Cancer Innovation最新文献

Tryptophan (Trp) is an essential amino acid that serves as a precursor for the synthesis of several important bioactive compounds. Trp is involved in a variety of pathophysiological processes, including neuronal function, metabolism, inflammatory responses, oxidative stress, immune regulation, and intestinal homeostasis. The role of Trp metabolism in tumorigenesis and cancer progression is of particular significance. The influence of Trp and its metabolites on tumor growth and metastasis is mediated through various mechanisms, such as immune evasion, promotion of angiogenesis, and increased resistance to therapeutic agents. This review presents the physiological pathways involved in Trp metabolism and its implications for various malignancies. We also highlight the latest clinical research targeting Trp metabolic pathways in oncology, in addition to exploring future directions for therapeutic advancements aimed at modulating Trp metabolism to enhance cancer treatment outcomes.

Breast cancer is the most common malignant tumor among women globally. In 2022, there were approximately 357,161 new cases and 74,986 deaths from breast cancer among Chinese females. Of the new cases of breast cancer each year, about 5%–10% of patients have distant metastasis at the time of diagnosis. Of the early-stage patients, 20%–30% of cases eventually develop into advanced breast cancer (ABC). Although ABC is currently difficult to cure, we can alleviate the clinical symptoms of patients, improve their quality of life, and further prolong their survival time by applying new therapeutic drugs and optimizing treatment models to achieve the purpose of long-term survival with tumors. To better guide clinical practice, the Chinese expert group, based on the latest research progress in breast cancer, has analyzed, discussed, and updated the relevant research data on the basis of the “Guidelines for clinical diagnosis and treatment of advanced breast cancer in China (2022 edition)” to formulate the “Guidelines for clinical diagnosis and treatment of advanced breast cancer in China (2024 edition).” The updated guidelines incorporate new evidence generated by high-quality evidence-based medicine, new concepts in molecular pathological detection, new treatment strategies, new progress in precision medicine, and adverse events of new therapeutic drugs. At the same time, the updated guidelines emphasize multidisciplinary collaboration and pay attention to patient-reported outcomes. The “Guidelines for clinical diagnosis and treatment of advanced breast cancer in China (2024 edition)” aim to provide clinicians with recommendations for the diagnosis and treatment of ABC in China, thereby improving patient outcomes and quality of life.

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This review examines the future of metronomic chemotherapy (MCT) in the treatment of breast cancer and emphasizes its transformative potential. MCT refers to the continuous administration of a low dose of chemotherapeutic agents. It reduces toxicity, improves the quality of life, and demonstrates antitumor effects through multiple mechanisms. Although used as a stand-alone treatment for breast cancer, MCT has been combined with other therapies in recent years to further enhance its antitumor efficacy through mechanisms such as direct cytotoxicity, anti-angiogenesis, and immunomodulation. The findings of recent studies emphasize the benefits of MCT in combination with immunotherapy, endocrine therapy, and targeted therapies such as anti-human epidermal growth factor receptor 2 and anti-angiogenesis agents. Clinical trials on optimizing MCT regimens are underway. MCT is a promising approach that can revolutionize breast cancer treatment by improving patient outcomes and shifting cancer care toward a chronic disease model.

Breast cancer is the most prevalent female malignancy worldwide. In 2022, China recorded approximately 357,000 new breast cancer cases and 75,000 deaths, posing a serious threat to female health. Given the “inverted pyramid” structure of China's healthcare system in service provision and resource distribution, there is an urgent need to establish a rational medical service framework that can optimize resource allocation, ensure patients receive appropriate diagnosis and treatment at different stages, and strengthen patient-centered continuity of care, thereby enhancing overall therapeutic outcomes. Under the tiered diagnosis and treatment framework, the Breast Cancer Expert Committee of the National Cancer Quality Control Center and the National Health Development Research Center of the National Health Commission have jointly drafted and formulated this Expert Consensus on Tiered Diagnosis and Treatment of Breast Cancer as a Single-disease Management Model of Breast Cancer in China (2025 Edition) to clarify the functional roles of different tiers of healthcare institutions, rationally allocate medical resources, and establish an integrated healthcare service system. This system emphasizes primary care, two-way referrals, differentiated management of acute and chronic conditions, and coordinated multi-level collaboration. The goal is to optimize comprehensive breast cancer management, spanning prevention, screening, diagnosis, treatment, and rehabilitation, ultimately improving patient survival and quality of life.

One of the greatest challenges in bioscience is to gain a unified view of the human immune system. This paper presents a perspective on the multilevel and multiscale complexities inherent in the immune system and discusses how these features influence the traditional research methodologies rooted in reductionism and holism. It is acknowledged that diverse complexities of the immune system are multilevel in nature, with each level showing multiscale properties, and the complexity emerging always at mesoscales in mesoregimes. Mesoscience encompasses both mesoscales, which represent the intermediate scales between the element scales and system scales at different levels, and mesoregimes, defined as transitional regimes governed by the interplay of at least two dominant mechanisms between two limiting regimes at each level. Therefore, mesoscience provides a promising paradigm to study the complexity and diversity of the immune system by bridging the gaps across multiple hierarchical levels. In particular, we focus on the mesoscience methodology to address the complexities in the immune system and offer insights into potential diagnostic, therapeutic, and theranostic strategies for immune-related diseases from a mesoscience perspective.

The diagnosis of cancer-related microangiopathic hemolytic anemia (CR-MAHA) in patients with breast cancer is often delayed, and this condition is associated with high mortality. A 71-year-old female with CR-MAHA secondary to bone marrow metastasis received trastuzumab deruxtecan (T-DXd) after first-line chemotherapy failure and achieved partial hematological remission. Treatment was discontinued because of interstitial lung disease (ILD). Early antitumor therapy is crucial; antibody-drug conjugates such as T-DXd offer promise, but vigilance for adverse effects is needed.

Cancer immunotherapy is a groundbreaking therapeutic strategy, yet it continues to face significant challenges, including limited overall response rates and treatment resistance. Emerging research has demonstrated the pivotal role of epigenetic modifications in tumor immune evasion, providing a strong rationale for developing “epi-immunotherapy”—an innovative approach that combines epigenetic therapy with immunotherapy. This comprehensive review systematically examines how epigenetic regulation mediates tumor immune escape and the mechanisms involved, including suppression of tumor antigen expression and antigen presentation, upregulation of immune checkpoint molecules, inhibition of antitumor immune cell recruitment and function, and enhancement of immunosuppressive cell proliferation and activity. By integrating epigenetic modulation with immunotherapeutic strategies, epi-immunotherapy demonstrates a remarkable ability to enhance treatment efficacy and reverse therapeutic resistance. We also summarize the current clinical applications of epi-immunotherapy in both hematological malignancies and solid tumors, with particular emphasis on its mechanisms for overcoming immune checkpoint inhibitor resistance and converting immunologically “cold” tumors into “hot” tumors. Despite its promising potential, epi-immunotherapy faces several challenges that require urgent resolution. This review provides an in-depth analysis of these limitations, which include the complexity of epigenetic regulation, a lack of reliable biomarkers, and constraints in drug development. As our understanding of epigenetic mechanisms deepens and technologies continue to advance, epi-immunotherapy is poised to become an essential component of cancer treatment, offering patients more effective and personalized therapeutic options.

Gastrointestinal stromal tumors (GISTs), the most prevalent mesenchymal neoplasms of the gastrointestinal tract, frequently metastasize to the liver. Despite this clinical reality, there is a lack of standardized therapeutic protocols for GIST liver metastases (GISTLM). Here we present the first case of a GISTLM patient treated with Yttrium-90 (Y90) resin microsphere selective internal radiation therapy (SIRT) in China. We further reviewed the current challenges in GISTLM management and highlighted the emerging role of SIRT. By integrating case-specific insights with broader therapeutic paradigms, we aim to develop safe and effective individualized treatment strategies for GIST patients.