David F. Jarrard

All supplementary Figures and tables.

Background/Objectives: Renal mass biopsy (biopsy) is increasingly incorporated into the evaluation of localized renal masses, yet its role in guiding management remains variable among clinical practices. We evaluated the clinical association of biopsy using a simplified classification system categorizing biopsy results as Biopsy Actionable for Immediate Treatment (BAIT) or Biopsy Actionable for Active Surveillance (BAAS)—assessing how biopsy-derived histology influences real-world management. Methods: We identified all patients undergoing biopsy for a renal mass measuring 2–7 cm at a single academic center between 2010 and 2025. After excluding nondiagnostic biopsies, repeat biopsies, and biopsies performed for metastatic diagnosis, 1395 patients formed the analytic cohort. Histologic subtypes and initial treatment were evaluated. Multivariable logistic regression assessed predictors of (1) radical versus partial nephrectomy, (2) surgery versus thermal ablation, and (3) active surveillance versus intervention, adjusting for tumor diameter, age, and BAIT/BAAS status. Results: Of 1395 patients, 1119 (80.2%) had BAIT pathology and 276 (19.8%) had BAAS pathology. Initial management included surgery (36.3%), thermal ablation (36.3%), active surveillance (24.2%), no treatment (1.7%), and radiation (1.5%). BAAS pathology was strongly associated with the selection of active surveillance (OR 21.80, p < 0.001). Larger tumor diameter was the principal driver of radical nephrectomy (OR 2.04/cm, p < 0.001) and of choosing surgery over ablation (OR 2.05/cm, p < 0.001). Younger age was associated with selection of surgery over ablation (OR 0.93/year, p < 0.001). Biopsy histology showed a stronger association with surveillance selection than either tumor diameter or age. Conclusions: Biopsy provides actionable diagnostic information for patients with 2–7 cm renal masses, identifying benign or indolent pathology in nearly one in five patients. BAIT/BAAS categorization was strongly associated with the selection of active surveillance for renal masses.

Purpose: Circulating tumor cells (CTC) provide a minimally invasive window into metastatic disease and treatment response, but their clinical utility has been constrained by manual, subjective, low-throughput identification in multichannel fluorescence microscopy data. Experimental Design: To address this limitation, we developed and clinically validated the System for Enhanced Evaluation of Tumor Cells (SEE-TC), a deep learning approach for scalable, reproducible phenotyping of individual circulating cells. SEE-TC was developed and evaluated on more than 8.5 million cells from 3,386 blood samples spanning six cancer types, enabling generalization across heterogeneous imaging conditions, staining panels, and acquisition platforms. Results: SEE-TC achieved single-cell segmentation accuracy on par with humans, learned biologically relevant latent cellular representations that correlate with established morphologic and immunofluorescent biomarkers, and reliably distinguished CTCs from background populations without reliance on arbitrary thresholds. When applied longitudinally, SEE-TC provides a quantitative, patient-level readout of CTC burden over time, which was significantly associated with worse overall survival across multiple cancer types. Conclusions: To our knowledge, this is the first fully automated artificial intelligence approach to single-cell segmentation and CTC phenotyping. By transforming CTC analysis from a human-dependent task into a scalable and reproducible digital assay, SEE-TC enables high-fidelity longitudinal monitoring of tumor burden and supports broader clinical deployment of CTC-based liquid biopsies in precision oncology. It is currently being deployed to identify CTCs and quantify target expression for both prognostic and predictive biomarker evaluation in multiple prospective clinical trials on a commercial platform.

One of the most commonly diagnosed malignancies in men worldwide, prostate cancer (PCa) is the subject of much study across various treatment approaches and medical specialties. Currently, 5-year survival rates exceed 90%, and research efforts have increasingly shifted towards approaches that improve quality of life, minimizing the likelihood and severity of morbidities associated with treatment. Focal cryoablation is an approach that has been steadily gaining traction in recent years, both for its reduced risk of morbidity and greater potential for salvage therapy, relative to standard treatment. The goal of this work is to discuss the safety and efficacy of focal cryoablation for prostate cancers and define it in context among other treatment approaches. Publications describing approaches to, results from, and the science behind PCa cryoablation were reviewed and collated, describing the current landscape. Additional comparisons were made against analogous approaches, including radiation, surgical resection, hormone therapy, and other ablation modalities. Currently available literature characterizes prostate cryoablation as an effective and well-tolerated approach for treating primary and recurrent PCa, although the data are limited by heterogeneous evidence, lack of standardized endpoints, and an absence of robust randomized comparisons. Cryoablation for prostate cancer continues to evolve, offering a minimally invasive treatment option for both primary and salvage prostate cancer patients, although additional long-term studies are needed.

MECOM Overexpression CRPC are vulnerable to PARP inhibitors and inhibitors of the DNA repair pathway irrespective of HRR or DDR genes mutation status

MECOM suppression enhances spheroid inhibition and apoptosis

Ranking of Differential Expressed Transcription Factors Related to Figure 1C

PARP inhibitors in combination with enzalutamide suppress MECOM and AR expression, suppress proliferation, and increase apoptosis in enzalutamide-resistant CRPC

MECOM overexpression is associated with treatment resistance