Metabolic dysfunction-associated steatohepatitis (MASH) is a progressive liver disease linked to type 2 diabetes (T2D), obesity, and dyslipidaemia, which are all parts of the metabolic syndrome. In 2024, for non-cirrhotic MASH with mild to advanced fibrosis, resmetirom, a selective thyroid hormone receptor-β agonist, became the first FDA-approved treatment for this condition. By increasing β-oxidation and lipid metabolism, it minimises systemic thyroid or cardiac effects while reducing hepatic fat, inflammation, and fibrosis. Resmetirom is being developed for use in combination with lifestyle interventions, such as diet and exercise, to maximize patient benefit. Nevertheless, the lack of congruence between clinical trial populations and real-world payer criteria underscores access obstacles that necessitate policy reform. The successful delivery of screening programs depends on the education of providers from various disciplines and the establishment of uniform screening standards. Future studies should investigate the clinical application of resmetirom in combination with agents that may provide additional benefits, such as GLP-1 receptor agonists, SGLT2 inhibitors, and statins. These results are significant in light of recent long-term safety monitoring of these agents, particularly regarding the thyroid axis. Ensuring equitable uptake will be crucial, as it involves defining fair access through payer endpoints, conducting cost-effectiveness analysis, and considering patient-reported outcomes. Resmetirom represents a breakthrough in MASH management, offering potential metabolic benefits in conjunction with comprehensive clinical and lifestyle approaches.

Antibody–drug conjugates (ADCs) are reshaping the therapeutic approach to advanced gastrointestinal cancers by integrating tumor-specific monoclonal antibodies with potent cytotoxic payloads to improve targeted tumor cell destruction while minimizing systemic exposure. Compared to traditional chemotherapy, trastuzumab deruxtecan has significantly improved objective response rates and overall survival in HER2-positive gastric and gastroesophageal junction tumors after trastuzumab-based therapy. This supports its role as an important second-line or later treatment option. The ongoing advancement of ADCs targeting CLDN18.2, TROP2, and CEACAM5 indicates that this therapeutic category will continue to expand across gastrointestinal neoplasms. Nonetheless, these advancements are accompanied by a specific and clinically significant toxicity profile. Hematologic suppression, gastrointestinal side effects, hepatotoxicity, and notably interstitial lung disease (ILD) are essential consequences that may need inpatient assessment and care. Interstitial lung disease (ILD), although uncommon, may be severe or lethal if not identified immediately and treated swiftly with medication cessation and corticosteroids. In hospitalized patients, distinguishing ADC-related toxicity from infection or disease progression is often difficult owing to overlapping clinical manifestations, requiring meticulous evaluation and interdisciplinary cooperation. As ADCs are integrated into earlier treatment lines and across a broader patient population, hospital systems must evolve to ensure prompt identification, consistent management protocols, and efficient collaboration between oncology and inpatient teams. This study analyzes the mechanisms, clinical effectiveness, and safety profile of ADCs in gastrointestinal oncology, pointing out the importance of institutional preparedness to safely incorporate these medicines into standard clinical practice. These features also align ADC therapy with personalized medicine by emphasizing biomarker-guided patient selection and individualized toxicity monitoring.

Background: Chimeric antigen receptor (CAR) T-cell therapy has transformed haematological-malignancy care, but its dermatologic safety profile remains incompletely characterised across products and indications. Methods: We analysed 8,431,841 deduplicated FDA Adverse Event Reporting System reports from 2016 Q3 to 2026 Q1. Seven approved CAR T-cell products were identified. The primary outcome was any dermatologic adverse event, defined using the MedDRA Skin and subcutaneous tissue disorders system organ class. Secondary outcomes included broad severe cutaneous adverse reactions, narrow Stevens-Johnson syndrome/toxic epidermal necrolysis, and 14 phenotype-specific categories. Multivariable models adjusted for demographics, polypharmacy, cancer, immune checkpoint inhibitor exposure, lymphodepleting chemotherapy and cytokine release syndrome. Additional sensitivity analyses evaluated HSCT/GVHD co-reporting proxies, infection and cytopenia/bleeding proxies, severe-event clinical characteristics, comparator robustness and multiplicity correction. Results: Dermatologic adverse events were identified in 996,654 reports, including 425 CAR-T-associated cases. CAR T-cell exposure was associated with reduced adjusted reporting odds for the primary outcome (adjusted odds ratio 0.13, 95% confidence interval 0.09–0.20) and broad severe cutaneous adverse reactions (0.35, 0.23–0.52). The primary SKIN_ANY reduced-reporting pattern was consistent across all-FAERS, haematological-malignancy and active haematology-oncology comparators. HSCT/GVHD proxy co-reporting was uncommon and did not materially alter estimates. Severe dermatologic reports frequently co-mentioned CRS and serious outcomes. The tisagenlecleucel vascular cutaneous signal was nominally significant but attenuated after excluding infection-attributable and cytopenia/bleeding-proxy reports. Conclusions: Within spontaneous reporting systems, CAR T-cell therapy showed reduced relative reporting of dermatologic adverse events across broad, phenotype-specific and product-level analyses. These results should be interpreted as differences in reporting behaviour, not as evidence of reduced true clinical incidence or lower patient-level risk. Early severe cutaneous reports frequently overlapped with cytokine release syndrome, while infection, cytopenia/bleeding proxies and supportive-care drugs were important alternative explanations for selected cutaneous signals.

Background: Revisional bariatric surgery is increasingly performed due to weight regain, inadequate weight loss, or complications following primary bariatric procedures. These operations are technically challenging, and while laparoscopic surgery remains the standard approach, robotic platforms have gained adoption. However, comparative evidence on safety and efficiency remains limited and methodologically heterogeneous. Methods: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed/Medline, Embase, Scopus, Web of Science, and Cochrane Central were searched. Comparative studies of robotic versus laparoscopic revisional bariatric surgery were included. To reduce bias from overlapping cohorts, we systematically identified and excluded duplicate datasets from national and institutional registries, prioritising the most contemporary and comprehensive reports, and retained partially overlapping studies only when the non-overlapping period spanned ≥3 years. Study quality was assessed using the Newcastle–Ottawa Scale. Outcomes analysed included length of hospital stay, operative time, postoperative complications, reoperation, anastomotic leakage and pneumonia. Random-effects models were used to generate pooled estimates. Results: Six retrospective studies encompassing 7199 robotic and 34,584 laparoscopic procedures were included. Robotic surgery was associated with a statistically significant reduction in length of hospital stay compared with laparoscopy (mean difference −1.06 days; 95% CI −1.97 to −0.15; I² = 84%). This finding was sensitive to the inclusion of a single large registry-based study. No significant differences were observed in the overall postoperative complications, reoperation rates, anastomotic leakage or pneumonia. Operative time did not differ significantly in the primary analysis. (I² = 93%), but sensitivity analyses suggested shorter procedure durations with laparoscopic surgery after exclusion of influential studies. Conclusions: In this systematic review and meta-analysis, robotic revisional bariatric surgery was associated with a shorter length of hospital stay and similar short-term safety outcomes to laparoscopic surgery. However, the very high statistical heterogeneity, observational design and potential for selection bias mean that these findings should be interpreted as hypothesis-generating rather than definitive evidence of superiority or equivalence. Larger, prospective, multi-centre studies with standardised outcome definitions and robust adjustment for confounding are needed to clarify the comparative clinical and cost-effectiveness of robotic versus laparoscopic approaches in revisional bariatric surgery.

Background: We examined temporal trends in deaths mentioning both pancreatic cancer and renal failure in the United States. Methods: We analyzed CDC WONDER multiple-cause-of-death data for adults aged ≥25 years from 1999 to 2024. Age-adjusted mortality rates (AAMRs) were assessed using Joinpoint regression. Secondary analyses quantified renal-failure co-recording among pancreatic-cancer-involving deaths, renal-failure subtypes, disparities, and comparisons with lung and bronchus, colorectal, and liver and intrahepatic bile duct cancers. Results: Overall, 31,497 deaths mentioned both conditions. The AAMR increased from 0.37 per 100,000 in 1999 to 0.82 in 2024, with the most rapid increase during 2018–2024 (annual percentage change, 10.77%; 95% CI, 7.18–18.22%). Renal failure was co-recorded in 2.98% of pancreatic-cancer-involving deaths. Corresponding proportions were 2.37% for lung and bronchus, 4.75% for colorectal, and 5.77% for liver and intrahepatic bile duct cancer; recent trends did not differ significantly from pancreatic cancer. Acute kidney failure was the most frequently recorded renal subtype (43.22%). In 2024, AAMRs were higher among males and highest among non-Hispanic Black individuals. Conclusions: Renal-failure co-recording with pancreatic cancer increased markedly after 2018 but was not unique to pancreatic cancer. Death-certificate data do not establish temporal sequence or causality; linked clinical data are needed to clarify potentially modifiable kidney-related pathways.