MSK-impact heme accurately reproduces diffuse large B-cell (DLBCL) dlbclass cluster classification across clinical scenarios, including diagnosis, relapse, and histological transformation

Tallforest: Multi-omic classifier for T-lineage acute lymphoblastic leukemia

Long-read profiling of structural variants reveals mechanisms of chemo-resistance and prognostic heterogeneity in acute lymphoblastic leukemia

Deciphering clonal progression in MDS via longitudinal sequencing

Multicenter study of the ion AmpliseqTM Liverpool Lymphoid Network community NGS panel for molecular characterization of lymphoid malignancies

Objective: To assess the prognostic performance of the 2023 FIGO staging system for endometrial cancer, which incorporates molecular classification (FIGO 2023m), we analyzed survival outcomes and compared them with the 2009 FIGO system (FIGO 2009).Methods: We retrospectively reviewed 720 patients with endometrial cancer treated between 2013 and 2021. Staging was performed according to FIGO 2009 and FIGO 2023m. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier analysis. Factors associated with survival were identified through univariate and multivariate Cox proportional hazards analyses.Results: Of the 720 patients, 27.4% (197/720) were reclassified under FIGO 2023m, and 182 were upstaged from stage I to stage II, primarily due to p53 abnormalities (54.9%). Patients with stage I disease according to FIGO 2023m had comparable survival rates (PFS: 95.3% vs. 92.8%; OS: 99.2% vs. 95.9% under FIGO 2009). Within stage II, OS in patients classified as FIGO 2023m IIC was slightly lower than in stage IIC but did not differ statistically (92.3% vs. 86.9%). Aggressive histology, positive peritoneal cytology, and deep myometrial invasion were associated with poorer outcomes. Patients harboring POLE mutations showed excellent prognosis (5-year OS, 100.0%), even at advanced stages.Conclusion: Compared with FIGO 2009, the FIGO 2023m staging system offers improved prognostic value and better discriminative ability. Incorporating molecular subtyping is crucial even in advanced disease. However, omitting peritoneal cytology from prognostic assessment may risk undertreatment. Continued refinement in quantifying lympho-vascular space invasion (LVSI) and differentiating complex endometrial-myometrial junctions from genuine myometrial invasion remains a challenge.

PET imaging biomarkers predict survival in peripheral T-cell lymphoma: A systematic review and meta-analysis.

Circulating CD161high CD8 T cells at leukapheresis are associated with reduced risk of progression at 12 months (PFS12) in large B-cell lymphoma treated by axicabtagene ciloleucel: Results from the Phase 2 alycante study (LYSA)

Comprehensive and rapid detection of genomic alterations in pediatric leukemias using whole-genome sequencing with adaptive sampling

Evaluating reverse transcriptase efficiency in CML: Consequences for deep molecular response classification and treatment-free remission decisions

Machine learning uncovers invariant evolutionary molecular trajectories in MDS.

Identify high-risk disease in multiple myeloma through single-cell transcriptomic detection of highly proliferative (PR) cells

First-line selinexor plus R-CHOP for high-risk GCB-subtype diffuse large B-cell lymphoma: A multi-center, single-arm, Phase II trial

Zanubrutinib combined with intrathecal chemotherapy for prevention of CNS relapse in high-risk diffuse large B-cell lymphoma

Real-world patient-based next-generation sequencing assessments identify a high-risk subgroup and associated gene signature in diffuse large B cell lymphoma

Age-stratified prognostic performance of patient- vs disease-related IPI factors in large B-cell lymphoma

Endometrial Carcinoma Molecular Classification and Barriers to Implementation, Possible Solutions, and the Implications for Ongoing Clinical Trials.

The classification of endometrial cancer (EC) has diverged from traditional histologic features based on microscopic appearance to objective molecular characterization. Molecular characterization of EC is pivotal to inform prognosis and to guide therapeutic recommendations. First described by the Cancer Genome Atlas, molecular profiling was later revised by the Proactive Molecular Risk Classifier for Endometrial Cancer and TransPORTEC algorithms to create clinically applicable and relatively easy-to-implement molecular classification systems. Since 2020, the World Health Organization recommended molecular classification of EC into four distinct prognostic subtypes: ECs with polymerase ε (POLE) pathogenic mutations assessed by gene sequencing, mismatch repair deficiency determined by immunohistochemistry or microsatellite instability assay, and p53 abnormalities determined by immunohistochemistry or next-generation sequencing. The final molecular subtype without any of these defining features is called "no specific molecular profile" (NSMP). This is further stratified by estrogen receptor (ER) immunohistochemistry status. Patients with cancers identified as POLE pathogenic mutations have the best prognosis with almost no recurrence or death events, followed by those with strong ER-positive NSMP cancers. Mismatch repair deficiency ECs have intermediate prognosis, whereas p53 abnormalities and ER-negative NSMP have the worst prognosis. Other molecular and pathologic biomarkers of interest include tumor mutational burden, human epidermal growth factor receptor 2, L1 cell adhesion molecule, β-catenin ( CTNNB1 ), and lymph vascular space invasion, which may have prognostic and predictive implications. The current guidelines will continue to evolve; however, at minimum, it is recommended that all patients undergo testing for mismatch repair, p53, and ER, and POLE testing may be prioritized in select circumstances. Molecular classification provides the critical framework to deliver effective, personalized, high-quality care and informs clinical trial design. Molecular assessment ensures consistent diagnosis and provides prognostic information and predictive data to guide appropriate management.

Molecular classification of nonurothelial histologic subtypes of bladder cancer.

Biomarkers estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) may undergo alteration on reassessment, with significant impact on management. There is a paucity of large-scale paired data on biomarker changes from low- and middle-income countries (LMICs). We performed a retrospective audit on 1,107 paired samples, wherein biomarkers were performed at least twice between: core needle biopsy (CNB) and upfront resection (category 1, n = 277); CNB and postchemotherapy resection (category 2, n = 104); primary (CNB/resection) and recurrence (local/metastatic; category 3, n = 702); and initial and subsequent distant metastasis (category 4, n = 24). Concordance was noted for individual receptors and surrogate molecular classification (hormone receptor+HER2-, hormonal receptor+HER2+, hormonal receptor-HER2+, triple-negative). Overall concordance for ER, PR, and HER2 was 85.4% (k value = 0.693), 77.1% (k value = 0.541), and 93.8% (k value = 0.827), respectively. For HRs, higher concordance was in category 1 > 3 > 2 > 4 (ER k value = 0.764 > 0.684 > 0.591 > 0.515, respectively; PR k value = 0.68 > 0.495 > 0.482 > 0.329, respectively), while HER2 was relatively constant across categories (k value range, 0.808-0.882). Molecular classification showed overall 79.5% concordance (k value = 0.688). Discordance was 27.1% in triple-positive (highest) and 17.7% in HER2+/hormonal receptor- (lowest). Univariate and multivariate analyses showed poorer concordance for therapy (v no therapy; odds ratio [OR], 0.437 [95% CI, 0.255 to 0.749]; P = .003) and specific/targeted therapy (v CT alone; OR, 0.126 [95% CI, 0.073 to 0.217]; P = .001). Shorter time interval (<6 months), both specimens breast, CNB, and optimum fixation showed better concordance on univariate (P = .004, .002, .01, and .009, respectively) but not multivariate analysis. Biomarker re-evaluation is not mandatory between CNB and upfront resection or evaluating HER2 status alone, but one in five patients may show discordance at metastasis/recurrence. We recommend re-evaluation in recurrent/metastatic settings, post-treatment, >6 months' time interval, or poorly fixed material, which is of particular relevance in LMICs.