Abstract: AI agents are transforming healthcare by advancing clinical decision support, automatingworkflows, and personalizing patient care. This review categorizes AI agents into four progressivemodels Foundation, Assistant, Partner, and Pioneer each representing increasing autonomy andclinical integration. Central to our contribution is a comprehensive implementation roadmapthat leverages a modular architecture, including perception, reasoning, interaction, and memorycomponents, to enable the seamless integration of these diverse AI agents. By providing actionableguidelines and illustrative architectural examples for deploying each agent type, this paperaddresses critical challenges such as data privacy, interoperability, and regulatory compliance,empowering healthcare organizations to effectively incorporate AI-driven solutions that enhancepatient outcomes and operational efficiency. The roadmap offers a step-by-step blueprint forselecting suitable agent models, integrating with existing systems, and establishing continuousfeedback loops. This contribution serves as a strategic guide for clinicians and IT professionalsto confidently adopt scalable, safe, and compliant AI innovations in complex clinical settings.

Abstract: Current lifestyle brings about increasing prevalence of unhealthy habits that can negatively affect male fertility. Cigarette smoking, alcohol intake, stress, inadequate physical activity, unequilibrated diet leading to obesity, and use of mobile telephones and portable electronic devices can affect male reproductive system through multiple mechanisms. Moreover the modern man is often exposed to environmental factors independent of his will, such as air pollution, exposure to heat or toxicants in his workplace, or the presence of harmful chemicals in food, beverages, agricultural and industrial products, etc. The susceptibility to these factors depends on genetic and epigenetic predisposition, potentially present systemic disease and medication, and local affections of genitourinary system. The multifaceted nature of both the causative factors and the susceptibility background makes the resulting fertility disturbance highly individual and variable among different men exposed to the same conditions. This paper critically reviews current knowledge of different causative and susceptibility factors with a special attention to molecular mechanisms of their action. Finally, strategies for prevention of abnormalities due to lifestyle and environmental factors and available treatment modalities for already present abnormalities are exposed.

Abstract: Since the implementation of the National Health Insurance (NHI) program in 1995, Taiwan has demonstrated outstanding healthcare performance in urban areas. However, remote and island regions face challenges in medical service provision due to transportation difficulties and resource limitations. Since 2019, the Taiwan government has promoted telemedicine, which has proven its advantages during the COVID-19 pandemic. This study examines a telemedicine outpatient program at a rural hospital in southern Taiwan, employing the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method to identify key success factors. By collecting insights from healthcare professionals and policymakers, the findings of this study can serve as a reference for rural healthcare institutions to enhance telemedicine effectiveness, thereby promoting healthcare equity and public health.

Abstract: Background: Intracranial atherosclerotic stenosis (ICAS) is a primary cause of ischemic stroke and understanding its pathogenesis aids in therapeutic decision-making. This study integrates computational fluid dynamics (CFD), CT perfusion (CTP) metrics, anatomical indexes, and machine learning to classify anterior circulation ICAS within the Chinese Ischemic Stroke Subclassification (CISS) framework and identify characteristics of different stroke mechanisms. Methods: A total of 118 ICAS patients were classified based on CISS criteria. Key indicators were identified through one-way ANOVA, correlation, and effect size analysis. A decision tree model established thresholds for stroke mechanisms, and six machine learning models were evaluated for classification performance using confusion matrices, ROC curves, and PR curves. Results: Time to Maximum (Tmax)> 4.0s, Area stenosis rate (AS%), wall shear stress ratio (WSSR), and pressure ratio (PR) were key indicators for classification, while cerebral blood flow (CBF) and cerebral blood volume (CBV) showed no significant differences across infarction types. Thresholds identified included Tmax > 4.0s = 49.85 ml, WSSR = 52.79/86.51, PR = 0.69, and AS% = 0.73. Logistic regression outperformed other models (AUC = 0.923, AP = 0.872), followed by the ensemble model. Conclusion: Combining CFD and CTP metrics with machine learning effectively classifies anterior circulation ICAS-related stroke mechanisms within CISS typing, offering a reliable approach for precise diagnosis and individualized treatment of ischemic stroke.

Abstract: Chronic venous disease (CVD) involves complex pathophysiological processes where the imbalance between matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) contributes to venous remodelling and varicosities. Elevated levels of MMP-2 and MMP-9 are notably observed in tissues affected by venous ulcers. Local inflammation is a key feature in CVD, with increased concentrations of pro-inflammatory markers in varicose veins compared to healthy veins. Syndecans, components of the endothelial glycocalyx, play critical roles in inflammation. Recent studies have shown that alterations in glycocalyx structure are indicative of vascular damage in both venous and arterial diseases. This study aims to explore the inflammatory alterations in CVD patients, focusing on glycocalyx damage and the potential therapeutic effects of mesoglycan, a compound used in CVD treatment. A prospective, monocentric study was conducted with 23 patients diagnosed with CVD of CEAP class C2. Serum samples were analyzed at baseline and after mesoglycan treatment. Results showed significantly higher levels of VCAM-1, MMP-2, MMP-9, SDC-1, IL-6, and IL-8 in blood from varicose veins compared to systemic circulation. After treatment with mesoglycan, there was a notable reduction in these inflammatory markers, indicating a positive therapeutic effect. These findings support the hypothesis that mesoglycan may help reduce local and systemic inflammation in CVD. This study contributes to a better understanding of the inflammatory mechanisms in CVD and the role of mesoglycan in modulating these processes, offering insights into potential therapeutic strategies for managing CVD.

Abstract: Objective: To assess the outcomes of upfront Optilume drug-coated balloon (DCB) treatment in patients after failed treatment for complex recurrent urethral stricture disease. All patients presented with acute urinary retention, and were treated with DCB dilation regardless of stricture site/length. Patients and Methods: We retrospectively evaluated patients with acute urinary retention and known complex recurrent urethral strictures. Patients presented at the urology emergency room of our tertiary centre with an inability to void or a post-void residual (PVR) exceeding 400 ml between August 2021 and February 2024. Urinary tract infection was immediately excluded, and urethrography and/or endoscopic imaging confirmed the diagnosis of urethral stricture. Urethral dilation to 20 Fr was performed, followed by drug-coated balloon dilation (30 Fr, 10 bar, 10 minutes). The primary endpoints were anatomical success (≥14 Fr by cystoscopy/calibration) at 12 months and freedom from repeat interventions. Patients requiring suprapubic catheterisation for UTI/sepsis and those with neurological disease were excluded. Results: Thirty-one consecutive male patients were evaluated, with 26 patients followed for ≥ 12 months (mean age 65 ± 16.8 years). Stricture sites: seven bulbopenile, seven bulbomembranous, seven anastomotic, three bladder neck, one penile, and one panurethral. The median number of prior urethral/surgical interventions was 2 [IQR: 1-3] (range: 1-31). The median stricture length was 3 [IQR: 2-4] cm. (range: 1-8). At 12 months 65.4% (17/26) of subjects voided satisfactorily, free of recurrence and reoperation. Conclusions: Nearly two-thirds of multimorbid patients with previously treated complex recurrent urethral strictures had a patent urethra at 12 months after a single treatment with DCB dilatation. Optilume dilation offers a viable treatment option for patients with complex recurrent urethral strictures and urinary retention, particularly those who are unable or unwilling to undergo surgical reconstruction and prefer to avoid indwelling urethral catheters.

Abstract: Development of drug delivery systems has revolutionized drug formulation in pharmaceuticals to provide enhanced drug efficacy and compliance. The subsequent article describes the revolution from classic chewable tablets to emerging nanomedicine-based drugs. Chewable tablets are an inexpensive oral drug delivery in pediatric and geriatric patients with notwithstanding stability and formulation constraints. Targeted drug delivery revolutionized therapeutic specificity by reducing systemic side effects and enhancing drug bioavailability.Liposomal and particulate-based drug delivery systems have advanced therapeutic modality to a greater extent to realize FDA-approved nanomedicines with enhanced therapeutic performance. Naso-pulmonary drug delivery has also emerged to the forefront for respiratory care management using inhaled nanoparticles for direct and effective drug delivery. Regardless of all these technologies, regulatory approval, scale-up formulation of the product, and long-term safety issues remain at the center of attention.Theranostic approaches and image-guided drug delivery are revolutionizing the fate of drug delivery through real-time diagnosis and therapy. These new technologies hold the promise of precision medicine with enhanced targeting, monitoring, and patient response. With ongoing research, overcoming current challenges will unlock the potential of the next generations of drug delivery systems.

Abstract: Background and Objectives: The aim of the present study was to explore the histopathological effects and tissue Vascular Endothelial Growth Factor (VEGF) levels of filgrastim and hyaluronic acid treatment in a rat model with experimentally induced Asherman Syndrome. In this study, 26 female Sprague Dawley rats were used. First, a rat model of Asherman Syndrome model was established in 2 rats. The remaining rats were randomly divided into three groups. A total of 0.1 ml trichloroacetic acid was applied to the right uterine horns of all groups to induce adhesion formation. Group I received no treatment. Group II received intrauterine hyaluronic acid treatment (0.01), Group III received subcutaneous Filgrastim treatment (50 μg/kg/day), and Group IV received both intrauterine hyaluronic acid and subcutaneous Filgrastim treatment. Histopathological analysis of uterine corns in the rats with and without Asherman Syndrome, inflammation, glandular count, and fibrosis levels were examined. Tissue VEGF levels were investigated immunohistochemically. Hyaluronic acid treatment resulted in an increase only in uterine lumen diameter and VEGF levels, while filgrastim treatment led to an increase in uterine wall diameter, lumen diameter, gland count, and VEGF levels, as well as a decrease in fibrosis and inflammation scores. Combined treatment with filgrastim and hyaluronic acid showed an increase in lumen diameter, gland count, and VEGF levels, along with a decrease in inflammation and fibrosis scores (P< 0.05). Filgrastim treatment resulted in better effects for Asherman Syndrome compared to hyaluronic acid treatment. There were no beneficial effects seen with the combined therapy.

Abstract: Food hypersensitivity remains an understudied and overlooked subject globally. It is characterized by adverse reactions to dietary substances potentially triggered by various mechanisms. Food allergy, a subset of food hypersensitivity, denotes an immune response to food proteins categorized into immunoglobulin IgE-mediated or non-IgE-mediated reactions. Conversely, food intolerance, another facet of food hypersensitivity, refers to non-immunological reactions occurring at typically tolerated doses of food or its components. The main objective of this study is to determine and differentiate the differences, characteristics, and types of food hypersensitivities. We conducted an extensive review encompassing the key studies from 1990 onwards, including prospective studies, nested case-control studies, and meta-analysis. In conclusion, there are big differences between the main characteristics such as symptoms, complications, and treatments between allergies, and food intolerances. Commonly reported trigger foods include cow milk, gluten, eggs, nuts, and seafood.

Abstract: Background/Objectives: Delayed diagnosis in psoriatic arthritis (PsA) is associated with significant health consequences. We hypothesize that musculoskeletal (MSK) surgery rates may be higher during the diagnostic delay period. This study aimed to compare the frequency of MSK surgeries in PsA patients during the period of diagnostic delay with the frequency of MSK surgeries post-diagnosis. Methods: This retrospective cohort study included PsA patients who fulfilled CASPAR criteria and were followed up in our outpatient clinic. PsA patients fulfilling the CASPAR criteria and followed in our outpa-tient clinic were included. The pre-diagnosis symptomatic period was considered as the period of diagnostic delay. Data on MSK surgeries were obtained from patient records. The annual number of surgeries was calculated separately for the diagnostic delay and post-diagnosis periods. Results: The study included 84 PsA patients. The mean diagnos-tic delay in PsA patients was 7.49 years. During this period, 27.4% of patients under-went at least one MSK surgery. The mean annual number of MSK surgeries was signifi-cantly higher during the diagnostic delay period compared to the post-diagnosis period (P = 0.001). Conclusion: Following PsA diagnosis, a reduction in MSK surgery rates was observed compared to the diagnostic delay period. This suggests that inflammatory symptoms in PsA patients, which could have been managed with medical therapy, may have led to avoidable MSK surgeries. Our findings highlight the need for early diagnosis to prevent unnecessary surgical interventions.

Abstract: Anaplastic thyroid carcinoma (ATC) is the rarest and most aggressive form of thyroid cancer, marked by a poor prognosis and resistance to conventional treatments. Like many malignancies, ATC has a complex genetic landscape, with numerous mutations driving tumor initiation, progression, and therapeutic resistance. However, recent advances in molecular research have expanded our understanding of these genetic alterations, paving the way for new targeted treatment strategies. Currently, therapies targeting specific genetic mutations, such as BRAF and MEK, show promise, but their effectiveness is limited to patients harboring these mutations. To explore broader therapeutic possibilities, we conducted a comprehensive literature review using the PubMed database and Google to identify studies on key genetic mutations in ATC. By leveraging these molecular insights, we aim to highlight potential therapeutic avenues that could enhance treatment options and improve patient outcomes.

Abstract: Since its introduction, optical coherence tomography (OCT) has significantly progressed in addressing its limitations. By integrating artificial intelligence and multimodal imaging, OCT enhances both speed and image quality while reducing its size. OCT continues to advance, offering new possibilities beyond the in-office setting, including intraoperative applications. This review will explore the different types of home OCT and intraoperative OCT, as well as the uses of each device and their future potential in ophthalmology.

Abstract: Background: Sickle cell disease (SCD) significantly impacts diverse racial groups, particularly African American and Hispanic persons, who experience notable disparities in healthcare outcomes. Despite the extensive literature on SCD, studies focusing on in-hospital racial inequities remain limited. Methods: We conducted a retrospective analysis using the National Inpatient Sample (NIS) from 2016 to 2020, identifying adult hospitalizations for SCD. Hospitalizations were categorized by race—White, African-American, Hispanic, and Other, and analyzed for demographic variables, admission types, disposition outcomes, and complications. Statistical analyses included chi-square tests and multivariate logistic regression, adjusting for confounders. Results: Of the 1,089,270 identified hospitalizations, 90.31% were African-American. African-American and Hispanic patients exhibited significantly higher non-elective admissions compared to Whites (77.81%). In-hospital mortality was highest among Hispanics (0.82%). Multivariate regression analysis revealed that African-Americans and Others had higher odds of prolonged hospital stays (Adjusted Odds Ratio (AOR): 1.30 and 1.20, respectively). African-Americans and Hispanics also had increased risks of in-hospital complications of SCD. Conclusion: This study highlights substantial racial disparities in SCD hospitalizations, with African Americans and Hispanics facing poorer outcomes compared to Whites. Hispanics also demonstrated increased mortality. These findings underscore the need for targeted healthcare interventions to address racial inequities in SCD management and improve outcomes for all affected populations.

Abstract: Approximately 70–80% of breast cancers are ER+ and 65% of them also are ER+PR+. In most cases of ER+ advanced disease, endocrine therapy (ET) is the initial treatment with different drugs that act by inhibiting the ER signaling, mainly tamoxifen, a selective estrogen receptor modulator (SERM), or fulvestrant, a selective estrogen receptor degrader (SERD), or by impeding the estrogen formation as aromatase inhibitors (AIs). However, hormone resistance intrinsic or acquired, eventually develops, making disease progression unavoidable. An increased progression-free survival (PFS) and, sometimes, overall survival (OS) recently occurred after the association of ET with the cyclin-dependent kinases 4 and 6 inhibitors (CDK4/6is) that block cell-division cycle in the G1 phase and halt DNA production thus synergizing with ET. This review focuses on the main mechanisms of resistance to ET, whether used alone or in combination with biological agents, and on new drugs/strategies currently in use or under investigation to overcome it. Overcoming resistance to ET is a “work in progress” and early in the next it is expected to better select patients for different therapeutic strategies based on more specific biologic and/or genetic markers. Particularly, liquid biopsy may provide a real-time portrait of the disease state including mechanisms responsible for ET independence and cancer proliferation.

Abstract: Background/Objectives: Osteoporosis is a skeletal disorder characterized by reduced bone mineral density (BMD) and increased fracture risk. Chronic inflammation is implicated in osteoporosis pathogenesis, with inflammatory mediators promoting bone resorption. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of systemic inflammation and have emerged as potential indicators of bone health. This study’s aim was to highlight the potential role of NLR and PLR as markers of bone health in postmenopausal women affected by osteoporosis or osteopenia and to evaluate the possible influence of autoimmune disease in this context. Methods: This cross-sectional study included 124 postmenopausal women diagnosed with osteopenia or osteoporosis at the Orthopedic Unit of the Policlinico G. Rodolico in Catania, Italy. Demographic, clinical, laboratory, and diagnostic imaging data were collected. NLR and PLR were calculated from complete blood counts, and BMD was measured using dual-energy X-ray absorptiometry (DEXA). Statistical analyses included correlations, group comparisons, and multiple and logistic regressions. Results: NLR and PLR did not directly correlate with BMD or fracture incidence. However, PLR weakly correlated with vitamin D levels. Notably, women without Hashimoto's thyroiditis exhibited higher NLR values than those with the condition. Hypertensive women had lower PLR than non-hypertensive women, while euthyroid women had higher PLR than hyperthyroid or hypothyroid women. Multiple regression analysis revealed that age, BMI, CKD stage, vitamin D levels, NLR, PLR, diabetes, and autoimmune diseases significantly predicted BMD at the femur neck, with PLR contributing significantly. Logistic regression confirmed these predictors for osteoporosis or osteopenia, with increased PLR being associated with a higher likelihood of osteoporosis. Conclusion: While NLR and PLR may not independently predict bone health, their inclusion in a multifactorial assessment considering age, BMI, vitamin D, and comorbidities could enhance osteoporosis management.

Abstract: INTRODUCTION: There is lack of knowledge about glycemic and blood pressure effects of resistance exercises with different amounts of muscle mass involved. OBJECTIVE: To analyze the acute glycemic and blood pressure effects of single- and multi-joint resistance training in individuals with type 2 diabetes (T2DM). METHODS: This is a randomized crossover clinical trial, being included adults with T2DM, of both genders. The participants performed three sessions (two experimental: one with single-joint exercises (SIN) and the other with multi-joint exercises (MULTI); and a control session (CON)) in randomized order, with outcomes being evaluated in the pre-exercise, immediately, 15 and 30 minutes after the sessions. Both sessions consisted of five exercises performed in three sets of 10 to 12 maximum repetitions. Analyzes were performed by generalized estimation equations. RESULTS: Fifty adults (11 women) participated in the study. Both experimental sessions showed expressive glycemic reductions immediately after the sessions (MULTI: -17 mg/dl; SIN: -29 mg/dl), and these values were kept similar up to 30 minutes after the session. The control session presented a glycemic reduction immediately after the exercise (-18mg/dl), which increased 15 minutes later (-29mg/dl), stabilizing up to 30 minutes after the session. Systolic blood pressure was increased immediately after both experimental sessions, retuning to baseline values 15 minutes post-session. Diastolic blood pressure was increased in control session along of time, without alterations in experimental sessions. CONCLUSION: Similar glycemic reductions were found in the experimental sessions, but without superiority over the control session. Minimal effects were found in blood pressure.

Abstract: Background: Malignant bowel obstruction (MBO) is a common and distressing complication in advanced gastrointestinal cancers, significantly impacting patients' quality of life. When conservative management fails, palliative decompression is essential to relieve symptoms such as nausea, vomiting, and abdominal distension. Venting gastrostomy is the most established method; however, anatomical challenges may necessitate alternative percutaneous approaches. Objective: This narrative review aims to provide a comprehensive overview of percutaneous gastrostomy techniques for palliative gastrointestinal decompression, including percutaneous endoscopic gastrostomy (PEG), interdisciplinary imaging-guided percutaneous or transhepatic gastrostomy, and percutaneous transesophageal gastrostomy (PTEG). Methods: A literature review was conducted to evaluate the indications, techniques, efficacy, and complications associated with these procedures. The role of a multidisciplinary approach, incorporating radiologic, endoscopic, and palliative care expertise, was also explored. Results: PEG remains the gold standard for venting gastrostomy, achieving symptom relief in up to 92% of cases with a low complication rate. However, interdisciplinary imaging-guided percutaneous or transhepatic gastrostomy offers a viable alternative for patients with surgically altered anatomy or difficult percutaneous access. PTEG, a newer technique, has demonstrated high technical success and symptom improvement, particularly in patients with extensive peritoneal carcinomatosis or massive ascites, where transabdominal approaches are not feasible. Conclusion: Palliative percutaneous decompression provides effective symptom relief in advanced gastrointestinal cancer. The choice of technique should be individualized based on patient anatomy, clinical condition, and resource availability. Further research is needed to optimize patient selection criteria and procedural outcomes. A multidisciplinary approach remains crucial in tailoring decompression strategies to improve the quality of life in end-stage malignancies.

Abstract: Introduction: Lipomas are among the most encountered neoplasms in clinical practice, occurring mainly in adults between the fourth and sixth decades of life. Deep-seated lipomas in children are found in the thorax, chest wall, mediastinum, pleura, pelvis, retroperitoneum, and paratesticular area. Herein, we present a case of a three-year-old child with a giant mesenteric lipoma, along with a review of the literature on mesenteric lipomas in childhood. Case presentation: A three-year-old male toddler was referred to our hospital for severe, intermittent abdominal pain. Imaging studies at admission revealed a fat lesion occupying most of the peritoneal cavity and dislocating adjacent structures. An urgent laparotomy was performed. A giant lipoma arising from the mesentery and leading to the torsion of the mesenteric radix was confirmed and completely excised alongside an adherent small tract of jejunum. The child recovered uneventfully and is still being followed-up with no signs of recurrence. Discussion: Lipomas of the mesentery in children are very rare, and they are reported to be more common among children younger than three years of age. Mesenteric lipomas appeared to be more frequent in males than females. Even though they might be asymptomatic, voluminous lipomas can also create a lead point for intermittent torsion of the mass causing ischemia and infarction. Abdominal pain was the most frequent symptom, and the ileum was the tract of bowel more frequently involved by the tumor. Laparotomy was reported to be the preferable approach to safely remove this abdominal mass, especially in case of huge dimensions.

Abstract: Sensory dysregulation represents a core challenge in autism spectrum disorder (ASD), affecting perception, behavior, and adaptive functioning. The brain's ability to reorganize, known as neuroplasticity, serves as the basic principle for therapeutic interventions targeting these deficits. Neuroanatomical mechanisms include altered connectivity in the sensory and visual cortices, limbic system and amygdala, while imbalances of neurotransmitters, in particular glutamate and gamma-aminobutyric acid (GABA), contribute to atypical sensory processing. Traditional therapies used in sensory integration are based on the principles of neuroplasticity. Increasingly, new treatments use this knowledge, and modern therapies such as neurofeedback, transcranial stimulation, and immersive virtual environments are promising in modulating neuronal circuits. However, further research is needed to optimize interventions and confirm long-term effectiveness. This narrative review discusses the role of neuroplasticity in the etiopathogenesis of sensory integration deficits in autism spectrum disorder. The neuroanatomical and neurotransmitter basis of impaired perception of sensory stimuli is considered, and traditional and recent therapies for sensory integration are discussed.

Abstract: Background/Objectives: Skin cancer is the most common cancer worldwide, primarily divided into melanoma and non-melanoma types, with non-melanoma being the most prevalent. Cutaneous squamous cell carcinoma (cSCC) represents 50% of primary skin cancers and is characterized by uncontrolled keratinocyte proliferation. cSCC current standard treatment is surgical resection and chemotherapy. Unfortunately these methods often lead to disfigurement, functional morbidly and compromised function. In contrast from immunotherapy emerging scenarios that have shown promising results, especially in neoadjuvant settings. Cemiplimab (Libtayo®; Regeneron, Tarrytown, New York, United States), a PD-1 monoclonal antibody, has shown efficacy in treating advanced or metastatic cSCC, and its use as a neoadjuvant therapy has been recently explored. This review aims to evaluate Cemiplimab neoadjuvant setting on cSCC treatment. Methods: Following PRISMA guidelines, this review analyzed studies on Cemiplimab as neoadjuvant therapy for cSCC, sourced from PubMed, Web of Science, and Scopus. Only controlled trials, cohort studies, case series, and systematic reviews were included. A total of 21 studies were examined, focusing on response rates, adverse effects, and outcomes. Results: From 341 records, 21 studies were included, and six clinical trials provided key data.The targeted data revealed that neoadjuvant Cemiplimab showed a mean pathologic response rate of 72%, with a 62% objective response rate. The most commonly found treatment-related adverse events (TRAEs) included fatigue, maculopapular rash, and diarrhea, affecting 66% of patients, with few severe cases. The studies demonstrated high rates of complete pathological responses (cPR) and major pathological responses (mPR), suggesting a strong therapeutic potential. Conclusions: Neoadjuvant Cemiplimab for cSCC therapy shows high response rates, low recurrence, improved survival, and manageable side effects. Despite more research is still needed to confirm its long-term benefits and real-world settings feasibility, some case series already indicate comparable results in immunosuppressed patients. Finally, there is strong evidence to consider neoadjuvant Cemiplimab as a promising and efficient treatment