Survival analysis plays a critical role in predicting patient outcomes and guiding personalized cancer therapies. Although multi-omics data provide rich biological insights, their high dimensionality poses significant challenges for robust analysis and clinical implementation. While many studies rely on the traditional Cox proportional hazards model, few have explored alternative survival algorithms combined with rigorous feature selection to identify low-dimensional, clinically feasible prognostic signatures that retain strong predictive power comparable to models using the full feature set. To address these gaps, we developed PRISM (PRognostic marker Identification and Survival Modelling through Multi-omics Integration), a comprehensive framework aimed at improving survival prediction and discovering minimal yet robust biomarker panels across multiple omics modalities. PRISM systematically evaluates various feature selection methods and survival models through a robust pipeline that selects features within single-omics datasets before integrating them via feature-level fusion and multi-stage refinement. Applied to TCGA cohorts of Breast Invasive Carcinoma (BRCA), Cervical Squamous Cell Carcinoma and Endocervical Adenocarcinoma (CESC), Ovarian Serous Cystadenocarcinoma (OV), and Uterine Corpus Endometrial Carcinoma (UCEC), PRISM revealed that cancer types benefit from unique combinations of omics modalities reflecting their molecular heterogeneity. Notably, miRNA expression consistently provided complementary prognostic information across all cancers, enhancing integrated model performance (C-index: BRCA 0.698, CESC 0.754, UCEC 0.754, OV 0.618). PRISM advances cancer prognosis by delivering scalable, interpretable multi-omics integration and identifying concise biomarker signatures with performance comparable to full-feature models, promoting clinical feasibility and precision oncology.

The role of local consolidative therapy (LCT) in metastatic non-small cell lung cancer (mNSCLC) with oligoresidual disease (ORD) after first-line immunotherapy remains undefined. This study evaluated survival outcomes of LCT in this population. We retrospectively analyzed 127 mNSCLC patients lacking EGFR/ALK alterations who developed ORD (≤ 3 organs or ≤ 5 residual lesions) following first-line PD-1/PD-L1 inhibitor therapy at two centers (2019-2025). Patients received LCT (surgery/SABR/MWA/cryoablation/SABT, n = 57) or systemic therapy alone (non-LCT, n = 70). Progression-free survival (PFS) and overall survival (OS) were compared via Kaplan-Meier analysis; multivariate Cox regression identified prognostic factors. LCT significantly prolonged median PFS (14.0 vs. 7.0 months; HR = 0.171, 95% CI: 0.109-0.268; P < 0.001) and OS (27.3 vs. 15.8 months; HR = 0.049, 95% CI: 0.031-0.078; P < 0.001) versus non-LCT. Notably, survival benefits were independent of PD-L1 expression: PD-L1-high (≥ 50%) subgroup: mPFS 15.4 vs. 11.2 months (P = 0.004); mOS 32.8 vs. 22.0 months (P < 0.001). PD-L1-low (< 50%) subgroup: mPFS 14.0 vs. 7.0 months (P < 0.001); mOS 25.4 vs. 13.8 months (P < 0.001). Multivariate analysis confirmed LCT (HR ~ PFS ~ = 0.171, HR ~ OS ~ = 0.049; both P < 0.001) and high PD-L1 (HR ~ PFS ~ = 0.269, HR ~ OS ~ = 0.136; both P < 0.001) as independent protective factors. Grade 3-4 adverse events occurred in 8.8% of LCT patients (pneumothorax/radiation edema). LCT enhances survival in mNSCLC with ORD post-immunotherapy, irrespective of PD-L1 status. These findings support integrating LCT into standard care for immunotherapy-responsive ORD populations.

In this study, we introduce a machine learning optimized graphene-based biosensor tailored for the early and accurate detection of breast cancer, aiming to elevate diagnostic reliability and clinical efficacy. The device employs a multilayer Ag-SiO₂-Ag architecture to amplify optical response, achieving a peak sensitivity of 1785 nm/RIU. Machine learning models are used to optimize structural parameters, enabling systematic refinement of detection accuracy and reproducibility. The optimized design demonstrates superior sensitivity compared with conventional biosensor configurations, underscoring its effectiveness in bioanalytical applications. The proposed platform offers a precise and robust solution for breast cancer screening and monitoring, with strong potential for clinical translation. To further refine sensor efficacy, a comprehensive parametric optimization approach is employed, strategically enhancing its sensitivity metrics. The sensor's heightened precision and responsiveness position it as a promising tool in biomedical diagnostics, particularly for early-stage breast cancer screening and monitoring.

Breast cancer poses a significant threat to public health, as demonstrated by its high incidence rate. While postoperative radiotherapy remains an important adjuvant treatment for patients with breast cancer undergoing breast-conserving surgery, radiation-induced dermatitis (RID) is a prevalent side effect, for which no standardised prevention method currently exists. Our previous preclinical research demonstrated that ursodeoxycholic acid (UDCA) significantly reduced radiation-induced skin damage in mice. Therefore, this phase I/II clinical study aims to further evaluate the safety and efficacy of UDCA in preventing RID during adjuvant radiotherapy in patients with breast cancer after breast-conserving surgery.

This single-centre phase I/II clinical study, with a single-arm cohort design in phase II, will include female patients who have undergone adjuvant radiotherapy after breast-conserving surgery for breast cancer. The sample size for the study is 40. Eligible patients will receive adjuvant radiotherapy at a prescribed dose of 50 Gy/25 F to the entire breast and lymphatic drainage area, where indicated, and 66 Gy/33 F to the tumour bed. After each irradiation, a 250 mg dose of UDCA will be topically administered to the irradiated area. Radiological dermatitis and skin temperature were assessed once a week after the initiation of radiotherapy, and haematological toxicity, radiation lung injury and quality of life were monitored and analysed on a regular basis until the second week after the conclusion of radiotherapy. The primary objectives of phase I and II studies are the safety profile and incidence of grade II or higher RID in patients, respectively.

This study was approved by the ethics committee of Mianyang Central Hospital, China (No: S20230211-02) and is registered in the Chinese Clinical Trial Register (registration number: ChiCTR2400085925). Results will be published in peer-reviewed journals.

ChiCTR2400085925.

The behaviour of tumour metastases and the different responses to therapies are still not fully understood. The project 'targeted autopsies' of the Universities of Regensburg and Erlangen aimed to further uncover the metastatic behaviour of malignant tumours by scientifically processing different tumour samples. To initiate such a programme, the concerns of all possible stakeholders must be analysed so that the programme can be set up accordingly and the highest possible level of approval can be achieved.

This study investigated the basic attitude toward a targeted autopsy programme for patients with tumours and possible criteria for such a programme using qualitative interviews. Focus group discussions were held to explore the opinions and views regarding ethical aspects of various professional groups (experts) involved in this project. An interview guideline was prepared beforehand by the supervising project group. Semistructured interviews were conducted, transcribed and analysed through qualitative content analysis according to Mayring.

University of Regensburg, Germany and cooperating medical partners.

Altogether, 15 experts were interviewed. The experts described the project as interesting and feasible. They assumed a sufficient participation rate in this autopsy programme from the population; however, they recommend giving importance to providing sufficient and professional education to all persons involved. Preserving the dignity of the donor and providing appropriate care for relatives is of great importance. Good organisation is considered imperative for the success of the project.

Generally, experts favour the implementation of a targeted autopsy programme. However, some hurdles must be overcome. Challenges similar to those in general or rapid autopsy and organ donation programmes exist, such as donor recruitment, staffing shortages and financial constraints. People involved must be well informed before the project.

Imiquimod is a standard therapy option for vulvar high-grade squamous intraepithelial lesions (vHSIL). In a retrospective study, the pre-existing composition of the immune cell infiltrate was associated with clinical outcome after imiquimod treatment. To validate these findings, an in-depth analysis of the tumor microenvironment was performed on a vHSIL cohort treated with imiquimod in the prospective PITVIN randomized controlled trial (ClinicalTrials.gov identifier: NCT01861535). Pretreatment biopsies of per-protocol patients participating in the PITVIN trial allocated to the imiquimod arm were included (n=38). These were analyzed by multispectral immunofluorescence using two seven-color staining panels for T cell and myeloid cell composition. Samples were scanned with the Vectra imaging microscope. Cell phenotyping was conducted using semi-supervised machine learning. Quick complete response (qCR) (n=27) was defined as absence of clinical lesions at 16 weeks; slow complete response (n=4) as delayed clearance requiring treatment up to 6 months; and non-response (n=7) as persistent histological vHSIL after 6 months, necessitating extended treatment or surgery. Analysis of the tumor immune microenvironment revealed interpatient variability in immune cell infiltration. Immune infiltrate composition in primary and recurrent vHSIL was comparable and this was also reflected by their clinical responsiveness to imiquimod. Higher numbers of intraepithelial CD3+CD8-(CD4+) T helper cells CD4+FoxP3+ regulatory T cells and CD14+ inflammatory myeloid cells and lower numbers of intraepithelial CD33+ immature cells were detected in qCR when compared with other response groups. Importantly, the lesions of complete responders displayed a positive correlation between the numbers of CD4+, CD8+ T cells and CD14+ inflammatory myeloid cells infiltrating the stroma and epithelium, indicative of a coordinated immune response. Slow complete responders displayed increased intraepithelial infiltration of recently activated CD4+PD1+ T cells (p<0.05), but displayed a lower CD14+ and CD68+ myeloid cell infiltration when compared with qCR. The presence of a pre-existing coordinated infiltration of vHSIL lesions with CD4+ T cells, CD8+ T cells and CD14+ inflammatory myeloid cells in patients displaying a CR after imiquimod treatment confirms our previous findings and suggests their use as biomarkers to predict responsiveness, but may also function as biomarkers to reduce or extend treatment duration of imiquimod.

This study aimed to analyze the current radiotherapy (RT) consent forms in Korea and present inter-institutional variations in the content, format, and level of detail provided to patients across major cancer types.

Between June and October 2022, the Informatics Committee and Clinical Practice Guidelines Committee of the Korean Society for Radiation Oncology collected RT consent forms from board-certified radiation oncologists. The consent forms for six cancer types were analyzed, including the five most common cancers treated with RT in Korea (breast, lung, prostate, colorectal, and liver cancer) as well as head and neck cancers.

Forty-nine institutions (49% of 101 institutions) submitted their consent forms, including all 13 Regional Cancer Centers. Of these, 46 provided complete site- or cancer-specific forms for analysis, whereas one provided partial information and two used free-text forms. Seventy percent of institutions (33/47) clearly documented the purpose for RT. Seventy percent of institutions (33/47) categorized side effects as acute and chronic, whereas 30% (14/47) did not make this distinction. In addition to variations in categorizing acute and chronic side effects, a wide range of variations was observed in reporting the side effects of each cancer type. Most forms did not specify the probability of having side effects.

This study uncovered notable inter-institutional variations in RT consent forms across Korea, especially in specifying side effects. These findings establish a basis for developing standardized consent forms, which could enhance patient-centered care, strengthen legal clarity, and promote ethical practices in radiation oncology.

Breast cancer remains the most common cancer among women worldwide, and recurrence rates stay high despite current treatments, especially for those with negative estrogen receptor status, where therapies are less effective, and prognosis is worse. Identifying molecules with predictive value for therapy response and prognosis is therefore crucial. In this context, FOXA1 could serve as a potential biomarker to predict the progression of ER-negative tumors. A search was conducted to answer the question, "What is the prognostic value of FOXA1 expression in breast cancer, estrogen receptor negative?" using various databases. Controlled vocabulary and Boolean operators were employed. Only studies reporting overall survival and disease-free survival, defined as the time from evaluation to death or relapse, were included. We identified seven articles evaluating FOXA1 and its relationship with disease-free survival (DFS) or overall survival (OS) in patients with ER-negative breast cancer. Our data indicate that higher FOXA1 expression is associated with improved overall survival (HR = 0.61, CI = 0.45-0.83, p < 0.002) and better disease-free survival (HR = 0.69, CI = 0.51-0.93, p < 0.02). These findings suggest that FOXA1 is linked to a favorable prognosis in terms of overall survival and disease-free survival. Further studies are needed to assess the role of FOXA1 in response to chemotherapy. PROSPERO registration number: CRD42024453750.

Needs assessment tools may guide optimization of clinical services to be more patient-centered. As needs of patients living with and beyond colorectal cancer (CRC) may also be influenced by socio-cultural backgrounds and healthcare ecosystems, we developed and validated a needs assessment questionnaire for CRC in a multi-ethnic, low-and middle-income setting.

The study methodology was guided by the COSMIN checklist. Items generation was based on findings from independent qualitative inquiries with patients, input from cancer stakeholders, and literature review. Following translation into Malay language, content and face validation were undertaken. The tool was administered to 300 individuals living with and beyond CRC. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed. Criterion validity was assessed using EORTC QLQ-C30 and QLQ-CR29 questionnaires.

The 48-item bilingual needs assessment tool for colorectal cancer (NeAT-CC) encompassed six domains of needs, namely (i) diagnosis, (ii) psychosocial and information, (iii) healthcare, (iv) practical and living with cancer, (v) financial and (vi) employment. Cronbach's alpha was above 0.70 for all domains, indicating good internal consistency. CFA also demonstrated acceptable convergent and divergent validity with composite reliability >0.70 and Heterotrait-Monotrait index <0.90 for all constructs. Criterion validity was established given the significant correlation with quality of life. The NeAT-CC was easily understandable, took 15-20 minutes for completion and may be self-administered.

Utilization of NeAT-CC may facilitate optimization of supportive and survivorship care services following CRC in local settings. The tool has wider potential for adaptation in other multi-ethnic and/or low and middle-income settings.

Several colorectal cancer (CRC) screening modalities (eg, colonoscopy, stool-based tests) are currently available. Yet, recent national patterns in screening using these modalities and potential differences across sociodemographic groups remain unclear.

To evaluate possible changes in the use of different CRC screening modalities among average-risk individuals aged 50 to 75 years in the US.

This retrospective cohort study used deidentified claims data from 2017 to 2024. Participants included a dynamic cohort of commercially insured Blue Cross Blue Shield beneficiaries. Data were analyzed from May 1 to June 30, 2025.

Invasive and noninvasive CRC screening modalities.

Changes in screening modality use were compared between the periods preceding the onset of the COVID-19 pandemic (ie, preonset: January 1, 2017, to February 28, 2020) and following the onset of the pandemic (ie, postonset: July 1, 2020, to December 31, 2024). Changes in screening by modality were also evaluated using autoregressive integrated moving average models, adjusting for temporal autocorrelation and seasonality.

In this retrospective cohort study of 24 973 642 distinct beneficiaries (mean [SD] age, 57.36 [4.27] years; 12 789 413 female [51.21%]), the use of colonoscopy (mean [SD], 1.29% [0.09%] to 1.14% [0.07%]; P < .001) and fecal immunochemical test (FIT) decreased between the 2 periods (mean [SD], 0.54% [0.03%] to 0.38% [0.07%]; P < .001). However, stool DNA test use increased (mean [SD], 0.19% [0.13%] to 0.61% [0.16%]; P < .001). Males had higher use of colonoscopy than females (mean [SD], 1.21% [0.07%] vs 1.07% [0.07%]; P < .001), whereas females had higher use of stool DNA test than males (mean [SD], 0.68% [0.16%] vs 0.55% [0.15%]; P < .001) and FIT (mean [SD], 0.43% [0.08%] vs 0.33% [0.05%]; P < .001). Areas with socioeconomic status (SES) in the top 20% had higher use of colonoscopy compared with areas where a marker of SES was in the bottom 20% (mean [SD], 1.37% [0.09%] vs 0.91% [0.06%]; P < .001) and stool DNA test (mean [SD], 0.65% [0.17%] vs 0.48% [0.13%]; P < .001) and lower use of FIT (mean [SD], 0.36% [0.09%] vs 0.48% [0.06%]; P < .001). Metropolitan area residents, compared with nonmetropolitan area residents, more frequently underwent colonoscopy (mean [SD], 1.18% [0.08%] vs 0.97% [0.06%]; P < .001) and FIT (mean [SD], 0.41% [0.08%] vs 0.25% [0.04%]; P < .001); however, their use of stool DNA test were similar (mean [SD], 0.61% [0.16%] vs 0.64% [0.16%]; P = .51).

Among privately insured individuals, the use of colonoscopy and FIT decreased after the COVID-19 pandemic while stool DNA test use increased, with differences by sex, area-level SES, and metropolitan area residence.