Patients with advanced ovarian cancer (OC) have a detrimental prognosis. The options for systemic treatment of advanced OC in later lines of treatment are limited by the availability of active therapies and their applicability to often fragile, exhausted patients with poor performance status. Metronomic chemotherapy (MC) is a concept of a continuous administration of cytotoxic drugs, which is characterized by multidirectional activity (anti-proliferative, anti-angiogenic, and anti-immunosuppressive) and low toxicity. We have performed a retrospective analysis of consecutive, advanced, chemo-refractory OC patients treated with MC based on single-agent topotecan (1 mg p.o. q2d) or on a topotecan (1 mg q2d) and cyclophosphamide (50 mg p.o. qd) combination (CyTo). Metronomic chemotherapy demonstrated promising activity, with 72% and 86% of patients achieving biochemical or objective disease control and 18% and 27% of patients achieving a biochemical or objective response, respectively. The median PFS in the whole population was 3.65 months, but the median PFS in patients with a biochemical response to MC (18.2% of patients) reached 10.7 months. The study also suggested that overweight or obese patients had significantly better outcomes on MC than patients with BMI <25 kg/m². This article is the first report in the literature on metronomic chemotherapy based on a topotecan + cyclophosphamide combination (CyTo). The CyTo regimen demonstrated safety, clinical activity, and potential broad clinical applicability in advanced OC patients and will be evaluated in a forthcoming clinical trial.

Introduction Postoperative morbidity after colorectal resections for cancer remains a significant problem. Data on the influence of complications on survival after laparoscopic colorectal resection are still limited. Aim To analyze the impact of postoperative complications on long-term...

Background: Chemotherapy is a cornerstone of treatment in advanced gastric cancer (GC) with a proven impact on overall survival, however, reliable predictive markers are missing. The role of various inflammatory markers has been tested in gastric cancer patients, but there is still no general consensus on their true clinical applicability. High neutrophil-to-lymphocyte (NLR) and low (medium)-platelets-volume-to-platelet ratio (PVPR) are known markers of unspecific immune system activation, correlating significantly with outcomes in advanced GC patients. Methods: Metastatic GC patients (N:155) treated with chemotherapy +/− trastuzumab were enrolled in this retrospective study. Pre-treatment NLR and PVPR, as well as other inflammatory markers were measured in peripheral blood. Univariate Cox regression was conducted to find markers with a significant impact on overall survival (OS) and progression-free survival (PFS). Spearman correlation and Cohen’s kappa was used to analyze multicollinearity. Multiple multivariable Cox regression models were built to study the combined impact of NLR and PVPR, as well as other known prognostic factors on OS. Results: Elevated NLR was significantly associated with increased risk of death (HR = 1.95; 95% CI: 1.17–3.24), and lower PVPR was significantly associated with improved outcomes (HR = 0.53; 95% CI: 0.32–0.90). A novel inflammatory marker, based on a combination of NLR and PVPR, allows for the classification of GC patients into three prognostic groups, characterized by median OS of 8.4 months (95% CI 5.8–11.1), 10.5 months (95% CI 8.8–12.1), and 15.9 months (95% CI 13.5–18.3). Conclusion: The NLR and PVPR score (elevated NLR and decreased PVPR) is a marker of detrimental outcome of advanced GC patients treated with chemotherapy.

BRAF V600E and KRAS mutations that occur in colorectal cancer (CRC) define a subpopulation of patients with an inferior prognosis. Recently, the first BRAF V600E-targeting therapy has been approved and novel agents targeting KRAS G12C are being evaluated in CRC. A better understanding of the clinical characteristics of the populations defined by those mutations is needed. We created a retrospective database that collects clinical characteristics of patients with metastatic CRC evaluated for RAS and BRAF mutations in a single laboratory. A total of 7604 patients tested between October 2017 and December 2019 were included in the analysis. The prevalence of BRAF V600E was 6.77%. Female sex, primary in the right colon, high-grade, mucinous, signet cell, partially neuroendocrine histology, perineural and vascular invasion, and surgical tissue sample were factors associated with increased mutation rates. The prevalence of KRAS G12C was 3.11%. Cancer of primary origin in the left colon and in samples from brain metastases were associated with increased mutation rates. The high prevalence of the BRAF V600E mutation in cancers with a neuroendocrine component identifies a potential candidate population for BRAF inhibition. The association of KRAS G12C with the left part of the intestine and brain metastases of CRC are new findings and require further investigation.

Background/Objectives: To systematically review and critically appraise AI methods for RECIST-based radiologic treatment response assessment in solid tumors, comparing image-derived and report-derived approaches and summarizing their performance, agreement with reference standards, and validation quality. Methods: This systematic review followed PRISMA guidelines. We searched Embase, MEDLINE, Web of Science, Scopus, and the Cochrane Library on 6 December 2025. We included English-language original studies (2015–2025) in solid tumors where AI directly assigned RECIST response categories and was validated against a reference standard; studies without RECIST-based response endpoints or non–solid tumor populations were excluded. We distinguished image-based techniques that assign RECIST categories from direct analysis of imaging data from report-based techniques that infer RECIST categories from radiology reports using natural language processing. Results: Evidence remains sparse; we identified four eligible studies (two image-based and two report-based). DeepSeek-V3-0324 and GatorTron, both report-based approaches, achieved high accuracy (96.5% and 89%, respectively) in treatment response evaluation, with DeepSeek demonstrating higher expert agreement (κ 0.85–0.90). The nnU-Net and 3D U-Net pipelines, both image-based, showed high segmentation performance (DSC 0.85, VS 0.89) and treatment response classification accuracy of 0.77 for R1, with moderate agreement with the manual reference (κ = 0.60); nnU-Net also achieved moderate to almost perfect agreement (Cohen’s κ 0.67–0.81) in RECIST 1.1 measurements. Conclusions: AI-based RECIST-oriented response assessment is feasible and potentially beneficial for standardization, efficiency, and scalability, but current evidence is limited and heterogeneous, requiring larger multi-center studies with rigorous external validation before clinical adoption. Key limitations include data source variability, reference standard inconsistencies, and lack of robust external validation.

Immunotherapy has redefined the therapeutic paradigm in extensive-stage small cell lung cancer (ES-SCLC). However, the potential role of consolidative thoracic radiotherapy (cTRT) in this context remains unresolved. This study evaluated the efficacy and safety of cTRT in patients with ES-SCLC treated with chemoimmunotherapy, with particular focus on patients with baseline liver and brain metastasis. A systematic review and pairwise meta-analysis were conducted per PRISMA guidelines, including studies from PubMed, Embase, and Scopus up to September 1, 2025. Outcomes were reported as hazard ratios (HR) for overall survival (OS), progression-free survival (PFS), and brain metastasis-free survival (BMFS), and odds ratios (OR) for treatment-related adverse events (TRAEs) with 95 % confidence intervals (95 % CI). Twenty studies involving 5282 patients were included. cTRT combined with chemoimmunotherapy improved OS (HR: 0.57, 95 %CI: 0.48-0.66, p < 0.001) and PFS (HR: 0.53, 95 %CI: 0.45-0.63, p < 0.001). In patients with baseline brain metastasis, cTRT improved both OS (HR:0.57, 95 %CI: 0.39-0.84, p = 0.01) and PFS (HR:0.42, 95 %CI: 0.28-0.64, p < 0.001), whereas in patients with liver metastasis, there was no improvement. Furthermore, cTRT increased BMFS (HR: 0.46, 95 %CI: 0.33-0.64, p < 0.001). Grade ≥ 3 pneumonitis and esophagitis were observed in 3.86 % and 1.27 % of cTRT patients, respectively. cTRT confers significant improvements in OS and PFS in the general population of patients with ES-SCLC, as well as in patients with baseline brain metastasis. Moreover, cTRT may be associated with prolonged BMFS, potentially reflecting an abscopal effect. The safety profile remains acceptable, given the substantial survival benefit.