The London Clinic is a private healthcare organisation and registered charity based on the corner of Devonshire Place and Marylebone Road in central London. According to HealthInvestor, it is one of England's largest private hospitals.
e15576 Background: Tertiary lymphoid structures (TLSs) and histopathological growth pattern (HGP) are potential prognostic histological features of cancer. We investigated their prognostic value in patients with colorectal cancer liver metastases (CRCLM). Methods: 133 patients with CRCLM treated by surgical resection from two cancer centres were categorized into desmoplastic (d) and non-desmoplastic (nd) HGP cohorts along with presence/absence of TLS (+/-). Multiplex immunohistochemical staining using 13 immune cell markers was used to determine the cellular composition and spatial distribution of TLSs. Results: Patients with CRCLM demonstrating dHGP (n = 54) had improved overall survival compared to patients with ndHGP (n = 79) (Hazard ratio (HR) = 0.53 (0.29-0.93), p = 0.034, log-rank test). Similarly, patients with TLS+ CRCLM (n = 65) showed improved survival compared to those with TLS- CRCLM (n = 68) (HR = 0.51 (0.29-0.90), p = 0.04). On assessment of four patient groups (dHGP/ TLS+ (n = 28), dHGP/ TLS- (n = 26), ndHGP/TLS+ (n = 37), ndHGP/ TLS-(n = 42), there was added prognostic value with absence of both dHGP and TLS having worse prognosis (p = 0.05, chi-square = 7.67, df = 3). Further analysis to interrogate TLS maturation and activity along with spatial distribution is underway to understand their prognostic impact. Conclusions: The presence of HGP and TLS individually have prognostic value with added benefit of combining the two parameters. Further evaluation is underway to assess the underlying biological mechanisms.
IntroductionThe integration of genomics, proteomics, and artificial intelligence (AI) is shaping the approach to personalized skincare and aesthetic dermatology, moving from generalized protocols toward precision-based interventions.ObjectiveTo systematically review the emerging field of cosmetogenomics, focusing on how AI and multi-omics technologies are enabling personalized dermatologic treatments, and to critically evaluate the strength, scope, and limitations of current evidence.MethodsWe conducted a systematic review in accordance with PRISMA 2020 guidelines. PubMed, Scopus, and Embase databases were searched for articles from January 2012 to April 2025 using Boolean combinations of terms including [“cosmetogenomics” OR “AI in dermatology” OR “personalized skincare” OR “multi-omics dermatology”] AND [“SNP” OR “genomics” OR “proteomics”]. Eligible studies included peer-reviewed clinical or ex vivo research involving human subjects and reporting measurable dermatologic outcomes related to genomics, single nucleotide polymorphisms (SNPs), AI tools, or proteomics. Study quality was assessed using the JAMA Users’ Guides to the Medical Literature quality scheme.ResultsFrom 403 screened articles, 74 met inclusion criteria. Of these, 22 were randomized controlled trials (RCTs, Level I evidence), 35 observational studies (Level II), and 17 conceptual or expert opinion papers (Level III). AI and genomics were found to enhance skincare personalization by identifying SNPs associated with collagen degradation, oxidative stress, and inflammation. AI-powered platforms integrate these insights with imaging, lifestyle data, and digital twins to optimize interventions ranging from topical regimens to laser and injectable treatments. However, a significant proportion of studies were exploratory, with limited geographic diversity and underrepresentation of darker skin phototypes. No quantitative synthesis (meta-analysis) was performed due to heterogeneity in outcome measures, though hydration, elasticity, and pigmentation outcomes may permit such analysis in future work.ConclusionAI-driven cosmetogenomics is advancing dermatology into a predictive, personalized era. While the evidence base is expanding, clinical translation requires stronger validation, ethical safeguards, and regulatory oversight. This field holds significant promise for enhancing treatment efficacy, patient satisfaction, and long-term skin health. Broader validation, greater diversity in study populations, more transparent methodologies, and expanded ethical safeguards, including genetic discrimination risks, data ownership, and cross-border data transfer, are necessary before widespread clinical integration.
Background and purpose: Robustness evaluation (RE) is vital for proton treatment planning, but lacks international consensus or guidelines, with clinics using varied, self-developed methods focused on selected uncertainties. This ESTRO project surveys expert opinions on clinical RE methods to inform future treatment planning system (TPS) development. Materials and methods: A study within the European Particle Therapy Network (EPTN) involved 24 European proton therapy centres, with one radiation oncologist and one medical physicist per centre. The goal was to reach a consensus on transitioning from Planning Target Volume (PTV)-based planning to robustly optimized planning, including uncertainties, methods, and reporting of robustness evaluations. An internal committee drafted 39 statements, reviewed by an independent committee. Following a two-round Delphi procedure, consensus was set at a 75% agreement threshold. Results: Twenty of 24 contacted centers (83.0%) responded to both questionnaire rounds. Consensus was reached on 26 of 39 statements (66.7%), with 5 being high-priority. Strong agreement emerged regarding which uncertainties to include in RE (range, setup, intra-fraction, anatomy changes), methodologies (e.g., for moving targets, combining setup and range), and how to report RE results clinically. Disagreement was found on using the PTV for both planning and dose reporting. The results also offer important implications for TPS vendors and future software development. Conclusions: The ESTRO Delphi consensus may serve as practical guidance on points where a clear consensus was achieved. For remaining points, the development of guidelines is recommended to standardize methodologies and reporting. Furthermore, TPS vendors are encouraged to align their developments with the community’s articulated requirements.
