Search Results (74,923)

Undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) is a rare, distinct subtype of pancreatic carcinoma, formally classified separately from undifferentiated carcinoma (UC) of the pancreas in the World Health Organization’s 2010 and 2019 revisions. Whereas classic UC is associated with a poor prognosis and low survival rates, recent studies suggest that patients with UCOGC experience significantly longer survival and more frequent diagnosis at surgically resectable stages. Molecular profiling reveals that UCOGC consistently harbors canonical mutations in KRAS, CDKN2A, TP53, and SMAD4, aligning its classification within pancreatic ductal adenocarcinoma. In addition, UCOGC demonstrates a heterogeneous molecular landscape with distinctive mutations of uncertain biological relevance. Immunologically, UCOGC is characterized by a unique tumor microenvironment, notably a deficiency in regulatory T cells (Tregs) and a relative abundance of antigen-presenting cells. Elevated expression of PD-1 within UCOGC further suggests a potential for enhanced response to PD-1-targeted immunotherapies. Collectively, these findings underscore the need for ongoing research into the molecular and immunological characteristics of UCOGC, with the aim of identifying novel biomarkers and developing targeted treatment strategies. Full article

Introduction: The endocannabinoid system is a complex regulatory network whose functioning is associated with maintaining homeostasis and regulating immune response. The aim of this study was to evaluate the relationship between endocannabinoid system activity, inflammation, and the progression of chronic kidney disease (CKD) in patients with autosomal dominant polycystic kidney disease (ADPKD). Materials and Methods: The study included 105 participants: 60 individuals with ADPKD and 45 healthy volunteers. From a single venous blood draw, concentrations of anandamide (AEA), 2-arachidonoylglycerol (2-AG), tumor necrosis factor α (TNF-α), and interleukin 6 (IL-6) were measured in EDTA plasma. Basic laboratory parameters were also assessed, including complete blood count, iron metabolism indices, electrolyte panel, and azotemia parameters. Results: There were statistically significant differences in the concentrations of both endocannabinoids, with higher mean values observed in the control group (p < 0.001). IL-6 concentrations were significantly higher in the ADPKD group compared with controls (p < 0.001). Although TNF-α concentrations were higher in the ADPKD group than in the control group, these differences did not reach statistical significance. Statistically significant correlations were also identified between inflammatory markers, endocannabinoid concentrations, and indices of renal function. Conclusions: Patients with ADPKD exhibit an altered endocannabinoid profile characterized by reduced AEA and 2-AG concentrations, which correlates with disease progression and poorer kidney function. The endocannabinoid system may modulate inflammation in ADPKD. Full article

Metabolic heterogeneity within the cell microenvironment is a key driver of cancer progression and resistance to therapy. However, current approaches lack the spatial and temporal resolution required to capture its dynamics in living systems. While recent advances in 3D cell culture models and metabolomic profiling have improved our understanding of the tumor niche, their integration with real-time optical sensing remains underdeveloped. Here, we present an integrated platform combining a 3D-printed microreactor culture chamber with Raman spectroscopy to enable non-invasive, spatially resolved metabolic monitoring of living cell cultures. Our microreactor platform generates controlled oxygen and nutrient cues while simultaneously acquiring label-free Raman spectra, revealing extracellular metabolic fingerprints linked to cell catabolism (e.g., glucose and lactate shifts) and acidification. Analysis across four cell lines uncovered temporal evolution as the dominant source of metabolic variance, while spatial heterogeneity along oxygen gradients is a secondary factor. In particular, diffusion-limited regions exhibited localized acidification and accumulation of stress biomarkers—such as the release of nucleotides—features that cannot be detected using conventional bulk assays. By providing a versatile platform for real-time mapping, this work enables the mechanistic dissection of cell adaptation to microenvironmental stress and supports the prediction of metabolic signatures underlying drug response and treatment outcomes. Full article

Magnetic resonance imaging (MRI) remains one of the most important tests for diagnosing and monitoring various diseases. In recent years, machine learning methods have been widely applied to automate MRI analysis. It supports decision-making by predicting disease and highlighting relevant regions. However, the proper use of feature extraction methods can improve the performance of the model. This paper proposes a WaveletFusion architecture that combines a two-dimensional Haar wavelet decomposition with a convolutional neural network (CNN) for classification. The approach was demonstrated on the Brain Tumor MRI dataset and further examined on the Br35H :: Brain Tumor Detection 2020 (Br35H). The model decomposes each MRI slice into approximation and directional detail subbands and fuses multi-scale wavelet features within the convolutional pipeline. To evaluate the effect of decomposition depth, WaveletFusion variants from one to eight levels were compared with a Baseline CNN model under the same training protocol. The results showed that performance improved progressively with increasing decomposition depth up to level 7, whereas the 8-level configuration consistently declined, indicating that excessive decomposition introduces information loss and over-compression in the deepest approximation pathway. The best-performing configuration, which outperformed both the Baseline CNN and the WaveletFusion variations in five independent runs, was the 7-level WaveletFusion model, achieving a test accuracy of 0.94 ± 0.01 and test macro-F1 of 0.93 ± 0.02. A similar tendency was observed on the Br35H dataset, where the 7-level model achieved a 0.97 ± 0.01 test accuracy and 0.97 ± 0.01 test macro-F1, while the 8-level configuration remained weaker on both datasets. These results show that multi-scale wavelet fusion can improve Brain Tumor MRI classification while maintaining a compact model size and a fair comparison setting, and that the decomposition depth must be selected carefully. Full article

Background: Although immune function and tumor biology follow circadian rhythms, it is unclear whether optimizing the timing of immunotherapy can enhance clinical outcomes. This study evaluated the association between time-of-day administration of immune checkpoint inhibitors (ICIs) and treatment efficacy, and explored whether blood type modifies ICI response in Chinese lung cancer patients living in an alpine region. Methods: We performed a retrospective analysis of 1247 Chinese lung cancer patients treated with first-line chemoimmunotherapy between January 2016 and March 2021 at Harbin Medical University Cancer Hospital (Cohort 1, n = 839) and the Fourth Affiliated Hospital of Harbin Medical University (Cohort 2, n = 408). Primary endpoints were overall survival (OS) and progression-free survival (PFS) estimated by the Kaplan–Meier method. Secondary endpoints included immune-related adverse events (irAEs), disease control rate (DCR), and objective response rate (ORR). Results: Patients treated before 13:00 had superior outcomes compared with those treated later, with longer mOS (34.3 vs. 22.0 months, p < 0.0001) and mPFS (16.7 vs. 12.7 months, p < 0.001). The ORR was significantly higher in the before 13:00 group of Cohort 1 (64.4% vs. 55%, p = 0.005). Additionally, blood type O was associated with a higher irAEs rate (35.6% vs. 20.1%, p < 0.01) and longer mOS (34.5 vs. 23.1 months, p < 0.0001) than non-O types. Conclusions: Time-of-day administration and blood type may influence ICI efficacy, supporting circadian-informed and patient-tailored immunotherapy. These findings support incorporating circadian timing and patient-specific factors into cancer immunotherapy strategies. Full article

Background/Objectives: Paragangliomas (PGLs) and pheochromocytomas (PCCs) are rare neuroendocrine tumors. While external beam radiation therapy (EBRT), particularly stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT), is established for head and neck PGLs (HNPGLs), its efficacy for non-head and neck PGLs (non-HNPGLs) and PCCs is less defined. We aimed to compare treatment outcomes of EBRT across these anatomic sites. Methods: We retrospectively reviewed patients with confirmed PGL or PCC treated with EBRT at a single institution between 1998 and 2025. Treated lesions were classified as non-HNPGL or HNPGL based on the radiation treatment field. Outcomes included local control (LC), distant progression-free survival (dPFS), overall survival (OS), symptomatic/biochemical response, and toxicity. We also conducted a systematic review examining EBRT for non-HNPGLs and PCCs following PRISMA guidelines. Results: We included 74 patients with 129 lesions who were treated with EBRT, with 62 HNPGL lesions and 67 non-HNPGL lesions. Of the non-HNPGL lesions, 50.7% (34/67) received SRS/SBRT with a median BED₁₀ of 50.8 Gy (range, 35.7–112.5). 5-year LC rate for non-HNPGL lesions was 95.3%, compared to 100% for HNPGL lesions, with 78% of lesions achieving symptomatic control. For non-HNPGL patients, median dPFS and OS were 37.6 and 131 months, respectively. There were no acute or late G ≥ 3 toxicities. Our systematic review (61 studies, 183 patients) showed LC and symptomatic improvement ranges of 76–100% and 76–94%, respectively. Conclusions: EBRT, including SRS and SBRT, provides excellent local control and symptomatic relief for both non-HNPGLs and HNPGLs. It represents a safe, effective treatment option for these rare tumors regardless of anatomic location. Full article

Background: Treatment options for recurrent ovarian cancer (OC) are limited, leading to poor prognosis. Targeting tumor-promoting signaling transduction pathways (STPs), such as Hedgehog (HH) and Phosphoinositide-3-kinase (PI3K) STPs, might be an option for treatment. This study evaluates the efficacy of itraconazole as a targeted treatment in HH and/or PI3K active recurrent OC. Methods: We assessed HH and PI3K STP activity in recurrent OC patients. If activity was aberrantly high in either STP, patients received itraconazole treatment, which has been shown to inhibit both HH and PI3K pathways. The primary objective is to compare progression-free survival (PFS) on itraconazole therapy (PFS2) to the PFS on therapy prior to enrolment (PFS1). A PFS2/PFS1 ≥ 1.0 was considered successful. Secondary objectives included side effects, best overall response, one-year survival, and CA125 levels, though this was not a secondary endpoint. Results: Of sixteen patients with successful STP analysis, 93% were eligible for itraconazole therapy. Nine patients started treatment, with a mean duration of 55 days. None achieved a PFS2/PFS1 ratio ≥ 1.0 (mean 0.26, range 0.1–0.7). One patient had radiologically stable disease, while the others experienced disease progression. Side effects were mostly limited to grade 1–2, including fatigue, nausea, dysgeusia, dyspnea, cough, vertigo, and edema. No grade ≥ 3 adverse effects were linked to treatment. One-year survival was 22%. CA125 levels did not correlate with the treatment outcome, but increased rapidly after ceasing treatment. Conclusions: Itraconazole monotherapy for recurrent HH and/or PI3K aberrantly active OC is an ineffective treatment. While CA125 did not correlate with treatment outcome, the rapid increase in CA125 after therapy cessation suggests tumor inhibitory effects. Full article

Antibody–drug conjugates (ADCs) are a rapidly evolving class of oncology therapeutics that enable precise delivery of potent cytotoxic agents to tumor cells while minimizing systemic toxicity. While HER2-targeted ADCs such as trastuzumab deruxtecan (T-DXd) in HER2-mutant, Datopotamab deruxtecan (Dato-Dxd) in EGFR-mutant, and telisotumumab vedotin (Teliso-V) in MET IHC 3+ expressing lung cancer have already established a clinical role in non-small cell lung cancer (NSCLC), multiple ADCs targeting alternative antigens, including additional TROP2 ADCs, HER3, MET, CEACAM5, B7-H3, Nectin-4, and others, are now in advanced clinical development. This review synthesizes the current evidence for non-HER2 ADCs in NSCLC, highlighting mechanisms of action, clinical efficacy, safety profiles, biomarker strategies, and emerging resistance mechanisms. Key safety concerns, including interstitial lung disease (ILD), ocular toxicity, and peripheral neuropathy, are emphasized alongside approaches for re-challenge following toxicity. We further discuss next-generation ADC platforms, including bispecific and conditionally activated constructs, as well as combination strategies with immunotherapy. Collectively, ADCs beyond HER2 are poised to reshape treatment paradigms in NSCLC, offering hope for patients with limited therapeutic options. This review identifies current gaps, highlights ongoing research priorities, and proposes practical considerations for integrating these therapies into clinical practice. Full article

The Papanicolaou (Pap) smear, a cornerstone of cervical cancer prevention, has emerged as a compelling, though unconventional, biospecimen for the detection of ovarian cancer (OC). This structured narrative review synthesizes the evolving evidence on the utility of cervicovaginal cytology and molecular analysis of Pap test material for OC detection. While conventional cytology provides a proof of concept, its sensitivity is low, ranging from incidental detection of OC in 0.004% of routine screens to 19.3% in patients with known OC. Specific cytologic findings, however, carry significant predictive value: atypical glandular cells (AGC) confer a two-fold increased OC risk, and psammoma bodies (PB) are strongly associated with serous malignancies. Driven by the sensitivity limitations of morphology, the field has undergone a paradigm shift towards molecular detection. Foundational studies confirmed tumor-derived DNA, including hallmark TP53 mutations, is detectable in Pap samples years before diagnosis, though sensitivity is constrained by low DNA abundance and confounded by background clonal mutations. To overcome this, strategies have expanded to target broader genomic signatures, such as somatic copy number alterations (EVA test: 75% sensitivity, 96% specificity), and multi-gene mutation panels (PapSEEK: 33–45% sensitivity). The most promising advances lie in multi-omic approaches, particularly DNA methylation biomarkers, which have demonstrated sensitivities up to 81% with high specificity. Collectively, this evidence argues against repurposing the Pap test as a standalone OC screen but supports its strategic integration into a risk-stratified clinical algorithm. We propose a “reflex-to-molecular” model where high-risk cytology (e.g., AGC, PB) automatically triggers advanced molecular testing on the same sample. This model efficiently leverages existing infrastructure to triage high-risk women for definitive diagnostics. Prospective validation of this integrated approach is the essential next step toward transforming this test into a sentinel for malignancies of the upper female reproductive tract. Full article

Background/Objectives: Colorectal cancer (CRC) remains a leading cause of cancer-related mortality and is characterized by substantial molecular heterogeneity, including epigenetic dysregulation. Histone acetylation, regulated by histone acetyltransferases and histone deacetylases (HDAC), has been implicated in CRC development and progression. The aim of the present study was to evaluate HDAC-2 expression in CRC and investigate its association with clinicopathological parameters and patient outcomes. Methods: In this retrospective study, tumor tissue samples from 77 patients with CRC and documented recurrence were examined. HDAC-2 expression was assessed by immunohistochemistry and classified as low or high using a semi-quantitative scoring system. Associations with clinicopathological parameters and survival outcomes (disease-free survival, DFS; overall survival, OS) were analyzed. Results: High HDAC-2 expression was associated with younger patient age and earlier disease recurrence, while its association with overall survival was borderline. Conclusions: HDAC-2 expression may have clinicopathological relevance in CRC, particularly in relation to recurrence-related outcomes, although larger studies are needed to confirm its prognostic significance. Full article

Bone metastasis remains a major cause of morbidity in advanced cancer, driven not only by tumor–bone crosstalk but also by profound immune remodeling within the marrow. Myeloid-derived suppressor cells (MDSCs), including polymorphonuclear (PMN-MDSC) and monocytic (M-MDSC) subsets, are increasingly recognized as central effectors of this process, integrating inflammatory signals with metabolic and stromal cues to enforce immune suppression and support skeletal colonization. In this review, we synthesize current evidence that bone metastases transform the bone marrow into an “MDSC amplifier,” where vascular and endosteal niches, CXCL12-rich stromal compartments, hypoxia, and adipocyte-derived lipids collectively promote MDSC recruitment, persistence, and functional maturation. We discuss the dominant suppressive programs deployed by MDSCs in bone (e.g., arginase-1 activity, reactive oxygen/nitrogen species, and checkpoint ligand expression), and how these mechanisms converge to impair cytotoxic T-cell and NK-cell responses while fostering regulatory T-cell dominance. Importantly, because the marrow is a hematopoietic organ, bone lesions can also generate systemic consequences through myeloid spillover, providing a mechanistic basis for reduced responsiveness to immune checkpoint blockade in bone-dominant disease. We then evaluate pharmacologic strategies to target MDSCs in the context of bone metastasis, including approaches that block trafficking (e.g., CCR2/CXCR2 axes), deplete or reprogram suppressive myeloid states (e.g., STAT3-directed strategies, differentiation therapy), and disrupt bone-resorptive feedback loops (e.g., receptor activator of NF-κB ligand (RANKL) inhibition and bisphosphonates), emphasizing rational combinations and sequencing to limit marrow toxicity. Finally, we highlight emerging single-cell and spatial profiling tools that can resolve bone-specific heterogeneity in MDSCs and guide biomarker-driven, mechanism-informed therapeutic development. Full article

Neuroinflammation plays a critical role in the pathogenesis of various neurological diseases. Therefore, alleviating neuroinflammation has become a core therapeutic strategy for these disorders. In recent years, neural stem/progenitor cell (NSPC) transplantation has shown remarkable advantages and broad prospects in the treatment of neurological diseases. This narrative review systematically summarizes research progress over the past decade on how NSPC transplantation ameliorates neurological deficits by regulating neuroinflammation-related signaling pathways, and compares the shared mechanisms and disease-specific differences. In addition, we discuss the key bottlenecks limiting the clinical translation of NSPC transplantation and propose future research directions. Accumulating preclinical evidence highlights NSPC transplantation as a compelling candidate intervention for multiple neurological disorders. Full article

Background: Stromal remodeling in the tumor microenvironment contributes to multiple myeloma (MM) progression and drug resistance, but the extracellular mediators that drive these changes remain incompletely defined. Extracellular enolase-1 (ENO1), including membrane-associated and secreted forms, has been implicated in tumor progression; however, its role in cancer-associated fibroblast (CAF)-associated stromal reprogramming in MM is unclear. Methods: The effects of extracellular ENO1 on stromal activation and tumor-supportive functions were examined in MM using MM–bone marrow stromal cell (BMSC) co-cultures, lactate production and viability assays, immunoblotting, cytokine analyses, and a subcutaneous xenograft model of bortezomib (BTZ)-resistant MM in male 6–7-week-old NOD.Cg-Prkdc^scid Il2rg^tm1Vst/Vst (NPG) mice. HuL001, an anti-ENO1 monoclonal antibody, was used to evaluate the therapeutic relevance of extracellular ENO1 targeting. Results: Extracellular ENO1 promoted fibroblast activation protein expression through plasmin-mediated transforming growth factor-β (TGF-β) activation and induced a CAF-associated stromal phenotype marked by enhanced glycolytic activity and increased secretion of tumor-promoting cytokines in MM-BMSC co-cultures. HuL001 suppressed these ENO1-driven effects. HuL001-pretreated stromal cells also exhibited reduced tumor-supportive activity in a BTZ-resistant MM xenograft model. In addition, HuL001 combined with lenalidomide overcame BTZ resistance in MM. Conclusions: Extracellular ENO1 drives CAF-associated stromal reprogramming in the MM microenvironment through the ENO1/plasminogen/plasmin/TGF-β axis. Therapeutic targeting of extracellular ENO1 with HuL001 may disrupt these tumor-supportive stromal activities and help overcome drug resistance in MM. Full article

Androgen receptor (AR) signaling has emerged as a potential molecular target in triple-negative breast cancer (TNBC), a clinically aggressive and biologically heterogeneous subtype of breast cancer with limited targeted treatment options. Androgens, the main ligands of AR, have been reported to exert antiproliferative and anti-estrogenic effects in normal mammary epithelium; however, the role of AR signaling in TNBC remains controversial and appears to depend strongly on tumor molecular context. In certain experimental settings, elevated androgen levels have been associated with reduced tumor growth, whereas AR activation has also been linked to signaling pathways involved in cell survival, migration, and invasiveness. AR signaling can occur through classical androgen-dependent mechanisms, as well as through ligand-independent activation mediated by protein kinases and intracellular pathways. Increasing interest in AR biology has led to the evaluation of several anti-androgen therapies in AR-positive TNBC, including agents such as enzalutamide, enobosarm, orteronel, bicalutamide, and seviteronel. Although clinical activity has generally been modest, these studies highlight the potential relevance of AR-targeted strategies in selected patient subgroups. This review summarizes current knowledge on androgen and AR signaling in TNBC, integrating molecular mechanisms, preclinical evidence, and clinical studies, and discusses emerging therapeutic strategies aimed at improving patient treatment outcomes. Full article

Background/Objectives: Pediatric cancers are disorders of dysregulated development driven largely by genomic and epigenetic alterations. Precisely modeling these developmental differences is essential for understanding the unique biology of childhood cancers. Patient-derived organoids (PDOs) offer a powerful in vitro platform that recapitulates tumor heterogeneity, plasticity, microenvironment (including immune cells) and disease-relevant features. Methods: Here, we describe a step-by-step protocol for the establishment of PDOs from cells derived from pediatric brain tumors and extracranial solid tumor biopsies and bone marrow aspirates, including tumor processing, organoid culture/subculture, and cryopreservation. Results: Furthermore, we present the use of PDOs for further experimental analysis such as fluorescence imaging, Western blotting, flow cytometry, and immunohistochemistry (IHC) to investigate the underlying pathophysiology of tumorigenesis. Conclusions: Expanding the application of organoids to childhood malignancies holds exceptional promise for elucidating pediatric tumor biology and advancing therapeutic strategies, representing the long-overdue convergence of technology and clinical need. Full article