As the number of cancer survivors continues to grow, optimizing long-term survivorship care models has become increasingly important. Telehealth has the potential to improve access to health care for survivors; however, studies evaluating telehealth in this population remain limited. Additionally, concerns persist regarding equity in technology access and digital literacy.

This study aimed to examine demographic factors and patient attitudes influencing telehealth use among cancer survivors compared to the general population.

Adult participants were identified from the nationally representative database Health Information National Trends Survey 6 (HINTS 6). Multivariable logistic regression was used to calculate the predictors of telehealth use among cancer survivors. χ2 tests compared the prevalence of reported reasons of not using telehealth in the last 12 months between cancer survivors and the general population.

A total of 5793 (weighted n=239,557,883) individuals were included in this study, 7.7% (weighted n=18,545,434) who are cancer survivors. 5092 individuals from the general population and 701 cancer survivors were included. Older age was associated with lower telehealth use (adjusted odds ratio [aOR] 0.11; 95% CI 0.02-0.59 for patients aged ≥65, compared to those under 40 y old). Higher education (aOR 2.55; 95% CI 1.24-5.27) and heart disease history (aOR 2.52; 95% CI 1.20-5.28) were associated with increased telehealth use. Employed (aOR 0.46; 95% CI 0.22-0.97) and retired (aOR=0.37; 95% CI: 0.18-0.77) cancer survivors were less likely to use telehealth than unemployed individuals. Of the nonusers, over 60% reported that telehealth options were not offered, and 80% preferred in-person visits. Technical issues and privacy concerns were not major factors in utilizing telehealth.

Despite greater telehealth use among cancer survivors, a negative association between older age and telemedicine utilization persists. Efforts should focus on improving access for older cancer survivors and addressing employment-related factors, patient attitudes, and telehealth availability. Future studies should explore personalized approaches to enhance cancer survivors' health care experiences. Our findings emphasize the need to address specific factors including age and employment related disparities, patient preferences and telehealth availability to optimize equitable access to telehealth and enhance the delivery of cancer survivorship care.

Background and objectives Glioblastoma is the most aggressive primary adult central nervous system of malignancy, with a median overall survival of 12-18 months. Recurrence is almost inevitable and carries poor outcomes, with median overall survival of 2-9 months and progression-free survival of 1.5-6 months. Treatment options are limited, as locoregional therapies apply to selected patients, and systemic treatments are restricted by the blood-brain barrier. Focused ultrasound has emerged as a noninvasive method to transiently and reversibly increase blood-brain barrier permeability. This study aims to systematically evaluate the clinical efficacy and safety of focused ultrasound-mediated blood-brain barrier modulation to enhance drug delivery in recurrent glioblastoma. Methods A systematic search of PubMed, ScienceDirect, Scopus, the Cochrane Library, ClinicalTrials.gov, and Wiley Online Library identified studies published between 2015-2024. The review followed PRISMA guidelines, with risk of bias assessed using ROBINS-I and protocol registration in PROSPERO (CRD420251010548). Disagreements were resolved by consensus. Results Twelve clinical trials involving 841 patients met inclusion criteria. Focused ultrasound-mediated platforms included SonoCloud-1, SonoCloud-9, ExAblate Neuro, and NaviFUS, with 1-10 sonication sessions lasting 2.5-22 min. blood-brain barrier opening was achieved in 68-100% of procedures. Median overall survival ranged from 9.95-18 months and median progression-free survival (PFS) from 2.2-3.5 months. Several studies reported improved outcomes vs historical chemotherapy-only controls, including progression-free survival-6 rates of 42-52%. Adverse events were mostly mild and transient, with >85% graded as Grade 1 and no treatment-related mortality. Interpretation and conclusions Focused ultrasound-mediated blood-brain barrier modulation is a practical therapeutic adjunct that improves intracerebral drug penetration and might extend survival beyond traditional outcomes; providing a noninvasive approach suitable for patients where systemic dose escalation is limited by toxicity and access.

Background and objectives The prevalence and significance of programmed death-1 ligand (PD-L1) expression in serous ovarian carcinoma are not well established. This study aimed to evaluate PD-L1 expression using immunohistochemistry (IHC) in whole tissue sections of serous ovarian carcinoma and to correlate its expression with relevant clinicopathological characteristics. Methods A retrospective study of 30 cases was conducted at a tertiary care centre in New Delhi, India, over one yr. All cases were reviewed using HandE staining, and IHC for PD-L1 was performed manually on poly-L-lysine-coated slides using the PD-L1 (E1L3N®) XP® Rabbit monoclonal antibody. Additional clinicomorphological data were recorded and analysed. Results Based on the combined positive score (CPS) with a 1% cutoff, PD-L1 expression was observed in 33% of cases. PD-L1 expression demonstrated a positive correlation with higher FIGO stage and the presence of tumour-infiltrating lymphocytes (TILs) (P=0.029). Interpretation and conclusion PD-L1 may serve as a potential prognostic marker in serous ovarian carcinoma. Its expression could help identify patients who may benefit from targeted PD-L1-based therapies and contributes to a better understanding of the biological behaviour of ovarian carcinoma.

Although there have been significant advances in the management of gynecologic malignancies in recent years, individuals with advanced disease continue to have high rates of recurrence. Strategies to decrease rates of recurrence and increase time to recurrence are urgently needed. Historically, prolonged chemotherapy treatment and consolidation therapy were unsuccessful. However, continuation of maintenance therapy after initial chemotherapy may offer improved progression-free survival (PFS) and overall survival (OS) in select circumstances. In recent years, maintenance agents including VEGF and poly(adenosine diphosphate ribose) polymerase (PARP) inhibitors have improved PFS and sometimes even OS among women with ovarian cancer when used as monotherapy or in combination. PARP inhibitors demonstrate particularly robust results in patients with BRCA-mutated disease or other homologous recombination-deficient cancers. In endometrial and cervical cancers, immune checkpoint inhibitors combined with chemotherapy and used as maintenance thereafter have improved PFS and OS, with particular benefits noted in mismatch repair-deficient endometrial cancer and PD-L1-positive cervical cancer. Beyond currently available therapies, ongoing trials are exploring additional options for maintenance therapy, including antibody-drug conjugates, hormone-directed therapies, and novel targeted therapies such as XPO-1 inhibitors. Maintenance therapy can be accompanied by increased toxicity and cost; as such, careful consideration must be made about the relative benefit of any given maintenance strategy weighed against potential impacts on quality of life or financial toxicity. This review focuses on current maintenance therapy practices, emerging areas of research, and challenges in this area of study.

Cervical ectropion is a common anatomical condition in women of reproductive age. Although often considered a physiological variant, its potential role as a factor associated with epithelial alterations remains under debate. Exposure of immature columnar epithelium in the transformation zone may facilitate the persistence of human papillomavirus (HPV) and other infectious agents.

We conducted an analytical case-control study (1:2 ratio) at a referral hospital in Ica, Peru. Cases were women with histologically confirmed high-grade cervical dysplasia (CIN2-3), while controls had consecutive negative cytology results (NILM). Cervical ectropion was assessed by standardized colposcopy. Hierarchical multivariate logistic regression was used to adjust for demographic, behavioral, and infectious factors.

A total of 276 women were included (92 cases and 184 controls). Cervical ectropion was observed in 33.0% of cases and in 10.3% of controls (p < 0.001). In multivariate analysis, ectropion remained significantly associated with high-grade cervical dysplasia (adjusted OR = 3.86; 95% CI: 1.74-8.53; p < 0.001). Significant associations were also found with bacterial vaginosis (adjusted OR = 2.47; 95% CI: 1.04-5.86; p = 0.041) and with a history of multiple sexual partners (adjusted OR = 3.55; 95% CI: 1.53-8.20; p = 0.003).

Cervical ectropion was significantly associated with high-grade cervical dysplasia after adjustment for measured covariates and may constitute a potential clinical marker of epithelial vulnerability. However, residual confounding related to unmeasured HPV infection cannot be excluded. These findings support the importance of systematic screening and colposcopic surveillance, particularly in resource-limited settings where molecular HPV testing is not widely available.

Achieving a balance between efficacy and side effects is essential for the success of new combinatorial cancer therapies. This study investigated the impact of adding BKM120, a PI3K inhibitor, to a dual regimen consisting of BI-3406, a KRAS/SOS1 inhibitor, and trametinib, a MEK inhibitor.

The therapeutic effects of these drug combinations were evaluated in the pancreatic cancer cell line 6606PDA using both monolayer and three-dimensional cultures. Additionally, their efficacy and potential side effects were assessed in vivo using a syngeneic orthotopic mouse model of pancreatic cancer.

In vitro studies demonstrated that the addition of BKM120 to BI-3406 and trametinib significantly reduced cell viability in both monolayer and three-dimensional cultures. However, in a syngeneic pancreatic cancer mouse model, the triple therapy failed to significantly improve survival outcome compared to the dual therapy. Tumor weights were unaffected in female mice, while a minor, non-significant reduction was observed in male mice. This was accompanied by a slight, non-significant decrease in cancer cell proliferation. In the triple therapy group, Cdkn2a expression in tumors, a marker for senescence, remained largely unchanged. However, PD-L1 was significantly reduced in males, and CD8⁺ T-cell infiltration was notably enhanced in females. Importantly, the triple therapy demonstrated several concerning drawbacks. It significantly increased lung metastases in female mice, reduced lymphocyte and erythrocyte counts, and elevated C-peptide concentrations in both sexes. Furthermore, behavioral analysis indicated a significant decline in burrowing and nesting activities among female mice during specific experimental phases.

The addition of BKM120 to the combination of BI-3406 and trametinib provides minimal therapeutic benefit while introducing significant adverse effects, underscoring the need for caution when considering clinical applications.

Second-line chemotherapy (2L) is recommended after gemcitabine plus nab-paclitaxel (GnP) first-line chemotherapy (1L) for unresectable pancreatic cancer (UR-PC). However, in routine clinical practice, not all patients proceed to 2L. This retrospective study aimed to identify baseline clinical and biological factors associated with 2L eligibility.

We retrospectively reviewed the data of 124 consecutive patients with UR-PC who received 1L GnP between 2016 and 2024 at a single center, excluding those with postoperative recurrence. Patients were grouped by 2L receipt [2L( +), n = 63] or non-receipt [2L( -), n = 61]. Ascites was assessed based on baseline imaging findings and additionally classified as none, mild, or moderate-to-severe. Overall survival (OS) was assessed from completion or discontinuation of 1L GnP, and progression-free survival (PFS) was assessed from 1L GnP initiation, using Kaplan-Meier and Cox regression analyses. Cox regression analysis for OS included only baseline variables.

The 2L( +) group less frequently had baseline ascites and better Eastern Cooperative Oncology Group performance status. The distribution of ascites severity also differed significantly between the groups. Median OS was 7.1 vs. 1.9 months (p < 0.001) and median PFS was 5.9 vs. 3.0 months (p = 0.004) for 2L( +) vs. 2L( -). Multivariate Cox analysis identified the absence of ascites as an independent factor associated with longer OS (hazard ratio [HR] 0.595, 95% confidence interval 0.367-0.963; p = 0.035). Multivariate logistic regression revealed that the absence of ascites independently predicted 2L eligibility (adjusted odds ratio 4.435, 95% CI 1.583 - 12.423, p = 0.005).

Baseline ascites was independently associated with reduced eligibility for 2L after 1L GnP in patients with UR-PC. Nevertheless, patients who received 2L had longer survival than those who did not, including among those with baseline ascites. However, this association should be interpreted cautiously because of the retrospective design and potential treatment-selection bias. These findings may support individualized reassessment and proactive supportive care to maximize opportunities for sequential chemotherapy.

The antitumor effects of Lasiokaurin (LAS), a natural compound derived from traditional Chinese medicine extracts, remain poorly understood in hepatocellular carcinoma (HCC). Therefore, this study investigates the anticancer effects of LAS in liver cancer. The experiment employed Wound healing assay, colony formation assays, Transwell assays, flow cytometry, Western blot analysis, and reverse transcription quantitative polymerase chain reaction (RT-qPCR) to evaluate the relationship between LAS and apoptosis, migration, proliferation, and cell cycle arrest. RNA-sequencing, RT-qPCR, and Western blot techniques were used to detect markers associated with the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) pathway. The anti-tumor efficacy was assessed using a subcutaneous tumor-bearing mouse model. LAS promotes apoptosis and cell cycle arrest, significantly inhibiting tumor growth. These findings indicate that LAS mediates apoptosis through the JAK2/STAT3 pathway, suggesting its potential as a novel anticancer agent.

Medulloblastoma (MB) with MYC amplification is associated with aggressive clinical behavior and a high risk of metastatic dissemination. Extraneural metastasis (ENM), although rare in the modern treatment era, remains a devastating manifestation linked to poor survival. We report a pediatric case of MB with high-level MYC amplification and NanoString-based molecular subgrouping confirming Group 3 identity in a 9-year-old girl who developed rapidly progressive and widespread ENMs involving the bone marrow, liver, lymph nodes, and peritoneum shortly after craniospinal irradiation. Planned adjuvant chemotherapy could not be initiated because of persistent cytopenias associated with marrow infiltration during disease progression. Targeted next-generation sequencing identified somatic alterations in PTEN, ARID2, and ERCC6, as well as a heterozygous germline SLX4 variant of uncertain clinical significance. While these findings do not establish a causal role in tumor progression, they further illustrate the molecular complexity of high-risk MB. The clinical course observed in this patient is consistent with prior reports linking MYC amplification to aggressive metastatic behavior. This case underscores the challenges of managing molecularly high-risk MB and highlights the importance of comprehensive molecular characterization and timely systemic therapy.

To report an EWSR1::BEND2 fusion astroblastoma-like tumor arising in the fourth ventricle of a 7-year-old girl and to highlight the diagnostic value of molecular pathology in astroblastoma-like tumors with an atypical immunophenotype.

Clinical, histopathological, immunohistochemical, and molecular findings of the present case are presented.

Despite gross total resection followed by radiotherapy, the patient died 7 months after surgery. Histologically, the tumor showed typical astroblastoma-like morphology but an unusual immunophenotype characterized by complete loss of GFAP and Olig2 expression, focal EMA positivity, and diffuse SOX2 positivity. Because of this atypical immunoprofile, diagnosis was challenging and was ultimately established by molecular testing demonstrating an EWSR1::BEND2 fusion.

This case highlights the critical role of molecular pathology in diagnosing astroblastoma-like tumors lacking conventional glial markers and suggests that SOX2 expression may represent a novel immunophenotypic finding in this tumor spectrum.