Cancer progression and therapeutic resistance are driven by complex molecular interactions between genomic instability and immune modulation. Defects in the DNA damage response (DDR) not only promote tumor heterogeneity but also shape the tumor immune landscape through the generation of neoantigens, activation of the cGAS–STING pathway, and modulation of immune checkpoints. This review provides an integrative overview of the molecular mechanisms linking DDR dysfunction to immune crosstalk, emphasizing how these processes influence tumor evolution and response to therapy. We discuss emerging therapeutic strategies that exploit DDR–immune interactions, including PARP and ATR inhibitors, synthetic lethality approaches, and combination regimens with immune checkpoint blockade. Understanding the bidirectional connection between DNA repair pathways and immune signaling unveils new translational opportunities for precision oncology and offers a framework for developing combinatorial therapies capable of overcoming resistance and improving long-term cancer control.

Background: Saphenous vein degeneration is associated with significant morphological changes. This study compares the clinical and morpho-anatomical characteristics between patients with aneurysmal and non-aneurysmal insufficient great saphenous vein (GSV). Methods: A retrospective observational analysis was conducted on 75 patients with chronic venous disease. Patients were divided into Group A (n=17, GSV diameter ≥1.2 cm) and Group B (n=58, GSV diameter 0.6-1.2 cm). Clinical data and morpho-anatomical features were assessed using ultrasonography and histopathological examination. Results: Group A had significantly larger GSV diameter (1.4 ± 0.2 cm vs. 0.7 ± 0.1 cm, p < 0.001) and wall thickness (0.4 ± 0.1 cm vs. 0.2 ± 0.1 cm, p < 0.001). Elastic fiber fragmentation was more severe in Group A (55% vs. 29%, p < 0.01). Group A also had a higher mean BMI (31.4 ± 4.5 kg/m² vs. 27.4 ± 4.0 kg/m², p = 0.007) and longer hospitalization (2.1 ± 0.6 days vs. 1.5 ± 0.6 days, p = 0.0023). Conclusions: Aneurysmal degeneration is linked to more severe clinical and morphoanatomical changes, indicating a need for closer monitoring and more aggressive treatment strategies.