Early clinical development of anticancer drugs traditionally focused on exploring candidate treatments in patients. For instance, due to their cytotoxic action, administration of chemotherapies to healthy volunteers (HVs) for evaluation of their pharmacokinetic profiles was not considered feasible nor ethical from a safety and tolerability perspective. With the introduction of more targeted anticancer agents, such as the tyrosine kinase inhibitors (TKIs), enrolment of HVs in clinical pharmacology trials has become an advantageous alternative to early, non-therapeutic testing in cancer patients. Futibatinib (Lytgobi) is a TKI acting upon the fibroblast growth factor receptor (FGFR) 1-4 and is approved for the treatment of patients with locally advanced or metastatic intrahepatic cholangiocarcinoma harboring FGFR2 gene fusions or other rearrangement. During its clinical development, a series of studies were conducted enrolling HVs, for example, to evaluate pharmacokinetic properties (ADME), drug-drug interaction (DDI) potential and QT liability. In this review article, we will discuss when and why enrolment of HVs can be considered for small molecule anticancer drug trials and touch upon the risks and limitations as well as the advantages of administering this type of drugs to HVs. The case of futibatinib provides an illustrative example of the opportunities and challenges for exploring an anticancer small molecule in HVs.

In biopharmaceutical studies, it is often of interest to compare the effects of two treatments (say, A and B), but data that contain a direct comparison are not available. However, there may be studies that compare them against another competitor (say, C). In this case, an indirect comparison of A versus B through C needs to be conducted. In this article, we consider the scenario where individual participant data (IPD) is available for the comparison of A versus C, but only aggregate-level data (AgD), for example, from a publication, is available for the comparison of B versus C. For such analysis, multilevel network meta-regression (ML-NMR) is advantageous since it can combine evidence from multiple trials with either IPD or AgD and can compare the treatments of interest in any target population. Most of the existing ML-NMR studies have focused on binary and continuous outcomes, while, relatively, research on censored survival outcomes remains limited with perhaps only one study modeling the marginal likelihood for AgD. Here, we aim to extend ML-NMR for time-to-event outcomes. We consider multiple popular parametric survival models and develop Bayesian estimation approaches built on mean and median survival. Extensive simulations show satisfactory performance. We further consider a case study on early-stage non-small cell lung cancer (NSCLC) overall survival. Emulation analyses of the Surveillance, Epidemiology, and End Results (SEER)-Medicare data are conducted. It is found that limited resection (LR) with adjuvant chemotherapy (ACT) prolongs survival compared to LR or lobectomy without ACT.

Human papillomavirus (HPV) vaccination is a key preventive measure against cervical cancer. In Japan, proactive recommendations for HPV vaccination were suspended from 2013 to 2022, resulting in persistently low coverage. We explored the post-intervention knowledge, attitudes, and short -term self-reported HPV vaccination behavior following a near-peer educational intervention by medical students. Between February 2022 and March 2024, medical students conducted 1-hour sessions covering HPV transmission, cervical cancer prevention, and vaccine efficacy. The sessions incorporated quizzes, discussions, and workshops in which high school students created role-play scenarios or social media messages to promote HPV vaccination. A follow-up survey was administered 1-2 weeks after the sessions to assess vaccination uptake, knowledge, and self-reported explanatory ability. Of 864 junior and senior high school students who participated in the sessions, 332 were included in the followed-up analysis. Of these, 248 were unvaccinated before the session: 134 females and 114 males. Within two weeks, 10 female (7.5%) and one male (0.9%) reported receiving HPV vaccination. Students with positive vaccination intentions demonstrated higher comprehension scores than those without such intentions. Voluntary participants had higher knowledge scores than whole-class attendees. Subjective and objective comprehension scores were positively correlated, although there were some discrepancies. Vaccinated respondents were more likely than unvaccinated respondents to correctly identify HPV-preventable cancers. Near-peer outreach sessions delivered by medical students may represent a useful approach to enhancing adolescents' understanding of HPV vaccination. Leveraging the near-peer position of medical students may be a promising approach to address vaccine hesitancy in Japan.

Cancer remains a leading cause of mortality worldwide, with prevention and early detection dependent on the public awareness of its risk factors and warning signs. However, knowledge of cancer-related symptoms and modifiable risk factors remains limited in many populations, particularly in low- and middle-income countries. Limited research exists examining general cancer awareness in Egypt's general population.

To assess public knowledge of cancer's early warning signs, risk factors, and prevention strategies in Mansoura, Egypt.

A descriptive cross-sectional study was conducted at five primary healthcare facilities in Mansoura from June to August 2025. We used a validated Arabic questionnaire to assess general cancer knowledge, awareness of cancer warning signs, and knowledge of its risk factors. Descriptive statistics and non-parametric tests (Mann-Whitney U and Kruskal-Wallis) were used to analyze the data. Statistical significance was set at p < 0.05.

Three hundred ninety nine adult participants completed the questionnaire (60.7% female); most were aged 18-35 and demonstrated high general cancer knowledge, with 90.2% aware that regular check-ups aid early detection. However, awareness of specific warning signs was limited-only 33.3% recognized non-healing sores and 35.1% identified persistent cough as a warning sign. Knowledge of cancer risk factors was also inconsistent; while 89.5% identified smoking as a risk factor, only 13.5% recognized genetically modified foods as a risk factor. The median overall knowledge score was 28 out of 52. Educational attainment and association with the medical field were significant predictors of cancer knowledge across all domains (p < 0.001), while sex and residency showed no significant associations. The internet and social media were the primary sources of information (53.9%).

While general cancer awareness was moderately high, knowledge of specific warning signs and modifiable risk factors remains limited. Targeted educational interventions, particularly among non-medical populations and those with lower educational attainment, are essential to improving cancer prevention and early detection.

General practitioners (GPs) play an important role in the care of patients with cancer across the entire cancer continuum, from diagnosis to palliative care. Despite their broad range of responsibilities, structures to facilitate the systematic involvement of GPs into cancer care remain insufficient in Germany. To date, the specific role and contribution of GPs within the German cancer care system have not been comprehensively synthesized.

This scoping review aimed to summarize the available evidence on GP involvement in cancer care in Germany, including their roles across the cancer trajectory, collaboration with other healthcare providers, and barriers and needs affecting their participation in cancer care.

A scoping review was conducted according to Arksey & O'Malley. The search was conducted on 2 January 2024 in the databases Cochrane Library, MEDLINE, and Web of Science. Eligible studies examined the role of GPs in the care of patients with cancer or long-term cancer survivors in Germany. Extracted review's domains (GPs' roles and responsibilities, collaboration, needs) were derived from an exploratory literature search and a GP advisory board. Findings were synthesized narratively. Studies published before 2008 were excluded.

The search yielded 646 hits, of which 71 could be included in the full-text screening and 24 in the data extraction. GPs are involved in all phases of cancer care, including diagnosis, active treatment, follow-up care, and palliative care. GPs as "persons of trust" and experts in counselling, provide patient-centered cancer care and emotional support. GPs collaborate with other healthcare providers, but are rarely involved in specific treatment decisions. Deficiencies in communication, information exchange, and role clarification were identified. GPs expressed a need for greater involvement and better information through informal, bidirectional communication with various stakeholders in the oncology healthcare sector. Evidence on GP involvement in survivorship care and the management of comorbidities in patients with cancer was limited.

Efficient structures for information exchange and knowledge transfer between GPs and other healthcare providers may support continuous and comprehensive care for patients with cancer. Future guidelines should explicitly address the role of GPs and provide clear recommendations for their integration into cancer care pathways. SCOPING REVIEW REGISTRATION: https://doi.org/10.17605/OSF.IO/T8XEN .

Immune checkpoint inhibitors (ICIs) have limited efficacy in proficient mismatch repair/microsatellite stable (pMMR/MSS) metastatic colorectal cancer (mCRC). However, selected patients with specific metastatic patterns may derive benefit.

Patients with chemorefractory pMMR/MSS mCRC treated with ICI-based regimens were retrospectively identified. A comparison cohort treated with trifluridine/tipiracil±bevacizumab, regorafenib, or fruquintinib as standard of care (SOC) was generated through 1:1 propensity score matching by age, sex, Eastern Cooperative Oncology Group performance status (ECOG PS), liver metastases (present/absent), and RAS/BRAF status. Overall survival (OS) was compared using Cox regression.

A total of 354 patients treated with ICIs and 354 treated with SOC were matched. Median age was 55 years, 52% male, 32% ECOG PS 0, 30% right-sided, and 69% RAS mutated in both groups, while 61% and 60% had liver metastases, respectively. Median OS (mOS) was 10.8 months with ICIs and 9.0 months with SOC (HR 0.76, 95% CI 0.64 to 0.92, p=0.004). In patients without liver metastases, mOS was longer with ICIs than SOC (19.1 vs 13.2 months, HR 0.59, 95% CI 0.43 to 0.80, p<0.001), whereas outcomes were similar in patients with liver metastases (6.4 vs 6.5 months, p=0.303). In univariable analyses, age, sex, primary tumor site, and RAS/BRAF status were not associated with OS. Treatment with ICIs, absence of liver metastases, one prior line of therapy, less than three metastatic sites, and ECOG PS 0 were associated with the most favorable outcomes in univariable and multivariable models.

In chemorefractory pMMR/MSS mCRC without liver metastases, ICI-based regimens yielded longer OS than SOC. Further investigation of ICIs in this patient population is warranted.

Implant-based breast reconstruction after mastectomy causes acute pain.

To determine whether a single-shot T5 erector spinae plane block (ESPB) reduces postoperative pain.

Single-center, RCT with allocation concealment; blinded assessors and statisticians.

Tertiary cancer center in China.

100 adults scheduled for radical mastectomy with implant reconstruction were randomized (1:1); follow-up complete.

Before induction, ESPB was given under ultrasound guidance at T5 with 30 mL of 0.375% ropivacaine plus dexmedetomidine 1 μg/kg; controls received no block. Standardized general anesthesia and postoperative PCA for both groups.

Resting NRS at 6 h (MCID=1). Secondary outcomes were opioid consumption, quality of recovery, and PONV.

ESPB did not significantly reduce resting pain at 6 h at the median (τ =0.50; adjusted difference -0.9; p = 0.08). At the upper tail, pain intensity was lower (τ = 0.75; -1.8; p <0.01). Repeated measures provided additional time-point information, improving estimation precision and test sensitivity. ESPB get lower pain scores at 6, 12, and 24 hours (all p <0.01). But, the 95% CI includes the MCID, the clinical benefit remains uncertain. Opioid use decreased at 24 h (-13.5 mg; p <0.01) and 48 h (-6.6 mg; p <0.01). Quality of recovery improved at 24 h (difference 5 points; p <0.01), but not later. No differences were observed in intraoperative hemodynamics or PONV.

Single-shot T5 ESPB with perineural dexmedetomidine may reduce postoperative pain and opioid requirements and improve early recovery. Further large trials are warranted. Clinical relevance remains to be confirmed.

ClinicalTrials.gov NCT06143020.

Understanding when key mutations occur in cancer is critical for prevention and detection, especially for early-onset cancers that have risen in recent years. Yet, intermediate mutational steps remain difficult to observe. Here, we extend a tumor kinetic model and combine it with long-term cancer registry data to estimate mutational timelines. Using differential equation systems to represent sequential carcinogenic stages and a convolution-based method, we derive and estimate the expected ages of mutational transitions for breast, colorectal, and thyroid cancers. Model results suggest early-life initiations across all cancers. Malignant transitions occur ∼10 years earlier in early- vs late-onset breast and colorectal cancers (late 30s versus late 40s to 50s), while thyroid cancer shows similarly early transitions (late 20s) regardless of onset age. Across cohorts (1950-1954, 1965-1969, and 1980-1984), more recent cohorts show accelerated progression and earlier malignancy. These findings can inform early-onset cancer etiologic studies and intervention strategies.

BackgroundShort-video platforms increasingly influence patients' access to glioma treatment information; however, the quality and reliability of such content remain unclear.MethodsThis cross-sectional study analyzed 200 high-visibility Chinese-language videos on TikTok and Bilibili (TikTok, n = 103; Bilibili, n = 97). Videos were evaluated for engagement metrics, uploader characteristics, and content coverage. Information quality and reliability were assessed using the Global Quality Score, modified DISCERN, Journal of the American Medical Association benchmark criteria, and the Patient Education Materials Assessment Tool.ResultsTikTok videos were shorter and received greater user engagement than Bilibili videos, while also achieving higher Global Quality Score and modified DISCERN scores. Professional uploaders provided more reliable and evidence-based content, whereas non-professional videos were longer and attracted significantly more comments (p < 0.001); differences in likes, collections, and shares were not statistically significant. Only 30.0% of videos addressed grade- or molecular-specific treatment pathways, and prognostic factors were discussed in only 15.5% of videos; recurrence management and long-term care were seldom covered. Engagement metrics were weakly correlated with quality scores, indicating a mismatch between popularity and information quality.ConclusionsChinese-language short videos on glioma treatment provide accessible but uneven patient education. Verified medical authorship, guideline-based content labeling, and quality-weighted recommendation strategies may improve the visibility of trustworthy information.

BackgroundThe heterogeneity of hepatocellular carcinoma (HCC) complicates diagnosis and treatment, and previous prognostic models have failed to yield satisfactory results. Given that the metabolic reprogramming of cholesterol plays a crucial role in the pathogenic mechanism of hepatocellular carcinoma, this study was conducted as a breakthrough point.MethodsUtilizing multi-cohort data from TCGA, ICGC, and GEO, we screened Cholesterol metabolism-related genes (CMRGs) to construct a CMRG-derived prognostic model based on two key genes: KIF20A and NDC80. Predictive performance was evaluated via Kaplan-Meier and ROC analyses. Additionally, the tumor immune microenvironment (TME) was characterized using CIBERSORT and ESTIMATE algorithms.ResultsThe two-gene signature stratified patients into high- and low-risk groups, with high-risk patients showing poorer survival (HR = 2.71, P < 0.001). Elevated risk scores correlated with an immunosuppressive TME enriched in monocytes/macrophages. Exploratory anti-PD-1 analysis suggested higher risk scores were associated with non-response, warranting further validation.ConclusionThe integrated nomogram achieved AUC values of 0.747 (95% CI: 0.665-0.830), 0.728 (95% CI: 0.652-0.804), and 0.778 (95% CI: 0.706-0.851) for 1-, 2-, and 3-year predictions. This KIF20A/NDC80-based model is a reliable prognostic tool for HCC; its immunotherapeutic utility remains exploratory and requires prospective validation.