Pub Date : 2025-12-10DOI: 10.1038/s43018-025-01071-5
Zhiyun Duan, Qihao Duan, Benjamin Wild, Roland Eils
Foundation models hold transformative promise for oncology, yet their clinical implementation remains limited, largely owing to their current model design as narrow specialists optimized for static tasks, whereas clinical oncology requires generalist systems capable of integrating multimodal data, capturing disease evolution over time and considering patient perspectives. Design along these requirements is essential to integrating foundation models as trusted partners in cancer care.
{"title":"Foundation models in oncology win benchmarks but miss the clinic","authors":"Zhiyun Duan, Qihao Duan, Benjamin Wild, Roland Eils","doi":"10.1038/s43018-025-01071-5","DOIUrl":"10.1038/s43018-025-01071-5","url":null,"abstract":"Foundation models hold transformative promise for oncology, yet their clinical implementation remains limited, largely owing to their current model design as narrow specialists optimized for static tasks, whereas clinical oncology requires generalist systems capable of integrating multimodal data, capturing disease evolution over time and considering patient perspectives. Design along these requirements is essential to integrating foundation models as trusted partners in cancer care.","PeriodicalId":18885,"journal":{"name":"Nature cancer","volume":"6 12","pages":"1925-1927"},"PeriodicalIF":28.5,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-04DOI: 10.1038/s43018-025-01070-6
Federico Giovannoni, Craig A. Strathdee, Camilo Faust Akl, Brian M. Andersen, Zhaorong Li, Hong-Gyun Lee, María Florencia Torti, Joseph M. Rone, Pere Duart-Abadia, Martina Molgora, Linxing Kong, Michael Floyd, Jian Teng, Yulia Gyulakian, Peter Grezsik, Terry Farkaly, Agnieszka Denslow, Sonia Feau, Irene Rodriguez-Sanchez, Judith Jacques, Marco Colonna, Edward M. Kennedy, Tooba Cheema, Lorena Lerner, Christophe Quéva, Francisco J. Quintana
Glioblastoma (GBM) is an aggressive, immunotherapy-resistant brain tumor. Here, we engineered an oncolytic virus platform based on herpes simplex virus 1 for GBM viroimmunotherapy. We mutated the highly cytopathic MacIntyre strain to increase spread and oncolytic activity, limit genetic drift, prevent neuron infection and enable PET tracing. We incorporated microRNA target cassettes to attenuate replication in healthy brain cells. Moreover, we engineered the gD envelope protein to specifically target GBM using EGFR-specific or integrin-specific binders. Lastly, we incorporated five immunomodulators to remodel the tumor microenvironment (TME) by locally expressing IL-12, anti-PD1, a bispecific T cell engager, 15-hydroxyprostaglandin dehydrogenase and anti-TREM2 to target T cells and myeloid cells in the GBM TME. A single intratumoral injection increased survival in GBM preclinical models, while promoting tumor-specific T cell, natural killer cell and myeloid cell responses in the TME. In summary, we engineered a retargeted, safe and traceable oncolytic virus with strong cytotoxic and immunostimulatory activities for GBM immunotherapy. Quintana and colleagues describe the engineering of oncolytic viruses armed with multiple immunomodulators and with targeted tropism for tumor cells for glioblastoma immunotherapy.
{"title":"Retargeted oncolytic viruses engineered to remodel the tumor microenvironment for glioblastoma immunotherapy","authors":"Federico Giovannoni, Craig A. Strathdee, Camilo Faust Akl, Brian M. Andersen, Zhaorong Li, Hong-Gyun Lee, María Florencia Torti, Joseph M. Rone, Pere Duart-Abadia, Martina Molgora, Linxing Kong, Michael Floyd, Jian Teng, Yulia Gyulakian, Peter Grezsik, Terry Farkaly, Agnieszka Denslow, Sonia Feau, Irene Rodriguez-Sanchez, Judith Jacques, Marco Colonna, Edward M. Kennedy, Tooba Cheema, Lorena Lerner, Christophe Quéva, Francisco J. Quintana","doi":"10.1038/s43018-025-01070-6","DOIUrl":"10.1038/s43018-025-01070-6","url":null,"abstract":"Glioblastoma (GBM) is an aggressive, immunotherapy-resistant brain tumor. Here, we engineered an oncolytic virus platform based on herpes simplex virus 1 for GBM viroimmunotherapy. We mutated the highly cytopathic MacIntyre strain to increase spread and oncolytic activity, limit genetic drift, prevent neuron infection and enable PET tracing. We incorporated microRNA target cassettes to attenuate replication in healthy brain cells. Moreover, we engineered the gD envelope protein to specifically target GBM using EGFR-specific or integrin-specific binders. Lastly, we incorporated five immunomodulators to remodel the tumor microenvironment (TME) by locally expressing IL-12, anti-PD1, a bispecific T cell engager, 15-hydroxyprostaglandin dehydrogenase and anti-TREM2 to target T cells and myeloid cells in the GBM TME. A single intratumoral injection increased survival in GBM preclinical models, while promoting tumor-specific T cell, natural killer cell and myeloid cell responses in the TME. In summary, we engineered a retargeted, safe and traceable oncolytic virus with strong cytotoxic and immunostimulatory activities for GBM immunotherapy. Quintana and colleagues describe the engineering of oncolytic viruses armed with multiple immunomodulators and with targeted tropism for tumor cells for glioblastoma immunotherapy.","PeriodicalId":18885,"journal":{"name":"Nature cancer","volume":"6 12","pages":"1994-2010"},"PeriodicalIF":28.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-28DOI: 10.1038/s43018-025-01095-x
Vincenzo Giacco
The ESMO Congress 2025 took place from 17 to 21 October in Berlin. Marking ESMO’s 50th anniversary, the meeting showcased breakthroughs in precision oncology, antibody–drug conjugates, and AI-driven cancer care, providing new insights and innovation in clinical oncology.
{"title":"Key insights from ESMO Congress 2025","authors":"Vincenzo Giacco","doi":"10.1038/s43018-025-01095-x","DOIUrl":"10.1038/s43018-025-01095-x","url":null,"abstract":"The ESMO Congress 2025 took place from 17 to 21 October in Berlin. Marking ESMO’s 50th anniversary, the meeting showcased breakthroughs in precision oncology, antibody–drug conjugates, and AI-driven cancer care, providing new insights and innovation in clinical oncology.","PeriodicalId":18885,"journal":{"name":"Nature cancer","volume":"6 12","pages":"1938-1939"},"PeriodicalIF":28.5,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145636132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Spatial quantification is a critical step in most computational pathology tasks, from guiding pathologists to areas of clinical interest to discovering tissue phenotypes behind novel biomarkers. To circumvent the need for manual annotations, modern computational pathology methods have favored multiple-instance learning approaches that can accurately predict whole-slide image labels, albeit at the expense of losing their spatial awareness. Here we prove mathematically that a model using instance-level aggregation could achieve superior spatial quantification without compromising on whole-slide image prediction performance. We then introduce a superpatch-based measurable multiple-instance learning method, SMMILe, and evaluate it across 6 cancer types, 3 highly diverse classification tasks and 8 datasets involving 3,850 whole-slide images. We benchmark SMMILe against nine existing methods using two different encoders—an ImageNet pretrained and a pathology-specific foundation model—and show that in all cases SMMILe matches or exceeds state-of-the-art whole-slide image classification performance while simultaneously achieving outstanding spatial quantification. Gao et al. present SMMILe, a multiple-instance learning-based tool that leverages whole-slide images for accurate spatial quantification without compromising on classification performance, and show it outperforms state-of-the-art methods.
{"title":"SMMILe enables accurate spatial quantification in digital pathology using multiple-instance learning","authors":"Zeyu Gao, Anyu Mao, Yuxing Dong, Hannah Clayton, Jialun Wu, Jiashuai Liu, ChunBao Wang, Kai He, Tieliang Gong, Chen Li, Mireia Crispin-Ortuzar","doi":"10.1038/s43018-025-01060-8","DOIUrl":"10.1038/s43018-025-01060-8","url":null,"abstract":"Spatial quantification is a critical step in most computational pathology tasks, from guiding pathologists to areas of clinical interest to discovering tissue phenotypes behind novel biomarkers. To circumvent the need for manual annotations, modern computational pathology methods have favored multiple-instance learning approaches that can accurately predict whole-slide image labels, albeit at the expense of losing their spatial awareness. Here we prove mathematically that a model using instance-level aggregation could achieve superior spatial quantification without compromising on whole-slide image prediction performance. We then introduce a superpatch-based measurable multiple-instance learning method, SMMILe, and evaluate it across 6 cancer types, 3 highly diverse classification tasks and 8 datasets involving 3,850 whole-slide images. We benchmark SMMILe against nine existing methods using two different encoders—an ImageNet pretrained and a pathology-specific foundation model—and show that in all cases SMMILe matches or exceeds state-of-the-art whole-slide image classification performance while simultaneously achieving outstanding spatial quantification. Gao et al. present SMMILe, a multiple-instance learning-based tool that leverages whole-slide images for accurate spatial quantification without compromising on classification performance, and show it outperforms state-of-the-art methods.","PeriodicalId":18885,"journal":{"name":"Nature cancer","volume":"6 12","pages":"2025-2041"},"PeriodicalIF":28.5,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s43018-025-01060-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-14DOI: 10.1038/s43018-025-01073-3
Elinor Gigi, Nancy Gavert, Lilach Raijman-Nagar, Yaara Zwang, Hofit Zemach, Ilana Livyatan, Adva Levy-Barda, Yossi Laviv, Andrew A. Kanner, Alexandra Amiel, Tali Siegal, Anca Leibovici, Inna Selezen, Omar Badran, Yaniv Zohar, Esraa Safadi, Lyndsey L. Prather, Cassandra R. Helfer, Patricia Castro, Iris Barshack, Tali Dadosh, Smadar Levin-Zaidman, Inna Goliand, Ofra Golani, Suzana Horn, Jacob J. Mandel, Noam Shental, Ayelet Shai, Shlomit Yust-Katz, Ravid Straussman
Brain tumors, including glioblastoma multiforme (GBM) and brain metastases, present a notable clinical challenge. Recent research highlights the presence of intratumor bacteria across many tumor types, yet the microbiome of brain tumors remains largely underexplored. Here we show that the microbiome of 322 brain tumors differs markedly by tumor type and location. Using multiple approaches to visualize, culture and sequence bacterial communities, we found that brain metastases harbor higher bacterial richness and diversity than GBM, with distinct microbial compositions. Moreover, metastases in posterior brain regions exhibited greater diversity than those in anterior regions. Pathway analysis revealed enrichment of bacterial metabolic pathways associated with tumor spread and metastasis in brain metastases while GBM was enriched with pathways supporting alternative phosphorus use. These findings provide valuable insights into the microbial landscape of brain tumors, highlighting tumor-type-specific and location-specific variation and suggesting potential roles for bacteria in brain tumor biology. Using multiple visualization and profiling methods, Gigi et al. characterize the microbiome diversity of 322 brain tumors including brain metastases and glioblastomas.
{"title":"Characterization of the tumor microbiome of brain metastases and glioblastoma reveals tumor-type-specific and location-specific microbial signatures","authors":"Elinor Gigi, Nancy Gavert, Lilach Raijman-Nagar, Yaara Zwang, Hofit Zemach, Ilana Livyatan, Adva Levy-Barda, Yossi Laviv, Andrew A. Kanner, Alexandra Amiel, Tali Siegal, Anca Leibovici, Inna Selezen, Omar Badran, Yaniv Zohar, Esraa Safadi, Lyndsey L. Prather, Cassandra R. Helfer, Patricia Castro, Iris Barshack, Tali Dadosh, Smadar Levin-Zaidman, Inna Goliand, Ofra Golani, Suzana Horn, Jacob J. Mandel, Noam Shental, Ayelet Shai, Shlomit Yust-Katz, Ravid Straussman","doi":"10.1038/s43018-025-01073-3","DOIUrl":"10.1038/s43018-025-01073-3","url":null,"abstract":"Brain tumors, including glioblastoma multiforme (GBM) and brain metastases, present a notable clinical challenge. Recent research highlights the presence of intratumor bacteria across many tumor types, yet the microbiome of brain tumors remains largely underexplored. Here we show that the microbiome of 322 brain tumors differs markedly by tumor type and location. Using multiple approaches to visualize, culture and sequence bacterial communities, we found that brain metastases harbor higher bacterial richness and diversity than GBM, with distinct microbial compositions. Moreover, metastases in posterior brain regions exhibited greater diversity than those in anterior regions. Pathway analysis revealed enrichment of bacterial metabolic pathways associated with tumor spread and metastasis in brain metastases while GBM was enriched with pathways supporting alternative phosphorus use. These findings provide valuable insights into the microbial landscape of brain tumors, highlighting tumor-type-specific and location-specific variation and suggesting potential roles for bacteria in brain tumor biology. Using multiple visualization and profiling methods, Gigi et al. characterize the microbiome diversity of 322 brain tumors including brain metastases and glioblastomas.","PeriodicalId":18885,"journal":{"name":"Nature cancer","volume":"6 11","pages":"1761-1776"},"PeriodicalIF":28.5,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-11DOI: 10.1038/s43018-025-01057-3
Relapse after CAR T cell therapy is often caused by tumors that have low levels of the target antigen. By engineering a membrane-tethered version of the signaling adaptor SLP-76, we improved the ability of CAR T cells to respond to antigen-low tumors. This restored CAR T cell function in multiple preclinical models and offers a potential strategy to overcome this common form of resistance.
CAR - T细胞治疗后的复发通常是由目标抗原水平低的肿瘤引起的。通过设计信号转接器SLP-76的膜系版本，我们提高了CAR - T细胞对低抗原肿瘤的反应能力。这在多个临床前模型中恢复了CAR - T细胞的功能，并提供了克服这种常见抵抗形式的潜在策略。
{"title":"Enhancing CAR sensitivity through engineering of proximal signaling molecules","authors":"","doi":"10.1038/s43018-025-01057-3","DOIUrl":"10.1038/s43018-025-01057-3","url":null,"abstract":"Relapse after CAR T cell therapy is often caused by tumors that have low levels of the target antigen. By engineering a membrane-tethered version of the signaling adaptor SLP-76, we improved the ability of CAR T cells to respond to antigen-low tumors. This restored CAR T cell function in multiple preclinical models and offers a potential strategy to overcome this common form of resistance.","PeriodicalId":18885,"journal":{"name":"Nature cancer","volume":"6 12","pages":"1936-1937"},"PeriodicalIF":28.5,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1038/s43018-025-01065-3
Jing Han, Xiaoman Lu, Mengmeng Guo, Ruizhe He, Meilian Zhuo, Saisai Wang, Yong Li, Xiangzheng Liu, Di Zou, Jiacheng Wang, Jiangjiao Mao, Qian Chen, Xia Wang, Junya Peng, Wei Xie, Charles J. David, Mo Chen
Acute pancreatitis-induced acinar-to-ductal metaplasia involves global chromatin remodeling and contributes to normal tissue regeneration. Oncogenic KRAS hijacks this process to promote PDAC formation. Here we show that regeneration and KRASG12D-driven oncogenesis can be decoupled from tissue regeneration through a chromatin remodeler, SMARCA5. We show that SMARCA5 maintains KRASG12D-dependent chromatin accessibility at regions specifically required for malignancy, without affecting chromatin opening that occurs during normal regeneration. Without SMARCA5, regeneration can be restored in the presence of KRASG12D. Mechanistically, regeneration-related or malignancy-related chromatin remodeling activities occur in a time-sensitive manner. The activity of SMARCA5 is controlled spatiotemporally by transcription factor RUNX1, which only accumulates at sufficient levels with sustained MAPK signals. We further show that inhibition of the SMARCA5-containing NoRC complex specifically inhibits the growth of PDAC organoid but not that of normal tissue derived from patients. Han et al. show that SMARCA5 is required for the sustained expression of genes required for malignancy in pancreatic cells with mutant KRAS. Inhibiting SMARCA5 activity prevents malignant transformation while maintaining pancreatic regeneration.
{"title":"Spatiotemporal control of SMARCA5 by a MAPK–RUNX1 axis distinguishes mutant KRAS-driven pancreatic malignancy from tissue regeneration","authors":"Jing Han, Xiaoman Lu, Mengmeng Guo, Ruizhe He, Meilian Zhuo, Saisai Wang, Yong Li, Xiangzheng Liu, Di Zou, Jiacheng Wang, Jiangjiao Mao, Qian Chen, Xia Wang, Junya Peng, Wei Xie, Charles J. David, Mo Chen","doi":"10.1038/s43018-025-01065-3","DOIUrl":"10.1038/s43018-025-01065-3","url":null,"abstract":"Acute pancreatitis-induced acinar-to-ductal metaplasia involves global chromatin remodeling and contributes to normal tissue regeneration. Oncogenic KRAS hijacks this process to promote PDAC formation. Here we show that regeneration and KRASG12D-driven oncogenesis can be decoupled from tissue regeneration through a chromatin remodeler, SMARCA5. We show that SMARCA5 maintains KRASG12D-dependent chromatin accessibility at regions specifically required for malignancy, without affecting chromatin opening that occurs during normal regeneration. Without SMARCA5, regeneration can be restored in the presence of KRASG12D. Mechanistically, regeneration-related or malignancy-related chromatin remodeling activities occur in a time-sensitive manner. The activity of SMARCA5 is controlled spatiotemporally by transcription factor RUNX1, which only accumulates at sufficient levels with sustained MAPK signals. We further show that inhibition of the SMARCA5-containing NoRC complex specifically inhibits the growth of PDAC organoid but not that of normal tissue derived from patients. Han et al. show that SMARCA5 is required for the sustained expression of genes required for malignancy in pancreatic cells with mutant KRAS. Inhibiting SMARCA5 activity prevents malignant transformation while maintaining pancreatic regeneration.","PeriodicalId":18885,"journal":{"name":"Nature cancer","volume":"7 1","pages":"43-59"},"PeriodicalIF":28.5,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1038/s43018-025-01058-2
Sijia Gu, Qiyu Luo, Yalei Zhang, Ling Qian, Kun Chen, Fei Liang, Yudi Hu, Runye Zhou, Yating Wang, Jingjing Liu, Zhouyu Ning, Litao Xu, Zhiqiang Meng, Ye Li, Peng Wang
Treatment options for advanced or metastatic intrahepatic cholangiocarcinoma (ICC) are limited. In this single-arm, phase 2 trial (CASTLE-01, NCT05010668 ), 28 participants with advanced or metastatic ICC who have progressed after chemotherapy were treated with cryoablation, followed by anti-PD1 sintilimab (200 mg every 3 weeks) plus lenvatinib (8–12 mg per day) 2 weeks later. The objective response rate assessed by Response Evaluation Criteria in Solid Tumors version 1.1 was 75.0% (95% confidence interval (CI): 59–91%), meeting the prespecified primary endpoint. Secondary endpoints of disease control rate, median progression-free survival and overall survival were respectively 100% (95% CI: 100–100%), 16.8 months (95% CI: 11.5–not reached (NR)) and 25.4 months (95% CI: 13.3–NR). Treatment was well tolerated. Post hoc multiomics analysis of paired pretreatment and on-treatment tumor biopsies suggested that cryoablation increased the tumor immunogenicity and dendritic cell activation, followed by triggering continuous replenishment of intratumoral CD8+PD1hi effectors from peripheral blood. The addition of lenvatinib transitioned endothelial cells into inflamed venules to boost lymphocyte influx and targeted tumor stroma to promote CD8+PD1hi effectors penetrating into tumor cell nests. Therefore, cryoablation combined with sintilimab plus lenvatinib represents a promising approach for the treatment of advanced or metastatic ICC. These findings also support the notion that cryoablation may trigger abscopal antitumor immunity in ICC when combined with lenvatinib and PD1 blockade. ClinicalTrials.gov registration: NCT05010668 . Wang and colleagues report the clinical results and immunological correlates of a phase 2 clinical trial of cryoablation plus lenvatinib and sintilimab in persons with advanced or metastatic intrahepatic cholangiocarcinoma.
{"title":"Cryoablation plus sintilimab and lenvatinib in advanced or metastatic intrahepatic cholangiocarcinoma: a phase 2 trial","authors":"Sijia Gu, Qiyu Luo, Yalei Zhang, Ling Qian, Kun Chen, Fei Liang, Yudi Hu, Runye Zhou, Yating Wang, Jingjing Liu, Zhouyu Ning, Litao Xu, Zhiqiang Meng, Ye Li, Peng Wang","doi":"10.1038/s43018-025-01058-2","DOIUrl":"10.1038/s43018-025-01058-2","url":null,"abstract":"Treatment options for advanced or metastatic intrahepatic cholangiocarcinoma (ICC) are limited. In this single-arm, phase 2 trial (CASTLE-01, NCT05010668 ), 28 participants with advanced or metastatic ICC who have progressed after chemotherapy were treated with cryoablation, followed by anti-PD1 sintilimab (200 mg every 3 weeks) plus lenvatinib (8–12 mg per day) 2 weeks later. The objective response rate assessed by Response Evaluation Criteria in Solid Tumors version 1.1 was 75.0% (95% confidence interval (CI): 59–91%), meeting the prespecified primary endpoint. Secondary endpoints of disease control rate, median progression-free survival and overall survival were respectively 100% (95% CI: 100–100%), 16.8 months (95% CI: 11.5–not reached (NR)) and 25.4 months (95% CI: 13.3–NR). Treatment was well tolerated. Post hoc multiomics analysis of paired pretreatment and on-treatment tumor biopsies suggested that cryoablation increased the tumor immunogenicity and dendritic cell activation, followed by triggering continuous replenishment of intratumoral CD8+PD1hi effectors from peripheral blood. The addition of lenvatinib transitioned endothelial cells into inflamed venules to boost lymphocyte influx and targeted tumor stroma to promote CD8+PD1hi effectors penetrating into tumor cell nests. Therefore, cryoablation combined with sintilimab plus lenvatinib represents a promising approach for the treatment of advanced or metastatic ICC. These findings also support the notion that cryoablation may trigger abscopal antitumor immunity in ICC when combined with lenvatinib and PD1 blockade. ClinicalTrials.gov registration: NCT05010668 . Wang and colleagues report the clinical results and immunological correlates of a phase 2 clinical trial of cryoablation plus lenvatinib and sintilimab in persons with advanced or metastatic intrahepatic cholangiocarcinoma.","PeriodicalId":18885,"journal":{"name":"Nature cancer","volume":"7 1","pages":"60-79"},"PeriodicalIF":28.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s43018-025-01058-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-27DOI: 10.1038/s43018-025-01061-7
Yijie Tao, Shulei Yin, Kai Wei, Liyuan Zhao, Yani Cui, Chunzhen Li, Yunyang Wu, Panpan Hu, Shenhui Yin, Likun Cui, Yunyan Zhang, Yixian He, Shu Yu, Jie Chen, Shaoteng Lu, Guifang Qiu, Mengqi Song, Siqi Yang, Qianshan Hou, Yiquan Xue, Chen Qian, Sheng Xu, Yizhi Yu, Zui Zou
Systemic therapy is the optimal choice for individuals with unresectable or advanced hepatocellular carcinoma (HCC). However its effectiveness is constrained by resistance. Ferroptosis is a unique form of regulated cell death and plays an essential role in HCC systemic therapy. Here we identified that secernin-1 (SCRN1) was closely associated with ferroptosis resistance and poor prognosis in HCC. Specifically, high expression of SCRN1 enhances the interaction of phosphokinase serine/threonine kinase 38 (STK38) and glutathione peroxidase 4 (GPX4) to promote the phosphorylation of GPX4 at S45. This phosphorylation impairs heat shock protein family A member 8 (HSC70) recognition and degradation of GPX4 by chaperone-mediated autophagy, which further alleviates lipid peroxidation and ferroptosis. Our findings reveal a critical mechanism by which tumor cells antagonize ferroptosis through enhanced GPX4 phosphorylation and provide potential targets and strategies for HCC treatment. Tao et al. show that SCRN1 acts as a scaffold to facilitate GPX4 phosphorylation by STK38, thereby preventing chaperone-mediated autophagy of GPX4 and subsequent ferroptosis in patient-derived organoids and mouse models for hepatocellular carcinoma.
{"title":"SCRN1 confers hepatocellular carcinoma resistance to ferroptosis by stabilizing GPX4 via STK38-mediated phosphorylation","authors":"Yijie Tao, Shulei Yin, Kai Wei, Liyuan Zhao, Yani Cui, Chunzhen Li, Yunyang Wu, Panpan Hu, Shenhui Yin, Likun Cui, Yunyan Zhang, Yixian He, Shu Yu, Jie Chen, Shaoteng Lu, Guifang Qiu, Mengqi Song, Siqi Yang, Qianshan Hou, Yiquan Xue, Chen Qian, Sheng Xu, Yizhi Yu, Zui Zou","doi":"10.1038/s43018-025-01061-7","DOIUrl":"10.1038/s43018-025-01061-7","url":null,"abstract":"Systemic therapy is the optimal choice for individuals with unresectable or advanced hepatocellular carcinoma (HCC). However its effectiveness is constrained by resistance. Ferroptosis is a unique form of regulated cell death and plays an essential role in HCC systemic therapy. Here we identified that secernin-1 (SCRN1) was closely associated with ferroptosis resistance and poor prognosis in HCC. Specifically, high expression of SCRN1 enhances the interaction of phosphokinase serine/threonine kinase 38 (STK38) and glutathione peroxidase 4 (GPX4) to promote the phosphorylation of GPX4 at S45. This phosphorylation impairs heat shock protein family A member 8 (HSC70) recognition and degradation of GPX4 by chaperone-mediated autophagy, which further alleviates lipid peroxidation and ferroptosis. Our findings reveal a critical mechanism by which tumor cells antagonize ferroptosis through enhanced GPX4 phosphorylation and provide potential targets and strategies for HCC treatment. Tao et al. show that SCRN1 acts as a scaffold to facilitate GPX4 phosphorylation by STK38, thereby preventing chaperone-mediated autophagy of GPX4 and subsequent ferroptosis in patient-derived organoids and mouse models for hepatocellular carcinoma.","PeriodicalId":18885,"journal":{"name":"Nature cancer","volume":"6 12","pages":"1976-1993"},"PeriodicalIF":28.5,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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