Journal of the Egyptian National Cancer Institute最新文献

{"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}

{"title":"Clinical efficacy and safety outcomes of anlotinib therapy in sarcoma: a systematic review and meta-analysis.","authors":"Hasan Matar, Ahmad Melhem, Abdallah Shawwa, Taleen Yousef, Mohammad Alananbeh, Enad Alsalim, Eman Al-Refai, Malaak Abuhwaij, Dina Elayan","doi":"10.1186/s43046-026-00384-5","DOIUrl":"10.1186/s43046-026-00384-5","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcomas are rare, aggressive and unpredictable tumors that arise from mesenchymal tissues. Despite treatment, outcomes for advanced or metastatic cases remain poor. Anlotinib is a new oral tyrosine kinase inhibitor that blocks multiple angiogenic pathways and has shown encouraging results in solid tumors. This review aims to summarize and clarify the current evidence on anlotinib's role in treating sarcoma.</p><p><strong>Methods: </strong>A systematic search across five major databases up to February 2025 identified clinical studies that evaluate anlotinib in sarcoma patients. Eligible studies included randomized controlled trials and observational studies evaluating anlotinib in advanced or metastatic sarcoma. Pooled estimates for median progression-free survival (mPFS) and overall survival (mOS) were calculated using random-effects models.</p><p><strong>Results: </strong>Twenty-one studies involving 1,230 patients were included. The pooled mPFS was 6.7 months and the mOS was 19.3 months. Results varied widely due to differences in sarcoma subtype, disease stage, and prior therapies, yet most studies showed meaningful tumor control and manageable toxicity.</p><p><strong>Conclusions: </strong>Anlotinib appears to be a promising therapy for refractory or metastatic sarcomas. It offers modest yet real improvements in survival and quality of life. Larger, multicenter and biomarker-guided studies are needed to define which patients benefit most and how this drug can be best integrated into future treatment strategies.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579412","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":"Efficacy and safety of antibody-drug conjugates in HER2-positive and HER2-low advanced gastric cancer: a systematic review and update.","authors":"Lili Lei, Kun Hu, Shuangwei Xie, Bingqi Dong, Zhuona Rong, Xiaocong Pang, Junling Zhang, Ying Zhou","doi":"10.1186/s43046-026-00388-1","DOIUrl":"10.1186/s43046-026-00388-1","url":null,"abstract":"<p><strong>Purpose: </strong>Gastric cancer is a highly prevalent malignancy of the digestive tract in China. Conventional chemotherapeutic drugs and human epidermal growth factor receptor 2 (HER2)‑targeted agents such as trastuzumab remain limited by significant challenges in the treatment of GC, including high rates of drug resistance, significant toxicity and adverse effects, and suboptimal tolerability. The advent of antibody-drug conjugates (ADCs) has marked a paradigm shift in the therapeutic landscape. This review systematically summarises the structural design, mechanisms of action, and current clinical applications of ADCs in HER2-positive or HER2-low advanced gastric cancer.</p><p><strong>Methods: </strong>The present review focuses on key clinical trial data for new-generation ADCs, specifically trastuzumab deruxtecan (T-DXd) and disitamab vedotin (RC48), drawing from the DESTINY-Gastric series and the RC48-C008 study. The review systematically synthesised data on efficacy, safety profiles, resistance mechanisms, and future therapeutic directions.</p><p><strong>Results: </strong>New-generation ADCs have demonstrated significant improvements in objective response rates (ORR) and overall survival (OS) compared with traditional chemotherapy in later-line treatment settings. Emerging evidence also suggests the presence of activity in HER2-low-expressing populations. A systematic assessment of adverse drug reactions highlights both common events (e.g. gastrointestinal reactions, haematologic toxicity) and distinctive adverse events (e.g. interstitial lung disease), with corresponding management strategies. A comprehensive analysis of multiple resistance mechanisms, including HER2 heterogeneity, endocytic barriers, drug efflux, and target mutations, is conducted.</p><p><strong>Conclusion: </strong>The present study demonstrates that ADCs represent a transformative therapeutic modality for HER2-positive or HER2-low cases. Ongoing advancements in ADC structural optimisation, combination strategies with immune checkpoint inhibitors show great promise in terms of further improving clinical outcomes. The objective of this review is to furnish clinicians and researchers with a detailed reference for future clinical practice and investigation.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549608","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":"Disclosure of gynecological cancer diagnosis: a mixed-methods study from an Islamic cultural context.","authors":"Israa Malli, Hatim Al-Jifree, Farah Bakhamees, Loujen Alamoudi, Ola Bahadur","doi":"10.1186/s43046-026-00386-3","DOIUrl":"10.1186/s43046-026-00386-3","url":null,"abstract":"<p><strong>Background: </strong>Delivering devastating news of cancer is a universal challenge, but cultural and religious contexts impact disclosure. In Saudi Arabia, family engagement frequently influences communication, yet little is known about stakeholders' perspectives on gynecological cancer.</p><p><strong>Methods: </strong>This mixed-methods study used validated questionnaires and semi-structured interviews.</p><p><strong>Results: </strong>A total of 737 participants were included (54.1% public, 18.5% physicians, 16.0% relatives, and 11.4% patients); the majority were female (67.8%) and Saudi citizens (81.9%), with a median age of 38 years.</p><p><strong>Results: </strong>Overall, 90.5% of participants preferred that a cancer diagnosis be disclosed to the patient rather than withheld. However, only 25-36% supported disclosing a bad prognosis, with physicians being the least supportive (6.7%, p < 0.0001). Most groups supported the use of the term \"chemotherapy\" (88-98%). 94% of clinicians favored disclosing treatment failure, but only 61% of patients and 53% of the public agreed (p < 0.0001). More than half of patients (51.5%) and three-quarters of clinicians (73.1%) were opposed to concealing diagnoses at the request of the family. Patients greatly preferred engagement in treatment (66.3%) and end-of-life talks (80.7%), whereas physicians showed less support. In terms of communication dynamics, most patients preferred that the head of the medical team disclose directly to them, face-to-face, and framed with \"Allah's will.\"</p><p><strong>Conclusions: </strong>Although patients, family, the public, and clinicians mostly supported direct disclosure, there were still disagreements over prognosis and end-of-life talks. These findings emphasize the importance of culturally sensitive, ethically based communication training to enhance patient-centered treatment in gynecological oncology.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536284","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":"A prospective development and evaluation of a 2D convolutional neural network-based auto-segmentation model for cervical cancer radiotherapy.","authors":"Sidharth Satish Menon, Mahak Gupta, Aakriti Bhardwaj, Srinidhi G Chandraguthi, Jayashree Np, Umesh Velu, Anshul Singh, Ankita Mehta, Srinivasan Vijayakumar, Lavanya Gurram, Chaitra Raghuram, Roshan David Jathanna, Shirley Lewis","doi":"10.1186/s43046-026-00382-7","DOIUrl":"10.1186/s43046-026-00382-7","url":null,"abstract":"<p><strong>Background: </strong>Accurate delineation of target volumes and organs at risk (OAR) is essential in radiotherapy planning for cervical cancer. Deep learning (DL)-based auto-segmentation has the potential to improve contouring efficiency and workflow. This study reports the prospective development and internal validation of a DL-based auto-segmentation model- Deep contour (DC) for cervical cancer radiotherapy.</p><p><strong>Methods: </strong>In this prospective single-institution study, a 2-dimensional convolutional neural network based on the LinkNet architecture, DC, was trained on 190 computed tomography (CT) datasets for abdominal and pelvic OARs and 90 cervical cancer datasets for target volumes. Independent validation was performed on 20 CT datasets. Model performance was evaluated using dice similarity coefficient (DSC), Jaccard Index (JI), 95th percentile Hausdorff distance (HD95), average symmetric surface distance (ASSD), and surface dice coefficient (NSD). Expert internal and external radiation oncologists qualitatively explored clinical acceptability using a Likert scale, and segmentation time was compared with manual contouring.</p><p><strong>Results: </strong>The DC demonstrated the greatest geometric performance for the femur (DSC 0.92 ± 0.03; NSD 0.94 ± 0.04), bowel bag (DSC 0.89 ± 0.03; NSD 0.77 ± 0.12), and bladder (DSC 0.88 ± 0.14; NSD 0.87 ± 0.12). Among the target volumes, the inguinal nodal clinical target volume (CTVn_inguinal) achieved the greatest agreement (DSC 0.77 ± 0.04; NSD 0.76 ± 0.07). Moderate performance was observed for the rectum (DSC 0.75 ± 0.16), liver (DSC 0.73 ± 0.21), and pelvic nodal clinical target volume (CTVn_pelvis) (DSC 0.60 ± 0.10), whereas lower performance was observed for anatomically complex structures such as the duodenum, anal canal, common bile duct, pancreas, and pelvic vessels. Clinical evaluation of two cases revealed a Likert score of III-IV for key pelvic organs, such as the bladder, femur, pelvic bowel bag, rectum, and sigmoid. Auto-segmentation significantly reduced the segmentation time from 77 min to 5 s per dataset (p < 0.001).</p><p><strong>Conclusions: </strong>This prospective validation demonstrates that DC auto-segmentation model can achieve acceptable geometric performance congruent across multiple abdominal and pelvic OARs and reasonable geometric performance for the elective inguinal CTV volume. Further validation on larger datasets and evaluation of clinical workflow integration are warranted.</p><p><strong>Registry: </strong>CTRI, TRN: CTRI/2024/02/063055, Registration date: February 22, 2024.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447732","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":"Immune organoids for Africa: a roadmap for bridging the innovation gap in infectious diseases and cancer research.","authors":"Ahmad Onikoko Abdulgafar, Adeyemi Sallam Febilola, Catherine Rono, Chinemerem Henry Ugo, Saerimam Nzunde Markus, Mariam Iyabo Adeoba, Dagunduro Emmanuel Tolu","doi":"10.1186/s43046-026-00385-4","DOIUrl":"10.1186/s43046-026-00385-4","url":null,"abstract":"<p><strong>Background: </strong>Sub-Saharan Africa bears approximately 25% of the global disability-adjusted life-year (DALY) burden yet contributes fewer than 3% of global health research outputs. HIV/AIDS, tuberculosis (TB), and malaria coexist with a rising cancer burden, with attributable mortality projected to increase 75% by 2050. Fewer than 0.2% of genome-wide association study (GWAS) participants are of African ancestry, constraining precision medicine relevance. Conventional two-dimensional cultures and murine models inadequately replicate immune dynamics, tissue-level pathogenesis, and African pharmacogenomics. Immune organoids (three-dimensional microphysiological constructs) offer human-relevant platforms for mechanistic immunology, drug screening, vaccine evaluation, and precision oncology.</p><p><strong>Method: </strong>A narrative review was conducted across PubMed, Scopus, Web of Science, and Google Scholar (January 2019-June 2025), integrating technical descriptors (lymph node-on-a-chip, patient-derived organoids, microphysiological systems) with regional keywords (sub-Saharan Africa, genomic sovereignty, STISA-2034, frugal bioengineering). Gray literature from WHO, World Bank, and Africa CDC was incorporated. Thematic synthesis identified technological advances, infrastructural barriers, regulatory gaps, and sociopolitical determinants of adoption.</p><p><strong>Result: </strong>Lymph node-on-a-chip, tonsil-derived, and tumor-immune co-culture organoids enable high-fidelity interrogation of host-pathogen and tumor-immune interactions. Adoption is constrained by infrastructure deficits, reagent costs, energy instability, bioinformatics gaps, and nascent regulatory frameworks. Scalable solutions include a three-tier hub framework (Coordinator-Generator-Collaborator), ABCOMICS for continental genomic data governance, frugal LCD-based bioprinting, and passive microfluidic perfusion. Harmonized ethical guidelines and community-engaged consent are essential for genomic sovereignty.</p><p><strong>Conclusion: </strong>A phased, STISA-2034-aligned roadmap integrating frugal bioengineering, ethical governance, and targeted capacity-building can position Africa as a global leader in human-centric biomedical research, accelerating precision medicine, pandemic preparedness, and health equity.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447806","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":"Liquid crystal thermography for breast cancer detection: principles, current evidence, limitations, and future directions.","authors":"Ainnur Bazilah Mohd Sha'ari, Heba Mohammed Arafat, Tengku Ahmad Damitri Al Astani Tengku Din, Bazli Md Yusoff, Ohood Mohammed Shamallakh, Wan Faiziah Wan Abdul Rahman","doi":"10.1186/s43046-026-00383-6","DOIUrl":"10.1186/s43046-026-00383-6","url":null,"abstract":"<p><p>Breast cancer remains a leading cause of cancer-related mortality in women worldwide, making early and accurate detection a global clinical priority. Conventional screening modalities, including mammography, ultrasonography, and Magnetic Resonance Imaging (MRI), each have well-established strengths and limitations; in particular, mammographic sensitivity is reduced in women with heterogeneously or extremely dense breast tissue, where it may fall to approximately 50%. Liquid Crystal Thermography (LCT) is a contact-based, non-invasive, radiation-free technique that uses thermochromic liquid crystal (TLC) foils to map surface thermal patterns on the breast and has been investigated as a potential adjunct to standard breast screening. This narrative review summarises the physical and physiological basis of LCT, describes the Braster-based contact thermography workflow, evaluates published diagnostic performance data, and provides a structured analysis of current limitations, confounding factors, and evidence gaps in comparison with established screening modalities. Available studies suggest that LCT may have a role as an investigational adjunctive or triage tool, particularly in settings with limited access to standard imaging; however, the evidence base is heterogeneous, predominantly small in sample size, and methodologically variable, and is insufficient at this stage to establish LCT as a standalone substitute for mammography. The U.S. Food and Drug Administration (FDA) has explicitly stated that thermography should not be used in place of mammography for breast cancer screening or diagnosis. Any potential advantage of LCT in dense breast tissue remains unconfirmed, as no published comparative study has yet provided head-to-head false-negative and false-positive counts across modalities within this subgroup. Preliminary observational data from an ongoing Malaysian case series are included only to illustrate the clinical workflow; these findings are exploratory, unpublished, and not peer-reviewed, and should not be interpreted as confirmatory evidence of diagnostic performance. Future research priorities include large-scale prospective validation, standardised acquisition and interpretation protocols, and rigorous comparative reporting of sensitivity, specificity, and misclassification rates.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447749","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":"Global burden of multiple myeloma(1990-2021) and projections up to 2035: a methodical analysis leveraging the global burden of disease 2021 study and Mendelian randomization.","authors":"Run Qu, Xin Zhang, Jing Zou, Jinghua Ning, Yanhong Zhao, Yi Liang, Yuzhe Zhang","doi":"10.1186/s43046-026-00377-4","DOIUrl":"10.1186/s43046-026-00377-4","url":null,"abstract":"<p><strong>Objective: </strong>Multiple myeloma (MM), being the second-most frequently occurring hematologic malignancy, is comprehensively assessed for its global disease burden and risk factors using the Global Burden of Disease (GBD) database and Mendelian Randomization (MR).</p><p><strong>Methods: </strong>This research utilized data from the GBD 2021 database to extensively investigate age-standardized incidence rates, mortality rates, as well as Disability - Adjusted Life Years (DALYs) linked to MM. We evaluated the impact of various geographical areas, age brackets, genders, risk factors, and Socio-Demographic Index (SDI) on the disease burden of MM. Additionally, Joinpoint regression was employed by us to analyze the temporal trends of this burden. We integrated GBD data with a two-sample MR method for causal inference to further investigate causal relationships between risk factors and MM. Finally, we applied Bayesian-Age-Period-Cohort (BAPC) models to predict future trends in MM's disease burden by using GBD data as a foundation.</p><p><strong>Results: </strong>In 2021, the global incidence of MM was 148,755 cases, with 116,359 deaths and a total of 2,595,595 DALYs. The global age-standardized rates of MM were 1.74 (incidence), 1.37 (mortality), and 30.00 (DALYs) per 100,000 population, with higher rates observed in high-income areas. From 1990 to 2021, the annual average percentage change (AAPC) in global MM incidence was 0.54%, mortality was 0.20%, and DALYs was 0.18%. The MM burden associated with high BMI was concentrated within high-income areas such as those in Australasia and North America, while South Asia and Southeast Asia exhibited the lowest proportional burden. To further validate the causal link between BMI and MM, we conducted a two-sample MR.</p><p><strong>Conclusion: </strong>Over 30 years, the worldwide burden of MM has shown a significant rise. High-income countries show slowing trends due to improved healthcare, while low/middle-income regions face rising burdens from underdiagnosis and limited access. We demonstrate a positive association between elevated BMI and increased MM risk by using MR, underscoring the imperative for obesity control in high-income nations to alleviate the MM disease burden. This study offers a basis for optimizing global health policies, improving early diagnosis, and resource allocation against the ongoing threat of MM.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422140","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":"Prospective evaluation of dose rate effects on acute radiation toxicities and quality of life in head and neck cancer.","authors":"Ahmed Adel Ahmed, Wahib M Attia, O ELemary, Mohamed Abouegylah","doi":"10.1186/s43046-026-00375-6","DOIUrl":"10.1186/s43046-026-00375-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the influence of different dose rates on the radiation-related adverse events.</p><p><strong>Materials and methods: </strong>The study involved 60 patients divided into three groups, each receiving different dose rates of the Flattening Filter-Free (FFF) 6MV IMRT technique: 20 patients at 600, 20 at 1000, and 20 at 1400. Acute adverse events were monitored weekly. The EORTC-translated QLQ-H&N 35 questionnaire was used to assess health-related quality of life (QoL) according to established EORTC criteria during radiotherapy.</p><p><strong>Results: </strong>During the initial phase of radiotherapy treatment, no significant differences were noted in the prevalence of conditions such as mucositis and weight loss among the treatment groups. However, weight loss showed a significant variation (p = 0.028) at third week for the 600-dose rate group. From the fourth to fifth week, no notable differences emerged for mucositis and xerostomia among groups, while increase radiation dose rate was correlated with significant rise in dermatitis and dysphagia (p = 0.020 and p = 0.036, respectively). Similarly, from week five to six and from week six to seven, no significant differences were observed for mucositis. Yet significant increase in xerostomia and other conditions was evident with rising radiation dose rate. The evaluation of the QLQ-H&N 35 for head and neck cancer patients revealed a numerical scale for symptom severity, from 1 (not at all) to 4 (very much). While differences in symptom intensity across dose rates were noted, they did not reach statistical significance.</p><p><strong>Conclusion: </strong>The dose rate appears to influence patient health outcomes, although it does not seem to affect the QoL during the period of radiotherapy course treatment.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412204","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":"Immune checkpoint inhibitors in advanced cholangiocarcinoma: a systematic review of efficacy, safety, and emerging biomarkers.","authors":"Faiz Un Nisa, Moeez Ali, Talha Khan, Muskan Lohana, Aniba Asif, Nandni Kumari, Maaz Ali","doi":"10.1186/s43046-026-00381-8","DOIUrl":"10.1186/s43046-026-00381-8","url":null,"abstract":"<p><strong>Background: </strong>Cholangiocarcinoma (CCA) is an aggressive biliary tract malignancy often diagnosed at an advanced stage. For over a decade, gemcitabine-cisplatin (GemCis) remained the standard of care with limited survival benefit. The advent of immune checkpoint inhibitors (ICIs) has transformed the therapeutic landscape, but variability in outcomes and a rapidly expanding evidence base require systematic synthesis.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA 2020 guidelines. The review was not registered in PROSPERO or another prospective registry. PubMed/MEDLINE and Embase were searched from inception through 31 December 2024. Studies evaluating PD-1/PD-L1/CTLA-4 inhibitors alone or in combination for advanced CCA were included. Risk of bias was assessed using ROBINS-I for non-randomized studies and Cochrane RoB 2 for randomized controlled trials. A narrative synthesis was performed due to clinical and methodological heterogeneity.</p><p><strong>Results: </strong>Fifty-one studies (≈ 4,800 patients) met inclusion criteria, including 8 randomized controlled trials and 43 non-randomized studies. First-line chemo-immunotherapy with durvalumab or pembrolizumab plus GemCis established new standards of care in TOPAZ-1 (mOS 12.9 vs. 11.3 months; HR 0.76) and KEYNOTE-966 (mOS 12.7 vs. 10.9 months; HR 0.83). Triplet regimens (chemotherapy + ICI + tyrosine kinase inhibitor [TKI]) demonstrated high activity (e.g., toripalimab + lenvatinib + GEMOX: ORR 80%, mOS 22.5 months). Second-line ICI monotherapy yielded modest ORRs (3-22%), while ICI + TKI combinations showed ORRs of 9-28%. Grade ≥ 3 treatment-related adverse events ranged from 10 to 17% (ICI monotherapy) to 70-75% (chemo-ICI). PD-L1 expression was not predictive in chemo-ICI; homologous recombination deficiency (HRD)/DNA damage response (DDR) mutations and circulating tumor DNA (ctDNA) clearance emerged as promising biomarkers.</p><p><strong>Conclusions: </strong>ICIs combined with chemotherapy have redefined first-line treatment for advanced CCA. Triplet and locoregional combinations show encouraging efficacy, warranting further validation. Biomarker-driven selection, particularly HRD/DDR status and ctDNA monitoring, will be critical to optimizing outcomes.</p>","PeriodicalId":17301,"journal":{"name":"Journal of the Egyptian National Cancer Institute","volume":"38 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391067","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}