Oncology Reviews最新文献

{"title":"CAR-T cell therapy in glioblastoma: from αβ to γδ T-cell platforms.","authors":"Costanza Dieli, Roberta Costanzo, Anna Maria Corsale, Federica Paolini, Marta Di Simone, Claudia Avellone, Francesco Dieli, Domenico Gerardo Iacopino, Salvatore Marchiafava, Rosario Maugeri, Serena Meraviglia","doi":"10.3389/or.2026.1808229","DOIUrl":"10.3389/or.2026.1808229","url":null,"abstract":"<p><p>Glioblastoma multiforme (GBM) remains a highly aggressive brain tumor with limited treatment options and poor survival. The persistent clinical failure has driven interest in novel, immune-based strategies with higher specificity and greater cytotoxic potency, among which chimeric antigen receptor (CAR)-T-cell therapy has emerged as a leading approach. αβ CAR-T cells demonstrate safety but limited efficacy due to antigen heterogeneity, an immunosuppressive tumor microenvironment (TME), and restricted trafficking to the central nervous system (CNS). γδ CAR-T cells, combining innate major histocompatibility complex (MHC)-independent tumor recognition with engineered antigen specificity, have demonstrated preclinical cytotoxicity and features consistent with intratumoral persistence in selected models, as well as off-the-shelf potential, making them a next-generation immunotherapy strategy for GBM.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"20 ","pages":"1808229"},"PeriodicalIF":4.0,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471869","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":"Bidirectional regulatory mechanisms and therapeutic prospects of tumor hypercoagulable state and immunosuppressive tumor microenvironment.","authors":"Yongli Lai, Ruyu Qin, Zhaidong Liu","doi":"10.3389/or.2026.1863533","DOIUrl":"10.3389/or.2026.1863533","url":null,"abstract":"<p><p>The tumor hypercoagulable state (THS) is an acquired and persistent prothrombotic condition driven by the tumor and its microenvironment. An immunosuppressive tumor microenvironment (TME) is a local microenvironment that suppresses antitumor immune responses and promotes tumor evasion of immune surveillance and is also a key driver of tumorigenesis, tumor progression, and metastasis. An intricate bidirectional regulatory axis exists between THS and immunosuppressive TME, establishing a self-reinforcing \"hypercoagulability-immunosuppression\" vicious cycle that severely impairs patient prognosis and reduces the efficacy of immunotherapy. To break this vicious cycle, the combined use of anticoagulant therapy and immunotherapy has garnered increasing attention. Current treatment techniques aimed at the coagulation-immune axis hold significant promise. However, this combinatorial method has a number of translational issues, including bleeding hazards, tumor heterogeneity, a lack of prognostic biomarkers, unexplained resistance mechanisms, and difficulties in clinical implementation. This review delineates the bidirectional regulatory mechanisms that link THS and immunosuppressive TME, assesses the promise of combined therapeutic modalities, discusses current challenges, and outlines future directions for precision oncology, with the ultimate goal of providing more effective cancer treatment options.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"20 ","pages":"1863533"},"PeriodicalIF":4.0,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437414","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":"Risk factors for return to work in workers who experienced cancer: a systematic review with meta-analysis.","authors":"M Franco, F Buscema, A Catalano, L Dansero, L Milani, G W Gilcrease, F Ricceri","doi":"10.3389/or.2026.1759182","DOIUrl":"10.3389/or.2026.1759182","url":null,"abstract":"<p><strong>Background: </strong>The number of people who have experienced cancer is increasing, and by 2040 cases are expected to rise by 40%, with a high prevalence among working-age individuals. Many people who experienced cancer (pwEC) face reduced work ability due to health, personal, and occupational factors. Therefore, this study aims to identify the main factors that hinder RTW among pwEC.</p><p><strong>Methods: </strong>A systematic literature search was conducted via PubMed, CINAHL, and the Cochrane Library, covering studies published between January 2012 and June 2024. Inclusion criteria focused on studies analysing RTW and Time to RTW in relation to sociodemographic, clinical, and occupational factors. Meta-analysis grouped studies by design, exposure, and effect measures. Fixed or random effects models were applied based on heterogeneity. Risk of bias was assessed using NOS and RoB2 tools. Certainty of evidence was assessed using GRADE tool and STROBE checklist.</p><p><strong>Results: </strong>Among 2,151 screened articles, 43 met the inclusion criteria. Chemotherapy (OR = 0.56, 95% CI: 0.52-0.60) and radiotherapy were associated with a reduced likelihood of RTW. Women were more likely than men to RTW. Manual labour was linked to a lower likelihood of re-employment than white-collar jobs (OR = 0.84, 95% CI: 0.78-0.89). In terms of timing, male sex and chemotherapy delayed the process, whereas radiotherapy accelerated it (HR = 1.03, 95% CI: 1.00-1.06).</p><p><strong>Conclusion: </strong>Identifying barriers to RTW after cancer is essential for improving quality of life and social reintegration in people who have experienced cancer. These findings highlight the complexity of RTW and the need for a personalized approach. However, the evidence is limited by heterogeneity and differences in study design.</p><p><strong>Trial registration: </strong>The protocol was registered in PROSPERO (registration number: CRD42022384364).</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"20 ","pages":"1759182"},"PeriodicalIF":4.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437409","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":"Artificial intelligence-driven multimodal fusion for precision diagnosis and personalized management of breast cancer.","authors":"Mingyu Zhang, Juhang Chu, Zixin Wang, Yaru Wang, Luyao Huang, Mingping Qian","doi":"10.3389/or.2026.1849152","DOIUrl":"10.3389/or.2026.1849152","url":null,"abstract":"<p><p>Breast cancer is the most common malignancy among women worldwide, characterized by pronounced heterogeneity across molecular profiles, imaging phenotypes, and the tumor microenvironment. As precision oncology continues to advance, diagnostic strategies that rely predominantly on single-modality imaging or pathology face inherent limitations in early detection, individualized risk stratification, and timely recurrence assessment. Recent progress in artificial intelligence, particularly deep learning-based methods, has accelerated the development of multimodal fusion models that integrate radiomics, digital pathology, multiomics data, liquid biopsy biomarkers such as circulating tumor DNA, and clinical variables within unified computational frameworks. These integrative approaches enable the discovery of cross-modal associations and have demonstrated improved performance in diagnosis, molecular subtyping, treatment response prediction, and prognostic evaluation. In this review, we provide a comprehensive overview of the fundamental principles, methodological advances, and representative clinical applications of AI-driven multimodal fusion in breast cancer. We further discuss emerging directions, including digital twin-based modeling, dynamic monitoring of minimal residual disease, and multimodal large language models. Finally, we highlight current challenges related to data standardization, model interpretability, and multi-center validation, and outline future perspectives toward clinically translatable and robust intelligent systems.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"20 ","pages":"1849152"},"PeriodicalIF":4.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352695","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":"Cardio-oncology in multidisciplinary synergy: addressing the rising burden of cancer therapy-related cardiovascular toxicity (CTR-CVT) in advancing oncology practices.","authors":"Putri Dwi Astuti, Eko Adhi Pangarsa, Andreas Arie Setiawan, Daniel Rizky, Budi Setiawan, Charles Limantoro, Damai Santosa, Catharina Suharti","doi":"10.3389/or.2026.1852886","DOIUrl":"10.3389/or.2026.1852886","url":null,"abstract":"<p><strong>Introduction: </strong>Improvements in cancer detection and the development of modern anticancer therapies have markedly increased survival rates among patients with malignancies, resulting in a rapidly expanding survivor population. Alongside these advances, cardiovascular complications related to cancer treatment have emerged as a major clinical concern, significantly affecting long-term morbidity and mortality. The growing intersection between oncology and cardiovascular medicine has led to the development of cardio-oncology, a multidisciplinary field focused on balancing effective cancer treatment with cardiovascular safety. This review discusses current perspectives on the mechanisms, risk assessment, prevention, surveillance, and management of cancer therapy-related cardiovascular toxicity (CTR-CVT) in contemporary oncology practice.</p><p><strong>Methods: </strong>A narrative literature review was conducted using electronic databases including PubMed, Scopus, and ScienceDirect. Relevant studies published between 2015 and 2025 were identified using predefined keywords related to cardio-oncology and cardiovascular toxicity. Eligible articles included clinical trials, observational studies, guidelines, and systematic reviews focusing on CTR-CVT. Studies were screened based on relevance, and key findings were synthesized narratively.</p><p><strong>Key-content and findings: </strong>CTR-CVT comprises diverse cardiovascular complications associated with both conventional and emerging anticancer therapies. Risk stratification tools such as HFA-ICOS facilitate early identification of high-risk patients and guide surveillance strategies. Early multidisciplinary management, particularly for severe toxicities such as immune checkpoint inhibitor-associated myocarditis, is essential to optimize both cardiovascular and oncologic outcomes.</p><p><strong>Conclusion: </strong>CTR-CVT represents a major challenge in contemporary oncology care. A multidisciplinary cardio-oncology approach integrating early risk assessment, preventive strategies, and structured monitoring is essential to balance oncologic efficacy with cardiovascular safety. Future research should focus on personalized risk prediction and targeted cardioprotection strategies.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"20 ","pages":"1852886"},"PeriodicalIF":4.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345884","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":"Association of MMP-2 and hematological parameters with breast cancer metastasis: a cross-sectional study in Central Java, Indonesia.","authors":"Alyssa Imani, Yan Wisnu Prajoko, Rudi Nirwantono, Fitya Syarifa Mozar, Bens Pardamean, Edward Kurnia Setiawan Limijadi","doi":"10.3389/or.2026.1818926","DOIUrl":"10.3389/or.2026.1818926","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer metastasis remains a major contributor to morbidity and mortality, partly due to the disease's marked biological heterogeneity. Identification of reliable biomarkers associated with metastatic progression is essential for improving risk stratification and clinical management. Matrix metalloproteinase-2 (MMP-2) and routine hematological and metabolic parameters have been implicated in cancer progression, but their roles in breast cancer metastasis remain inconsistent across populations.</p><p><strong>Methods: </strong>This cross-sectional study evaluated general, hematological and metabolic parameters in breast cancer patients from Dr. Kariadi General Hospital, the main referral hospital for Central Java, Indonesia. Associations with metastasis were assessed using univariate analyses, followed by least absolute shrinkage and selection operator (LASSO) logistic regression for variable selection. Multicollinearity was assessed using variance inflation factor (VIF), and selected variables were entered simultaneously into a multivariable binary logistic regression model. Associations between selected hematological parameters and estrogen receptor (ER) and progesterone receptor (PR) status were also examined. Associations between clinicopathological variables and histologic grade were analyzed using the Kruskal-Wallis test.</p><p><strong>Results: </strong>Histologic grade was the only general characteristic significantly associated with metastasis (<i>P</i> < 0.001). In univariate analysis, metastatic patients showed significantly higher MMP-2, WBC count, and SGOT levels, whereas lower MCV and uric acid levels were detected. Multivariable logistic regression identified MMP-2 (<i>P</i> = 0.015; OR = 1.124, 95% CI: 1.023-1.236) and platelet count (<i>P</i> = 0.047; OR = 0.973, 95% CI: 0.947-1.000) as independently associated with breast cancer metastasis. Platelet count was also significantly associated with ER status (<i>P</i> = 0.039), but not with PR status (<i>P</i> = 0.054). Kruskal-Wallis analysis demonstrated significant differences in MMP-2 and uric acid levels across histologic grades I-III.</p><p><strong>Conclusion: </strong>Elevated MMP-2 levels and reduced platelets were independently associated with breast cancer metastasis, while platelets were additionally associated with ER status. These findings suggest that MMP-2 and platelet count may serve as potential biomarkers associated with metastatic behavior and hormone receptor status in breast cancer.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"20 ","pages":"1818926"},"PeriodicalIF":4.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318282","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 PD-1 inhibitors in recurrent or metastatic squamous cell carcinoma of the head and neck: a systematic review and meta-analysis.","authors":"Abdullah Alabbasi, Muhanad Alzahrani, Ziyad Alzahrani, Faris Sultan, Maha AlQahtani, Alaa Sultan","doi":"10.3389/or.2026.1745071","DOIUrl":"10.3389/or.2026.1745071","url":null,"abstract":"<p><strong>Background: </strong>Conventional cytotoxic regimens for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) offer limited durable benefit and are associated with significant toxicity. Immune checkpoint inhibitors targeting the PD-1/PD-L1 pathway have emerged as alternative treatments; however, variability in response, survival, and toxicity across studies necessitates comprehensive synthesis. This systematic review and meta-analysis evaluated the efficacy and safety of PD-1 inhibitors in adults with R/M HNSCC.</p><p><strong>Methods: </strong>A systematic search of PubMed (MEDLINE), Embase, Scopus, and Cochrane databases was conducted. Study selection followed the PICOS framework and PRISMA guidelines, with screening performed using Rayyan. Data synthesis was conducted in R (version 4.1.1) using the meta and metafor packages. The protocol was registered in PROSPERO (CRD420251169189).</p><p><strong>Results: </strong>Fourteen studies (n = 1,231) were included: nine in non-NPC HNSCC (primary analysis) and five NPC-only studies (sensitivity subgroup). In non-NPC HNSCC, pooled ORR was 22% (95% CI: 8%-48%, I² = 87%) for combination therapy and 14% (95% CI: 3%-46%, I² = 29%) for monotherapy. For combination regimens, pooled best responses were: CR 5.6%, PR 21.7%, SD 28.2%, and PD 34.9%. One-year PFS was 29.3% (95% CI: 13.5%-52.4%, I² = 88%, k = 3), and 1-year OS was 59.0% (95% CI: 42.3%-73.8%, I² = 82%, k = 8). Grade 3-5 treatment-related adverse events occurred in 16.3% of monotherapy patients and 48.2% of combination therapy patients. In NPC-only studies (k = 5), pooled ORR was 61.1% (95% CI: 13.4%-94.1%, I² = 89%). Estimates are descriptive and largely derived from single-arm studies with substantial heterogeneity.</p><p><strong>Conclusion: </strong>PD-1 inhibitor combinations may be associated with higher response rates and 1-year survival compared with monotherapy in non-NPC HNSCC, at the cost of increased toxicity. These findings are hypothesis-generating and do not establish causal efficacy. Well-designed randomized trials stratified by disease subtype and treatment context are needed, alongside greater focus on quality-of-life outcomes.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"20 ","pages":"1745071"},"PeriodicalIF":4.0,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13279530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295919","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":"Diagnostic utility of FAPI PET/CT in radioiodine-refractory thyroid cancer and TENIS syndrome: a systematic review.","authors":"Akram Al-Ibraheem, Saad Ruzzeh, Ahmad Al-Muhtaseb, Ahmed Saad Abdlkadir, Serin Moghrabi, Hongcheng Shi, Habibollah Dadgar, Mahed Al-Foqahaa, Marwah Abdulrahman, Soud Al-Qasem, Issa Mohamad, Gerasimos P Sykiotis","doi":"10.3389/or.2026.1811291","DOIUrl":"10.3389/or.2026.1811291","url":null,"abstract":"<p><strong>Background: </strong>Fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography (PET/CT) has emerged as a promising molecular imaging modality with favorable lesion-to-background contrast across several malignancies. In radioiodine-refractory thyroid carcinoma (RAIR-TC) and thyroglobulin-elevated negative iodine scintigraphy (TENIS) syndrome, conventional radioiodine imaging and fluorodeoxyglucose (FDG) PET/CT may be limited in selected clinical scenarios. This systematic review evaluated the diagnostic utility, comparative performance, and potential clinical impact of FAPI PET/CT in this patient population.</p><p><strong>Methods: </strong>PubMed, Embase, and Scopus were searched from inception to 6 August 2025 according to PRISMA 2020 guidelines. Eligible studies included original clinical studies and case reports evaluating FAPI PET/CT in RAIR-TC or TENIS syndrome. Non-original, non-human, <i>in vitro</i>, conference abstract, and non-English publications were excluded. Two reviewers independently performed study selection, data extraction, and quality assessment. QUADAS-2 was applied to eligible cohort studies.</p><p><strong>Results: </strong>Eight studies comprising 167 patients were included: three prospective studies, one retrospective study, and four case reports. FAPI PET/CT showed promising complementary diagnostic value in selected clinical scenarios, particularly for lesions with low FDG conspicuity or high physiologic FDG background. In one prospective cohort of 24 patients, [⁶⁸Ga]Ga-DOTA-FAPI-04 PET/CT detected disease in 87.5% of patients. In the largest retrospective cohort (n = 117), [⁶⁸Ga]Ga-DOTA.SA.FAPi showed higher detection than FDG PET/CT for selected metastatic sites, including lymph nodes, liver, and brain. However, comparative performance varied across tracers, lesion sites, and study designs; one prospective [¹⁸F]FAPI-74 study reported lower lesion detection than FDG PET/CT.</p><p><strong>Conclusion: </strong>FAPI PET/CT demonstrates promising but preliminary diagnostic utility in RAIR-TC and TENIS syndrome. Current evidence supports a complementary role in selected patients, but remains insufficient to establish routine diagnostic superiority over FDG PET/CT. Larger prospective multicenter studies with standardized protocols and robust reference validation are required.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251123809.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"20 ","pages":"1811291"},"PeriodicalIF":4.0,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278138","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":"Signaling pathway mechanisms in pancreatic ductal adenocarcinoma tumor microenvironment and emerging targeting strategies for improved prognosis.","authors":"Tosin Akinsipe, Caroline O Odewumi, Lekan Latinwo, Omorose O Aghimien, Musiliyu A Musa, Philip O Igbinoba, Anthony L Simons, Monica O Aghimien","doi":"10.3389/or.2026.1814540","DOIUrl":"10.3389/or.2026.1814540","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, characterized by a dense desmoplastic stroma and a profoundly immunosuppressive tumor microenvironment (TME). The TME plays a major role in tumor progression, metastasis, and resistance to conventional therapies through a network of dysregulated signaling pathways, including KRAS, PI3K/AKT/mTOR, Raf/MAPK/ERK, TGF-β, NF-κB, Notch and Hedgehog. Moreover, cellular components such as cancer-associated fibroblasts (CAFs), tumor-associated macrophages (TAMs), and regulatory T cells (Tregs) drive immune evasion and therapeutic resistance via cytokine signaling axes, including IL-6/STAT3 and CXCL12/CXCR4. Recent advances in nanomedicine have introduced polymeric nanoparticles as promising delivery vehicles for targeted disruption of these aberrant pathways. Polymeric nanoparticles are engineered to enhance bioavailability, tissue penetration, and selective delivery, co-deliver small-molecule inhibitors, siRNA, or immunomodulatory agents directly to the TME. This approach offers a strategy to overcome biological barriers, reprogram the stroma, and sensitize tumors to immunotherapy and chemotherapy. This review comprehensively examines the signaling mechanisms of PDAC in the TME, discusses current therapeutic strategies targeting these pathways, highlights challenges, including resistance and adverse effects, and explores future directions to optimize pancreatic cancer treatment by modulating this key signaling axis with nanomedicine.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"20 ","pages":"1814540"},"PeriodicalIF":4.0,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252561","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":"Applications of large language models in tumor boards: a systematic review.","authors":"Benjamin Konzmann, Maurice Henkel, Christian Breit, Christian Wetterauer","doi":"10.3389/or.2026.1757059","DOIUrl":"10.3389/or.2026.1757059","url":null,"abstract":"<p><strong>Background: </strong>Multidisciplinary tumor boards (MDTs) are the gold standard for cancer care but currently face significant pressure from rising case volumes and the increasing complexity of precision medicine. Large Language Models (LLMs) offer potential as Clinical Decision Support Systems (CDSS) to augment these workflows. This systematic review evaluates the current applications, accuracy, and safety of LLMs in MDT decision-making.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA 2020 guidelines. We searched PubMed/MEDLINE, Embase, IEEE Xplore, and arXiv for primary research published between January 2023 and November 2025. Inclusion criteria required studies to evaluate LLM performance in tumor board settings against human consensus or established clinical guidelines.</p><p><strong>Results: </strong>Thirty-one studies encompassing 3,845 unique patient cases were included. The analysis revealed a distinct \"complexity gap\" in model performance. In standardized, high-incidence domains such as breast and prostate cancer, advanced models (particularly the GPT-4 family) demonstrated high concordance (up to 94%) with human experts. However, performance degraded significantly in complex, rare, or multimodal scenarios-such as sarcoma or neuro-oncology-where models struggled with \"gray zone\" decision-making and lacked the ability to interpret non-textual data. While LLMs showed utility in administrative tasks and guideline retrieval, they remained prone to hallucinations and lacked the nuance required for holistic patient assessment.</p><p><strong>Conclusion: </strong>Current LLMs exhibit sufficient maturity to function as assistive tools for documentation and decision support in routine oncological cases but are not yet reliable enough for autonomous decision-making. Successful clinical implementation will require \"human-in-the-loop\" safeguards, the development of multimodal architectures, and rigorous prospective validation to ensure patient safety.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"20 ","pages":"1757059"},"PeriodicalIF":4.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13230141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164018","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}