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Triple-negative breast cancer (TNBC) is one of the most aggressive types of breast cancer (BC), most commonly diagnosed in young premenopausal women. It is characterized by the absence of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). For this reason, therapeutic options using hormone therapy or targeted anti-HER2 treatment are significantly limited. TNBC is associated with a poor prognosis, which requires the search for new treatment strategies. A promising option is the use of an antibody-drug conjugate (ADC) directed against Trophoblast cell-surface antigen 2 (Trop-2), namely Sacituzumab govitecan (SG). Recent findings indicate that, beyond its direct cytotoxic effect, SG may also induce immunogenic cell death, remodel the tumor immune microenvironment, and enhance antitumor immune responses-features that make it a molecule of particular relevance in immuno-oncology. A systematic review was conducted based on databases from PubMed, Web of Science and the ClinicalTrials.gov registry using the keywords: 'Sacituzumab govitecan', 'Triple-negative breast cancer', 'Antibody-drug conjugate', 'metastatic triple-negative breast cancer', 'Trop-2'. The inclusion criteria covered studies from 2017 to 2025. Ultimately, after a thorough analysis, 4 randomized controlled trials (RCTs) and 4 single-arm studies were included in the review. Analysis of clinical trial results evaluating the safety and efficacy of SG in TNBC therapy showed promising therapeutic potential for the drug. Significant improvements were observed in key clinical parameters, such as overall response rate (ORR) and progression-free survival (PFS). In addition, the safety profile was acceptable and consistent with previous reports, with the most commonly reported adverse events being neutropenia, diarrhea and alopecia, which were well controlled in most cases. Due to its aggressive course and poor prognosis, TNBC remains a therapeutic challenge. SG is a promising therapeutic option, but further studies are needed, especially randomized controlled trials and studies on combinations with immunotherapy, to improve treatment outcomes and quality of life for patients. Importantly, SG also exhibits immunomodulatory potential through the induction of immunogenic cell death and enhancement of immune effector activity, positioning it as a bridge between cytotoxic and immune-based therapeutic strategies in TNBC.

Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with improved survival in recurrent ovarian cancer (ROC) but carries a high risk of postoperative complications. Accurate perioperative risk stratification remains an unmet need. To develop and internally validate a perioperative risk model for postoperative complications in ROC patients using information available by the end of surgery (pre- and intra-operative data), and to compare logistic regression (LR) and artificial neural networks (ANN) as possible predictive models. A retrospective analysis of 71 patients treated with CRS and HIPEC between 2011 and 2022 was performed. Clinical, surgical, and perioperative variables were analysed. Predictors were restricted to variables available at or before the end of the index operation, which prevents information leakage by using only data available at prediction time. LR and ANN models were developed and assessed with cross-validation. Performance reporting followed TRIPOD (Type b) and TRIPOD + AI, with Brier score, and calibration slope/intercept from out‑of‑fold (OOF) predictions. Thresholded metrics (accuracy, precision, recall, F1 score, and the area under the receiver operating characteristic curve, AUC) were summarised at a prespecified probability cut-off. Exploratory univariate odds ratio analyses with Holm-adjusted p-values were used to explore procedure–complication associations. Postoperative complications occurred in 45% of patients. LR identified blood loss ( p  = 0.005) and number of procedures ( p  = 0.042) as significant predictors of complications. The LR model achieved an accuracy of 66.2%, precision of 64.3%, recall of 56.2%, F1 score of 60.0%, and AUC of 0.700. The ANN model achieved an accuracy of 97.2%, precision of 94.3%, recall of 100%, F1 score of 97.1%, and AUC of 0.967. Hysterectomy with adnexa (OR = 11.67, p  = 0.035) and metastasectomy (OR = 7.42, p  = 0.042) were significantly associated with higher postoperative complication rates. ANN demonstrated superior predictive performance compared to LR in identifying postoperative complications after CRS and HIPEC, as indicated by ROC analysis. Combining traditional statistical modelling with modern machine learning may enhance ROC for perioperative risk stratification after CRS with HIPEC. A well-calibrated, interpretable LR model together with a highly discriminative ANN could enable more tailored allocation of intensive care resources and earlier identification of high-risk patients, potentially improving the safety of this demanding but beneficial treatment. However, external multicentre validation is required before clinical implementation.

European data suggests that over 30% of gastric cancer (GC) patients are diagnosed with sarcopenia before surgery, while unintentional weight loss occurs in approximately 30% of patients following gastrectomy. Preoperative sarcopenia significantly increases the risk of major postoperative complications, and preoperative body weight loss remains a superior predictor of outcome and an independent prognostic factor for overall survival (OS) in patients with GC. A standardized approach of nutritional risk screening of GC patients is yet to be established. Therefore, the MOONRISE study aims to prospectively analyze the changes in nutritional status and body composition at each stage of multimodal treatment among GC patients from five Western expert centers. Specifically, we seek to assess the association between nutritional status and body composition on tumor response following neoadjuvant chemotherapy (NAC). Secondary outcomes of the study are treatment toxicity, postoperative complications, quality of life (QoL), and OS. Patients with locally advanced gastric adenocarcinoma scheduled for multimodal treatment will be included in the study. Four consecutive nutritional status assessments will be performed throughout the treatment. The following study was registered in ClinicalTrials.gov (Identifier: NCT05723718) and will be conducted in accordance with the STROBE statement. The anticipated duration of the study is 12–24 months, depending on the recruitment status. Results of this study will reveal whether nutritional status and body composition assessment based on BIA will become a validated and objective tool to support clinical decisions in GC patients undergoing multimodal treatment.

Since increasing evidence underlines the prominent role of systemic inflammation in carcinogenesis, the inflammation burden index (IBI) has emerged as a promising biomarker to estimate survival outcomes among cancer patients. The IBI has only been validated in Eastern gastric cancer (GC) patients; therefore, the aim of this study was to evaluate the IBI as a prognostic biomarker in Central European GC patients undergoing multimodal treatment. Ninety-three patients with histologically confirmed GC who underwent multimodal treatment between 2013 and 2021 were included. Patient recruitment started with the standardization of neoadjuvant chemotherapy (NAC). Blood samples were obtained one day prior to surgical treatment. The textbook outcome (TO) served as the measure of surgical quality, and tumor responses to NAC were evaluated according to Becker’s system tumor regression grade (TRG). A high IBI was associated with an increased risk of postoperative complications (OR 2.95, 95% CI 1.13–7.72). In multivariate analysis, a high IBI (HR = 2.56, 95% CI 1.28–5.13) and a high neutrophil-to-lymphocyte ratio (NLR, HR = 2.55, 95% CI 1.32–4.94) were associated with an increased risk of death, while NAC administration (HR = 0.40, 95% CI 0.18–0.90) and TO achievement (HR = 0.42, 95% CI 0.22–0.81) were associated with a lower risk of death. The IBI was associated with postoperative complications and mortality among GC patients undergoing multimodal treatment.

Basal cell carcinoma (BCC) is one of the most common neoplasms in the population. A good prognosis and mainly non-aggressive development have made it underdiagnosed and excluded from the statistics. Due to the availability of efficient surgical therapy, BCC is sometimes overlooked in the search for novel therapies. Most clinicians are unaware of its complicated pathogenesis or the availability of effective targeted therapy based on Hedgehog inhibitors (HHI) used in advanced or metastatic cases. Nevertheless, the concomitance and esthetic burden of this neoplasm are severe. As with other cancers, its pathogenesis is multifactorial and complicated with a network of dependencies. Although the tumour microenvironment (TME), genetic aberrations, and risk factors seem crucial in all skin cancers, in BCC they all have become accessible as therapeutic or prevention targets. The results of this review indicate that a central role in the development of BCC is played by the Hedgehog (Hh) signalling pathway. Two signalling molecules have been identified as the main culprits, namely Patched homologue 1 (PTCH1) and, less often, Smoothened homologue (SMO). Considering effective immunotherapy for other neoplastic growths being introduced, implementing immunotherapy in advanced BCC is pivotal and beneficial. Up to now, the US Food and Drug Administration (FDA) has approved two inhibitors of SMO for the treatment of advanced BCC. Sonidegib and vismodegib are registered based on their efficacy in clinical trials. However, despite this success, limitations might occur during the therapy, as some patients show resistance to these molecules. This review aims to summarize novel options of targeted therapies in BCC and debate the mechanisms and clinical implications of tumor resistance.

Cholangiocarcinomas (CCAs) are rare but aggressive tumours with poor diagnosis and limited treatment options. Molecular targeted therapies became a promising proposal for patients after progression under first-line chemical treatment. In light of an escalating prevalence of CCA, it is crucial to fully comprehend its pathophysiology, aetiology, and possible targets in therapy. Such knowledge would play a pivotal role in searching for new therapeutic approaches concerning diseases’ symptoms and their underlying causes. Growing evidence showed that fibroblast growth factor/fibroblast growth factor receptor (FGF/FGFR) pathway dysregulation is involved in a variety of processes during embryonic development and homeostasis as well as tumorigenesis. CCA is known for its close correlation with the FGF/FGFR pathway and targeting this axis has been proposed in treatment guidelines. Bearing in mind the significance of molecular targeted therapies in different neoplasms, it seems most reasonable to move towards intensive research and testing on these in the case of CCA. However, there is still a need for more data covering this topic. Although positive results of many pre-clinical and clinical studies are discussed in this review, many difficulties lie ahead. Furthermore, this review presents up-to-date literature regarding the outcomes of the latest clinical data and discussion over future directions of FGFR-directed therapies in patients with CCA.

Gastric cancer (GC) is one of the most frequent reasons for cancer‐related death worldwide. The multimodal therapeutic strategies are now pragmatically tailored to each patient, especially in advanced GC. A radical but safe gastrectomy remains the cornerstone of the GC treatment. Moreover, the quality‐of‐life (QoL) outcome measures are now routinely utilized in order to select optimal type of gastrectomy, as well as reconstruction method. Postoperative complications are frequent, and effective diagnosis and treatment of complications is crucial to lower the mortality rates. The postoperative complications prolong hospital stay and may result in poor QoL, thus eliminating the completion of perioperative adjuvant therapy. Therefore, avoiding morbidity is not only relevant for the immediate postoperative course, but can also affect long‐term oncological outcome. Measuring outcome enables surgeons to: monitor their own results; compare quality of treatment between centres; facilitate improvement both for surgery alone and combined treatment; select optimal procedure for an individual patient. Textbook oncological outcome is a composite quality measure representing the ideal hospitalization for gastrectomy, as well as stage‐appropriate (perioperative) adjuvant chemotherapy. Standardized system for recording complications and adherence to multimodality treatment guidelines are crucial for achieving the ultimate goal of surgical quality‐improvement that can benefit patients QoL and long‐term outcomes after fast and uneventful hospitalization for gastrectomy. The multimodal therapy is used for advanced gastric cancer. A radical gastrectomy remains the cornerstone of the treatment. Standardized system for recording complications and adherence to multimodality treatment guidelines are crucial to improve surgical quality that can benefit patients’ quality of life and long‐term outcomes.

Peritoneal dissemination is a common form of gastric cancer (GC) recurrence, despite surgery with curative intent. This study aimed to evaluate the prognostic value of intraperitoneal lavage One-Step Nucleic Acid Amplification (OSNA) assay in advanced GC patients. OSNA assay targeting CK-19 mRNA was applied to detect free cancer cells (FCC) in intraperitoneal lavage samples obtained during gastrectomy. A total of 82 GC patients were enrolled to investigate the correlation between OSNA assay and patient’s prognosis. Of the 82 patients, OSNA assay was positive in 25 (30.5%) patients. The median OS in OSNA positive patients was significantly lower than in OSNA negative patients (19 vs 45 months). Positive OSNA assay result was a significant unfavourable prognostic factor in both, univariable (HR 3.45, 95% CI 0.95–12.48; p = 0.0030) and multivariable analysis (HR 3.10, 95% CI 1.22–8.54; p = 0.0298). Positive OSNA assay in intraperitoneal lavage is a valuable indicator of poor survival in advanced GC patients after multimodal treatment. After further confirmation on larger sample size, OSNA assay of peritoneal washings could be considered an adjunct tool to conventional cytology, the current gold standard, to provide precise intraoperative staging and additional prognostic information.

Breast implantation (BI) is the most common plastic surgery worldwide performed among women. Generally, BI is performed both in aesthetic and oncoplastic procedures. Recently, the prevalence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) or breast implant illness (BII) has aroused concerns. As a result, several countries, like Australia, Korea or the United Kingdom, introduced national registries dedicated to the safety and quality of BI surgeries. This narrative review aimed to focus on the clinical challenges, management and the current state of knowledge of BI. Both short and long-term outcomes of BI are determined by various alternatives and differences, which surgeons must consider during the planning and performing breast augmentation along with further complications or risk of reoperation. Proper preoperative decisions and aspects of surgical technique emerged to be equally important. The number of performed breast reconstructions is increasing, providing the finest aesthetic results and improving patient’s quality of life. Choice of prosthesis varies according to individual preferences and anatomical variables. A newly diagnosed cases of BIA-ALCL with lacking data on prevention, diagnosis, and treatment are placing it as a compelling medical challenge. Similarly, BII remains one of the most controversial subjects in reconstructive breast surgery due to unspecified diagnostic procedures, and recommendations.

IntroductionAdvanced gastric and gastroesophageal junction (G/GEJ) adenocarcinomas are characterized by an aggressive course and a very poor prognosis. Due to the limited benefit of immunotherapy in patients with HER2-negative tumors, new therapeutic targets are sought. Zolbetuximab is a chimeric monoclonal antibody targeting the CLDN18.2 protein, which is overexpressed in 50–80% of gastric cancers.Materials and methodsThis review is based on phase I–III clinical trials, including the pivotal SPOTLIGHT, GLOW, FAST, and ILUSTRO trials. The efficacy and safety of zolbetuximab in combination with chemotherapy were assessed as first-line treatment for adults with locally advanced or metastatic G/GEJ adenocarcinoma, HER2-negative, and highly CLDN18.2-expressing.ResultsEarly phase studies confirmed the clinical activity and tolerability of zolbetuximab. A Japanese phase I study demonstrated the safety and pharmacokinetic profile of zolbetuximab as monotherapy, establishing the recommended dose in subsequent studies. The phase II FAST study demonstrated that the addition of zolbetuximab to EOX chemotherapy significantly improved both PFS (HR 0.44; p=0.0005) and OS (HR 0.55; p=0.0001). The phase II ILUSTRO study demonstrated activity of zolbetuximab both as monotherapy (ORR 9%) and in combination with mFOLFOX6 (ORR 39%), supporting its advancement to phase III. These results were confirmed in two pivotal randomized phase III studies. In the SPOTLIGHT study, the addition of zolbetuximab to mFOLFOX6 reduced the risk of death by 25% (median OS 18.23 vs. 15.54 months), and in the GLOW study, the addition of zolbetuximab to CAPOX reduced the risk of death by almost 23% (median OS 14.39 vs. 12.16 months). The most common adverse events were nausea and vomiting, occurring primarily in the first treatment cycle.ConclusionsZolbetuximab represents a significant advancement in the treatment of patients with advanced G/GEJ adenocarcinoma overexpressing CLDN18.2, addressing an important unmet clinical need. However, optimizing the stringent threshold for CLDN18.2 positivity (requiring staining in ≥75% of cells) and establishing a treatment regimen for patients with concurrent CLDN18.2 and PD-L1 expression remains a significant challenge. The review protocol was prospectively registered in the PROSPERO database (International Prospective Register of Systematic Reviews) under registration number CRD420261383764.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261383764.