Breast cancer exhibits profound molecular heterogeneity. Each subtype is characterized by distinct biological features, therapeutic responses, and prognostic outcomes. However, a unifying feature across most breast cancer subtypes is an adipocyte-enriched microenvironment. Dysregulated lipid metabolism drives tumor progression across subtypes.
We developed a universal prognostic model independent of molecular classification based on fatty acid metabolism-related genes.
Prognostic fatty acid metabolism-related genes were identified in the training set using univariate Cox regression. LASSO regression refined these genes to construct the fatty acid metabolic signature for prognosis (FAMOUS), enabling risk stratification. FAMOUS's prognostic utility was validated in the testing set and external cohort, and across molecular subtypes and therapies.
FAMOUS comprises 15 genes. High FAMOUS scores independently predicted poor overall survival in the training set (HR = 4.97, 95% CI: 3.17–7.79; p < 0.001), testing set (HR = 7.39, 95% CI: 2.19–24.97; p = 0.001), and GSE72245 (HR = 7.97, 95% CI: 3.39–18.75; p < 0.001), after adjusting for molecular subtype, stage, and age. It stratified risk across Luminal A, Luminal B, HER2+, and TNBC subtypes and retained prognostic value in patients receiving chemotherapy, radiotherapy, endocrine therapy, or trastuzumab. High FAMOUS scores correlated with immune-suppressive microenvironments, marked by downregulated immune-related pathways and altered immune cell infiltration (e.g., reduced CD8+ T cells, enriched M2 macrophages), suggesting implications for immunotherapy patient stratification.
FAMOUS is a novel, pan-subtype prognostic tool for breast cancer, transcending molecular classification and therapeutic modalities.
Hematopoietic stem cell transplantation (HSCT) is associated with significant morbidity and mortality. Frailty further increases these risks in recipients of HSCT. This systematic review analyzes the extent of frailty in patients with hematologic malignancies and patients undergoing HSCT, and explores the associations between frailty and age, and clinical outcomes.
CINAHL (EBSCO), Embase (Ovid), and Medline were searched for quantitative studies including assessment tools aimed at identifying frailty or vulnerability. Two reviewers independently assessed eligibility, extracted data from the included articles, performed a quality appraisal, and analyzed the findings through narrative synthesis.
Of the 5190 abstracts screened, 17 articles involving 17 different tools describing frailty were identified. Frailty was characterized as abnormal nutritional status, comorbidities, and an impact on social support, physical activity, and mental health. Frailty was associated with increased age but was also shown in younger patients. Moreover, frailty was associated with worse clinical outcomes.
Patients with hematologic malignancies and patients undergoing HSCT were at risk of frailty, and frailty was associated with older age and worse clinical outcomes.
Dasatinib, a potent second-generation tyrosine kinase inhibitor (TKI), is highly effective in chronic myeloid leukemia in chronic phase (CML-CP) resistant to imatinib at standard dosing (100 mg daily), but is often limited by adverse events. Emerging evidence suggests low-dose dasatinib (50 mg daily) may maintain efficacy with improved safety, but data in imatinib-resistant CML-CP remain limited.
To evaluate the efficacy and safety of low-dose dasatinib (50 mg daily) in patients with imatinib-resistant CML-CP and to identify predictors of treatment response and disease progression.
This retrospective cohort study included 53 adults with imatinib-resistant CML-CP treated with low-dose dasatinib at a tertiary center in Northern India (2002–2025). Early molecular response (EMR), major molecular response (MMR), deep molecular response (DMR), progression-free survival (PFS), overall survival (OS), and adverse events were assessed. Multivariate Cox regression identified predictors of poor response and disease progression. Among 53 patients (median age 50 years), 41.5% achieved MR4.5, 20.8% MR4.0, and 15.1% MMR without DMR. Prior loss of MMR on imatinib significantly correlated with a superior response to dasatinib (p = 0.002). TKD mutations were present in 32.1%; the T315I mutation, high ELTS risk, and baseline BCR-ABL1 ⟩ 100% independently predicted poor response. Clinically significant adverse events occurred in 49.1%, primarily cytopenias and pleural effusion. Among our cohort, 22.6% required a TKI switch due to inadequate response and 7.5% due to intolerance.
Low-dose dasatinib is effective and tolerable in imatinib-resistant CML-CP, with nearly two-thirds achieving DMRs. Predictive biomarkers (T315I mutation, high ELTS risk, high baseline BCR-ABL1) can guide dose optimization.
Young patients with breast cancer frequently receive chemotherapy and/or endocrine therapy that adversely affect ovarian function, leading to fertility, pregnancy, and other reproductive health concerns. Despite available evidence-based management strategies, dissemination to survivors and healthcare providers remains limited, resulting in substantial unmet informational and care needs. Web-based survivorship care plans may offer an effective approach to address these gaps.
To evaluate the effect of a web-based Reproductive Health Survivorship Care Plan (SCP-R) on reproductive concerns and reproductive healthcare access among nulliparous young breast cancer survivors (YBCS).
This is a secondary analysis of a 24-week randomized controlled trial on the effectiveness of a web-based SCP-R addressing unmet informational and clinical management needs for breast cancer survivors aged 18–50 years. The current analysis is restricted to nulliparous participants ages 18–40. The primary outcomes are improvement in fertility and pregnancy health concerns, as measured by the Reproductive Concerns After Cancer (RCAC) scale. The secondary outcome is fertility specialist access measured by referral, consultation, or treatment by a fertility specialist. Among 182 study participants from the parent trial, 47 met the inclusion criteria for the current study (17 in the intervention and 30 in the attention control). Mean age at diagnosis was 30.7 (SD = 3.5) years, and mean age at study participation was 34.0 (SD = 3.8) years. Fertility potential and pregnancy concerns improved in 35.3% of participants randomized to the intervention arm compared to 10.0% in the control arm (RR = 3.5, 95% CI = 1.01–12.34, p = 0.05). Intervention arm participants were significantly more likely to receive a fertility specialist referral, schedule a fertility consult, or undergo fertility treatment (37.5% in the intervention arm vs. 6.7% in the control arm; RR = 5.6, 95% CI = 1.28–24.73, p = 0.02).
The web-based SCP-R intervention led to improvements in fertility potential and pregnancy concerns over time and resulted in more YBCS accessing fertility specialists, highlighting the importance of age- and parity-specific survivorship care interventions to address reproductive health concerns.
Chronic myeloid leukaemia (CML) is an infrequent myeloproliferative neoplasm in the paediatric population as compared to adults. Despite vast progress in understanding the disease biology and therapy of CML-chronic phase (CML CP), the applicability of risk scoring systems in practice and prognostic factors in children remain grey areas. Hence, we tried to analyse disease characteristics, molecular response to frontline imatinib therapy and its clinical predictors along with long-term outcomes in our population.
In this study, we retrospectively analysed 104 paediatric patients aged ≤ 18 years, diagnosed with CML CP, treated at our centre between 2007 and 2024. Their baseline demographic profile, clinical characteristics, haematological parameters and molecular transcripts as diagnosed by RT-PCR were recorded. The follow-up response assessments, including haematological response, molecular response and long-term survival, were collected from medical records. Risk scores were computed and correlated with clinical outcomes.
Our study included 104 paediatric patients presenting with CML CP. Splenomegaly was a universal feature with a median size of 10 cm below costal margin. The majority of patients belonged to the low-risk group according to Sokal, EUTOS and ELTS systems. Imatinib was initiated in all of them and was followed up for a median duration of 72 months. Overall, 95.2% patients achieved complete hematologic response (CHR) at 3 months. A total of 42.5% (43/101) patients achieved MMR at 12 months and 54.4% (55/101) patients achieved MMR at 18 months. Sokal scoring system and EMR at 3 months were significantly correlated with the achievement of MMR at 12 months. A total of 11 patients progressed to blast crisis and 10 patients expired in due course of the disease. The 2- and 10-year PFS was 96% and 82%, respectively. CHR at 3 months was significantly predictive of PFS. None of the scoring systems had predictive value for PFS.
This is one of the largest reported data on Indian paediatric CML CP patients with long-term outcomes. The dynamics of adult CML, including risk scores, do not perfectly fit the scenario of paediatric patients. Hence, further studies and newer strategies are required for optimal management of paediatric CML patients.
Fecal microbiota transplantation (FMT) has emerged as a groundbreaking strategy for modulating the gut microbiome and improving cancer treatment outcomes. This review synthesizes the current evidence on the role of FMT in oncology, focusing on its potential to enhance the efficacy of immunotherapy, restore microbiome homeostasis, and mitigate cancer-associated complications.
Preclinical and clinical studies have demonstrated that FMT can reprogram the tumor microenvironment, augment immune checkpoint inhibitor responses, and reduce chemotherapy-induced toxicity. However, risks such as pathogen transmission, immune dysregulation, and unintended microbial shifts necessitate rigorous donor screening and a personalized approach. Challenges in standardization, regulatory frameworks, and mechanistic understanding further complicate their clinical translation. Emerging innovations, including precision microbial consortia, synthetic biology, and biomarker-driven strategies, have the potential to address these limitations.
While FMT holds transformative potential in cancer care, its integration into oncological practice requires robust clinical validation, long-term safety assessments, and interdisciplinary collaboration to harness its full therapeutic potential.
Maxillofacial squamous cell carcinoma (SCC) typically metastasizes to lymph nodes, yet coexisting tuberculous lymphadenitis is extraordinarily rare, posing diagnostic challenges.
A 68-year-old female with right maxillofacial SCC and ipsilateral lymphadenopathy underwent radical resection and selective neck dissection after computed tomography had shown nodes with central necrosis and rim enhancement—features indeterminate for metastasis versus infection. Histopathological examination of the dissected lymph nodes revealed concurrent metastatic SCC foci and tuberculous granulomas. Further tuberculosis-specific tests returned positive results, confirming the final diagnosis of metastatic maxillofacial SCC with coexisting tuberculous lymphadenitis. Notably, the patient had no tuberculosis-related symptoms, with tuberculous lymphadenitis unsuspected preoperatively, underscoring the diagnostic challenge of such coexisting conditions.
This case highlights the importance of considering infectious comorbidities, particularly in cases with atypical imaging or clinical manifestations, when evaluating lymph node lesions in cancer patients to avoid misdiagnosis and optimize therapeutic strategies.
Cancer remains one of the leading global health problems, with treatments that can compromise patients' quality of life.
This study aimed to determine the prevalence and characteristics of resilience in cancer patients and to analyze the influence of psychological and social factors on disease perception.
An analytical cross-sectional study was conducted between April and August 2023 including 61 cancer patients under treatment. Resilience was assessed with the RS-14, anxiety and depression with HADS (Hospital Anxiety and Depression Scale), and family functioning with the Family Apgar (Adaptation, Partnership, Growth, Affection, Resolve questionnaire). Sociodemographic and clinical data were obtained through structured questionnaires. Continuous variables were tested with Shapiro–Wilk and Levene's tests; descriptive statistics, t-tests, Mann–Whitney U, Chi-square were applied. Binary logistic regression examined resilience predictors, adjusting for confounders (BMI, employment status, surgery). Statistical significance was defined as p ⟨ 0.05. Participants were 50.8% women, aged 35–82 years. Cancer types included breast (18%), lung (29.5%), colon (9.8%), pancreas (11.5%), renal (1.6%), and others (29.5%). 11.5% had not received oncological treatment, while 93.4% underwent surgery. Most were non-smokers (82%) and retired (57.4%). Main comorbidities were respiratory (24.6%) and cardiovascular (23%). In surveys, 54.1% reported family members with cancer and 36.1% noted a lack of free time affected quality of life. Mean scores: resilience 69.3 (SD = 22.1), anxiety 10.3 (SD = 3.2), depression 11.6 (SD = 2.2), Apgar 17.1 (SD = 3.7). Logistic regression identified Apgar as the only significant predictor of resilience (OR = 0.294, 95% CI 0.113–0.761, p = 0.012), with higher family functioning linked to lower resilience. Model accuracy was 81.1% overall, 90.9% for resilient, and 65.0% for non-resilient patients.
Social, clinical, and family situations all have an impact on cancer patients' resilience. In order to maximize resilience and quality of life, family functioning appears as a contradictory component, indicating the necessity of psychological, family-centered, and interdisciplinary interventions.
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