BACKGROUND:Delirium is a common and distressing complication in terminally ill patients with advanced cancer, often impairing communication and decision-making, and diminishing the quality of the remaining life. Effective symptom management is essential; however, current clinical guidelines offer limited recommendations, and supporting evidence remains insufficient. OBJECTIVES:This scoping review systematically mapped the existing literature on pharmacological and nonpharmacological interventions for delirium symptom management in terminally ill patients with cancer and identified gaps in the evidence base. METHODS:Following the framework proposed by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines, we conducted a comprehensive literature search of PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Ichushi-Web of the Japan Medical Abstract Society for studies published up to August 31, 2023. Subsequently, two updated searches were conducted using the same procedure with the first covering studies published between September 1, 2023, and September 30, 2024, and the second covering studies published between October 1, 2024, and September 30, 2025. Eligible studies evaluated interventions for delirium in adults with terminal cancer with a life expectancy of one month or less. Two reviewers independently screened the studies for inclusion. RESULTS:Of the 1640 articles identified, seven met the inclusion criteria including four randomized controlled trials on pharmacologic interventions, one randomized controlled trial on hydration, and two observational studies on opioid switching. All studies targeted terminally ill patients with advanced cancer and assessed the outcomes related to delirium symptom relief. CONCLUSIONS:This review revealed that the literature addressing delirium symptom management in terminally ill patients with cancer is limited and heterogeneous. Further research is warranted to strengthen the evidence base and to inform clinical practice guidelines for the care of this vulnerable population.
This Consensus Statement outlines management for nursing care-dependent older adults (Categories 3-4). Key principles include prioritizing QOL over strict BP targets, avoiding reduction of SBP < 120 mmHg, and implementing stepwise deprescribing. It also emphasizes safety protocols during bathing and rehabilitation to prevent adverse event.
Abstract Introduction: Petosemtamab, a bispecific antibody targeting LGR5 (Leucine-rich repeat-containing G-protein coupled receptor 5) and EGFR, is under clinical development. Wnt-driven LGR5, a stem cell-associated marker, stabilizes EGFR by preventing lysosomal degradation, thereby promoting cancer cell survival. However, its role in lung squamous cell carcinoma (LUSC) remains unclear. This study evaluates the impact of LGR5 expression on clinical characteristics, genomic alterations, and therapeutic outcomes in LUSC. Methods: Using the LC-SCRUM-Asia clinico-genomic database, mRNA levels of LGR5, EGFR, and other genes were assessed via the AMOY Master Panel. High LGR5 was defined as above the median. Clinical, genomic characteristics, and treatment outcomes were compared between high and low LGR5 groups. Results: LGR5 expression was evaluated in 233 LUSC patients between June 2021 and February 2022. The median LGR5 expression was 0.02 FPKM (range: 0.00-5.44), and the median EGFR expression was 12.09 FPKM (range: 0.07-572.49). No correlation was observed between LGR5 and EGFR expression (Pearson r = -0.0387, P = 0.687). Clinical characteristics, including age, sex, smoking history, ECOG-PS, and clinical stage, did not differ significantly between high and low LGR5 groups. The prevalence of driver gene alterations (KRAS mutation: 6 vs. 3, EGFR mutation: 2 vs. 4, MET ex14 skipping: 2 vs. 4, ALK fusion: 3 vs. 1) also showed no significant differences (P = 0.816). Among 103 patients receiving first-line ICI with or without chemotherapy, the median PFS was 8.0 months in the high LGR5 group and 5.6 months in the low LGR5 group (HR = 0.91, 95% CI: 0.58-1.44, P = 0.570). In 90 patients treated with first-line platinum-based chemotherapy, the median PFS was 5.5 months in the high LGR5 group and 4.3 months in the low LGR5 group (HR = 0.99, 95% CI: 0.52-1.91, P = 0.985). Wnt (P-weighted Log2FC = 0.753), Hedgehog (P-weighted Log2FC = 0.877), and Notch (P-weighted Log2FC = 0.564) pathways, key regulators of stem cell function, were significantly upregulated in the high LGR5 group (all P < 0.05). Conclusion: High LGR5 expression does not define a clinically or genomically distinct subgroup of LUSC; however, it is associated with a transcriptionally stemness-activated phenotype characterized by upregulation of Wnt, Hedgehog, and Notch pathways. These findings suggest that LGR5-high LUSC represents a biologically distinct subtype that may inform future development of LGR5×EGFR-targeted therapies. Citation Format: Yu Tanaka, Shuji Murakami, Kazumi Nishino, Motoko Tachihara, Ichiro Nakachi, Mayu Kawakami, Satoshi Hara, hitomi Aono, Shoichi Kuyama, Gaku Yamamoto, Eri Sugiyama, Tetsuya Sakai, Hiroki Izumi, Shigeki Umemura, HIBIKI UDAGAWA, Yoshitaka Zenke, Shingo Matsumoto, Kiyotaka Yoh, Koichi Goto. Clinical, genomic, and therapeutic outcomes of lung squamous cell carcinoma with high LGR5 expression : A study from the LC-SCRUM-Asia database [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 7919.
Long-term nucleos(t)ide analog (NUC) treatment improves the outcomes of patients with chronic hepatitis B virus (HBV) infection. However, only a limited number of patients treated with NUC can achieve hepatitis B surface antigen (HBsAg) seroclearance, the so-called “functional cure.” However, it remains unclear how on-treatment viral factors affect HBsAg seroclearance during long-term NUC treatment. We aimed to investigate whether the baseline and on-treatment HBV markers can predict HBsAg seroclearance and reduction in patients treated with long-term NUC treatment. This study included two independent cohorts consisting of 843 patients in the derivation cohort and 1781 patients in the validation cohort. HBsAg seroclearance was infrequent (3.7–6.2
