Introduction/Objective: Breast cancer therapy increasingly depends on biomarkers that identify drug sensitivity, acquired resistance, or treatment-related toxicity. Pharmacogenomic information becomes clinically relevant when a molecular result changes drug selection, dose, treatment sequence, or monitoring; consequently, germline and somatic biomarkers are most informative when interpreted within the clinical course of disease, from baseline pathological classification to molecular reassessment after treatment pressure and clonal evolution. This review examines the clinical actionability of germline and somatic biomarkers across this care pathway. Methods: PubMed/MEDLINE was searched for English-language literature published from January 2015 to August 2026, while reference lists of major guidelines and pivotal trials were screened for landmark evidence published before 2015. Targeted searches of ASCO, ESMO, CPIC, U.S. FDA, and publisher sources were additionally used to verify contemporary guidelines, regulatory decisions, companion-diagnostic requirements, approved dosing information, and pivotal clinical trials. Eligible evidence included clinical guidelines, regulatory documents, randomized or prospective studies, large translational cohorts, and highquality reviews directly addressing biomarker-guided treatment, dose modification, toxicity, resistance, or implementation. The evidence was synthesized as a structured narrative review; systematic-review and meta-analytic procedures were not applied. Results: Clinically established applications span ER/PR/HER2-directed treatment selection, germline BRCA1/2-directed PARP inhibition, PIK3CA/AKT1/PTEN-directed pathway inhibition, ESR1-directed endocrine sequencing, and DPYD-guided fluoropyrimidine dose modification. CYP2D6 can inform tamoxifen interpretation when genotype is available, although outcome evidence and clinical uptake remain heterogeneous. In addition, PALB2 has prospective evidence of PARP-inhibitor sensitivity, whereas ATM and CHEK2 do not currently show equivalent predictive value. Liquid biopsy can identify acquired resistance alterations and support longitudinal testing; in contrast, integrated multi-omics, artificial intelligence/ machine learning, and quantitative systems pharmacology remain predominantly investigational. Discussion: These findings support a context-specific approach to biomarker use, with routine implementation constrained by uneven evidence maturity, assay limitations, and access to matched therapies. Investigational approaches require prospective validation before informing prescribing. Conclusion: Clinical pharmacogenomic interpretation depends on the therapeutic question, specimen type, analytical method, strength of evidence, treatment consequence, and timing of reassessment. When these elements are integrated across the disease course, biomarkers with validated prescribing implications can be distinguished from findings that remain context-dependent or exploratory, thereby supporting treatment individualization without overstating molecular associations.
Abstract: Oral drug delivery remains the most preferred route due to its convenience, safety, and high patient compliance. However, conventional dosage forms often fail to provide optimal therapeutic outcomes for drugs with poor bioavailability, narrow absorption windows, pH-dependent solubility, or instability in the intestinal environment. Gastroretentive Drug Delivery Systems (GRDDS) have emerged as an effective strategy to overcome these limitations by prolonging gastric residence time and enabling controlled, site-specific drug release in the upper gastrointestinal tract. This review highlights various GRDDS approaches, including floating, mucoadhesive, swelling, high-density, raftforming, and hybrid systems, along with their mechanisms, advantages, and limitations. It also emphasizes the critical role of natural and synthetic polymers in achieving buoyancy, adhesion, swelling, and sustained drug release. Recent advancements in nanotechnology, such as lipid-based nanocarriers, nanoparticles, and stimuli-responsive systems, have further enhanced the efficiency of GRDDS by improving drug solubility, stability, and targeted delivery. Additionally, emerging technologies like 3D and 4D printing offer promising opportunities for developing personalized and intelligent gastroretentive systems with consistent performance. Despite these advancements, challenges related to safety, toxicity, scalability, and regulatory compliance remain. Overall, GRDDS represent a promising and evolving platform for improving oral drug delivery, reducing dosing frequency, and enhancing therapeutic efficacy.
Abstract: Dry eye disease (DED) is a common and multifactorial disorder that adversely affects vision and quality of life. Conventional treatments, such as artificial tears and topical medications, are often limited by poor ocular bioavailability and rapid drug clearance. To overcome these barriers, herbal hydrogel systems have gained attention as innovative drug-delivery platforms. These hydrogels, prepared from natural polymers like hyaluronic acid and chitosan, combine excellent biocompatibility, high water retention, and tunable drug release with the therapeutic benefits of herbal extracts. By enhancing corneal permeability and prolonging ocular residence time, they provide both symptomatic relief and anti-inflammatory or antioxidative effects. Recent advances in smart hydrogels, including temperature-, pH-, and ion-responsive systems, further enable controlled drug release and extended contact with the ocular surface. In addition, applications such as hydrogel-laden contact lenses and biosensor-integrated hydrogels demonstrate their potential for both therapy and real-time monitoring. By mimicking the physiological tear-film environment, these systems enhance comfort, improve treatment efficacy, and may reduce dosing frequency. Future progress in polymer engineering, clinical trials, and clearer regulatory pathways will be essential for clinical translation. Overall, herbal hydrogel systems represent a promising strategy to advance DED management and improve long-term patient outcomes.
Introduction: Deprescribing has emerged as a critical intervention to address polypharmacy-related complications in older adults. This comprehensive review examines the current evidence base, implementation strategies, and future directions for deprescribing in geriatric populations. Objective: To provide a comprehensive overview of deprescribing in older populations by examining its definition, evidence base, potential benefits and risks, implementation strategies, and emerging technologies, including applications of artificial intelligence. Methods: A comprehensive narrative review was conducted using multiple databases, including Embase, Google Scholar, PubMed, and Scopus. Studies reporting deprescribing interventions in older adults, systematic reviews, meta-analyses, and articles addressing implementation barriers were included. References were hand-searched for additional relevant studies. Results and Discussion: Deprescribing interventions demonstrate significant benefits, including reduced adverse drug reactions (ADRs), decreased falls, improved quality of life, and reduced healthcare utilization. Evidence from multiple international studies shows success rates ranging from 67.4% to 96.9% across different clinical settings. However, potential negative effects include withdrawal symptoms, rebound effects, and disease relapse, occurring in approximately 26% of medication cessations. Key implementation facilitators include patient-centred approaches, multidisciplinary collaboration, and structured decision-making tools. Barriers include time constraints, clinician reluctance, and insufficient standardized protocols. Emerging artificial intelligence technologies show promise for personalizing deprescribing recommendations. Conclusion: Successful deprescribing requires coordinated efforts integrating evidencebased protocols, patient-centred care, and multidisciplinary collaboration. Future research should focus on developing standardized methodologies, addressing implementation barriers, and exploring AI-assisted personalized approaches to optimize medication management in older adults.
Abstract: For many generations, people have used Dracaena sanderiana to treat various health conditions; however, much of this knowledge has been passed down through oral narratives rather than documented records. This review aimed to compile relevant information on the phytochemistry and potential pharmacological effects of D. sanderiana and to validate the relationship between traditional claims and modern scientific evidence. Earlier findings indicated that this plant species likely possesses diverse chemical constituents, particularly secondary metabolites. Studies have identified diverse secondary metabolites, including phenolic compounds, flavonoids, terpenoids, saponins, and fatty acids. Experimental investigations have reported promising antioxidant activity and plausible anti-inflammatory, antibacterial, and cytoprotective properties, although all these studies remain preliminary. This review also emphasised that computational approaches, such as molecular docking, can be used to evaluate the drug-development potential of D. sanderiana-derived phytochemicals identified through experimental and preclinical studies. Despite these advances, several challenges remain, as the proportions and quality of active constituents in this plant species may vary considerably depending on growing habitats, cultivation, and post-harvest processing conditions. In general, D. sanderiana represents an interesting case in which traditional use has overtaken scientific validation. Respecting indigenous knowledge while also conducting thorough pharmacological research and computational screening may help determine whether this ubiquitous houseplant has real medicinal potential or is just a cultural curiosity.
