Jue Wang

First case report of lorlatinib in the treatment of ALK-fusion-positive lung adenocarcinoma with ovarian metastasis: Clinicopathological and molecular characterization

Background: Ovarian metastasis from anaplastic lymphoma kinase (ALK)-positive lung adenocarcinoma is exceedingly rare. Reporting such cases is vital for understanding its clinical management. Patient concerns: A 49-year-old woman presented with a 10-day history of amenorrhea and lower abdominal pain. Diagnoses: Imaging revealed bilateral ovarian masses and liver nodules. Liver biopsy and genetic testing confirmed the diagnosis of stage IV EML4-ALK fusion-positive lung adenocarcinoma with ovarian and hepatic metastases. Interventions: First-line treatment with the third-generation ALK inhibitor lorlatinib (100 mg, once daily) was initiated. Outcomes: The patient achieved a partial response with significant lesion regression and normalized tumor markers, sustained for over 12 months. No severe adverse events occurred. Lessons: This case underscores the importance of molecular profiling in diagnosing metastatic tumors and confirms lorlatinib as a highly effective first-line therapy for ALK-positive non-small cell lung cancer with atypical metastases.

Machine Learning for Preoperative Assessment and Postoperative Prediction in Cervical Cancer: Multicenter Retrospective Model Integrating MRI and Clinicopathological Data

Abstract Background Machine learning (ML) has been increasingly applied to cervical cancer (CC) research. However, few studies have combined both clinical parameters and imaging data. At the same time, there remains an urgent need for more robust and accurate preoperative assessment of parametrial invasion and lymph node metastasis, as well as postoperative prognosis prediction. Objective The objective of this study is to develop an integrated ML model combining clinicopathological variables and magnetic resonance image features for (1) preoperative parametrial invasion and lymph node metastasis detection and (2) postoperative recurrence and survival prediction. Methods Retrospective data from 250 patients with CC (2014‐2022; 2 tertiary hospitals) were analyzed. Variables were assessed for their predictive value regarding parametrial invasion, lymph node metastasis, survival, and recurrence using 7 ML models: K-nearest neighbor (KNN), support vector machine, decision tree, random forest (RF), balanced RF, weighted DT, and weighted KNN. Performance was assessed via 5-fold cross-validation using accuracy, sensitivity, specificity, precision, F1-score, and area under the receiver operating characteristic curve (AUC). The optimal models were deployed in an artificial intelligence–assisted contouring and prognosis prediction system. Results Among 250 women, there were 11 deaths and 24 recurrences. (1) For preoperative evaluation, the integrated model using balanced RF achieved optimal performance (sensitivity 0.81, specificity 0.85) for parametrial invasion, while weighted KNN achieved the best performance for lymph node metastasis (sensitivity 0.98, AUC 0.72). (2) For postoperative prognosis, weighted KNN also demonstrated high accuracy for recurrence (accuracy 0.94, AUC 0.86) and mortality (accuracy 0.97, AUC 0.77), with relatively balanced sensitivity of 0.80 and 0.33, respectively. (3) An artificial intelligence–assisted contouring and prognosis prediction system was developed to support preoperative evaluation and postoperative prognosis prediction. Conclusions The integration of clinical data and magnetic resonance images provides enhanced diagnostic capability to preoperatively detect parametrial invasion and lymph node metastasis detection and prognostic capability to predict recurrence and mortality for CC, facilitating personalized, precise treatment strategies.