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Liquid Biopsy in Non-Metastatic Prostate Cancer: Clinical Evidence and Future Directions

Cancers (Basel). 2026 Feb 28;18(5):800. doi: 10.3390/cancers18050800.

ABSTRACT

BACKGROUND AND OBJECTIVE: Liquid biopsy has transformed the management of advanced prostate cancer, yet its clinical role in non-metastatic disease remains uncertain. Conventional biomarkers such as PSA, imaging, and pathology have limited ability to capture minimal residual disease and biological aggressiveness. The objective of this review was to critically evaluate the current evidence on circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) in non-metastatic prostate cancer, focusing on feasibility, prognostic value, and potential clinical applications.

METHODS: A narrative review of PubMed-indexed original studies evaluating liquid biopsy in clinically localized or non-metastatic prostate cancer was performed. Eligible studies included patients treated with curative-intent local therapy or experiencing biochemical recurrence without radiologic metastases. Study designs were predominantly prospective or retrospective observational cohorts. Liquid biopsy analytes included CTCs and ctDNA assessed from peripheral blood plasma using EpCAM-based enrichment, targeted next-generation sequencing, whole-genome sequencing, or ultra-sensitive tumor-informed assays. Primary outcomes included detection rates, associations with clinicopathologic features, biochemical recurrence, metastasis-free survival, and overall survival. Key Findings and Limitations: Across 11 studies, CTC detection using EpCAM-based platforms was infrequent in localized disease and biochemical recurrence and showed limited prognostic value (10-11% in preoperative settings). In contrast, ctDNA was detectable in a minority of patients but consistently identified biologically aggressive disease and a higher risk of recurrence when present, particularly using tumor-informed ultra-sensitive assays. Limitations include low detection rates, heterogeneous methodologies, small sample sizes, and predominantly exploratory study designs.

CONCLUSIONS AND CLINICAL IMPLICATIONS: Currently, its most promising application is not broad screening, but as a selective, biology-driven tool for detecting minimal residual disease and refining risk assessment. CtDNA acts as a biological risk modifier, potentially guiding the escalation or de-escalation of adjuvant therapy. However, prospective biomarker-driven trials are required to validate these strategies before routine clinical implementation.

PMID:41827734 | PMC:PMC12984391 | DOI:10.3390/cancers18050800

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Dissecting the Phospho-Regulatory Landscape of Protein Kinase N1 (PKN1) and Its Downstream Signaling: Functional Insights into the Activity-Dependent and Disease-Relevant Phosphosites

Int J Mol Sci. 2026 Feb 25;27(5):2137. doi: 10.3390/ijms27052137.

ABSTRACT

Protein Kinase N1 (PKN1) is a PKC-related serine/threonine kinase of the AGC group within the eukaryotic protein kinase superfamily (ePK) that orchestrates oncogenic, metabolic, and cytoskeletal signaling. Despite these critical roles, the phosphorylation-dependent regulatory network of PKN1 remains largely undefined. We performed a large-scale phosphoproteomic data integration of publicly available human datasets (892 profiling datasets and 191 differential datasets) to identify recurrent PKN1 phosphorylation sites. This analysis identified two predominant PKN1 phosphosites, S562 and S916, that were frequently observed and differentially regulated across studies. The S916 maps to a turn motif (TM) in the AGC group of kinases, which is evolutionarily conserved among PKN paralogs, while S562 is non-conserved and appears to be PKN1-specific. Co-regulation and enrichment analyses suggest that S916 is associated with insulin/AMPK signaling and metabolic pathways, whereas S562 co-occurs with phosphosites involved in cell division, cytoskeletal regulation, and microtubule cytoskeleton organization. Integrating predicted and experimentally validated kinases, substrates, and interactors, we reconstructed a phospho-regulatory network that positions PKN1 at the crossroads of cytoskeleton organization and metabolic signaling. To assess the disease relevance of these phosphorylation events, we integrated transcriptomic and phosphoproteomic data from the hepatocellular carcinoma database (HCCDB). PKN1 was markedly up-regulated in HCC, and its phosphorylation at S916 was positively co-regulated with multiple oncogenic and proliferation-associated protein phosphosites. These results predict S562 and S916 as potential sites for targeted biochemical validation and functional experiments. The identification of S562 and S916 as key regulatory sites provides new mechanistic insight into PKN1 activation and highlights potential avenues for therapeutic targeting.

PMID:41828364 | PMC:PMC12984926 | DOI:10.3390/ijms27052137

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Elucidating genetic backgrounds of myasthenia gravis in Japanese by genome-wide association studies and multi-omics analyses of thymoma

Nat Commun. 2026 Mar 12. doi: 10.1038/s41467-026-70376-5. Online ahead of print.

ABSTRACT

Myasthenia gravis (MG) is an autoimmune disorder characterized by impaired neuromuscular transmission and motor symptoms. Its genetic background remains unclear, particularly beyond specific subtypes reported in European populations. Here, we perform a genome-wide association study (GWAS) of 1,434 MG cases covering all disease subtypes and 42,913 controls of Japanese, which newly identify the TERT locus (odds ratio [OR] = 1.31, P = 1.7×10-10). Subtype-stratified GWASs show stronger signals for generalized MG (gMG; OR = 1.38, P = 1.6×10-12), anti AChR antibody-positive gMG (g-AChR-Ab(+)MG; OR= 1.49, P = 2.1×10-15), and thymoma-associated gMG (g-TAMG; OR = 1.92, P = 1.1×10-15). Fine-mapping of the major histocompatibility complex region reveal distinct associations of HLA-DRB1 with late onset gMG (g-LOMG) and HLA-A with early onset gMG (g-EOMG). The MG risk TERT lead variant rs2736099 is associated with poor treatment response, especially in g-AChR-Ab(+)MG and g-EOMG (P < 0.0042). The biobank-based phenome-wide association study identify pleiotropic effects on lung cancer, hematological traits, and telomere length. Single cell transcriptomics and immunohistochemistry identified immature lymphocyte-specific TERT expression in thymoma specimens. Full-length transcriptomics reveal allele-specific decreasing effect of rs2736099-A on TERT expression. Our study unveils genetics of MG distinctly across disease subtypes, and involvement of TERT in its pathogenesis.

PMID:41820352 | DOI:10.1038/s41467-026-70376-5

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Insights and Recommendations From Moderators and Community Members for Keeping Online Peer Support Safe: Thematic Analysis

Background: Online peer support can help people living with long-term physical health conditions to manage their mental well-being. Although the potential negative events that can occur and risks associated with web-based peer communities are well recognized, our understanding of how best to moderate these spaces is relatively limited, particularly with regard to new communities. Previous work has focused on the experiences of either moderators or community members. Objective: This study aims to explore the perspectives of both members and moderators of a new online peer support community to evaluate the moderation procedures and inform recommendations for best practice. Methods: Community members (n=39) who participated in a research trial of a new online peer community, CommonGround, were interviewed. The moderation team (n=5) was invited to a focus group. Community member interviews explored their opinions of moderation policies and the behavior of the moderation team. The moderator focus group explored their experiences of moderating the community, including perceived benefits, common challenges, and areas for improvement. All interviews and the focus group were conducted online, audio-recorded, and transcribed verbatim. An inductive thematic analysis was conducted to sort the data into overarching themes through an iterative process. Results: Effective moderation was considered critical in creating a safe space that members wanted to engage with and for mitigating any risks, particularly around the spread of medical misinformation. Both moderators and community members felt that the moderation policies and practices were appropriate and applicable to the community. Moderators found navigating the moderation threshold, where they balanced safety against free speech, challenging when determining whether to intervene or not. Being part of a team with mixed clinical expertise helped moderators build confidence in navigating this threshold and also presented other benefits of easy access to support and improving the consistency of their moderation practices. It was suggested that in order for a community to flourish, community members would self-moderate. However, moderators and members felt that the strong community culture and high levels of member engagement that are needed to support self-moderation had not yet evolved. Proposed improvements to moderation included new features to support the efficiency of identifying new content for review and reviewing the rule of anonymity. Conclusions: Moderation is critical in making online peer communities feel safe and engaging. Moderation practices should be co-produced with the target audience to ensure that they are aligned with the community’s unique moderation wants and needs, including clear escalation pathways, transparent communication patterns, and plans to review and update policies or procedures as the community evolves. There should be technological features that promote self-moderation, as the community may shift towards self-moderation as it matures. It is also critical to ensure that moderators feel supported so that they are best placed to support the broader community. Trial Registration: ClinicalTrials.gov NCT06222346; https://clinicaltrials.gov/study/NCT06222346
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A structure-based mRNA vaccine for Nipah virus in healthy adults: a phase 1 trial

Nature Medicine, Published online: 12 March 2026; doi:10.1038/s41591-026-04265-1

In this phase 1, open-label dose-escalation study in healthy adults found that the mRNA vaccine (mRNA-1215), encoding the Nipah virus Malaysian strain chimeric pre-fusion F protein linked to glycoprotein G, was safe and induced elevated immune responses at 1 year of follow-up, indicating that this is a promising vaccine candidate for further development.
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A clinical environment simulator for dynamic AI evaluation

Nature Medicine, Published online: 12 March 2026; doi:10.1038/s41591-026-04252-6

The authors propose a framework for clinical AI evaluation within simulated digital hospital environments that capture the evolving constraints, and cascading effects, of clinical decisions.
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A sorghum pangenome reference improves global crop trait discovery

Nature, Published online: 11 March 2026; doi:10.1038/s41586-026-10229-9

A pangenome reference for the phenotypically diverse crop sorghum aims to help accelerate future efforts to breed crops that are better adapted to changing environments.
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Immune evasive DNA donors and recombinases license kilobase-scale writing

Nature, Published online: 11 March 2026; doi:10.1038/s41586-026-10241-z

INSTALL overcomes fundamental challenges for DNA delivery and integration methods by synergizing immune-stealth nucleic acids with recombinases to enable kilobase-scale integration strategies without viral vectors.
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Natural maternal immunity protects neonates from <i>Escherichia coli</i> sepsis

Nature, Published online: 11 March 2026; doi:10.1038/s41586-026-10225-z

Neonatal sepsis caused by Escherichia coli is associated with reduced transfer of pathogen-specific maternal antibodies and, in a mouse model, can be prevented by maternal preconceptual colonization with probiotic E. coli.
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Ageing promotes metastasis via activation of the integrated stress response

Nature, Published online: 11 March 2026; doi:10.1038/s41586-026-10216-0

Ageing reprograms the evolutionary trajectory of KRAS-driven lung adenocarcinoma, limiting primary tumour growth while promoting metastatic dissemination through epigenetic activation of the integrated stress response, and a therapeutic opportunity in older patients is revealed.
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FinSheet-Bench: From Simple Lookups to Complex Reasoning, Where LLMs Break on Financial Spreadsheets

arXiv:2603.07316v1 Announce Type: new Abstract: While Large Language Models (LLMs) can accelerate text-heavy tasks in alternative investment due diligence, a gap remains in their ability to accurately extract and reason over structured tabular data from complex financial spreadsheets. Progress is held back by the lack of real industry fund portfolio datasets for benchmarking, as private equity data rooms are confidential. To address this, we introduce FinSheet-Bench, a benchmark of synthetic financial portfolio data modeled on real private equity fund structures, designed to evaluate LLM performance on text-serialized spreadsheet question answering and numeric reasoning tasks. Our evaluation of ten model configurations from OpenAI, Google, and Anthropic on financial spreadsheets, including complex layouts, fund dividers, and multi-line column names, reveals that no standalone model achieves error rates low enough for unsupervised use in professional finance applications. The best-performing model, Gemini 3.1 Pro, achieves 82.4% accuracy across twenty-four evaluation files of varying complexity and structural layout (approximately 1 error per 6 questions), followed by GPT-5.2 with reasoning at 80.4%, Claude Opus 4.6 with thinking at 80.2%, and Gemini 3 Pro at 80.2%. Performance degrades substantially on larger, more complex spreadsheets: the largest spreadsheet (152 companies, 8 funds) yields an average accuracy of just 48.6% across all models, compared to 86.2% on the easiest evaluation file. These difficulty patterns are consistent across all ten models, indicating that they reflect LLM limitations rather than idiosyncratic model weaknesses. Reliable financial spreadsheet extraction will likely require architectural approaches that separate document understanding from deterministic computation.
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SoK: Agentic Retrieval-Augmented Generation (RAG): Taxonomy, Architectures, Evaluation, and Research Directions

arXiv:2603.07379v1 Announce Type: new Abstract: Retrieval-Augmented Generation (RAG) systems are increasingly evolving into agentic architectures where large language models autonomously coordinate multi-step reasoning, dynamic memory management, and iterative retrieval strategies. Despite rapid industrial adoption, current research lacks a systematic understanding of Agentic RAG as a sequential decision-making system, leading to highly fragmented architectures, inconsistent evaluation methodologies, and unresolved reliability risks. This Systematization of Knowledge (SoK) paper provides the first unified framework for understanding these autonomous systems. We formalize agentic retrieval-generation loops as finite-horizon partially observable Markov decision processes, explicitly modeling their control policies and state transitions. Building upon this formalization, we develop a comprehensive taxonomy and modular architectural decomposition that categorizes systems by their planning mechanisms, retrieval orchestration, memory paradigms, and tool-invocation behaviors. We further analyze the critical limitations of traditional static evaluation practices and identify severe systemic risks inherent to autonomous loops, including compounding hallucination propagation, memory poisoning, retrieval misalignment, and cascading tool-execution vulnerabilities. Finally, we outline key doctoral-scale research directions spanning stable adaptive retrieval, cost-aware orchestration, formal trajectory evaluation, and oversight mechanisms, providing a definitive roadmap for building reliable, controllable, and scalable agentic retrieval systems.
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