Clinical & Translational Oncology最新文献

{"title":"Recent advances in the regulation of CD47 by non-coding RNAs and its therapeutic potential in cancer.","authors":"Jingwen Hua, Weijin Zhu, Xiaochun Sun, Huabiao Chen","doi":"10.1007/s12094-026-04380-y","DOIUrl":"https://doi.org/10.1007/s12094-026-04380-y","url":null,"abstract":"<p><p>Cluster of Differentiation 47 (CD47) is regarded as a highly promising next-generation immunotherapy target following PD-1/PD-L1. It mediates tumor immune escape by transmitting a \"don't eat me\" signal through the signal regulatory protein alpha (SIRPα) pathway. However, the clinical application of existing antibody therapies remains constrained by erythrocyte toxicity, the antigen sink caused by widespread CD47 expression on normal cells, and recent setbacks in clinical trials. \"Growing evidence establishes non-coding RNAs (ncRNAs), including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), as key upstream regulators of CD47. Here, we systematically review how these ncRNAs control CD47 gene expression, focusing on their impact on phagocytosis, drug resistance, and tumor microenvironment remodeling. Unlike antibody-mediated blockade, targeting the ncRNA-CD47 axis provides a unique avenue for genetic modulation, offering reduced systemic toxicity. We summarize these regulatory mechanisms and explore how exploiting these gene-regulatory networks can address the current challenges in CD47 immunotherapy.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845642","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":"Overcoming T cell exhaustion and senescence in CAR T cell therapy for solid tumors.","authors":"Ignacio Pérez-Criado, Mariona Figols, Ainhoa Moya-Sevilla, Ana Bautista, Daniela Gómez-Díaz, Albert Font, Juan Martin-Liberal, Vicenç Ruiz de Porras","doi":"10.1007/s12094-026-04383-9","DOIUrl":"https://doi.org/10.1007/s12094-026-04383-9","url":null,"abstract":"<p><p>Chimeric antigen receptor (CAR) T cell therapies have demonstrated remarkable efficacy in hematologic malignancies; however, their clinical benefit in solid tumors remains limited. A major barrier is T cell dysfunction, particularly exhaustion and senescence, which impair persistence, effector function, and durable tumor control. Targeting these dysfunctional states is therefore essential in order to improve CAR T cell efficacy in solid tumors.This review summarizes recent preclinical strategies aimed at preventing or reversing CAR T cell exhaustion and senescence in solid malignancies. While both exhaustion and senescence are relevant dysfunctional states, the preclinical evidence summarized in this review is currently more extensive for modulation of exhaustion-associated programs than for direct reversal of canonical T cell senescence. Approaches are organized according to their primary mechanistic focus, including gene editing, metabolic modulation, receptor redesign, and remodeling of the tumor microenvironment.Across these mechanistic categories, reported benefits include enhanced CAR T cell persistence, reduced expression of inhibitory receptors, such as PD-1, LAG-3, and TIM-3, preservation or restoration of memory-like phenotypes, and improved antitumor cytotoxicity. Notably, combinatorial strategies targeting multiple dysfunction pathways consistently demonstrate superior efficacy in preclinical models. Despite these advances, important translational challenges remain, including the limited predictive value of current preclinical systems, potential safety concerns, and the manufacturing complexity associated with increasingly engineered cell products.Collectively, preclinical evidence supports the rational integration of complementary approaches to generate next-generation CAR T cells capable of resisting dysfunction and maintaining activity within immunosuppressive solid tumor microenvironments. Further validation in clinically relevant models will be critical to facilitate translation into safe and durable cancer immunotherapies.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845560","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":"Challenges in the measurement and valuation of oncological treatments in Spain: recommendations and call to action.","authors":"Maria Rosario García-Campelo, Jesús Corral, Fernando Moreno, Andrés Munoz, Jesús M Balea, Begoña Barragán, Jordi Ginés, Fernando Gutiérrez Nicolás, Bruno Sangro, Eva Martín Martin-Sánchez, Marta Trapero-Bertran","doi":"10.1007/s12094-026-04323-7","DOIUrl":"https://doi.org/10.1007/s12094-026-04323-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The evaluation of innovative oncology medicines presents significant challenges related to the selection of appropriate clinical endpoints and the sufficiency of evidence, particularly in therapeutic areas, such as immunotherapies, targeted treatments, single-arm trials, and tumor-agnostic therapies. In these contexts, the added value of new treatments is often not adequately captured by traditional clinical trial endpoints, such as overall survival (OS), which remains the gold standard in oncology assessment. This article aims to analyze the main sources of uncertainty in the value assessment of oncology therapies in Spain, with a focus on the limitations of current endpoints and evidence-generation processes, and to provide recommendations for enhancing the recognition and assessment of additional clinical benefit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multidisciplinary expert panel composed of twelve professionals, including medical oncologists, hospital pharmacists, health economists, and patient representatives, was convened to identify and discuss key sources of uncertainty in the value assessment of oncology treatments, particularly those related to clinical endpoint selection and evidence generation. The panel participated in three structured plenary sessions. Additional external experts were engaged to provide complementary input in areas, such as tumor-specific characteristics and statistical methodology. Consensus statements were developed through an iterative process of discussion, critical appraisal, and refinement across and between sessions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The expert panel issued twelve recommendations to improve value assessment in oncology. These include tailoring clinical endpoints to treatment type, tumor characteristics, and stage; complementing overall survival with milestone analysis and quality-of-life measures; and standardizing real-world evidence collection across the healthcare system. The panel advocated for a national portfolio of prioritized endpoints, appropriate statistical methods by context, and the conditional use of early-phase data for decision-making. Additional recommendations addressed the use of synthetic control arms, flexible reimbursement models, advanced analytics (e.g., AI and Big Data), evaluator expertise, and the promotion of stakeholder training and transparency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Addressing the challenges of clinical endpoint selection and evidence generation is essential to reduce uncertainty in the value assessment of innovative oncology treatments. The twelve expert recommendations outlined in this study provide a structured roadmap to improve methodological consistency, enhance the relevance and robustness of clinical and real-world data, and promote a more adaptive and transparent evaluation framework. These proposals aim to support more evidence-based, equitable, and sustainable decision-making within the Spanish healthcare syst","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845549","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":"Mechanisms of chemoresistance in gastric cancer: interplay between microRNAs and the tumor microenvironment.","authors":"Vlad-Costin Ilie, Corina-Elena Minciuna, Catalin Andras, Simona Nicoleta Turcu, Vlad Herlea, Simona Olimpia Dima, Gabriela Droc, Monica Lacatus, Stefan Tudor, Catalin Vasilescu","doi":"10.1007/s12094-026-04377-7","DOIUrl":"https://doi.org/10.1007/s12094-026-04377-7","url":null,"abstract":"<p><p>Chemoresistance remains a major barrier to durable disease control in gastric cancer, limiting the effectiveness of perioperative and palliative systemic therapies. Increasing evidence indicates that resistance is driven by a complex interplay between tumor-intrinsic adaptations and tumor microenvironment-mediated survival pathways. Although chemoresistance can be innate or acquired, a variety of mechanisms could coexist within the tumor, with various processes acting synergistically. MicroRNAs, as key post-transcriptional regulators, have emerged as central modulators of these resistance networks. This review summarizes the principal mechanisms of chemoresistance in gastric cancer and synthesizes current evidence on how microRNAs-derived from tumor cells and the tumor microenvironment-promote or reverse resistance to commonly used chemotherapeutic agents and targeted therapy/immunotherapies, highlighting therapeutic opportunities. Evidence was organized by mechanism (drug transport and metabolism, DNA damage response, apoptosis and survival signaling, autophagy, epithelial-to-mesenchymal transition/cancer stem cell plasticity, and immune escape) and by drug class.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845604","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":"Expression and diagnostic significance of plasma exosomal RNA in diffuse large B-cell lymphoma.","authors":"Xiaomei Ma, Zimiao Zhang, Jiayi Deng, Yueyuan Lai, Aili Zhang, Congjie Chen, Xiaohui Shangguan, Weihao Wu, Longtian Chen","doi":"10.1007/s12094-026-04336-2","DOIUrl":"https://doi.org/10.1007/s12094-026-04336-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the expression profiles of plasma exosomal RNAs in patients with Diffuse Large B-Cell Lymphoma (DLBCL) and evaluate their diagnostic potential.</p><p><strong>Methods: </strong>Exosomes were isolated from 9 DLBCL patients and 9 healthy controls, followed by whole transcriptome RNA sequencing to identify differentially expressed RNAs. Key RNAs were selected and validated via qRT-PCR using an independent cohort of 41 treatment-naïve DLBCL patients and 41 healthy controls. The StarBase database was utilized to predict target relationships and construct lncRNA/miRNA competing endogenous RNA (ceRNA) pairs. Diagnostic efficacy was assessed using Receiver Operating Characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>High-throughput sequencing revealed significant RNA expression differences between DLBCL patients and healthy controls. Specifically, 35 microRNAs (miRNAs), 1604 long non-coding RNAs (lncRNAs), and 330 messenger RNAs (mRNAs) were differentially expressed in the DLBCL group, while no significant differences were observed in circular RNA (circRNA) expression. Two ceRNA pairs, MALAT1/hsa-miR-181a-5p and SLC9A3-AS1/hsa-miR-10a-5p, were constructed. qRT-PCR validation confirmed that hsa-miR-181a-5p and hsa-miR-10a-5p were significantly down-regulated, while SLC9A3-AS1 was up-regulated in the DLBCL group; MALAT1 expression showed no significant difference. ROC analysis demonstrated Area Under the Curve (AUC) values of 0.813 for hsa-miR-181a-5p, 0.800 for hsa-miR-10a-5p, and 0.787 for SLC9A3-AS1. The combined AUC for SLC9A3-AS1 and hsa-miR-10a-5p was 0.8226, and for SLC9A3-AS1 and hsa-miR-181a-5p was 0.852.</p><p><strong>Conclusion: </strong>Exosome-derived miRNAs, lncRNAs, and mRNAs exhibit distinct expression patterns in DLBCL patients compared to healthy controls. The RNAs hsa-miR-181a-5p, hsa-miR-10a-5p, and SLC9A3-AS1 show promise as diagnostic biomarkers for DLBCL, with combined RNA panels offering improved diagnostic efficacy over single markers. The SLC9A3-AS1/hsa-miR-10a-5p pair may form a regulatory network influencing DLBCL pathogenesis.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845621","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":"Association between the systemic inflammation response index and prognosis in lung cancer: a systematic review and meta-analysis.","authors":"Tongtong Chu, Xiuxi Li, Lijuan Shan, Chunshan Zhao","doi":"10.1007/s12094-026-04372-y","DOIUrl":"https://doi.org/10.1007/s12094-026-04372-y","url":null,"abstract":"<p><strong>Background: </strong>The systemic inflammation response index (SIRI) is an emerging inflammation-immune indicator calculated from counts of neutrophils, monocytes, and lymphocytes. The potential prognostic value of SIRI in various tumors has been reported in several studies. However, updated and comprehensive evidence regarding its prognostic value in lung cancer (LC) remains insufficient. This study, through a systematic review and meta-analysis, intends to comprehensively analyze the relationship of SIRI with overall survival (OS) and progression-free survival (PFS) among individuals experiencing LC.</p><p><strong>Methods: </strong>Cochrane Library, Web of Science, Embase, and PubMed were systematically searched from the commencement of the databases to October 2025. Cohort studies reporting the relation of SIRI with OS or PFS were included. Hazard ratios (HRs) alongside their 95% confidence intervals (CIs) were obtained, and a random-effects model was employed for data synthesis. Subgroup analysis, sensitivity analysis, and assessment of publication bias were conducted to evaluate the robustness of the findings.</p><p><strong>Results: </strong>In total, 27 studies involving 6195 patients with LC were incorporated into this meta-analysis, which revealed that high SIRI levels were significantly associated with poorer OS (HR = 1.83, 95% CI 1.58-2.13) and PFS (HR = 1.53, 95% CI 1.31-1.79). Differences in age, region, and cutoff value for SIRI were identified as the primary sources of heterogeneity. The sensitivity analysis indicated stable results, while the Egger's test demonstrated publication bias.</p><p><strong>Conclusion: </strong>A higher SIRI level is significantly associated with adverse survival outcomes among individuals suffering from LC. As a simple and low-cost hematological marker, SIRI is potentially applied in the risk stratification and prognosis assessment of LC. In the future, prospective studies based on multicenter data and with a larger sample size, and a unified cutoff standard for SIRI are warranted to further corroborate the clinical utility of SIRI.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823161","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":"The intersection of colorectal cancer and cardiovascular disease: shared mechanisms and clinical implications.","authors":"Shuzhen Wu, Luyao Yu, Meitong Liu, Bo Dong","doi":"10.1007/s12094-026-04367-9","DOIUrl":"https://doi.org/10.1007/s12094-026-04367-9","url":null,"abstract":"<p><p>Colorectal cancer (CRC) and cardiovascular disease (CVD) are major contributors to the global disease burden, with CRC as the third most common malignancy and second leading cause of cancer-related death, and CVD as the top killer among non-communicable diseases. The growing ageing population has driven a continuous rise in CRC-CVD comorbidity. Treatment-related cardiovascular toxicity, shared pathophysiological links, and the prognostic impact of comorbidity have made this interdisciplinary field a critical focus in cardio-oncology. This review addresses core scientific questions at the CRC-CVD intersection, including their shared risk factors and pathological mechanisms (metabolic syndrome, chronic inflammation, oxidative stress, gut microbiota dysbiosis, etc.), epidemiological and molecular associations between CRC and major CVD subtypes, as well as cardiovascular toxicity mechanisms, monitoring, and intervention strategies for CRC therapies (chemotherapy, targeted therapy, immunotherapy). Beneficial lifestyle modifications and cross-effective medications, together with multidisciplinary team (MDT) collaboration, hold great value for comorbidity management. Current studies have confirmed their epidemiological and partial mechanistic links, but key gaps remain: unclear core molecular regulatory networks, insufficient gut microbiota-cardiovascular-tumor axis research, lack of personalized risk prediction models, limited long-term cardiovascular data for novel anticancer drugs, and absent standardized precision prevention protocols. Future multi-omics studies, large-scale clinical trials, and real-world data research will help clarify shared targets, build risk models, and formulate interdisciplinary management guidelines to improve outcomes of CRC-CVD comorbidity patients.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823219","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":"An automated, workload-adjusted framework for continuous quality assessment in clinical radiation oncology.","authors":"Jose López Torrecilla, Pilar Ma Samper Ots, Germán Juan Rijo, Pilar Rey Castro, Jose Bayón Llera, Carlos Jose Ferrer Albiach","doi":"10.1007/s12094-026-04366-w","DOIUrl":"https://doi.org/10.1007/s12094-026-04366-w","url":null,"abstract":"<p><strong>Background: </strong>Quality assessment in radiation oncology is essential to ensure safe, timely, and effective care. Although multiple quality indicators have been proposed, their routine implementation is often limited by heterogeneous definitions, manual data collection, and the lack of adjustment for clinical workload and treatment complexity.</p><p><strong>Methods: </strong>Within a national quality initiative, a structured revision of previously proposed quality indicators was performed. A survey among heads of Radiation Oncology departments was conducted to assess the relevance, feasibility, and management value of existing indicators. Based on survey results, a reduced set of prioritized indicators was selected and operationally defined for automated extraction from routine radiotherapy information systems. In parallel, a workload-based complexity stratification was developed, defining six levels for external beam radiotherapy and five levels for brachytherapy. Automated data extraction was implemented using commonly deployed clinical information systems, enabling continuous indicator monitoring without additional manual data entry.</p><p><strong>Results: </strong>Forty-one department heads participated in the survey, with strong support for reinforcing quality indicator use. The original set of 29 indicators was reduced to 17 prioritized indicators covering structure, process, and outcome domains. Process indicators related to treatment preparation times for conventional and special techniques showed the highest acceptance. Automated extraction resulted in a standardized quality report enabling routine monitoring of indicator performance and data quality. The workload-based complexity stratification revealed substantial heterogeneity across treatment techniques and enabled contextual interpretation of activity and performance.</p><p><strong>Conclusions: </strong>This study presents an automated and workload-adjusted framework for continuous quality assessment in Radiation Oncology. By integrating prioritized quality indicators, workload-based complexity stratification, and automated data extraction, the proposed approach supports sustainable quality monitoring and facilitates meaningful inter-center comparison. Although developed within a national initiative, the methodological principles are broadly applicable to other healthcare systems and technologically complex oncological settings.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823167","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":"Impact of radiotherapy on quality of life reported by elderly patients.","authors":"Pilar MªSamper Ots, Carolina de la Pinta, Dolores de Las Peñas Cabrera, Miriam Palomas Moreno, Lucia Tueros Farfán, Lidia Gómez Perea, Carla Sánchez Cortés, Andrea Bobo Jaureguizar, José Luis Monroy Antón","doi":"10.1007/s12094-026-04298-5","DOIUrl":"https://doi.org/10.1007/s12094-026-04298-5","url":null,"abstract":"<p><strong>Objectives and purposes: </strong>To determine the impact of radical radiotherapy (RT) treatment on the quality of life reported by elderly patients.</p><p><strong>Materials and methods: </strong>A prospective multicenter study was conducted in 8 national centers. Patients over 70 years old who had an indication for radical RT were included. All patients were initially assessed with the Geriatric-8 (G8) scale, ECOG PS, Nutriscore, SARC_F (sarcopenia questionnaire), and completed two patient-reported outcomes measure (PROMs) questionnaires: the EORTC_QLQ_C30 and the EORTC_ELD_14 quality of life (QoL), at baseline, at the end of RT, and 3 months later.</p><p><strong>Results: </strong>A total of 156 patients with a mean age of 77 years (range 70-93) were included. The characteristics of the patients are as follows: 65.4% are men, 45.5% have prostate cancer, 20% breast cancer, and 12.2% lung cancer. The baseline PROMs show general health status of patients >70 years with some deterioration (73.5 ± 20.3). Patients also present deterioration in physical function (85.29 ± 19.94), emotional function (81.02 ± 21.28), and maintenance of purpose (70.94 ± 30.5), and the most frequent baseline symptoms are constipation, fatigue, insomnia, worries about others, future worries, disease burden, and joint stiffness. The prognostic factors that increase the risk of these alterations are ECOG PS >1, female sex, diabetes, dyslipidemia, pulmonary pathology, cognitive impairment, and especially the risk of sarcopenia. When comparing PROMs at the beginning and at the end of oncological treatment, a significant deterioration in role function (89.86 vs. 85.62, p = 0.004) and an increase in fatigue (19.89 vs. 25.78, p = 0.002) are observed. While the PROMs at 3 months show improvement in all functions and symptoms, statistically significant improvement was only found in emotional function (84 vs. 89.26, p = 0.000), fatigue (25.87 vs. 20.4, p = 0.001), loss of appetite (12.75 vs. 6.7, p = 0.003), and maintenance of purpose (68 vs. 73.6, p = 0.14).</p><p><strong>Conclusion: </strong>Older patients, due to their comorbidities, already have alterations in QoL, with sarcopenia being an important factor. Cancer treatment further deteriorates QoL in a significant way, role function and fatigue, but 3 months after the treatment, improvements in QoL, significantly emotional function, fatigue, loss of appetite and maintenance of purpose are observed.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823247","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":"Role of surgery in metastatic gastric cancer.","authors":"Israel Manzanedo, Ángel Serrano, Estíbalitz Pérez-Viejo, Fernando Pereira Pérez","doi":"10.1007/s12094-025-04123-5","DOIUrl":"10.1007/s12094-025-04123-5","url":null,"abstract":"<p><p>Gastric cancer is frequently diagnosed at an advanced stage, leading to a poor overall prognosis, particularly in regions without population-based screening. Stage IV disease, defined by distant metastases, is associated with dismal survival outcomes. Current management is primarily palliative, consisting of systemic therapy-chemotherapy, immunotherapy, or targeted agents tailored to molecular biomarkers. Despite the recent therapeutic advances, durable survival remains rare. In selected patients with limited metastatic disease, surgical resection has emerged as a potential therapeutic strategy, with reports of favorable oncological outcomes. Several international guidelines and consensus statements now acknowledge surgery as an option in patients who demonstrate stable disease after a period of systemic therapy. The central challenge is the accurate identification of patients most likely to benefit from surgical intervention and the precise delineation of low-volume metastatic disease. This review synthesizes the available evidence on the role of surgery in the management of metastatic gastric cancer.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":"1476-1483"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551751","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}