Journal of the Egyptian National Cancer Institute最新文献

{"title":"Machine learning and AI for cancer research and care: a review of applications, limitations, and future directions.","authors":"Kanishk Yadav, Taneesha Gupta","doi":"10.1186/s43046-026-00399-y","DOIUrl":"https://doi.org/10.1186/s43046-026-00399-y","url":null,"abstract":"<p><p>Machine learning (ML) is transforming cancer research and care by enabling analysis of complex, high-dimensional datasets spanning genomics, transcriptomics, proteomics, imaging, and clinical records. By improving risk stratification, accelerating detection and diagnosis, and supporting treatment selection, ML has the potential to enhance survival outcomes while increasing efficiency across oncology workflows. This review synthesizes key developments in ML for oncology, covering foundational algorithms alongside emerging approaches. We highlight major application areas including early cancer detection, tumor classification, molecular subtyping, biomarker discovery, prognosis estimation, multi-omics integration, computational pathology, pharmacogenomics, and clinical decision support. We also summarize commonly used datasets, discuss the importance of interpretability for clinical trust, and outline barriers to translation such as data heterogeneity, bias, and regulatory constraints. Finally, we describe future directions, including federated learning, graph neural networks, longitudinal modeling, and integration of real-world and wearable data to support precision oncology. This review is intended for cancer researchers, clinicians, and data scientists seeking a practical overview of ML methods, opportunities, and translational considerations in oncology.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From black-box prediction to transparent insight: the status quo and paradigm shift of explainable artificial intelligence in hepatocellular carcinoma research.","authors":"Yuehua Li, Pengfei Li","doi":"10.1186/s43046-026-00397-0","DOIUrl":"10.1186/s43046-026-00397-0","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is a malignancy with high global incidence and mortality, whose significant heterogeneity and poor prognosis pose severe clinical challenges. While artificial intelligence (AI) shows potential in HCC imaging, pathology, and prognosis, its \"black-box\" nature limits clinical adoption. Explainable AI (XAI) aims to reveal the decision-making logic of AI models. This narrative review synthesizes recent advances of XAI across four key domains of HCC research. In imaging diagnosis, techniques such as Grad-CAM and SHAP have enabled semantic alignment between AI outputs and clinical standards like LI-RADS, enhancing interpretability. In biomarker discovery, XAI has progressed from identifying single markers to revealing functional gene modules and molecular subtypes through multi-omics integration. In treatment efficacy prediction, XAI-based models have quantified feature contributions to therapeutic responses, supporting individualized treatment stratification. In prognosis assessment, XAI has enabled dynamic risk stratification by integrating clinical, imaging, and pathological features. However, three cross-cutting limitations persist across these domains: explanations remain predominantly correlational rather than causal, a semantic gap exists between pixel-level heatmaps and high-level clinical reasoning, and most models are static, unable to adapt to evolving clinical data. Current research is moving toward causal inference frameworks, concept-driven interpretability, and interactive, dynamic systems. In summary, XAI is transitioning from a retrospective explanation tool toward a prospective clinical decision partner, yet bridging the gap between explanation and actionable decision support remains the central challenge.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of potential biomarkers for oral squamous cell carcinoma through multi-cohort bioinformatic analysis.","authors":"Duanreiliu Kamei, Simran Kaur, Anjali Priya, Akshay Bansal, Aarti Yadav, Ashwini Kumar Ray, Yamini Agrawal","doi":"10.1186/s43046-026-00392-5","DOIUrl":"10.1186/s43046-026-00392-5","url":null,"abstract":"<p><strong>Background: </strong>Oral squamous cell carcinoma (OSCC) arises in the context of diverse etiological exposures, such as tobacco, alcohol, areca nut use and viral infections. This etiological heterogeneity drives distinct molecular alterations, contributing to tumor complexity and significant challenges in identifying robust, clinically applicable biomarkers.</p><p><strong>Methods: </strong>To resolve this, we employed an integrative bioinformatics approach, analyzing five gene expression datasets retrieved from the GEO repository, which encompass heterogenous clinical samples with diverse clinical stages of OSCC Differentially expressed genes (DEGs) were identified using stringent thresholds (|LogFC|≥ 1.5 to 3.0; p < 0.05), followed by GO and KEGG pathway enrichment analysis. A protein-protein interaction (PPI) connectome was generated, leading to identification of key hub genes using five topological properties. The biological relevance of hub genes was validated via GEPIA, HPA, immune infiltration analysis, and miRNet.</p><p><strong>Results: </strong>Screening of datasets provided 1764 DEGs. Enrichment analysis revealed dysregulation in immune response, metabolic processes, remodeling of the extracellular matrix, and inflammatory signaling. Five hub genes, EGFR, FN1, IL6, STAT1, and PTPRC, emerged as central regulators with distinct expression-survival profiles and associations with immune infiltration patterns. Notably, STAT1 and IL6 demonstrated context-dependent behavior, reflecting both tumor-intrinsic and microenvironment-derived expression patterns.</p><p><strong>Conclusion: </strong>This study highlights five key genes with potential diagnostic, prognostic, and therapeutic relevance in OSCC, emphasizing their consistency across clinically heterogeneous patient cohorts.</p><p><strong>Impact: </strong>These results extend a mechanistic understanding of OSCC pathobiology, thus promising leads towards the development of clinically robust biomarkers.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine transposition for fertility preservation prior to pelvic irradiation: an initial Egyptian case series.","authors":"Basel Refky, Mohamed Abdelkhalek, Mohamed Hamdy, Khalid Atallah, Amr Abuzenah, Amira Zaidan, Sahar Elhawari, Basma Gadelhak, Alaa Ismail, Hisham Ahmed Abou-Taleb, Khaled Gaballa","doi":"10.1186/s43046-026-00395-2","DOIUrl":"10.1186/s43046-026-00395-2","url":null,"abstract":"<p><strong>Background: </strong>Recently, uterine transposition has been proposed as a novel technique for fertility preservation in young females undergoing radiation therapy for pelvic malignancies.</p><p><strong>Patients and methods: </strong>This is an interventional pilot study including six female patients with pelvic malignancies planned to receive pelvic radiation aiming at preserving their fertility after a multidisciplinary team decision to have uterine transposition. Our study aims to assess the feasibility of this novel technique.</p><p><strong>Results: </strong>Six patients underwent uterine transposition. Three of them were done through open technique, with successful repositioning. The other three patients underwent laparoscopic uterine transposition, one of them underwent repositioning and still receiving chemotherapy for Ewing's sarcoma, the other two patients are still receiving radiation therapy after transposition. Unfortunately, one of them died of disease and adjuvant therapy complications four months after laparoscopic uterine transposition.</p><p><strong>Conclusion: </strong>Uterine transposition is a feasible procedure with safe outcomes. The preliminary results carry a promising hope for better fertility preservation in young patients undergoing radiation for pelvic malignancies.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation comparing Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) and surgical mediastinoscopy for mediastinal staging of lung cancer: a systematic review.","authors":"Zainib Amirah Anwar, Airy Anak Andrew Atoi, Catherine Soo Shen Chan, Dhinagar Selgal Raddy, Edwin De Cruz, Rafidah Lamit, Nabilah Ayob, Suzana Awg Piut, Mohd Hanafiah Ahmad Hijazi, Abdul Rahman Ramdzan, Larry Ellee Nyanti","doi":"10.1186/s43046-026-00396-1","DOIUrl":"10.1186/s43046-026-00396-1","url":null,"abstract":"<p><strong>Introduction: </strong>Mediastinal sampling is essential for diagnosing and staging thoracic diseases, particularly non-small cell lung cancer (NSCLC). Traditional mediastinoscopy has been the gold standard; however, Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) has emerged as a minimally invasive alternative. This systematic review compares the economic evaluations of EBUS-TBNA to determine their cost-effectiveness, healthcare resource use, and overall economic impact.</p><p><strong>Methodology: </strong>A systematic review was conducted following PRISMA guidelines. Databases searched included PubMed and ScienceDirect, using keywords such as \"EBUS-TBNA,\" \"mediastinoscopy,\" and \"cost-effectiveness.\" Inclusion criteria focused on studies evaluating studies comparing EBUS-TBNA with traditional mediastinoscopy, with direct economic comparisons between EBUS-TBNA and traditional mediastinoscopy. Articles published in English within the last 10-15 years were included, covering randomized controlled trials, cohort studies, and economic modeling analyses. Four studies met the eligibility criteria after screening and full-text review.</p><p><strong>Results: </strong>The review revealed that EBUS-TBNA consistently demonstrated lower costs and better cost-effectiveness compared to TMC. In the study by Steinfort et al. [1], EBUS-TBNA reduced costs by AU$5,898 per patient compared to mediastinoscopy. Similarly, Chouaid et al. [2] reported cost savings of €1,450 per patient in France. EBUS-TBNA avoided mediastinoscopy in 80% of cases while maintaining high diagnostic accuracy. Sensitivity analyses confirmed that EBUS-TBNA was the most cost-effective when its sensitivity exceeded 17% and mediastinal lymph node metastases (MLNM) prevalence was below 79%.</p><p><strong>Discussion: </strong>EBUS-TBNA offers significant economic and clinical advantages over traditional mediastinoscopy. It reduces the need for invasive procedures, minimizing patient risk and healthcare costs. Its combination with diagnostic tools like PET-CT further enhances its value, as seen in Søgaard et al. [3], where this approach yielded the most cost-effective outcomes for NSCLC staging. While most studies relied on modeled populations, the findings are robust across diverse healthcare settings. Limitations include the lack of real-world long-term analyses and variability in healthcare systems.</p><p><strong>Conclusion: </strong>This systematic review highlights that EBUS-TBNA is a cost-effective and clinically valuable alternative to traditional mediastinoscopy for mediastinal sampling. Its integration into clinical practice can improve resource utilization and patient outcomes while significantly reducing healthcare costs. Future research should explore its long-term cost-effectiveness and broader applicability in diverse healthcare settings. EBUS-TBNA represents a critical advancement in the diagnostic staging of thoracic diseases.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating microRNAs: a new era in early detection of oral squamous cell carcinoma (OSCC) - a systematic review and meta-analysis.","authors":"Roshan Mustafa Pathan, Umadevi Subramanian, Jugraj Singh, Venkata Chandana Heshma Anumalasetty, Mukesh Ram Kumar Kommu, Vamsi Krishna Kondepati, Ponni Gayatri Twinkle Bade","doi":"10.1186/s43046-026-00393-4","DOIUrl":"10.1186/s43046-026-00393-4","url":null,"abstract":"<p><strong>Background: </strong>The chances of oral squamous cell carcinoma (OSCC) being diagnosed at an early stage are very low, and this leads to a poor prognosis. The presence of circulating miRNAs (miRNAs) in blood or saliva is now a potential non-invasive diagnostic biomarker, although the diagnostic accuracy of the studies reported remains vastly different due to differences in biofluids, miRNA panels, disease spectrum, and platforms.</p><p><strong>Methods: </strong>We did a meta-analysis of diagnostic accuracy and a systematic review in accordance with PRISMA-DTA 2020 guidelines (PROSPERO: CRD420251274288). Articles that evaluated circulating miRNAs in any biofluid in diagnosing OSCC were taken into consideration. A Bayesian bivariate random-effects model was used to pool together the sensitivity, specificity, likelihood ratios, diagnostic odds ratios and the summary receiver operating characteristic (sROC) curves. Heterogeneity sources were analyzed using pre-constructed subgroup analysis and meta-regression.</p><p><strong>Results: </strong>The number of studies that were evaluated in totality was seventeen and seven were incorporated in the meta-analysis. The pooled sensitivity of the circulating miRNAs towards the detection of OSCC was 0.89 (95% CI: 0.77-0.95) and the pooled specificity was 0.88 (95% CI: 0.75-0.95). It had a pooled positive likelihood ratio (PLR) of 7.25 (95% CI: 3.42-16.08), a negative likelihood ratio (NLR) of 0.13(95% CI: 0.05-0.27), and a diagnostic odds ratio (DOR) of 59.69(95%CI:14.33-209.95). Good performance in discriminating was also noted in the sROC curve with an area under the curve value of approximately 0.90. However, substantial between-study heterogeneity was observed (τ ≈ 0.93 for sensitivity; τ ≈ 0.83 for specificity), and the 95% credible intervals around the DOR were wide (14.33-209.95). Individual studies of multi-miRNA panels reported AUCs up to 0.98, though pooled subgroup estimates were limited by small study numbers and wide uncertainty.</p><p><strong>Conclusions: </strong>Circulating miRNAs and in particular multi-miRNA saliva-based profiles provide promising but heterogenous diagnostic accuracy for OSCC. While individual panel studies have reported high AUCs, the current pooled evidence-derived from only seven small, mostly case-control studies of advanced-stage disease-does not yet establish utility for true early detection or population screening.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pooled safety profiles of bispecific antibodies targeting PD-1/CTLA-4 or PD-1/VEGF in non-small cell lung cancer: a systematic review and single-arm meta-analysis.","authors":"Jiayun Ma, Weixing Zhao","doi":"10.1186/s43046-026-00387-2","DOIUrl":"10.1186/s43046-026-00387-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to systematically synthesize and separately quantify the pooled safety profiles of bispecific antibodies (BsAbs) targeting PD-1/CTLA-4 or PD-1/VEGF in patients with non-small cell lung cancer (NSCLC), and to descriptively summarize class-specific safety patterns.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we systematically reviewed prospective clinical trials published through January 2026. A total of 17 studies, encompassing 1802 patients, were included. Single-arm proportion meta-analyses were conducted separately for each BsAb class using random-effects models. No formal between-class statistical comparison was performed. Given the clinical heterogeneity across included cohorts, including differences in study phase, treatment line, molecular subtype, and treatment regimen, pooled estimates were interpreted descriptively. Subgroup analyses by treatment regimen, treatment line, and individual BsAb agent were considered exploratory. Because of the limited number of cohorts within each phase stratum, the impact of study phase was assessed descriptively rather than through formal stratified meta-analysis.</p><p><strong>Results: </strong>In separate pooled analyses, the incidence of grade 3 or higher treatment-related adverse events (TRAEs) was 41.79% for PD-1/CTLA-4 BsAbs and 43.51% for PD-1/VEGF BsAbs. Exploratory subgroup analyses suggested different patterns of heterogeneity across the available cohorts. In PD-1/CTLA-4 BsAb studies, AE rates appeared to vary across individual agents, whereas in PD-1/VEGF BsAb studies, higher AE rates were observed mainly in chemotherapy-containing regimens. These observations should be interpreted cautiously because they may reflect differences in the distribution of included agents, patient populations, study phases, and treatment strategies rather than inherent class-specific toxicity mechanisms. Regarding tolerability, the pooled treatment discontinuation rate due to TRAEs was 10.26% in the PD-1/CTLA-4 analysis and 4.44% in the PD-1/VEGF analysis. The pooled incidence of immune-related adverse events (irAEs) was 46.68% in the PD-1/CTLA-4 analysis and 27.10% in the PD-1/VEGF analysis, whereas the pooled rates of grade 3 or higher irAEs were low in both analyses.</p><p><strong>Conclusion: </strong>This systematic review provides a descriptive synthesis of available safety data for PD-1/CTLA-4 and PD-1/VEGF BsAbs in NSCLC. Because the included cohorts differed substantially in study phase, treatment line, molecular background, and concomitant therapies, the pooled AE estimates should not be interpreted as direct comparative evidence. Instead, the findings should be viewed as hypothesis-generating signals that require validation in more homogeneous prospective studies or head-to-head trials.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MSA U-Net: a multi-scale attention-enhanced network for automatic segmentation of uterine lymph nodes in MRI images.","authors":"Jingde Hong, Chunxia Chen, Juping Qiu, Zeng Lin, Yuhang Xie, Yongping Lin","doi":"10.1186/s43046-026-00391-6","DOIUrl":"10.1186/s43046-026-00391-6","url":null,"abstract":"<p><strong>Objective: </strong>Lymph nodes (LNs) in medical images often have fuzzy boundaries, vary in size and shape, and have intensities similar to those of neighboring tissues, making accurate segmentation challenging. To address this issue, we propose a multi-scale attention-enhanced network (MSA U-Net) that integrates channel-wise and spatial attention mechanisms for automatic segmentation of metastatic pelvic LNs associated with uterine malignancies from sagittal magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>This network integrates a U-Net backbone, fuses features from different encoder levels at skip connections, and feeds the fused features into the decoder at each layer. Different receptive fields are used at the bottleneck nodes to capture multiscale contextual information. A detection head is added to the bottom layer of the network and the detection results are used to assist in the final segmentation of the image. A lightweight design of the convolutional block attention module is also implemented to optimize feature representation.</p><p><strong>Results: </strong>The experimental results demonstrate that the proposed network achieves better segmentation performance compared to the baseline model. The proposed network achieves a mean intersection over union of 0.76, an average pixel accuracy of 0.97, a precision of 0.78, a recall of 0.97, a Dice coefficient of 0.82, and a Hausdorff distance of 2.21.</p><p><strong>Conclusions: </strong>The proposed MSA U-Net segmentation network effectively segments LNs in uterine MRI images, outperforming existing segmentation methods. This study provides a reliable and automated method to help clinicians detect LN, thus improving clinical decision-making.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world efficacy and safety of CDK4/6 inhibitors plus endocrine therapy in HR+/HER2 - metastatic breast cancer: a single-institution experience.","authors":"Nawal E Hussein, Ahmed M Gad, Abeer AbdAllah, Noha S El Baghdady","doi":"10.1186/s43046-026-00390-7","DOIUrl":"10.1186/s43046-026-00390-7","url":null,"abstract":"<p><strong>Background: </strong>Hormone receptor-positive, HER2-negative (HR+/HER2-) metastatic breast cancer is the most common type of advanced breast cancer. The addition of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors to endocrine therapy (ET) has made a marked change to patient outcomes. While clinical trials have established their efficacy, real-world studies like this one are needed to confirm their effectiveness given the many variables which may arise in patient demographics and clinical presentation.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with HR+/HER2 - metastatic breast cancer treated with palbociclib, ribociclib, or abemaciclib plus ET at Electricity Hospital, Cairo, Egypt, between January 2019 and January 2025. Data on demographics, clinical characteristics, and treatment outcomes were collected from medical records. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method, and prognostic variables were analyzed using Cox regression.</p><p><strong>Results: </strong>A total of 59 patients (94.9% female; median age 58 years) were included. De novo metastatic disease was present in 39%, and visceral metastases in 33.9%. Ribociclib was prescribed to 52.5%, palbociclib to 39%, and abemaciclib to 8.5%. The objective response rate (ORR) was 88.1%, and the clinical benefit rate (CBR) was 98.3%. Median PFS was 23.7 months (95% CI, 11.9-23.9), and median OS was 38.9 months (95% CI, 27.0-60.3). On univariate analysis, absence of brain metastases, endocrine sensitivity, treatment response, and neutropenia were linked to longer PFS and OS. Dose reduction did not negatively impact outcomes. Toxicities were generally manageable, with grade 3-4 neutropenia in 33.9% of patients and no febrile episodes.</p><p><strong>Conclusion: </strong>In this real-world cohort, CDK4/6 inhibitors plus ET achieved survival outcomes similar to those reported in clinical trials, with a favorable safety profile. Endocrine sensitivity, absence of brain metastases, and development of neutropenia were associated with better survival, supporting the use of CDK4/6 inhibitors across a broad patient population.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The promising role of engineered T lymphocytes in immunotherapy for high-grade serous ovarian carcinoma: a review of mechanisms, clinical landscape, and future strategies.","authors":"Dwi Faradina, Muhammad Rusda, Muhammad Fidel Ganis Siregar, Cut Adeya Adella, Agung Putra, Arya Tjipta Prananda, Dodi Suardi, Johny Marpaung, Felix Khosasi","doi":"10.1186/s43046-026-00389-0","DOIUrl":"10.1186/s43046-026-00389-0","url":null,"abstract":"<p><p>High-grade serous ovarian carcinoma (HGSC) demonstrates poor prognosis with approximately 80% recurrence rates and significant chemotherapy resistance. Conventional checkpoint inhibitors show limited efficacy (10-15%), necessitating alternative immunotherapeutic approaches. Engineered T lymphocytes, particularly CAR-T and TCR-T cells, have emerged as promising strategies for HGSC. This literature review examines the promising role of engineered T lymphocytes in immunotherapy for HGSC. A comprehensive literature search was conducted across PubMed, Scopus, and Cochrane Library databases for peer-reviewed studies published between 2015 and 2025. Search terms included \"engineered T lymphocytes,\" \"CAR-T cells,\" \"TCR-T cells,\" \"ovarian cancer immunotherapy\". CAR-T cells demonstrate promising preclinical antitumor activity in HGSC, with high-avidity T-cell clones showing robust efficacy. Engineered T lymphocytes demonstrate promising approaches across disease contexts. In high-grade serous ovarian carcinoma, Engineered T lymphocytes orchestrate tumor cell apoptosis through coordinated granzyme/perforin and Fas/FasL signaling, enabling rapid cytotoxic elimination of multiple tumor targets.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13407792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}