Perfusion assessment is critical in clinical oncology, particularly in tumor characterization, intraoperative decision making, and postoperative outcome predictions. Hyperspectral imaging (HSI) has emerged as a promising, non-contact, non-invasive, and contrast-free modality capable of capturing spatial and spectral information related to tissue oxygenation and hemoglobin distribution. This study provides an up-to-date review of recent advances in the use of HSI for perfusion monitoring in clinical oncological applications, with a special focus on its adoption in laparoscopic surgeries, brain tumor delineation, and head and neck cancer interventions. The integration of HSI into surgical workflows and its potential to reduce complications are discussed. Overall, while HSI is emerging as an appealing, real-time, quantitative perfusion imaging modality, a lack of standardized protocols and interpretation guidelines pose the most significant challenges. Addressing these gaps through multicenter clinical trials is essential for advancing the routine use of HSI in oncological surgery.

Despite tremendous advances in new drug development over recent decades, the medical needs of an ever increasing and ageing global population are still significantly unmet. Drug repurposing (DR)—finding new therapeutic uses for existing medicinal substances and products—offers a promising strategy by potentially reducing development time, costs and risk. However, currently, significant hurdles restrict broader application of DR. This study was conducted within the European Commission funded REMEDi4ALL consortium to systematically identify and analyse the key policy obstacles perceived to be hindering the success of DR. A systematic literature review was conducted using PubMed and Embase, supplemented by grey literature searches and expert interviews within the consortium. The extracted data underwent thematic analysis. A barrier tree was developed and validated through five workshops with 80 experts from seven stakeholder groups. From 4059 hits, 192 were included for data extraction, resulting in the identification of 33 key barriers grouped into nine main themes: perception of off‐patent medicines, business case for on‐patent DR, business case for off‐patent DR, non‐industry‐funded DR, ecosystem for non‐profit or small and medium‐sized enterprise‐driven repurposing, market authorisation, exclusivity rights, health technology assessment and pricing. This comprehensive analysis provides a foundation for prioritizing the main areas for future interventions. Surprisingly, there were considerable differences in how different stakeholders perceived the importance of a number of key barriers. Such multidimensional aspects of DR barriers will need to inform future development of actionable policy recommendations to enhance the DR ecosystem and facilitate broader access to repurposed medicines.

At diagnosis, metastatic prostate cancer (PC) is sensitive to androgen deprivation therapy (ADT), and patients are usually referred to as having castration-sensitive prostate cancer (mCSPC). The combination of ADT and androgen receptor pathway inhibitors (ARPI) is the current standard of care for mCSPC. This study aimed to review the literature on economic evaluations and health economic models related to mCSPC. A literature search was performed covering Medline, Embase, and Scopus with additional grey literature sources. Studies with data on health economic evaluations focusing on Europe or North America were relevant. 18 peer-reviewed articles and 10 grey literature documents were included. The majority (n = 23) had a deterministic Markov structure and applied either Markov cohort or partitioned survival models. Evaluations investigated various types of ADT-based combinations, comparing the addition of ARPI, chemotherapy agents, or radiation therapy to ADT alone. We concluded that economic evaluations in the field of PC are widely published, and there are a large number of publications even in the specific subgroup of mCSPC. Regardless of the investigated interventions, most studies applied similar methodologies and simulated patients from the mCSPC state until the development of mCRPC or death.

Increasing evidence links elevated serum uric acid levels to adverse cardiorenal outcomes. To date, limited data exist on whether the benefits of urate-lowering therapies (ULTs) depend on timely treatment initiation and sustained adherence in patients at high cardiovascular risk. An economic evaluation was conducted, based on a simulation model populated by Italian real-world patient-level data from the Uric Acid Right for Heart Health (URRAH) cohort to evaluate long-term cardiovascular, renal, and economic outcomes associated with timely allopurinol use. 10,000 patients with hyperuricemia (serum uric acid >5.6 mg/dL) and elevated cardiovascular risk were simulated over a 20-year time horizon. Timely initiation of allopurinol (before the first gout flare) was compared with treatment initiated only after symptomatic disease onset. Scenarios reflecting current and improved adherence to ULTs were assessed. Outcomes included major adverse cardiovascular events, end-stage renal disease onset, and economic outcomes from the payer's perspective. According to our model, timely initiation of allopurinol was associated with modest but consistent health gain (0.04 quality adjusted life years) including reductions in gout flares, cardiovascular- and renal endpoints. Timely allopurinol initiation was cost-saving and, from a health economic perspective, dominant over current practice. Improved ULT adherence amplified these benefits. Our hypothesis-generating research suggests that, in hyperuricemic patients at high cardiovascular risk, the potential benefits of allopurinol also depend on timely initiation and sustained adherence. While these findings do not constitute evidence of causal clinical benefit, they support a broader cardiorenal clinical approach to hyperuricemia management that extends beyond gout prevention.

Background/Objectives: Iron-deficiency anemia (IDA) is a common extraintestinal complication of inflammatory bowel disease (IBD). Among high-dose intravenous (IV) iron options, ferric carboxymaltose (FCM) carries a higher risk of treatment-emergent hypophosphatemia than ferric derisomaltose (FDI), with potential clinical consequences. Slovenia’s healthcare setting, characterized by very low IV iron infusion tariffs and recent pricing in which FCM is substantially less expensive than FDI, warrants a setting-specific cost effectiveness evaluation. Methods: We integrated two methodological components: (i) a payer-perspective cost-effectiveness analysis using a patient-level microsimulation model with (ii) an umbrella review of systematic reviews and a targeted search of expert consensus statements on IV-iron-associated hypophosphatemia. Results: In the base case, FDI required fewer infusions than FCM (11.1 vs. 14.2 over 10 years) but generated only €95 in IV iron administration savings due to low tariffs, while drug procurement was €1166 higher with FDI than FCM. When incorporating the clinical impact of hypophosphatemia, incremental quality-adjusted life years (QALYs) were 0.136, yielding an incremental cost-effectiveness ratio (ICER) of €6590/QALY. The umbrella review consistently showed higher hypophosphatemia incidence with FCM (up to 92%) compared with other IV iron formulations (<10%), with recent recommendations emphasizing phosphate monitoring and risk mitigation through alternative formulations. Conclusions: Despite Slovenia’s low IV iron infusion tariffs and lower FCM price, FDI remained cost-effective in this model, largely due to its more favorable hypophosphatemia profile within the model. These findings suggest that hypophosphatemia risk should be considered when selecting IV iron therapy in routine IBD care.

Background/objectives: This systematic review and meta-analysis quantified global and regional birth prevalence of hyperphenylalaninemia (HPA) caused by phenylalanine (Phe) hydroxylase deficiency. Data sources and methods: Searches of PubMed, Embase, the Cochrane Library and PROSPERO yielded 4297 records; 210 met inclusion and 97 contributed to a rasyndom-effects model stratified by blood Phe cut-off values. Results: The regionally weighted global prevalence of HPA was 0.84 per 10 000 live births (95% CI 0.44-1.24), ranging from 0.60 in South America to 1.30 in the Middle East and North Africa (MENA). Classic PKU (Phe: 1200 ± 200 μmol/l) occurred in 0.29 per 10 000 births overall, reaching 0.58 (0.34-0.87) in North America and 0.67 (0.28-1.23) in Europe. Conclusion: Prevalence patterns mirrored consanguinity rates, explaining the high burden in MENA and the low figures in Southeast Asia. The meta-analysis, applying rare-disease-specific minimum sample-size threshold, confirmed HPA, incl. PKU as a rare disease and validated prevalence estimates.