Journal of Clinical Medicine

Background/Objectives: This scoping review mapped how hyaluronic acid (HA) molecular weight has been defined and investigated in direct clinical comparisons for temporomandibular disorders (TMDs), including formulations, populations, procedures, outcomes, and methodological limitations. Methods: Final searches and selection were completed on 9 September 2026 using PubMed, BASE, CENTRAL, and Europe PMC. Prospective human studies comparing different intra-articular HA preparations under the same procedural protocol were eligible, including matched comparisons within multi-arm studies. Two reviewers independently screened and charted the evidence. Findings were synthesized descriptively without meta-analysis or formal risk-of-bias assessment. The protocol was registered in OSF (osf.io/sc8wv). Results: Five reports were included: three quasi-randomized trials and two prospective studies with sequential or unreported allocation between HA formulations. Four reported efficacy comparisons; one contributed safety data only after swelling and marked pain in 2 of 5 recipients prompted discontinuation of a high-molecular-weight arm. Molecular-weight categories overlapped across reports, formulation characteristics were incompletely reported, and protocols varied from one to five injections with differing use of arthrocentesis. Comparative follow-up ranged from 3 to 12 months. No eligible efficacy comparison detected a statistically significant difference, but small samples, allocation limitations, and incomplete subgroup reporting restricted interpretation. Conclusions: The evidence map identifies inconsistent formulation classification, procedural heterogeneity, and deficiencies in outcome and safety reporting as barriers to interpretation. It does not establish equivalence, superiority, or comparative safety of molecular-weight categories and provides specific priorities for future studies.

Background/Objectives: Diffuse large B-cell lymphoma (DLBCL) is an aggressive hematologic malignancy with a defined, first-line (1L) standard of care (SOC). Several novel agents have been approved for the treatment of relapsed/refractory (R/R) disease in recent years, leading to a heterogeneous treatment landscape in later lines of therapy (LOTs). Our study aimed to characterize real-world treatment patterns for patients who received third-line or later (3L+) therapy using a multiple index date qualification methodology to enable a comparison to clinical trials. Methods: This observational, retrospective study identified eligible patients in the COTA (now Verana Health) electronic health record-based, DLBCL dataset. Patients were assessed for eligibility at the initiation of each 3L+ LOT. The results were summarized overall and by qualification methodology, and the Kaplan–Meier method was used to evaluate real-world overall survival (rwOS). Results: Among 476 unique patients, 716 index-LOTs were identified, and 3L+ index therapies were variable. The Eastern Cooperative Oncology Group (ECOG) score was 0–2 for 57% of qualifying-LOTs and missing/unknown (M/U) for 43%. The median rwOS among all-qualifying, first-qualifying, and last-qualifying index-LOTs was 8.0 (95% CI: 6.9, 10.6), 11.4 (95% CI: 9.7, 13.6), and 6.3 months (95% CI: 5.3, 8.0), respectively. Patients with M/U ECOG did not experience worse outcomes compared to those with ECOG 0–2. Conclusions: The outcomes in our study are similar to those from comparator arms of contemporary clinical trials, demonstrating a continued unmet need for effective, SOC therapy for patients with 3L+ DLBCL. Additionally, the variable outcomes based on qualifying index-LOTs underscores the criticality of appropriate patient identification and comparison for clinical trials.

Background/Objectives: Immune checkpoint inhibitors have become a standard treatment option for advanced/metastatic non-small cell lung cancer (NSCLC); however, considerable heterogeneity exists among patients regarding treatment response and survival. This study aimed to determine whether the pretreatment modified Glasgow Prognostic Score (mGPS), a marker of systemic inflammation and nutritional status, is prognostically associated with progression-free survival (PFS) and overall survival (OS) in patients with advanced/metastatic NSCLC treated with nivolumab at a single tertiary oncology center. Methods: This retrospective, single-center cohort study included 130 adult patients with histologically confirmed advanced/metastatic NSCLC who received nivolumab at the Department of Medical Oncology, Çukurova University Faculty of Medicine. The pretreatment mGPS (0, 1, or 2), derived from baseline serum C-reactive protein (CRP) and albumin levels, was analyzed in relation to PFS and OS using the Kaplan–Meier method, log-rank test, and Cox proportional hazards regression. The prognostic value of mGPS was tested in multivariable Cox models adjusted for age, sex, Eastern Cooperative Oncology Group (ECOG) performance status, histology, brain metastasis, liver metastasis, and neutrophil-to-lymphocyte ratio (NLR); the proportional hazards assumption was formally tested, and the incremental discriminative contribution of mGPS was assessed using bootstrap resampling. Results: Among 130 patients, 83.8% received nivolumab as second-line therapy. Pretreatment mGPS was 0, 1, and 2 in 40 (30.8%), 55 (42.3%), and 35 (26.9%) patients, respectively. Median OS was not reached, 9.7 months, and 3.0 months across mGPS 0, 1, and 2, respectively; corresponding median PFS values were 10.2, 4.8, and 3.0 months (log-rank p < 0.001 for both endpoints). After adjustment for age, sex, ECOG performance status, histology, brain metastasis, liver metastasis, and NLR, each one-point increase in mGPS remained associated with worse OS (adjusted HR 2.38; 95% CI 1.64–3.46; p < 0.001) and PFS (adjusted HR 1.81; 95% CI 1.32–2.48; p < 0.001), independent of the covariates included in the model. The proportional hazards assumption held for mGPS in both models. Addition of mGPS to the clinical-variables-only model was associated with higher model discrimination (Harrell’s C-index: 0.676 to 0.737 for OS and 0.620 to 0.666 for PFS), a difference confirmed as statistically significant by bootstrap resampling (2000 iterations; 95% CI for the difference excluding zero, p < 0.001 for both endpoints). Conclusions: Pretreatment mGPS is a simple, readily available marker that shows a robust prognostic—rather than treatment-predictive—association with both OS and PFS in patients with advanced/metastatic NSCLC treated predominantly as second-line nivolumab monotherapy. Its addition to established clinical variables was associated with a statistically significant, though modest, improvement in prognostic discrimination. These findings require prospective, multicenter validation, including in first-line immunotherapy settings, before mGPS can be recommended for routine clinical risk stratification.