Patients with recurrent/metastatic nasopharyngeal carcinoma (RM-NPC) do not yet have a strong recommended regimen after failure of first-line systemic therapy. This study retrospectively analyzed the efficacy of immunotherapy regimens in RM-NPC that failed at least first-line therapy. From February 2014 to August 2023, a total of 794 patients with RM-NPC were included in this study, of which 75 patients received anti-programmed cell death protein-1 (PD-1) only (P), 130 patients received anti-PD-1 plus antiangiogenic therapy (AP), 210 patients received anti-PD-1 plus single-agent chemotherapy (C1P), 276 patients received anti-PD-1 plus two-agent chemotherapy (C2P), and 103 patients received anti-PD-1 plus antiangiogenic plus chemotherapy (CAP). Progression-free survival (PFS), overall survival (OS), and adverse events were analyzed. In the inverse probability of treatment weighting (IPTW) cohort, median follow-up time was 28.7 months, median PFS in the P, AP, C1P, C2P, and CAP were 3.6, 8.5, 7.6, 12.7, and 16.3 months, respectively. PFS was significantly better in the CAP, C2P, C1P, and AP than P (p values of <.001, <.001, .026, and .002). Median OS in the P, AP, C1P, C2P, and CAP were 35.8, 46.6, 50.9, 50.6, and 47.2 months, respectively. Grade 3-4 treatment-related adverse events (TRAEs) occurred in 288 patients, with rates significantly higher in the C1P than AP (34.3% vs. 16.9%) and higher in the C2P than CAP (54.0% vs. 42.7%). These results showed that, in RM-NPC patients who failed at least first-line therapy, anti-PD-1 combination therapy was associated with improved PFS compared with anti-PD-1 monotherapy.

For fever in neutropenia (FN) during chemotherapy timely start of antibiotics is recommended. We analyzed time to antibiotics (TTA) and sub-timespans between detection of fever and start of antibiotics in children undergoing chemotherapy for cancer with FN. Specifically, we aimed to assess where delays occur, which variables influence TTA, and whether the order of certain process steps affects TTA. We analyzed 349 FN episodes reported prospectively in 155 Swiss patients from April 2016 to August 2018. In outpatients, the median TTA from fever to the start of antibiotics was 165 minutes, and the median duration from fever to hospital arrival was 80 minutes. For inpatients, the median TTA from fever to the start of antibiotics was 75 minutes. The longest delays were identified for the timespans from phone call to arrival (median, 75min) and from arrival to decision on treatment (60min). Known blood counts at recognition of fever, decision to treat FN before arrival at the emergency department, and arrival during office hours contributed to shorter TTA. In conclusion, the time before arrival is relevant and should be considered when optimizing TTA and evaluating its influence on outcomes. Support for transportation, using time to arrive for preparations, and regular blood counts could reduce TTA.

Targeted microbubbles (MBs) have emerged as pivotal dual-functional agents for molecular ultrasound (US) imaging and US-triggered targeted drug delivery. However, the efficacy of traditional ligand-directed MBs is often compromised by the inherent heterogeneity of tumor receptor expression and physiological barriers. Herein, we report a robust targeting platform based on dibenzocyclooctyne-functionalized MBs (MB-DBCO) that leverages metabolic glycoengineering and bioorthogonal strain-promoted azide-alkyne cycloaddition (SPAAC). This strategy decoupled targeting efficiency from genetic receptor expression by pre-installing azide chemical handles onto the tumor cell surface. Our results demonstrate that MB-DBCO provides a stable "chemical anchor" in both 4T1 tumor cells and vascular endothelial cells, significantly enhancing contrast-enhanced ultrasound (CEUS) sensitivity and tumor cell specificity. Crucially, the synergistic combination of SPAAC-mediated covalent tethering and US cavitation-induced sonoporation breaches the endothelial cell barrier and tumor stromal barriers, driving the deep penetration of the paclitaxel (PTX) payload. In vivo studies showed that the MB-DBCO + US treatment leads to profound tumor regression, extensive vascular depletion, and a significantly prolonged survival time in aggressive 4T1 tumor models. This study establishes a modular, chemically-defined, and scalable targeting platform that overcomes the critical biological barriers of solid tumors, offering a promising paradigm for CEUS imaging and US-triggered chemotherapy. STATEMENT OF SIGNIFICANCE: Contrast-enhanced ultrasound (CEUS) imaging and US-triggered targeted chemotherapy efficacy of dual functional microbubbles (MBs) is often compromised by heterogeneous receptor expression and the endothelial cell barrier of solid tumors. This study introduces a modular bioorthogonal platform that decouples tumor targeting from genetic markers by converting metabolic flux into a robust chemical interface for MBs anchoring. We demonstrate that this stable chemical-mechanical coupling enables localized cavitation to physically breach the tumor stroma, providing a scalable and universal framework for CEUS imaging and US-triggered targeted chemotherapy.

Rational design of a stable W/O lipid emulsion for enhanced oral delivery of vinblastine.

The incidence of gastric cancer ranks fifth worldwide, and peritoneal metastasis is a crucial factor leading to high mortality. Combination therapy strategies have demonstrated great value in treating metastatic gastric cancer. Herein, inspired by the adhesive ability of mussels, biomimetic adhesive hydrogel microspheres (MSs) encapsulated with NO donors (S-nitrosoglutathione, GSNO), polydopamine (PDA) nanoparticles, and a chemotherapeutic agent (Oxaliplatin, OXA) were fabricated for gastric cancer combination therapy. Owing to the adhesion properties of PDA, the MSs can firmly adhere to the peritoneum. Benefiting from the outstanding photothermal properties of PDA and the thermosensitive characteristics of GSNO, the MSs enable photothermal therapy and NO-triggered gas therapy upon near-infrared irradiation. Together with OXA-mediated chemotherapy, the adhesive MSs can effectively eradicate cancer cells in vitro and potently inhibit tumor growth in vivo, while exhibiting minimal systemic side effects. Therefore, these biomimetic adhesive MSs hold great promise as a multimodal therapeutic system for peritoneal metastasis of gastric cancer. STATEMENT OF SIGNIFICANCE: Gastric cancer often spreads to the abdominal lining, causing high mortality. Inspired by how mussels stick to surfaces, we developed adhesive hydrogel microspheres that combine three therapies in one platform: heat-generating particles (polydopamine, PDA), nitric oxide gas donors (S-nitrosoglutathione, GSNO), and chemotherapy drug (Oxaliplatin, OXA). These sticky microspheres firmly attach to the peritoneum and unleash heat, gas, and drugs simultaneously when activated by near-infrared light. This triple-action strategy effectively destroys cancer cells and significantly suppresses tumor growth in mice with minimal side effects. By integrating mussel-like adhesion with multimodal therapy, this work offers an innovative approach for treating metastatic gastric cancer.

Sustained co-delivery of Parecoxib and cisplatin via a biodegradable thermosensitive hydrogel for preoperative synergistic combination chemotherapy in triple-negative breast cancer

To investigate MRI-based breast edema patterns as biomarkers of tumor aggressiveness and their predictive value for pathological response to neoadjuvant chemotherapy (NAC) in invasive breast cancer. This retrospective study evaluated 235 female patients (mean age, 52 ± 12 years) with biopsy-proven invasive breast cancer who underwent pre-NAC breast MRI. After excluding 19 patients (10 for inadequate image quality, 9 for post-biopsy imaging), 216 patients were analyzed. Breast edema score (BES) was independently assessed by two radiology residents to evaluate interobserver agreement. Subsequently, a breast radiologist reviewed all cases to establish the definitive dataset. The differences in clinicopathological characteristics between the two groups and between different BES were compared. Interobserver agreement for BES classification was very high (92.6% concordance). Edema presence correlated significantly with larger tumor size (p = 0.001), higher histological grade (p = 0.001), axillary lymph node metastasis (p = 0.015), hormone receptor negativity (p < 0.001), lymphovascular invasion (p = 0.031), and elevated Ki-67 (p = 0.001). Higher BES groups (BES 2-4) showed stronger associations with aggressive features: tumor size (p < 0.001), grade (p = 0.022), hormone receptor negativity (p = 0.001), non-luminal subtypes (p = 0.001), and intratumoral necrosis (p = 0.002). Neither edema nor BES predicted pathological response to NAC (p = 0.999, p = 0.299). BES and edema are robust imaging biomarkers of tumor aggressiveness but demonstrate no predictive value for NAC response. MRI-based edema scoring holds clinical relevance for noninvasive tumor phenotyping and risk stratification in breast cancer management. Question Can MRI-based breast edema patterns predict tumor aggressiveness and pathological response to neoadjuvant chemotherapy in invasive breast cancer patients, aiding noninvasive risk stratification? Findings BES correlates with aggressive tumor features (larger size, higher grade, hormone negativity; all p < 0.050 but shows no predictive value for NAC response (p = 0.299). Clinical relevance BES serves as a practical imaging biomarker for risk stratification and tumor phenotyping, guiding individualized therapy. However, it shows no utility in predicting NAC response, emphasizing the need for complementary predictive tools in treatment planning.

Targeting keratin 6 A overcomes gemcitabine resistance by restoring equilibrative nucleoside transporter 1 and TAM-mediated metabolic compensation in pancreatic cancer.

Harnessing the HMnO2 nanoparticles as the DNA injury amplifier to improve the OXA-based trans-artery infusion chemotherapy.

Customised radiation after neoadjuvant chemotherapy in breast cancer.

Traditional open cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal limited metastatic gastric cancer (GC) is associated with significant morbidity and prolonged recovery. We hypothesized that a robotic approach may significantly reduce postoperative recovery. Prospective phase II, single-arm trial conducted in patients with synchronous, low volume (PCI ≤ 7) peritoneal limited metastatic GC who had completed ≥ 4 months of systemic chemotherapy were enrolled. Patients were treated with laparoscopic HIPEC followed by robotic cytoreduction, gastrectomy, and HIPEC with 175 mg/m2 paclitaxel and 100 m2/mg cisplatin. The primary end point was hospital length of stay (LOS). The secondary outcomes were 90-day postoperative complications, readmission, reoperations, and mortality. Between January 2023 and March 2025, 20 patients met eligibility criteria and were enrolled. Two patients subsequently progressed and were deemed ineligible for complete cytoreduction and were thus excluded leaving 18 evaluable patients. A total of 2 patients had positive peritoneal cytology only, and 16 had peritoneal carcinomatosis. Patients completed a median of 9 (IQR 8-10) cycles of neoadjuvant chemotherapy, most (72.2.%) commonly FOLFOX +/- nivolumab. The median peritoneal carcinomatosis index (PCI) at CRS/Gastrectomy and HIPEC was 6 (IQR 3-7). A complete cytoreduction was achieved in 100%. The median blood loss was 300 ml (IQR 200-450 ml) and the red blood cell (RBC) transfusion rate was 22.2%. The median operative time was 688 min (642-722 min) and the primary end point of hospital LOS was 5 days (4-6). The 90-day major morbidity, and readmission rate was 38.9% and 27.8%. There was a single (5.6%) 90-day reoperation and death. There were negligible risks attributed to HIPEC with only two (11.1%) grade IV cytopenia and one (5.9%) acute kidney injury. Robotic cytoreduction, gastrectomy, and HIPEC for low volume peritoneal limited metastatic gastric cancer, in this highly selected patient population, is associated with favorable outcomes such as decreased hospital LOS and less blood loss/blood transfusions compared with the open approach in the literature. We continue to enroll and follow patients to assess long-term oncologic outcomes.

Marine fungal-derived natural products against prostate cancer: A comprehensive review of discoveries and mechanisms.

Recapitulating tumor extracellular matrix alignment to decipher its role in eliciting malignant cell phenotypes using a peptide liquid crystal hydrogel.

Proton beam therapy (PBT) has emerged as an alternative to conventional photon therapy for locally advanced pancreatic cancer (LAPC). This study evaluated the outcomes and adverse events of PBT combined with chemotherapy in LAPC, with outcomes of chemotherapy alone presented for reference. This study included 58 patients diagnosed with LAPC between January 2016 and December 2022. We analyzed data from 14 patients receiving chemoradiotherapy with PBT of 67.5 Gy relative biological effectiveness in 25 fractions (PBT group). As a reference, data from 32 patients receiving chemotherapy alone were analyzed (chemotherapy group). PBT with concurrent chemotherapy was initiated in patients without distant metastasis after upfront chemotherapy, and all patients subsequently underwent maintenance chemotherapy. Overall survival (OS), progression-free survival (PFS), local control (LC), and distant metastasis-free survival (DMFS) were evaluated using the Kaplan-Meier method. In the PBT group, the median interval from chemotherapy initiation to PBT was 180 days. The 1-year/2-year OS and PFS rates were 92.9%/57.1% and 78.6%/42.9%, respectively. The corresponding LC and DMFS rates were 85.7%/77.1% and 85.7%/60.6%. Gastrointestinal adverse events in the PBT group included gastric perforation, gastric antral vascular ectasia, and bile duct stenosis in one patient each (7.1%). In the chemotherapy group, the 1-year/2-year OS and PFS rates were 74.4%/32.0% and 36.8%/13.4%, respectively, while LC and DMFS rates were 44.4%/18.4% and 44.0%/27.0%. Chemoradiotherapy with PBT yielded favorable outcomes in patients with LAPC, suggesting that PBT is a promising treatment option.

Biomolecular condensates formed via phase separation are emerging targets for pharmacologic or genetic manipulation for cancer therapy. In this commentary, we envisage that further deciphering the composition and the physicochemical properties of oncogenic condensates will provide unprecedented opportunities to develop novel strategies for cancer chemotherapy and immunotherapy.

Discovery and in vitro and in vivo activity evaluation of novel baicalein phosphonium salt derivatives targeting mitochondrial MTHFD2 as anti-colon cancer agents.

Efficacy and Toxicity Associated with Cancer Drug Approvals in Switzerland: International Implications.

Two amide functionalized Zn–MOFs as dual–functional materials with luminescent sensing of anti‒cancer drugs and proton conduction

Microbiota metabolite lithocholic acid in cancer: Mechanisms and therapeutic potential.

The optimal approach between perioperative chemotherapy (CT) versus preoperative chemoradiotherapy (CRT) for esophageal carcinoma remains debated. This meta-analysis compares the safety and efficacy of CT versus CRT in resectable esophageal and gastroesophageal junction carcinoma. Electronic databases were systematically searched for eligible randomized controlled trials (RCTs) that enrolled adult patients (aged ≥ 18 years) with histologically confirmed, resectable esophageal or gastroesophageal junction carcinoma, directly compared perioperative CT with preoperative CRT, and reported at least one outcome of interest. Meta-analysis was conducted using RevMan 5.4 with a random-effects model. Hazard Ratios (HRs) were pooled for time-to-event outcomes, and risk ratios (RR) for dichotomous endpoints. Eight RCTs were included. Compared with CRT, CT had significantly reduced R0 resection rates (RR 0.94, 95% CI 0.89, 0.99) and a lower pathologic complete response (RR 0.27, 95% CI 0.13, 0.58). No statistically significant differences were observed in overall survival, progression-free survival, postoperative mortality, or severe adverse events. There was a trend toward greater benefit of CRT in squamous cell carcinoma; however, the test for subgroup differences did not attain statistical significance. This meta-analysis suggests that CRT improves local tumor control by increasing R0 resection rates and complete response rates, but without a clear survival advantage over CT. This meta-analysis further highlights the need for an updated multidisciplinary framework and highlights the importance of biomarker-driven strategies in future research.