For Tumor Marker Prognostic Studies) criteria still regarded as the gold standard

The gap

Evidence profile

Sourced from the future work and recommendations of the source papers, classified as general, spanning 4 journals. Those papers have been cited 14 times in total.

Supporting evidence — 5 representative gaps

• Omission of Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: Expanding Evidence in Clinically Node-Negative and Neoadjuvant Therapy Responders (2026) · World Journal of Oncology · doi

  Deimplementation strategies Several strategies have been proposed to support omission of SLNB. These include prediction nomograms, cost-focused analyses, provider targeted de-implementation interventions, natural language models, alternative imaging approaches, and tumor genomic profiling. Multiple institutions have developed nomograms to esti- mate the probability of nodal metastasis. The Memorial Sloan Kettering Cancer Center externally validated model incorpo- rates age, tumor size, type, location, multifocality, lympho- vascular invasion, and ER/PR status, achieving an area under the curve (AUC) of 0.754 [61]. University of Texas MD An- derson Cancer Center’s externally validated tool uses similar variables, in addition to triple-negative status [62]. Welsh et al [46] identified a low-risk cohort—grade 1, cT1mi–T1c (≤ 2 cm), or grade 2, clinical T1mi–T1b (≤ 1 cm)—with pathologic nodal positivity rate of 7.8%, compared to 22.3% in higher- Articles © The authors | Journal compilation © World J Oncol and Elmer Press Inc™ | https://wjon.elmerpub.com 301 SLNB Omission in Early-Stage Breast Cancer World J Oncol. 2026;17(3):292-309 l a n o i t n e v n o c ( R B W T S A N - t s o P - e m t n a t s i d , S O r a e y - 5 r a e y - 5 4 6 4 = N , 3 – 1 T c h t i w d l o s r a e y 0 2 ≥ n e m o W - c a r f o p y h , d e b r o m u t p o - e r p d n a - e s a e s i d l a n o i g e r o c o l s i n e m i g e r d e t a n o i t n o i s n e t x e , d e w o l l a s i s t n e g n a t h g i h d l e i f n o i t a i d a r f o o t d e d n e m m o c e r t o n o t r o i r p S U d n a T S A N y r e g r u s y r a l l i x a l a r e t a l i s p i , e t a r e c n e r r u c e r y c a r u c c a c i t s o n g a i d s d o h t e m g n i g a m i f o y r a l l i x a , S F R A , l a v i v r u s e e r f / T C T E P - G D F d e i f i c e p s t o N - l i x a p o - e r P d n a S U y r a l , S F D , S O , S F R r a e y - 5 s e m o c t u o L O Q d n a ) d e t a n o i t c a r f o p y h r o g n i d u l c n i I N R h t i w I I d n a I l e v e l y r a l l i x a , m a r g o m I R M , S U l a n o i t n e v n o c ( R B W - m a m t s a e r B l a r e t a l i s p i d n a e c n e r - r u c e r r o m u t t s a e r b e c n e r r u c e r y r a l l i x a l a r e t a l i s p i r a e y - 5 t n a t s i d , s l a v r e t n i e e r f s i s a t s a t e m , S O , S S C B , l a v i v r u s , l a v i v r u s e e r f r e c n a c t s a e r b l a r e t a l a r t n o c - d a , s e t a r n o i t a r e p o - e r L O Q d n a , s t n e v e e s r e v - r u c e r y r a l e e r f e c n e r l a v i v r u s e c n e r r u c e r y r a l l i x a r a e y - 5 e e r f e c n e r l a v i v r u s r a e y - 5 - r u c e r h t i w R B W 1 N c f i ; m r a l e v e l , s t n e g n a t d r a d n a t s I N R r o , s t n e g n a t h g i h ,

  generalfuture work
  Keywords: cancer strategies omission slnb nomograms tumor nodal center externally validated status grade world oncol deimplementation
• Mechanism-Driven Diagnostic Development: A Specimen-Aware Framework Illustrated by Colorectal Cancer and Solid Tumours (2026) · Cancers · doi

  The next generation of cancer profiling should be defined less by the expansion of biomarker candidates and more by the construction of mechanistically coherent compos- ite signatures [1,6,12,15,17,29,47]. In practice, panels that deliberately combine tumour intrinsic biomarkers with host response and microbial communities facilitate a contextual understanding of the fundamental biology within pathogenesis. Moreover, further consid- erations should be placed on the sampling strategies selected and how the results generated are supported by anatomical and biological credibility, while model training and analytics, should be applied to a clinically relevant question, to ensure the highest utility is achieved. Equally, progress in translation will depend on moving multiomic analysis from retrospective explanation to prospective intervention. Biomarker validation studies that measure stage shift, treatment selection efficiency, time to diagnosis, over-treatment, under- treatment, patient acceptability, and survival, will allow further applications beyond ana- lytical validity [51,52]. The strongest future candidates are likely to be those that integrate high signal analytes, such as methylation or fragmentomics, with a broader understanding of regulated pathway activity and its linkage to the microenvironment, in a tissue-relevant matrix [4,5,9–12,15,29–31,43,44,47,50]. https://doi.org/10.3390/cancers18172766 C: ·;;; ..0 I <.."'...r:; 0.. (.) .. .r:; 0.. • • 0 • 0 • 0 0 Translational pipeline for mechanism-driven profiling Clinical question defined screening· triage • diagnosis • targetability • MRO Specimen strategy selected tissue • plasma • CSF • urine • stool • rectal mucus • other local fluid Pre-analytical design collection-device • lube chemistry • transport • timing • stabilisation contamination control l Assay selection mutation • methylation • fragmentomics • cfRNA microbiome • protein/pathway Analytical QC yield • coverage • conversion • fragment size • negative controls • replicate concordance Bioinformatics & integration feature selection • deconvolution site inference • explainable Al orthogonal confirmation 1 Biological interpretation driver architecture • cell of origin • immune state • host-microbe ecology shedding dynamics • Clinical report with actionability tiering positive/negative -probable site -targetable alteration -residual-disease signal Pathway execution confirmatory imaging/endoscopy/biopsy • MDT review • treatment selection surveillance plan l Implementation evaluation time to diagnosis • co(onoscopy avoided or triggered -stage shift -harms cost-effectiveness • equity Prospective validation & regulation FDA/NCI-style benefit -risk evidence • post-market learning • reimbursement Cancers 2026, 18, 2766 15 of 18 The general principles that are likely to remain stable are that specimens are not biologi- cally interchangeable, clinical utility is pathway-dependent, and additional molecular layers require justification. Specific assays, effect sizes, and early performance estimates are likely to change as technologies and datasets mature, findings are recapitulated/reinterpreted, and prospective trials are reported.

  generalfuture work
  Keywords: treatment selection pathway prospective diagnosis likely clinical profiling defined biomarker candidates host understanding further selected
• Emerging technologies and current challenges in intratumoral microbiota research (2026) · Frontiers in Cellular and Infection Microbiology · cited 14× · doi

  9.1 From description to mechanism and targeted intervention data ecosystems, will shape the future of intratumoral microbiome research. To translate microbial findings into applications, we need an open and trustworthy scientific infrastructure that will help advance the field of microbial cancer research and redefine tumor biology. Intratumoral microbiome research is shifting from descriptive profiling and correlative associations toward rigorous mechanistic dissection and precision therapeutics (Wong-Rolle et al., 2021; Boesch et al., 2022; Bahuguna and Dubey, 2023; Chen and Huang, 2024; Wang et al., 2025). Future progress demands experimental systems that establish causality, define molecular pathways of microbial influence on tumor biology and immunity, and enable rational, microbiota-directed interventions.

  generalfuture work
  Keywords: microbial future intratumoral microbiome tumor biology description mechanism targeted intervention ecosystems shape translate ndings applications
• Toward Precision Imaging in Lung NET: A Clinically Oriented Framework Integrating Dual Tracer PET and Radiomics (2026) · Cancers · doi

  Lung NETs are biologically heterogeneous neoplasms requiring a multimodal imaging approach beyond conventional anatomical assessment. Contrast-enhanced CT remains the cornerstone of anatomical staging, while molecular imaging enables non-invasive charac- terization of tumor biology. SSTR PET/CT provides information on receptor expression and supports selection for receptor-targeted therapies, whereas 18F-FDG PET/CT offers complementary information on metabolic activity, heterogeneity, and aggressiveness in selected scenarios. Rather than competing modalities, CT, SSTR PET/CT, and 18F-FDG PET/CT should be considered complementary components of an integrated strategy, improving assessment https://doi.org/10.3390/cancers18193111 Cancers 2026, 18, 3111 13 of 17 of disease extent, biological behavior, prognosis, and treatment selection, and supporting the transition toward precision imaging. Emerging approaches such as radiomics and artificial intelligence may further refine this paradigm by identifying quantitative biomarkers of tumor heterogeneity and indi- vidualized risk, although their application remains investigational. Future prospective multicenter studies should validate these biomarkers, standardize dual-tracer imaging algorithms, and assess their impact on clinically meaningful outcomes. The integration of multimodal imaging, radiomics, and artificial intelligence may increasingly support personalized management of patients with lung NETs. Author Contributions: Conceptualization: A.L.S., D.P. and A.F.; Methodology: A.L.S. and D.P.; Investigation: A.L.S., D.P., E.D., P.P., A.G., G.M.G., R.M., L.C. and R.E.R.; Data Curation: A.L.S. and D.P.; Writing—Original Draft Preparation: A.L.S., D.P., E.D., P.P., A.G., G.M.G., R.M., L.C. and R.E.R.; Writing—Review and Editing: A.L.S., D.P., E.D., P.P., A.G., G.M.G., R.M., L.C., R.E.R., D.C., A.S. and A.F.; Visualization & Supervision: D.C., A.S., A.C. and A.F. The NIKE Group contributed to the scientific discussion and critical revision of the manuscript. All authors have read and agreed to the published version of the manuscript. Funding: This research received no external funding. Data Availability Statement: No new data were created or analyzed in this study. Data sharing is not applicable to this article. Acknowledgments: The Neuroendocrine Tumors Innovation Knowledge and Education (NIKE) project, led by Annamaria Colao and Antongiulio Faggiano, aims to increase knowledge of neuroen- docrine tumors. Conflicts of Interest: No potential commercial conflicts of interest are associated with the NIKE group. The authors declare no conflicts of interest.

  generalfuture work
  Keywords: imaging nike conflicts interest lung nets multimodal anatomical assessment remains tumor sstr information receptor selection
• Revisiting the grand challenges in oral cancers: advances in biomarkers and treatment strategies (2026) · Frontiers in Oral Health · doi

  for Tumor Marker Prognostic Studies) criteria still regarded as the gold standard. Moreover, though these observations are promising, a grand challenge will be to develop a robust panel of validated biomarkers, integrating AI- based analytical approaches, that will accurately predict disease status, therapeutic response and clinical outcome. Therapeutic approaches: current practices and evolving strategies the research extensive treatment,

  generalrecommendations
  Keywords: approaches therapeutic tumor marker prognostic criteria still regarded gold standard though observations promising grand challenge

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