 36-87 years) were included. Elevated chemokine (C-C motif) ligand 20, interleukin-15, and interleukin-8 levels were associated with poor clinical outcomes across various liver tumors and were therefore incorporated into an immune-inflammatory prognostic model (all P < .05). AUC analysis revealed the predictive accuracy of the model for OS at 6, 12, and 18 months (AUCs: 0.70, 0.72, and 0.74, respectively), and bootstrap optimism-corrected performance ranged from 0.61 to 0.68. Conclusion The findings revealed a cross-cancer panel of circulating proteins that reliably and effectively predicts treatment response and prognosis after local ablation of liver malignancies. Keywords: Prognosis & Prediction, Treatment Response Assessment, Ablation Techniques, Interventional Oncology, Molecular Imaging-Clinical Translation, Molecular Imaging-Cancer, Liquid Biopsy, Abdomen/GI, Decision Analysis, Evidence-based Medicine, Outcomes Analysis, Liver Cancer, Interstitial Brachytherapy, Cross-Cancer Biomarkers, Proximity Extension Assay German Clinical Trials Register no. DRKS 00010587 Supplemental material is available for this article. © RSNA, 2026.