Pub Date : 2025-10-23DOI: 10.20892/j.issn.2095-3941.2025.0290
Rui Ding, Zhiming Shao, Tianjian Yu
Objective: Large-scale CRISPR screens have identified essential genes across cancer cell lines, but links between tumor functional properties and specific dependencies require investigation to reveal the mechanisms underlying dependencies and broaden understanding of targeted therapy.
Methods: We selected 47 breast cancer cell lines from the Cancer Cell Line Encyclopedia (CCLE) with multi-omics data including gene dependency; somatic mutations; copy number alterations; and transcriptomic, proteomic, metabolomic, and methylation data. We established a dependency marker association (DMA) analytic pipeline by using linear regression modeling to assess associations between 3,874 representative gene dependencies and multi-omics markers. Additionally, we conducted non-negative matrix factorization clustering, to stratify breast cancer cell lines according to gene dependency features, and investigated cluster-specific DMAs.
Results: We interpreted valuable DMAs according to two primary aspects. First, dependencies associated with gain-of-function alterations revealed addiction to lactate transporter SLC16A3, thus suggesting a promising therapeutic target. Second, dependencies associated with loss-of-function alterations included synthetic lethality (SL), collateral SL, and prioritized metabolic SL, encompassing paralog SL (e.g., IMPDH1 and IMPDH2), single pathway SL (e.g., GFPT1 and UAP1), and alternative pathway SL (e.g., GPI and PGD). DMA analysis of the two clusters with divergent dependency signatures demonstrated that cluster1 cell lines exhibited extensive metabolism with mitochondrial protein dependencies, whereas cluster2 displays enhanced cell signaling, and reliance on DNA replication and membrane organelle regulators.
Conclusions: We established a DMA analysis pipeline linking the gene dependencies of breast cancer cell lines to multi-omics characteristics, thus elucidating the underpinnings of tumor dependencies and offering a valuable resource for developing novel precision treatment strategies incorporating relevant markers.
目的:大规模的CRISPR筛选已经确定了跨越癌细胞系的必要基因,但肿瘤功能特性与特定依赖之间的联系需要研究,以揭示依赖的潜在机制,并拓宽对靶向治疗的理解。方法:从美国癌症细胞系百科全书(cancer cell Line Encyclopedia, CCLE)中选取47株乳腺癌细胞系,其中包含多组学数据,包括基因依赖性;体细胞突变;副本号码更改;转录组学、蛋白质组学、代谢组学和甲基化数据。我们利用线性回归模型建立了依赖标记关联(DMA)分析管道,评估了3874个具有代表性的基因依赖与多组学标记之间的关联。此外,我们进行了非阴性基质因子聚类,根据基因依赖特征对乳腺癌细胞系进行分层,并研究了簇特异性DMAs。结果:我们从两个主要方面解释了有价值的dma。首先,与功能获得改变相关的依赖性揭示了对乳酸转运蛋白SLC16A3的依赖性,从而提示了一个有希望的治疗靶点。其次,与功能丧失改变相关的依赖性包括合成致死率(SL)、侧支SL和优先代谢SL,包括平行SL(例如,IMPDH1和IMPDH2)、单途径SL(例如,GFPT1和UAP1)和替代途径SL(例如,GPI和PGD)。对具有不同依赖特征的两个集群的DMA分析表明,cluster1细胞系表现出广泛的线粒体蛋白依赖代谢,而cluster2细胞系表现出增强的细胞信号传导,并依赖DNA复制和膜细胞器调节因子。结论:我们建立了将乳腺癌细胞系的基因依赖性与多组学特征联系起来的DMA分析管道,从而阐明了肿瘤依赖性的基础,并为开发包含相关标记的新型精准治疗策略提供了宝贵的资源。
{"title":"Comprehensive investigation of the molecular basis of cancer dependencies suggests therapeutic options for breast cancer.","authors":"Rui Ding, Zhiming Shao, Tianjian Yu","doi":"10.20892/j.issn.2095-3941.2025.0290","DOIUrl":"10.20892/j.issn.2095-3941.2025.0290","url":null,"abstract":"<p><strong>Objective: </strong>Large-scale CRISPR screens have identified essential genes across cancer cell lines, but links between tumor functional properties and specific dependencies require investigation to reveal the mechanisms underlying dependencies and broaden understanding of targeted therapy.</p><p><strong>Methods: </strong>We selected 47 breast cancer cell lines from the Cancer Cell Line Encyclopedia (CCLE) with multi-omics data including gene dependency; somatic mutations; copy number alterations; and transcriptomic, proteomic, metabolomic, and methylation data. We established a dependency marker association (DMA) analytic pipeline by using linear regression modeling to assess associations between 3,874 representative gene dependencies and multi-omics markers. Additionally, we conducted non-negative matrix factorization clustering, to stratify breast cancer cell lines according to gene dependency features, and investigated cluster-specific DMAs.</p><p><strong>Results: </strong>We interpreted valuable DMAs according to two primary aspects. First, dependencies associated with gain-of-function alterations revealed addiction to lactate transporter SLC16A3, thus suggesting a promising therapeutic target. Second, dependencies associated with loss-of-function alterations included synthetic lethality (SL), collateral SL, and prioritized metabolic SL, encompassing paralog SL (e.g., IMPDH1 and IMPDH2), single pathway SL (e.g., GFPT1 and UAP1), and alternative pathway SL (e.g., GPI and PGD). DMA analysis of the two clusters with divergent dependency signatures demonstrated that cluster1 cell lines exhibited extensive metabolism with mitochondrial protein dependencies, whereas cluster2 displays enhanced cell signaling, and reliance on DNA replication and membrane organelle regulators.</p><p><strong>Conclusions: </strong>We established a DMA analysis pipeline linking the gene dependencies of breast cancer cell lines to multi-omics characteristics, thus elucidating the underpinnings of tumor dependencies and offering a valuable resource for developing novel precision treatment strategies incorporating relevant markers.</p>","PeriodicalId":9611,"journal":{"name":"Cancer Biology & Medicine","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12724301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The aim of the current study was to identify independent prognostic factors, evaluate differential adjuvant chemotherapy efficacy across clinicopathologic subgroups, and define adjuvant chemotherapy-sensitive populations.
Methods: A retrospective analysis of 168 AAC patients undergoing curative pancreaticoduodenectomy (2011-2020) was performed. Cases were classified into intestinal (28.0%), pancreatobiliary (30.4%), and mixed subtypes (18.5%) per NCCN (v2.2025) criteria. Independent prognostic factors for AAC patients were identified through uni- and multi-variable Cox proportional hazards modeling and subgroup analyses were stratified by age range, gender, differentiation, T stage, N stage, BVI, TDs, and PNI.
Results: The pancreatobiliary signature (HR = 2.884, P < 0.001) and BVI (HR = 2.330, P = 0.001) were independent poor prognostic factors. Adjuvant chemotherapy improved overall survival (OS) in the following AAC patients: T3-T4 stage (HR = 0.485, P = 0.050); N1-N2 stage (HR = 0.365, P = 0.008); and TD-positive (HR = 0.401, P = 0.026). The median OS increased from 22.3-51.3 months with adjuvant chemotherapy in TD-positive patients (P = 0.019). TD positivity conferred a worse prognosis in BVI-negative subgroups (OS: HR = 3.840, 95% CI: 2.058-7.166, P < 0.001; and progression-free survival (PFS): HR = 2.950, 95% CI: 1.550-5.617, P = 0.002).
Conclusions: The pancreatobiliary signature and BVI constitute critical high-risk pathologic features in AAC. TD status identified high-risk cohorts, thus enabling postoperative risk-stratified treatment strategies. In patients negative for pancreatobiliary signature or BVI, TD positivity predicted significantly worse survival.
目的:本研究的目的是确定独立的预后因素,评估不同临床病理亚组的辅助化疗疗效,并确定辅助化疗敏感人群。方法:对2011-2020年行根治性胰十二指肠切除术的168例AAC患者进行回顾性分析。根据NCCN (v2.2025)标准,病例分为肠道(28.0%)、胰胆道(30.4%)和混合亚型(18.5%)。通过单变量和多变量Cox比例风险模型确定AAC患者的独立预后因素,并按年龄范围、性别、分化、T分期、N分期、BVI、TDs和PNI进行亚组分析。结果:胰胆管特征(HR = 2.884, P < 0.001)和BVI (HR = 2.330, P = 0.001)是独立的不良预后因素。辅助化疗提高了以下AAC患者的总生存期(OS): T3-T4期(HR = 0.485, P = 0.050);N1-N2期(HR = 0.365, P = 0.008);td阳性(HR = 0.401, P = 0.026)。td阳性患者辅助化疗的中位OS从22.3-51.3个月增加(P = 0.019)。bvi阴性亚组的TD阳性预后较差(OS: HR = 3.840, 95% CI: 2.058-7.166, P < 0.001;无进展生存期(PFS): HR = 2.950, 95% CI: 1.550-5.617, P = 0.002)。结论:胰胆特征和BVI是AAC的高危病理特征。TD状态确定高风险队列,从而实现术后风险分层治疗策略。在胰胆管特征或BVI阴性的患者中,TD阳性预测生存率明显较差。
{"title":"Identifying occult high-risk features and stratified management strategies following curative resection for ampullary adenocarcinoma.","authors":"Xiaoqing Ma, Chenyang Meng, Xuejing Shi, Zhaoyu Zhang, Qiuli Li, Hongwei Wang, Yuexiang Liang, Song Gao, Xiuchao Wang, Chuntao Gao, Jian Wang, Weidong Ma, Yukuan Feng, Shuo Li, Xingyun Chen, Wei Li, Shangheng Shi, Tianxing Zhou, Jun Yu, Jihui Hao","doi":"10.20892/j.issn.2095-3941.2025.0181","DOIUrl":"10.20892/j.issn.2095-3941.2025.0181","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the current study was to identify independent prognostic factors, evaluate differential adjuvant chemotherapy efficacy across clinicopathologic subgroups, and define adjuvant chemotherapy-sensitive populations.</p><p><strong>Methods: </strong>A retrospective analysis of 168 AAC patients undergoing curative pancreaticoduodenectomy (2011-2020) was performed. Cases were classified into intestinal (28.0%), pancreatobiliary (30.4%), and mixed subtypes (18.5%) per NCCN (v2.2025) criteria. Independent prognostic factors for AAC patients were identified through uni- and multi-variable Cox proportional hazards modeling and subgroup analyses were stratified by age range, gender, differentiation, T stage, N stage, BVI, TDs, and PNI.</p><p><strong>Results: </strong>The pancreatobiliary signature (HR = 2.884, <i>P</i> < 0.001) and BVI (HR = 2.330, <i>P</i> = 0.001) were independent poor prognostic factors. Adjuvant chemotherapy improved overall survival (OS) in the following AAC patients: T3-T4 stage (HR = 0.485, <i>P</i> = 0.050); N1-N2 stage (HR = 0.365, <i>P</i> = 0.008); and TD-positive (HR = 0.401, <i>P</i> = 0.026). The median OS increased from 22.3-51.3 months with adjuvant chemotherapy in TD-positive patients (<i>P</i> = 0.019). TD positivity conferred a worse prognosis in BVI-negative subgroups (OS: HR = 3.840, 95% CI: 2.058-7.166, <i>P</i> < 0.001; and progression-free survival (PFS): HR = 2.950, 95% CI: 1.550-5.617, <i>P</i> = 0.002).</p><p><strong>Conclusions: </strong>The pancreatobiliary signature and BVI constitute critical high-risk pathologic features in AAC. TD status identified high-risk cohorts, thus enabling postoperative risk-stratified treatment strategies. In patients negative for pancreatobiliary signature or BVI, TD positivity predicted significantly worse survival.</p>","PeriodicalId":9611,"journal":{"name":"Cancer Biology & Medicine","volume":"22 10","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-09DOI: 10.20892/j.issn.2095-3941.2025.0369
Jinqin Qian, Zhongyi Xie, Liqun Zhou, Wei-Guo Zhu
{"title":"Chromatin relaxation dynamics and histone PTMs in the early DNA damage response.","authors":"Jinqin Qian, Zhongyi Xie, Liqun Zhou, Wei-Guo Zhu","doi":"10.20892/j.issn.2095-3941.2025.0369","DOIUrl":"10.20892/j.issn.2095-3941.2025.0369","url":null,"abstract":"","PeriodicalId":9611,"journal":{"name":"Cancer Biology & Medicine","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12624809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-06DOI: 10.20892/j.issn.2095-3941.2025.0387
Panliang Zhong, Li Zhang, Fanghui Zhao
{"title":"Modeling cervical cancer elimination: a pathway to inform policy decisions.","authors":"Panliang Zhong, Li Zhang, Fanghui Zhao","doi":"10.20892/j.issn.2095-3941.2025.0387","DOIUrl":"10.20892/j.issn.2095-3941.2025.0387","url":null,"abstract":"","PeriodicalId":9611,"journal":{"name":"Cancer Biology & Medicine","volume":"22 9","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-06DOI: 10.20892/j.issn.2095-3941.2025.0403
Mingyang Chen, Jiayi Ma, Yijin Wu, Haiyan Hu, Xiaoli Cui, Maria José Gonzalez Mendez, Roberto Altamirano, Nomin-Erdene Tsogtgerel, Erdenejargal Ayush, Lingqing Qiu, Xinhua Jia, José Luis López Velázquez, Sulaiya Husaiyin, Aiyuan Wu, Man Tat Alexander Ng, Youlin Qiao
Objective: Cervical cancer remains a global health challenge with substantial disparities between countries. High-quality colposcopy is essential for cervical cancer prevention, yet training opportunities remain inadequate worldwide. We developed the Intelligent Digital Education Tool for Colposcopy (iDECO) to address training gaps and evaluated the effect across diverse international settings.
Methods: Six pre-post interventional training programmes were conducted in China, Mexico, and Mongolia from December 2024 to May 2025. A total of 369 trainees from 87 centers participated in a 3-week online training programme using iDECO, a bilingual web-based platform featuring authentic colposcopy cases, gamified learning pathways, and personalized analytics. The primary outcomes included colposcopy competence in general assessment, colposcopic findings, diagnostic accuracy, and management decisions. The secondary outcomes focused on participant feedback and satisfaction.
Results: Of 369 participants who completed pretests, 333 (90.24%) completed post-training assessments. Significant improvements were observed across all competency domains. Diagnostic accuracy increased with an odds ratio (OR) of 1.72 (95% CI: 1.60-1.86) with the greatest gains in high-grade lesion identification [OR = 2.27 (95% CI: 1.94-2.64)]. Squamocolumnar junction visibility and transformation zone type assessments improved with ORs of 1.41 (95% CI: 1.31-1.51) and 1.87 (95% CI: 1.73-2.01), respectively. Biopsy decision-making accuracy also showed significant improvement [OR = 2.09 (95% CI: 1.91-2.29)]. International participants showed lower baseline performance but achieved the greatest improvements. Greater than 85% of participants rated the training highly satisfactory and 83.56% preferred intelligent training over traditional methods.
Conclusions: iDECO-based training significantly improved colposcopy competence across diverse international settings with high user satisfaction. These findings support the potential for worldwide implementation of intelligent digital training tools to address colposcopy training gaps and contribute to the elimination of cervical cancer.
{"title":"Accelerating the elimination of global cervical cancer through intelligent training for colposcopy.","authors":"Mingyang Chen, Jiayi Ma, Yijin Wu, Haiyan Hu, Xiaoli Cui, Maria José Gonzalez Mendez, Roberto Altamirano, Nomin-Erdene Tsogtgerel, Erdenejargal Ayush, Lingqing Qiu, Xinhua Jia, José Luis López Velázquez, Sulaiya Husaiyin, Aiyuan Wu, Man Tat Alexander Ng, Youlin Qiao","doi":"10.20892/j.issn.2095-3941.2025.0403","DOIUrl":"10.20892/j.issn.2095-3941.2025.0403","url":null,"abstract":"<p><strong>Objective: </strong>Cervical cancer remains a global health challenge with substantial disparities between countries. High-quality colposcopy is essential for cervical cancer prevention, yet training opportunities remain inadequate worldwide. We developed the Intelligent Digital Education Tool for Colposcopy (iDECO) to address training gaps and evaluated the effect across diverse international settings.</p><p><strong>Methods: </strong>Six pre-post interventional training programmes were conducted in China, Mexico, and Mongolia from December 2024 to May 2025. A total of 369 trainees from 87 centers participated in a 3-week online training programme using iDECO, a bilingual web-based platform featuring authentic colposcopy cases, gamified learning pathways, and personalized analytics. The primary outcomes included colposcopy competence in general assessment, colposcopic findings, diagnostic accuracy, and management decisions. The secondary outcomes focused on participant feedback and satisfaction.</p><p><strong>Results: </strong>Of 369 participants who completed pretests, 333 (90.24%) completed post-training assessments. Significant improvements were observed across all competency domains. Diagnostic accuracy increased with an odds ratio (OR) of 1.72 (95% CI: 1.60-1.86) with the greatest gains in high-grade lesion identification [OR = 2.27 (95% CI: 1.94-2.64)]. Squamocolumnar junction visibility and transformation zone type assessments improved with ORs of 1.41 (95% CI: 1.31-1.51) and 1.87 (95% CI: 1.73-2.01), respectively. Biopsy decision-making accuracy also showed significant improvement [OR = 2.09 (95% CI: 1.91-2.29)]. International participants showed lower baseline performance but achieved the greatest improvements. Greater than 85% of participants rated the training highly satisfactory and 83.56% preferred intelligent training over traditional methods.</p><p><strong>Conclusions: </strong>iDECO-based training significantly improved colposcopy competence across diverse international settings with high user satisfaction. These findings support the potential for worldwide implementation of intelligent digital training tools to address colposcopy training gaps and contribute to the elimination of cervical cancer.</p>","PeriodicalId":9611,"journal":{"name":"Cancer Biology & Medicine","volume":"22 9","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-06DOI: 10.20892/j.issn.2095-3941.2025.0370
Lanfang Zhu, Jingtao Pu, Yufen Tao, Lei Shi, Shuyuan Liu, Xinwen Zhang, Weipeng Liu, Ming Sun, Yufeng Yao, Li Shi
Objective: Cervical cancer caused by persistent high-risk human papillomavirus (hrHPV) infection remains a leading cause of cancer-related mortality in women. As prophylactic HPV vaccines cannot eliminate existing infections, developing therapeutic vaccines targeting HPV E6/E7 oncoproteins is critical for reversing precancerous lesions. This study aimed to design a novel multi-epitope vaccine against HPV16, incorporating newly identified immunodominant epitopes and evaluating the therapeutic efficacy.
Methods: The multi-epitope vaccine HSP70-12P was bioinformatically designed to include cytotoxic T lymphocyte (CTL) and helper T lymphocyte (HTL) epitopes from HPV16 E6/E7, which were fused to the C-terminal domain (residues 359-610) of Mycobacterium tuberculosis HSP70 as an adjuvant. Two formulations were used, as follows: (1) protein-based Pro-HSP70-12P; and (2) DNA-based DNA-HSP70-12P. Therapeutic efficacy was evaluated in TC-1 tumor-bearing mouse models. Tumor regression, survival rates, and immune correlates (T cell responses and cytokine profiles) were assessed. Immunodominant epitopes were identified using ELISpot.
Results: The Pro-HSP70-12P protein vaccine induced strong immune responses and provided lasting antitumor protection. The vaccine activated cell-mediated immunity and stimulated effector memory T cells in the HPV-16-related tumor mouse model, resulting in strong tumor clearance effects. Pro-HSP70-12P demonstrated superior performance compared to the DNA-HSP70-12P vaccine, achieving complete regression of small tumors (diameter < 2 mm) with a single dose and conferring long-lasting protection in TC-1 rechallenge experiments. Three novel immunodominant epitopes were identified (E6-38-45, E6-124-132, and E7-50-57). The E6 epitopes address a critical gap in E6-targeted vaccine design.
Conclusions: The multi-epitope protein vaccine, Pro-HSP70-12P, represents a potent therapeutic candidate against HPV-driven malignancies, which has the capacity to induce tumor regression and long-term immunity. These findings support further clinical development.
{"title":"A therapeutic multi-epitope protein vaccine targeting HPV16 E6 E7 elicits potent tumor regression and cytotoxic immune responses.","authors":"Lanfang Zhu, Jingtao Pu, Yufen Tao, Lei Shi, Shuyuan Liu, Xinwen Zhang, Weipeng Liu, Ming Sun, Yufeng Yao, Li Shi","doi":"10.20892/j.issn.2095-3941.2025.0370","DOIUrl":"10.20892/j.issn.2095-3941.2025.0370","url":null,"abstract":"<p><strong>Objective: </strong>Cervical cancer caused by persistent high-risk human papillomavirus (hrHPV) infection remains a leading cause of cancer-related mortality in women. As prophylactic HPV vaccines cannot eliminate existing infections, developing therapeutic vaccines targeting HPV E6/E7 oncoproteins is critical for reversing precancerous lesions. This study aimed to design a novel multi-epitope vaccine against HPV16, incorporating newly identified immunodominant epitopes and evaluating the therapeutic efficacy.</p><p><strong>Methods: </strong>The multi-epitope vaccine HSP70-12P was bioinformatically designed to include cytotoxic T lymphocyte (CTL) and helper T lymphocyte (HTL) epitopes from HPV16 E6/E7, which were fused to the C-terminal domain (residues 359-610) of <i>Mycobacterium tuberculosis</i> HSP70 as an adjuvant. Two formulations were used, as follows: (1) protein-based Pro-HSP70-12P; and (2) DNA-based DNA-HSP70-12P. Therapeutic efficacy was evaluated in TC-1 tumor-bearing mouse models. Tumor regression, survival rates, and immune correlates (T cell responses and cytokine profiles) were assessed. Immunodominant epitopes were identified using ELISpot.</p><p><strong>Results: </strong>The Pro-HSP70-12P protein vaccine induced strong immune responses and provided lasting antitumor protection. The vaccine activated cell-mediated immunity and stimulated effector memory T cells in the HPV-16-related tumor mouse model, resulting in strong tumor clearance effects. Pro-HSP70-12P demonstrated superior performance compared to the DNA-HSP70-12P vaccine, achieving complete regression of small tumors (diameter < 2 mm) with a single dose and conferring long-lasting protection in TC-1 rechallenge experiments. Three novel immunodominant epitopes were identified (E6-38-45, E6-124-132, and E7-50-57). The E6 epitopes address a critical gap in E6-targeted vaccine design.</p><p><strong>Conclusions: </strong>The multi-epitope protein vaccine, Pro-HSP70-12P, represents a potent therapeutic candidate against HPV-driven malignancies, which has the capacity to induce tumor regression and long-term immunity. These findings support further clinical development.</p>","PeriodicalId":9611,"journal":{"name":"Cancer Biology & Medicine","volume":"22 9","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Drawbacks of human papillomavirus (HPV) primary screening, including high referral rates and low specificity, highlight the necessity for triage strategies to balance the screening benefits with potential harms.
Methods: A cross-sectional, population-based diagnostic study was conducted in rural Xinjiang, China involving 8,638 women ≥ 25 years of age who participated in organized cervical cancer screening between 2023 and 2024. The study evaluated the accuracy and efficiency of multiple HPV-based "screen-triage" strategies. Histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+ and CIN3+) served as disease outcomes.
Results: Among single-step triage strategies, only extended genotyping for the seven most carcinogenic HPV types (HPV16/18/31/33/45/52/58) maintained sensitivity for CIN2+ comparable to HPV screening without triage (90.0% vs. 92.5%, P = 0.50) but significantly improved specificity (94.7% vs. 90.8%, P < 0.001). This approach led to a 38% reduction in colposcopy referrals (relative rate, 0.62; 95% CI: 0.59-0.65). Two-step triage algorithms (HPV16/18 with reflex ASC-US+ or methylation) showed slightly lower but non-significant sensitivity (87.5%, P = 0.13/89.6%, P =0.50) than HPV primary screening without triage, yet achieved significantly increased specificity (> 95%, P < 0.001) and reduced colposcopy referral by ~50% (relative rate, 0.5; P < 0.001). If negative for cytology or methylation, women positive for 12 high-risk HPV types (excluding HPV16/18) had a < 2% risk of CIN2+ (CIN3+ risk < 1%), indicating delayed follow-up.
Conclusions: Focusing on the seven high-risk HPV types within a one-step "screen-triage" framework effectively balances minimal sensitivity loss with significant gains in specificity, reducing unnecessary referrals and treatments, especially valuable in resource-limited settings. Integrating HPV genotyping with methylation results improves the accurate identification of women requiring immediate referral, which is advisable when resources allow.
目的:人乳头瘤病毒(HPV)初级筛查的缺点,包括转诊率高和特异性低,突出了筛选策略的必要性,以平衡筛查的好处和潜在的危害。方法:在中国新疆农村开展了一项基于人群的横断面诊断研究,涉及8638名年龄≥25岁的妇女,她们于2023年至2024年参加了有组织的宫颈癌筛查。该研究评估了多种基于hpv的“筛选分诊”策略的准确性和效率。组织学证实宫颈上皮内瘤变2级或更严重(CIN2+和CIN3+)作为疾病结局。结果:在单步分诊策略中,对于7种最具致癌性的HPV类型(HPV16/18/31/33/45/52/58),仅扩展基因分型对CIN2+的敏感性与未分诊的HPV筛查相当(90.0% vs 92.5%, P = 0.50),但特异性显著提高(94.7% vs 90.8%, P < 0.001)。这种方法导致阴道镜转诊减少38%(相对率,0.62;95% CI: 0.59-0.65)。两步分诊算法(HPV16/18伴ASC-US+或甲基化)的敏感性(87.5%,P = 0.13/89.6%, P =0.50)略低于未分诊的HPV初筛,但特异性显著提高(bb0 95%, P < 0.001),阴道镜转诊减少约50%(相对率,0.5,P < 0.001)。如果细胞学或甲基化阴性,12种高危HPV类型(不包括HPV16/18)阳性的女性CIN2+风险< 2% (CIN3+风险< 1%),表明随访延迟。结论:在一步“筛查分诊”框架内关注7种高危HPV类型,有效地平衡了最小的敏感性损失和显著的特异性增益,减少了不必要的转诊和治疗,在资源有限的情况下尤其有价值。整合HPV基因分型与甲基化结果提高了需要立即转诊的妇女的准确识别,在资源允许的情况下,这是可取的。
{"title":"Evaluation of the multiple HPV-based \"screen and triage\" algorithms in real-world settings of rural China.","authors":"Remila Rezhake, Guzhanuer Abuduxikuer, Guligeina Abudurexiti, Qian Zhuo, Kadeliya Muhetaer, Tangnuer Abulimiti, Yumei Ouyang, Wenyun Li, Jing Yang, Gulixian Tuerxun, Fanghui Zhao, Guzhalinuer Abulizi, Marc Arbyn","doi":"10.20892/j.issn.2095-3941.2025.0384","DOIUrl":"10.20892/j.issn.2095-3941.2025.0384","url":null,"abstract":"<p><strong>Objective: </strong>Drawbacks of human papillomavirus (HPV) primary screening, including high referral rates and low specificity, highlight the necessity for triage strategies to balance the screening benefits with potential harms.</p><p><strong>Methods: </strong>A cross-sectional, population-based diagnostic study was conducted in rural Xinjiang, China involving 8,638 women ≥ 25 years of age who participated in organized cervical cancer screening between 2023 and 2024. The study evaluated the accuracy and efficiency of multiple HPV-based \"screen-triage\" strategies. Histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+ and CIN3+) served as disease outcomes.</p><p><strong>Results: </strong>Among single-step triage strategies, only extended genotyping for the seven most carcinogenic HPV types (HPV16/18/31/33/45/52/58) maintained sensitivity for CIN2+ comparable to HPV screening without triage (90.0% <i>vs.</i> 92.5%, <i>P</i> = 0.50) but significantly improved specificity (94.7% <i>vs</i>. 90.8%, <i>P</i> < 0.001). This approach led to a 38% reduction in colposcopy referrals (relative rate, 0.62; 95% CI: 0.59-0.65). Two-step triage algorithms (HPV16/18 with reflex ASC-US+ or methylation) showed slightly lower but non-significant sensitivity (87.5%, <i>P</i> = 0.13/89.6%, <i>P</i> =0.50) than HPV primary screening without triage, yet achieved significantly increased specificity (> 95%, <i>P</i> < 0.001) and reduced colposcopy referral by ~50% (relative rate, 0.5; <i>P</i> < 0.001). If negative for cytology or methylation, women positive for 12 high-risk HPV types (excluding HPV16/18) had a < 2% risk of CIN2+ (CIN3+ risk < 1%), indicating delayed follow-up.</p><p><strong>Conclusions: </strong>Focusing on the seven high-risk HPV types within a one-step \"screen-triage\" framework effectively balances minimal sensitivity loss with significant gains in specificity, reducing unnecessary referrals and treatments, especially valuable in resource-limited settings. Integrating HPV genotyping with methylation results improves the accurate identification of women requiring immediate referral, which is advisable when resources allow.</p>","PeriodicalId":9611,"journal":{"name":"Cancer Biology & Medicine","volume":"22 9","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}