Cancer diagnosis & prognosis最新文献

{"title":"Real-world Outcomes of First-line Platinum-based Chemotherapy in Patients Aged 80 Years or Older With Metastatic Urothelial Carcinoma.","authors":"Akinori Minato, Kazumasa Jojima, Yuto Tsubonuma, Yui Mizushima, Yoshihiro Sugita, Takuo Matsukawa, Ikko Tomisaki, Eiji Kashiwagi","doi":"10.21873/cdp.10589","DOIUrl":"10.21873/cdp.10589","url":null,"abstract":"<p><strong>Background/aim: </strong>As populations age, more patients aged ≥80 years with metastatic urothelial carcinoma (mUC) require systemic therapy. However, the efficacy and safety of first-line platinum-based chemotherapy (PBC) in octogenarians remain unclear. This study aimed to describe clinical outcomes in patients aged ≥80 years with mUC eligible for PBC.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 30 patients with mUC who received first-line PBC between 2005 and 2022. Patient characteristics, tumour response, treatment-related adverse events (TRAEs), and survival outcomes were assessed.</p><p><strong>Results: </strong>The median age was 83 (range=80-92) years. The bladder and upper urinary tract were the primary tumour site in 17 and 13 patients, respectively. Performance status was 0 or 1 in 15 patients each. Lymph node-only metastasis was present in 18 patients (60%). Regimens included methotrexate, vinblastine, doxorubicin, and cisplatin in six patients and gemcitabine plus platinum in 24; 15 patients received carboplatin. The median number of cycles was three. The objective response and disease control rates were 40% and 76.7%, respectively. Grade ≥3 TRAEs occurred in 23 patients (76.7%), mainly hematologic toxicities (myelosuppression). Dose reduction was required in 21 patients (70%), and treatment was discontinued in 14 (46.7%) because of toxicity or patient preference (7 each). Median progression-free survival and overall survival were 5.2 and 11.3 months, respectively.</p><p><strong>Conclusion: </strong>First-line PBC demonstrated measurable anti-tumour activity in eligible patients aged ≥80 years with mUC. However, myelosuppression often necessitated dose reduction or treatment discontinuation. Thus, PBC in this population warrants careful patient selection and proactive toxicity management.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 5","pages":"882-889"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876252","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":"Transcriptomic Association Between Poliovirus Receptor (PVR/CD155) and Claudin Signaling Pathways in Colorectal Cancer.","authors":"Steven Lehrer, Peter H Rheinstein","doi":"10.21873/cdp.10585","DOIUrl":"10.21873/cdp.10585","url":null,"abstract":"<p><strong>Background/aim: </strong>Enterotoxigenic <i>Bacteroides fragilis</i> promotes colorectal carcinogenesis through toxin-mediated cleavage of E-cadherin, a process facilitated by membrane-associated Claudin-4 (CLDN4). Separately, the poliovirus receptor (PVR/CD155) modulates tumor epithelial and immune dynamics. This study explored potential transcriptomic interactions and co-expression frameworks between PVR and claudin signaling pathways in colorectal cancer.</p><p><strong>Materials and methods: </strong>Transcriptomic and proteomic data from the The Cancer Genome Atlas-colon adenocarcinoma cohort (TCGA-COAD) were evaluated. An exploratory E-cadherin Cleavage Index was modeled to capture transcript-protein discordance. To control for tissue composition heterogeneity without mathematical circularity, a de-circularized, non-parametric partial rank residual model adjusted for independent CLDN4 expression was deployed within the stable microsatellite-stable (MSS) sub-cohort (N=473).</p><p><strong>Results: </strong>Multivariable survival models showed no independent associations between overall survival and continuous PVR (<i>p</i>=0.79) or CLDN3 (<i>p</i>=0.56) expression. Robust linear modeling revealed no significant baseline interaction between PVR and CLDN4 regarding the exploratory Cleavage Index (<i>p</i>=0.82). However, de-circularized partial correlation analysis revealed a highly stable, positive co-expression between PVR and CLDN3 (rho=0.2459, <i>p</i>=3.23×10^-7). Both epithelial markers retained modest inverse correlations with the infiltrating lymphocytic axis (TIGIT and CD96).</p><p><strong>Conclusion: </strong>Baseline PVR expression is coordinated with CLDN3 tissue programs independent of general epithelial cellularity but does not interact with the CLDN4 axis or impact overall survival in an unexposed cohort. Because TCGA lacks virome or active microbial exposure tracking, these findings serve as baseline benchmarks for future context-dependent mechanistic studies.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 5","pages":"833-842"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876527","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":"Prognostic Significance of Number of Liver Metastases in Patients With Advanced Pancreatic Cancer Receiving Nab-paclitaxel Plus Gemcitabine.","authors":"Kiyotsugu Iede, Terumasa Yamada, Hirotoshi Takayama, Masaru Sasaki, Tomo Ishida, Masafumi Yamashita, Yukako Mokutani, Tsukasa Tanida, Jin Matsuyama, Ken Nakata, Shusei Tominaga","doi":"10.21873/cdp.10592","DOIUrl":"10.21873/cdp.10592","url":null,"abstract":"<p><strong>Background/aim: </strong>The prognostic significance of the number of liver metastases in patients with advanced pancreatic cancer (APC) treated with nab-paclitaxel plus gemcitabine (AG) remains unclear. This study was performed to investigate the impact of the number of liver metastases on survival outcomes in this population.</p><p><strong>Patients and methods: </strong>From January 2015 to July 2024, 103 patients with APC received AG as first-line chemotherapy at Higashiosaka City Medical Center. The patients were categorized into three groups based on contrast-enhanced computed tomography findings: no liver metastases (NLM), several liver metastases (SLM) (1-9), and multiple liver metastases (MLM) (≥10). Overall survival (OS) was estimated using the Kaplan-Meier method and compared using the log-rank test. Patient characteristics and clinical courses were compared between the non-MLM and MLM groups. Prognostic factors were analyzed using Cox regression models.</p><p><strong>Results: </strong>Fifty-two patients were assigned to the NLM group, 23 to the SLM group, and 28 to the MLM group. Median OS was significantly longer in the NLM group (12.0 months) than in the SLM group (9.9 months, <i>p</i>=0.012), whereas the MLM group had a significantly shorter median OS (4.6 months) than the NLM group (<i>p</i><0.001). Multivariate analysis identified the number of liver metastases as an independent prognostic factor for OS.</p><p><strong>Conclusion: </strong>The number of liver metastases in patients with APC treated with nab-paclitaxel plus gemcitabine may help stratify prognosis in clinical practice and could serve as a useful parameter for treatment decision making and for stratification in future clinical trials.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 5","pages":"909-917"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Ascites to Malignant Peritoneal Mesothelioma: The Diagnostic Workup of a Rare Tumor.","authors":"Mirko Nastasi, Chiara Ferrante, Giuliana Michelis, Enrica Branca, Manuel Ventura, Silvia Novello, Emanuela Laurita","doi":"10.21873/cdp.10581","DOIUrl":"10.21873/cdp.10581","url":null,"abstract":"<p><strong>Background/aim: </strong>Ascites is a common clinical manifestation of a wide spectrum of heterogeneous underlying conditions. All possible causes of ascites should be considered in the differential diagnosis to ensure an appropriate diagnostic workup. Among the rare causes, malignant peritoneal mesothelioma must be considered, as its diagnosis is particularly challenging.</p><p><strong>Case report: </strong>We present the case of a 77-year-old female who developed ascites and lower-quadrant abdominal pain. She had no prior history of cancer and no documented occupational exposure to asbestos or other known carcinogens. After exclusion of the principal benign and malignant causes of ascites, we performed a biopsy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). The final diagnosis was primary malignant peritoneal mesothelioma, an extremely rare tumor.</p><p><strong>Conclusion: </strong>This case highlights the complexity of the differential diagnosis. The diagnostic work-up for peritoneal mesothelioma must integrate the patient's clinical history, physical examination, tumor markers, and imaging findings. Biomarkers such as mesothelin and advanced imaging modalities including PET/CT assume an increasingly important role in staging and in distinguishing peritoneal disease entities.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"803-809"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370997","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":"Tumor Marker Index Based on CEA and CA19-9 as a Prognostic Biomarker in Resectable Colon Cancer.","authors":"Tatsufumi Kosuge, Junichi Mazaki, Kenta Kasahara, Hiroaki Osakabe, Hiroshi Kuwabara, Kenichi Iwasaki, Junya Oguma, Hiroyuki Koga, Akishige Kanazawa, Yuichi Nagakawa","doi":"10.21873/cdp.10572","DOIUrl":"10.21873/cdp.10572","url":null,"abstract":"<p><strong>Background/aim: </strong>Despite curative resection, the prognosis after surgery for colon cancer varies considerably even among patients within the same TNM stage. There is a need for reliable biomarkers to complement the TNM classification. In pancreatic cancer, tumor markers have been reported as indicators of biological resectability. We therefore focused on tumor markers in colon cancer and investigated the prognostic significance of the tumor marker index (TMI).</p><p><strong>Patients and methods: </strong>We retrospectively reviewed patients with colon cancer (cecum to rectosigmoid) who underwent curative resection at our institution between 2011 and 2023. Among them, 361 patients without missing clinical or laboratory data were included. TMI was defined as the product of preoperative serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels. Patients were stratified into low- and high-TMI groups based on cutoff values determined by receiver operating characteristic (ROC) curve analysis with recurrence as the outcome. Three-year recurrence-free survival (3y-RFS), local recurrence-free survival (3y-LRFS), and distant metastasis-free survival (3y-DMFS) were compared between groups.</p><p><strong>Results: </strong>The optimal TMI cutoff value was 64, with 226 cases classified into the low-TMI group and 135 cases into the high-TMI group. The 3y-RFS rate was significantly higher in the low-TMI group than in the high-TMI group (94.0% <i>vs</i>. 88.4%, <i>p</i>=0.023). Similarly, the 3y-LRFS rate was significantly better in the low-TMI group (97.7% <i>vs</i>. 95.2%, <i>p</i>=0.044). In contrast, there was no significant difference in 3y-DMFS between the low- and high-TMI groups (95.4% <i>vs</i>. 91.4%, <i>p</i>=0.103).</p><p><strong>Conclusion: </strong>TMI was associated with postoperative recurrence patterns in curatively resected colon cancer. TMI may serve as a simple and clinically useful biomarker to complement TNM staging and improve risk stratification after curative surgery.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"723-728"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Impact of Prognostic Nutritional Index at Recurrence of Pancreatic Cancer.","authors":"Teruhisa Sakamoto, Kentaro Uehira, Jun Yoshida, Mikiya Kishino, Masaki Morimoto, Yuki Murakami, Kozo Miyatani, Yuji Shishido, Kyoichi Kihara, Tomoyuki Matsunaga, Manabu Yamamoto, Yoshiyuki Fujiwara","doi":"10.21873/cdp.10573","DOIUrl":"10.21873/cdp.10573","url":null,"abstract":"<p><strong>Background/aim: </strong>Most patients with pancreatic cancer experience recurrence after curative surgical resection. Nutritional-related indicators have been evaluated to analyze prognosis in pancreatic cancer. However, it is unknown whether the cachexia index (CXI) or the prognostic nutritional index (PNI) is better for prediction of survival in patients with recurrence of pancreatic cancer. In this study, we compared the ability of the PNI to predict survival at 1 year after recurrence of pancreatic cancer with that of the CXI.</p><p><strong>Patients and methods: </strong>The study included 113 patients whom we retrospectively identified to have developed recurrence of pancreatic cancer as of September 2025 following pancreatectomy at our Institution between July 2005 and December 2022.</p><p><strong>Results: </strong>The 5-year post-recurrence overall survival rate was 5.8% and the median survival time was 378 days. The 1-year survival curve was significantly better for the high PNI group than the low PNI group and for the high CXI group than the low CXI group (<i>p</i><0.001 for both comparisons). Analysis of receiver-operating characteristic curves showed that the discriminatory ability of the PNI was higher than that of the CXI for prediction of 1-year post-recurrence survival [area under the curve: 0.711 for PNI (<i>p</i><0.001) <i>vs.</i> 0.670 for CXI (<i>p</i>=0.002)]. Multivariate analysis identified the PNI as an independent prognostic factor for 1-year survival in patients with recurrence of pancreatic cancer (<i>p</i>=0.006).</p><p><strong>Conclusion: </strong>Patients with a low PNI at the time of recurrence of pancreatic cancer have poorer prognostic outcomes than those with a high PNI. Improvement of nutritional status after curative surgery might improve prognosis after recurrence of pancreatic cancer.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"729-736"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370995","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":"<i>CDKN2A</i> mRNA Over-expression Is Associated With CD8+ T Cell Exclusion and IDO1-Mediated Adaptive Immune Resistance in Gastric Adenocarcinoma.","authors":"Steven Lehrer, Peter Rheinstein","doi":"10.21873/cdp.10564","DOIUrl":"10.21873/cdp.10564","url":null,"abstract":"<p><strong>Background/aim: </strong>Cellular senescence, mediated by CDKN2A-encoded p16^INK4a, generates a senescence-associated secretory phenotype (SASP) that may promote immune evasion in solid tumors. Recent immunohistochemical studies have identified associations between p16^INK4a over-expression and CD8+ T cell exclusion in gastric adenocarcinoma, but transcriptomic validation and mechanistic characterization remain limited.</p><p><strong>Materials and methods: </strong>We analyzed 386 gastric adenocarcinoma samples from The Cancer Genome Atlas (TCGA-STAD) cohort, stratifying patients by CDKN2A mRNA expression using z-score thresholds: Loss (z <-1.0; n=57), Wild-Type (-1.0 ≤ z ≤ +1.0; n=253), and Over-expression (z >+1.0; n=76). Immune cell infiltration was estimated with quanTIseq deconvolution. SASP factor expression (IDO1, TGFB1, NT5E) and correlations with immune populations were assessed using Kruskal-Wallis tests, pairwise Wilcoxon rank-sum tests, and Spearman correlation analyses.</p><p><strong>Results: </strong>CDKN2A over-expression was significantly associated with CD8+ T cell depletion (<i>p</i>=0.024) and IDO1 up-regulation (<i>p</i>=0.015) compared to wild-type tumors, validating prior immunohistochemical findings. However, TGFB1 (<i>p</i>=0.56) and NT5E (<i>p</i>=0.75) showed no significant differential expression. Paradoxically, IDO1 correlated positively with CD8+ T cell infiltration, as did TGFB1, suggesting reactive up-regulation rather than primary exclusion. Overall survival did not differ significantly across expression groups (<i>p</i>=0.3), nor did stratification by chromosomal instability (CIN <i>p</i>=0.76) or microsatellite instability (MSI <i>p</i>=0.73) molecular subtypes reveal prognostic associations.</p><p><strong>Conclusion: </strong>This transcriptomic analysis confirms the association between CDKN2A over-expression and an immunosuppressive microenvironment characterized by CD8+ T cell depletion and IDO1 up-regulation. The strong positive correlation between IDO1 and CD8+ T cells supports an adaptive immune resistance model, wherein IDO1 is induced <i>via</i> interferon-gamma signaling as a reactive checkpoint rather than functioning as a primary T cell exclusion factor. These findings suggest that CDKN2A-over-expressing gastric adenocarcinomas may benefit from combination immunotherapy strategies incorporating IDO1 inhibition.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"639-648"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370989","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":"Impact of Local Treatment of the Primary Tumor on Overall Survival in <i>De Novo</i> Metastatic Breast Cancer: A Systematic Review and Meta-analysis.","authors":"Luisana Sisca, Mariam Grazia Polito, Michele Iuliani, Giuseppe Tonini, Francesco Pantano","doi":"10.21873/cdp.10562","DOIUrl":"10.21873/cdp.10562","url":null,"abstract":"<p><strong>Background/aim: </strong>The prognostic impact of local treatment (LT) of the primary tumor in patients with <i>de novo</i> metastatic breast cancer (dnMBC) remains unclear. We conducted a systematic review and meta-analysis to evaluate whether surgery and/or radiotherapy of the primary tumor improves overall survival (OS).</p><p><strong>Materials and methods: </strong>Electronic databases (PubMed, Embase, Cochrane) were searched up to March 2025 for studies comparing LT (surgery and/or radiotherapy) plus systemic therapy <i>versus</i> systemic therapy alone. Hazard ratios (HRs) for OS were pooled using a random-effects model. Subgroup analyses were performed by study design, treatment modality, biological subtype, and metastatic site. Heterogeneity was quantified using <i>I²</i>, and meta-regression was used to explore potential moderators.</p><p><strong>Results: </strong>Twenty studies, including randomized controlled trials (RCTs) and retrospective studies, were included. In pooled analyses, LT was associated with improved OS compared to systemic therapy alone. [HR=0.62; 95% confidence interval (CI)=0.52-0.75; <i>p</i><0.0001; <i>I²</i>=97.3%]. In RCTs, the difference was not significant (HR=0.91; 95% CI=0.67-1.25; <i>p</i>=0.57). Surgery of the primary tumor was associated with improved OS (pooled HR=0.62; 95% CI=0.52-0.75). In the radiotherapy-only subgroup, based on a very limited number of heterogeneous retrospective studies, no survival benefit was observed (pooled HR=1.51; 95% CI=0.87-2.63). Given the very limited number of studies and the substantial heterogeneity (<i>I²</i>=91.5%), these findings need to be interpreted with caution. Subgroup analyses showed a non-significant trend in hormone receptor-positive disease (HR=0.78; 95% CI=0.58-1.04) and no benefit in HER2-positive (HR=0.90; 95% CI=0.61-1.33) or liver-limited disease (HR=1.17; 95% CI=0.77-1.78). No covariates were significantly associated with OS in meta-regression.</p><p><strong>Conclusion: </strong>Although pooled analyses suggest an association between local treatment and improved OS, this effect appears largely driven by retrospective data and is not confirmed in randomized trials.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"619-629"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371034","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":"When Blood Speaks Before the Scan: The Role of ctDNA in Real-time CRC Care.","authors":"Nasim Salimiaghdam, Emma Li, Hongyan Liang","doi":"10.21873/cdp.10578","DOIUrl":"10.21873/cdp.10578","url":null,"abstract":"<p><strong>Background/aim: </strong>Colorectal cancer (CRC) recurrence, especially in stage III disease, remains a clinical challenge. Circulating tumor DNA (ctDNA) has emerged as a minimally invasive biomarker for detecting minimal residual disease (MRD) and predicting recurrence. The Signatera assay is a personalized, tumor-informed ctDNA test reported in mean tumor molecules per milliliter (MTM/ml), offering dynamic monitoring beyond traditional mutant allele frequency methods. The objective of the current study was to demonstrate the clinical utility of Signatera in managing four patients with stage III CRC, particularly in detecting recurrence earlier than imaging and informing curative interventions.</p><p><strong>Case report: </strong>We conducted a retrospective case series of four patients with histologically confirmed stage III CRC who underwent curative-intent surgery, completed adjuvant chemotherapy, and received longitudinal Signatera ctDNA testing for at least 12 months. ctDNA was assessed every three months, and imaging was performed every six months or sooner if ctDNA became positive. We documented trends in ctDNA, recurrence patterns, imaging results, and treatment changes. All patients initially achieved a disease-free status. In all cases, ctDNA positivity preceded radiographic detection of recurrence. Each had isolated liver metastases, which were detected early and treated surgically. Post-surgical ctDNA clearance was associated with improved outcomes, and one patient remained ctDNA-negative without additional chemotherapy.</p><p><strong>Conclusion: </strong>Serial ctDNA monitoring with Signatera enabled earlier detection of recurrence and guided timely interventions in stage III CRC. These findings support its clinical integration, pending further validation in prospective trials.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"769-779"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371090","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":"Total Bone Uptake as a Quantitative Imaging Biomarker for Prostate Cancer With Bone Metastases.","authors":"Shunsuke Watanabe, Daisuke Motoyama, Kyohei Watanabe, Hiromitsu Watanabe, Keita Tamura, Teruo Inamoto","doi":"10.21873/cdp.10576","DOIUrl":"10.21873/cdp.10576","url":null,"abstract":"<p><strong>Background/aim: </strong>Bone scintigraphy is widely used for evaluating bone metastases in prostate cancer, but conventional planar imaging is limited by its qualitative nature and poor reproducibility for longitudinal assessment. The Bone Scan Index (BSI) provides a semiquantitative measure of skeletal tumor burden, but it does not reflect tracer uptake intensity. Quantitative single-photon emission computed tomography/computed tomography (SPECT/CT) allows volumetric assessment of uptake, and total bone uptake (TBU) derived from GI-BONE (Nihon Medi-Physics Co., Ltd, Tokyo, Japan) may offer a more comprehensive biomarker of skeletal disease activity.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed three patients with prostate cancer and bone metastases who underwent serial ^99mTc-HMDP bone SPECT/CT in routine practice between January and September 2025. Clinical data, prostate-specific antigen (PSA) levels, and quantitative indices from GI-BONE, including BSI, metabolic bone volume, and TBU, were extracted from medical records.</p><p><strong>Results: </strong>In all three cases, serial TBU measurements provided an objective representation of skeletal disease activity over time. Changes in TBU were consistent with the clinical course and treatment response, suggesting that this parameter may be useful for monitoring disease dynamics during follow-up.</p><p><strong>Conclusion: </strong>GI-BONE-derived TBU may be a practical quantitative biomarker for assessing bone metastatic burden and treatment response in prostate cancer. This case series suggests that TBU can complement conventional bone scintigraphy by providing objective and reproducible longitudinal information.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"6 4","pages":"755-760"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371108","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}