Colorectal cancer (CRC) remains a leading cause of cancer morbidity and mortality worldwide, with nearly one quarter of patients presenting with metastatic disease at diagnosis. The epidermal growth factor receptor (EGFR) plays a central role in CRC pathogenesis through activation of downstream RAS/RAF/MAPK and PI3K/AKT/mTOR signaling pathways, and has become a major therapeutic target. Anti-EGFR monoclonal antibodies, cetuximab and panitumumab, have demonstrated survival benefit in selected patients, particularly those with left-sided, RAS wild-type tumors. However, primary and acquired resistance limit their efficacy, underscoring the need for predictive biomarkers and novel strategies. This review synthesizes current knowledge of EGFR biology, therapeutic integration, and biomarker development, including RAS and BRAF mutations, MSI status, HER2 amplification, EGFR ligands (AREG/EREG), consensus molecular subtypes, and liquid biopsy applications. We also discuss mechanisms of resistance such as pathway reactivation, receptor mutations, and epithelial-to-mesenchymal transition, alongside emerging approaches, including combination regimens, ctDNA-guided rechallenge, and genotype-specific inhibitors. Collectively, these insights highlight the evolving landscape of precision oncology in CRC and the importance of molecular stratification to optimize EGFR-targeted therapy and overcome resistance.

Acquired haemophilia A (AHA) is a rare immune-mediated disorder characterised by the development of autoantibodies against factor VIII. Morbidity and mortality are in general high due to multiple f...

Background: Hepatitis B and C are life-threatening infections that can result in liver-associated complications. Lebanon is a country experiencing its worst economic and political crises to date and is considered to be of low endemicity for hepatitis B virus (HBV) and hepatitis C virus (HCV). We aimed to assess the prevalence of HBV and HCV infections among Lebanese and Syrian refugees residing in Lebanon, to describe the current situation beyond statistical scrutiny and identify risks and long-term consequences associated with neglecting these infections. Methods: We extracted data on the prevalence of HBV and HCV among the Lebanese population and Syrian refugees residing in Lebanon from 2013 to 2018 and sorted them based on age and gender. We compared the prevalence of HBV and HCV among these groups to the prevalence among the Syrians remaining in Syria, after which we calculated the expected number of HBV and HCV cases in Lebanon based on the total number of registered Syrian refugees in Lebanon. We conducted an extensive literature review using MEDLINE, Google Scholar, and PubMed. Results: The prevalence of HBV and HCV in Lebanon from 2013 to 2018 was 1.74% and 0.21%, respectively. 13% of HBV cases and 6% of HCV cases were associated with Syrian refugees. HBV and HCV were more prevalent among men than women for both the Lebanese population and the Syrian refugees. Among the total population, the 20-39 age group represented 40% of HBV and 30% of HCV cases. For the Syrian refugee subgroup, 57% of HBV cases and 28% of HCV cases were reported among individuals aged 20-39 years. The prevalence of HBV and HCV among the total Syrian population in Syria was 5.6% and 2.8%, which was significantly higher than the prevalence among the Syrian refugees in Lebanon for both HBV (0.003%) and HCV (0.001%). The number of HBV and HCV cases recorded among the Syrian refugees in Lebanon was significantly lower than the expected number of HBV and HCV cases. Conclusions: Hepatitis B and C are neglected diseases among the Syrian refugee population in Lebanon. Continued neglect can increase the risk of chronic viral hepatitis complications and mortality, further increasing the health and economic burden in Lebanon. Urgent action is needed from the host country and the international community to achieve better surveillance, detection, and linkage to medical care in order to manage and prevent unexpected consequences.

Bladder cancer is a major malignancy worldwide. Although cigarette smoking is the leading modifiable risk factor, the contribution of waterpipe smoking (WPS), which is increasingly popular globally and often misperceived as safer, remains unclear. In 2019, Lebanese males had the highest bladder cancer incidence in the Arab world (five times the global average), prompting investigation of WPS as a potential carcinogen. We performed a cross-sectional genomic analysis of patients with exclusive WPS and urothelial carcinoma treated at the American University of Beirut Medical Center (n=250 screened; 14 exclusively WPS), integrating targeted sequencing (MSK-IMPACT®) and whole-exome sequencing (TEMPO pipeline). Tumor mutational burden (TMB), microsatellite instability, mutational signatures, and oncogenic alterations were assessed. Previously profiled bladder cancer tumors from cigarette smokers and non-smokers at Memorial Sloan Kettering Cancer Center (n=751) served as comparators. MSK-IMPACT® successfully profiled 13 tumors. WPS-associated tumors exhibited a numerically higher median TMB than cigarette (20 vs. 10 mut/Mb; p=0.10, q=0.2), with 38.5% classified as MSS-hypermutated, a phenotype associated with elevated mutational load despite microsatellite stability. Common mutations included TERT promoter (62%), TP53 and FGFR3 (46%), and PIK3CA (38%). APOBEC mutational signatures predominated across all cohorts, suggesting shared mutagenic processes, while chromatin-modifying gene alterations were less frequent. PD-L1 expression was generally low. Implications: Exclusive WPS induces bladder tumors with overall genomic features resembling cigarette-associated disease, yet with numerically higher TMB and enrichment of MSS-hypermutated phenotypes. These findings provide novel mechanistic evidence of tobacco-related carcinogenesis beyond cigarettes and highlight potential biomarker relevance for immunotherapy in a globally rising exposure group.