Adjuvant cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) improve outcomes in hormone receptor-positive (HR+), HER2-negative early breast cancer, though trial results have been heterogeneous. Menopausal status and endocrine therapy backbone may contribute to variability in treatment effect. We performed a meta-analysis evaluating whether menopausal status influences the efficacy of adjuvant CDK 4/6 inhibition.

Disease-free survival (DFS) is commonly used as a primary end point in trials for localized renal cell carcinoma (RCC), although its validity as a surrogate for overall survival (OS) remains uncertain. The objective of this study was to evaluate whether DFS is a reliable surrogate end point for OS in this setting.

Polyploid giant cancer cells (PGCCs) are increasingly recognized as major drivers of therapy resistance and tumor relapse, yet the conserved molecular programs underlying their persistence remain incompletely defined. To identify genes consistently deregulated across eight independent datasets, we performed an integrative transcriptomic analysis of PGCCs derived from prostate, ovarian, and breast cancers. By focusing on consistently up- or down-regulated genes that were expressed in at least five datasets and showed a concordant direction of expression across more than 70% of datasets and met a significance threshold of adjusted p < 0.05, we defined the core regulatory architecture stabilizing the PGCC state under therapeutic stress. Our analysis reveals that PGCCs exhibit a paradoxical ranscriptomic signature consistent with cytolytic activity alongside reduced immune detection. These cells activated pro-inflammatory cytokine and chemokine signaling while simultaneously engaging immune-evasion mechanisms, including PD-L1-associated and virus-like escape programs. Concurrently, PGCCs displayed transcriptional features characteristic of immune-privileged cellular states, including embryonic development, reproductive programs, senescence-associated survival, apoptosis resistance, and deep dormancy marked by coordinated suppression of major housekeeping processes. Notably, PGCCs also activated neuronal differentiation and neurodegeneration-associated pathways, including axon guidance, neurogenesis, and calcium signaling. This neuron-like, calcium-dependent stress adaptation program may further enhance immune privilege and long-term survival capacity. We propose that PGCCs represent an immune-adaptive polyploid survival state in which inflammatory and ontogenetic pathways are repurposed to support immune evasion and tumor persistence. By identifying actionable vulnerabilities within calcium signaling, neuronal mimicry, and checkpoint-associated pathways, this study provides a framework for therapeutic strategies aimed at dismantling the PGCC reservoir and preventing tumor relapse.

Chordoma is a rare notochordal malignancy of the axial skeleton, and distant cutaneous metastasis is among its rarest manifestations-an under-recognised mimic of benign and malignant skin tumours that often presents with an incomplete clinical history.

BackgroundPathological fractures (PFs) are clinically important skeletal-related events in patients with bone metastases from solid tumors and may negatively affect survival. This meta-analysis aimed to quantify the association between PFs and overall survival (OS) in patients with metastatic solid cancers.MethodsThis systematic review and meta-analysis was conducted in accordance with PRISMA 2020 using a PICOS-defined protocol. PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library were searched from inception to 2025 without language restrictions. Eligible studies included adults with metastatic solid tumors, compared patients with and without PFs, and reported OS using hazard ratios (HRs). Tumor types were pooled a priori because the included studies evaluated the same exposure-comparator-outcome framework across metastatic solid tumors. Random-effects models were used, and heterogeneity was explored through moderator analyses and meta-regression. Two reviewers independently screened records, extracted data, and assessed risk of bias using MINORS for observational studies and the Cochrane tool for randomized trials.ResultsFrom 198 records, four studies comprising seven cohorts and 3,607 participants met the inclusion criteria. Random-effects pooling showed that PFs were significantly associated with poorer OS compared with no PFs (pooled HR 1.40, 95% CI 1.08-1.81; p = 0.010). However, heterogeneity was substantial (I2 = 92.6%), indicating that the pooled estimate should be interpreted cautiously. Meta-regression suggested a positive association between publication year and effect size (β = 0.041; p = 0.041), whereas primary cancer subgrouping was not a significant moderator. Funnel-plot asymmetry and Egger's test suggested possible small-study effects.ConclusionsPFs appear to be associated with worse OS in patients with metastatic solid tumors, highlighting the importance of fracture prevention, early identification of impending fractures, and multidisciplinary care. Nevertheless, the small evidence base, substantial heterogeneity, and possible publication bias warrant cautious interpretation. Prospective studies with standardized PF definitions and adjusted survival analyses are needed.

Esophagectomy remains the standard of care for T1b esophageal cancer. Guidelines support the use of endoscopic resection (ER) including endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) in carefully selected patients. We compared patients with T1b esophageal cancer who underwent ER or esophagectomy. We searched MEDLINE, EMBASE and CENTRAL from inception to November 2025 for studies comparing esophagectomy and ER for patients with T1b esophageal cancer. We excluded studies if patients received neoadjuvant or adjuvant treatment. Outcomes were 5-year overall survival (OS) and cancer specific survival (CSS), recurrence, and mortality. Meta-analysis (with propensity-matched data when available) was performed, with a subgroup analysis of ESD versus esophagectomy. Ten retrospective studies were identified comprising 2491 patients who underwent ER (n = 890) or esophagectomy (n = 1601). Mean age was 65.7 years with 16.1% female. Six studies grouped EMR and ESD together, three reported ESD alone, one examined EMR only. OS and CSS were available in seven and four studies, respectively. There was no significant difference between esophagectomy and ER regarding 5-year OS (HR 1.26; 95% CI 1.00-1.60; P = 0.05), 5-year CSS (HR 0.65; 95% CI 0.20-2.17; P = 0.49), and 30-day mortality (HR 0.39; 95% CI 0.13-1.16; P = 0.09). Recurrence was 18.1% after esophagectomy and 17.7% after ER. Subgroup analysis showed no difference in OS or mortality. Risk of bias was high in five studies. Available retrospective comparative evidence suggests no clear difference between ER and esophagectomy for patients with T1b esophageal cancer. Randomized controlled trials are needed to reduce patient heterogeneity.

The prevalence of major LARS and its associated risk factors remains variably reported in the literature. This meta-analysis aimed to assess the pooled prevalence of major LARS and to identify its predictive factors.

Extensive-stage small cell lung cancer (SCLC) carries a poor prognosis and has limited therapeutic options. The addition of immune-checkpoint inhibitors (ICIs) to platinum-etoposide (PE) chemotherapy has become an important first-line treatment strategy. However, the comparative benefits and harms of different first-line chemotherapy-based regimens, including ICI-containing combinations, remain unclear.

Radical hysterectomy with pelvic lymphadenectomy has been considered the primary treatment for early-stage cervical cancer without lymph node involvement. This study aimed to evaluate recurrence rates and the prevalence of lymph node metastasis after treatment with conization combined with lymph node assessment.

The multicentre ALaCaRT and ACOSOG Z6051 randomized trials were unable to demonstrate non-inferiority of laparoscopic versus open surgery for rectal cancer with respect to a composite pathology metric indicating successful resection. Neither trial was individually powered to detect differences in long-term recurrence or survival. This planned meta-analysis determined long-term oncological outcomes of laparoscopic versus open proctectomy for rectal adenocarcinoma.

Liquid biopsy demonstrates clinical utility as a non-invasive tool for discriminating malignant tumours from benign pulmonary nodules, as evidenced by recent research. This systematic review compared the diagnostic performance of current clinical modalities for pulmonary nodules, aiming to generate evidence-based solutions to address the underdiagnosis of malignant nodules and the overdiagnosis of benign lesions. A Bayesian bivariate random-effects model was employed to perform meta-analysis across diagnostic categories, followed by meta-regression and subgroup analyses. Results were visualised using summary receiver operating characteristic curves. Subgroup analysis revealed that liquid biopsy-derived multimodal diagnostic models achieved superior performance (sensitivity: 90.2%; specificity: 83.6%) compared to CT-based evaluation (81.5%, 67.9%) and risk prediction models (68.7%, 70.6%). These findings indicate that multimodal models integrating liquid biopsy, radiological features, and risk prediction significantly outperform single-modality approaches, thereby potentially addressing diagnostic imbalances in pulmonary nodule assessment. Key Words: Liquid biopsy, Pulmonary nodules, Multimodal diagnostic model, Comparative diagnostic test accuracy studies.

Concurrent chemoradiotherapy (cCRT) remains the standard treatment for patients diagnosed with limited-stage small-cell lung cancer (LS-SCLC); however, recurrence rates remain high and prognosis remains poor. This study collected data regarding patient-reported outcomes and adverse events (AEs) to evaluate the effects of chemoradiotherapy combined with immunotherapy in patients with LS-SCLC.

The potential of image-based deep learning (DL) in the diagnosis of oral squamous cell carcinoma has been investigated recently. This review aims to evaluate its effectiveness to provide an evidence base for future development.

KRAS mutations are common in colorectal cancer, but the impact of KRAS mutation subtypes on treatment response remains poorly understood. This research aimed to investigate whether different KRAS mutations influence pathological complete response (pCR) rates after neoadjuvant chemoradiotherapy in locally advanced rectal cancer (LARC).

Background and objectives Despite substantial research on immunotherapy, its efficacy and safety in treating advanced non-small cell lung cancer (NSCLC) without identifiable driver mutations remain unclear. The objective of this review was to examine the efficacy and safety of immunotherapy, used as monotherapy or alongside chemotherapy, vs. chemotherapy alone in patients with advanced driver mutation-negative NSCLC. Methods A comprehensive literature search of PubMed, Embase, Scopus, and CENTRAL databases was conducted until December 2024. The protocol was registered in PROSPERO (CRD42024585050). Randomised controlled trials (RCTs) evaluating the efficacy and safety of immunotherapy, either as monotherapy or in combination with chemotherapy, compared with chemotherapy alone, were included. A random-effects meta-analysis was performed. Risk of bias was assessed using the Cochrane RoB 2 tool, and the certainty of evidence was evaluated using the GRADE framework. Results Twenty-three RCTs (n=14605 participants) were included. Immunotherapy (± chemotherapy) significantly improved overall survival [22 RCTs; 14,375 participants, hazard ratio (HR): 0.77; 95% Confidence interval (CI): 0.72-0.83] and progression-free survival (22 RCTs; 14,003 participants, HR: 0.67; 95% CI: 0.58-0.76) compared with chemotherapy alone. The objective response rate was also higher with immunotherapy (23 RCTs; 12,967 participants, RR 1.38, 95% CI: 1.24-1.54). No statistically significant differences were observed between the groups in terms of overall adverse event rates. Interpretation and conclusions Immunotherapy, whether administered alone or in combination with chemotherapy, provides significant survival benefits in patients with advanced driver mutation-negative NSCLC.

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are the standard of care for advanced non-small cell lung cancer (NSCLC). However, their comparative efficacy and safety profile in early-stage versus advanced-stage disease remains systematically unexplored.

This study aimed to systematically synthesize and separately quantify the pooled safety profiles of bispecific antibodies (BsAbs) targeting PD-1/CTLA-4 or PD-1/VEGF in patients with non-small cell lung cancer (NSCLC), and to descriptively summarize class-specific safety patterns.

Current European expert consensus definitions for esophagogastric oligometastatic disease (OMD) primarily relate to adenocarcinoma. Oligometastatic esophageal squamous cell carcinoma (OMESQ) may require a distinct definition and treatment strategy. This systematic review and meta-analysis aimed to identify applied OMESQ definitions and assess the impact of local treatment on overall survival (OS). A systematic search of PubMed, Embase, CENTRAL, and ClinicalTrials.gov was conducted (February 2026). Studies or protocols were eligible if they reported an OMESQ definition or outcomes of local treatment in patients with limited metastatic ESCC. The primary outcomes were the maximum number of involved organs and metastases defined as OMD. Agreement across studies was scored as absent/poor (< 50%), fair (50%-75%), or strong (≥ 75%). A meta-analysis of OS after local treatment (+/- systemic therapy) versus systemic therapy alone was conducted through a random-effects pooled analysis of hazard ratios (HRs). Of the 3844 screened articles, 27 studies (23 retrospective, 4 prospective [one randomized]) and 7 protocols were included. Agreement was observed for defining synchronous OMESQ as disease in one organ with ≤3 metastases and metachronous OMESQ as disease in one organ with ≤2 metastases. Across 10 studies, meta-analysis showed that local treatment (+/- systemic therapy) was associated with improved OS compared with systemic therapy alone (pooled HR 0.61, 95% confidence interval: 0.52-0.72; I2 = 50.7%). Current literature and trial protocols considers OMESQ as ≤3 synchronous or ≤ 2 metachronous metastases in 1 organ. Local treatment is associated with improved OS compared with systemic therapy alone.

Endoscopic transsphenoidal surgery is indicated when non-functioning pituitary adenomas (NFPAs) cause visual compromise, but its timing is less certain in patients with preserved vision and intact pituitary function, where the risk of new post-operative pituitary dysfunction influences decision-making. This systematic review aimed to determine the rate of new post-operative endocrine deficits following transsphenoidal surgery for NFPAs and to identify predictive factors.

Spatial patterns of glioblastoma (GBM) progression inform focal salvage eligibility, but interpretation across studies is limited by heterogeneous spatial definitions, high between-study heterogeneity, and incomplete reporting of non-enhancing/FLAIR-dominant progression. We synthesized reported progression-location involvement after upfront radiotherapy/temozolomide (RT/TMZ) and salvage therapy.