The treatment of Cutaneous Squamous Cell Carcinoma (CSCC) has undergone significant changes with the introduction of Immune Checkpoint Inhibitors (ICIs). While promising results have been observed, their efficacy remains limited to a subset of patients. Soluble immune checkpoint molecules, Interferon-gamma (IFN-γ), and cell-free DNA (cfDNA) could serve as potential biomarkers, particularly in ICI-based therapies.

Achieving optimal surgical margins is critical in breast-conserving surgery (BCS) to reduce local recurrence (LR) and the need for re-excision. This meta-analysis evaluated the impact of intraoperative margin optimization strategies on key surgical and oncologic outcomes in patients who underwent BCS.

Melanoma, a highly aggressive and immunogenic skin cancer, often develops resistance to immunotherapy due to the immunosuppressive tumor microenvironment (TME). Although PD-1/PD-L1 inhibitors have significantly improved treatment outcomes, 30%-40% of patients exhibit no response or develop resistance. Mechanisms such as T-cell exhaustion within the TME limit therapeutic efficacy, necessitating the exploration of novel strategies to enhance immune responses.

Current consensus guidelines lack robust evidence to advocate the optimal treatment approach for locoregional upper esophageal squamous cell carcinoma (L-UESCC). The purpose of this study was to conduct an in-depth investigation of the treatment patterns, outcomes, and prognostic factors among patients with L-UESCC.

The advent of targeted therapy and immunotherapy has revolutionised the management of hepatocellular carcinoma (HCC) patients with all stages, dramatically improving their survival outcomes. Currently, radical resection is still the preferred first-line treatment for early-stage HCC, nevertheless, the surgical outcomes remain unsatisfactory due to high recurrence rate of 70% within 5 years after surgery. Moreover, up to two thirds of diagnosed HCC patients are in the advanced stages of the disease, exhibiting intrahepatic or extrahepatic metastases and vascular invasion. In recent years, the combination of surgical and other local treatments with targeted therapy and immunotherapy has dramatically improved the overall survival for HCC patients and also increased the complexity of HCC management, demanding a dynamic adaptation of the available staging-based strategies and flexible therapeutic allocation. In this review, we mainly elaborate the fundamental principles and recent advancements in the surgical management of locally advanced HCC, such as neoadjuvant, adjuvant and conversion therapy, as well as the regulatory effects of local treatments on targeted therapy and immunotherapy. Finally, the value of splenectomy for unresectable HCC patients with hypersplenism is also discussed.

Acral melanoma (AM) is the predominant subtype of melanoma in Asians. Early detection and prevention can significantly improve patient outcomes; however, there is a lack of effective early biomarkers for predicting AM metastasis. Here, we employed single-cell and spatial transcriptomics analyses to investigate early microsatellite lesions of AM and identify biomarkers of invasiveness in these lesions. Our results characterize a highly immunosuppressive microenvironment and metabolic process shifts in early AM microsatellite lesions that promote the metastatic potential. The transcription factor SOX6 is overexpressed in microsatellite lesions and marks a population of highly invasive melanoma cells. The pro-invasive role of overexpressed SOX6 was validated in vivo and in vitro, including its ability to enhance tumor invasion by upregulating cellular glycolysis, disrupt fatty acid transport, and increase intracellular phosphatidylcholine content. This study suggests that SOX6-overexpressing melanoma cells are the main driver subpopulation promoting early invasion of AM and establishes SOX6 and fatty acid transport processes as biomarkers and potential therapeutic targets for early melanoma metastasis.

Small-cell lung cancer (SCLC) is an aggressive malignancy with a poor prognosis. Despite the initial chemosensitivity, survival for extensive-disease (ED) SCLC remains limited. Immune checkpoint inhibitors (ICIs) in combination with chemotherapy have recently been redefined as the standard of care. We evaluated the efficacy of ICI combination therapy in clinical trials translated into real-world clinical practice for patients with ED-SCLC.

Pathologically, intrahepatic cholangiocarcinoma (ICC) is classified into small-duct (SD) type and large-duct (LD) type, each with distinct clinicopathological characteristics. The contrast-enhanced ultrasound (CEUS) features of the two ICC types remain insufficiently explored.

Brain metastases (BrMs) frequently manifest in patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), and the optimal treatment approach for these individuals remains controversial. This study aimed to evaluate the cost-effectiveness of adding pemetrexed-platinum chemotherapy to first-line gefitinib in EGFR-mutant NSCLC patients with BrMs, considering the perspective of the Chinese healthcare system.

Nutritional risk assessment indices impact disease prognosis, yet their prognostic roles in preoperative digestive system tumor (DST) patients remain unclear.

Pathological diagnosis is important for the treatment of deep suprahyoid head and neck lesions, and tissue sampling needs to balance minimal invasiveness and accuracy. The purpose of this study was to evaluate diagnostic accuracy and factors associated with diagnostic failure of core needle biopsy (CNB) with CT-guided in deep suprahyoid head and neck lesions.

Angiosarcoma (AS), a rare and highly malignant tumour, can manifest spontaneously (primary AS, pAS) or secondary to previous radiation, exposure to chemical agents or Stewart-Treves syndrome (secondary AS, sAS). The aim of this study was to characterise the clinical presentation, management, treatment and outcome-including local recurrence, metastasis and overall survival-among patients diagnosed with AS and treated at Sahlgrenska University Hospital, Gothenburg, Sweden.

Conversion immunochemotherapy may enable curative surgery in patients with initially unresectable locally advanced gastric cancer, but its response rate remains low. Little evidence has shown how to easily predict therapeutic efficacy from hematological biomarkers, apart from tissue biomarkers. This study aimed to identify predictive factors for treatment response from hematological biomarkers and propose strategies for non-responsive patients.

Gastric cancer is the fourth most common cancer globally and the leading cause of cancer-related deaths in Peru. Current synthetic treatments often fail to distinguish cancerous cells from healthy cells, resulting in severe side effects and drug resistance. This study aimed to evaluate the effects of the chloroform fraction of Dracontium spruceanum bulb (DSBCl) on cancer stem cells (CSCs) from AGS and KATO III gastric cancer cell lines, which represent primary and metastatic cancers. The methanolic extract was prepared and characterized via thin-layer chromatography to isolate the chloroform fraction. CSCs were identified via the CD44 marker and isolated via magnetic assisted cell sorting. The cytotoxic effect of DSBCl was evaluated to determine the IC50, revealing its ability to modulate CSC markers and genes associated with tumorigenesis, chemoresistance, and metastasis. In AGS CSCs, DSBCl reduced CD24 expression and downregulated the expression of genes, including ID1, BCL2L2, ABCC2, NANOG, and OCT4, while it upregulated KLF17, BAX, and KLF4. In KATO III CSCs, DSBCl increased ID1 and MYC but decreased BCL2L1 and BAX. These findings suggest that DSBCl modulates critical markers and genes in gastric CSCs, highlighting its potential for gastric cancer treatment.

Lymph node metastasis (LNM) is a crucial risk factor influencing an unfavorable prognosis in specific cancers. Fundamental research illuminates our understanding of tumor behavior and identifies valuable therapeutic targets. Nevertheless, the exploration of fundamental theories and the validation of clinical therapies hinge on preclinical experiments. Preclinical models, in this context, serve as the conduit connecting fundamental theories to clinical outcomes. In vivo models established in animals offer a valuable platform for comprehensively observing interactions between tumor cells and organisms. Using various experimental animals, including mice, diverse methods, such as carcinogen-induced tumorigenesis, tumor cell line or human tumor transplantation, genetic engineering, and humanization, have been used effectively to construct numerous models for tumor LNM. Carcinogen-induced models simulate the entire process of tumorigenesis and metastasis. Transplantation models, using human tumor cell lines or patient-derived tumors, offer a research platform closely mirroring the histology and clinical behavior of human tumors. Genetically engineered models have been used to delve into the mechanisms of primary tumorigenesis within an intact microenvironment. Humanized models are used to overcome barriers between human and murine immune systems. Beyond mouse models, various other animal models have unique advantages and limitations, all contributing to exploring LNM. This review summarizes existing in vitro and animal preclinical models, identifies current bottlenecks in preclinical research, and offers an outlook on forthcoming preclinical models.

Anti-programed cell death protein-1 (PD-1) and anti-programmed cell death 1 ligand 1 (PD-L1) antibodies combined with anti-vascular endothelial growth factor (VEGF) or anti-cytotoxic T lymphocyte antigen 4 (CTLA-4) antibodies are now standard therapeutic options for patients with treatment-naïve, advanced stage, hepatocellular carcinoma. Given the observed efficacy in the advanced setting, the unmet need for therapies for intermediate stage liver cancer, and compelling preclinical rationale for combination with liver-directed therapies, such as transarterial chemoembolization, immunotherapies have quickly moved into earlier stages of the disease. Several phase 1/2 clinical trials have collectively verified the safety of immune checkpoint blockade with regional therapy for intermediate stage, liver-limited, hepatocellular carcinoma. Recently, two global, randomized, double-blind, placebo-controlled studies have demonstrated superior efficacy, based on the surogate of progession free survial, for transarterial chemoembolization plus combination immunotherapy over chemoembolization alone. In this issue of the Journal, Li and colleagues present data for an anti-PD-1 inhibitor with chemoembolization in liver-limited hepatocellular carcinoma (HCC). This study, along with the status of the field, provides the opportunity to highlight key issues for implementation of combinatorial approaches in patients with liver-limited liver cancer, which are discussed in this Commentary. Regional treatment with immune checkpoint inhibition combinations for intermediate stage disease is now rightly at the forefront of HCC drug development, though specific biologic factors, ideal patient characteristics, and optimal combinations require deeper investigation prior to routine use for all patients.

T-cell activation and clonal expansion are essential to effective immunotherapy responses in non-small cell lung cancer (NSCLC). The distribution of T-cell clones may offer insights into immunogenic mechanisms and imply potential prognostic and predictive information.

Metastatic ovarian cancer patients who have recurrent disease after multiple lines of prior treatment have dismal prognosis. The Kristen rat sarcoma viral oncogene homologue (KRAS) G12C mutation is very rare in ovarian cancers and no approved KRAS G12C targeted treatment options exist for ovarian cancer. Here we present a case of metastatic ovarian serous adenocarcinoma in a female patient in her late 70s who was heavily pretreated with multiple lines of treatment before, showing an excellent durable response to KRAS G12C inhibitor sotorasib at reduced dose of 240 mg oral daily for over 26 months and ongoing. Our case highlights KRAS G12C as a driver mutation in ovarian cancer patients that is potentially targetable in certain subgroups of patients.

Cervical teratoblastoma in paediatric patients is an extremely rare and aggressive malignancy, with limited documentation in the medical literature. Teratoblastoma is a malignant variant of germ cell tumours, distinguished by its invasive growth pattern and poor cellular differentiation.A female child in early adolescence presented to our oncology hospital with complaints of persistent lower abdominal discomfort and abnormal uterine bleeding. These symptoms had been progressively worsening over time. On physical examination and imaging, pelvic ultrasonography and MRI revealed a complex cystic mass with hypoechoic features, located in the region between the cervix and the hymenal ring. Histopathological evaluation of a biopsy specimen confirmed the diagnosis of malignant cervical teratoblastoma. A multidisciplinary tumour board recommended surgical intervention. The patient underwent transvaginal excision of the cervical mass, with care taken to preserve reproductive anatomy.Postoperatively, adjuvant chemotherapy was initiated with the bleomycin, procarbazine (Natulan) and cisplatin regimen to reduce the risk of recurrence and metastasis. This case highlights the importance of early recognition, accurate diagnosis and a coordinated treatment approach in managing rare paediatric cervical malignancies.

Orbital metastasis is a rare manifestation of systemic malignancy, accounting for approximately 2%-5% of orbital tumours. The most common primary cancers associated with orbital metastases include breast carcinoma, malignant melanoma and prostate carcinoma. Hepatocellular carcinoma (HCC) is an uncommon source of all reported orbital metastases. We report the case of a man in his mid-50s with a history of alcoholic cirrhosis who presented with an acute onset of left periorbital pain, conjunctival injection, proptosis and restrictive ophthalmoplegia, in addition to abdominal discomfort. Orbital CT demonstrated a heterogeneously enhancing mass in the superolateral left orbit, associated with osseous erosion and displacement of adjacent orbital structures. Further imaging revealed multifocal hepatic lesions with evidence of portal vein invasion. A biopsy of the orbital mass confirmed metastatic HCC. The patient experienced rapid clinical deterioration before initiating treatment and ultimately passed away. This case highlights the importance of considering metastatic liver malignancy in the differential diagnosis of orbital masses, particularly in patients with risk factors for HCC.