Tuberous sclerosis complex (TSC) is an autosomal dominant multisystem genetic disorder caused by pathogenic variants in the TSC1 or TSC2 genes, resulting in dysregulation of the mTOR signaling pathway and subsequent hamartoma formation. Although the genetic basis of TSC is well established, population-specific data on TSC1 and TSC2 variants are still emerging. The aim of this study was to characterize the variant spectrum of the TSC1 and TSC2 genes in a cohort of 34 unrelated probands from Greece, 26 of whom had a definite TSC diagnosis, whereas eight had a possible TSC diagnosis. Targeted next-generation sequencing (NGS) was performed to analyze all coding exons and flanking exon-intron boundaries of TSC1 and TSC2. Identified variants were subsequently validated by Sanger sequencing. Pathogenic or likely pathogenic variants were identified in 22 of 34 probands, corresponding to an overall diagnostic yield of 65% using the testing strategy applied in this study. Of these variants, 32% (7/22) occurred in TSC1 and 68% (15/22) in TSC2; seven variants (7/22; 32%) were previously unreported. The molecular detection rate was 77% (20/26) for patients meeting the criteria for definite clinical TSC diagnosis and 25% (2/8) for those with a possible TSC diagnosis. Exploratory genotype-phenotype analysis revealed a trend toward a more severe clinical presentation among patients harboring TSC2 variants. These findings expand the known molecular landscape of TSC and support the clinical utility of genetic testing for diagnosis, genetic counseling, and patient management.

Immune checkpoint blockade (ICB) therapy has dramatically improved the survival outcomes of patients with locally advanced unresectable and metastatic non-small cell lung cancer (NSCLC). In particular, accumulated clinical trials and systematic reviews have further verified that induction ICB regimen following surgery confers superior benefits for IIIB-N3 NSCLC. Herein, we present a clinical case of a patient diagnosed with bulky contralateral mediastinal N3 (cT1bN3M0) left upper lung adenocarcinoma and devoid of actionable driver gene alterations. The patient achieved pathological complete response following anti-PD-1 treatment and subsequently underwent left upper lobectomy, followed by anti-PD-1 therapy for three consecutive years. To date, the patient has maintained a recurrence-free survival status for more than 5 years. Notably, we dynamically monitored the T-cell receptor (TCR) repertoire throughout the entire treatment course. Further analysis of TCR profiles revealed distinct dynamic patterns of certain specific T-cell clonotypes during treatment. These clonal alterations may help interpret sustained immune responses and warrant further exploration as candidate indicators for therapeutic outcome.

Post-translational modifications (PTMs) are pivotal in tumor biology, yet their role in papillary thyroid cancer (PTC) remains unclear. We integrated bulk and single-cell transcriptomes with clinical data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases to analyze 17 PTMs and construct a prognostic model using 12 machine learning algorithms for predicting the thyroid cancer-free interval (TCFi). Enrichment analysis, single-cell analysis, and immune-related analysis were performed to elucidate the biological role of PTMs. Therapeutic responses of PTC patients were predicted based on the model. We validated the expression of model genes and identified the key signature associated with the malignant phenotypes of PTC. We filtered out 12 genes to construct a post-translational modification index (PTMI) and identified three molecular clusters of PTC. Shapley additive explanations (SHAP) and nomogram models confirmed the predictive efficacy of PTMI. Integrated analyses revealed significant associations between PTMI and immune features. High-PTMI patients showed sensitivity to FDA-approved drugs and chemotherapeutics but resistance to radioactive iodine therapy. Notably, we identified TYMS as a key functional PTMI signature. The PTMI proposed in this study holds strong potential as a prognostic biomarker and therapeutic predictor, offering valuable insights for personalized management of PTC patients.

CD73 is an enzyme that generates extracellular adenosine and has been implicated in tumor-associated immune suppression, but its biological and clinical significance in pancreatic ductal adenocarcinoma (PDAC) remains incompletely understood. We investigated the prognostic relevance and biological functions of CD73 in PDAC using transcriptomic analyses, in vitro functional assays, and in vivo mouse models. Transcriptomic analyses consistently showed that CD73 expression was correlated with hypoxia, glycolysis related, and cell-cycle programs. In agreement with these findings, hypoxic exposure induced CD73 mRNA expression in a subset of PDAC cell lines, and CD73 knockdown modestly affected glycolysis related extracellular acidification (ECAR) in a cell line dependent manner, and modulation of CD73 expression altered PDAC cell growth. CD73 expression was also associated with reduced intratumoral CD8+ T cell infiltration and cytolytic activity in human PDAC cohorts. In vivo, CD73 overexpression accelerated cancer progression and shortened survival in immunocompetent mice, whereas this effect was abrogated in immunodeficient NSG mice. Flow cytometric analysis further demonstrated reduced intratumoral CD8+ T cell infiltration in CD73 overexpressing tumors. Clinically, high CD73 expression was consistently associated with worse survival in multiple PDAC cohorts. Collectively, these findings suggest that CD73 is associated with multiple features of PDAC progression, including hypoxia-related metabolic programs, tumor growth, and suppression of anti-tumor immunity. CD73 may therefore represent a biologically relevant biomarker and a potential therapeutic target in PDAC.

Benefit from first-line immunotherapy-based treatment in advanced biliary tract cancer (BTC) is heterogeneous, and selection biomarkers are lacking. We investigated whether genomic features could stratify benefit from intensified immunotherapy-based treatment versus chemotherapy.

Multiple myeloma (MM) persists within a specialized bone marrow niche in which malignant plasma cells, immune dysfunction, inflammatory signaling, and metabolic stress reinforce one another. To resolve this ecosystem at compartment-level resolution, we integrated public single-cell RNA sequencing data with pathway scoring, cell-cell communication inference, independent clinical validation, multiplex immunofluorescence, and metabolic perturbation experiments. Analysis of 95,940 bone marrow cells identified 32 annotated populations and revealed broad microenvironmental remodeling in MM, including plasma-cell expansion, altered cytotoxic and dendritic-cell compartments, TAM-associated inflammatory programs, and lineage-specific hematopoietic perturbations. Hallmark pathway analysis identified recurrent immunometabolic programs, including IL6-JAK-STAT3, TNFα-NFκB, mTORC1 signaling, oxidative phosphorylation, unfolded protein response, hypoxia, and checkpoint/exhaustion-associated pathways. CellChat analysis showed disease-associated rewiring of ligand-receptor networks involving malignant plasma cells, TAMs, dendritic cells, and T/NK subsets, with checkpoint-enriched communication and clinically relevant plasma-cell and CD274 survival associations. Serum IL-6 was elevated in an independent clinical validation cohort. Multiplex immunofluorescence confirmed PD-L1-positive plasma cells, C1QA/C1QB/C1QC-positive TAMs expressing LAG3, and CD8-positive/LAG3-positive cytotoxic T cells. Mechanistically, malignant plasma cells showed transcriptional activation of LDH-associated glycolytic/lactate programs and ASCT2/SLC1A5-GLS-linked glutamine-metabolic programs, nominating these pathways as functional vulnerabilities. Accordingly, the LDH inhibitor galloflavin and the ASCT2/SLC1A5 glutamine-transport inhibitor V-9302 suppressed RPMI-8226 viability in dose- and time-dependent manners; their combination produced synergistic anti-myeloma activity supported by Bliss synergy, combination-index analysis, observed-versus-expected inhibition, and apoptosis-related validation. Together, these findings support an IL6-centered immunometabolic communication circuit linking malignant plasma cells, TAMs, and dysfunctional T cells, and identify cooperative glycolytic/lactate and glutamine-dependent metabolic vulnerabilities with therapeutic relevance in MM.

In the OptiTROP-Lung04 trial, sacituzumab tirumotecan (sac-TMT) yielded a median progression-free survival of 8.3 months-a clinically significant outcome that has approval by the National Medical Products Administration. This study evaluates the cost-effectiveness of sac-TMT as a later-line therapy for patients with EGFR-mutant advanced NSCLC who have progressed on EGFR-TKIs, from the perspective of Chinese healthcare system.

This study aims to integrate network pharmacology, machine learning, and survival analysis to preliminarily explore the molecular mechanisms underlying the inhibitory effects of thalidomide on the malignant transformation of oral leukoplakia (OLK).

RAS mutations occur in patients with several types of vascular anomalies, but effective treatments remain limited. To address this need, we evaluated the RAS (ON) multi-selective inhibitor RMC-7977 in human endothelial cells (ECs) expressing the NRASQ61R mutation found in kaposiform lymphangiomatosis (KLA). RMC-7977 was evaluated using in vitro and in vivo models. Doxycycline-inducible NRASWT and NRASQ61R human ECs were treated with RMC-7977 (3.12-100 nM) or vehicle. We assessed signalling pathways, proliferation, migration, morphology, and angiopoietin-2 (ANG-2) production. NRASQ61R ECs in a 3D angiogenesis assay were also treated with RMC-7977. For in vivo studies, NRASQ61R ECs were injected into flanks of nude mice on a doxycycline diet to generate xenografts. Mice received oral RMC-7977 or vehicle, and xenografts were collected after 11 days. RMC-7977 inhibited NRASQ61R-induced ERK phosphorylation and reduced proliferation, migration, spindle-like morphology, and ANG-2 production in a dose-dependent manner. RMC-7977 reduced vascular area in the angiogenesis assay. In vivo, RMC-7977 reduced xenograft weight, vascular area, and p-ERK staining. Overall, RMC-7977 suppressed NRASQ61R-mediated signalling, aberrant EC behaviour, and ANG-2 production in vitro and reduced vascular overgrowth in angiogenesis assays and mouse xenografts. Therefore, RMC-7977 may be a promising therapeutic candidate for RAS-driven vascular anomalies, including KLA.

To investigate the effects of miR-183-5p overexpression on proliferation, invasion, migration, and ferroptosis of triple-negative breast cancer (TNBC) cells and the role of Kelch-like protein 24 (KLHL24) in mediating these effects.

Colorectal cancer (CRC) is a heterogeneous disease shaped by genetic and epigenetic alterations. Approximately 20% of CRCs exhibit widespread CpG island hypermethylation, termed the CpG Island Methylator Phenotype (CIMP), frequently accompanied by MLH1 promoter hypermethylation, deficient mismatch repair (dMMR) and microsatellite instability (MSI). However, methylation patterns associated with MSI, independent of CIMP and MLH1 silencing, and the influence of anatomical location and patient age on the CRC methylome remain incompletely defined. We performed epigenome-wide DNA methylation profiling of 259 sporadic CRCs using the Illumina EPICv2 array. Differential methylation between MSI and microsatellite stable (MSS) CRCs was assessed after adjustment for tumour purity and anatomical location, then MLH1 promoter methylation and CIMP status, to delineate MSI-associated methylation changes. Additionally, we evaluated the effects of anatomical location and age on methylation patterns. While differential methylation between MSS and MSI CRCs was dominated by MLH1 promoter hypermethylation, additional adjustment for MLH1 hypermethylation and CIMP identified 656 CpG sites associated with MSI, beyond the global methylator phenotype. These included hypermethylation at LRP6, GSK3β, and CDK12, identifying differential methylation of genes involved in WNT signalling and transcriptional regulation. Within MSI CRCs, we observed the co-occurrence of MLH1 hypermethylation with promoter hypermethylation at TXNRD1. Anatomical location was strongly associated with methylation, whereas age had more modest effects. These results identify methylation changes associated with sporadic MSI beyond CIMP status and MLH1 hypermethylation, reveal heterogeneity within MSI CRCs, and indicate that anatomical location is a major determinant of the CRC methylome, advancing molecular stratification of CRC.

Glioblastoma is profoundly heterogeneous, and single-modality analyses often miss prognostically relevant structure. We introduce a transparent, end-to-end workflow that fuses available whole-slide histology and RNA-seq to discover clinically meaningful glioblastoma subgroups using an unsupervised learning model after feature extraction. Haematoxylin-eosin slides are tiled, tissue-screened and stain-normalised; tiles are embedded with a pretrained ResNet-50 to yield 2048-dimensional features, averaged per patient and compressed to 30-D by an autoencoder. In parallel, RNA-seq (~48 k genes) undergoes low-variance filtering and normalisation, then a second autoencoder produces a 30-D transcriptomic embedding. The two 30-D representations are concatenated into a 60-D fused vector, robustly scaled and refined with PCA (≈98% variance retained). Across K-means, Gaussian mixture models and Agglomerative clustering (k = 2-20), Agglomerative k = 2 was decisively best (mean silhouette ≈0.53), yielding clusters of 150 and 8 patients (survival subset 147 and 8). Survival separation was substantial (median 454 vs. 138 days; log-rank p = 0.0096). In Cox models, the poorer-prognosis cluster showed increased risk (HR ≈ 2.70), which remained significant after age adjustment (HR = 2.15, 95% CI 1.04-4.46; age per year HR = 1.02, 95% CI 1.01-1.04). Attribution and consensus analyses yielded compact, interpretable gene sets (22 shared; 8 per cluster), including markers associated with NOTCH/γ-secretase and oxidative phosphorylation. These findings nominate biologically plausible hypotheses for future validation rather than immediate treatment-selection rules. Overall, this study demonstrates that auditable late fusion of histology and transcriptomics, built from routine data, can identify survival-associated glioblastoma subgroups and provides a hypothesis-generating framework for prospective, harmonised, multi-centre validation.

Hepatocellular carcinoma (HCC) is characterized by pronounced metabolic reprogramming and is frequently accompanied by the development of an immunosuppressive microenvironment. However, the key molecular mediators linking tumour metabolic dysregulation to immune microenvironment remodelling remain insufficiently defined. This study aimed to identify critical metabolic genes in HCC and to investigate their roles in lipid metabolic reprogramming and immunosuppression.

Anti-PD-1 therapy resistance remains a critical barrier in non-small cell lung cancer (NSCLC) management, and the underlying mechanisms are incompletely defined.

Clonal hematopoiesis (CH) arises from the expansion of hematopoietic stem and progenitor cells bearing somatic mutations, often in genes linked to epigenetic regulation and inflammation. Once considered a benign age-related phenomenon, CH has gained increasing attention for its potential to influence cancer biology beyond hematologic malignancies. Recent studies have uncovered an unexpectedly high prevalence of CH in patients with colorectal cancer (CRC), raising important questions about its origin, context-specific drivers, and pathological consequences. While cytotoxic therapies are known contributors, accumulating evidence suggests that the chronic inflammatory and metabolic alterations intrinsic to CRC may also shape hematopoietic clonality. In turn, CH-derived myeloid cells harboring mutations such as DNMT3A or TET2 can modulate the tumor microenvironment, promote inflammation, and impair antitumor immunity. In this review, we synthesize emerging findings on the bidirectional relationship between CH and CRC, highlighting the mechanistic underpinnings and potential implications for disease progression, therapeutic resistance, and immune modulation. Understanding this evolving interface may open new avenues for risk stratification and treatment personalization in CRC.

Bevacizumab is widely used as an anti-angiogenic maintenance therapy in ovarian cancer; however, there are currently no validated clinical criteria to guide patient selection for its use.

Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer with limited treatment options. Although PARP inhibitor (PARPi) offers great promise in treating TNBC with deficiency in homologous recombination (HR), most TNBC patients are HR-proficient. Furthermore, acquired resistance to PARPi remains as a challenge. Thus, there is an unmet need to identify new therapeutic target for developing advanced TNBC treatment strategy.

Ferroptosis, an iron-dependent form of cell death driven by lipid peroxidation, has emerged as a potential therapeutic strategy for therapy-resistant cancers. Glutathione peroxidase 4 and the selenoprotein biosynthesis pathway essential for its translation are key regulators of ferroptosis but lack effective therapeutic targeting. In a drug screening using a selenoprotein translation reporter, here we identify FMS-like tyrosine kinase 3 (FLT3) inhibitors as suppressors of selenoprotein translation that induce ferroptosis in FLT3-mutant acute myeloid leukaemia. Mechanistically, FLT3 inhibition disrupts selenocysteine recoding, in which a UGA stop codon is recoded as selenocysteine via the SECIS element and associated binding proteins. Notably, the antileukemic efficacy of the FLT3 inhibitor gilteritinib was markedly reduced by dietary vitamin E, which attenuated ferroptosis. This study highlights ferroptosis as a vulnerability in FLT3-mutant acute myeloid leukaemia and suggests that high vitamin E intake may compromise tyrosine kinase inhibitor efficacy partly by suppressing ferroptosis.

The high incidence and mortality rates of tumors have resulted in significant social and economic burdens, posing a major global threat to human life and societal development. In recent years, molecular targeted therapy for tumors has become a research hotspot. C-MET, the receptor for hepatocyte growth factor (HGF), plays a crucial role in the HGF/C-MET signaling pathway, which is involved in various processes such as tumor cell growth, invasion, migration, angiogenesis, epithelial-mesenchymal transition, tumor microenvironment remodeling and therapeutic resistance. Several C-MET-targeting strategies have been developed, including small-molecule tyrosine kinase inhibitors (TKIs), monoclonal antibodies (mAbs) against C-MET or HGF, antibody-drug conjugates (ADCs), nucleic acid aptamers, soluble receptors, natural compounds, and proteolysis targeting chimeras (PROTACs) targeting MET. These inhibitors have demonstrated encouraging anti-tumor effects in both preclinical and clinical studies, with several already available on the market. However, further research is still needed on the activation mechanisms of the HGF/C-MET signaling pathway and its interactions with other receptor tyrosine kinases, which will aid in identifying suitable patients for these treatments. This review provides a comprehensive overview of the structure, regulation, signaling pathways, and functions of C-MET, along with recent advances in C-MET inhibitors, offering valuable insights for cancer therapy.

Chimeric antigen receptor (CAR) T-cell therapy has revolutionized oncology, and its foundational logic-precise antigen recognition coupled with durable effector activity-extends naturally to chronic non-malignant diseases sustained by long-lived pathological cells. These include viral reservoirs, autoreactive B and plasma cells, activated fibroblasts, alloimmune clones, and senescent cells that remodel tissue niches and evade clearance by conventional therapies. This review highlights how CAR-based strategies can be adapted across diverse disease settings by redirecting engineered immune responses toward disease-sustaining cellular compartments. Co-stimulatory domains such as CD28, 4-1BB, and OX40 enhance persistence and effector function; programmed cell death protein 1 (PD-1)-CD28 switch receptors reverse inhibitory signaling; and cytokine-resistant CARs incorporating dominant-negative transforming growth factor-β (TGF-β) receptors maintain activity within suppressive microenvironments. We discuss these approaches across infections, including human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV); autoimmunity involving CD19- and B-cell maturation antigen (BCMA)-directed depletion strategies and CAR-engineered regulatory T cells (CAR-Tregs); fibrosis targeting fibroblast activation protein (FAP); hemophilia using B-cell antibody receptor (BAR)-CARs against factor VIII and factor IX inhibitors; transplantation employing human leukocyte antigen (HLA)-specific CAR-Tregs; and senescence-associated pathologies targeting urokinase plasminogen activator receptor (uPAR) and natural killer group 2D ligands (NKG2DLs). Early clinical experiences in systemic lupus erythematosus, systemic sclerosis, myositis, and multiple sclerosis, together with preclinical successes in chronic infections and fibrotic disease, demonstrate both feasibility and durable disease modification. By extending CAR-T therapy beyond oncology, these applications position programmable cellular immunotherapy as a broadly adaptable platform for eliminating persistent pathological cells, remodeling diseased tissue environments, and restoring long-term immune homeostasis.