Frontiers in Oncology最新文献

{"title":"Editorial: Artificial intelligence and anti-cancer drugs: advancing discovery, personalization, and precision oncology.","authors":"Mohamed El-Shazly, Neeraj Kumar, Sumit Sheoran","doi":"10.3389/fonc.2026.1988629","DOIUrl":"https://doi.org/10.3389/fonc.2026.1988629","url":null,"abstract":"","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1988629"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fusion-specific co-mutational architecture and treatment-response associations in pediatric core-binding factor acute myeloid leukemia: a multicenter exome-profiled cohort.","authors":"Mei Li, Chunxia Cai, Chunping Wu, Xiaoqin Feng, Mincui Zheng, Huirong Mai, Lihua Yang, Xiangling He, Hong Wen, Shaohua Le, Nainong Li, Yongzhi Zheng","doi":"10.3389/fonc.2026.1897872","DOIUrl":"10.3389/fonc.2026.1897872","url":null,"abstract":"<p><strong>Introduction: </strong>Core-binding factor acute myeloid leukemia (CBF-AML) is defined by one of two founding fusions, but cooperating lesions may differ between fusion subtypes. We characterized the broader diagnostic co-mutational architecture of pediatric CBF-AML and examined its relationship with post-induction measurable residual disease (MRD) and outcome.</p><p><strong>Methods: </strong>This retrospective analysis included 170 children with diagnostic whole-exome sequencing (WES) data (2019-2023), a subset of a reported 289-patient cohort. Candidate leukemia-associated variants were curated conservatively because matched normal samples were unavailable. Variant frequencies were compared between RUNX1::RUNX1T1 and CBFB::MYH11 AML with false-discovery-rate control. Associations with MRD were tested using Fisher's exact test. Primary feature-specific Cox models for event-free survival (EFS) were adjusted only for fusion subtype and induction regimen; sensitivity analyses additionally addressed age and presenting WBC count, MRD, and transplantation.</p><p><strong>Results: </strong>In a limited selection audit, fusion-subtype and FLT3-ITD distributions were similar between WES-included and non-included patients, whereas clinical-source KIT positivity was more frequent in the WES subset. The analytic cohort included 138 RUNX1::RUNX1T1 and 32 CBFB::MYH11 cases; 137 received FLAG-IDA, and 33 received DAE induction. At least one curated candidate variant was present in 135 patients (79.4%), and 69 (40.6%) had alterations in two or more genes. Tyrosine-kinase signaling alterations occurred in 115 patients (67.6%). RAS-pathway alterations were enriched in CBFB::MYH11 AML (53.1% vs. 19.6%; P < 0.001, q=0.002), driven principally by NRAS (50.0% vs. 15.2%; P < 0.001, q < 0.001). Chromatin-modifier alterations were numerically enriched in RUNX1::RUNX1T1 AML (24.6% vs. 6.2%; P = 0.028) but did not remain significant after multiplicity correction (q=0.114). After false-discovery-rate correction, no tested genomic feature was associated with MFC-MRD or molecular MRD positivity after the second induction. With a median follow-up of 33.2 months, 3-year EFS and overall survival were 84.2% and 89.8%, respectively. No baseline genomic feature showed a significant association with EFS in either the primary or expanded baseline-covariate models.</p><p><strong>Conclusions: </strong>Among WES-profiled patients, pediatric CBF-AML showed fusion-specific co-mutational architecture, especially RAS-pathway enrichment in CBFB::MYH11 AML. In this WES-defined cohort, baseline genomic features were not established as response or outcome predictors. These findings are descriptive and hypothesis-generating; they do not support treatment-specific causal inference.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1897872"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase angle assessed by bioelectrical impedance analysis in patients with colorectal cancer: a systematic review.","authors":"Yuzhou Mei, Tengfei Wang, Songhao Liu, Haoyu Wang, Zhenguo Han","doi":"10.3389/fonc.2026.1768933","DOIUrl":"10.3389/fonc.2026.1768933","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition, altered body composition, and sarcopenia are common among patients with colorectal cancer (CRC) and are associated with poor treatment tolerance and adverse clinical outcomes. PhA, derived from BIA, reflects cellular membrane integrity and body cell mass and has been increasingly investigated as a potential marker of nutritional status and prognosis in oncology. However, the clinical relevance of PhA in patients with CRC has not yet been systematically synthesized.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with the PRISMA 2020 guidelines. PubMed, Embase, Web of Science, and Scopus were searched for observational studies published between January 2000 and October 2025 that assessed PhA in adult patients with CRC. Data extraction and risk-of-bias assessment using the AXIS tool were performed independently by two reviewers. Due to substantial heterogeneity in study design, outcome definitions, and PhA cut-off values, a narrative synthesis was conducted.</p><p><strong>Results: </strong>A total of 10 studies involving 1,439 patients were included. Lower PhA values were consistently associated with adverse clinical outcomes. Four studies reported significantly shorter overall or progression-free survival among patients with low PhA. Four studies demonstrated associations between low PhA and unfavorable short-term outcomes, including postoperative complications, prolonged hospital stay, cancer-related complications, and early chemotherapy-related toxicity. Several studies also reported positive associations between PhA and indicators of nutritional status, body composition, muscle mass, muscle strength, and hydration balance. One longitudinal study showed that postoperative increases in PhA were accompanied by improvements in body composition parameters and reduced early chemotherapy-related toxicity.</p><p><strong>Conclusions: </strong>Current evidence indicates that BIA-derived phase angle is associated with nutritional status, body composition, treatment tolerance, and survival outcomes in patients with colorectal cancer. However, heterogeneity in measurement protocols and cut-off values limits direct clinical application. Standardized assessment methods and prospective studies are needed to establish CRC-specific reference values and to determine whether interventions that improve PhA can translate into improved clinical outcomes.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1768933"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in conversion therapy for hepatocellular carcinoma with portal vein tumor thrombosis.","authors":"Panpan Xie, Jianfang Zhu, Peng Xu, Peng Zhang, Fengguo Jian","doi":"10.3389/fonc.2026.1925747","DOIUrl":"https://doi.org/10.3389/fonc.2026.1925747","url":null,"abstract":"<p><p>Portal vein tumor thrombosis (PVTT) is one of the most clinically consequential manifestations of advanced hepatocellular carcinoma (HCC). It reflects aggressive tumor biology, compromises portal venous inflow, and reduces the therapeutic window for locoregional intervention. Historically, macroscopic portal vein invasion generally placed patients within advanced-stage treatment pathways, in which systemic therapy constituted the standard treatment backbone and curative-intent approaches were applicable only to selected patients. This paradigm has now shifted. In recent years, the management of unresectable HCC has been reshaped by immune-based systemic therapy, more active tyrosine kinase inhibitor-based combinations, hepatic arterial infusion chemotherapy (HAIC), selective transarterial therapies, thrombus-directed radiotherapy, and increasingly standardized multidisciplinary conversion strategies. Consequently, a subset of patients with liver-dominant HCC and PVTT can now be downstaged to radical resection or other definitive local treatment, particularly when liver function is preserved and therapy is initiated before irreversible hepatic decompensation develops. This review summarizes recent advances in the diagnosis and classification of PVTT, the biological and technical rationale for conversion therapy, and the evolving evidence for systemic therapy, HAIC, transarterial chemoembolization (TACE), radiotherapy, triple-modality treatment, salvage surgery, and postoperative management. It also highlights key limitations, including the predominance of retrospective East Asian cohorts, heterogeneity in PVTT classification and treatment protocols, uncertainty regarding the optimal timing of surgery, and the absence of validated biomarkers for selecting patients most likely to benefit from aggressive multimodality treatment. Overall, the available evidence supports integrating response-guided multidisciplinary strategies into established evidence-based treatment frameworks for carefully selected patients. Even so, conversion therapy for HCC with PVTT remains an evidence-evolving strategy that should be applied with careful patient selection, disciplined treatment sequencing, and substantial institutional expertise rather than adopted as a universal standard of care.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1925747"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global clinical trial activity in metastatic castration-resistant prostate cancer from January 2020 to March 2026: a landscape analysis.","authors":"Lin Fan, Shuang Wu, Xingxing Xie, Yang Zheng, Longxia Chen, Ruilin Ding","doi":"10.3389/fonc.2026.1930401","DOIUrl":"https://doi.org/10.3389/fonc.2026.1930401","url":null,"abstract":"<p><strong>Background: </strong>Metastatic castration-resistant prostate cancer (mCRPC) remains a lethal stage of prostate cancer with poor prognosis. Clinical trials for mCRPC are growing rapidly worldwide. However, a comprehensive systematic analysis of the global research and development landscape in mCRPC remains lacking.</p><p><strong>Methods: </strong>This study queried the Trialtrove database for interventional trials in mCRPC registered between January 1, 2020 and March 27, 2026. After exclusion of unrelated trials and non-therapeutic studies, 474 trials were analyzed.</p><p><strong>Results: </strong>The therapeutic landscape for mCRPC has evolved into a highly diversified and dynamic field, overwhelmingly dominated by early-phase investigations. Targeted therapy, particularly PARP inhibitors, remain the leading class, while radiopharmaceutical therapy (RPT), centered on ¹⁷⁷Lu-PSMA, has reached a mature stage of development. Immunotherapy is expanding beyond checkpoint blockade into bispecific T-cell engagers and cellular therapies, and endocrine therapy is being reshaped by PROTAC degraders. Antibody-drug conjugates (ADCs) are also gaining momentum, with B7 homolog 3 protein (B7-H3) as the most actively pursued targets. Combination regimens account for 39.2% of trials.</p><p><strong>Conclusion: </strong>mCRPC clinical research landscape has diversified remarkably, shifting from conventional chemotherapy and endocrine therapy toward mechanism-based, biomarker-guided, and combination-oriented strategies.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1930401"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silent, but not innocent: the emerging role of clonal hematopoiesis in predicting therapy-related myeloid neoplasms.","authors":"Şerife Emre Ünsal","doi":"10.3389/fonc.2026.1943135","DOIUrl":"https://doi.org/10.3389/fonc.2026.1943135","url":null,"abstract":"<p><p>Therapy-related myeloid neoplasms (t-MNs), which develop following cytotoxic chemotherapy or radiotherapy, remain one of the most significant clinical challenges in modern hematology due to their aggressive clinical course and poor survival outcomes. The traditional paradigm regarded the development of t-MNs as a consequence of <i>de novo</i> genetic damage induced by anticancer therapies. However, recent data concerning genomics and clonal evolution have fundamentally transformed our understanding of the biological origins of the disease. Current evidence demonstrates that low-level, clinically silent hematopoietic clones are present in the peripheral blood or bone marrow years prior to disease onset in a substantial proportion of t-MN cases. The pathogenesis of t-MNs is therefore being reconceptualized, not merely as the emergence of <i>de novo</i> treatment-induced mutations, but rather as the expansion and progression to malignant transformation of pre-existing silent clones under selective pressure. Clonal hematopoiesis (CH) is a dynamic biological process characterized by the acquisition of a proliferative advantage by specific cell populations, resulting from somatic mutations accumulated by hematopoietic stem cells (HSCs) throughout life. A clinically defined subgroup of this process, including CH of indeterminate potential (CHIP) and clonal cytopenia of undetermined significance (CCUS), are defined as the presence of somatic mutations with a variant allele frequency (VAF) of ≥2% in genes associated with myeloid malignancies. Both are recognized as clinically meaningful pre-cancerous states, differentiated primarily by the presence of unexplained cytopenias in CCUS. The presence of CH by itself is insufficient to drive malignant transformation. The observation that only a small fraction of individuals harboring CHIP or CCUS ultimately develop myeloid neoplasia indicates that clonal progression is not solely dictated by the presence of a mutation, but rather by the biological characteristics of the clone, the specific mutation type, clone size, environmental stressors, and the bone marrow microenvironment. The fundamental paradigm has thus shifted from simply asking \"which patients have CH?\" to determining \"which silent clones possess the potential to evolve into aggressive myeloid neoplasms in the future?\" The concept of the \"power of silent clones\" provides a novel biological perspective in t-MN risk stratification, establishing a foundational framework for the future development of personalized surveillance, early intervention, and targeted preventative strategies. Deciphering CH enables precise risk stratification and helps intercept myeloid malignancies before clinical onset.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1943135"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-grade gliomas where resources define survival: a systematic review and meta-analysis of outcomes, surgical access, and molecular diagnostic gaps in low- and middle-income countries.","authors":"Carlos Castillo Rangel, Gervith Reyes Soto, Edinson David Berrio Perea, José De Jesús Gutiérrez-Baños, Eduardo Diaz Juarez, Bayron Salazar, Vishal K Chavda, Ismael Antonio Peralta Baez, Renat Nurmukhametov, David Cuevas, Lizardi de la Cruz, Andreina Rosario Rosario, Bary Bigay, Abuzer Gungor, Manuel De Jesus Encarnacion Ramirez","doi":"10.3389/fonc.2026.1909193","DOIUrl":"https://doi.org/10.3389/fonc.2026.1909193","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;High-grade gliomas remain among the most aggressive tumors in neuro-oncology. Although prognosis is strongly influenced by tumor biology, survival in low- and middle-income countries is also shaped by health-system factors, including delayed diagnosis, limited surgical infrastructure, incomplete adjuvant therapy, and restricted molecular diagnostics. The implementation of the 2021 World Health Organization Classification of Central Nervous System Tumors has further exposed diagnostic inequities, as integrated histomolecular classification depends on molecular tools that are not uniformly available in resource-limited settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This systematic review and meta-analysis aimed to synthesize contemporary evidence on survival outcomes, surgical access, extent of resection, adjuvant treatment delivery, and molecular diagnostic gaps among patients with high-grade gliomas treated in low- and middle-income countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search was conducted following PRISMA 2020 recommendations. MEDLINE/PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL, Global Index Medicus, LILACS, African Index Medicus, IndMED, and Google Scholar were searched for studies published between January 2016 and May 2026. Eligible studies included patients with histologically or molecularly confirmed WHO grade 3 or grade 4 gliomas treated in low- or middle-income countries and reporting survival, surgical-access, adjuvant-treatment, or molecular-diagnostic outcomes. The protocol was registered in PROSPERO as CRD420261398058.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 30 independent studies met the predefined eligibility criteria and were included in the qualitative synthesis. Twenty-four studies contributed overall survival data, 18 reported surgical-access outcomes, 21 evaluated adjuvant-treatment delivery, and 12 examined molecular-diagnostic availability. Most included investigations were retrospective institutional cohorts, although registry-based studies, randomized clinical trials, and molecular implementation studies were also identified. Survival outcomes varied substantially across healthcare settings and were consistently influenced by delayed diagnosis, limited access to maximal safe resection, incomplete radiotherapy, restricted temozolomide availability, treatment abandonment, and insufficient molecular characterization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Survival in high-grade gliomas in low- and middle-income countries is not determined by tumor biology alone. It is shaped by sequential \"survival gates\": timely diagnosis, access to maximal safe resection, completion of radiotherapy and temozolomide-based chemotherapy, molecular classification, and longitudinal follow-up. Future strategies should move beyond simple guideline translation and focus on scalable neuro-oncology pathways that improve surgical capacity, adjuvant-treatment continuity, and access to essentia","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1909193"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A dual-branch CNN-LSTM framework for exploratory classification of colorectal cancer histopathology and hepatocellular carcinoma clinical records.","authors":"Xiaoyan Guo, Jing Lai, Lili Wu, Dianke Chen","doi":"10.3389/fonc.2026.1878061","DOIUrl":"10.3389/fonc.2026.1878061","url":null,"abstract":"<p><p>Colorectal cancer (CRC) and hepatocellular carcinoma (HCC) remain major diagnostic challenges because classification often depends on modality-specific evidence that is stored in separate public datasets. This study evaluates a dual-branch CNN-LSTM framework using two independent and unpaired data sources: colorectal histopathological image patches and structured HCC clinical-biochemical records. The study is therefore positioned as an exploratory investigation of representation learning across heterogeneous medical datasets. The CNN branch extracts spatial and glandular texture features from curated CRC image patches, whereas the LSTM branch treats fixed-order clinical attributes as a structured feature sequence to learn inter-feature dependencies in the HCC records. Under internal public-dataset testing with bootstrap uncertainty estimation, the full CNN + LSTM + MLP framework achieved an accuracy of 0.978 (95% CI, 0.971-0.984), Macro-F1 of 0.977 (95% CI, 0.971-0.984), and Macro OVR AUC of 0.997 (95% CI, 0.996-0.998). Ablation and baseline comparisons showed lower performance for CNN only (accuracy 0.938), LSTM only (0.875), clinical encoder only (0.890), CNN + LSTM (0.966), CNN + clinical MLP (0.958), late fusion (0.952), EfficientNet-B0-style fusion (0.970), ViT-tiny-style fusion (0.960), XGBoost (0.910), random forest (0.900), and logistic regression (0.875). The full model also exceeded the EfficientNet-B0-style baseline in Macro AUC by 0.003 (95% CI, 0.002-0.004; paired bootstrap P = 0.007; McNemar exact P = 0.011). Grad-CAM and SHAP analyses are used to interpret branch-specific decisions, while the findings remain limited to internal public-dataset validation.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1878061"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year dynamic risk stratification and adjuvant radioiodine efficacy in initial non-distant metastatic papillary thyroid carcinoma harboring TERT promoter mutations.","authors":"Xian-Zhao Deng, Meng-Yue Liu, Chen-Tian Shen, Hong-Jun Song, Jian Wang, You-Ben Fan, Quan-Yong Luo, Juan Tang, Xiao-Er Wei, Zhong-Ling Qiu","doi":"10.3389/fonc.2026.1895987","DOIUrl":"10.3389/fonc.2026.1895987","url":null,"abstract":"<p><strong>Background: </strong>The clinical utility of postoperative radioiodine (¹³¹I) ablation remains unclear for patients with initially diagnosed non-distant metastatic papillary thyroid carcinoma (PTC) with harboring TERT promoter(TERT-p) mutations, it is unknown whether ¹³¹I therapy reduces the risk of persistent or recurrent disease. This study investigated clinicopathological features, 2-year dynamic therapeutic responses and progression-free survival (PFS) in this specific patient cohort.</p><p><strong>Methods: </strong>A single-center retrospective cohort study enrolled 113 eligible patients, allocated to the ¹³¹I ablation group (n=62) and non-¹³¹I group (n=51). Two-year dynamic risk stratification assessed treatment response. Kaplan-Meier curves and Cox regression models were used for survival analysis.</p><p><strong>Results: </strong>The predominant TERT-p variant was C228T (89.4%), and most patients carried concurrent BRAF^V600E mutations. Only initial surgical approach remained an independent intergroup variable. Within 2 years, 46.0% achieved acceptable responses, associated with sex and primary surgery (p=0.036,p < 0.001). High baseline ATA risk was strongly correlated with structural residual lesions and unfavorable therapeutic response (p < 0.001).No significant between-group differences in response were observed across all ATA risk subgroups. The median follow-up was 4.6 years; 3- and 5-year PFS rates were 67.5% and 39.1%. Age ≥55 years, N1b stage and high baseline ATA risk were independent adverse predictors of PFS. Both 2-year therapeutic response and PFS at the end of follow-up exhibited no statistical differences between the ¹³¹I group and non-¹³¹I group.</p><p><strong>Conclusions: </strong>In this retrospective observational cohort, postoperative ¹³¹I ablation was not associated with improved PFS among patients with non-distant metastatic TERT-p-mutant PTC. Advanced age, N1b lymphatic metastasis and high baseline ATA risk independently predict poor outcomes. Biologically, TERT-p mutations induce tumor dedifferentiation and impaired iodine uptake, diminishing ¹³¹I efficacy. Clinically, routine ¹³¹I yields no survival benefit for this high-risk molecular subgroup, guiding individualized surveillance and avoiding redundant ¹³¹I exposure.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1895987"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report: A rare primary adrenal malignant rhabdoid tumor in a 42-year-old man.","authors":"Jiali Zhu, Jingcui Guo, Yang Zhang, Lin Liu, Shengya Xu, Nan Gu, Ying Gao","doi":"10.3389/fonc.2026.1971354","DOIUrl":"10.3389/fonc.2026.1971354","url":null,"abstract":"<p><strong>Background: </strong>Primary adrenal malignant rhabdoid tumor (MRT) is a rare, highly aggressive neoplasm lacking specific clinical manifestations and imaging characteristics.</p><p><strong>Methods: </strong>This case report delineates the clinical course of a patient with primary adrenal MRT managed at our institution. We provide a comprehensive characterization of the patient's clinical presentation, histopathological and molecular genetic profiles, and the therapeutic strategy employed. Furthermore, we critically examine contemporary evidence regarding its pathogenesis, diagnostic challenges, and therapeutic strategies.</p><p><strong>Results: </strong>A 42-year-old man was initially admitted to the Department of Endocrinology presenting with pyrexia and an adrenal mass. The patient underwent surgical resection of an adrenal mass; definitive histopathological examination and molecular genetic profiling confirmed a diagnosis of primary adrenal MRT. Despite undergoing surgical resection and adjuvant chemotherapy, the patient ultimately succumbed to sudden cardiac death.</p><p><strong>Conclusion: </strong>Primary adrenal MRT represent an exceptionally rare clinical entity. Consequently, clinicians must maintain high suspicion for this diagnosis when evaluating non-functioning adrenal masses, especially those with atypical radiological features or aggressive behavior.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"16 ","pages":"1971354"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}