Clinical & Translational Oncology最新文献

{"title":"Rediscovering medical humanism in the age of artificial intelligence: lessons from historical medical traditions.","authors":"Miriam López-Gómez, Eva-María Corrales-García, César Gómez-Raposo, Ana Ruiz-Casado, Enrique Casado-Sáenz, Pedro-David Delgado-López","doi":"10.1007/s12094-026-04591-3","DOIUrl":"https://doi.org/10.1007/s12094-026-04591-3","url":null,"abstract":"<p><p>Artificial intelligence (AI) is increasingly transforming diagnosis, treatment selection, prognostic assessment, and administrative work in medicine. Although these technologies may improve efficiency and clinical performance, their integration also raises questions about medical humanism, professional responsibility, and the physician-patient relationship. This narrative historical review examines the contributions of Hippocrates, Asclepiades, Galen, Avicenna, and Maimonides to the relationship between medical knowledge, clinical judgment, and moral responsibility, and considers how these historical traditions may inform contemporary debates on AI in medicine and oncology. Primary historical texts and secondary scholarly literature were examined through a targeted, non-systematic approach, with emphasis on clinical observation, therapeutic responsibility, the physician-patient relationship, and the ethical purposes of medicine. The analysis identifies three normative themes of contemporary relevance: the non-delegable responsibility of the physician, the relational and contextual nature of clinical reasoning, and the ethical limits of technological optimization. Contemporary philosophy of medicine and recent AI ethics literature provide a conceptual bridge between these historical traditions and current technological practice. This bridge might be the source of a lack of humanism in daily practice and a deterioration in patient-physician relationship. In oncology, these principles related to AI use are particularly relevant to AI-assisted imaging and pathology, molecular profiling, treatment selection, prognostic prediction, and shared decision-making. AI should, therefore, be understood as a clinical instrument whose value depends not only on technical performance, but also on its integration into relationships of trust, accountability, and patient-centered care.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant treatment intensity in circulating tumour DNA-negative colorectal cancer: a systematic review and reconstructed individual patient data meta-analysis.","authors":"Shugo Yajima, Soichiro Yoshida, Kohei Hirose, Wei Chen, Hiroyuki Sato, Akihiro Hirakawa, Hitoshi Masuda, Yasuhisa Fujii","doi":"10.1007/s12094-026-04589-x","DOIUrl":"https://doi.org/10.1007/s12094-026-04589-x","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative circulating tumour DNA (ctDNA) is strongly prognostic after curative-intent surgery, but whether a negative result identifies patients with colorectal cancer (CRC) who can safely receive less-intensive adjuvant management remains uncertain. We synthesised prospective comparative evidence using reconstructed individual patient data (r-IPD), distinguishing the types of treatment contrast that have been studied.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Google Scholar, Web of Science, the Cochrane Library, and ClinicalTrials.gov were searched through August 2025, and the structured databases and trial registry were updated to 1 October 2026. Time-to-event data for postoperative ctDNA-negative patients were reconstructed from published Kaplan-Meier curves. CRC analyses were organised by type of contrast: omission of chemotherapy, treatment duration, or addition of an investigational agent to standard chemotherapy. A pooled estimate across contrasts was reported as an exploratory summary.</p><p><strong>Results: </strong>Thirteen studies involving 9552 patients were included; r-IPD were reconstructed for 5323 ctDNA-negative patients, including 4236 with CRC from five studies. Hazard ratios (HRs) favoured more-intensive management for chemotherapy versus observation in the non-randomised GALAXY registry (HR 0.72, 95% confidence interval [CI] 0.52-0.99) and for 6 versus 3 months of chemotherapy in IDEA-France (HR 0.75, 95% CI 0.58-0.97), whereas adding an investigational agent to standard chemotherapy in three randomised trials did not show a clear benefit (HR 0.95, 95% CI 0.75-1.20). The exploratory pooled estimate was HR 0.84 (95% CI 0.73-0.96; I²= 0%), corresponding to a 36-month disease-free survival difference of 2.2 percentage points (95% CI - 0.3 to 4.6); with GALAXY analysed as a single study and methods suited to few studies, the CI included the null.</p><p><strong>Conclusions: </strong>Current evidence does not support omission or broad de-escalation of adjuvant therapy solely because postoperative ctDNA is negative. The association with treatment intensity depended on the type of contrast, complete omission has been examined only in non-randomised data, and absolute differences were small. Research registration PROSPERO registration number: CRD420251153449.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-related local complications as a major contributor to mortality after definitive radiotherapy for unresectable extrahepatic bile duct cancer.","authors":"Ye Jin Yoo, Jin-Hong Park","doi":"10.1007/s12094-026-04581-5","DOIUrl":"https://doi.org/10.1007/s12094-026-04581-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated oncologic outcomes and causes of death after radiotherapy in patients with unresectable extrahepatic bile duct cancer.</p><p><strong>Methods: </strong>We retrospectively analyzed 74 patients with localized unresectable or inoperable extrahepatic bile duct cancer treated with conventionally fractionated radiotherapy between September 2005 and February 2019. Fifty-five patients (74.3%) underwent three-dimensional conformal radiotherapy, and 19 patients (25.7%) received intensity-modulated radiotherapy. Induction chemotherapy was administered in 18 patients and 57 patients received concurrent chemotherapy.</p><p><strong>Results: </strong>Among all patients, 90.5% (67/74) had perihilar bile duct cancer, and the median radiotherapy dose was 54.0 Gy. With a median follow-up of 16.2 months, the median progression-free survival and overall survival were 11.5 and 18.3 months, respectively. Distant metastasis was the predominant first failure pattern (52.7%), followed by locoregional progression (20.3%). The 1- and 2-year freedom from local progression rates were 86.3% and 36.2%, respectively. Cholangitis, liver failure, and tumor bleeding accounted for 26 of 65 deaths, corresponding to at least 40.0% of all deaths. Radiotherapy dose above 54 Gy was not significantly associated with freedom from local progression, progression-free survival, or overall survival. No patients experienced grade ≥ 3 acute gastrointestinal toxicity, whereas grade ≥ 3 late toxicities occurred in 8.1%.</p><p><strong>Conclusion: </strong>Definitive radiotherapy provided favorable local control with acceptable toxicity in unresectable extrahepatic bile duct cancer. Although distant metastasis was the predominant failure pattern, local complications accounted for at least 40% of deaths, supporting continued efforts to optimize local treatment alongside emerging systemic therapies.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value and research advances of ctDNA in perioperative therapy for non-small cell lung cancer.","authors":"Jie Diao, Fan Cen, Yuqiong Gao, Min Jiang, Hong Yin","doi":"10.1007/s12094-026-04565-5","DOIUrl":"https://doi.org/10.1007/s12094-026-04565-5","url":null,"abstract":"<p><p>Perioperative treatment plays an increasingly important role in improving outcomes for patients with resectable non-small cell lung cancer (NSCLC). Circulating tumor DNA (ctDNA) offers a new perspective for optimizing individualized perioperative management. This review systematically examines the core value of ctDNA in perioperative therapy for resectable NSCLC, encompassing its correlation with treatment response and pathological remission during the neoadjuvant phase, its utility as a dynamic monitor of treatment efficacy, and its emerging role in prognostic stratification and recurrence prediction in the postoperative setting. Importantly, while ctDNA demonstrates considerable promise for guiding individualized perioperative management, most applications remain investigational; we therefore distinguish between established correlative uses and prospective strategies currently under evaluation in clinical trials. It also addresses current technical challenges in ctDNA application, including limited sensitivity, false positives, lack of standardization, cost-effectiveness concerns, and difficulties in integration into clinical decision-making. Future prospective interventional studies are needed to validate ctDNA-guided treatment adjustments and to establish standardized protocols and multidisciplinary collaboration pathways, thereby facilitating the integration of ctDNA into the full course of perioperative management for NSCLC and enabling precise efficacy assessment, risk stratification, and individualized treatment decisions.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring uncertainties in melanoma management: a Spanish multidisciplinary Delphi consensus.","authors":"Aram Boada, Alfonso Berrocal, Miguel-Ángel Berciano-Guerrero, César Casado, Enrique Espinosa, Iván Márquez-Rodas, Eduardo Nagore, Teresa Puértolas, José Luis Rodríguez-Peralto, Lorena Ostios-García, Cristina Sáez-López, Eva Muñoz-Couselo","doi":"10.1007/s12094-026-04539-7","DOIUrl":"https://doi.org/10.1007/s12094-026-04539-7","url":null,"abstract":"<p><strong>Purpose: </strong>Melanoma is a highly metastatic tumor responsible for 90% of skin cancer deaths. Despite established clinical guidelines, certain areas of its management in Spain remain heterogeneous, particularly in complex scenarios such as neoadjuvant therapy, metastatic sequencing, and follow-up. This project aimed to generate expert-informed recommendations to standardize care in areas of clinical uncertainty.</p><p><strong>Materials and methods: </strong>A two-round Delphi process was conducted. Following a systematized review, a multidisciplinary panel of 35 specialists (oncology, dermatology, surgery, and pathology) evaluated 59 statements on uncertain areas of melanoma management. Consensus was defined as ≥ 80% agreement using a 5-point Likert scale.</p><p><strong>Results: </strong>Overall, 52 statements achieved consensus (3 unanimous, 49 by agreement). Key findings support the use of neoadjuvant immunotherapy in resectable stage III melanoma, particularly in patients with clinically detectable nodal disease, due to its benefit in reducing recurrence risk. A major pathological response was considered a key factor to individualize subsequent surgical and adjuvant decisions. In metastatic disease, therapeutic sequencing algorithms were defined according to BRAF mutational status, prior treatments, and timing of progression. The panel agreed that PD-L1 expression should not be used as the sole factor to exclude patients from anti-PD-1 therapy. Marked variability in follow-up practices was identified, highlighting the need for standardized approaches and quality indicators.</p><p><strong>Conclusion: </strong>This Delphi consensus reflects the views of a multidisciplinary panel of Spanish melanoma experts on key areas of uncertainty in melanoma management. By integrating evidence and expert experience, the findings may help support clinical decision-making and serve as a complementary reference for clinical practice.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher TIGIT expression in the intraperitoneal immune microenvironment is associated with shorter progression-free survival in patients with gastric cancer with peritoneal metastasis treated with intraperitoneal paclitaxel.","authors":"Atsushi Yamada, Motohiro Imano, Hiroaki Kato, Ryusuke Kobayashi, Naoko Kounami, Masuhiro Terada, Masashi Kohda, Tomoya Nakanishi, Yoko Hiraki, Osamu Shiraishi, Atsushi Yasuda, Masayuki Shinkai, Takushi Yasuda","doi":"10.1007/s12094-026-04587-z","DOIUrl":"https://doi.org/10.1007/s12094-026-04587-z","url":null,"abstract":"<p><strong>Purpose: </strong>Gastric cancer with peritoneal metastasis has a poor prognosis. This exploratory study evaluated whether immune checkpoint molecules in the intraperitoneal immune microenvironment are associated with clinical outcomes during intraperitoneal paclitaxel (ipPTX)-based combination chemotherapy.</p><p><strong>Methods: </strong>Twenty-nine previously untreated patients with gastric cancer and macroscopic peritoneal metastasis who underwent staging laparoscopy and received ipPTX-based combination chemotherapy were retrospectively analyzed. Lymphocyte subsets in peritoneal lavage fluid were evaluated by flow cytometry. TIGIT, TIM-3, and LAG-3 expression was assessed in cell block specimens prepared from peritoneal lavage fluid by immunohistochemistry. Biomarker analyses were exploratory. Immune-related markers were analyzed primarily as continuous variables, and multivariable progression-free survival (PFS) and overall survival (OS) models were restricted to TIGIT and baseline Peritoneal Carcinomatosis Index (PCI) using Firth's penalized Cox regression.</p><p><strong>Results: </strong>Median PFS and OS were 10.6 and 17.2 months, respectively. Among 27 patients evaluable for TIGIT, higher TIGIT expression was associated with shorter PFS in a continuous-variable Cox model (hazard ratio [HR] per 10-percentage-point increase, 1.53; 95% confidence interval [CI] 1.12-2.08; p = 0.008). After adjustment for baseline PCI, the association remained (HR, 1.48; 95% CI 1.04-2.10; p =0.030). TIM-3 did not show a clear association with survival outcomes.</p><p><strong>Conclusions: </strong>Higher TIGIT expression in the intraperitoneal immune microenvironment was associated with shorter PFS in this small exploratory cohort receiving ipPTX-based combination chemotherapy.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic signatures of lung cancer: association and biomarker potential of EGFR, KRAS, and HER2 polymorphisms.","authors":"Timothy C Ortiz, Nida Qasim, Kashif Bashir, Rimsha Adnan, Muhammad Sadullayev, Tashbaev Sherzodbek, Usamah Sayed","doi":"10.1007/s12094-026-04586-0","DOIUrl":"https://doi.org/10.1007/s12094-026-04586-0","url":null,"abstract":"<p><strong>Background and objective: </strong>Lung cancer is a key global health challenge. Genetic variations in the key oncogenic pathways, including EGFR, HER2, and KRAS, can contribute to personal susceptibility and disease progression. The objective of this study was to assess the association between single-nucleotide polymorphisms (SNPs) in candidate genes, including KRAS, HER2, and EGFR, and lung cancer risk in the Pakistani population.</p><p><strong>Methodology: </strong>The case-control study comprised 600 participants, including 300 patients with histologically verified lung cancer and 300 healthy controls. DNA was extracted, followed by ARMS-PCR for genotyping.</p><p><strong>Results: </strong>Genetic research revealed a strong correlation between EGFR (rs712829) and lung cancer risk. The mutant (TT) genotype had a protective effect (OR = 0.11; 95% CI = 0.07-0.17; p < 0.0001), whereas the mutant (GT) significantly increased the risk (OR = 3.27; 95%CI = 2.32-4.60; p < 0.0001). The polymorphisms of the other two genes, HER2 and KRAS, did not show any significant association with disease. All demographic parameters, including age, gender, and smoking, did not show any significant association in our studied population.</p><p><strong>Conclusions: </strong>This study determined that polymorphisms in the EGFR and KRAS genes were found to be significantly associated with lung cancer risk, whereas HER2 variations were found to have a potential protective role.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: SEOM-GEMCAD-TTD clinical guideline for the diagnosis and treatment of esophageal cancer (update 2025).","authors":"Ana Fernández-Montes, Julia Alcaide, Ana Belén Custodio, Lourdes Fernández Franco, Javier Gallego Plazas, Carlos Gómez-Martín, Paula Richart, Fernando Rivera, Maria Alsina","doi":"10.1007/s12094-026-04555-7","DOIUrl":"https://doi.org/10.1007/s12094-026-04555-7","url":null,"abstract":"","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MACC1 in colorectal cancer: a claim-level evidence audit from metastasis driver to proposed microenvironmental regulator.","authors":"Rui Yang, Ruilan Deng, Hao Lin, Dongyang Huang, Ting Su, Xuhong Song, Bin Liang, Lingzhu Xie","doi":"10.1007/s12094-026-04588-y","DOIUrl":"https://doi.org/10.1007/s12094-026-04588-y","url":null,"abstract":"<p><p>Metastasis-associated in colon cancer 1 (MACC1) is an established regulator of colorectal cancer (CRC) progression and metastatic competence, but its proposed role in the tumour microenvironment is less certain. We performed a critical claim-level audit of original studies, classifying evidence by cancer-type match, manipulated cellular compartment, direct MACC1 perturbation, functional recipient cell endpoint, and immune context. The audit identifies convergent CRC evidence for tumour cell-intrinsic functions and inflammatory regulation of tumour cell MACC1. It also supports MACC1-dependent extracellular vesicle communication between CRC cells. By contrast, direct immune or stromal causality in CRC is not yet demonstrated: the available macrophage result is pharmacologically conditioned, functional immune and fibroblast mechanisms come from other cancers, and CRC immune associations are mainly computational. We define the conclusions permitted by each evidence class, specify clinical guardrails for prognostic and treatment-predictive claims, and propose two experiments that could establish or falsify cell-specific microenvironmental functions.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SEOM-GGCC clinical guidelines for the prophylaxis of infectious diseases in patients with cancer (UPDATE 2026).","authors":"Isabel Echavarria, Jesús Corral, María Pilar Diz Taín, Fernando Henao Carrasco, Vega Iranzo González-Cruz, Xabier Mielgo-Rubio, Teresa Quintanar, Carlos Rivas Corredor, Pedro Pérez Segura","doi":"10.1007/s12094-026-04578-0","DOIUrl":"https://doi.org/10.1007/s12094-026-04578-0","url":null,"abstract":"<p><p>Infections are still a major cause of morbidity and mortality in patients with cancer. Some of these infections are preventable through specific measures, such as vaccination or prophylaxis. This guideline (updated in 2026) aims to summarize the current evidence and recommendations for the prevention of infections in patients with cancer, devoting special attention to the most prevalent preventable infectious diseases. All of the evidence is graded according to The Infectious Diseases Society of America grading system.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}