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Defining precancer: a grand challenge for the cancer community 定义癌前病变:癌症界面临的巨大挑战
IF 72.5 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-10-01 DOI: 10.1038/s41568-024-00744-0
Jessica Faupel-Badger, Indu Kohaar, Manisha Bahl, Andrew T. Chan, Joshua D. Campbell, Li Ding, Angelo M. De Marzo, Anirban Maitra, Daniel T. Merrick, Ernest T. Hawk, Ignacio I. Wistuba, Irene M. Ghobrial, Scott M. Lippman, Karen H. Lu, Mark Lawler, Neil E. Kay, Thea D. Tlsty, Timothy R. Rebbeck, Sudhir Srivastava, the Precancer Think Tank Team
The term ‘precancer’ typically refers to an early stage of neoplastic development that is distinguishable from normal tissue owing to molecular and phenotypic alterations, resulting in abnormal cells that are at least partially self-sustaining and function outside of normal cellular cues that constrain cell proliferation and survival. Although such cells are often histologically distinct from both the corresponding normal and invasive cancer cells of the same tissue origin, defining precancer remains a challenge for both the research and clinical communities. Once sufficient molecular and phenotypic changes have occurred in the precancer, the tissue is identified as a ‘cancer’ by a histopathologist. While even diagnosing cancer can at times be challenging, the determination of invasive cancer is generally less ambiguous and suggests a high likelihood of and potential for metastatic disease. The ‘hallmarks of cancer’ set out the fundamental organizing principles of malignant transformation but exactly how many of these hallmarks and in what configuration they define precancer has not been clearly and consistently determined. In this Expert Recommendation, we provide a starting point for a conceptual framework for defining precancer, which is based on molecular, pathological, clinical and epidemiological criteria, with the goal of advancing our understanding of the initial changes that occur and opportunities to intervene at the earliest possible time point. In this Expert Recommendation, Faupel-Badger and colleagues present a conceptual framework to define precancer and advance our understanding of the earliest changes that occur in the progression to overt cancer, providing novel opportunities to intervene to prevent or treat their emergence.
癌前病变 "一词通常是指肿瘤发展的早期阶段,由于分子和表型的改变,导致异常细胞至少部分具有自我维持能力,并在限制细胞增殖和存活的正常细胞线索之外发挥作用,从而与正常组织区分开来。虽然这类细胞在组织学上往往有别于相同组织来源的相应正常细胞和浸润性癌细胞,但如何界定癌前病变仍然是研究和临床界面临的一项挑战。一旦癌前病变发生了足够的分子和表型变化,组织病理学家就会将该组织鉴定为 "癌症"。虽然诊断癌症有时也很困难,但浸润性癌症的确定通常不那么模糊,而且表明转移性疾病的可能性很高。癌症的标志 "规定了恶性转化的基本组织原则,但究竟有多少标志以及它们以何种形式定义癌前病变,尚未得到明确一致的确定。在本专家建议中,我们以分子、病理、临床和流行病学标准为基础,为定义癌前病变的概念框架提供了一个起点,目的是促进我们对发生的初始变化和尽早干预的机会的了解。
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引用次数: 0
A standing platform for cancer drug development using ctDNA-based evidence of recurrence 利用基于ctDNA的复发证据开发癌症药物的常设平台
IF 72.5 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-09-30 DOI: 10.1038/s41568-024-00742-2
Arielle J. Medford, Ariel B. Carmeli, Alexandra Ritchie, Nikhil Wagle, Levi Garraway, Eric S. Lander, Aparna Parikh
The time required to conduct clinical trials limits the rate at which we can evaluate and deliver new treatment options to patients with cancer. New approaches to increase trial efficiency while maintaining rigor would benefit patients, especially in oncology, in which adjuvant trials hold promise for intercepting metastatic disease, but typically require large numbers of patients and many years to complete. We envision a standing platform — an infrastructure to support ongoing identification and trial enrolment of patients with cancer with early molecular evidence of disease (MED) after curative-intent therapy for early-stage cancer, based on the presence of circulating tumour DNA. MED strongly predicts subsequent recurrence, with the vast majority of patients showing radiographic evidence of disease within 18 months. Such a platform would allow efficient testing of many treatments, from small exploratory studies to larger pivotal trials. Trials enrolling patients with MED but without radiographic evidence of disease have the potential to advance drug evaluation because they can be smaller (given high probability of recurrence) and faster (given short time to recurrence) than conventional adjuvant trials. Circulating tumour DNA may also provide a valuable early biomarker of treatment effect, which would allow small signal-finding trials. In this Perspective, we discuss how such a platform could be established. Efficient clinical trials are crucial for advancing cancer care. In this Perspective, the authors propose a platform that leverages circulating tumour DNA to identify patients with early-stage cancer at high risk of recurrence and enrol them onto therapeutic clinical trials. This approach would enable faster, smaller trials and streamline evaluation of drugs aimed at preventing disease recurrence and increasing cure.
开展临床试验所需的时间限制了我们为癌症患者评估和提供新治疗方案的速度。提高试验效率同时保持严谨性的新方法将使患者受益,尤其是在肿瘤学领域,辅助试验有望拦截转移性疾病,但通常需要大量患者和多年时间才能完成。我们设想建立一个常设平台--一个支持对早期癌症治愈性治疗后出现早期疾病分子证据(MED)的癌症患者进行持续识别和试验登记的基础设施,其基础是循环肿瘤 DNA 的存在。MED 可有力地预测随后的复发,绝大多数患者会在 18 个月内出现放射学上的疾病证据。有了这样一个平台,就可以对许多治疗方法进行高效测试,从小型探索性研究到大型关键性试验。招募有 MED 但无放射学疾病证据的患者参加的试验有可能推动药物评估,因为与传统的辅助试验相比,这些试验规模更小(因为复发概率高)、速度更快(因为复发时间短)。循环肿瘤 DNA 也可能为治疗效果提供有价值的早期生物标志物,从而允许进行小型信号搜索试验。在本视角中,我们将讨论如何建立这样一个平台。
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引用次数: 0
VIBRANT: mapping cell phenotypes using vibrational spectroscopy VIBRANT:利用振动光谱绘制细胞表型图
IF 78.5 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-09-19 DOI: 10.1038/s41568-024-00749-9
Xinwen Liu
In this Tools of the Trade article, Xinwen Liu describes the development of VIBRANT, a vibrational spectroscopy method for high-content phenotypic profiling, and highlights its use to predict drug mechanisms of action or identify potential drug candidates.
在这篇 "贸易工具"(Tools of the Trade)文章中,刘新文介绍了用于高含量表型分析的振动光谱法 VIBRANT 的开发过程,并重点介绍了该方法在预测药物作用机制或确定潜在候选药物方面的应用。
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引用次数: 0
The recruitment of metastasis-associated monocytes 转移相关单核细胞的招募
IF 72.5 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-09-18 DOI: 10.1038/s41568-024-00753-z
Suhn Hyung Kim, Keehoon Jung
In this Journal Club, Kim and Jung discuss a study that demonstrates the role of CCL2 in recruiting monocytes to the metastasic site.
在本期 "期刊俱乐部 "中,Kim 和 Jung 讨论了一项研究,该研究证明了 CCL2 在招募单核细胞到转移部位方面的作用。
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引用次数: 0
Managing cancer following the World Trade Center disaster 世贸中心灾难后的癌症管理
IF 72.5 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-09-11 DOI: 10.1038/s41568-024-00730-6
Rachel Zeig-Owens, David J. Prezant
The World Trade Center (WTC) disaster exposed individuals to carcinogens, leading to elevated cancer rates. Responders who received care through the WTC Health Program have higher survival rates. Twenty-three years post-disaster, we summarize cancer incidence and outcome studies in this population and highlight the importance of a dedicated health programme response.
世界贸易中心(WTC)灾难使人们接触到致癌物质,导致癌症发病率升高。通过 "世贸中心健康计划 "接受治疗的救灾人员存活率更高。灾后 23 年,我们总结了这一人群的癌症发病率和治疗效果研究,并强调了专门的健康计划应对措施的重要性。
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引用次数: 0
The evolutionary theory of cancer: challenges and potential solutions 癌症进化论:挑战与潜在解决方案
IF 72.5 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-09-10 DOI: 10.1038/s41568-024-00734-2
Lucie Laplane, Carlo C. Maley
The clonal evolution model of cancer was developed in the 1950s–1970s and became central to cancer biology in the twenty-first century, largely through studies of cancer genetics. Although it has proven its worth, its structure has been challenged by observations of phenotypic plasticity, non-genetic forms of inheritance, non-genetic determinants of clone fitness and non-tree-like transmission of genes. There is even confusion about the definition of a clone, which we aim to resolve. The performance and value of the clonal evolution model depends on the empirical extent to which evolutionary processes are involved in cancer, and on its theoretical ability to account for those evolutionary processes. Here, we identify limits in the theoretical performance of the clonal evolution model and provide solutions to overcome those limits. Although we do not claim that clonal evolution can explain everything about cancer, we show how many of the complexities that have been identified in the dynamics of cancer can be integrated into the model to improve our current understanding of cancer. Clonal evolution is now a central theoretical framework in cancer research. In this Perspective, Laplane and Maley identify challenges to that theory such that some non-evolutionary phenomena in cancer cannot be captured by the theory. They also outline how other challenges, including non-genetic heredity, phenotypic plasticity, reticulate evolution and clone diversity, can be included in an expanded cancer evolutionary theory.
癌症的克隆进化模式是在 20 世纪 50-70 年代提出的,主要通过癌症遗传学的研究,在 21 世纪成为癌症生物学的核心。尽管它的价值已经得到了证明,但其结构也受到了表型可塑性、非遗传形式的遗传、克隆适应性的非遗传决定因素以及基因的非树状传递等观察结果的挑战。克隆的定义甚至也存在混乱,我们的目的就是要解决这个问题。克隆进化模型的性能和价值取决于进化过程在癌症中的实证参与程度,以及其解释这些进化过程的理论能力。在此,我们指出了克隆进化模型理论性能的局限性,并提供了克服这些局限性的解决方案。虽然我们并不声称克隆进化可以解释癌症的一切,但我们展示了如何将癌症动力学中已发现的许多复杂性纳入模型,以改善我们目前对癌症的理解。
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引用次数: 0
Creating a dietary vulnerability 制造饮食漏洞
IF 72.5 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-09-10 DOI: 10.1038/s41568-024-00751-1
Daniela Senft
In a recent Nature paper, Ruggero and colleagues found that fasting and ketogenic diets induce metabolic rewiring through a translational mechanism involving MNK-mediated phosphorylation of eIF4E, which enhances ketogenesis. This process creates a metabolic vulnerability in pancreatic cancer that could be therapeutically exploited.
在最近的一篇《自然》论文中,Ruggero 及其同事发现,禁食和生酮饮食会通过一种涉及 MNK 介导的 eIF4E 磷酸化的翻译机制诱导代谢重构,从而增强生酮作用。这一过程在胰腺癌中产生了一种代谢脆弱性,可用于治疗。
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引用次数: 0
CAF-induced physical constraints controlling T cell state and localization in solid tumours 控制实体瘤中 T 细胞状态和定位的 CAF 诱导物理约束
IF 72.5 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-09-09 DOI: 10.1038/s41568-024-00740-4
Ludovica Arpinati, Giulia Carradori, Ruth Scherz-Shouval
Solid tumours comprise cancer cells that engage in continuous interactions with non-malignant cells and with acellular components, forming the tumour microenvironment (TME). The TME has crucial and diverse roles in tumour progression and metastasis, and substantial efforts have been dedicated into understanding the functions of different cell types within the TME. These efforts highlighted the importance of non-cell-autonomous signalling in cancer, mediating interactions between the cancer cells, the immune microenvironment and the non-immune stroma. Much of this non-cell-autonomous signalling is mediated through acellular components of the TME, known as the extracellular matrix (ECM), and controlled by the cells that secrete and remodel the ECM — the cancer-associated fibroblasts (CAFs). In this Review, we delve into the complex crosstalk among cancer cells, CAFs and immune cells, highlighting the effects of CAF-induced ECM remodelling on T cell functions and offering insights into the potential of targeting ECM components to improve cancer therapies. In this Review, Arpinati et al. summarize how the extracellular matrix, produced primarily by cancer-associated fibroblasts, impacts tumour progression, metastasis and therapy response through modulation of T cell-mediated antitumour immunity and propose routes to target these mechanisms therapeutically.
实体瘤由癌细胞组成,这些癌细胞与非恶性细胞和无细胞成分不断相互作用,形成肿瘤微环境(TME)。肿瘤微环境在肿瘤进展和转移过程中起着至关重要的多种作用,人们一直致力于了解肿瘤微环境中不同类型细胞的功能。这些努力凸显了非细胞自主信号在癌症中的重要性,它介导着癌细胞、免疫微环境和非免疫基质之间的相互作用。这种非细胞自主信号大多通过 TME 的细胞外基质 (ECM) 的细胞成分介导,并受控于分泌和重塑 ECM 的细胞--癌症相关成纤维细胞 (CAF)。在这篇综述中,我们将深入探讨癌细胞、CAFs 和免疫细胞之间复杂的相互关系,强调 CAF 诱导的 ECM 重塑对 T 细胞功能的影响,并深入探讨以 ECM 成分为靶点改善癌症疗法的潜力。
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引用次数: 0
Overcoming heterogeneity with 3D whole-tumour sampling 利用三维全肿瘤取样克服异质性
IF 78.5 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-09-06 DOI: 10.1038/s41568-024-00746-y
Radhika Mathur
In this Tools of the Trade article, Radhika Mathur describes the development of a novel 3D whole-tumour sampling approach for glioblastoma, which can be used to elucidate tumour heterogeneity.
在这篇 "贸易工具 "文章中,Radhika Mathur 介绍了针对胶质母细胞瘤开发的新型三维全肿瘤取样方法,该方法可用于阐明肿瘤的异质性。
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引用次数: 0
Intercepting gastric cancer 拦截胃癌
IF 72.5 1区 材料科学 Q1 CHEMISTRY, MULTIDISCIPLINARY Pub Date : 2024-09-05 DOI: 10.1038/s41568-024-00748-w
Anna Dart
Pan et al. performed a large-scale, cluster-randomized controlled trial to assess whether eradicating Helicobacter pylori in asymptomatic individuals would be beneficial in preventing gastric cancer.
Pan 等人进行了一项大规模的分组随机对照试验,以评估根除无症状者体内的幽门螺杆菌是否有益于预防胃癌。
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引用次数: 0
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Energy & Environmental Science
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