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Original Article Open Access
Fei Deng, Lanjing Zhang
Published online March 19, 2026
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Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2025.00051
Abstract
Normalization can standardize and improve machine learning (ML) performance on omics data. However, it is unclear whether normalization is associated with overfitting (i.e., worse [...] Read more.

Normalization can standardize and improve machine learning (ML) performance on omics data. However, it is unclear whether normalization is associated with overfitting (i.e., worse cross-dataset performance than intra-dataset performance). Therefore, we aimed to examine associations of normalization and regularization with overfitting of ML on omics data.

Using three paired transcriptomic and clinical datasets (lung adenocarcinoma: the Cancer Genome Atlas (TCGA)/Oncology Singapore; melanoma: TCGA/Dana-Farber Cancer Institute; glioblastoma: TCGA/Clinical Proteomic Tumor Analysis Consortium), we applied ANOVA-based gene selection methods, six normalization methods, and six ML models to classify cancer patients’ deaths. Balanced accuracy (BA) and area under the curve (AUC) in intra- and cross-dataset settings were compared using inferential analyses.

Normalization consistently improved intra-dataset performance (median BA/AUC changes: 0.035–0.214/0.115–0.279) on all data, particularly with Z_Raw, but decreased or slightly increased cross-dataset performance (median BA/AUC changes: −0.029–0.079/0.029–0.064). Least Absolute Shrinkage and Selection Operator (LASSO) model without normalization consistently outperformed most of the ML models in cross-dataset testing across cancer types. ML models on all and molecular-alone data showed similar best performances.

Normalization increases ML’s intra-dataset performance and overfitting in three paired cancer transcriptomic and clinical datasets. Regularized models such as LASSO appear to mitigate overfitting and achieve robust cross-dataset performance. Therefore, cross-dataset evaluation and regularized models are recommended to assess and reduce overfitting, while normalization should be used cautiously. Adding clinical data seems to have little impact on ML models’ performance. However, future work on other diseases and datasets is warranted.

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Mini Review Open Access
Madhunika Agrawal, Satyam Kumar Agrawal
Published online April 14, 2026
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Gene Expression. doi:10.14218/GE.2025.00067
Abstract
The bromodomain and extra-terminal domain (BET) protein family, particularly BRD4, is critical for the control of oncogenic transcriptional programs in solid tumors. Although initial-generation [...] Read more.

The bromodomain and extra-terminal domain (BET) protein family, particularly BRD4, is critical for the control of oncogenic transcriptional programs in solid tumors. Although initial-generation BET inhibitors, such as JQ1, molibresib, and birabresib, have demonstrated preclinical efficacy in repressing MYC-dependent pathways, their clinical translation has been hampered by low monotherapy activity, pharmacokinetic heterogeneity, and dose-limiting toxicities. This review aims to update the mechanistic foundations, clinical trial results, and development of therapeutic approaches to BET inhibition in solid tumors, outlining its evolving role in the next generation of cancer treatment strategies. Various clinical trials in different phases have demonstrated heterogeneous responses among solid tumor types, with greater effects in NUT carcinoma and castration-resistant prostate cancer. Resistance mechanisms, including BRD4 isoform switching and compensatory signaling activation, emphasize the need for advanced and innovative BET-targeting modalities. BD2-selective BET inhibitors and proteolysis-targeting chimeras are likely to overcome these limitations by increasing target specificity and reducing systemic side effects. In addition, combination strategies, such as PARP inhibitors, AR antagonists, and immune checkpoint blockade, have synergistic potential to augment anticancer activity. In conclusion, this review provides a comprehensive overview of the advances, challenges, and future directions of BET bromodomain inhibition in solid tumors.

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Guideline Open Access
Yun Bian, Jing Li, Zhaoshen Li, Jianping Lu, Chengwei Shao, Shiyuan Liu, Min Chen, Xun Li, on behalf of the Professional Committee of Pancreatic Diseases, Chinese Medical Doctor Association; the Radiology Branch of the Chinese Medical Association; the National Clinical Research Center for Digestive Diseases (Shanghai); and the Shanghai Medical Association Radiology Quality Control Center
Published online March 28, 2026
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Cancer Screening and Prevention. doi:10.14218/CSP.2025.00029
Abstract
Pancreatic solid tumors encompass diverse pathological subtypes. Objective, accurate, and comprehensive imaging examinations and diagnostic reports are essential for preoperative [...] Read more.

Pancreatic solid tumors encompass diverse pathological subtypes. Objective, accurate, and comprehensive imaging examinations and diagnostic reports are essential for preoperative staging, treatment planning, and prognostic evaluation. Currently, China lacks corresponding guidelines or consensus documents, leading to prominent issues including subjective diagnostic reports, incomplete descriptions, and inconsistent terminology. The present guideline was developed to standardize diagnostic imaging reporting of pancreatic solid tumors in China. Relevant domestic and international evidence on imaging examination techniques, key reporting elements, and diagnostic criteria was systematically reviewed and synthesized. This guideline was developed by a multidisciplinary expert panel through systematic evidence retrieval and appraisal, GRADE-based recommendation grading, modified Delphi consensus, and external review. A total of 20 evidence-based recommendations, 13 strong and 7 weak, were formulated, in aspects of imaging examination and diagnostic reporting standards, including the measurement of the tumor size of pancreatic solid tumors, assessment of the obstruction of the main pancreatic duct and common bile duct, definition, assessment, and clinical significance of pancreatic parenchymal atrophy, the assessment of obstructive acute pancreatitis, pseudocysts/retention cysts, and peripancreatic vessels, criteria for resectability, regional lymph node assessment, criteria for suspicious lymph nodes and descriptions of their specific location, and detection of hepatic and peritoneal metastases. Implementation of this guideline in clinical practice will help standardize the accuracy and consistency of diagnostic imaging reports for pancreatic solid tumors in China, thereby advancing standardized imaging diagnosis and informing clinical treatment decisions.

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Reviewer Acknowledgement Open Access
Editorial Office of Journal of Exploratory Research in Pharmacology
Published online December 25, 2025
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Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2025.000RA
Case Report Open Access
Tsuneyoshi Hamada, Miyako Kobayashi, Ayaka Fukui, Naoki Nakajima, Naoyuki Anzai, Shinsaku Imashuku
Published online March 23, 2026
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Oncology Advances. doi:10.14218/OnA.2025.00030
Abstract
Development of mixed histiocytosis (Langerhans cell histiocytosis (LCH))/Erdheim–Chester disease (ECD)) after treatment in patients with an initial skull LCH lesion has not been [...] Read more.

Development of mixed histiocytosis (Langerhans cell histiocytosis (LCH))/Erdheim–Chester disease (ECD)) after treatment in patients with an initial skull LCH lesion has not been well recognized. An elderly woman initially developed LCH at the left temporal bone, preceded by polyuria and polydipsia five years earlier; the lesion was surgically removed. Two years thereafter, she experienced her first LCH relapse with a right parietal skull lesion, in which a BRAF V600E mutation was confirmed, and chemotherapy was initiated. After a second LCH relapse involving the left parietal bone, the patient presented with a third relapse at the L2 vertebra. This lesion was pathologically diagnosed as mixed histiocytosis (LCH/ECD), resulting in refractoriness to conventional chemotherapy, and was successfully treated with targeted therapy using BRAF and MEK inhibitors. Spinal mixed histiocytosis (LCH/ECD) may develop following relapses of skull LCH after chemotherapy, for which targeted therapy could be effective.

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Original Article Open Access
Aicha Sylvanie Magniteu Lekefack, Boniface Pone Kamdem, Yolande Nzeulienou Noubissi, Jamila Aminatou Kone, Staelle Pierre Tedonzang, Aimerance Mabelle Madoung, Christelle Amanda Djakam Ngola, Aaron Junior NKana, Fabrice Fekam Boyom
Published online March 31, 2026
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Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2025.00047
Abstract
Vulvovaginal candidiasis, an infection caused by an abnormal proliferation of Candida species in the vagina and vulva, is particularly relevant, affecting up to 75% of women of [...] Read more.

Vulvovaginal candidiasis, an infection caused by an abnormal proliferation of Candida species in the vagina and vulva, is particularly relevant, affecting up to 75% of women of reproductive age. Because of antifungal drug resistance, a significant number of plants are used to treat vaginal candidoses in Cameroon. Thus, the scientific validation of the use of these plants in treating candidiasis is valuable. This study sought to identify medicinal plants used to treat vaginal infections in the Dschang district and evaluate the antifungal activity of the most promising plants on five Candida species.

The ethnobotanical survey was conducted in Dschang (Menoua Division, West Cameroon) through individual interviews using a semi-structured questionnaire. Extracts from seventeen plants were obtained by maceration using water or a water–ethanol solution (3:7; v/v). Antifungal activity was evaluated using the microdilution method.

Forty-eight plants belonging to 33 families were identified as treating vaginal infections. Decoction and formulation of ovules were the prevalent modes of plant preparation, with leaves and bark being the predominant plant organs used. Out of thirty-four extracts tested, two (CSEHAlc and MIEHAlc) showed antifungal activity, with minimum inhibitory concentrations ranging from 0.315 to 2.5 mg/mL. The determination of the minimum fungicidal concentrations revealed the fungicidal orientation of these bioactive extracts.

This study identifies medicinal plants used to treat vaginal infections in Dschang and their modes of preparation. The in vitro antifungal screening of selected plants indicated Mangifera indica and Canarium schweinfurthii as the anti-Candida plants that can be further exploited for antifungal drug discovery.

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Mini Review Open Access
Hongjun Guo, Yuan Bao, Shuai Feng, Tonghua Yang, Zengzheng Li
Published online March 28, 2026
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Oncology Advances. doi:10.14218/OnA.2025.00032
Abstract
Despite the emergence of new approaches in acute myeloid leukemia (AML) treatment in recent years, the overall prognosis remains poor. Particularly for elderly patients and relapsed/refractory [...] Read more.

Despite the emergence of new approaches in acute myeloid leukemia (AML) treatment in recent years, the overall prognosis remains poor. Particularly for elderly patients and relapsed/refractory cases, the five-year survival rate consistently remains below 30%. While traditional chemotherapy regimens can rapidly suppress tumor burden and alleviate clinical symptoms, they suffer from limitations such as insufficient targeting, prominent toxic side effects, and a tendency to induce drug resistance. Immunotherapy offers a novel therapeutic pathway for AML due to its advantages of precise targeting, long-lasting antitumor effects, and a controllable safety profile. However, single-agent immunotherapy demonstrates limited clinical response rates in AML and struggles to achieve complete tumor cell clearance. In this context, combination regimens of chemotherapy and immunotherapy are increasingly becoming the focus of research. This review aims to summarize the rationale and advances in the combination of immune checkpoint inhibitors, chimeric antigen receptor T-cell therapy, antibody-drug conjugates, bispecific antibodies, and cancer vaccines with chemotherapy for the treatment of AML. We have detailed the preclinical research and clinical trial progress of each combined regimen, analyzed the core challenges—including off-target toxicity, high tumor heterogeneity, and limited efficacy in specific AML subtypes—and further propose targeted solutions and future development directions, such as exploring novel specific antigens, developing multi-targeted drugs, and formulating precision individualized treatment plans. The clinical application of such combined strategies is attracting increasing attention. In conclusion, chemo-immunotherapy combinations represent a highly promising therapeutic paradigm for AML, harnessing the synergy of chemotherapy-mediated immune microenvironment remodeling and the specific antitumor activity of immunotherapies to overcome single-agent limitations and deliver meaningful survival benefits.

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Opinion Open Access
Jiani Ma, Xinxin Yao, Wei Li, Hao Li, Dongao Chen, Hui Wang, Mingjun Zhang, Senbang Yao
Published online March 6, 2026
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Oncology Advances. doi:10.14218/OnA.2025.00016
Original Article Open Access
Xianwu Yang, Shirui Huang, Ruisi Ma, Zhihui Zhu, Yingquan Zhuo, Jiafei Yang, Jun Du, Huajian Gu
Published online March 24, 2026
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00561
Abstract
Steatotic donor livers are highly susceptible to post-transplant dysfunction; however, the underlying mechanisms remain incompletely understood. This study aimed to investigate [...] Read more.

Steatotic donor livers are highly susceptible to post-transplant dysfunction; however, the underlying mechanisms remain incompletely understood. This study aimed to investigate the role of galectin-3 (LGALS3)-mediated pyroptosis in steatotic liver graft injury and explore its therapeutic potential.

A mouse model of steatotic liver transplantation was established. Graft tissues were subjected to RNA sequencing to identify key regulators. In vitro, LGALS3 was modulated in steatotic hepatocytes under ischemia/reperfusion stress to assess its impact on the NLRP3 inflammasome and pyroptosis. The regulatory mechanism by which LGALS3 modulates NLRP3 ubiquitination was further examined. Finally, the therapeutic efficacy of LGALS3 inhibition was evaluated in an orthotopic liver transplantation model.

Transcriptomic analysis identified LGALS3 as a key upregulated molecule in steatotic grafts, associated with pyroptosis pathways. In vitro, LGALS3 overexpression enhanced NLRP3 inflammasome activation and pyroptotic cell death, whereas LGALS3 knockdown exerted protective effects. Mechanistically, LGALS3 modulated NLRP3 inflammasome activity by regulating its ubiquitination. In vivo, pharmacological inhibition of LGALS3 significantly improved graft function, reduced histological injury, suppressed pyroptosis, and prolonged recipient survival.

This study demonstrates that LGALS3 drives steatotic graft injury by promoting NLRP3-mediated pyroptosis through the regulation of ubiquitination. These findings identify LGALS3 as a promising therapeutic target for improving the outcomes of liver transplantation using steatotic donor organs.

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Original Article Open Access
Lingyun Gao, Yanqiu Rao, Hongna Gao, Jun Li, Jianqin Huang, Wenjun Wang
Published online March 17, 2026
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Future Integrative Medicine. doi:10.14218/FIM.2025.00047
Abstract
Chronic stress-induced hypercortisolism causes diminished ovarian reserve (DOR), contributing to infertility and miscarriage. Androgen supplementation is an emerging therapeutic [...] Read more.

Chronic stress-induced hypercortisolism causes diminished ovarian reserve (DOR), contributing to infertility and miscarriage. Androgen supplementation is an emerging therapeutic approach for DOR. The traditional Chinese herbal decoction modified Gengnianchun formula (MGNC) has shown clinical efficacy in treating DOR. This study aimed to compare the effectiveness of MGNC with that of androgens in a stress-induced DOR mouse model.

Sexually mature female C57 mice aged six weeks were randomly assigned to six groups (n = 10 per group, with 3 independent replicates per group), including the control, model, low-dose testosterone (LT), medium-dose testosterone (MT), high-dose testosterone (HT), and MGNC groups. This sample size and study design were determined based on preliminary experimental data. Chronic stress was induced in mice, except for the control group, by daily glucocorticoid injection, and the mice in the LT, MT, HT, and MGNC groups were treated at the same time with testosterone (low, medium, or high dose) or MGNC for six weeks. Body weight, estrous cycles, ovarian follicle counts, hormone profiles, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and testosterone, and in vitro preantral follicle growth rates (via MGNC-enriched or androgen-treated serum) were assessed.

All groups presented stable body weights. MGNC ameliorated estrous cycle irregularities caused by stress, while testosterone exacerbated the abnormality. Moreover, MGNC outperformed LT in improving primordial/primary/antral follicle counts and corpus luteum formation, while MT and HT did not improve ovarian follicle reserve. LT was associated with the highest serum estradiol level, but none of the testosterone doses reduced FSH levels or the FSH/LH ratio, whereas MGNC lowered FSH and the FSH/LH ratio. Additionally, MGNC-enriched serum significantly enhanced the in vitro follicular growth rate in corticosterone-supplemented culture medium, and this effect was superior to that observed with testosterone-pretreated serum.

MGNC demonstrates superior efficacy over androgen therapy in treating chronic stress-induced DOR in mice, supporting further investigations into its clinical potential and mechanisms.

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