Targeted therapy is the standard treatment for driver-mutated lung cancer, but its efficacy in multiple primary lung cancers (MPLCs) remains limited due to significant inter-lesional molecular heterogeneity. We present a case of synchronous MPLC with 34 bilateral pulmonary nodules. The dominant right upper lobe lesion was an EGFR L858R-mutated adenocarcinoma that responded to osimertinib, while other nodules progressed. Switching to chemoimmunotherapy induced regression of all lesions, enabling surgical resection. Postoperative pathological analysis revealed two resected lesions with discordant molecular profiles-one EGFR-mutated and one driver-negative. Despite adjuvant therapy, the patient developed early recurrence as non-small cell lung carcinoma-not otherwise specified with no driver mutation and died within 6 months post-radiotherapy. This case highlights the limitations of single-agent targeted therapy in MPLC, challenges the assumption that driver-negative lesions typically follow an indolent course, and supports early chemotherapy-based systemic combination strategies to address the significant molecular heterogeneity in MPLC.

To determine the prevalence, severity and characteristics of potential drug-drug interactions (DDIs) in a homogeneous cohort of patients with early-stage breast cancer receiving adjuvant or neoadjuvant chemotherapy.

We performed a retrospective observational study of patients treated with systemic chemotherapy at a tertiary hospital. All medications prescribed during chemotherapy were recorded. Potential DDIs were identified using the Lexicomp database and classified by risk level, clinical severity, quality of evidence and mechanism of action. Associations between patient-related factors and DDIs were analysed.

A total of 273 patients were included (median age 52 years) and 56% had at least one comorbidity. Overall, 2842 drugs were prescribed (median 10 per patient), resulting in 2287 potential DDIs. All patients presented at least one DDI; 89% had at least one type D interaction and 14.6% at least one type X interaction. Most DDIs were classified as type C (75.3%), followed by type D (21.7%) and type X (3.0%). The total number of DDIs was significantly associated with age, comorbidity burden and number of prescribed drugs.

Potential DDIs are highly prevalent in patients with early-stage breast cancer receiving chemotherapy, with a substantial proportion involving clinically significant or contraindicated combinations. Polypharmacy, age and comorbidities are key risk factors, highlighting the importance of systematic medication review and interdisciplinary collaboration to improve treatment safety.

Patients with metastatic breast cancer (MBC) have limited opportunities for a cure, as they develop resistance to therapies and continually form new metastases. Clinical overt metastases emerge from metastasis-initiating cancer cells (MICs) that disseminate during breast cancer (BC) progression. Currently, there are no available therapies that inhibit MIC dissemination to prevent overt metastasis. We provide preclinical evidence that intratumoral (IT) delivery of type I polarized dendritic cells (DC1) limited the MIC dissemination mechanisms in tumor lesions of human epidermal growth factor receptor 2 (HER2)+ mammary carcinoma. Interferon gamma, a prominent cytokine secreted by T helper 1 and innate-like immune effector cells, inhibited dissemination of MICs from the tumor lesions via the modulation of HER2/progesterone receptor/Wnt family member 4/receptor activator of nuclear factor kappa beta ligand signaling. Importantly, we provide clinical evidence that in patients with stage I-III HER2+ BC, there was significant regression of the primary tumor treated with IT DC1, as well as inhibition of disseminating MIC phenotypes. We observed a reduced burden of MICs in the bone marrow (BM) of patients with stage I-III HER2+BC treated with IT DC1, compared with untreated patients and those treated with standard neoadjuvant HER2 therapies paclitaxel, with or without carboplatin, trastuzumab and pertuzumab (Taxol, Carboplatin, Herceptin and Perjeta or THP). We also treated a single patient with de novo stage IV HER2+ MBC with trastuzumab, pertuzumab and tamoxifen in combination with IT DC1. Remarkably, this treatment resulted in near-complete regression of primary tumor and metastatic disease, along with inhibition of MIC seeding in the BM. These findings suggest an intriguing strategy to inhibit the dissemination of MICs and prevent further overt metastasis in all patients with BC.

Despite advances in HER2-targeted therapies and CSC-directed agents, resistance remains a major barrier in breast cancer. Synthesize evidence for exercise as a precision strategy to disrupt HER2/CD44-driven resistance circuits. Preclinical and clinical data demonstrate that physical activity: (1) downregulates HER2/PI3K signaling via myokine-mediated pathways (IL-6/SPARC), (2) reduces CD44 through NK-dependent immune surveillance, and (3) synergizes with biologics to overcome cardiotoxicity and chemoresistance. Molecular subtype-specific exercise prescriptions are defined. Exercise reprograms the tumor-immune microenvironment to target therapy-resistant pathways, establishing a paradigm for exercise as adjuvant precision medicine.

This article describes the case of a man in the early 50s diagnosed with left-sided colon cancer with peritoneal metastasis, who underwent neoadjuvant chemotherapy, followed by laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). One week postoperatively, he developed a painful, erythematous rash over the left flank, which rapidly progressed to ulceration and was associated with hyperalgesia. The diagnosis was challenging, and the patient was initially treated with various empiric therapies without improvement. A skin biopsy ultimately revealed necrosis, attributed to cytotoxic tissue injury from mitomycin C used during HIPEC. Management was primarily supportive, including analgesia, local wound care and infection prevention measures. This case highlights a rare complication of HIPEC with localised chemotherapy cytotoxic skin injury.

Primary spinal angiosarcoma is extremely rare with few reported cases globally. While en bloc resection is the only definitive and curative treatment modality, this case highlights the potential for curative-intent, non-surgical management of spinal epithelioid angiosarcoma using taxane-based chemoradiotherapy, especially in anatomically challenging and surgically unresectable locations. It also emphasises the role of multimodal imaging and histopathological correlation in the diagnosis and monitoring of rare spinal tumours.

This case describes a woman in her mid-40s with recurrent colorectal cancer who developed severe dermatologic toxicity during panitumumab-based therapy. Three months after treatment initiation, she developed a diffuse acneiform eruption, pronounced xerosis and painful periungual inflammation with exuberant granulation tissue consistent with epidermal growth factor receptor (EGFR)-inhibitor-induced paronychia. Multidisciplinary, guideline-concordant supportive care (including prompt topical measures and short-course systemic therapy) achieved symptom control and allowed continuation of anticancer treatment. This report underscores the importance of early recognition and structured management of EGFR-inhibitor toxicities to prevent treatment disruption and preserve quality of life.

Research on molecular classification of lung cancer based on transcriptomic features has achieved remarkable progress. The complementary information provided by distinct molecular profiles has motivated the integration of multi-omics datasets to refine the classification system for lung cancer. In this study, we employed a computational pipeline incorporating 10 clustering algorithms to integrate multi-omics datasets from lung adenocarcinoma (LUAD) patients, combined with 10 machine learning methods, leading to the identification of high-resolution molecular subtypes and the development of a consensus machine learning-driven signature (CMLS) with robust predictive performance. Our findings reveal that the CS1 subtype is associated with more favorable prognosis and enhanced immune responsiveness. Furthermore, a CMLS model constructed from 26 core genes demonstrated strong prognostic predictive power. Patients with high CMLS scores exhibited lower infiltration of CD8⁺ T cells, poorer survival, and diminished response to immunotherapy. In contrast, the low-CMLS group showed improved clinical outcomes, greater responsiveness to immunotherapy, and a tendency toward an immunologically "hot" tumor phenotype. Integrated multi-omics analysis indicated that Gremlin-1 (GREM1) acts as a key regulator within the differential screening-selected gene aberrant in neuroblastoma (DAN) family genes-mediated transforming growth factor-beta (TGF-β) signaling pathway. In conclusion, our data establish a molecular classifier that stratifies patients into distinct score groups, with those in the low-CMLS group potentially benefiting from treatment with pilaralisib.

Children with cancer and their parents face multidimensional demands in home-based pediatric cancer care, spanning informational, practical, and psychosocial domains, often requiring acute decision-making at home. However, qualitative evidence integrating both children's and parents' perspectives remains limited. This study aimed to explore and understand the needs, expectations, and experiences of children with cancer and their parents during home-based care.

A qualitative dyadic child-parent study was conducted in a pediatric oncology ward of a university hospital. Purposeful sampling continued until thematic saturation. Data were collected using a researcher-developed Characteristics Information Form and semi-structured interviews informed by Empowerment Theory. Reflexive thematic analysis guided by theoretical frameworks was used. Ethical approval was obtained, and trustworthiness was ensured through strategies addressing credibility, dependability, transferability, and confirmability.

Eighteen children and eighteen parents participated. Two overarching themes emerged: (1) Navigating Challenges in Home-Based Pediatric Cancer Care, encompassing physical, informational, clinical, emotional, and psychosocial difficulties; and (2) The Lighthouse of Empowerment: Guiding Support, highlighting the need for tailored, structured support mechanisms, including home-care education, symptom management guidance, coordinated communication pathways, digital tools, psychological support modules, and clear emergency roadmaps.

The study reveals complex challenges and empowerment needs of children with cancer and their parents during home-based care. Findings emphasize the importance of family-centered and child-focused, empowerment-oriented, and technology-supported approaches to enhance home-care competence and psychosocial well-being.

Pediatric oncology nurses can enhance home-based care by providing structured education, individualized symptom guidance, empowerment-focused interventions, digital tools, clear communication, and emergency planning, thereby improving family confidence, continuity of care, and psychosocial outcomes.

Solid pseudopapillary tumor of the pancreas is a rare low-grade malignant neoplasm. The clinical relevance of lymph node dissection during surgical resection remains controversial due to limited evidence.

We retrospectively reviewed the clinical records of patients with solid pseudopapillary tumor of the pancreas who underwent surgery at Shandong Provincial Hospital between 2005 and 2024. Lymph node status and clinicopathologic characteristics were analyzed. The patients were divided into 2 groups according to whether the lymph nodes were cleared or not, and the association between lymph node dissection and postoperative outcomes was evaluated.

A total of 351 patients were included, with a male to female ratio of 63:288. Among 109 patients who underwent lymph node dissection, no lymph node metastasis was identified. Tumor location, age at diagnosis, and clinical presentation did not differ between sexes; however, female patients had significantly larger tumors than male patients (5.74 ± 3.46 cm vs 4.57 ± 2.82 cm, P = .013). A total of 182 patients were followed up after surgery, with a 41-month median follow-up time, including 60 patients with lymph node dissection and 122 patients without lymph node dissection. No tumor recurrence or metastasis occurred in either group, and the complication rates were comparable.

In the absence of radiologic or intraoperative suspicion of nodal involvement, routine lymph node dissection may be unnecessary in solid pseudopapillary tumor of the pancreas surgery.