bims-necame Biomed News
on Metabolism in small cell neuroendocrine cancers
Issue of 2026–02–15
seventeen papers selected by
Grigor Varuzhanyan, UCLA



  1. J Med Chem. 2026 Feb 08.
      Using our proprietary AI/ML platform AURIGIN that maps tumor cells against normal developmental pathways, we identify targets that have been hijacked by cancerous cells to maintain a highly plastic proliferative cell state. We identified the histone acetyltransferase KAT2A as a key driver of tumor cell plasticity in a subset of acute myeloid leukemias (AML) and neuroendocrine carcinomas such as small cell lung cancer (SCLC) and neuroendocrine prostate cancer (NEPC). Herein, we describe our development of heterobifunctional degraders of KAT2A/B, resulting in compound 7, a picomolar degrader that is capable of inhibiting proliferation of AML (MOLM-13) and SCLC (NCI-H1048) cell lines in vitro and demonstrates robust degradation of KAT2A in NCI-H1048 engrafted mice when administered IP. Building on the success of compound 7, we subsequently developed orally bioavailable degraders of KAT2A/B, exemplified by compound 24, that achieved an oral bioavailability of 47% in mice.
    DOI:  https://doi.org/10.1021/acs.jmedchem.5c03208
  2. Mol Cancer Ther. 2026 Feb 12.
      Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumor characterized by a high relapse rate, limited treatment options, and a poor prognosis. Delta-like ligand 3 (DLL3) has emerged as a promising target for SCLC. Notably, CAR T cells that use the variable domain of heavy-chain-only antibodies (VHH) demonstrate superior efficacy compared to their ScFv counterparts. However, the therapeutic effectiveness of anti-DLL3 VHH-CAR T cells has yet to be fully explored. To leverage the therapeutic potential of VHHs, we first immunized alpacas and screened for anti-DLL3 VHHs using yeast display. Then, 1-B12 and 5 identified the positive clones and compared them based on their affinity, specificity, and cytotoxicity in CAR T cell models. Moreover, 1-B12 was selected as the humanized sequence due to its higher affinity, greater specificity, and stronger cytotoxicity. Finally, the functionality of the four humanized VHH-CAR T cells from the 1-B12 sequence was evaluated through in vitro assays that measured cytokine production and cytotoxicity, followed by in vivo studies to assess their antitumor efficacy. The anti-DLL3 VHHs exhibited strong affinity, specificity, and cytotoxicity in CAR T cell models. Notably, the HM-CAR T cells exhibited robust cytokine secretion and cytotoxic activity against tumor cells. Moreover, these HM-CAR T cells demonstrated significant antitumor efficacy in vivo. This study highlights effective strategies for developing DLL3-specific VHHs and their application in CAR T therapy, which supports their clinical potential as a promising immunotherapeutic approach for cancers that express DLL3.
    DOI:  https://doi.org/10.1158/1535-7163.MCT-25-0965
  3. Histopathology. 2026 Feb 13.
       BACKGROUND: Epstein-Barr virus (EBV)-positive small cell neuroendocrine carcinoma of the nasopharynx (SCNEC-nasopharynx) is exceptionally rare and aggressive, with poorly characterized molecular features.
    METHODS: Clinicopathological, immunohistochemical (synaptophysin, INSM1, chromogranin A, CK-pan, EGFR, NUT, INI1), and molecular profiles of 15 EBV-positive SCNEC-nasopharynx cases (2012-2025) were analysed. EBV status was confirmed by EBER-ISH. Exploratory next-generation sequencing compared nine SCNEC with five EBV-positive nasopharyngeal non-keratinizing carcinomas (NKUC).
    RESULTS: Patients (median age 51; male:female = 2:1) presented with advanced-stage disease and cervical lymphadenopathy. Histology showed solid nests of small cells with high-grade features. All tumours were diffusely positive for synaptophysin and EBER, showed perinuclear dot-like CK-pan staining, and were negative for squamous markers and EGFR. NUT was negative and INI1 retained. Comparative genomics revealed greater mutational burden and unique alterations enriched in cell cycle/DNA damage pathways in SCNEC versus NKUC. After multimodal therapy, median overall survival was 33 months.
    CONCLUSION: This largest integrated study defines the distinct clinicopathological and molecular profile of EBV-positive SCNEC-nasopharynx. The identified diagnostic immunophenotype and potential oncogenic pathways provide a foundation for precise diagnosis and future targeted therapy development.
    Keywords:  Epstein–Barr virus; nasopharynx; next‐generation sequencing; small cell neuroendocrine carcinoma
    DOI:  https://doi.org/10.1111/his.70118
  4. bioRxiv. 2026 Feb 02. pii: 2026.01.31.702982. [Epub ahead of print]
      Combined small-cell lung cancer (cSCLC) is a rare and aggressive subtype of small-cell lung cancer (SCLC) characterized by mixed histology comprising SCLC and non-small cell lung cancer (NSCLC) or large cell neuroendocrine carcinoma (LCNEC) components. Despite its histological heterogeneity and even poorer prognosis than de novo SCLC, cSCLC is clinically managed as pure SCLC, largely due to the lack of molecular insights into its biology, lineage plasticity, and tumor microenvironment (TME). Here, we perform multi-omics profiling, including spatially-resolved whole-exome sequencing (WES), spatial transcriptomics (ST) and single-nucleus RNA sequencing (snRNA-seq), across 19 treatment-naïve cSCLC tumors spanning all major histological subtypes. Our analysis reveals that SCLC and NSCLC/LCNEC components share a monoclonal origin, with histological divergence characterized by distinct mutation and copy number alteration patterns. ST and snRNA-seq uncover spatially exclusive or interspersed tumor domains, with distinct TME compositions and immune landscapes. Notably, fibroblast-rich regions enriched for an aggressive fibroblast subtype form boundaries between tumor domains, potentially influencing immune TME and treatment responses. We identify extensive lineage plasticity within cSCLC, including active LUAD-to-SCLC transdifferentiation and SCLC subtype coexistence, suggesting transitional cellular states not captured by traditional diagnostics. Leveraging these insights, we developed the cSCLC Detector, a sensitive mutation-based diagnostic assay that improves the detection of cSCLC in tissue and liquid biopsy samples. Our findings offer critical insights into cSCLC lineage plasticity, cellular evolution, and microenvironmental interactions, underscoring the need for tailored treatment strategies and diagnostic frameworks for this aggressive cancer subtype.
    DOI:  https://doi.org/10.64898/2026.01.31.702982
  5. Transl Cancer Res. 2026 Jan 31. 15(1): 46
       Background: Small cell lung cancer (SCLC) is a subtype of lung cancer that is aggressive, progresses rapidly, and is prone to recurrence. The biological composition of SCLC is still under investigation. This study aims to characterize the intratumoral heterogeneity and immunosuppressive tumor microenvironment of SCLC using single-cell RNA sequencing (scRNA-seq), and to identify and validate the key genes BEX1 and MAP1b as potential therapeutic targets.
    Methods: To comprehend the heterogeneity of SCLC and the tumor microenvironment, we used scRNA-seq to analyze the primary tumor and adjacent noncancerous tissue from a patient. The findings were tested with cell experiments.
    Results: We observed that SCLC was mainly composed of neuroendocrine epithelial cells and displayed the immune-related cell failure state. The corresponding antitumor immune pathway activities were also downregulated, and the tumor microenvironment eventually showed immunosuppression. BEX1 and MAP1b were upregulated in most cell subtypes, which are verified by immunohistochemistry. In addition, downregulation of BEX1 in NCI-H209 and MAP1b in NCI-H82 significantly inhibited cell proliferation and migration, while increasing apoptosis. Based on preliminary data, BEX1 and MAP1b have been identified as promising candidates for the early diagnosis and therapy of SCLC; however, their clinical utility requires confirmation in subsequent studies. To investigate the heterogeneity and interaction among different cell types, we also constructed an intercellular communication network.
    Conclusions: Our knowledge of the basic traits of SCLC is improved by this highly accurate single-cell study, which also offers fresh suggestions for potential future therapies.
    Keywords:  Small cell lung cancer (SCLC); heterogeneity; immune; single-cell RNA sequencing (scRNA-seq); tumor microenvironment (TME)
    DOI:  https://doi.org/10.21037/tcr-2025-1674
  6. bioRxiv. 2026 Jan 28. pii: 2026.01.26.701784. [Epub ahead of print]
       Background: The histone methyltransferase EZH2, enzymatic core of the trimeric polycomb repressive complex 2 (PRC2), has been shown to promote small cell lung cancer (SCLC) survival through epigenetic silencing of multiple targets including Class I MHC molecules ( HLA-A/B ) and DNA repair factors ( SLFN11 ). Treatment of SCLC cells with EZH2 inhibitors in vitro can reactivate expression of these genes and result in therapeutic response to immune checkpoint inhibition (ICI) and chemotherapy. Here, we investigate the impact of EZH1/2 dual inhibition on 3D chromatin structure and its relationship to transcriptional regulation in neuroendocrine (NE) SCLC.
    Results: Employing Micro-C, a micrococcal nuclease-based 3D genome mapping technique, we show that EZH1/2 inhibition with Valemetostat induced significant changes at multiple genome organizational levels (compartment, topological associated domain, and chromatin loop) without incurring cell death in NE SCLC. Alterations in 3D genome permissive for transcriptional activation were correlated with increased chromatin accessibility (ATAC-sequencing) and expression of target genes (transcriptome profiling). Known transcription factor motif discovery revealed enrichment of non-NE motifs (e.g., REST ) in regions with gained chromatin accessibility in Valemetostat-treated cells, consistent with results from gene set enrichment analysis demonstrating NE to non-neuroendocrine lineage shift. Notably, EZH1/2 inhibition reactivated Class I MHC expression by facilitating enhancer-promoter looping.
    Conclusion: Our results demonstrate that repression of a subset of EZH2 targets including Class I MHC genes is affected through modulation of 3D genome structure to the level of chromatin looping and further support clinical investigation of EZH2 inhibition in boosting therapeutic efficacy of ICI in SCLC patients.
    DOI:  https://doi.org/10.64898/2026.01.26.701784
  7. Am J Transl Res. 2026 ;18(1): 788-796
       OBJECTIVE: The molecule known as Programmed death-ligand 1 (PD-L1) exerts an inhibitory effect on immune system reactions and promotes cancer progression. Its prognostic role in small cell lung cancer (SCLC) remains less defined than in non-small cell lung cancer. This study aimed to evaluate PD-L1 expression and its prognostic value in SCLC, comparing detection by immunohistochemistry (IHC) and reverse transcription quantitative polymerase chain reaction (RT-qPCR).
    METHODS: PD-L1 expression was assessed in paired tumor and non-tumor tissues from 66 SCLC patients using IHC and RT-qPCR. IHC positivity was defined as membrane staining in >5% of tumor cells. Associations with clinicopathological factors were examined by Fisher's exact test. Survival analysis employed Kaplan-Meier curves and log-rank tests. Univariate and multivariate Cox regression identified independent prognostic factors.
    RESULTS: IHC analysis showed PD-L1 positivity in 34/66 patients. RT-qPCR revealed significantly higher PD-L1 mRNA levels in tumor versus non-tumor tissues (P<0.01). Both IHC positivity and high mRNA levels were associated with larger tumor size, metastasis, and advanced clinical stage (all P<0.05), but not with age, gender, or smoking/drinking history. Patients with PD-L1-positive IHC staining or high PD-L1 mRNA exhibited significantly worse 5-year overall survival (P<0.05), with IHC showing stronger prognostic discrimination. Multivariate analysis confirmed IHC positivity (HR=2.45, P=0.004) and high mRNA level (HR=2.12, P=0.012) as independent predictors of poor survival.
    CONCLUSION: PD-L1 expression is associated with aggressive clinicopathological features and independently predicts poor survival in SCLC. IHC appears to be a more sensitive detection method than RT-qPCR for prognostic assessment.
    Keywords:  PD-L1; prognosis; small cell lung cancer
    DOI:  https://doi.org/10.62347/OZEK2695
  8. Cureus. 2026 Jan;18(1): e100913
      Gastrointestinal neuroendocrine neoplasms (GI NENs) represent a heterogeneous group of tumors distinguished by variable morphology, proliferative behavior, and clinical outcomes. Their incidence continues to rise globally, driven by improved detection methods and increased understanding of neuroendocrine biology. This narrative review synthesizes current knowledge on the morphologic, immunohistochemical, and molecular features of GI NENs across anatomic sites, highlighting advances in diagnostic evaluation and the prognostic significance of the WHO 2022 grade. Key diagnostic challenges, including differentiating neuroendocrine tumor grade 3 (NET G3) from neuroendocrine carcinoma (NEC) and accurately assessing mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs), are examined alongside sources of variability such as Ki-67 interpretation and sampling limitations. Emerging prognostic biomarkers, digital pathology applications, and evolving therapeutic strategies, particularly somatostatin analogs, peptide receptor radionuclide therapy, and systemic chemotherapy, are reviewed in the context of precision oncology. Continued integration of molecular profiling, artificial intelligence, and standardized diagnostic approaches promises to refine prognostication and personalize management for patients with GI NENs.
    Keywords:  gastrointestinal neuroendocrine neoplasms; ki-67; minen; net g3; neuroendocrine carcinomas; neuroendocrine tumors; who 2022 classification
    DOI:  https://doi.org/10.7759/cureus.100913
  9. Front Endocrinol (Lausanne). 2026 ;17 1738286
       Background: Evidence on the efficacy and safety of radioligand therapy (RLT) in lung neuroendocrine tumors (LNETs) remains scarce. The limited data available, derived mainly from retrospective analyses are based on small patient cohorts and heterogeneous treatment protocols. The objective of this study was to assess the efficacy and safety of RLT in patients with SSTR-positive LNETs treated with either [¹77Lu]Lu-DOTA-TATE or tandem therapy with [90Y]Y-DOTA-TATE/[¹77Lu]Lu-DOTA-TATE at Polish ENETS Center of Excellence.
    Methods: We conducted a retrospective analysis of 22 LNET patients who received RLT and had complete follow-up data. Treatment response and survival outcomes were evaluated. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Prognostic associations with PFS and OS were explored using univariate and multivariable Cox proportional hazards models, treatment-related AE were graded according to CTCAE.
    Results: A total of 22 patients with LNETs (Med. 61 years; 68.2% male) were included. Histology comprised 31.8% typical carcinoid, 54.5% atypical carcinoid, and 13.6% LNET G3. 14 patients received [¹77Lu]Lu-DOTA-TATE and 8 tandem [90Y]Y/[¹77Lu]Lu-DOTA-TATE. At a median follow-up of 54 months, median PFS and OS were 16.0 months (95% CI: 11.2-20.8) and 62.0 months (95% CI: 30.7-93.3), respectively. PFS was longer in patients with high SSTR uptake (34vs16 months; p=0.021) and, in unadjusted exploratory analyses, in those treated with tandem therapy (34vs16 months; p=0.037). OS differed significantly by histology and by prior chemotherapy, while FDG-avid disease was associated with shorter PFS and OS. However, these subgroup comparisons are based on a very small sample and should be regarded as exploratory and interpreted with caution. Treatment was generally well tolerated, with hematologic toxicity being the most common.
    Conclusions: RLT demonstrated signals of clinically meaningful activity and an acceptable safety profile in patients with advanced LNETs in this small retrospective cohort. Outcomes were numerically more favorable in individuals with high SSTR uptake and in those treated with tandem therapy, but the study was not designed to compare treatment regimens. These exploratory findings should be regarded as hypothesis-generating only and do not provide evidence of comparative efficacy.
    Keywords:  177-Lu; 90-Y; NEN; NET; RLT; lung neuroendocrine neoplasms; lung neuroendocrine tumors; outcomes
    DOI:  https://doi.org/10.3389/fendo.2026.1738286
  10. Eur J Nucl Med Mol Imaging. 2026 Feb 14.
      Peptide receptor radionuclide therapy (PRRT) has established itself as a pivotal component in the management of advanced, somatostatin receptor (SSTR)-positive neuroendocrine tumours (NETs). The NETTER-1 phase III trial demonstrated that [177Lu]Lu-DOTATATE significantly prolongs progression-free survival (PFS) and improves quality of life in patients with midgut NETs refractory to somatostatin analogues, leading to regulatory approval by both EMA (2017) and FDA (2018). The recent NETTER-2 phase III trial further extended these findings by supporting the first-line use of PRRT in Grade 2 and 3 gastroentero-pancreatic (GEP)-NETs (Ki-67 ≥ 10 ≤ 55%). Beyond standard β-emitting therapy, several developments are reshaping the field: the clinical adoption of SSTR antagonists such as radiolabelled JR-11 and LM3, targeted α-particle-emitting therapies (225Ac, 212Pb, 213Bi) for resistant disease, and rational combination strategies with chemotherapy, DNA-repair inhibitors, and immunotherapy. Parallel innovation in radiopharmaceutical chemistry has yielded new peptide ligands, including cholecystokinin-2 receptor (CCK2R)-targeted compounds such as DOTA-MGS5, which show promise for rare NETs such as medullary thyroid carcinoma (MTC) and small-cell lung cancer (SCLC). This review summarises clinical evidence, translational advances, and future perspectives for PRRT as a cornerstone of precision nuclear oncology. Emphasis is placed on expanding indications, integrating α-emitters, improving safety and dosimetry, and developing novel theragnostic ligands that enable personalised treatment strategies for NETs patients.
    Keywords:  CCK2 receptor; Combination therapy; Neuroendocrine tumour; Peptide receptor radionuclide therapy; SSTR antagonist; Targeted alpha therapy
    DOI:  https://doi.org/10.1007/s00259-025-07750-w
  11. Nat Commun. 2026 Feb 10.
      Small-cell lung cancer (SCLC) is the most lethal type of lung cancer. Paradoxically, this tumor displays a high mutation burden; however, a modest response to immunotherapy. Improving Immunotherapy response in SCLC patients remains an unmet need. Here, we report that across 24 tumor types, including over 179,000 real-world patient tumors, SCLC has the highest expression of nonhomologous end joining (NHEJ) DNA repair regulator PRKDC (DNAPKcs). High PRKDC expression predicts poor response to immunotherapy in SCLC. DNAPKcs depletion causes activation of cGAS/STING pathway due to cytoplasmic accumulation of double-stranded DNA, inducing immunogenicity and enhancing sensitivity of SCLC models to immunotherapy. Analyses in SCLC cell lines and mouse models shows that depletion of DNAPKcs leads to proteasomal degradation of MYC via GSK3β pathway. We show that DNAPKcs upregulation contributes to immunotherapy resistance and DNAPKcs inhibition represents a promising therapeutic strategy to induce antitumor immunity and potentiate immunotherapy efficacy in immunologically suppressed SCLC.
    DOI:  https://doi.org/10.1038/s41467-026-69262-x
  12. Eur Urol Oncol. 2026 Feb 10. pii: S2588-9311(26)00032-5. [Epub ahead of print]
       BACKGROUND AND OBJECTIVE: Aggressive-variant prostate cancer (AVPC) is an umbrella term that encompasses clinically defined AVPC (c-AVPC), molecularly defined AVPC (m-AVPC), and treatment-related neuroendocrine PC (t-NEPC), which represent a spectrum of metastatic castration-resistant PC phenotypes with poor clinical outcomes. Despite its clinical relevance, AVPC definitions remain heterogeneous and treatment guidelines are lacking. Our aim was to elucidate AVPC prognosis and treatment responsiveness across definitions.
    METHODS: We conducted a systematic literature search of PubMed, Embase, and Scopus up to September 15, 2025. Our meta-analysis included studies reporting survival outcomes and treatment responses for patients with AVPC.
    KEY FINDINGS AND LIMITATIONS: From 1518 records, 40 studies (including 10 abstracts) were analyzed. In comparison to non-AVPC, c-AVPC/m-AVPC was associated with shorter progression-free survival (PFS; hazard ratio [HR] 2.72, 95% confidence interval [CI] 1.54-4.81; I2 = 0%) and overall survival (OS; HR 2.81, 95% CI 1.87-4.22; I2 = 36%). Platinum-based chemotherapy (PBC) outperformed non-platinum regimens, with higher objective response rates in the overall AVPC cohort (46% vs 19%; p < 0.01) and in the c-AVPC/m-AVPC (41% vs 16%; p = 0.04) and t-NEPC (49% vs 22%; p < 0.01) subgroups. In c-AVPC/m-AVPC, PBC was associated with longer PFS (HR 0.39, 95% CI 0.24-0.62; I2 = 0%) and OS (HR 0.40, 95% CI 0.23-0.68; I2 = 0%) according to evidence from mixed-design studies. For t-NEPC, data were insufficient for meta-analytic comparison of PFS and OS by PBC use.
    CONCLUSIONS AND CLINICAL IMPLICATIONS: AVPC encompasses distinct subsets of advanced PC that are associated with higher risk of progression and death on standard PC therapies. Platinum-based chemotherapy was associated with better response rates across AVPC subtypes and appears to confer a survival benefit in c-AVPC and m-AVPC. Future studies should focus on molecularly informed classification frameworks that include genomics, histology, and advanced imaging to optimize patient stratification and guide targeted therapies.
    Keywords:  Aggressive-variant prostate cancer; Meta-analysis; Neuroendocrine prostate cancer; Predictive; Prostate carcinoma; Small-cell carcinoma; Survival; Systematic review
    DOI:  https://doi.org/10.1016/j.euo.2026.01.011
  13. J Coll Physicians Surg Pak. 2026 Feb;36(2): 186-193
       OBJECTIVE: To identify biomarkers capable of specifically diagnosing small cell lung cancer (SCLC).
    STUDY DESIGN: A descriptive study. Place and Duration of the Study: The Eighth Medical Centre of Chinese PLA General Hospital, Beijing, China, from January 2024 to December 2024.
    METHODOLOGY: This study included 196 lung cancer (LC) patients (70 with lung adenocarcinoma [LUAD], 56 with lung squamous cell carcinoma [LUSC], and 70 with SCLC), along with 33 patients with inflammatory pseudotumours, who served as healthy controls (HCs). Tissue samples from the included subjects underwent qRT-PCR and immunohistochemistry. Diagnostic performance was assessed using receiver operating characteristic (ROC) curves, while the Kaplan-Meier analysis was used to generate overall survival (OS) curves.
    RESULTS: Mixed Lineage Kinase Domain-Like Protein (MLKL) and Receptor-Interacting Protein Kinase 1 (RIPK1) genes exhibited significantly lower expression in SCLC cases compared to both the LUAD and LUSC groups. ROC curve analysis revealed that MLKL, but not RIPK1, effectively distinguished SCLC from both LUAD and LUSC. Furthermore, SCLC patients with high MLKL expression had a poorer prognosis, whereas no significant correlation between MLKL levels and prognosis was observed in the LUAD or LUSC groups. Additionally, MLKL expression showed specific correlations with SCLC-Y subtypes.
    CONCLUSION: MLKL, associated with necroptosis, plays a crucial role in SCLC progression and may serve as a potential prognostic biomarker.
    KEY WORDS: Necroptosis, SCLC, Prognosis, Immune checkpoint.
    DOI:  https://doi.org/10.29271/jcpsp.2026.02.186
  14. J Neuroendocrinol. 2026 Feb;38(2): e70137
      Neuroendocrine neoplasms are a rare and complex tumor entity, among which pancreatic neuroendocrine neoplasms generally display a more aggressive behavior. Despite a notable stage migration towards lower stages at initial diagnosis, the incidence of pancreatic neuroendocrine neoplasms is rising. In recent publications, iodine concentration derived from dual energy computed tomography was explored as a potential biomarker for pancreatic neuroendocrine neoplasia tumor grade and Ki67. However, methodologies exhibited significant variability, and reported outcomes were ambiguous, ranging from weak correlations to strong predictive performance in complex multivariate analyses. With the advent of photon counting computed tomography and improved technical capabilities, this study revisits the topic and aims to provide evidence for tumor characterization using photon counting computed tomography-derived iodine concentration in pancreatic neuroendocrine neoplasms. Iodine concentration in neuroendocrine pancreatic primaries was analyzed in the portal venous phase regarding correlation with histopathological tumor grade and Ki67. Iodine concentration was normalized to aortic iodine concentration (normalized iodine concentration), as well as calculated relative to unaffected pancreatic tissue (relative iodine concentration). Correlations were analyzed using Spearman's rank correlation, and mean concentrations were analyzed using Mann-Whitney U test. Eighteen cases with pancreatic neuroendocrine neoplasms were included. Relative Iodine concentration exhibited a strong and statistically significant correlation with tumor grade (ρ = 0.54, p = 0.02) and Ki67 (ρ = 0.53, p = 0.02). Mean relative iodine concentration was higher in high-grade tumors (p = 0.02). Normalized iodine concentration showed weak, non-significant correlations with tumor grade (ρ = 0.33, p = 0.18) and Ki67 (ρ = 0.30, p = 0.22). Mean normalized iodine concentration did not differ significantly between low-grade and high-grade pancreatic NEN. Our preliminary results show that photon counting computed tomography derived iodine concentration and especially relative iodine concentration is a potential biomarker for tumor grade and Ki67 prediction with strong, statistically significant correlations in untreated pancreatic neuroendocrine neoplasms. The method is non-invasive, requires little to no additional resources and may support early, evidence-based therapeutic decisions even before primary tumor biopsy.
    Keywords:  Ki67; neuroendocrine tumors; photon counting computed tomography
    DOI:  https://doi.org/10.1111/jne.70137
  15. Lung Cancer. 2026 Feb 04. pii: S0169-5002(26)00045-0. [Epub ahead of print]214 109301
       BACKGROUND: Lineage transformation from lung adenocarcinoma (LUAD) to small cell lung cancer (SCLC) represents a rare yet well-documented off-target mechanism associated with acquired resistance to tyrosine kinase inhibitors (TKIs). However, the relationship between this transformation and morphological changes remains inadequately understood. This study seeks to elucidate the molecular mechanisms by which RB1 depletion facilitates lineage transformation, with a particular emphasis on its role in morphological alterations.
    METHODS: Integrated molecular, morphological, and structural analyses were conducted in RB1-deficient LUAD models in vitro and in vivo. Functional perturbation and pharmacological inhibition of RB1-associated regulators were further performed to delineate the mechanism of the RB1/E2F1/HDAC1 axis.
    RESULTS: Patients with LUAD exhibiting low expression levels of TP53 and RB1 exhibited enhanced tumor invasion characteristics and a poor clinical prognosis. Our findings demonstrated that RB1 depletion induced epithelial-mesenchymal transition (EMT) characteristics in LUAD cells, as evidenced by spindle-shaped morphology, increased vimentin expression, and decreased E-cadherin expression. Furthermore, RB1 loss is responsible for nuclear abnormalities, including irregular distribution of nuclear hallmarks such as lamin A/C and emerin, which contribute to tumor aggressiveness. Through the downregulation of individual components of the RB1/E2F1/HDAC1 complex, we identified HDAC1 as a key regulatory factor influencing lamin A/C modification and nuclear deformation. Pharmacological inhibition of HDAC1 derivatives ameliorates the nuclear abnormalities observed in RB1-depleted lung cancer cells, suggesting a potential therapeutic strategy. Mechanistically, the loss of acetylated lamin A/C leads to its degradation and granular distribution, resulting in compromised nuclear mechanostability and defective cytoskeletal dynamics, which may elucidate the observed EMT.
    CONCLUSIONS: Collectively, our findings suggested that the downregulation of RB1 significantly influences the morphology of LUAD by facilitating EMT and nuclear abnormalities through HDAC1-mediated deacetylation of lamin A/C. Future research should prioritize the development of targeted therapies aimed at restoring RB1 function or inhibiting HDAC1 to mitigate cancer progression, thereby enhancing patient stratification and treatment strategies in TKI-resistant LUAD.
    Keywords:  HDAC1; Histologic transformation; Lamin; Lung adenocarcinoma; Nuclear envelope
    DOI:  https://doi.org/10.1016/j.lungcan.2026.109301
  16. Future Oncol. 2026 Feb 10. 1-11
       BACKGROUND: Small cell lung cancer (SCLC) is an aggressive malignancy with limited treatment options. While surgery is increasingly considered for early-stage disease, its prognostic implications remain poorly characterized, and validated predictive tools are lacking.
    METHODS: This retrospective study analyzed 7718 patients from the SEER database and 237 patients from Tianjin Medical University General Hospital. Clinical variables including surgical approach, TNM stage, and adjuvant therapies were evaluated. Prognostic factors were identified through Cox regression, and a nomogram was developed from SEER data with external validation in the independent cohort.
    RESULTS: Surgical resection was associated with improved survival in stage I-IIIA patients but showed no benefit in stage IIIB-IV disease. Multivariate analysis identified TNM stage, lobectomy (versus sublobar resection), and postoperative chemotherapy as independent prognostic factors. The nomogram demonstrated strong predictive performance, with 1-, 3-, and 5-year AUC values of 0.871/0.727/0.725 in the development cohort and 0.775/0.744/0.723 in the validation cohort.
    CONCLUSIONS: Our findings support surgical consideration for early-stage SCLC and provide a validated prognostic tool for clinical decision-making. The nomogram incorporating TNM stage, surgical extent, and adjuvant therapy effectively predicts survival outcomes, offering practical guidance for treatment planning.
    Keywords:  Small cell lung cancer; prognostic model; surgical treatment; survival analysis; survival prediction
    DOI:  https://doi.org/10.1080/14796694.2026.2628109