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Artificial intelligence applications in ovarian cancer detection: A systematic literature review of deep learning approaches and clinical translation challenges 人工智能在卵巢癌检测中的应用:深度学习方法和临床翻译挑战的系统文献综述。
IF 5.6 2区 医学 Q1 HEMATOLOGY Pub Date : 2026-01-14 DOI: 10.1016/j.critrevonc.2026.105126
Burak Gülmez
This systematic literature review examines artificial intelligence applications in ovarian cancer detection through analysis of 61 studies published between 2020 and 2025. The investigation reveals advancing methodological sophistication alongside persistent limitations constraining clinical translation. Convolutional neural network architectures dominate current research, with ResNet variants achieving accuracy rates between 92 % and 99.7 %. Vision transformer integration demonstrates competitive performance while providing attention-based interpretability mechanisms. Ensemble methodologies produce superior diagnostic accuracy, reaching 98.96 % through multi-model integration strategies. Dataset heterogeneity presents barriers to model generalizability, with sample sizes ranging from hundreds to thousands of images and private institutional datasets limiting external validation opportunities. Hyperparameter optimization receives minimal attention across reviewed studies, with twelve investigations implementing systematic parameter tuning. Explainable AI implementation occurs in seven studies despite growing regulatory requirements for transparent medical AI systems. Object detection applications demonstrate limited adoption compared to classification approaches, with U-Net variants comprising the primary segmentation methodology. Bibliometric analysis indicates increasing research activity, with publication counts rising from 5 papers in 2020–2021, 34 papers in 2023–2024. Future research directions should prioritize standardization initiatives for data collection and evaluation metrics, prospective clinical trials for validation, and regulatory pathway development for medical AI system approval.
本系统文献综述通过分析2020年至2025年间发表的61项研究,探讨了人工智能在卵巢癌检测中的应用。调查揭示了先进的方法复杂性和持续限制临床翻译。卷积神经网络架构在当前的研究中占主导地位,ResNet变体的准确率在92%到99.7%之间。视觉转换器集成在提供基于注意力的可解释性机制的同时展示了竞争性性能。集成方法通过多模型集成策略产生卓越的诊断准确性,达到98.96%。数据集的异质性阻碍了模型的推广,样本量从数百到数千张不等,私人机构数据集限制了外部验证的机会。在回顾的研究中,超参数优化得到的关注最少,有12项研究实现了系统的参数调整。尽管对透明医疗人工智能系统的监管要求越来越高,但在七项研究中出现了可解释的人工智能实施。与分类方法相比,对象检测应用程序的采用有限,U-Net变体包括主要的分割方法。文献计量分析表明,研究活动不断增加,论文发表数量从2020-2021年的5篇增加到2023-2024年的35篇。未来的研究方向应优先考虑数据收集和评估指标的标准化举措、验证的前瞻性临床试验以及医疗人工智能系统批准的监管途径开发。
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引用次数: 0
Extrachromosomal DNA as a dynamic engine of cancer evolution: Structure, plasticity and therapeutic resistance 染色体外DNA作为癌症进化的动力引擎:结构、可塑性和治疗耐药性。
IF 5.6 2区 医学 Q1 HEMATOLOGY Pub Date : 2026-01-10 DOI: 10.1016/j.critrevonc.2026.105124
Yan Gu , Shuai Wang , Yuxuan Xiao , Yutao Li , Lin Weng , Kezhong Chen
Extrachromosomal DNA (ecDNA) has become recognized as a common and influential form of oncogene and regulatory element amplification in human cancers. EcDNA consists of large, acentric circular DNA molecules that replicate autonomously. They frequently carry oncogenes, immune modulatory genes and enhancers, and they segregate in a non-Mendelian manner during mitosis. These properties support high transcriptional output, marked intratumoral heterogeneity and rapid adaptation. EcDNA has been proved that is associated with immune evasion, treatment resistance and poor prognosis. In this review, we bring together recent work to argue that ecDNA is better understood as a dynamic and selectable genomic subsystem rather than a static amplification artifact. First, we summarize current models of ecDNA formation, maintenance and structural plasticity. We then outline key functional features of ecDNA, such as oncogene amplification, enhancer hijacking, three-dimensional clustering into transcriptional hubs and epigenetic remodeling of cell states. Drawing on multi-region and longitudinal analyses, we distinguish between tumor lineage and circle lineage and describe how ecDNA architectures can define parallel evolutionary trajectories within and across lesions. We next consider how ecDNA behaves under therapeutic pressure and contributes to different cancer therapy through reversible copy number changes, pathway rewiring and non-genetic state transitions. Finally, we discuss recent advances in ecDNA detection from diverse data sources, potent clinical applications and early attempts to exploit ecDNA-specific vulnerabilities. Viewing ecDNA in this dynamic framework emphasizes its central role in cancer evolution and points to concrete opportunities to refine patient stratification and to develop strategies that selectively eliminate ecDNA-driven tumors.
染色体外DNA (ecDNA)已被认为是人类癌症中致癌基因和调控元件扩增的一种常见和有影响的形式。EcDNA由大的、无中心的环状DNA分子组成,这些分子可以自主复制。它们经常携带致癌基因、免疫调节基因和增强子,并在有丝分裂过程中以非孟德尔方式分离。这些特性支持高转录输出、显著的肿瘤内异质性和快速适应。EcDNA已被证实与免疫逃避、治疗抵抗和预后不良有关。在这篇综述中,我们汇集了最近的研究成果,认为ecDNA是一个动态的、可选择的基因组子系统,而不是一个静态的扩增产物。首先,我们总结了ecDNA形成、维持和结构可塑性的现有模型。然后,我们概述了ecDNA的关键功能特征,如癌基因扩增、增强子劫持、转录中心的三维聚类和细胞状态的表观遗传重塑。通过多区域和纵向分析,我们区分了肿瘤谱系和圆形谱系,并描述了ecDNA结构如何定义病变内部和跨病变的平行进化轨迹。接下来,我们将考虑ecDNA在治疗压力下的行为,并通过可逆拷贝数变化、通路重新连接和非遗传状态转变,为不同的癌症治疗做出贡献。最后,我们讨论了来自不同数据源的ecDNA检测的最新进展,有效的临床应用以及利用ecDNA特异性漏洞的早期尝试。在这个动态框架中观察ecDNA强调了它在癌症进化中的核心作用,并指出了改进患者分层和制定选择性消除ecDNA驱动肿瘤的策略的具体机会。
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引用次数: 0
Immunometabolic heterogeneity in hepatocellular carcinoma: Transforming cold tumors into hot tumors 肝细胞癌的免疫代谢异质性:冷肿瘤转化为热肿瘤。
IF 5.6 2区 医学 Q1 HEMATOLOGY Pub Date : 2026-01-10 DOI: 10.1016/j.critrevonc.2026.105123
Yuanhao Xu, Jianguang Sun
Despite significant progress in the field of immunotherapy for hepatocellular carcinoma (HCC), many patients still fail to respond to the treatment and develop "cold tumors". This review systematically clarifies the immunological and metabolic heterogeneity between “cold” and “hot” tumors in HCC—cold tumors are characterized by immunosuppression and more disordered metabolism, while hot tumors exhibit robust immune cell infiltration and active metabolism and respond favorably to immune checkpoint inhibitor therapy. We also summarize the biomarkers of HCC cold tumors and the therapeutic strategies for converting cold tumors to hot tumors, including cryoablation, immune combination therapy, nanocarrier-based approaches, vaccines, and metabolic interventions. Moreover, establishment of a hierarchical evidence system to evaluate these strategies revealed that immune combination therapy has sufficient clinical validation and significant clinical value, whereas other therapies require further research. We hope that this review will help improve the understanding of cold and hot HCC tumors and provide a novel perspective for the precision treatment of HCC.
尽管肝细胞癌(HCC)的免疫治疗领域取得了重大进展,但仍有许多患者对治疗无效而发展为“冷肿瘤”。本综述系统阐明了hcc“冷”瘤和“热”瘤之间的免疫学和代谢异质性,冷肿瘤以免疫抑制和代谢紊乱为特征,而热肿瘤则表现出强大的免疫细胞浸润和活跃的代谢,对免疫检查点抑制剂治疗反应良好。我们还总结了HCC冷肿瘤的生物标志物和将冷肿瘤转化为热肿瘤的治疗策略,包括冷冻消融、免疫联合治疗、基于纳米载体的方法、疫苗和代谢干预。此外,建立了分级证据系统来评价这些策略,表明免疫联合疗法具有足够的临床验证和显著的临床价值,而其他疗法有待进一步研究。我们希望本文综述有助于提高对冷、热HCC肿瘤的认识,并为HCC的精准治疗提供新的视角。
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引用次数: 0
Why isn’t an oncogenic mutation in KRAS enough to induce and sustain transformation? 为什么KRAS中的致癌突变不足以诱导和维持转化?
IF 5.6 2区 医学 Q1 HEMATOLOGY Pub Date : 2026-01-06 DOI: 10.1016/j.critrevonc.2025.105110
Juan Iovanna , Nelson Dusetti
KRAS, a key member of the RAS proto-oncogene family, encodes a small GTPase involved in regulating cell proliferation, differentiation, and survival through signaling cascades such as MAPK/ERK, PI3K/AKT/mTOR, RalGEF/RalA/B, JAK/STAT3, and NF-κB. Although KRAS mutations, especially at codons 12, 13, or 61, lead to its activation and contribute to uncontrolled growth, these changes alone are not enough to fully transform a normal cell. KRAS activation requires cooperation with other genetic or epigenetic events, such as inactivation of p53 or p16INK4a, tumor suppressor genes to overcome critical cellular barriers, for example, senescence and apoptosis. This need for cooperation reflects the complexity of the oncogenic process, requiring simultaneous deregulation of multiple signaling pathways for malignant transformation. Indeed, in experimental models, mutant KRAS expression in normal cells often induces oncogene-induced senescence rather than unlimited proliferation. These findings highlight that KRAS functions more as an initiator of tumorigenesis than as an autonomous driver. Thus, in depth understanding of the genetic context in which KRAS operates is essential for the development of effective and personalized therapeutic strategies.
KRAS是RAS原癌基因家族的重要成员,其编码一个小的GTPase,通过信号级联如MAPK/ERK、PI3K/AKT/mTOR、RalGEF/RalA/B、JAK/STAT3和NF-κB参与调节细胞增殖、分化和存活。虽然KRAS突变,尤其是密码子12、13和61处的突变,会导致KRAS活化并导致不受控制的生长,但这些变化本身并不足以完全转化正常细胞。KRAS的激活需要与其他遗传或表观遗传事件合作,例如p53或p16INK4a等肿瘤抑制基因的失活,以克服关键的细胞屏障,例如衰老和凋亡。这种合作需求反映了致癌过程的复杂性,需要同时解除恶性转化的多种信号通路。事实上,在实验模型中,正常细胞中突变的KRAS表达通常会诱导癌基因诱导的衰老,而不是无限增殖。这些发现强调,KRAS更像是肿瘤发生的启动器,而不是自动驱动程序。因此,深入了解KRAS运作的遗传背景对于制定有效和个性化的治疗策略至关重要。
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引用次数: 0
Androgen receptor as a prognostic biomarker in breast cancer: A systematic review and meta-analysis 雄激素受体作为乳腺癌预后的生物标志物:系统综述和荟萃分析。
IF 5.6 2区 医学 Q1 HEMATOLOGY Pub Date : 2026-01-03 DOI: 10.1016/j.critrevonc.2025.105112
Manjusha Pal , Ankita Chakrawal , Bhavana Singh , Atindra Pandey , Ruhi Dixit , Manoj Pandey

Background

Breast cancer (BC) is the most prevalent malignancy and a leading cause of cancer-related death among women globally. The androgen receptor (AR), a nuclear receptor, exhibits both pro- and anti-tumorigenic effects, but its prognostic value in BC remains unclear.

Objective

To evaluate the association between AR expression and clinical outcomes like disease-free survival (DFS) and overall survival (OS) in BC across different subtypes.

Methods

This study is registered with PROSPERO (CRD4251023927) and follows PRISMA guidelines. We searched PubMed, Scopus, Web of Science, Embase, and Cochrane Library. Inclusion criteria encompassed original studies with female patients, survival data based on AR status, and at least one additional clinicopathological marker (e.g., ER, PR, HER2, TNBC). Pooled hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed with the I² statistics.

Results

Twenty-four studies with 17329 patients were included. In multivariate analysis, AR positivity showed a trend towards better OS (HR=0.59, 95 % CI: 0.18–1.95, p = 0.39) and DFS (HR=0.62, 95 % CI: 0.30–1.25, p = 0.18), though not statistically significant. Subgroup analysis showed significant benefits in AR and ER-positive BC for both OS (HR=0.66, 95 % CI: 0.56–0.77) and DFS (HR=0.78, 95 % CI: 0.60–1.02), while it was ambiguous in other subsets.

Conclusion

AR expression is associated with improved prognosis in ER-positive BC, but its role in TNBC and HER2-positive BC remains unclear due to heterogeneity and non-significant results. Standardized AR evaluation and prospective studies are needed to confirm its prognostic and predictive value for personalized BC treatment.
背景:乳腺癌(BC)是全球最常见的恶性肿瘤,也是女性癌症相关死亡的主要原因。雄激素受体(AR)是一种核受体,具有促肿瘤和抗肿瘤作用,但其在BC中的预后价值尚不清楚。目的:评估不同亚型BC中AR表达与临床结果(如无病生存期(DFS)和总生存期(OS))之间的关系。方法:本研究已在PROSPERO注册(CRD4251023927),并遵循PRISMA指南。我们检索了PubMed、Scopus、Web of Science、Embase和Cochrane Library。纳入标准包括女性患者的原始研究,基于AR状态的生存数据,以及至少一个额外的临床病理标志物(例如ER, PR, HER2, TNBC)。采用随机效应模型计算合并风险比(hr)和95%置信区间(ci)。采用I²统计量评估异质性。结果:共纳入24项研究,17329例患者。在多因素分析中,AR阳性患者有改善OS (HR=0.59, 95% CI: 0.18-1.95, p=0.39)和DFS (HR=0.62, 95% CI: 0.30-1.25, p=0.18)的趋势,但无统计学意义。亚组分析显示AR和er阳性BC对OS (HR=0.66, 95% CI: 0.56-0.77)和DFS (HR=0.78, 95% CI: 0.60-1.02)均有显著益处,而在其他亚组中则不明确。结论:AR表达与er阳性BC的预后改善相关,但由于异质性和无显著性结果,其在TNBC和her2阳性BC中的作用尚不清楚。标准化的AR评估和前瞻性研究需要证实其对个性化BC治疗的预后和预测价值。
{"title":"Androgen receptor as a prognostic biomarker in breast cancer: A systematic review and meta-analysis","authors":"Manjusha Pal ,&nbsp;Ankita Chakrawal ,&nbsp;Bhavana Singh ,&nbsp;Atindra Pandey ,&nbsp;Ruhi Dixit ,&nbsp;Manoj Pandey","doi":"10.1016/j.critrevonc.2025.105112","DOIUrl":"10.1016/j.critrevonc.2025.105112","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) is the most prevalent malignancy and a leading cause of cancer-related death among women globally. The androgen receptor (AR), a nuclear receptor, exhibits both pro- and anti-tumorigenic effects, but its prognostic value in BC remains unclear.</div></div><div><h3>Objective</h3><div>To evaluate the association between AR expression and clinical outcomes like disease-free survival (DFS) and overall survival (OS) in BC across different subtypes.</div></div><div><h3>Methods</h3><div>This study is registered with PROSPERO (CRD4251023927) and follows PRISMA guidelines. We searched PubMed, Scopus, Web of Science, Embase, and Cochrane Library. Inclusion criteria encompassed original studies with female patients, survival data based on AR status, and at least one additional clinicopathological marker (e.g., ER, PR, HER2, TNBC). Pooled hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed with the I² statistics.</div></div><div><h3>Results</h3><div>Twenty-four studies with 17329 patients were included. In multivariate analysis, AR positivity showed a trend towards better OS (HR=0.59, 95 % CI: 0.18–1.95, p = 0.39) and DFS (HR=0.62, 95 % CI: 0.30–1.25, p = 0.18), though not statistically significant. Subgroup analysis showed significant benefits in AR and ER-positive BC for both OS (HR=0.66, 95 % CI: 0.56–0.77) and DFS (HR=0.78, 95 % CI: 0.60–1.02), while it was ambiguous in other subsets.</div></div><div><h3>Conclusion</h3><div>AR expression is associated with improved prognosis in ER-positive BC, but its role in TNBC and HER2-positive BC remains unclear due to heterogeneity and non-significant results. Standardized AR evaluation and prospective studies are needed to confirm its prognostic and predictive value for personalized BC treatment.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105112"},"PeriodicalIF":5.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long noncoding RNAs as master regulators of autophagy in cancer: Implications for chemoresistance and therapeutic sensitization 长链非编码rna作为癌症自噬的主要调控因子:对化疗耐药和治疗增敏的影响。
IF 5.6 2区 医学 Q1 HEMATOLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.critrevonc.2025.105113
Zhenwang Zhang , Wenqiang Peng , Baoqing Zhao , Lei Meng , Ji Pan
Long noncoding RNAs (lncRNAs) have emerged as pivotal regulators of autophagy, a fundamental cellular process that maintains homeostasis under stress but also contributes to cancer progression and therapeutic resistance. Recent studies reveal that lncRNAs orchestrate autophagy through diverse mechanisms, including acting as competing endogenous RNAs (ceRNAs), directly interacting with core autophagy machinery such as Beclin1 and ATG proteins, or modulating key signaling pathways like PI3K/AKT/mTOR, Wnt/β-catenin, and HIF-1α. By fine-tuning autophagic activity, lncRNAs shape tumor cell survival, proliferation, and response to chemotherapy, targeted therapy, and radiotherapy. Importantly, the impact of autophagy is highly context-dependent: in some settings, lncRNA-driven autophagy promotes drug resistance and tumor progression, whereas in others, autophagy induction exerts tumor-suppressive effects. Targeting the lncRNA–autophagy axis therefore offers dual opportunities: inhibiting pro-autophagic lncRNAs to overcome chemoresistance, or restoring anti-autophagic lncRNAs to sensitize tumors to treatment. Advances in RNA-based therapeutics and delivery platforms, coupled with small-molecule autophagy modulators and immunotherapy, provide new avenues for translational applications. In this review, we summarize current knowledge of lncRNA-mediated autophagy in cancer, highlight its role in therapeutic resistance and sensitization, and discuss challenges and opportunities for clinical translation.
长链非编码rna (lncRNAs)已成为自噬的关键调节因子,自噬是一种基本的细胞过程,在压力下维持体内平衡,但也有助于癌症的进展和治疗耐药性。最近的研究表明,lncRNAs通过多种机制协调自噬,包括作为竞争内源性rna (ceRNAs),直接与核心自噬机制如Beclin1和ATG蛋白相互作用,或调节关键信号通路如PI3K/AKT/mTOR, Wnt/β-catenin和HIF-1α。通过微调自噬活性,lncrna影响肿瘤细胞的存活、增殖以及对化疗、靶向治疗和放疗的反应。重要的是,自噬的影响是高度依赖于环境的:在某些情况下,lncrna驱动的自噬促进耐药和肿瘤进展,而在其他情况下,自噬诱导发挥肿瘤抑制作用。因此,靶向lncrna -自噬轴提供了双重机会:抑制促自噬lncrna以克服化疗耐药,或恢复抗自噬lncrna以使肿瘤对治疗敏感。基于rna的治疗方法和递送平台的进展,加上小分子自噬调节剂和免疫疗法,为翻译应用提供了新的途径。在这篇综述中,我们总结了lncrna介导的自噬在癌症中的现有知识,强调了其在治疗耐药和致敏中的作用,并讨论了临床转化的挑战和机遇。
{"title":"Long noncoding RNAs as master regulators of autophagy in cancer: Implications for chemoresistance and therapeutic sensitization","authors":"Zhenwang Zhang ,&nbsp;Wenqiang Peng ,&nbsp;Baoqing Zhao ,&nbsp;Lei Meng ,&nbsp;Ji Pan","doi":"10.1016/j.critrevonc.2025.105113","DOIUrl":"10.1016/j.critrevonc.2025.105113","url":null,"abstract":"<div><div>Long noncoding RNAs (lncRNAs) have emerged as pivotal regulators of autophagy, a fundamental cellular process that maintains homeostasis under stress but also contributes to cancer progression and therapeutic resistance. Recent studies reveal that lncRNAs orchestrate autophagy through diverse mechanisms, including acting as competing endogenous RNAs (ceRNAs), directly interacting with core autophagy machinery such as Beclin1 and ATG proteins, or modulating key signaling pathways like PI3K/AKT/mTOR, Wnt/β-catenin, and HIF-1α. By fine-tuning autophagic activity, lncRNAs shape tumor cell survival, proliferation, and response to chemotherapy, targeted therapy, and radiotherapy. Importantly, the impact of autophagy is highly context-dependent: in some settings, lncRNA-driven autophagy promotes drug resistance and tumor progression, whereas in others, autophagy induction exerts tumor-suppressive effects. Targeting the lncRNA–autophagy axis therefore offers dual opportunities: inhibiting pro-autophagic lncRNAs to overcome chemoresistance, or restoring anti-autophagic lncRNAs to sensitize tumors to treatment. Advances in RNA-based therapeutics and delivery platforms, coupled with small-molecule autophagy modulators and immunotherapy, provide new avenues for translational applications. In this review, we summarize current knowledge of lncRNA-mediated autophagy in cancer, highlight its role in therapeutic resistance and sensitization, and discuss challenges and opportunities for clinical translation.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105113"},"PeriodicalIF":5.6,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chinese expert consensus on precision diagnosis and treatment of refractory tumors 中国难治性肿瘤精准诊疗专家共识。
IF 5.6 2区 医学 Q1 HEMATOLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.critrevonc.2025.105109
Lili Wang , Yu Zhang , Yanhong Shang , Yuanzhi Lu , Hailong Hu , Gang Wang , Haitao Wang , China Consortium for Precision Diagnosis and Therapeutics in Refractory Tumors (CCPT)
Refractory tumors, including rare and treatment-resistant malignancies, pose major challenges due to genomic and intra- and inter-tumoral heterogeneity. The Molecular Tumor Board provides a multidisciplinary model for precision oncology. To address the lack of consensus, the China Consortium for Precision Diagnosis and Therapeutics in Refractory Tumors (CCPT) developed evidence-based guidelines. Building on established frameworks and clinical expertise, CCPT also introduced a Chinese-specific classification system, together with recommendations on multi-omics testing, personalized therapy, combination strategies, dose optimization, and data-sharing, to standardize practice and advance integrated precision care.
难治性肿瘤,包括罕见和治疗耐药的恶性肿瘤,由于基因组和肿瘤内部和肿瘤间的异质性,构成了重大挑战。分子肿瘤委员会为精确肿瘤学提供了一个多学科模型。为了解决缺乏共识的问题,中国难治性肿瘤精准诊断与治疗协会(CCPT)制定了循证指南。在现有框架和临床专业知识的基础上,CCPT还引入了中国特有的分类系统,以及多组学检测、个性化治疗、联合策略、剂量优化和数据共享方面的建议,以规范实践,推进综合精准医疗。
{"title":"Chinese expert consensus on precision diagnosis and treatment of refractory tumors","authors":"Lili Wang ,&nbsp;Yu Zhang ,&nbsp;Yanhong Shang ,&nbsp;Yuanzhi Lu ,&nbsp;Hailong Hu ,&nbsp;Gang Wang ,&nbsp;Haitao Wang ,&nbsp;China Consortium for Precision Diagnosis and Therapeutics in Refractory Tumors (CCPT)","doi":"10.1016/j.critrevonc.2025.105109","DOIUrl":"10.1016/j.critrevonc.2025.105109","url":null,"abstract":"<div><div>Refractory tumors, including rare and treatment-resistant malignancies, pose major challenges due to genomic and intra- and inter-tumoral heterogeneity. The Molecular Tumor Board provides a multidisciplinary model for precision oncology. To address the lack of consensus, the China Consortium for Precision Diagnosis and Therapeutics in Refractory Tumors (CCPT) developed evidence-based guidelines. Building on established frameworks and clinical expertise, CCPT also introduced a Chinese-specific classification system, together with recommendations on multi-omics testing, personalized therapy, combination strategies, dose optimization, and data-sharing, to standardize practice and advance integrated precision care.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"218 ","pages":"Article 105109"},"PeriodicalIF":5.6,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The microbiome in head and neck squamous cell carcinoma: Biological drivers, therapeutic interactions, and emerging clinical applications 头颈部鳞状细胞癌中的微生物组:生物学驱动、治疗相互作用和新兴临床应用。
IF 5.6 2区 医学 Q1 HEMATOLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.critrevonc.2025.105108
A. Di Bello , A. Scala , R. Gili , R. Falcicchia , A. Bassolino , S. Polidori , F. D’Auria , G. Tortora , P. Bossi , A. Cassano
Head and neck squamous cell carcinoma (HNSCC) develops within a biologically complex niche shaped by epithelial, immune, environmental, and microbial interactions. Growing evidence indicates that microbial communities influence HNSCC initiation, progression, therapeutic response, and toxicity. This narrative review synthesizes current knowledge on microbiome composition in healthy mucosa, oral potentially malignant disorders, and established HNSCC, emphasizing how dysbiosis characterized by enrichment of periodontitis-associated taxa such as Fusobacterium and Porphyromonas and depletion of protective genera including Corynebacterium and Kingella may drive carcinogenesis through inflammation, genotoxic metabolites, immune modulation, and metabolic alterations. We also examine microbiome-mediated effects on systemic treatments, including chemotherapy, radiotherapy-induced mucositis, and immune checkpoint inhibitor (ICI) response, and review emerging approaches to therapeutically modulate microbial communities. Although several microbial signatures show potential as biomarkers or therapeutic targets, no reproducible microbiome-based tools are yet ready for clinical implementation. Standardized methodologies and prospective interventional studies will be essential to translate these findings into precision oncology for HNSCC.
头颈部鳞状细胞癌(HNSCC)在上皮、免疫、环境和微生物相互作用形成的生物复杂生态位中发展。越来越多的证据表明,微生物群落影响HNSCC的发生、进展、治疗反应和毒性。这篇叙述性综述综合了健康粘膜、口腔潜在恶性疾病中微生物组组成的现有知识,并建立了HNSCC,强调了以牙周炎相关分类群(如梭杆菌和卟啉单胞菌)的富集和保护性属(如杆状杆菌和金氏菌)的消耗为特征的生态失调如何通过炎症、遗传毒性代谢物、免疫调节和代谢改变驱动致癌。我们还研究了微生物组介导的对全身治疗的影响,包括化疗、放疗引起的粘膜炎和免疫检查点抑制剂(ICI)反应,并回顾了治疗性调节微生物群落的新方法。尽管一些微生物特征显示出作为生物标志物或治疗靶点的潜力,但目前还没有可重复的基于微生物组的工具准备好用于临床实施。标准化的方法和前瞻性介入研究对于将这些发现转化为HNSCC的精确肿瘤学至关重要。
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引用次数: 0
Research progress on immunotherapeutics for triple-negative breast cancer from a single-cell perspective 单细胞视角下三阴性乳腺癌免疫治疗研究进展
IF 5.6 2区 医学 Q1 HEMATOLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.critrevonc.2025.105111
Zixuan Yuan , Zhiwei Liu , Mengying Zhou , Huijuan Wen , Bei Li
Triple-negative breast cancer (TNBC) is a highly heterogeneous subtype with no effective therapeutic targets. Recent advances in immunotherapy, particularly PD-1/PD-L1 inhibitors and CTLA-4 antibodies, have yielded promising clinical outcomes in some patients. Additionally, cell-based therapies and tumor vaccines show substantial potential. Evidence increasingly supports the superior efficacy of combination therapies integrating immunotherapy with antitumor agents over traditional monotherapies. Single-cell and spatial multi-omics technologies, including scRNA-seq and scATAC-seq, as well as spatial transcriptomics, have provided insights into how therapeutic agents remodel the tumor microenvironment (TME), revealing mechanisms of action and TNBC’s cellular heterogeneity. This review integrates the latest advances in single-cell multi-omics and pharmacology to summarize progress in TNBC immunotherapy development, highlighting new therapeutic targets and optimized drug combinations. Furthermore, it discusses how the TME influences immunotherapy resistance from a single-cell perspective. Overall, single-cell-guided immunotherapy represents an innovative approach for better clinical translation, advancing precision medicine, and potentially transforming clinical practice.
三阴性乳腺癌(TNBC)是一种高度异质性的亚型,没有有效的治疗靶点。免疫治疗的最新进展,特别是PD-1/PD-L1抑制剂和CTLA-4抗体,在一些患者中产生了有希望的临床结果。此外,基于细胞的疗法和肿瘤疫苗显示出巨大的潜力。越来越多的证据表明,结合免疫治疗和抗肿瘤药物的联合治疗优于传统的单一治疗。单细胞和空间多组学技术,包括scRNA-seq和scATAC-seq,以及空间转录组学,已经为治疗剂如何重塑肿瘤微环境(TME)提供了见解,揭示了作用机制和TNBC的细胞异质性。本文结合单细胞多组学和药理学的最新进展,综述了TNBC免疫治疗的进展,重点介绍了新的治疗靶点和优化的药物组合。此外,它从单细胞的角度讨论了TME如何影响免疫治疗耐药性。总的来说,单细胞引导免疫疗法代表了一种创新的方法,可以更好地进行临床翻译,推进精准医学,并有可能改变临床实践。
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引用次数: 0
Resistance training: An overlooked tool in breast cancer recovery 抗阻训练:乳腺癌康复中一个被忽视的工具。
IF 5.6 2区 医学 Q1 HEMATOLOGY Pub Date : 2026-01-01 DOI: 10.1016/j.critrevonc.2025.105077
Abia Shariq , Hira Altaf Shaikh , Shajie Ur Rehman Usmani
Recent advancements in the treatment options for breast cancer survivors have significantly enhanced the survival rates, however, post treatment challenges remain. These long-term complications include lymphedema, sarcopenia, and psychological distress, that significantly results in reduced quality of life (QoL) in early and later stages of treatment, making demands for effective rehabilitation options, one of which is Resistance Training (RT). RT is a form of exercise that engages muscles by opposing forces to enhance muscular growth, strength and endurance. This is usually performed under trained individuals or structured home-based workouts with minimal equipment, enhancing metabolic health and overall well-being of the individual. Though once disregarded due to concerns of worsening lymphedema, it is now said that RT is indeed a safe and beneficial intervention. Many studies show that RT rebuilds muscular strength, decreases fat accumulation, and prevents chemotherapy-induced sarcopenia. In contrast to the previous beliefs, RT has now been shown to effectively reduce swelling, ultimately improving the lymphatic flow. Besides physical gains, RT plays a significant role in uplifting emotional and psychological wellbeing, thereby reducing anxiety and depression, along with boosting confidence and self-esteem. This commentary underscores the overlooked role of RT in post-treatment recovery by debunking myths and emphasizing the need for structured implementation. Integrating RT into post treatment care for survivors can assist in improving recovery and functional health in breast cancer survivors.
乳腺癌幸存者治疗方案的最新进展显著提高了生存率,然而,治疗后的挑战仍然存在。这些长期并发症包括淋巴水肿、肌肉减少和心理困扰,在治疗的早期和后期显著降低生活质量(QoL),需要有效的康复选择,其中之一是阻力训练(RT)。RT是一种通过相反的力量调动肌肉来增强肌肉生长、力量和耐力的运动形式。这通常是在训练有素的个人或有组织的家庭训练中进行的,用最少的设备,增强代谢健康和个人的整体健康。虽然由于担心加重淋巴水肿而一度被忽视,但现在认为RT确实是一种安全有益的干预措施。许多研究表明,RT可以重建肌肉力量,减少脂肪堆积,防止化疗引起的肌肉减少症。与之前的看法相反,现在已经证明放射治疗可以有效地减少肿胀,最终改善淋巴流动。除了身体上的收获,RT在提升情绪和心理健康方面也起着重要作用,从而减少焦虑和抑郁,同时增强自信和自尊。这篇评论通过揭穿神话和强调有组织实施的必要性,强调了RT在治疗后恢复中被忽视的作用。将放疗纳入幸存者的治疗后护理可以帮助改善乳腺癌幸存者的康复和功能健康。
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引用次数: 0
期刊
Critical reviews in oncology/hematology
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