Difficult benign intracranial tumors (including meningiomas, schwannomas, neurofibromatosis-related tumors, and pituitary neuroendocrine tumors) have substantial morbidity in patients. Due to their limited treatment options, there is a need for individualized treatment beyond histological and surgical approaches.

To summarize how novel treatment innovations have been implemented for these tumors, meningiomas and schwannomas are prioritized, followed by NF-associated neoplasms, and then pituitary neuroendocrine tumors in comparison to low-grade gliomas.

We summarize the current knowledge relating to targeted therapies for gliomas, meningiomas, schwannomas, neurofibromatosis (NF) tumors, and pituitary neuroendocrine tumors to investigate an individual's treatment options for difficult benign brain tumors. This review synthesizes evidence on tumor genomics and molecular markers, supported by methylation-based classification, immunohistochemistry, and functional assays, emphasizing current clinical applications.

The recent data show that DNA methylation-based models can predict post-surgical outcomes and radiotherapy responses, enabling risk stratification and radiotherapy benefit prediction. Early signals support target-directed treatment, including cMET blockade that radiosensitizes NF2 schwannoma models, brigatinib-associated tumor shrinkage in NF2-deficient models, and PitNET organoid data.

We support clinical decision-making that utilizes molecular profiling with functional testing to guide targeted treatment. We also identify evidence gaps such as biomarker-defined prospective trials that are needed for broader clinical implementation.

HER2-positive/hormone-receptor-positive breast cancer represents approximately 10% of all breast cancer cases and constitutes a distinct biological entity with unique therapeutic challenges. The complex crosstalk between HER2 and estrogen receptor signaling pathways contributes to both primary and acquired resistance to anti-HER2 therapies, and the convergence of these pathways on cell cycle regulation, particularly through the cyclin D1-CDK4/6-Rb axis, has provided a compelling rationale for combining CDK4/6 inhibitors with anti-HER2 therapy. This scoping review aimed to map preclinical and clinical evidence evaluating combinations of CDK4/6 inhibitors with HER2-targeted therapy in HER2+/HR+ disease. Eligible sources included preclinical models and clinical studies assessing CDK4/6 inhibitor-based combinations with anti-HER2 therapy, identified through searches of PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov. Data were charted and synthesized descriptively according to PRISMA-ScR guidelines. Preclinical studies have demonstrated synergistic antitumor activity when CDK4/6 inhibitors are combined with trastuzumab, pertuzumab, or newer HER2-targeted agents across multiple HER2+ breast cancer models. In the metastatic setting, phase II trials including MonarcHER and PATRICIA II have shown encouraging efficacy signals, while the phase III PATINA trial demonstrated a clinically meaningful 15.2-month progression-free survival benefit with palbociclib plus anti-HER2 therapy and endocrine therapy. In the neoadjuvant setting, trials including NA-PHER2 and MUKDEN-01 demonstrated marked Ki67 suppression and promising pathologic responses, supporting the exploration of chemotherapy de-escalation strategies. Despite these advances, key challenges remain including the identification of predictive biomarkers, optimal treatment sequencing, and the integration of emerging HER2-targeted agents such as trastuzumab deruxtecan. Novel CDK4/6 inhibitors including dalpiciclib and next-generation agents are expanding therapeutic options, while combination strategies incorporating CDK7 inhibition represent future therapeutic frontiers. The evolving landscape of HER2+/HR+ breast cancer treatment increasingly emphasizes precision medicine approaches that leverage cell cycle control mechanisms to overcome resistance and improve patient outcomes across all disease stages.

Nine new mycophenolic acid derivatives, penicacids O-W (1-9), two first-time reported natural products (10, 11), and five known compounds (12-16), were isolated from a marine-derived fungus Penicillium senticosum RCDB005 found in a South China Sea sediment sample. Their structures were determined using NMR, HRESIMS, and optical rotatory dispersion (ORD) spectra, electronic circular dichroism (ECD) calculations, X-ray crystallography, and modified Mosher's methods. Eight of these compounds were evaluated for anti-proliferative effects against nine human cancer cell lines and the IC₅₀ values ranged from nM to μM levels. Compounds 5, 7-9 showed potent inhibition activity against MOLM-13 acute myeloid leukemia cells with IC₅₀ values between 0.13 and 1.13 μM.

As primary producers in aquatic ecosystems, microalgae function not only as a natural source of nourishment for several economically important aquatic species but also as reservoirs of bioactive molecules. Microalgae can secrete exosome-like nanoparticles that transport functional biomolecules, such as proteins and nucleic acids, into the extracellular milieu, thereby mediating intercellular signaling and eliciting ecological or biomedical responses. Although plant-derived exosome-like nanoparticles have attracted attention for their utility in drug delivery and dermatology, the functional properties of microalgae-derived nanoparticles-particularly from species extensively applied in aquaculture-remain inadequately characterized. In this study, exosome-like nanovesicles were isolated from Nannochloropsis oculata (N-ELNs), a microalgal species widely used in aquaculture, and their skin-whitening potential was evaluated using the B16-F10 mouse melanoma cell model. The highest N-ELN yield was observed during the adaptation, exponential, and stationary growth phases. Uptake analyses confirmed the efficient internalization of N-ELNs by B16-F10 cells. Cell counting kit-8 assays indicated that N-ELNs exhibited no cytotoxic effects on melanoma cells or normal human dermal fibroblasts (HFF-1). Scratch wound healing assays revealed that N-ELNs exerted no significant effect on cellular migration. In B16-F10 cells, N-ELNs suppressed tyrosinase activity by downregulating Mitf and its downstream genes Tyr and Tyrp1, resulting in a substantial reduction in melanin synthesis (p < 0.05). The inhibitory effects of N-ELNs on melanin production, tyrosinase activity, and gene expression of Tyr, Tyrp1, and Mitf were comparable to those of the positive control, arbutin. Collectively, these findings suggest that N. oculata exhibits promising skin-whitening properties, providing a novel perspective for clinical applications and supporting the high-value utilization of the microalgae aquaculture industry.

Malignant melanoma is skin cancer arising from genetically altered melanocytes. Recently, a complex relationship between melanoma and chronic inflammation has been highlighted, representing an excellent condition for tumor development. Microalgae have been shown to be a promising source of bioactive compounds for drug discovery. In this study, we investigated Halamphora sp. (BEA0050) to identify possible compounds with immunomodulatory activity. The most active fraction (fraction D) showed anti-inflammatory activity against human melanoma cancer cells (A2058) stimulated using lipopolysaccharide (LPS) to induce an inflammatory phenotype. Chemical profiling of the bioactive fraction using chromatography and high-resolution mass spectrometry (UHPLC-HR-MS) revealed hydroxypheophorbide a, a breakdown product of chlorophyll a. In order to investigate the mechanism of action, the TNF-α release was detected through ELISA sandwich assays in A2058 cells and through confocal microscopy in LPS-stimulated HaCaT cells. Gene expression of principal pro-inflammatory cytokines and pathways was detected through real-time PCR, which showed the down-regulation of the inflammatory pathway in LPS-induced A2058 and HaCaT cells treated with 12.5 µg/mL of fraction D. This study reports for the first time the anti-melanoma and anti-inflammatory activities of Halamphora sp., identifying protein mediators and highlighting its biotechnological potential.

Glioblastoma is a highly invasive primary brain tumor with a poor prognosis, highlighting the need for new therapeutic strategies. Toxins derived from Macrodactyla doreensis have attracted attention for their potential anticancer activity. This study evaluated the anticancer and cytotoxic effects of M. doreensis crude venom on two commonly used glioblastoma cell lines (U251 and LN229), which mirror the phenotype of primary tumors. Cell viability and proliferation were assessed using the CCK-8 assay and colony formation assay, while cell migration and invasion capabilities were detected via wound healing assay and Transwell assay. Annexin V/PI staining and PI-based cell cycle analysis indicated that the crude venom significantly induced cell apoptosis and caused S-phase arrest. Proteomic analysis combined with GO and KEGG enrichment analyses as well as bioinformatics approaches showed that M. doreensis crude venom inhibits glioblastoma cell proliferation by downregulating the expression of CDK2, RRM2, and CHEK1, thereby hindering cell cycle progression and regulating the p53 signaling pathway. Notably, the downregulation of these key glioblastoma-related target genes was validated by qPCR. In addition, network pharmacology analysis indicated that several peptide families present in the sea anemone crude venom, including ShK peptides, inhibitor cystine knot (ICK) peptides, and EGF-like peptides, exhibit notable antitumor potential. Combined with AlphaFold2-based structural modeling and molecular docking, these analyses further elucidated the potential molecular mechanisms underlying their interactions with key targets, such as MD-381 with RRM2, MD-322 with CDK2, and MD-429 with CHEK1. Collectively, these findings highlight the therapeutic potential of M. doreensis crude venom and lay a foundation for the subsequent isolation of novel peptides and their further development in glioblastoma treatment.

Head and neck cancer (HNC) management requires highly coordinated multidisciplinary care. Radiation Therapy Technologists (RTTs) have increasingly expanded their role beyond technical execution, contributing to patient positioning, treatment delivery, monitoring, and supportive care. This narrative review integrates evidence from published literature with structured experiential insights collected through focus group discussions with RTTs and other multidisciplinary team (MDT) members. The resulting conceptual and operational framework highlights RTT contributions across the radiotherapy pathway, including adaptive planning, workflow coordination, and patient-centered interventions, supported by imaging and artificial intelligence (AI) tools for predictive modeling and treatment optimization. By facilitating communication, monitoring anatomical and functional changes, and integrating AI-informed insights, RTTs support timely interventions, reduce treatment interruptions, and enhance treatment safety and precision. Structured training, formal recognition of advanced practice roles, and interprofessional collaboration are key to maximizing the impact of RTTs in HNC care. This review provides a practical roadmap for institutions, professional societies, and research initiatives to support the evolution of RTT roles in complex radiotherapy settings.

To evaluate the effectiveness of different optimization parameters on radiotherapy plan quality for seventeen head and neck cancer patients.

Volumetric Modulated Arc Therapy with Simultaneous Integrated Boost (VMAT-SIB) plans, involving up to three tumors, were generated. For each participant, a reference plan (Plan_Ref) was created using dual-arc with 180 control points, 20° gantry-angle increment and 1 cm minimum segment width. Modified plans were developed with dose constraints and optimization settings constant by changing to single-arc, 150 and 200 control points, 0.5 cm minimum segment width, and 30° and 40° gantry-angle increments. These plans were referred to as Plan_Arc1, Plan_CP150, Plan_CP200, Plan_SW0.5, Plan_Inc30, and Plan_Inc40, respectively. D_95% of planning target volumes (PTVs), homogeneity index (HI), monitor units (MUs), maximum dose (D_max) of spinal cord, mandible, and brainstem were recorded. Statistical and Bland-Altman analysis was performed comparing the modified plans to Plan_Ref.

Average D_95% values for PTV1, PTV2, and PTV3 ranged from 93.13 to 98.82%. Plan_SW0.5 provided superior target coverage and homogeneity with higher MUs than Plan_Ref. Plan_Arc1 significantly reduced PTV coverage and dose homogeneity, while increasing MUs compared with Plan_Ref (p < 0.05). The average D_max as derived from all planning approaches was up to 43.86 Gy, 65.86 Gy, and 48.85 Gy for spinal cord, mandible and brainstem, respectively. For spinal cord, Plan_Ref led to significantly lower doses compared to Plan_Arc1 and Plan_Inc30, while the brainstem recorded statistically higher D_max doses than Plan_Arc1. Significantly higher D_max was observed for the mandible using Plan_SW0.5 (p < 0.05). However, for D_max, the comparison plans showed good agreement with Plan_Ref based on Bland-Altman analysis.

The VMAT plan quality is strongly affected by the minimum segment width whereas no differences were observed with the modification of the number of control points.

Objective: The objective of this study was to choose the optimal anesthesia method for gastric cancer patients undergoing surgery with lymph node dissection. Materials and Methods: The study included 53 patients with stage T1-4aN0-3M0 gastric cancer, who underwent radical surgery with xenon and dexmedetomidine (DMM) anesthesia in combination with epidural analgesia (main group, 27 patients) or with sevorflurane anesthesia in combination with epidural analgesia (comparison group, 26 patients). All patients underwent monitoring of hemodynamic parameters, blood coagulation system, thromboelastometry, and inflammation and metabolic parameters (interleukins, hormones and glucose levels), with an assessment of complications according to the Clavien-Dindo classification and the intensity of postoperative pain. Results: Awakening and extubation times, narcotic analgesic consumption, and Numeric Rating Scale pain scores were lower in the xenon + DMM group than in the sevoflurane group (p < 0.05). The overall number of patients experiencing complications did not differ significantly between anesthesia types; however, significant differences were found in the total number of complications (p = 0.003), the number of complications according to Clavien-Dindo I (p = 0.043) and II (p = 0.019), and the incidence of postoperative nausea and vomiting (p = 0.042). Conclusions: The BIS monitoring data obtained showed a sufficient level of anesthesia depth during surgery in both groups; however, post-anesthesia depression persisted longer in patients in sevoflurane group. Mathematical models for predicting Clavien-Dindo IIIb-V complications and severe postoperative pain syndrome are characterized by high sensitivity and specificity. They include simple clinical and laboratory parameters as well as type of anesthesia as predictors. The limitations of predictive models are also discussed in the article.

Background/Objectives: Breast Cancer-Related Lymphedema (BCRL) is one of the most prevalent complications among patients, causing physical limitations and a negative impact on their quality of life. Given its chronic nature and influence on personal autonomy, it is essential to review the therapeutic approaches applied to date. The main objective of this study was to analyze and to compare the effectiveness of the different treatments currently used in the management of BCRL, especially those that incorporate the intervention of an occupational therapist. Methods: A narrative review of the scientific literature published between 2013 and 2025 was conducted. The search was carried out in the PubMed, Scopus, Web of Science, and Dialnet databases. Inclusion and exclusion criteria were applied to select studies with therapeutic interventions, selecting eight studies for review. Results: Complex Decompression Therapy (CDT) is currently the standard treatment, although one of its components, manual lymphatic drainage, is controversial in terms of its effectiveness. Interventions such as Activity-Oriented Proprioceptive Anti-Edema Therapy (TAPA), adapted physical exercise, and hydrotherapy showed significant benefits in quality of life, functionality, and reduction in the volume of lymphedema. Conclusions: The therapeutic approach to BCRL must be multidisciplinary and personalized. Occupational Therapy (OT) provides a person-centered approach that contributes to improving occupational performance and patient well-being. More studies with greater methodological rigor and sample size are needed to unify clinical criteria.