Search Results (293)

Background: Hepatocellular carcinoma (HCC) with portal vein tumour thrombosis (PVTT) has a poor prognosis, and the benefits of neoadjuvant therapy are unclear. This systematic review and meta-analysis aim to evaluate the impact of neoadjuvant treatment (NAT) followed by surgery versus surgery alone on survival outcomes. Methods: A PRISMA-compliant systematic review was conducted by searching the OVID databases Embase, Medline, PubMed, and Scopus for English-language comparative studies of resectable HCC with PVTT, up to 23 January 2025. Two reviewers independently screened, extracted data, and assessed risk of bias (ROBINS-I/ROB2). Hazard ratios (HRs) for overall survival (OS) and recurrence-free survival (RFS) were pooled for meta-analysis. Results: Seven studies (2015–2024, five retrospective cohorts, one non-randomised comparative, one RCT) included 621 patients. The pooled analysis demonstrated that NAT followed by surgery was associated with a significantly improved OS (HR: 0.48, 95% CI: 0.295–0.67, p-value < 0.001, I² = 0.00) and improved RFS (HR: 0.4, 95% CI: 0.2–0.58, p-value < 0.001, I² = 0.00). Conclusions: For patients with HCC and an associated PVTT, neoadjuvant treatment before surgery significantly improves both overall and recurrence-free survival. These findings support a multimodal approach. Current evidence is largely non-randomised and HBV-endemic, warranting prospective validation in aetiologically diverse cohorts, including Western ones. Full article

Background: Maximal safe resection remains a central determinant of outcomes in glioma surgery, yet intraoperative discrimination between tumor and normal brain tissue is limited by the speed and subjectivity of frozen-section analysis. Label-free techniques such as Raman spectroscopy, mass spectrometry (MS), and optical coherence tomography (OCT) offer real-time biochemical and structural characterization that may enhance surgical precision. Their comparative diagnostic accuracy across clinically relevant endpoints has not been comprehensively evaluated. Methods: Following PRISMA 2020 guidelines, a systematic review and quantitative meta-analysis were conducted using PubMed, Embase, Scopus, and Web of Science through December 2024. Original human studies evaluating Raman, MS, or OCT for intraoperative glioma margin assessment were included. Pooled sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated using a random-effects model. Subgroup analyses addressed tumor versus normal brain tissue, infiltrated versus non-infiltrated margins, and IDH-mutant versus wild-type gliomas. Results: Twenty-four studies comprising 1768 patients met the inclusion criteria. Across all modalities, pooled sensitivity and specificity were 0.89 (95% CI 0.86–0.92) and 0.88 (95% CI 0.84–0.91), with a pooled DOR of 65.7 (95% CI 42.3–101.8; logDOR 4.18), indicating high overall discriminative performance. Tumor versus normal differentiation achieved DOR 72.4 (logDOR 4.28; I² = 26%), infiltrated margin detection DOR 41.8 (logDOR 3.73; I² = 41%), and IDH classification DOR 52.3 (logDOR 3.96; I² = 29%). No publication bias was observed. Raman and MS outperformed OCT. Conclusions: Raman spectroscopy, mass spectrometry, and OCT demonstrate strong diagnostic accuracy for real-time intraoperative glioma evaluation, enabling reliable tissue differentiation and molecular profiling that may enhance resection extent and support precision, molecularly informed neurosurgery. Full article

Background/Objectives: Radiomics, the high-throughput extraction of quantitative features from medical imaging, offers a promising method for identifying laryngeal cancer imaging biomarkers. We aim to systematically review the literature on radiomics in laryngeal squamous cell carcinoma, assessing applications in tumour staging, prognosis, recurrence prediction, and treatment response evaluation. PROSPERO ID: CRD420251117983. Methods: MEDLINE and EMBASE databases were searched in May 2025. Inclusion criteria: studies published between 1 January 2010 and 31 January 2024, extracted radiomic features from CT, PET/CT, or MRI, and analysed outcomes related to diagnosis, staging, survival, recurrence, or treatment response in laryngeal cancer. Exclusion criteria: case reports, abstracts, editorials, reviews, or conference proceedings, exclusive focus on preclinical or animal models, lack of a clear radiomics methodology, or did not include imaging-based feature extraction. Results were synthesised narratively by modelling objective, alongside formal assessment of methodological quality using the Radiomics Quality Score (RQS). Results: Twenty studies met the inclusion criteria, with most using CT-based radiomics. Seven incorporated PET/CT. Radiomic models demonstrated moderate-to-high accuracy across tasks including T-staging, thyroid cartilage invasion, survival prediction, and local failure. Key predictive features included first-order entropy, skewness, and texture metrics such as size zone non-uniformity and GLCM correlation. Methodological variability, limited external validation, and small samples were frequent limitations. Conclusions: Radiomics holds strong promise as a non-invasive biomarker for laryngeal cancer. However, methodological heterogeneity identified through formal quality assessment indicates that improved standardisation, reproducibility, and multicentre validation are required before widespread clinical implementation. Full article

Background/Objectives: Hepatocellular carcinoma (HCC) immunotherapy provides limited clinical benefits, partly due to the lack of reliable efficacy biomarkers. Radiomics, which non-invasively analyzes tumor heterogeneity, shows promising potential for predicting treatment outcomes. Methods: The present study systematically evaluated the predictive performance and methodological quality of radiomics models for assessing immunotherapy efficacy in patients with HCC. A literature search was conducted in PubMed, Web of Science, Embase, and the Cochrane Library for studies published up to 21 June 2025, which developed CT- or MRI-based radiomics models to predict immunotherapy efficacy in HCC. Study quality was assessed using the radiomics quality score (RQS) and the METhodological RadiomICs Score (METRICS). Results: A total of 11 studies were included and categorized by immunotherapy regimen: ICIs alone (1/11), ICIs combined with targeted therapy (6/11), and ICIs combined with targeted therapy plus locoregional therapy (4/11). The models primarily predicted treatment response (7/11), overall survival (OS) (4/11), or progression-free survival (PFS) (4/11). In the ICI monotherapy cohort, AUC values for predicting treatment response ranged from 0.705 to 0.772. In the ICI plus targeted therapy cohorts, AUC or concordance index (C-index) values for predicting the above efficacy endpoints were 0.792–0.956, 0.63–0.77, and 0.54–0.837, respectively. In the combination therapy cohorts incorporating locoregional treatment, predictive models showed AUC or C-index values of 0.721–0.92, 0.817–0.838, and 0.59. Quality assessment revealed a median RQS of 15 (range: 11–19) and a median METRICS of 72.5% (range: 56.0–79.5%) across all studies. Conclusions: CT/MRI-based radiomics uses routine imaging to non-invasively quantify whole-tumor phenotype and heterogeneity, enabling repeatable, longitudinal assessment in hepatocellular carcinoma. Evidence suggests that it can help to identify patients likely to benefit from immunotherapy before treatment. However, clinical implementation requires standardized imaging and analysis protocols, external validation, and transparent reporting. Full article

Background/Objective: Gliomas are the most common primary brain tumors in adults, with recurrence rates varying by tumor grade and initial treatment. Reoperation is a key strategy for managing recurrence; however, its impact on functional status and health-related quality of life (HRQoL) remains insufficiently defined. While HRQoL and neurocognitive outcomes have been described after primary treatment, far less is known following reoperation. This systematic review synthesizes available evidence on postoperative functional outcomes and summarizes HRQoL reporting in the reoperation literature. Methods: A systematic search of PubMed and Google Scholar retrieved 1336 articles. After removing duplicates (n = 76) and screening full texts (n = 42), 15 studies (total n = 1934; reoperation group n = 947) met the inclusion criteria. Studies were eligible if they employed validated functional or HRQoL instruments (e.g., Karnofsky Performance Status [KPS], FACT-G, SF-36, and EQ-5D-L). Due to limited and heterogeneous HRQoL reporting, only KPS could be aggregated for meta-analysis, and HRQoL measures were descriptively summarized. Results: Fixed-effect meta-analysis demonstrated a modest decline in postoperative KPS compared with preoperative scores (−3.28, 95% CI: −3.69 to −2.86; p < 0.001), though heterogeneity was high (I² ≈ 97%). The random-effects model, accounting for interstudy variability, showed no significant overall change (+0.16 KPS, 95% CI: −4.04 to +4.35; p = 0.94; I² ≈ 48%). The 95% prediction interval (−14.1 to +14.4) indicated that individual centers may observe either improvement or decline. Sensitivity analyses identified a small outlier study as a major contributor to heterogeneity; its exclusion did not materially alter the results. Conclusions: Across heterogeneous observational cohorts, reoperation for recurrent glioma was not associated with a consistent decline in functional status as measured by KPS, although substantial variability and uncertainty in outcomes remain. HRQoL reporting remains sparse and inconsistent, underscoring the need for prospective, multicenter studies employing standardized HRQoL instruments to better define quality-of-life trajectories after reoperation. Full article

Background: Multiple meta-analyses have compared liver resection (LR) with liver transplantation (LT) for hepatocellular carcinoma (HCC), but overlapping primary studies and heterogeneous outcome definitions have complicated interpretation. Methods: A PRISMA/PRIOR-compliant umbrella review (PROSPERO CRD420251069248) was conducted. PubMed, Embase, and CENTRAL were searched for meta-analyses published between 1 January 2000 and 30 September 2025. Quantitative meta-analyses comparing LT and LR were included, while one systematic review of meta-analyses was synthesised narratively. Effect directions were standardised; hazard ratio (HR)-based summaries (LR:LT; values > 1 favour LT) were pooled using random-effects models, whereas odds ratio (OR)-based summaries were described qualitatively because of heterogeneity in endpoint definitions. Results: Four quantitative meta-analyses and one systematic review of meta-analyses met the inclusion criteria. Pooled HRs confirmed LT superiority: overall survival (OS) HR 1.35 (95% CI 1.17–1.55) and disease-free survival (DFS) HR 2.58 (95% CI 2.25–2.96). OR-based summaries from recent meta-analyses were directionally consistent but were not pooled. Conclusions: This umbrella synthesis demonstrates that LT provides superior long-term OS and DFS compared with LR for HCC, with consistent robustness across both Milan and extended selection criteria. Methodological safeguards against study overlap and subgroup insights—including intention-to-treat analyses, viral etiology (hepatitis B virus/hepatitis C virus), era, and geographic region—reinforce LT as the preferred strategy for eligible patients, while LR remains a critical option where graft availability is limited. Full article

Background/Objectives: Myeloid sarcoma (MS) is a rare extramedullary manifestation of myeloid blasts, with limited systematic data, particularly regarding molecular (NGS) concordance between MS tissue and bone marrow. We hypothesized that clonal heterogeneity may exist between these sites due to their distinct biological environments. Methods: We conducted a systematic review and meta-analysis of 85 studies encompassing 7241 MS patients, to evaluate clinical characteristics, mutational profiles, treatment patterns, and outcomes. Mutational concordance or discordance between MS and bone marrow was assessed in a subset of 112 patients. Results: Male predominance (59%) and skin/soft tissue localization (31%) were most common. NPM1 (25%) and FLT3 (20%) were the most frequently reported mutations. Among 112 patients with paired sequencing, 56% showed discordance in mutational profiles. NPM1 was significantly enriched in MS sites compared to bone marrow (35% vs. 21%, p = 0.02) and was associated with skin involvement. Discordance was more frequent in isolated and secondary MS. Venetoclax with hypomethylating agents achieved a 44% response rate, mainly in secondary MS. Post-transplant isolated extramedullary relapse occurred in 46% of relapsed patients and was linked to high rates of graft-versus-host disease. The pooled median overall survival was 12.8 months. Conclusions: MS demonstrates significant molecular heterogeneity. Routine site-specific NGS profiling may guide targeted therapy in this rare disease. Full article

Background: Poly (ADP-ribose) polymerase inhibitors (PARPi) are the standard of care for first-line maintenance in advanced ovarian cancer, but their benefit varies by BRCA and homologous recombination deficiency (HRD) status, and no head-to-head comparisons are available. Methods: We conducted an indirect comparison of PARPi regimens using reconstructed individual patient data (IPD) from Kaplan–Meier curves of phase III randomized trials (SOLO1, PRIMA, PAOLA1, ATHENA, FLAMES). Progression-free survival (PFS) was the primary endpoint; overall survival (OS) was exploratory. Subgroups were defined as BRCA−mutated (BRCA+), BRCA−/HRD+, and BRCA−/HRD−. Safety outcomes were assessed through a network meta-analysis of adverse drug reactions (ADRs). Results: In BRCA+ patients, olaparib + bevacizumab achieved the largest PFS improvement (HR = 0.27; 95%CI: 0.19–0.39), followed by olaparib monotherapy, while niraparib performed significantly worse. In BRCA−/HRD+, olaparib + bevacizumab was superior to niraparib and rucaparib, with restricted mean survival time (RMST) gains of 3–4 months. In BRCA−/HRD−, PARPi produced only a modest benefit, with no advantage over bevacizumab monotherapy. Exploratory OS analysis confirmed long-term survival with olaparib in BRCA+ but not in the other subgroups. Safety analysis indicated olaparib had the most favorable hematological profile, while niraparib was associated with the highest rates of severe anemia, thrombocytopenia, and neutropenia, despite showing lower gastrointestinal toxicity and fatigue incidence. Conclusions: PARPi efficacy depends strongly on BRCA and HRD status. Olaparib-based regimens provide the greatest clinical benefit with acceptable safety in BRCA+ and HRD+ disease, whereas PARPi appear to be of limited value in HRD-negative ovarian cancer. Full article

Background: As survival rates among breast cancer (BC) patients continue to rise, Emotional Functioning (EF)—has become increasingly clinically relevant; however, researchers have yet to fully characterize its long-term, dynamic trajectories following surgery. This systematic review and meta-analysis aimed to (1) characterize the longitudinal trajectories of EF after BC surgery and (2) examine the moderating effects of surgical modality and age. Methods: We conducted this systematic review and meta-analysis in accordance with PRISMA 2020 guidelines. We synthesized data from studies published between 2000 and 2024 that assessed EF using the EORTC QLQ-C30 at multiple post-surgical time points. Using multilevel random-effects meta-analytic models, we examined EF trajectories across 116 effect sizes derived from 40 studies, and evaluated time, surgical modality (breast-conserving surgery (BCS), mastectomy (MA), mastectomy with immediate reconstruction (Mx + IR) and age group as moderators. Results: The overall pooled estimate for EF was 73.44 (95% CI: 70.29–76.58, p < 0.001). Time since surgery significantly influenced EF: scores were lowest during the initial 6 months (66.82, 95% CI: 59.75–73.89), peaked at 7–15 months (77.86, 95% CI: 74.51–81.22) and 31–54 months (77.52, 95% CI: 70.44–84.59), and showed lower values at 16–30 months (72.58, 95% CI: 61.45–83.72) and 55–72 months (69.81, 95% CI: 64.08–75.54). Surgical modality significantly shaped these trajectories (p = 0.013). The overall pooled estimate for EF was 73.44 (95% CI: 70.29–76.58, p < 0.001). Time since surgery significantly influenced EF: scores were lowest during the initial 6 months (66.82, 95% CI: 59.75–73.89), peaked at 7–15 months (77.86, 95% CI: 74.51–81.22) and 31–54 months (77.52, 95% CI: 70.44–84.59), and showed lower values at 16–30 months (72.58, 95% CI: 61.45–83.72) and 55–72 months (69.81, 95% CI: 64.08–75.54). Surgical modality significantly shaped these trajectories (p = 0.013). The BCS group showed a significant inverted-U trajectory in EF scores, with a positive linear slope (β = 1.22, SE = 0.50, p = 0.046) and a small negative quadratic term (β = −0.02, SE = 0.01, p = 0.046), indicating initial improvement followed by decline. A similar pattern was observed for MA, where the linear term (β = 1.19, SE = 0.51, p = 0.054) and quadratic curvature (β = −0.02, SE = 0.01, p = 0.054) suggested an early rise with subsequent decline. In contrast, Mx + IR displayed a high intercept (β = 71.46, SE = 4.46, p < 0.001) but no significant trajectory over time (p = 0.582), indicating stability. The 45–60 year group demonstrated a significant inverted-U trajectory in EF scores, with a positive linear coefficient (β = 0.87, SE = 0.38, p = 0.067) and a negative quadratic coefficient (β = −0.01, SE = 0.01, p = 0.067), suggesting an early rise in emotional functioning followed by a subsequent decline. Participants <45 years also showed a significant inverted-U pattern, starting from a moderately high baseline (β = 67.56, SE = 4.26, p < 0.001) with a positive linear slope (β = 0.82, SE = 0.34, p = 0.051) and a negative quadratic curvature (β = −0.01, SE = 0.01, p = 0.051). In contrast, the >60 year group reported the highest baseline scores (β = 75.60, SE = 5.18, p < 0.001) with no significant trajectory, indicating overall stability. These findings confirm that EF follows a significant inverted-U trajectory (p < 0.001) and is influenced by time, surgical modality, and age. Full article

Background: Smoking cessation has been associated with reduced lung cancer mortality. This study aimed to synthesize current evidence on the impact of quitting smoking at or around the time of diagnosis of lung cancer on survival, considering factors such as histological subtype, cancer stage, and cessation intervention. Methods: A systematic search was conducted in the Ovid-MEDLINE, Ovid-EMBASE, Cochrane Central Register of Controlled Trials, and KoreaMed databases up to September 2024. Randomized controlled trials and cohort studies enrolling adult current smokers with pathologically confirmed lung cancer and comparing smoking cessation at or around diagnosis with continued smoking, were included. The primary outcome was overall survival (minimum follow-up of 3 months). The included studies were critically appraised using the revised Risk of Bias for Nonrandomized Studies (RoBANS 2) tool and meta-analyzed. Results: A total of 25 cohort studies comprising 17,584 patients were reviewed. Quitting smoking at diagnosis was associated with a 26% reduction in mortality risk (adjusted HR [aHR] 0.74, 95% CI 0.68–0.81). In subgroup analyses, quitting smoking was associated with improved survival in both non-small cell lung cancer (aHR 0.73, 95% CI 0.64–0.83) and small cell lung cancer (aHR 0.61, 95% CI 0.51–0.72), with a more pronounced benefit among patients with early-stage disease (stage I–III or limited stage; aHR 0.64, 95% CI 0.56–0.74). Furthermore, active smoking cessation interventions were significantly associated with improved survival (aHR 0.55, 95% CI 0.35–0.88). Conclusions: The findings underscore the importance of encouraging smoking cessation at the time of lung cancer diagnosis as an integral part of patient management to improve survival outcomes. Full article

Bladder cancer is a prevalent malignancy with high morbidity and mortality, particularly when diagnosed at an advanced stage. Early detection is critical, as it significantly improves prognosis and the patient’s outcomes. Bladder cancer also has a high recurrence rate, necessitating long-term surveillance. While cystoscopy remains the gold standard for diagnosis and monitoring, it is invasive and costly. Urine cytology, though widely used, has high specificity for detecting high-grade urothelial carcinoma but suffers from low sensitivity and limited effectiveness as a stand-alone diagnostic tool. Urinary biomarkers offer a promising, noninvasive alternative for early detection and disease surveillance. This review examines FDA-approved urinary biomarker tests, including NMP 22, UroVysion, and BTA, highlighting their clinical utility and limitations. Additionally, we explore emerging biomarkers such as DNA methylation assays, genomic alterations, and proteomic signatures as well as advanced technologies like next-generation sequencing and machine learning-based platforms. These innovations have the potential to enhance diagnostic accuracy, risk stratification, and recurrent monitoring, ultimately improving early detection and long-term disease management. By evaluating both established and emerging urinary biomarkers, this review aims to provide clinicians and researchers with insights into evolving tools for bladder cancer diagnosis and surveillance. Full article

Background: While prostate-specific membrane antigen (PSMA)-targeted imaging has revolutionized metastatic detection, unspecific bone uptake (UBU)—particularly in the ribs—is a common but diagnostically challenging finding in prostate cancer (PCa) patients. This review aims to synthesize current evidence on PSMA-avid rib lesions in PCa and to propose a structured approach for differentiating true metastases from benign mimics. Methods: A comprehensive literature search across PubMed, EMBASE, Scopus, and Web of Science identified relevant studies on PSMA imaging interpretation, tracer-specific patterns, rib lesion morphology, and clinical correlates. Data on uptake intensity, CT features, lesion number, location, tracer type, patient-specific risk factors, and follow-up behavior were extracted and analyzed. Results: Most solitary rib lesions are benign, particularly in low-risk patients or when located in the anterior/lateral arcs. Metastatic lesions are more likely to present as multiple foci, show cortical destruction on CT, exhibit high uptake intensity, and occur in patients with elevated PSA, high Gleason score, or ongoing androgen deprivation. ¹⁸F-PSMA-1007 is especially prone to UBU in the ribs compared to ⁶⁸Ga-PSMA-11. Based on these variables, we propose a clinical decision tree to guide interpretation of PSMA-avid rib lesions. Conclusions: Accurate interpretation of rib lesions on PSMA PET/CT requires a multimodal, context-sensitive approach. Our diagnostic decision tree guides precise differentiation of benign versus metastatic rib lesions, enhancing staging accuracy and clinical decision-making. Biomarker-guided therapies offer potential for personalized treatment, though rib-specific validation remains a critical need. Full article

Background: Multifocal (MF) and multicentric (MC) breast cancers, defined by the presence of multiple synchronous tumor foci within the same breast, present important diagnostic, therapeutic, and prognostic challenges. Historically considered a contraindication for breast-conserving therapy (BCT), advances in imaging, surgical techniques, and adjuvant therapy have reshaped management strategies. Methods: A narrative literature review was conducted through PubMed, Web of Science, and Scopus, prioritizing ISI-indexed articles published within the last 10–15 years. More than 55 relevant studies, including systematic reviews, meta-analyses, and large cohorts, were analyzed to evaluate epidemiology, pathological features, imaging modalities, treatment outcomes, and prognosis of MF/MC breast cancers. Results: The reported incidence of MF/MC breast cancers ranges from 10% to 24%, increasing when MRI or whole-organ pathology is applied. MRI can detect otherwise occult additional foci in up to 30% of patients, improving staging accuracy but raising concerns of overdiagnosis. MF/MC presentation is strongly associated with lobular histology, younger age at diagnosis, and higher rates of axillary involvement—nodal positivity is observed in up to 45% of MF/MC cases versus 28% in unifocal tumors. Pathological analyses demonstrate frequent clonal origin of MF lesions, whereas MC lesions may represent independent primaries, occasionally with receptor heterogeneity that alters systemic therapy selection. From a prognostic perspective, older series suggested shorter breast cancer-specific survival (e.g., median 154 vs. 204 months for MF/MC vs. unifocal disease), and higher local recurrence with BCT. However, contemporary analyses, including a 2022 meta-analysis of 15,703 patients, demonstrated no significant difference in overall or disease-free survival once adjusted for tumor size and nodal status. Local recurrence remains slightly higher with BCT in MF/MC (5.6% vs. 4.2%), but outcomes are equivalent to mastectomy when radiotherapy is appropriately delivered. Five-year survival in early-stage MF/MC exceeds 90% with guideline-concordant multimodal therapy. Conclusions: MF/MC breast cancers represent a biologically heterogeneous entity. Optimal outcomes rely on precise imaging, complete excision, tailored systemic therapy, and multidisciplinary management, with increasing acceptance of breast conservation in selected patients. Full article

Background: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype characterized by poor prognosis and limited therapeutic options. Chemotherapy regimens are associated with significant adverse effects negatively impacting patients’ quality of life (QoL). This systematic review aims to evaluate and compare QoL outcomes of patients with TNBC receiving novel therapies—including immunotherapy, antibody–drug conjugates, and targeted therapies—versus standard chemotherapy. Methods: We systematically reviewed randomized controlled trials (RCTs) published within the past 15 years, identified through comprehensive searches in PubMed, Google Scholar, Research4Life, and Elicit. Included studies involved FDA-approved novel therapies (pembrolizumab, atezolizumab, sacituzumab-govitecan, olaparib, and talazoparib) administered to TNBC patients, and assessed QoL using validated tools such as EORTC QLQ-C30. Observational studies, case reports, and non-standardized assessments were excluded. Results: Eight RCTs comprising 3929 patients met the inclusion criteria. Sacituzumab govitecan and PARP inhibitors (olaparib and talazoparib) significantly improved QoL, notably delaying deterioration across physical, emotional, and functional domains compared to standard chemotherapy. Conversely, immunotherapies (pembrolizumab, atezolizumab) showed non-significant trends toward QoL improvement, with effects varying by patient subgroup and disease stage. Interpretation was limited by study design differences, inconsistent compliance, and incomplete data reporting. Conclusions: Immunotherapy showed a neutral effect on quality of life, providing neither significant improvement nor additional decline. Olaparib was associated with a delayed deterioration in quality of life, showing a more favorable tolerability profile compared to chemotherapy. Talazoparib leads to clinically meaningful enhancements in quality of life, while sacituzumab govitecan effectively improves patient-reported outcomes relative to standard chemotherapy. Full article