Tumor-targeted immunomodulation using oncolytic viral vectors is currently being investigated as a promising strategy in cancer therapy. In a previous study, we showed that a measles virus Schwarz vaccine strain (MeVac) vector encoding an interleukin-12 fusion protein (FmIL-12) is an effective immunotherapy in the MC38cea murine colon adenocarcinoma model. We hypothesized that MeVac encoding interleukin-15 may mediate enhanced T and NK cell responses and thus increase the therapeutic efficacy, especially in NK cell-controlled tumors. Therefore, we generated MeVac vectors encoding an interleukin-15 superagonist, FmIL-15. Replication and oncolytic capacity, transgene expression, and functionality of MeVac FmIL-15 vectors were validated in vitro. Effects on the tumor immune landscape and therapeutic efficacy of both FmIL-12 and FmIL-15 vectors were studied in the MC38cea and B16hCD46 tumor models. Treatment with MeVac FmIL-15 increased T and NK cell infiltration in both models. However, MeVac FmIL-12 showed more robust viral gene expression and immune activation, resulting in superior anti-tumor efficacy. Based on these results, MeVac encoding a human IL-12 fusion protein was developed for future clinical translation.

Purpose: In this retrospective study, we compared the impact of en bloc resection with negative margins to that of intralesional resection followed by adjuvant radiotherapy on local control (LC) and overall survival (OS) in patients with mobile spine chordomas. Secondary endpoints included mechanical complication rates, associated risk factors, and quality of life outcomes. Methods: Between June 2008 and March 2025, 26 patients aged ≥ 15 years with mobile spine (C1–L5) chordomas underwent surgical treatment at our institution. Patients were divided into en bloc resection (=Enneking appropriate (EA)) and intralesional resection (=Enneking inappropriate (EI)) plus HT groups. Clinical, oncologic, and surgical data were collected and analyzed to determine outcomes. Results: The EA group demonstrated a clear trend toward improved local recurrence-free survival (LRFS, EA median 35 months vs. EI resection median 14 months) and OS. Adjuvant therapy led to better LRFS and OS independently of the extent of resection. Clinical outcomes and quality of life were favorable in both groups, with no statistically significant differences in short-term, as well as long-term complications (27%). No specific risk factors for long-term complications were identified. Conclusions: En bloc resection remains the gold standard for mobile spine chordoma resection whenever feasible. Nevertheless, Enneking-appropriate resection is often limited by anatomical constraints. In such cases, every effort should still be made to achieve the most complete tumor resection possible prior to initiating adjuvant therapy. Due to the rarity of spinal chordomas and their surgical complexity, these procedures should be performed in specialized spine centers with multidisciplinary expertise.

Purpose: To compare intraoperative screw revision and outcomes of robot-assisted versus navigation-guided percutaneous pedicle screw placement and to explore whether outcomes differed by surgeon experience. Materials and methods: A prospective cohort of 43 consecutive patients undergoing robot-assisted percutaneous pedicle screw fixation between September 2024 and March 2026 was compared with a matched historical cohort of 129 patients treated using navigated conventional percutaneous instrumentation. Propensity score matching included age, sex, ASA physical status, anatomical region, surgical indication, and surgeon expertise. Surgeons were stratified according to prior spondylodesis case volume. Outcomes included screw revision rates (as a measure of screw accuracy), screw placement time, operative time, blood loss, and perioperative complications. Results: Unadjusted screw-level revision proportions were 2.3% with robotic assistance and 3.5% with navigation-guided instrumentation. In adjusted patient-level analysis, greater surgeon experience, but not robotic assistance, was associated with fewer revisions. In the lowest-experience group, the proportions were descriptively 4.3% and 8.2%, but the technique-by-experience interaction was not statistically significant. Median screw-placement time was longer with robotic assistance (7.8 vs. 5.5 min per screw, p < 0.001). No statistically significant between-group differences were detected in blood loss, length of stay, or complication rates. Conclusion: Robot-assisted pedicle screw placement is safe and accurate, with comparable complication rates to conventional navigation. The observed increase in screw placement time may reflect the early adaptation phase of the robotic technique rather than an inherent limitation of the system. The descriptive reduction in revision rates among less experienced surgeons suggests a potential role for robotic assistance in supporting standardization and surgical training; however, this exploratory finding warrants confirmation in larger studies.