Search Results (2,112)

Background and Objectives: Serrated adenocarcinoma (SAC) is a distinctive neoplasm that is histopathologically characterized by the presence of epithelial serration, an eosinophilic cytoplasm, and a vesicular nucleus. However, the literature data concerning somatic mutations in SACs remain extremely limited. Materials and Methods: A total of 159 colon resection cases diagnosed with adenocarcinoma whose DNA mutations were analyzed by next-generation sequencing (NGS) were retrospectively reviewed. In 23 cases, the SAC area exceeded 50%. A chi-square test was used to evaluate histopathologic characteristics and somatic mutations in SACs and non-serrated adenocarcinomas (non-SACs). Results: A significant difference was found in histological grade (p = 0.019) between SACs and non-SACs. TP53, KRAS, and PIK3CA genes have been identified as the most frequently mutated genes in both SACs and non-SACs. No statistically significant difference in somatic mutations was observed between the two groups (p > 0.05). Conclusions: In the present study, a higher prevalence of KRAS mutations was observed in SACs compared to BRAF mutations (KRAS: 39.1%, BRAF: 4.3%). This finding is consistent with the recent literature reporting a higher prevalence of KRAS mutations in colorectal SACs, in contrast to previous studies. The somatic mutation results of our study and the previous literature data suggest the potential importance of epigenetic alterations documented in the literature in the development of SACs. Full article

Lung cancer is the leading cause of cancer-related death worldwide, ranking first among men and second among women for both incidence and mortality. Surgery remains the primary treatment for early-stage, resectable non-small cell lung cancer (NSCLC), encompassing stages I and selected cases of stage IIIB. For patients with stage II to III disease, as well as some stage IB tumors, neoadjuvant or adjuvant systemic therapies are recommended. It is well recognized that specific driver gene mutations play a critical role in tumor progression and aggressiveness, and patients with these genetic alterations may benefit from targeted treatment approaches. These alterations are referred to as “druggable”, “targetable”, or “actionable”, representing specific targets for personalized treatments. Tyrosine kinase inhibitors (TKIs) are now the preferred first-line treatment for patients harboring mutations in EGFR, ALK, ROS1, and BRAF. Additionally, targeted therapies exist for patients with alterations in RET, ERBB2, KRAS, MET, and NTRK, either for those who have received prior treatments or as part of ongoing clinical trials. The success of targeted therapies is reshaping treatment approaches for NSCLC with targetable driver gene alterations, both in early-stage and locally advanced settings. This review focuses on current therapeutic strategies that combine targeted therapies with surgical resection in patients with resectable non-small cell lung cancer (NSCLC) harboring actionable driver gene alterations. Full article

Background: The epidermal growth factor receptor (EGFR) is overactive in many tumors. This phase I trial evaluated the safety and preliminary efficacy of afatinib plus capecitabine in refractory pancreatic ductal adenocarcinoma (PDA), biliary tract cancers (BTC), and other solid tumors. Patients and Methods: The phase Ia study had a 3 + 3 design with capecitabine 1000 mg/m² twice daily on days 1–14 and afatinib 20 mg, 30 mg, or 40 mg daily in 21-day cycles. In phase Ib, 15 patients, each with PDA and BTC, were treated at maximum tolerated dose (MTD). Results: A total of 41 patients were enrolled. No dose-limiting toxicities were observed, and the MTD was 40 mg afatinib plus capecitabine. Among 36 response-evaluable patients, one had a partial response (3%), and eight (22%) had stable disease. Median progression-free survival (PFS) was 1.9 months (95% CI 1.0, 2.0) for PDA and 1.9 months (95% CI 1.6, 3.4) for BTC. Median overall survival (OS) was 3.2 months (95% CI 2.0, 5.8) for PDA, and 4.6 months (95% CI 1.9, 6.1) for BTC. Median OS was 5.8 months (95% CI 2.0, 9.6) for KRAS^WT PDA, and 5.0 months (95% CI 1.6, 6.1) for KRAS^WT BTC, vs. 3.9 months (95% CI 1.9, 5.8) for KRAS^MUT PDA and 3.1 months (95% CI 1.0, 22.8) for KRAS^MUT BTC, respectively. Conclusions: Afatinib plus capecitabine is tolerable but does not have clinically meaningful efficacy in refractory PDA/BTC. Future studies should test novel anti-EGFR/HER2 therapies in KRAS^WT cancers further selected with a comprehensive molecular profile. Full article

Introduction: Lung adenocarcinoma (LUAD) is the leading cause of cancer-related mortality worldwide. Acinar is the most prevalent architectural pattern and is associated with an intermediate prognosis. Several studies have investigated the prognosis of acinar-predominant LUAD patients. Here, we aimed to move beyond the acinar-predominant classification and gain a more comprehensive understanding of how acinar minor components influence prognosis specifically when accompanying other histological patterns in LUAD. Methods: Patients were grouped by the proportion of acinar patterns in their tumors: acinar-predominant (AP), and acinar component (AC; non-acinar predominant LUAD with an acinar component of ≥5%). The clinicopathologic characteristics, recurrence-free survival (RFS), and a panel of well-characterized driver mutations, including KRAS, EGFR, BRAF, MET, and PIK3CA, were investigated in the two groups of patients. Results: Among 1263 LUAD patients, 716 (56.7%) were AP, and 547 (43.3%) were AC. In AP, the frequency of EGFR exon 19 deletions (EGFR-Del 19) was significantly higher than in AC (p = 0.014). AC demonstrated a worse RFS than AP in the unadjusted analysis (log-rank p: 0.006). In stage I, the difference in the RFS of AC in comparison to AP remained significant (p = 0.048). In the multivariable analysis, AC was significantly associated with a worse RFS in comparison to AP (hazard ratio [HR] AC vs. AP: 1.240, 95% CI: 1.103–1.312, p: 0.04), even after adjusting for other histological patterns, the mutational status, and relevant clinicopathological features. The post-recurrence survival was significantly better in patients with an acinar component of ≥5% who received EGFR tyrosine kinase inhibitors (TKIs) compared to those who did not receive TKIs (p = 0.033). Conclusions: While the predominant pattern primarily dictates prognosis in LAUD, the presence of an acinar minor component alongside other high-grade patterns may further worsen outcomes. This underscores the necessity of considering the broader histological landscape rather than focusing solely on predominant patterns, as our findings show that minor acinar components can impact RFS alongside other histological patterns. Full article

Mesonephric-like adenocarcinoma (MLA) of ovaries is a new and rare neoplastic entity, recently classified by the World Health Organization. Its morphological and immunohistochemical profile is similar to primitive cervical mesonephric adenocarcinoma, but its origin has not been determined yet. Some authors believe that this neoplasm originates from Wolffian remnants in the ovarian hilum, while others suggest an origin from the Mϋllerian epithelium, followed by a mesonephric trans-differentiation. Starting from a recently diagnosed mismatch repair-deficient ovarian MLA, we try to further develop this line of research. A detailed molecular analysis of the studied tumor helps clarify our ideas. In fact, the typical KRAS mutation was not present. We found mutations in numerous other genes, which are rarely described in the literature or are already described in the endometrioid histotype. We reached some interesting conclusions, which, if supported by future studies, will clarify the true nature of these tumors, allowing for better stratification and a better therapeutic framework. Full article

Pancreatic cancer remains one of the most aggressive malignancies globally, with a 5-year survival rate of less than 13%. This poor prognosis stems from late-stage diagnosis and intrinsic resistance to conventional therapies, including chemotherapy and radiotherapy. A hallmark of PC is oncogene-driven metabolic reprogramming—notably mediated by mutations in KRAS and other key pathways—which fuels tumor progression and undermines the efficacy of neoadjuvant treatments. Consequently, there is a pressing demand for non-invasive techniques capable of mapping metabolic alterations at both the tumor microenvironmental and systemic levels. This review will discuss molecular imaging techniques that identify metabolic changes within the tumor microenvironment. By bridging preclinical insights with clinical applications, we highlight how these innovations promise to revolutionize PC diagnosis, treatment stratification, and therapeutic monitoring, ultimately paving the way for precision oncology. Full article

Pancreatic cystic lesions (PCLs) are increasingly identified via computerized tomography (CT) and magnetic resonance (MR), with a prevalence of 2–45%. Distinguishing mucinous PCLs (M-PCLs), which include intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) that can progress to pancreatic ductal adenocarcinoma, from non-mucinous PCLs (NM-PCLs) is essential. Carcinoembryonic antigen (CEA) remains widely used but often demonstrates limited sensitivity and specificity. In contrast, endoscopic ultrasound-guided measurement of intracystic glucose more accurately differentiates PCL subtypes, as tumor-related metabolic changes lower cyst fluid glucose in mucinous lesions. Numerous prospective and retrospective studies suggest a glucose cut-off between 30 and 50 mg/dL, yielding a sensitivity of 88–95% and specificity of 76–91%, frequently outperforming CEA. Additional benefits include immediate point-of-care assessment via standard glucometers and minimal interference from blood contamination. DNA-based biomarkers, including KRAS and GNAS mutations, enhance specificity (up to 99%) but exhibit moderate sensitivity (61–71%) and necessitate specialized, expensive platforms. Molecular analyses can be crucial in high-risk lesions, yet their uptake is constrained by technical challenges. In practice, combining glucose assessment with targeted molecular assays refines risk stratification and informs the choice between surgical resection or active surveillance. Future investigations should establish standardized glucose thresholds, improve the cost-effectiveness of genetic testing, and integrate advanced biomarkers into routine protocols. Ultimately, these strategies aim to optimize patient management, limit unnecessary interventions for benign lesions, and ensure timely therapy for lesions at risk of malignant transformation. Full article

Background/Objectives: Endometrial cancer (EC) is the most common malignancy of the female genital tract. In 2013, The Cancer Genome Atlas analyzed the molecular profile of endometrial tumors identifying four risk classes (POLE ultramutated, mismatch repair-deficient, copy-number low-microsatellite stable, and copy-number high-serous-like. This classification is reshaping the current understanding of EC, enabling more refined risk stratification and uncovering potential therapeutic targets tailored to specific molecular subgroups. In the context of these four categories, it is possible to identify different molecular alterations that correlate with different prognoses. Methods and Results: We retrospectively analyzed tissue samples from eighty-five EC patients, performing multigene profiling using a 50-gene next-generation sequencing (NGS) panel to categorize them into distinct molecular subtypes; we observed the following distribution: 5.9% POLE, 25.8% mismatch repair-deficient/microsatellite instability (MMRd/MSI), 11.8% p53abn/TP53mut, and 56.5% NSMP. A favorable concordance (97.6%) was shown in MSI NGS-based analysis and MMR IHC results, and the agreement rate of p53 IHC and TP53 mutation was 92.3%. When we analyzed the correlation between molecular subtypes and clinicopathological features, we found that molecular subtypes significantly differentiated by grade, FIGO stage, and lymphovascular invasion (LVSI). These findings seem to support the effectiveness of our NGS-based classifier and its reliability in distinguishing both MSI and TP53 mutated cancers. This study also explored mutations in PIK3CA, PTEN, KRAS, ERBB2, and ESR1 genes, noting their potential as targets for treatments. PIK3CA mutations were linked to favorable features, such as early disease stage and absence of LVSI. Conclusions: Our study highlights the potential of a medium-complexity NGS panel for supporting the molecular classification of endometrial cancer, complementing the existing diagnostic algorithms. By identifying additional biomarkers, we provided valuable insights into the genomic landscape of EC. However, further exploration of the molecular profiles is needed to validate these findings and improve the identification of patients at a higher risk of unfavorable outcomes. Full article

Botulinum neurotoxin type A (BoNT/A), among the most potent known toxins, is widely used in cosmetic medicine. However, its toxicity mechanisms remain poorly understood due to a lack of suitable models. Here, we generated a doxycycline (DOX)-inducible Neuro-2a cell line stably expressing the BoNT/A light chain (ALC). ALC expression was confirmed by GFP and FLAG tag antibodies, and its activity was validated through cleavage of the substrate SNAP-25. Using this model, combined with natural toxin infection of cells, phospho-antibody microarray analysis revealed significant alterations in host phosphorylation networks in both ALC-expressing and toxin-infected cells. Among the shared phosphorylation changes, 75 proteins showed upregulation, while 27 were downregulated. Upregulated phosphorylation events were enriched in pathways such as PI3K-AKT signaling, EGFR tyrosine kinase inhibitor resistance, and Ras signaling, whereas downregulated events were associated with the ERBB and thyroid hormone signaling pathways. Key alterations were observed in AKT signaling, with protein–protein interaction analysis identifying Hsp90ab1 and Map2k1 as central hub molecules for upregulated and downregulated proteins, respectively. This study establishes a robust Neuro-2a-based model system to study BoNT/A toxicity and provides insights into toxin-induced phosphorylation network changes, offering a valuable platform for therapeutic screening and mechanistic exploration. Full article

Colorectal cancer (CRC) remains a leading cause of cancer-related mortality worldwide, highlighting the need for a deeper understanding of the genetic mechanisms driving its development and progression. Identifying genetic mutations that affect key molecular pathways is crucial for advancing CRC diagnosis, prognosis, and treatment. Patient-derived xenograft (PDX) models are essential tools in precision medicine and preclinical research, aiding in the development of personalized therapeutic strategies. In this study, a comparative analysis was conducted on the most frequently mutated genes—APC, TP53, KRAS, BRAF, NRAS, and ERBB2—using data from publicly available databases (n = 7894) and models from University Medicine Rostock (n = 139). The aim of this study was to evaluate the accuracy of these models in reflecting the mutational landscape observed in patient-derived samples, with a focus on both individual mutations and co-occurring mutational patterns. Our comparative analysis demonstrated that while the ranking of individual mutations remained consistent, their overall frequencies were slightly lower in the PDX models. Interestingly, we observed a notably higher prevalence of BRAF mutations in the PDX cohort. When examining co-occurring mutations, TP53 and APC mutations—both individually and in combination with other alterations—were the most frequent in both datasets. While the PDX models showed a greater prevalence of single mutations and a slightly higher proportion of tumors without detectable mutations compared to the public dataset, these findings present valuable insights into CRC’s mutational landscape. The discrepancies highlight important considerations, such as selective engraftment bias favoring more aggressive tumors, differences in sample size between the two cohorts, and potential bottleneck effects during PDX engraftment. Understanding these factors can help refine the use of PDX models in CRC research, enhancing their potential for more accurate and relevant applications in precision oncology. Full article

This study investigated the spatial distribution and radiological risks of naturally occurring radionuclides (²²⁶Ra, ²³²Th, ⁴⁰K) in 37 soil samples from Zacatecas, located in north-central Mexico, using high-resolution gamma spectrometry. Results revealed ⁴⁰K concentrations (mean: 736.81 Bq kg⁻¹), nearly double the global average, while ²²⁶Ra (29.96 Bq kg⁻¹) and ²³²Th (29.72 Bq kg⁻¹) aligned with worldwide norms. Geoaccumulation indices identified moderate ⁴⁰K accumulation at 22 sites, with El Capulín classified as moderately contaminated (I_geo = 1.07). Radiological risk indices showed absorbed dose rates (62.52 nGy h⁻¹) and excess lifetime cancer risk (0.330 × 10⁻³) exceeding global thresholds by 4% and 14%, respectively. Multivariate analyses demonstrated strong Spearman correlations (ρ = 0.75–1.00) among risk indices, while spatial interpolation identified southern/western regions as high-risk zones. These findings emphasize the necessity of integrating spatial analysis with multivariate statistical techniques in environmental radioprotection frameworks. While most of the study area complies with international safety standards, the identified zones exceeding dose thresholds warrant prioritized management to mitigate potential cumulative health risks. Full article

Axon guidance, a fundamental process in neural circuit formation, is intricately regulated by Fibroblast Growth Factors (FGFs) and their receptors (FGFRs) through dynamic cytoskeletal remodeling. FGF signaling, mediated by heparan sulfate proteoglycans or Klotho co-factors, activates key downstream pathways: PI3K-Akt, JAK-STAT, PLCγ, and RAS-MAPK. These pathways orchestrate actin filament dynamics, microtubule stability, and the organization of intermediate filaments. These pathways converge on Rho GTPases, cofilin, profilin, and tau to balance the cytoskeletal assembly−disassembly cycles, enabling growth cone navigation. Unresolved questions, such as the mechanisms underlying FGF-mediated growth cone steering, highlight critical future research directions. This review integrates structural, molecular, and functional insights into how FGF-FGFR interactions regulate axon pathfinding, emphasizing the crosstalk between signaling cascades and cytoskeletal plasticity. Elucidating these mechanisms not only advances our understanding of neural development but also opens therapeutic avenues for neuro-developmental disorders, nerve injury, and neurodegenerative diseases by targeting FGF-driven cytoskeletal dynamics. Full article

This work presents the results of a multi-technique comparative investigation aimed at assessing the mineralogical composition and radioactivity levels of two stone fragments from different areas of the archaeological site of Halaesa (Sicily, Italy). The analysis employed an integrated approach combining μ-energy-dispersive X-ray fluorescence (μ-EDXRF) spectroscopy, µ-Raman spectroscopy, X-Ray Diffraction (XRD), ion chromatography (IC), High-Purity Germanium (HPGe) gamma spectrometry, and E-PERM electret ion chamber methods. By examining the stone composition at both the elemental and molecular scales, with support from ion chromatography data, potential degradation patterns linked to post-depositional weathering and external decay agents were identified. Moreover, the specific activity of radionuclides (²²⁶Ra, ²³²Th, and ⁴⁰K) and the ²²²Rn exhalation rates were measured, enabling the estimation of a set of radiological indices that assess potential health hazards associated with prolonged exposure to these lithic materials. The findings highlight how a multidisciplinary approach can foster the assessment of stone deterioration mechanisms, supporting the design of optimized conservation strategies aimed at preserving the archaeological heritage of Halaesa and ensuring the safety of both the public and onsite personnel. Full article

With the widespread use of plastic products globally, the issue of microplastics as environmental pollutants has become increasingly severe. Due to their small size, large surface area, and hydrophobic properties, microplastics are capable of adsorbing various pollutants, particularly radionuclides, which, in turn, can impact the stability of ecosystems. This laboratory study investigates the adsorption capacity of microplastics (PVC) for radionuclides (Ra-226, Cs-137, and K-40) under controlled conditions, examining the effects of spatial distribution and particle size. The laboratory experiment results indicate that the adsorption of Ra-226 by microplastics was significantly higher in the bottom water compared to the surface layer, with concentrations of 13.29 mBq/kg on microplastics mixed with the bottom water and 1.65 mBq/kg in the surface layer. The concentration of Cs-137 on microplastics mixed with the bottom water was 6.99 mBq/kg, while on microplastics mixed with the surface water, the concentration was 1.31 mBq/kg. In contrast, the adsorption of K-40 was lower, with concentrations of 2.1 mBq/kg and 0.35 mBq/kg on microplastics mixed with the bottom and surface water, respectively. Furthermore, microplastics with smaller particle sizes exhibited stronger adsorption capacities. The adsorption concentrations of Ra-226 and Cs-137 by 50 µm microplastics were 13.29 mBq/kg and 6.99 mBq/kg, respectively, while the concentrations for 100 µm and 150 µm particles decreased to 3.14 mBq/kg and 1.39 mBq/kg, and 2.2 mBq/kg and 0.35 mBq/kg, respectively. These findings suggest that the adsorption capacity of microplastics is significantly influenced by particle size and sediment depth, highlighting the potential risk of exacerbating the spread of radioactive pollutants in marine ecosystems. Full article

Introduction: Prostate cancer has been generally resistant to immunotherapy approaches. Radiation can be immunostimulatory, but the extent to which standard prostate cancer treatments induce immune activation has not been well described. The bone-targeted radiopharmaceutical Radium223 (Ra223) has been proposed to enrich immune function, but clinical studies have not fully delineated whether this is true, or by what mechanisms. Enzalutamide has been shown to increase PD-L1 expression on dendritic cells, which could impact immune activation, though the extent to which this is associated with other evidence of immune activation remains uncertain, and combination strategies remain of interest. We performed a randomized phase II trial to evaluate whether Radium223 (Ra223) added to enzalutamide would induce greater immune activation and clinical responses compared to enzalutamide alone in men with metastatic castration-resistant prostate cancer (mCRPC). Methods: Eligible patients were randomized 2:1 to Arm A (enzalutamide 160 mg PO daily + Ra223 55 kBq/kg IV q4 weeks × 6 doses) or Arm B (enzalutamide 160 mg PO daily). Blood was collected at treatment start and during treatment to measure soluble immune checkpoint biomarkers (BTLA, TIM3, HVEM, GITR, LAG3, PD-1, CTLA-4, PD-L1, PD-L2, ICOS). Immunophenotyping by mass cytometry time of flight (CyTOF) was performed to measure peripheral blood mononuclear cell populations before and after treatment. CyTOF was used to determine changes in circulating immune cell population subsets before and after treatment. Biopsies were performed of an active bone metastatic lesion prior to study treatment and after at least 3 months. IHC was subsequently performed to examine changes in immune cell population subsets before and after treatment, and changes in pSTAT3 levels. Results: In total, 30 patients were enrolled, with median age 68. The median duration of follow up was 36 months. PSA responses, PFS, and OS were not significantly different between the two arms; however, the study was not powered for clinical endpoints. Peripheral blood and bone biopsy specimens were analyzed for immune correlatives. Soluble receptor concentrations showed significantly increased expression of PDL-2 in the combination arm, but this was not seen on CyTOF. Otherwise, there were no significant differences in markers of immune activation/exhaustion or immune cell population subsets in the combination arm and enzalutamide monotherapy arm. IHC also did not show a significant difference in immune cell population subsets in bone biopsy specimens before and after treatment in both arms. However, treatment with the combination arm did show significantly increased levels of pSTAT3 (p = 0.04), which was not seen in the enzalutamide monotherapy arm. Conclusions: Our study showed an overall lack of evidence for immune activation or cytokine induction with the combination, which does not make a strong case for combinatorial immunotherapy approaches. However, the combination did induce higher levels of pSTAT3, which has been implicated in radio-resistance. Therefore, the addition of a STAT3 inhibitor to the combination may be of interest to improve efficacy. Full article