Melittin, a cytolytic peptide derived from honeybee venom, has demonstrated potent anticancer activity through mechanisms such as membrane disruption, apoptosis induction, and modulation of key signaling pathways. Melittin exerts its anticancer activity by interacting with key molecular targets, including downregulation of the PI3K/Akt and NF-κB signaling pathways, and by inducing mitochondrial apoptosis through reactive oxygen species generation and cytochrome c release. However, its clinical application is hindered by its systemic and hemolytic toxicity, rapid degradation in plasma, poor pharmacokinetics, and immunogenicity, necessitating the development of targeted delivery strategies to enable safe and effective treatment. Nanoparticle-based delivery systems have emerged as a promising strategy for overcoming these challenges, offering improved tumor targeting, reduced off-target effects, and enhanced stability. This review provides a comprehensive overview of the mechanisms through which melittin exerts its anticancer effects and evaluates the development of various melittin-loaded nanocarriers, including liposomes, polymeric nanoparticles, dendrimers, micelles, and inorganic systems. It also summarizes the preclinical evidence for melittin nanotherapy across a wide range of cancer types, highlighting both its cytotoxic and immunomodulatory effects. The potential of melittin nanoparticles to overcome multidrug resistance and synergize with chemotherapy, immunotherapy, photothermal therapy, and radiotherapy is discussed. Despite promising in vitro and in vivo findings, its clinical translation remains limited. Key barriers include toxicity, manufacturing scalability, regulatory approval, and the need for more extensive in vivo validation. A key future direction is the application of computational tools, such as physiologically based pharmacokinetic modeling and artificial-intelligence-based modeling, to streamline development and guide its clinical translation. Addressing these challenges through focused research and interdisciplinary collaboration will be essential to realizing the full therapeutic potential of melittin-based nanomedicines in oncology. Overall, this review synthesizes the findings from over 100 peer-reviewed studies published between 2008 and 2025, providing an up-to-date assessment of melittin-based nanomedicine strategies across diverse cancer types.

Circulating tumor DNA (ctDNA) has gained increasing attention as a non-invasive biomarker with potential utility across multiple stages of melanoma. ctDNA reflects tumor-derived genetic alterations in real time and has shown value in detecting minimal residual disease, identifying early recurrence, estimating tumor burden, and monitoring response to systemic therapies. In early-stage melanoma, postoperative ctDNA positivity is strongly associated with higher recurrence risk and often precedes radiologic detection. In advanced disease, ctDNA correlates with tumor volume and can distinguish responders from non-responders during targeted therapy and immunotherapy, while also identifying emerging resistance mechanisms. Despite these advantages, clinical implementation remains limited by low shedding in early-stage disease, variation among detection platforms, and the absence of standardized clinical thresholds. Recent advances, including fragmentomics, methylation assays, and multi-target sequencing strategies, aim to improve sensitivity, particularly in low-tumor-burden settings. Integration of ctDNA with radiomics, artificial intelligence, and digital pathology represents an additional opportunity to enhance precision in risk stratification and treatment adaptation. This review summarizes current evidence on ctDNA biology, detection methods, and clinical applications in melanoma and outlines ongoing challenges and future directions required for translation into routine practice.

Stem cell therapy (SCT) is increasingly recognized for its potential in managing cognitive impairment, particularly that of dementia. The application of SCT aims to restore cognitive functioning in people living with dementia. Beyond pre-clinical studies, several clinical trials have evaluated specific stem cell (SC) types for their efficacy in treating dementia. To assess the status and efficacy of pre-clinical and clinical studies utilizing SCs as a therapeutic approach for dementia. A systematic review was conducted using two electronic databases: MEDLINE and Embase. We reviewed studies on the application of SCs in dementia, focusing on the following aspects: Animal models used in pre-clinical studies, tissue sources of SCs and donor species, and administrative routes and outcome assessments. Included papers comprised randomized control trials (RCTs) and original studies, while those involving adjuvant therapies for dementia were excluded. Quality assessment criteria included relevance to the research question, type of SCs, stage of SC transplantation, duration and route of administration, methods for outcome assessment, and the total number of animals implicated. A total of 32 papers were included, encompassing 21 clinical trials and 11 preclinical studies. The preclinical studies employed various transgenic animal models to evaluate SCT outcomes. Animal models of dementia, particularly transgenic mice, have proven instrumental in replicating human disease mechanisms. These models facilitate understanding of pathophysiology and preclinical testing of therapeutic interventions. Studies utilizing SCT demonstrated notable improvements in spatial memory, reduced neuroinflammation, and protection against amyloid-beta (Aβ) toxicity. Key mechanisms included modulation of inflammation, microglial immune responses, neurogenesis support, and anti-amyloidogenic effects. Preclinical studies predominantly employed human placenta-derived mesenchymal stem cells (PD-MSCs), umbilical cord-derived MSCs (U-MSCs), and induced pluripotent stem cell-derived neuronal precursors. Administration routes varied, with stereotactic and intravenous injections targeting affected brain regions. Reductions in inflammatory markers such as IL-1β, TNF-α, and increases in anti-inflammatory cytokines like IL-4 and IL-10 were observed. These outcomes emphasize the immunomodulatory and neuroprotective capacities of SCT. SCT shows promise in addressing dementia-related pathologies by leveraging diverse therapeutic mechanisms. Continued refinement of preclinical models and translational research is essential to bridge gaps between preclinical findings and clinical applications, potentially paving the way for novel treatments for dementia.

Introduction: The Middle East and North Africa (MENA) is a global outlier both for its low female labor force participation and investment in early childhood development services, and consistently ranks lowest on global rankings of gender parity. While the impact of the COVID-19 pandemic on global gender inequity has been acknowledged, specific challenges faced by partnered-women in MENA are underexplored. Additionally, with over half of the region affected by conflict and displacement, exploring these impacts sheds light on understudied gender disparities in humanitarian contexts during the pandemic. This scoping review aims to examine intra-household gender disparities during the COVID-19 pandemic, adding to a more comprehensive understanding of this particular public health emergency’s worldwide ramifications. The hypothesis is that the pandemic has exacerbated women’s pre-existing constraints in the MENA region, worsening gender inequities in economic empowerment, healthcare access, and general well-being. Methods: This review will explore intra-household gender disparities in decision-making, household labor division, economic independence, health, and access to resources and services during the COVID-19 pandemic that have been reported to have been affected by COVID-19 globally. Following PRISMA guidelines for Scoping Reviews, a comprehensive search will be conducted in APA PsycINFO, Arab World Research Source: Al Masdar, EconLit, Global Health, MEDLINE, Scopus, and Web of Science Core Collection, in consultation with an information specialist. Studies in English, French and Arabic from January 2020 to August 2024 will be included. Four independent reviewers will screen studies, and data will be charted, coded, and narratively synthesized. Discussion: This review is expected to shed light on gender disparities in healthcare accessibility, mobility, and decision-making during the COVID-19 pandemic across low- and middle-income countries in the MENA region, adding to the global literature.

Background/Objectives: Acral melanoma (AM) is a rare and aggressive melanoma subtype that arises on sun-shielded, non-hair-bearing skin of the palms, soles, and nail beds. Although more common among individuals of non-European descent, AM remains underrecognized and understudied in the Middle East and North Africa (MENA). This study presents the first dedicated AM registry from Lebanon, aiming to characterize clinical, histopathological, and molecular features and evaluate diagnostic, referral, treatment approaches, and clinical outcomes over a 12-year period. Methods: This retrospective cohort study was conducted at the American University of Beirut Medical Center (AUBMC), a major tertiary referral center in the MENA region. All melanoma cases diagnosed between January 2012 and January 2024 were identified through electronic health records. From this cohort, all adult patients (≥18 years) with biopsy-confirmed AM or tumors located on the palms, soles, or under the nails were selected. Results: Our cohort consisted of 26 adult AM patients, identified from a total of 331 melanoma cases during the study period (8%). Median age at diagnosis was 58.5 years; 54% were female; and 96% of Middle Eastern origin. Most tumors were plantar (81%), and over half (53%) were diagnosed at early stages (Stage I–II). Surgery was performed in 92% of patients, yet 55% had positive margins. Sentinel lymph node biopsy was performed in 46%, and 35% received immunotherapy. Only 35% underwent molecular testing, identifying BRAF mutations in 11% of those tested; no patients received circulating tumor DNA analysis. At a median follow-up of 24.5 months, recurrence occurred in 27%, and metastasis developed in 23%. At the last follow-up, 92% were alive. Conclusions: Despite early-stage detection, high rates of positive margins and limited molecular testing reveal care gaps. This first national registry highlights the need to improve surgical management and expand access to precision oncology in the region.

Background: Breast cancer is the most prevalent malignancy among women and the leading cause of cancer-related mortality. Sentinel lymph node biopsy (SLNB) has emerged as an alternative to axillary lymph node dissection (ALND), with the ACOSOG Z0011 trial demonstrating that SLNB alone yields equivalent oncologic outcomes to ALND for patients with 1–2 positive sentinel lymph nodes (SLNs). Objective: This study evaluates the adoption of Z0011 recommendations at the American University of Beirut Medical Center (AUBMC) and their impact on oncologic outcomes. Methods: This retrospective cohort study includes female patients with early-stage breast cancer (T1–T2, N0, M0) who underwent breast-conserving surgery with SLNB at AUBMC, between January 2011 and December 2016. Data were extracted from the institutional breast cancer database, including demographics, tumor characteristics, surgical management, and follow-up outcomes. Results: SLNB alone was adopted, following publication of the Z0011 trial, in 93.4% of patients, with 6.6% undergoing ALND. Among patients with 1–2 positive SLNs, 27.1% underwent completion ALND. The median number of lymph nodes retrieved increased from two to four over the study period. The most common molecular subtypes observed were luminal A (54.1%), characterized by a predominant stage T1 presentation and small tumor sizes (median tumor size, 1.4 cm). Among patients with 1–2 positive SLNs who underwent ALND, no recurrences or metastatic events were reported. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 95.9% and 93.4%, respectively. No notable differences in OS and DFS were observed between the SLNB alone and ALND groups. Conclusions: Our study demonstrates that SLNB alone provides comparable oncologic outcomes to ALND, supporting its safety and effectiveness as an alternative for early-stage breast cancer patients with 1–2 positive SLNs. These findings extend the Z0011 trial’s applicability to diverse populations, reinforcing SLNB as a less invasive, safe alternative to ALND.