The numbers of tumor-infiltrating immune cells (TIICs) expressing programmed death (PD)-1 or PD-ligand 1 (PD-L1) reportedly predict prognosis and resistance to targeted drugs in clear cell renal cell carcinoma (ccRCC). The impact of local tumor microenvironment based on immunosuppressive TIICs on recurrence and prognosis has not been fully investigated in localized ccRCC.

Despite advancements in treatment options for metastatic urothelial carcinoma (mUC), therapeutic choices remain limited for patients with disease refractory to platinum-based chemotherapy (PBC) and immune checkpoint inhibitors (ICIs). Enfortumab vedotin (EV) has demonstrated significant efficacy in later lines of therapy for mUC; however, its organ-specific responses remain uncertain.

Biliary tract cancer (BTC) remains among the most challenging malignancies with a poor prognosis and limited treatment options, particularly in pretreated patients. As most patients experience disease progression after first-line treatment, effective second-line and subsequent treatments are required. Although the addition of modified FOLFOX (fluorouracil, leucovorin, and oxaliplatin) to active symptom control improved the overall survival of patients with progressing advanced BTC despite gemcitabine plus cisplatin treatment, its efficacy was modest. Moreover, most clinical trials demonstrated modest efficacy of molecular-targeted agents for molecularly unselected pretreated advanced BTC. Patients with advanced BTC carry a relatively high druggable genetic alteration rate and have shown promising responses to molecular-matched therapies targeting gene alterations such as FGFR2 fusions/rearrangements, IDH1 mutation, and HER2 overexpression/amplification. Additionally, tumor-agnostic approaches, including BRAF V600E, NTRK fusion, and RET fusion, have expanded the treatment options for some patients. Immune checkpoint inhibitors have shown limited efficacy as mono- or combination therapy in patients with pretreated advanced BTC. Therefore, developmental efforts have shifted to immune checkpoint inhibitor and other combinations such as vascular endothelial growth factor receptor inhibitors or radiation. In addition to refining combination strategies to enhance the therapeutic potential of immune checkpoint inhibitor, future research should focus on elucidating the tumor microenvironment. This review delineates the evolution of systemic therapies in patients with pretreated advanced BTC. By examining past developments and recent advances through prospective trials, it highlights novel approaches that may improve outcomes in this challenging disease.

To evaluate outcomes of early-stage nonsmall cell lung cancer (NSCLC) patients in relation to patient and hospital factors.

The GLOW and SPOTLIGHT trials have demonstrated the efficacy of chemotherapy plus zolbetuximab for HER2-negative, claudin-18 isoform 2 (CLDN18.2)-positive unresectable advanced or recurrent gastric cancer (AGC)/gastroesophageal junction cancer. However, data on adverse events in real-world clinical practice are still insufficient. Specifically, gastritis and protein-losing enteropathy (PLE), which were not evident in either trials, are not generally recognized. This paper reports on the notable clinical course and examination findings of two cases of PLE observed in patients with unresectable AGC who were administered zolbetuximab. Case 1 involved a 66-year-old woman with HER2-negative, CLDN18.2-positive unresectable advanced gastric cancer (cT4aN1M1) with peritoneal dissemination. As a fifth-line treatment, she underwent combination therapy with capecitabine, oxaliplatin, and zolbetuximab (CAPEOX + Zolbe). Case 2 involved a 58-year-old woman with HER2-negative, CLDN18-positive gastric cancer (pT1aN3bM1) with extra-regional lymph node metastasis. After undergoing robot-assisted distal gastrectomy, she commenced CAPEOX + Zolbe therapy. In both cases, following the initiation of CAPEOX + Zolbe therapy, serum albumin levels decreased from 3.5 g/dL pre-treatment to 2.2 g/dL. Upper gastrointestinal endoscopy revealed diffuse redness and edema of the gastric mucosa. Pathological histological examination of the gastric mucosal biopsy also revealed findings consistent with PLE. A technetium-99m-labeled human serum albumin scintigraphy demonstrated leakage of Tc-99m albumin into the gastrointestinal tract, leading to a diagnosis of PLE. In the two cases we experienced, we observed gastritis and PLE caused by zolbetuximab. These adverse events are not widely recognized among clinicians. However, when hypoalbuminemia occurs during zolbetuximab administration, this diagnosis should be considered.

In this prospective observational cohort study, we aim to investigate the risk factors for early postoperative anastomotic leakage (AL) in patients undergoing rectal cancer resection.

To establish a nomogram model for predicting chemotherapy-induced nausea and vomiting (CINV) in patients with gynecological malignancies based on relevant risk factors.

This study aimed to assess the prognostic outcomes and risk of adverse events in elderly non-muscle invasive bladder cancer (NMIBC) patients receiving photodynamic diagnosis-assisted transurethral resection of bladder cancer (PDD-TURBT).

Traditionally, systemic therapy based on androgen deprivation therapy (ADT) has been the primary approach for treating metastatic prostate cancer. Local therapies targeting metastatic lesions have rarely been employed for cancer control. However, the advent of next-generation imaging modalities, such as choline positron emission tomography (PET), whole-body magnetic resonance imaging, and prostate-specific membrane antigen (PSMA)-PET, has enabled the detection of oligometastases that were previously undetectable using conventional imaging techniques, such as computed tomography and bone scintigraphy. This has led to increased attention to local therapy for oligometastatic prostate cancer with cancer control. Oligometastatic prostate cancer can be classified into three categories: de novo oligometastases (oligometastases identified at initial diagnosis), oligorecurrence (oligometastases arising after radical treatment of primary tumor), and oligoprogression (activation of oligometastases following ADT failure). Evidence from randomized controlled trials (RCTs) supports the efficacy of local therapy in these contexts. The phase III STAMPEDE trial demonstrated that the addition of prostate radiotherapy to ADT improved the overall survival in patients with de novo low-volume metastatic prostate cancer. Furthermore, in the STOMP and ORIOLE trials, phase II RCTs have shown that metastasis-directed therapy significantly prolongs progression-free survival (PFS) in patients with oligorecurrent prostate cancer after radical treatment. For oligoprogressive castration-resistant prostate cancer, the phase II ARTO trial demonstrated that the addition of radiotherapy targeting oligometastases to first-line abiraterone acetate and prednisone treatments improved PFS. With the global adoption of PSMA-PET, local therapy for primary tumor and metastases in oligometastatic prostate cancer is expected to play an increasingly prominent role in the future.

Precision medicine based on biomarkers, such as genetic abnormalities and PD-L1 expression, has been established for the treatment of nonsmall cell lung cancer. Recently, liquid biopsy has emerged as a valuable and minimally invasive alternative. This method analyzes blood and other bodily fluids to detect cancer-related genetic abnormalities and molecular residual disease (MRD). Liquid biopsy, which includes testing for circulating tumor cells, circulating tumor DNA (ctDNA), and microRNA (miRNA), offers several advantages over conventional methods. It is minimally invasive, can be performed repeatedly, and provides crucial information for early cancer diagnosis, genotyping, and treatment monitoring. Elevated ctDNA levels and miRNA markers show promise for early diagnosis. Liquid biopsy complements traditional tissue biopsy during genotyping, particularly when tumor samples are insufficient. Tests such as Cobas® EGFR Mutation Test v2 and Guardant360® CDx have been shown to be effective in detecting genetic mutations and guiding treatment decisions. Although the accuracy of liquid biopsy is still lower than that of tissue biopsy, its clinical utility continues to improve. For cancer prediction recurrence and treatment monitoring, ctDNA analysis can detect MRD earlier than conventional imaging, offering potential benefits for treatment adjustment and early relapse detection. The continuous development and validation of liquid biopsy methods are essential for improving personalized lung cancer treatment strategies.

Previously, we conducted the phase I study of 64Cu-ATSM, which is Cu-diacetyl-bis (N4-methylthiosemicarbazone) radiolabeled with Cu-64, for patients with brain tumors and determined the maximum tolerated dose. We started a subsequent multicenter, randomized, open-label phase III study to evaluate the efficacy of 64Cu-ATSM as an investigator-initiated registration-directed trial for recurrent or residual malignant glioma (protocol No. NCCH2301, STEP-64). Patients will be randomized to either the control or study arm (64Cu-ATSM). A large-scale randomized trial seems difficult to perform for patients with brain tumors because of small sample sizes. Therefore, we designed a small randomized trial with 56 patients. Furthermore, as a pragmatic approach in the control arm, physicians can choose treatments depending on the patient's condition among the clinically available options, where the drugs used are not regarded as investigational. The trial was registered in the Japan Registry of Clinical Trials as jRCT2031240090.

The JCOG1113, a multicenter, randomized phase III trial in patients with advanced/recurrent biliary tract cancer showed the non-inferiority of gemcitabine plus S-1 to gemcitabine plus cisplatin. Although liver cirrhosis (LC) is a known risk factor for intrahepatic cholangiocarcinoma (ICC), few reports focus on the efficacy and safety of chemotherapy in ICC patients with LC.

This study aimed to assess the influence of modifying the dose of enfortumab vedotin (EV) monotherapy in patients with advanced urothelial carcinoma (UC).

Head and neck cancer (HNC) frequently presents in the advanced stage, which necessitates treatments such as chemoradiotherapy and pharyngolaryngoesophagectomy. These treatments can impair functions including swallowing, speech, and saliva production, and diminish the quality of life (QOL). Key risk factors for HNC include alcohol consumption, smoking, and genetic polymorphisms in aldehyde dehydrogenase 2, which increase the susceptibility to carcinogenesis through the 'field cancerization phenomenon.' Advances in gastrointestinal endoscopy, including narrow band imaging with magnifying endoscopy, facilitate the early detection of superficial HNC. By identifying abnormal vessel patterns and mucosal changes, these diagnostic techniques improve the detectability, differential diagnosis, and identification of the invasion depth of superficial cancers. The latter is essential because tumor thickness is an important predictor of lymph node metastasis and prognosis. Minimally invasive transoral surgeries, including endoscopic mucosal resection, endoscopic submucosal dissection, endoscopic laryngopharyngeal surgery, transoral videolaryngoscopic surgery, and transoral robotic surgery, emphasize organ preservation, and are efficacious and safe for treating superficial HNC. Early detection of metachronous cancers, which are prevalent in patients with HNC and esophageal cancer, is crucial for improving long-term outcomes. Abstinence from alcohol consumption and smoking may reduce the development of cancers in the head and neck or esophagus. Future research directions include integrating artificial intelligence to improve diagnostic accuracy, refining transoral surgical techniques, and developing systematic surveillance protocols for the early detection of metachronous cancer. Continued efforts to optimize minimally invasive treatments and prevention strategies will improve the prognosis and QOL of patients with HNC.

Ensuring the high quality of colonoscopies in colorectal cancer (CRC) screening is essential to reducing CRC. Recently, computer-aided detection systems (CADe) that use artificial intelligence have attracted much attention as potentially useful tools for improving lesion detection in colonoscopy. However, evidence on the efficacy of CADe in CRC screening is lacking. We have planned a multi-national, multi-center, randomized controlled trial in the Asia-Pacific region to assess whether colonoscopy with CADe (test method) yields higher lesion detection (primary endpoint: adenoma detection rate) than colonoscopy without CADe (standard method) in CRC screening populations. The study will include 1400 participants aged 50-79 years who are due to undergo colonoscopy for CRC screening, whether as a primary screening colonoscopy or following a positive fecal immunochemical test. If the efficacy of CADe is proven from this study, the use of CADe in colonoscopy for CRC screening will become standard, leading to improved CRC screening.

Alemtuzumab is a monoclonal antibody directed against CD52 on T and B lymphocytes and is used to treat lymphoproliferative disorders including chronic lymphocytic leukaemia (CLL). This postmarketing surveillance, as mandated by the Japanese health authorities, investigated the safety and effectiveness of alemtuzumab in Japanese patients receiving alemtuzumab for relapsed/refractory CLL.

The aim of the present study was to investigate the association of C-reactive protein (CRP) and alpha-fetoprotein (AFP) (CRP-AFP) classification with prognosis in early- and intermediate-stage hepatocellular carcinoma (HCC) patients after undergoing transcatheter arterial chemoembolization (TACE).

In ovarian cancer (OvCa), achieving complete resection (RO) in initial surgery is crucial for improving prognosis. However, patients with undetected microscopic metastasis post-RO surgery often have poorer outcomes. This study explores prognostic factors for OvCa patients who underwent RO surgery, focusing on the role of ascites cytology as an indicator of microscopic peritoneal metastasis.

This study aimed to evaluate the clinical outcomes of patients who developed prostate-specific antigen failure after radical prostatectomy and were treated with salvage radiotherapy (SRT).