Current Oncology

Meningiomas are the most common primary intracranial tumors of the central nervous system. They exhibit highly heterogeneous biological behavior that current histological grading cannot reliably predict. Currently, there are no standardized systemic treatment regimens for recurrent or refractory meningiomas; therefore, molecular subtyping is crucial for assessing prognosis and guiding treatment decisions. Key alterations, including NF2, TERT promoter, CDKN2A/B, AKT1, and SMO, contribute to the proliferation, invasion, and recurrence of meningiomas. This review summarizes the advances in molecular pathological alterations and clinical studies on systemic therapy for meningiomas. Anti-angiogenic agents, immune checkpoint inhibitors, and inhibitors targeting multiple signaling pathways represent promising directions. Anti-angiogenic therapy has demonstrated disease control, whereas PD-1 inhibitors have shown limited benefit in unstratified populations but may be of value in specific molecular subgroups. Molecularly stratified umbrella and basket trials are advancing precision treatment, and peptide receptor radionuclide therapy provides benefit for patients with specific molecular alterations. Some early trials of targeted therapies and immunotherapies have shown positive signals, but the overall level of evidence remains limited. Future studies should employ more rigorous trial designs and encourage patient participation to clarify the clinical value of each strategy and drive the shift from empirical to molecularly guided treatment.

Background: Febrile neutropenia is a critical emergency construct, but infection and sepsis can occur without fever. Objective: To examine the clinical evidence of nonfebrile neutropenic infection, potential mechanisms of an attenuated febrile response, physiological body-temperature variation, and limitations of clinical thermometry. Methods: A narrative review was supplemented by a targeted, transparently documented three-domain evidence map of published systematic syntheses, thermometry-accuracy studies, and oncology-neutropenia cohorts, updated on 1 November 2026. No new exhaustive systematic review or meta-analysis was performed. Results: A synthesis of 36 studies (7636 healthy adults) reported site-specific oral and rectal temperature distributions of 35.73–37.41 °C and 36.32–37.76 °C (mean ± 2 SD), which do not establish a universal core-temperature interval. Peripheral and oral thermometers demonstrated pooled fever-detection sensitivities of 0.64 and 0.53, respectively, in non-neutropenia-specific populations. Nonfebrile infection proportions included 9/69 (13.0%) severe ICU infection episodes and 70/186 (37.6%) bloodstream infections without a recorded temperature ≥ 38.0 °C in a separate oncology-neutropenia cohort; an additional post-transplant corticosteroid cohort is discussed separately. These denominators do not permit a meaningful pooled incidence of afebrile neutropenic sepsis. Conclusions: Fever-based clinical pathways remain essential, but suspected infection, physiological deterioration, and organ dysfunction warrant evaluation irrespective of temperature.

Background: Hope is an important psychological resource in patients with hematologic malignancies, but how family functioning is associated with hope remains unclear. Methods: We retrospectively analyzed routine psychometric data from 226 hospitalized adults with hematologic malignancies assessed between June 2022 and December 2025 (39 patients [17.3%] had ≤10% missing items, imputed using individual scale means). Measures included the Herth Hope Index, Meaning in Life Questionnaire, Medical Coping Modes Questionnaire, and Family Adaptability and Cohesion Evaluation Scale. Correlation, multivariable linear regression, exploratory logistic regression, and an exploratory bootstrap decomposition of parallel indirect associations were performed. Results: Mean hope was slightly below an oncology reference value (difference −1.22 points; p < 0.001), a difference in uncertain clinical relevance; family cohesion and facing coping scores were below normative values, whereas resignation and avoidance were higher (all p < 0.001). Hope correlated positively with presence of meaning (r = 0.595), facing (r = 0.510), and family cohesion (r = 0.444), and negatively with resignation (r = −0.611). In multivariable linear regression, presence of meaning, search for meaning, facing, resignation, family cohesion, family adaptability, education, and ECOG performance status were associated with hope (R² = 0.653). Family cohesion showed a total association with hope of 0.209; the combined indirect association through facing, resignation, and presence of meaning was 0.111 (53.04% of the total association in the statistical decomposition). Conclusions: Family cohesion, coping style, and meaning in life are closely associated with hope in hematologic malignancies. Because of the cross-sectional design, these findings cannot establish causal direction; they support routine assessment of family functioning and the testing of family-based interventions in future prospective studies.