Primary liver cancer (PLC) is a major global healthchallenge, ranking as the sixth most common andthird most fatal malignancy worldwide, according toGLOBOCAN 2022 estimates[1]. This high mortalityrate underscores the ...Primary liver cancer (PLC) is a major global healthchallenge, ranking as the sixth most common andthird most fatal malignancy worldwide, according toGLOBOCAN 2022 estimates[1]. This high mortalityrate underscores the aggressive nature of thedisease and the significant burden it places on globalhealthcare systems. Although primary preventionremains the cornerstone of liver cancer control,improving outcomes for patients already diagnosedis equally critical for mitigating the impact of thedisease.展开更多
A recently published study(Xin et al.,Prog Biochem Biophys,2026,53(2):431-441.DOI:10.3724/j.pibb.2025.0508)addresses the therapeutic challenges of pancreatic ductal adenocarcinoma(PDAC)by innovatively developing an or...A recently published study(Xin et al.,Prog Biochem Biophys,2026,53(2):431-441.DOI:10.3724/j.pibb.2025.0508)addresses the therapeutic challenges of pancreatic ductal adenocarcinoma(PDAC)by innovatively developing an orally administered nanogene delivery system.Designed to achieve in situ,efficient delivery of chimeric antigen receptor(CAR)genes to tumor sites,this approach offers a novel strategy for CAR-macrophage(CAR-M)based immunotherapy.Its key highlights are as follows.展开更多
BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically...BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically experience a poor prognosis,highlighting an urgent need to explore novel treatment approaches.This study evaluated the overall efficacy and safety of CMT vs CMT combined with immune checkpoint inhibitors(ICIs)in the treatment of EC patients with liver metastases.Furthermore,prognostic factors influencing outcomes in this patient population were identified.AIM To evaluate the efficacy and safety of first-line chemoimmunotherapy for EC patients with liver metastases and to analyze prognostic factors.METHODS This retrospective study included 126 EC patients with liver metastases at Zhejiang Cancer Hospital between 2014 and 2024.Patients receiving CMT were compared with those receiving CMT+ICI.Analyzed variables included clinicopathological features,treatment history,characteristics of metastasis,systemic and local treatments,overall survival(OS),and treatment-related adverse events(TRAEs).Prognostic factors were evaluated using univariate and multivariate Cox proportional-hazards regression models.Finally,efficacy outcomes and TRAE profiles were compared between the two groups.RESULTS A significant difference in median OS was identified between the two groups(10.8 months in the CMT group vs 20.8 months in the CMT+ICI group,P=0.004).The CMT+ICI group also demonstrated a significantly longer median progression-free survival of 11.7 months(P<0.001).Patients receiving combination therapy exhibited significantly improved systemic objective response rate and disease control rate.Multivariate analysis identified key factors significantly influencing OS in EC patients with liver metastases:Karnofsky Performance Status score≥70,receipt of local therapy for liver metastases,and the number of cycles of CMT and immunotherapy received.Furthermore,the incidence of TRAEs did not significantly differ between the CMT+ICI and CMT groups.CONCLUSION For EC patients with liver metastases,the combination of CMT and ICIs demonstrates significantly superior efficacy compared with CMT alone,while maintaining manageable TRAEs.展开更多
Colorectal cancer(CRC)is the second deadliest cancer worldwide,being the presence of metastasis,mainly in the liver,a major contributor to high mortality rates in affected patients.The tumor microenvironment(TME)—com...Colorectal cancer(CRC)is the second deadliest cancer worldwide,being the presence of metastasis,mainly in the liver,a major contributor to high mortality rates in affected patients.The tumor microenvironment(TME)—comprised of interacting endothelial,stromal,and immune cells—plays a critical role in creating a supportive niche for tumor cell colonization and immune evasion and,thus,the establishment of metastases.The liver’s intrinsic nature further facilitates the development of immune tolerance,mediated by regulatory T cells,myeloid-derived suppressor cells,and soluble factors such as anti-inflammatory cytokines,which together dampen antitumor immune responses.This immunosuppressive milieu contributes significantly to resistance to immune checkpoint inhibitors,limiting the efficacy of immunotherapy in metastatic CRC.Deciphering the complex crosstalk between metastatic CRC cells and TME within the liver is essential for developing novel,effective immunotherapeutic approaches.Several strategies to overcome this lack of response are under research,including combination therapies,novel compounds,and approaches that target TME components.The scope of this review is to synthesize recent advances in the characterization of the hepatic metastatic microenvironment and emerging therapeutic approaches aimed at overcoming immune resistance in CRC liver metastases.展开更多
Liver cancer is an extremely heterogeneous malignant tumor characterized by high morbidity and mortality rates.Despite significant advancements in cancer care,the outcomes of liver cancer patients remain poor.Artifici...Liver cancer is an extremely heterogeneous malignant tumor characterized by high morbidity and mortality rates.Despite significant advancements in cancer care,the outcomes of liver cancer patients remain poor.Artificial intelligence(AI)is a major discipline in computer science that attempts to simulate human intelligence using machines or systems.Owing to the availability of multidimensional databases and recent algorithmic advancements,AI offers tremendous potential to overcome current obstacles in oncology research and practice.There is a growing body of evidence suggesting that AI models enable pathologists to diagnose liver cancer more accurately,customize personalized therapies,and predict cancer prognosis.Therefore,the increasing adoption of AI is expected to improve healthcare accuracy and patients’quality of life.However,only a few AI models are currently authorized for clinical use.This review outlines recent developments in research on the biomedical application of AI technology in liver cancer and discusses both the potential hurdles and future implications of employing AI for clinical cancer management,thereby providing insights for further research.Overall,the clinical implementation of AI technology is anticipated to induce a paradigm shift in medical oncology,leading to significant improvements in patient outcomes.展开更多
Liver cancer is a leading cause of death worldwide,and hepatocellular carcinoma(HCC)is the most frequent primary liver tumour,followed by cholangiocarcinoma.Notably,secondary tumours represent up to 90% of liver tumou...Liver cancer is a leading cause of death worldwide,and hepatocellular carcinoma(HCC)is the most frequent primary liver tumour,followed by cholangiocarcinoma.Notably,secondary tumours represent up to 90% of liver tumours.Chronic liver disease is a recognised risk factor for liver cancer development.Up to 90% of the patients with HCC and about 20% of those with cholangiocarcinoma have an underlying liver alteration.The gut microbiota-liver axis represents the bidirectional relationship between gut microbiota,its metabolites and the liver through the portal flow.The interplay between the immune system and gut microbiota is also well-known.Although primarily resulting from experiments in animal models and on HCC,growing evidence suggests a causal role for the gut microbiota in the development and progression of chronic liver pathologies and liver tumours.Despite the curative intent of“traditional”treatments,tumour recurrence remains high.Therefore,microbiota modulation is an appealing therapeutic target for liver cancer prevention and treatment.Furthermore,microbiota could represent a non-invasive biomarker for early liver cancer diagnosis.This review summarises the potential role of the microbiota and immune system in primary and secondary liver cancer development,focusing on the potential therapeutic implications.展开更多
In recent years,the rapid evolution of cancer therapies has markedly increased patient survival rates.However,the incidence of adverse events caused by anticancer treatments remains high,leading to significant clinica...In recent years,the rapid evolution of cancer therapies has markedly increased patient survival rates.However,the incidence of adverse events caused by anticancer treatments remains high,leading to significant clinical challenges.As the central hub of drug metabolism and detoxification,the liver is susceptible to therapeutic insults.The specific mechanisms of liver injury caused by different types of antineoplastic treatments vary.Chemotherapy induces hepatic damage via oxidative stress and mitochondrial dysfunction,whereas targeted therapy disrupts signaling pathways in hepatic cells.Immunotherapy triggers immunemediated hepatitis through cytokine storms and immune cell infiltration,and radiation therapy causes hepatic microvascular injury.Additionally,patients with preexisting chronic liver diseases(such as cirrhosis,hepatitis B/C,or nonalcoholic fatty liver disease)are more likely to face increased risks of hepatic injury during cancer treatment.Therefore,early detection and timely treatment are crucial for these high-risk populations.This review introduces the emerging field of“oncohepatology”,which illuminates the mechanisms underlying hepatic injury due to cancer treatments,summarizes the influence and management of preexisting liver disease during cancer treatment,analyzes diagnostic and therapeutic strategies for cancer treatment-associated liver function damage,and discusses potential future research directions to provide valuable insights for liver injury management in clinical oncology.展开更多
BACKGROUND Cancer-associated fibroblasts(CAFs),crucial components of the tumor microenvironment in primary and metastatic tumors,can impact the activity of cancer cells and contribute to their progression.Given their ...BACKGROUND Cancer-associated fibroblasts(CAFs),crucial components of the tumor microenvironment in primary and metastatic tumors,can impact the activity of cancer cells and contribute to their progression.Given their extensive interactions with cancer cells and other stromal cells,we aimed to evaluate the prognostic value of CAFs in patients with liver cancer(LC).AIM To investigate the association between CAF expression and clinicopathological characteristics as well as overall survival(OS)in patients with LC,including hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(iCCA).METHODS We performed a meta-analysis of cohort studies with available data on the effects of CAF expression on both clinicopathological characteristics and OS via hazard ratios(HRs)and risk ratios with 95%confidence intervals(CIs).Studies were subgrouped on the basis of CAF markers and cancer type,and the subgroup effects of CAF expression on both HCC and iCCA were analyzed through meta-regression.The Newcastle-Ottawa Scale was used to evaluate the included studies to guarantee their quality and minimize the possibility of bias.RESULTS Nine trials were selected and included a total of 1518 patients.According to our primary meta-analysis,the expression of CAFs in LC patients was significantly associated with a decrease in OS(LC:HR:1.62;95%CI:1.34-1.97;P<0.001;HCC:HR:1.67;95%CI:1.34-2.07;P<0.001;iCCA:HR:1.47;95%CI:0.97-2.23;P=0.07);nevertheless,it was not significantly associated with almost all clinicopathologic characteristics,including tumor size,venous infiltration,alpha-fetoprotein level,and differentiation grade.According to the subgroup analysis of smooth muscle actin(SMA)markers in both HCC patients and iCCA patients,high CAF expression in HCC(HR:2.29;95%CI:1.01-5.22;P=0.048)and iCCA(HR:2.04;95%CI:1.09-3.81;P=0.025)patients was a significant indicator of poor OS.Moreover,the clinicopathological characteristics were also verified by the SMA marker,which had a nearly significant effect on the venous infiltration of iCCA(risk ratio:2.70;95%CI:0.97-7.49;P=0.057).CONCLUSION High CAF expression,evaluated by both mixed markers and SMAs,is significantly associated with poor OS in patients with LC,including both HCC patients and iCCA patients.However,further research is necessary since how CAF expression and clinicopathologic features are related is yet unknown.展开更多
BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a ne...BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a new idea.AIM To analyze the post-surgical effect of the artificial liver support system with TCM in patients with liver cancer.METHODS Ninety-eight patients with liver cancer who underwent surgical treatment at the Fifth People’s Hospital of Huai’an from January 2023-2024 were selected and divided into two groups(49 patients each)via random lottery method.Both groups underwent surgery.The control group received artificial liver support,and the observation group was additionally treated with TCM for strengthening the body and removing blood stasis.Gastrointestinal recovery,liver function,tumor marker levels,immune function,and safety were compared between both groups.RESULTS There were significant differences in the levels of indicators related to gastrointestinal recovery between the groups(P<0.05).After treatment,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,and gamma-glutamyl transpeptidase in the observation group were lower,whereas the albumin level was higher(P<0.05).After treatment,tumor marker levels in the observation group were relatively lower(P<0.05).After treatment,compared to the control group,the CD4+level in the observation group was higher and the CD8+level was lower(P<0.05).There was no significant difference in the incidence of adverse reactions between both groups(P>0.05).CONCLUSION Combining the artificial liver support system with TCM significantly improves liver and gastrointestinal functions,enhances immune responses,and reduces tumor marker levels with high safety,suggesting that it could be a promising approach for optimizing postoperative care and improving patient outcomes,potentially reducing complications and enhancing quality of life.展开更多
Although the combination of chemotherapy and immunotherapy can improve the treatment of breast cancer,traditional drugs are highly toxic because they do not specifically target tumors.In this study,we developed a self...Although the combination of chemotherapy and immunotherapy can improve the treatment of breast cancer,traditional drugs are highly toxic because they do not specifically target tumors.In this study,we developed a self-driving bacteria/nanoparticle biohybrid called Bif@PDA-aPD1/DOX-Lip by attaching polydopamine(PDA)coated doxorubicin(DOX)liposomes and the immune checkpoint inhibitor anti-programmed cell death protein 1 antibody(aPD-1)to Bifidobacterium infantis(B.infantis,Bif).Using the homing abilities of bacteria,Bif@PDA-aPD1/DOX-Lip could actively accumulate in tumor tissue,releasing DOX and aPD-1 in the acidic environment to have a synergistic anti-tumor effect.Results show that the concentration of DOX in tumors of the Bif@PDA-aPD1/DOX-Lip group was 6.31 times higher than in the free DOX group.The combination of DOX and aPD-1 not only killed tumor cells but also promoted immune normalization by maturing dendritic cells(DCs),increasing M1 macrophage ratio,and enhancing infiltration of CD8^(+) and CD4^(+)T cells in tumors and spleen.Therefore,Bif@PDA-aPD1/DOX-Lip therapy significantly inhibited tumor growth and increased the average survival time of mice to over 80 days.The Bif@PDA-aPD1/DOX-Lip biomotors offer a highly effective method for enhancing chemo-immunotherapy in solid tumors.展开更多
Despite remarkable advances in nanomedicine,localized delivery of advanced cancer therapeutics remains underexploited.Advanced therapies based on biopharmaceuticals,immunotherapy,or gene therapy have revolutionized on...Despite remarkable advances in nanomedicine,localized delivery of advanced cancer therapeutics remains underexploited.Advanced therapies based on biopharmaceuticals,immunotherapy,or gene therapy have revolutionized oncology.Yet,their systemic administration is often associated with limitations such as poor sitespecific accumulation,instability,and systemic toxicity.Hydrogels/macrogels offer the ability to encapsulate,protect,and release biomolecules in situ with sustained and stimulus-responsive profiles,addressing key translational gaps.This review provides a focused synthesis of the last five years of hydrogel-based research for cancer therapy,with emphasis on peptides,antibodies,immunotherapeutic agents,and gene delivery systems.We discuss design principles,release mechanisms,and clinical translation challenges,highlighting structure-function relationships and comparative performance across therapeutic classes.By integrating mechanistic insights with recent breakthroughs,we outline how next-generation hydrogels can synergize with personalized medicine and combination therapies to redefine localized cancer treatment.This work explores the fundamental aspects and provides examples of hydrogel-based delivery for the advanced treatment of cancer.The review summarizes the dynamic landscape of hydrogel research of the last 5 years,showcasing their potential systems for the precise delivery of biomolecules.Specifically,we explore the multidimensional role of hydrogels in the sustained and localized release of antibodies,immunotherapeutic agents,and genes as next-generation platforms for localized cancer treatment.This review aims to critically evaluate the mechanisms and applications of these systems in order to assess their potential to transform medical interventions and advance patient care.展开更多
The incidence of colorectal cancer is gradually increasing,and a majority of patients are diagnosed with distant metastases at the time of initial diagnosis,with the liver being the most common site of metastasis.Unli...The incidence of colorectal cancer is gradually increasing,and a majority of patients are diagnosed with distant metastases at the time of initial diagnosis,with the liver being the most common site of metastasis.Unlike most malignant tumors,patients with distant metastases can still achieve favorable prognoses if both the primary tumor and liver metastases are surgically resected.With ad-vances in systemic therapies,many patients with initially unresectable liver me-tastases from colorectal cancer can undergo systemic treatment to achieve con-version therapy,thereby gaining the opportunity for surgery.However,there is still no consensus on several issues,including the timing of systemic therapy before and after surgery,whether neoadjuvant therapy should be employed,and the choice between simultaneous or staged surgeries.This review aims to system-atically describe the current treatment landscape for colorectal cancer with liver metastases and highlight several unresolved controversial issues,providing valuable insights for the diagnosis and treatment of colorectal liver metastases.展开更多
BACKGROUND: The increasing morbidity of liver cancer has led to a growing demand for transplantation. Split liver transplantation(SLT) is a promising way to ameliorate organ shortages. However, the safety and efficacy...BACKGROUND: The increasing morbidity of liver cancer has led to a growing demand for transplantation. Split liver transplantation(SLT) is a promising way to ameliorate organ shortages. However, the safety and efficacy of SLT are still controversial. The aim of this study was to assess the clinical outcome of SLT in liver cancer patients at our center. METHODS: A total of 74 patients who received liver transplantation at a tertiary hospital from March 2019 to July 2023 were retrospectively studied, of whom 37 recipients underwent SLT and 37 recipients underwent whole-graft liver transplantation(WGLT). Clinical data were analyzed and compared between patients who underwent SLT and WGLT.RESULTS: SLT and WGLT were successfully performed, with no intraoperative transplantrelated mortality. Postoperatively, no significant differences in total bilirubin(TB, P=0.266), alanine transaminase(ALT, P=0.403) and aspartate transaminase(AST, P=0.160) levels within 30 d were detected between the two groups. The transplant-related mortality rates were 8.1% in the SLT group and 5.4% in the WGLT group within 30 d of surgery(P=1.000), and 10.8% and 8.1%, respectively, at 90 d after surgery(P=1.000). There were no significant differences in overall survival(OS) and progress-free survival(PFS) between the SLT and WGLT groups(P=0.910, P=0.190). CONCLUSION: Our results show that SLT does not imply additional risks in treating liver cancer compared with WGLT.展开更多
Liver cancer is a major killer threatening human health worldwide.At this stage the clinical choice to the treatment of liver cancer is a combination of surgery,chemotherapy and radiotherapy.Alternatively,using hydrog...Liver cancer is a major killer threatening human health worldwide.At this stage the clinical choice to the treatment of liver cancer is a combination of surgery,chemotherapy and radiotherapy.Alternatively,using hydrogen to treat cancer has great prospects and development space.Herein,we fabricated a hierarchical and flexible electrode that being able to continuously generate hydrogen in vivo in the deep abdominal liver through efficient water electrolysis to kill tumor cells and regulate the tumor microenvironment.The flexibility of the electrode facilitated to fit the tumor surface and thus improved the contact area of hydrogen therapy.By in situ growth of molybdenum disulfide on a hierarchical carbon skeleton,improved reaction kinetics and smaller impedance with a low overpotential of 1.02 V at-10 m A/cm^(2)in cell culture medium and Tafel slope of 73 m V/dec were achieved.Animal experiments showed that the electrode could effectively inhibit the growth of human hepatocellular carcinoma cells in nude mice by efficient H_(2)-production in vivo.The apoptosis rate of cancer cells reached 81.8%,and the proliferation rate decreased to 3.39%.Moreover,this treatment does not affect the growth of normal hepatocytes according to the results of cell experiments.This study demonstrated that the in vivo hydrogen production by our flexible electrode is a safe and effective treatment for liver cancer,with the advantages of minimal invasiveness,simple operation,low side effects and low cost.展开更多
Colorectal cancer (CRC) is the third most common cancer globally, with 20%-25%of patients diagnosed at stage IV, significantly affecting overall survival (OS).Only 14% of stage IV patients survive for 5 years with pal...Colorectal cancer (CRC) is the third most common cancer globally, with 20%-25%of patients diagnosed at stage IV, significantly affecting overall survival (OS).Only 14% of stage IV patients survive for 5 years with palliative chemotherapy.However, the role of liver transplantation (LT) in the management of CRC livermetastasis (CRCLM) is an evolving area of interest. Recent advancements inoncologic outcomes and clinical understanding have prompted the re-evaluationof LT as a viable treatment option for CRCLM. A promising result from someprospective pilot studies reported a 5-year OS rate of 60% after LT for patientswith CRCLM. Key factors influencing eligibility include tumor biology, absence ofextrahepatic disease, and the patient's performance status. By synthesizing thelatest research findings, we aim to provide a comprehensive overview that summarizesthe most relevant data related to the clinical outcomes of patients whounderwent LT for CRCLM. We aim to provide a comprehensive overview by synthesizingthe latest research findings. This review discusses the inclusion criteriaand eligibility for LT in CRCLM, which are of great importance to patient outcomes.展开更多
BACKGROUND Multiple primary malignant tumors refer to the occurrence of two or more primary malignant tumors in the same organ or multiple organs or tissues at the same time or successively in the same patient,and can...BACKGROUND Multiple primary malignant tumors refer to the occurrence of two or more primary malignant tumors in the same organ or multiple organs or tissues at the same time or successively in the same patient,and can occur anywhere in the body.The treatment guidelines for patients with multiple primary malignant tumors are currently controversial.CASE SUMMARY A 51-year-old male patient with liver cancer and portal hypertension received 42 months of co-treatment with atezolizumab and bevacizumab.After that,the disease was rated stable disease.The patient was then diagnosed with gastric cancer.Since the patient was not sensitive to anti-programmed death ligand 1 immunosuppressive agents,a co-treatment with oxaliplatin,tegafur,apatinib,and cadonilimab was selected after multidisciplinary consultation and the patient’s agreement.After four cycles of treatment,partial response and stable disease were observed in gastric and liver cancers,respectively.Surgical treatment was performed considering the high-risk factors of gastrointestinal bleeding in patients with gastroesophageal varices.Postoperative pathology showed that the Tumor Regression Grade was 1.Moreover,the genetic testing of postoperative tumor specimens indicated negative programmed death ligand 1 and microsatellite stability.In addition,the latest follow-up indicated an 8 and 40-month progression-free survival in gastric and liver cancer patients,respectively.Currently,the patient is receiving postoperative immunotherapy with cadonilimab.CONCLUSION Cadonilimab not only treats microsatellite stability gastric cancer patients but can also be used for liver cancer treatment.展开更多
BACKGROUND In-depth comparative investigations in terms of clinical efficacies of liver tumor microwave ablation(MWA)and laparoscopic hepatectomy(LH),which are both important treatment modalities for liver neoplasms,h...BACKGROUND In-depth comparative investigations in terms of clinical efficacies of liver tumor microwave ablation(MWA)and laparoscopic hepatectomy(LH),which are both important treatment modalities for liver neoplasms,have been limited in patients diagnosed with primary small liver cancer(PSLC).AIM To compare and analyze the clinical efficacy of liver tumor MWA and LH for PSLC.METHODS This study retrospectively analyzed the medical records of 123 patients with PSLC admitted to Xuzhou Central Hospital from January 2015 to November 2022 and categorized them based on treatment modalities into the LH and MWA groups.The LH group,consisting of 61 cases,received LH,and the MWA group,which included 62 cases,underwent liver tumor MWA.Basic data and various periop-erative indicators were compared between the two groups,including changes in liver function indicators[alanine aminotransferase(ALT),glutamic aminotrans-ferase(AST),and total bilirubin(TBIL)]pre-and post-treatment,and efficacy and postoperative complications were analyzed.RESULTS No statistically significant difference was observed between the two groups in terms of age,gender,tumor diameter,liver function Child-Pugh classification and number of tumors,body mass index,and educational status(P>0.05).The overall effective rate was higher in the MWA group than in the LH group(98.39%vs 88.52%)(χ2=4.918,P=0.027).The MWA group exhibited less operation time,intraoperative bleeding,defecation time,and hospital stay than the LH group(P<0.05).No difference was found in liver function indicators between the two groups pre-treatment(P>0.05),and ALT,AST,and TBIL levels decreased in both groups post-treatment,with the MWA group demonstrating lower levels(P<0.05).The MWA and LH groups exhibited postoperative complication rates of 4.84%and 19.67%,respectively,with statistically significant differences between the two groups(P=0.012,χ2=6.318).CONCLUSION MWA is more effective in treating PSLC,and it promotes faster postoperative recovery for patients,and more security improves liver function and reduces postoperative complications compared to LH.展开更多
Cancer stem cells(CSCs)are a major challenge in cancer therapy.Stem cell-like cells form a unique subpopulation within many tumors,which govern the degree of malignancy by promoting metastasis,recurrence,heterogeneity...Cancer stem cells(CSCs)are a major challenge in cancer therapy.Stem cell-like cells form a unique subpopulation within many tumors,which govern the degree of malignancy by promoting metastasis,recurrence,heterogeneity,and resistance to drug and radiation.Furthermore,these cells can persist in patients even after undergoing multiple cycles of conventional cancer therapy via dormancy,where they no longer dividing but remain active.These may cause cancer recurrence at any time,even years after a supposed cure,and remain invisible to the immune system.Targeting specific surface markers,signaling pathways and tumor microenvironment,which all have a significant effect on CSC function and maintenance,could help to eradicate CSCs and improve patient survival.Combinations of traditional therapies with nano-based drug delivery systems can efficiently target CSCs.Considering the biology and properties of CSCs,we classify recent approaches involving nanoparticle engineering,extracellular matrix modulation,cocktail strategies,multi-stage therapy,CSC defanging,Trojan horse systems,targeted therapy and organelle targeting.We highlight the most recent advances in nanocarrier design and drug delivery technologies to target CSCs,combined with conventional treatment in preclinical and clinical trials.The prospects of these approaches for CSCs elimination and recurrent cancer treatment are discussed.展开更多
mRNA vaccines have emerged as a transformative platform in oncology,offering significant advantages in rapid development,flexibility,and safety over traditional modalities.However,their clinical translation faces chal...mRNA vaccines have emerged as a transformative platform in oncology,offering significant advantages in rapid development,flexibility,and safety over traditional modalities.However,their clinical translation faces challenges such as mRNA instability,inefficient in vivo delivery,and the immunosuppressive tumor microenvironment(TME).This review comprehensively outlines recent advancements in overcoming these hurdles.We discuss the molecular design of mRNA vaccines,including non-replicating and self-amplifying RNAs,and highlight breakthroughs in delivery strategies,particularly lipid nanoparticles(LNPs),that enhance stability and immunogenicity.Furthermore,we explore various administration routes and their impact on eliciting robust antitumor immunity.The review also covers the classification of antigens—viral,tumor-associated,and neoantigens—and the innovative use of mRNA to encode immunomodulators to reprogram the TME.Finally,we address key considerations for clinical translation,including manufacturing,stability,safety,and combination strategies with immunotherapies.By synthesizing these developments,this review underscores the potential of mRNA vaccines to realize personalized cancer immunotherapy and outlines future directions for the field.展开更多
Liver cancer is the fourth cause of cancer-related deaths and the primary cause of death in patients with compensated cirrhosis.In recent years,the role of traditional Chinese medicine in the treatment of liver cancer...Liver cancer is the fourth cause of cancer-related deaths and the primary cause of death in patients with compensated cirrhosis.In recent years,the role of traditional Chinese medicine in the treatment of liver cancer has attracted more and more attention and recognition.Luteolin(LUT)and glycyrrhetinic(GA)are natural compounds extracted from Chinese herbal medicine.LUT exhibits various biological activity including anti-inflammatory,antibacterial,antiviral,anti-tumor,and neuroprotective effects.GA significantly inhibits the growth and metastasis of cancer cells.However,the low water solubility of both compounds hinders their clinical applications.In this study,rod-shaped nanoparticles(NPs)self-assembled from LUT and GA were designed to enhance drug solubility and tumor-targeting capability.We verified that the assembly mechanism of the NPs was π-π stacking.These NPs significantly inhibited the proliferation of liver cancer cells while had no significant effect on normal liver cells.In a mouse model of liver cancer,these NPs demonstrated superior tumor-targeting ability due to the enhanced permeability and retention effect,and the affinity of GA for liver cancer cells,resulting in better therapeutic efficacy with lower systemic toxicity.Results of network pharmacology analysis showed that LUT and GA respectively targeted estrogen receptor 1(ESR1)protein and cyclin-dependent kinase 1(CDK1)protein to corporately induce tumor cell cycle arrest,which induced the inhibition of tumor cell proliferation.In conclusion,this study provides a novel reference for the treatment of liver cancer.展开更多
基金National Key Project of Research and Development Program of China[2021YFC2500404].
文摘Primary liver cancer (PLC) is a major global healthchallenge, ranking as the sixth most common andthird most fatal malignancy worldwide, according toGLOBOCAN 2022 estimates[1]. This high mortalityrate underscores the aggressive nature of thedisease and the significant burden it places on globalhealthcare systems. Although primary preventionremains the cornerstone of liver cancer control,improving outcomes for patients already diagnosedis equally critical for mitigating the impact of thedisease.
文摘A recently published study(Xin et al.,Prog Biochem Biophys,2026,53(2):431-441.DOI:10.3724/j.pibb.2025.0508)addresses the therapeutic challenges of pancreatic ductal adenocarcinoma(PDAC)by innovatively developing an orally administered nanogene delivery system.Designed to achieve in situ,efficient delivery of chimeric antigen receptor(CAR)genes to tumor sites,this approach offers a novel strategy for CAR-macrophage(CAR-M)based immunotherapy.Its key highlights are as follows.
基金Supported by National Natural Science Foundation of China,No.82303672Zhejiang Provincial Health Commission and Zhejiang Provincial Administration of Traditional Chinese Medicine through the Targeted Project for Medical and Health Research,No.2025ZL017and China Primary Health Care Foundation,No.ZLMY20240311001ZJ.
文摘BACKGROUND The liver represents a common site of distant metastasis in patients with esophageal cancer(EC).Conventional chemotherapy(CMT)presents limited efficacy for EC,and EC patients with liver metastases typically experience a poor prognosis,highlighting an urgent need to explore novel treatment approaches.This study evaluated the overall efficacy and safety of CMT vs CMT combined with immune checkpoint inhibitors(ICIs)in the treatment of EC patients with liver metastases.Furthermore,prognostic factors influencing outcomes in this patient population were identified.AIM To evaluate the efficacy and safety of first-line chemoimmunotherapy for EC patients with liver metastases and to analyze prognostic factors.METHODS This retrospective study included 126 EC patients with liver metastases at Zhejiang Cancer Hospital between 2014 and 2024.Patients receiving CMT were compared with those receiving CMT+ICI.Analyzed variables included clinicopathological features,treatment history,characteristics of metastasis,systemic and local treatments,overall survival(OS),and treatment-related adverse events(TRAEs).Prognostic factors were evaluated using univariate and multivariate Cox proportional-hazards regression models.Finally,efficacy outcomes and TRAE profiles were compared between the two groups.RESULTS A significant difference in median OS was identified between the two groups(10.8 months in the CMT group vs 20.8 months in the CMT+ICI group,P=0.004).The CMT+ICI group also demonstrated a significantly longer median progression-free survival of 11.7 months(P<0.001).Patients receiving combination therapy exhibited significantly improved systemic objective response rate and disease control rate.Multivariate analysis identified key factors significantly influencing OS in EC patients with liver metastases:Karnofsky Performance Status score≥70,receipt of local therapy for liver metastases,and the number of cycles of CMT and immunotherapy received.Furthermore,the incidence of TRAEs did not significantly differ between the CMT+ICI and CMT groups.CONCLUSION For EC patients with liver metastases,the combination of CMT and ICIs demonstrates significantly superior efficacy compared with CMT alone,while maintaining manageable TRAEs.
基金funded by the Italian Ministry of Health through the grant“PRIN 2022 PNRR”entitled“Landscape ANalyses of immune CEll signatures associated with early Liver metastatic cOlorecTal cancer”(LANCELOT),P2022N3NC4,which has received funding from European Commission—NextGeneration for the salary of the researcher Candela Cives-Losada.
文摘Colorectal cancer(CRC)is the second deadliest cancer worldwide,being the presence of metastasis,mainly in the liver,a major contributor to high mortality rates in affected patients.The tumor microenvironment(TME)—comprised of interacting endothelial,stromal,and immune cells—plays a critical role in creating a supportive niche for tumor cell colonization and immune evasion and,thus,the establishment of metastases.The liver’s intrinsic nature further facilitates the development of immune tolerance,mediated by regulatory T cells,myeloid-derived suppressor cells,and soluble factors such as anti-inflammatory cytokines,which together dampen antitumor immune responses.This immunosuppressive milieu contributes significantly to resistance to immune checkpoint inhibitors,limiting the efficacy of immunotherapy in metastatic CRC.Deciphering the complex crosstalk between metastatic CRC cells and TME within the liver is essential for developing novel,effective immunotherapeutic approaches.Several strategies to overcome this lack of response are under research,including combination therapies,novel compounds,and approaches that target TME components.The scope of this review is to synthesize recent advances in the characterization of the hepatic metastatic microenvironment and emerging therapeutic approaches aimed at overcoming immune resistance in CRC liver metastases.
基金supported by the Natural Science Foundation of Shandong Province,China(Grant No.:ZR2021MH018).
文摘Liver cancer is an extremely heterogeneous malignant tumor characterized by high morbidity and mortality rates.Despite significant advancements in cancer care,the outcomes of liver cancer patients remain poor.Artificial intelligence(AI)is a major discipline in computer science that attempts to simulate human intelligence using machines or systems.Owing to the availability of multidimensional databases and recent algorithmic advancements,AI offers tremendous potential to overcome current obstacles in oncology research and practice.There is a growing body of evidence suggesting that AI models enable pathologists to diagnose liver cancer more accurately,customize personalized therapies,and predict cancer prognosis.Therefore,the increasing adoption of AI is expected to improve healthcare accuracy and patients’quality of life.However,only a few AI models are currently authorized for clinical use.This review outlines recent developments in research on the biomedical application of AI technology in liver cancer and discusses both the potential hurdles and future implications of employing AI for clinical cancer management,thereby providing insights for further research.Overall,the clinical implementation of AI technology is anticipated to induce a paradigm shift in medical oncology,leading to significant improvements in patient outcomes.
文摘Liver cancer is a leading cause of death worldwide,and hepatocellular carcinoma(HCC)is the most frequent primary liver tumour,followed by cholangiocarcinoma.Notably,secondary tumours represent up to 90% of liver tumours.Chronic liver disease is a recognised risk factor for liver cancer development.Up to 90% of the patients with HCC and about 20% of those with cholangiocarcinoma have an underlying liver alteration.The gut microbiota-liver axis represents the bidirectional relationship between gut microbiota,its metabolites and the liver through the portal flow.The interplay between the immune system and gut microbiota is also well-known.Although primarily resulting from experiments in animal models and on HCC,growing evidence suggests a causal role for the gut microbiota in the development and progression of chronic liver pathologies and liver tumours.Despite the curative intent of“traditional”treatments,tumour recurrence remains high.Therefore,microbiota modulation is an appealing therapeutic target for liver cancer prevention and treatment.Furthermore,microbiota could represent a non-invasive biomarker for early liver cancer diagnosis.This review summarises the potential role of the microbiota and immune system in primary and secondary liver cancer development,focusing on the potential therapeutic implications.
文摘In recent years,the rapid evolution of cancer therapies has markedly increased patient survival rates.However,the incidence of adverse events caused by anticancer treatments remains high,leading to significant clinical challenges.As the central hub of drug metabolism and detoxification,the liver is susceptible to therapeutic insults.The specific mechanisms of liver injury caused by different types of antineoplastic treatments vary.Chemotherapy induces hepatic damage via oxidative stress and mitochondrial dysfunction,whereas targeted therapy disrupts signaling pathways in hepatic cells.Immunotherapy triggers immunemediated hepatitis through cytokine storms and immune cell infiltration,and radiation therapy causes hepatic microvascular injury.Additionally,patients with preexisting chronic liver diseases(such as cirrhosis,hepatitis B/C,or nonalcoholic fatty liver disease)are more likely to face increased risks of hepatic injury during cancer treatment.Therefore,early detection and timely treatment are crucial for these high-risk populations.This review introduces the emerging field of“oncohepatology”,which illuminates the mechanisms underlying hepatic injury due to cancer treatments,summarizes the influence and management of preexisting liver disease during cancer treatment,analyzes diagnostic and therapeutic strategies for cancer treatment-associated liver function damage,and discusses potential future research directions to provide valuable insights for liver injury management in clinical oncology.
基金Supported by the Sichuan Science and Technology Program,No.2024NSFSC1936.
文摘BACKGROUND Cancer-associated fibroblasts(CAFs),crucial components of the tumor microenvironment in primary and metastatic tumors,can impact the activity of cancer cells and contribute to their progression.Given their extensive interactions with cancer cells and other stromal cells,we aimed to evaluate the prognostic value of CAFs in patients with liver cancer(LC).AIM To investigate the association between CAF expression and clinicopathological characteristics as well as overall survival(OS)in patients with LC,including hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(iCCA).METHODS We performed a meta-analysis of cohort studies with available data on the effects of CAF expression on both clinicopathological characteristics and OS via hazard ratios(HRs)and risk ratios with 95%confidence intervals(CIs).Studies were subgrouped on the basis of CAF markers and cancer type,and the subgroup effects of CAF expression on both HCC and iCCA were analyzed through meta-regression.The Newcastle-Ottawa Scale was used to evaluate the included studies to guarantee their quality and minimize the possibility of bias.RESULTS Nine trials were selected and included a total of 1518 patients.According to our primary meta-analysis,the expression of CAFs in LC patients was significantly associated with a decrease in OS(LC:HR:1.62;95%CI:1.34-1.97;P<0.001;HCC:HR:1.67;95%CI:1.34-2.07;P<0.001;iCCA:HR:1.47;95%CI:0.97-2.23;P=0.07);nevertheless,it was not significantly associated with almost all clinicopathologic characteristics,including tumor size,venous infiltration,alpha-fetoprotein level,and differentiation grade.According to the subgroup analysis of smooth muscle actin(SMA)markers in both HCC patients and iCCA patients,high CAF expression in HCC(HR:2.29;95%CI:1.01-5.22;P=0.048)and iCCA(HR:2.04;95%CI:1.09-3.81;P=0.025)patients was a significant indicator of poor OS.Moreover,the clinicopathological characteristics were also verified by the SMA marker,which had a nearly significant effect on the venous infiltration of iCCA(risk ratio:2.70;95%CI:0.97-7.49;P=0.057).CONCLUSION High CAF expression,evaluated by both mixed markers and SMAs,is significantly associated with poor OS in patients with LC,including both HCC patients and iCCA patients.However,further research is necessary since how CAF expression and clinicopathologic features are related is yet unknown.
文摘BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a new idea.AIM To analyze the post-surgical effect of the artificial liver support system with TCM in patients with liver cancer.METHODS Ninety-eight patients with liver cancer who underwent surgical treatment at the Fifth People’s Hospital of Huai’an from January 2023-2024 were selected and divided into two groups(49 patients each)via random lottery method.Both groups underwent surgery.The control group received artificial liver support,and the observation group was additionally treated with TCM for strengthening the body and removing blood stasis.Gastrointestinal recovery,liver function,tumor marker levels,immune function,and safety were compared between both groups.RESULTS There were significant differences in the levels of indicators related to gastrointestinal recovery between the groups(P<0.05).After treatment,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,and gamma-glutamyl transpeptidase in the observation group were lower,whereas the albumin level was higher(P<0.05).After treatment,tumor marker levels in the observation group were relatively lower(P<0.05).After treatment,compared to the control group,the CD4+level in the observation group was higher and the CD8+level was lower(P<0.05).There was no significant difference in the incidence of adverse reactions between both groups(P>0.05).CONCLUSION Combining the artificial liver support system with TCM significantly improves liver and gastrointestinal functions,enhances immune responses,and reduces tumor marker levels with high safety,suggesting that it could be a promising approach for optimizing postoperative care and improving patient outcomes,potentially reducing complications and enhancing quality of life.
基金supported by the Science and Technology Strategic Cooperation Programs of Luzhou Municipal People's Government and Southwest Medical University(No.2024LZXNYDJ017)the Project Program of the Science and Technology Department of Sichuan Province(No.2025zNSFSC0679)the Project Program of Chongqing Science and Technology Bureau(No.cstc2020jcyjmsxmX1037).
文摘Although the combination of chemotherapy and immunotherapy can improve the treatment of breast cancer,traditional drugs are highly toxic because they do not specifically target tumors.In this study,we developed a self-driving bacteria/nanoparticle biohybrid called Bif@PDA-aPD1/DOX-Lip by attaching polydopamine(PDA)coated doxorubicin(DOX)liposomes and the immune checkpoint inhibitor anti-programmed cell death protein 1 antibody(aPD-1)to Bifidobacterium infantis(B.infantis,Bif).Using the homing abilities of bacteria,Bif@PDA-aPD1/DOX-Lip could actively accumulate in tumor tissue,releasing DOX and aPD-1 in the acidic environment to have a synergistic anti-tumor effect.Results show that the concentration of DOX in tumors of the Bif@PDA-aPD1/DOX-Lip group was 6.31 times higher than in the free DOX group.The combination of DOX and aPD-1 not only killed tumor cells but also promoted immune normalization by maturing dendritic cells(DCs),increasing M1 macrophage ratio,and enhancing infiltration of CD8^(+) and CD4^(+)T cells in tumors and spleen.Therefore,Bif@PDA-aPD1/DOX-Lip therapy significantly inhibited tumor growth and increased the average survival time of mice to over 80 days.The Bif@PDA-aPD1/DOX-Lip biomotors offer a highly effective method for enhancing chemo-immunotherapy in solid tumors.
基金supported by the Vall d’Hebron Research Institute(PI23/01345)the Networking Research Centre on Bioengineering,Biomaterials,and Nanomedicine(CIBER-BBN),which is financed by the Instituto de Salud Carlos III(ISCIII)with assistance from the European Regional Development Fund(ERDF)+4 种基金supported by ANID FONDECYT REGULAR(Chile)through project No.1250634,and FOVI230019 granted to Esteban Duran-LaraDiana Rafael was supported by Marie Skłodowska-Curie Actions(MSCA-PF ID 101107735),“La Caixa Foundation”(LCF/BQ/PR24/12050008),and ISCIII(PI24/00745)Fernanda Andrade was granted by the Fundación Científica de la Asociación Española Contra el Cáncer(FCAECC Refs.INVES211530DASI and SNRGS247164DASI)“La Caixa Foundation”(HR24-00927).Júlia German-Cortés was granted by the 791 FAECC(PRDBA258393GERM)The authors also thank the denomination of Consolidated group from Generalitat de Catalunya(2021 SGR 01173)granted to the CB-DDT group。
文摘Despite remarkable advances in nanomedicine,localized delivery of advanced cancer therapeutics remains underexploited.Advanced therapies based on biopharmaceuticals,immunotherapy,or gene therapy have revolutionized oncology.Yet,their systemic administration is often associated with limitations such as poor sitespecific accumulation,instability,and systemic toxicity.Hydrogels/macrogels offer the ability to encapsulate,protect,and release biomolecules in situ with sustained and stimulus-responsive profiles,addressing key translational gaps.This review provides a focused synthesis of the last five years of hydrogel-based research for cancer therapy,with emphasis on peptides,antibodies,immunotherapeutic agents,and gene delivery systems.We discuss design principles,release mechanisms,and clinical translation challenges,highlighting structure-function relationships and comparative performance across therapeutic classes.By integrating mechanistic insights with recent breakthroughs,we outline how next-generation hydrogels can synergize with personalized medicine and combination therapies to redefine localized cancer treatment.This work explores the fundamental aspects and provides examples of hydrogel-based delivery for the advanced treatment of cancer.The review summarizes the dynamic landscape of hydrogel research of the last 5 years,showcasing their potential systems for the precise delivery of biomolecules.Specifically,we explore the multidimensional role of hydrogels in the sustained and localized release of antibodies,immunotherapeutic agents,and genes as next-generation platforms for localized cancer treatment.This review aims to critically evaluate the mechanisms and applications of these systems in order to assess their potential to transform medical interventions and advance patient care.
基金Supported by the Project of Guizhou Provincial Department of Science and Technology,No.Qian Ke He Cheng Guo-LC[2024]109.
文摘The incidence of colorectal cancer is gradually increasing,and a majority of patients are diagnosed with distant metastases at the time of initial diagnosis,with the liver being the most common site of metastasis.Unlike most malignant tumors,patients with distant metastases can still achieve favorable prognoses if both the primary tumor and liver metastases are surgically resected.With ad-vances in systemic therapies,many patients with initially unresectable liver me-tastases from colorectal cancer can undergo systemic treatment to achieve con-version therapy,thereby gaining the opportunity for surgery.However,there is still no consensus on several issues,including the timing of systemic therapy before and after surgery,whether neoadjuvant therapy should be employed,and the choice between simultaneous or staged surgeries.This review aims to system-atically describe the current treatment landscape for colorectal cancer with liver metastases and highlight several unresolved controversial issues,providing valuable insights for the diagnosis and treatment of colorectal liver metastases.
基金Key Project of Traditional Chinese Medicine Science and Technology Plan of Zhejiang Province (GZY-ZJ-KJ-24077)National Natural Science Foundation of China (No. U23A202181, 8207101520, 82272860)+2 种基金Central Guidance on Local Science and Technology Development Fund of Zhejiang Province (2023ZY1017)Fundamental Research Funds for the Central Universities (No. 226-2023-00038)Special Financial Support for Zhejiang Traditional Chinese Medicine Innovation Teams。
文摘BACKGROUND: The increasing morbidity of liver cancer has led to a growing demand for transplantation. Split liver transplantation(SLT) is a promising way to ameliorate organ shortages. However, the safety and efficacy of SLT are still controversial. The aim of this study was to assess the clinical outcome of SLT in liver cancer patients at our center. METHODS: A total of 74 patients who received liver transplantation at a tertiary hospital from March 2019 to July 2023 were retrospectively studied, of whom 37 recipients underwent SLT and 37 recipients underwent whole-graft liver transplantation(WGLT). Clinical data were analyzed and compared between patients who underwent SLT and WGLT.RESULTS: SLT and WGLT were successfully performed, with no intraoperative transplantrelated mortality. Postoperatively, no significant differences in total bilirubin(TB, P=0.266), alanine transaminase(ALT, P=0.403) and aspartate transaminase(AST, P=0.160) levels within 30 d were detected between the two groups. The transplant-related mortality rates were 8.1% in the SLT group and 5.4% in the WGLT group within 30 d of surgery(P=1.000), and 10.8% and 8.1%, respectively, at 90 d after surgery(P=1.000). There were no significant differences in overall survival(OS) and progress-free survival(PFS) between the SLT and WGLT groups(P=0.910, P=0.190). CONCLUSION: Our results show that SLT does not imply additional risks in treating liver cancer compared with WGLT.
基金financially supported by research grants from the Natural Science Foundation of China(No.52173235)Science and Technology Innovation and Improving Project of Army Medical University(No.2021XJS24)+1 种基金Science and Technology Innovation Capability Enhancement Project of Army Medical University(No.2022XJS20)Key Innovation Project for Clinical Technology of the Second Affiliated Hospital of Army Medical University(No.2018JSLC0025)。
文摘Liver cancer is a major killer threatening human health worldwide.At this stage the clinical choice to the treatment of liver cancer is a combination of surgery,chemotherapy and radiotherapy.Alternatively,using hydrogen to treat cancer has great prospects and development space.Herein,we fabricated a hierarchical and flexible electrode that being able to continuously generate hydrogen in vivo in the deep abdominal liver through efficient water electrolysis to kill tumor cells and regulate the tumor microenvironment.The flexibility of the electrode facilitated to fit the tumor surface and thus improved the contact area of hydrogen therapy.By in situ growth of molybdenum disulfide on a hierarchical carbon skeleton,improved reaction kinetics and smaller impedance with a low overpotential of 1.02 V at-10 m A/cm^(2)in cell culture medium and Tafel slope of 73 m V/dec were achieved.Animal experiments showed that the electrode could effectively inhibit the growth of human hepatocellular carcinoma cells in nude mice by efficient H_(2)-production in vivo.The apoptosis rate of cancer cells reached 81.8%,and the proliferation rate decreased to 3.39%.Moreover,this treatment does not affect the growth of normal hepatocytes according to the results of cell experiments.This study demonstrated that the in vivo hydrogen production by our flexible electrode is a safe and effective treatment for liver cancer,with the advantages of minimal invasiveness,simple operation,low side effects and low cost.
基金Supported by the European Union-NextGenerationEU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No.BG-RRP-2.004-0008.
文摘Colorectal cancer (CRC) is the third most common cancer globally, with 20%-25%of patients diagnosed at stage IV, significantly affecting overall survival (OS).Only 14% of stage IV patients survive for 5 years with palliative chemotherapy.However, the role of liver transplantation (LT) in the management of CRC livermetastasis (CRCLM) is an evolving area of interest. Recent advancements inoncologic outcomes and clinical understanding have prompted the re-evaluationof LT as a viable treatment option for CRCLM. A promising result from someprospective pilot studies reported a 5-year OS rate of 60% after LT for patientswith CRCLM. Key factors influencing eligibility include tumor biology, absence ofextrahepatic disease, and the patient's performance status. By synthesizing thelatest research findings, we aim to provide a comprehensive overview that summarizesthe most relevant data related to the clinical outcomes of patients whounderwent LT for CRCLM. We aim to provide a comprehensive overview by synthesizingthe latest research findings. This review discusses the inclusion criteriaand eligibility for LT in CRCLM, which are of great importance to patient outcomes.
文摘BACKGROUND Multiple primary malignant tumors refer to the occurrence of two or more primary malignant tumors in the same organ or multiple organs or tissues at the same time or successively in the same patient,and can occur anywhere in the body.The treatment guidelines for patients with multiple primary malignant tumors are currently controversial.CASE SUMMARY A 51-year-old male patient with liver cancer and portal hypertension received 42 months of co-treatment with atezolizumab and bevacizumab.After that,the disease was rated stable disease.The patient was then diagnosed with gastric cancer.Since the patient was not sensitive to anti-programmed death ligand 1 immunosuppressive agents,a co-treatment with oxaliplatin,tegafur,apatinib,and cadonilimab was selected after multidisciplinary consultation and the patient’s agreement.After four cycles of treatment,partial response and stable disease were observed in gastric and liver cancers,respectively.Surgical treatment was performed considering the high-risk factors of gastrointestinal bleeding in patients with gastroesophageal varices.Postoperative pathology showed that the Tumor Regression Grade was 1.Moreover,the genetic testing of postoperative tumor specimens indicated negative programmed death ligand 1 and microsatellite stability.In addition,the latest follow-up indicated an 8 and 40-month progression-free survival in gastric and liver cancer patients,respectively.Currently,the patient is receiving postoperative immunotherapy with cadonilimab.CONCLUSION Cadonilimab not only treats microsatellite stability gastric cancer patients but can also be used for liver cancer treatment.
文摘BACKGROUND In-depth comparative investigations in terms of clinical efficacies of liver tumor microwave ablation(MWA)and laparoscopic hepatectomy(LH),which are both important treatment modalities for liver neoplasms,have been limited in patients diagnosed with primary small liver cancer(PSLC).AIM To compare and analyze the clinical efficacy of liver tumor MWA and LH for PSLC.METHODS This study retrospectively analyzed the medical records of 123 patients with PSLC admitted to Xuzhou Central Hospital from January 2015 to November 2022 and categorized them based on treatment modalities into the LH and MWA groups.The LH group,consisting of 61 cases,received LH,and the MWA group,which included 62 cases,underwent liver tumor MWA.Basic data and various periop-erative indicators were compared between the two groups,including changes in liver function indicators[alanine aminotransferase(ALT),glutamic aminotrans-ferase(AST),and total bilirubin(TBIL)]pre-and post-treatment,and efficacy and postoperative complications were analyzed.RESULTS No statistically significant difference was observed between the two groups in terms of age,gender,tumor diameter,liver function Child-Pugh classification and number of tumors,body mass index,and educational status(P>0.05).The overall effective rate was higher in the MWA group than in the LH group(98.39%vs 88.52%)(χ2=4.918,P=0.027).The MWA group exhibited less operation time,intraoperative bleeding,defecation time,and hospital stay than the LH group(P<0.05).No difference was found in liver function indicators between the two groups pre-treatment(P>0.05),and ALT,AST,and TBIL levels decreased in both groups post-treatment,with the MWA group demonstrating lower levels(P<0.05).The MWA and LH groups exhibited postoperative complication rates of 4.84%and 19.67%,respectively,with statistically significant differences between the two groups(P=0.012,χ2=6.318).CONCLUSION MWA is more effective in treating PSLC,and it promotes faster postoperative recovery for patients,and more security improves liver function and reduces postoperative complications compared to LH.
基金supported by Tabriz University of Medical Sciences,grant number 65364.
文摘Cancer stem cells(CSCs)are a major challenge in cancer therapy.Stem cell-like cells form a unique subpopulation within many tumors,which govern the degree of malignancy by promoting metastasis,recurrence,heterogeneity,and resistance to drug and radiation.Furthermore,these cells can persist in patients even after undergoing multiple cycles of conventional cancer therapy via dormancy,where they no longer dividing but remain active.These may cause cancer recurrence at any time,even years after a supposed cure,and remain invisible to the immune system.Targeting specific surface markers,signaling pathways and tumor microenvironment,which all have a significant effect on CSC function and maintenance,could help to eradicate CSCs and improve patient survival.Combinations of traditional therapies with nano-based drug delivery systems can efficiently target CSCs.Considering the biology and properties of CSCs,we classify recent approaches involving nanoparticle engineering,extracellular matrix modulation,cocktail strategies,multi-stage therapy,CSC defanging,Trojan horse systems,targeted therapy and organelle targeting.We highlight the most recent advances in nanocarrier design and drug delivery technologies to target CSCs,combined with conventional treatment in preclinical and clinical trials.The prospects of these approaches for CSCs elimination and recurrent cancer treatment are discussed.
文摘mRNA vaccines have emerged as a transformative platform in oncology,offering significant advantages in rapid development,flexibility,and safety over traditional modalities.However,their clinical translation faces challenges such as mRNA instability,inefficient in vivo delivery,and the immunosuppressive tumor microenvironment(TME).This review comprehensively outlines recent advancements in overcoming these hurdles.We discuss the molecular design of mRNA vaccines,including non-replicating and self-amplifying RNAs,and highlight breakthroughs in delivery strategies,particularly lipid nanoparticles(LNPs),that enhance stability and immunogenicity.Furthermore,we explore various administration routes and their impact on eliciting robust antitumor immunity.The review also covers the classification of antigens—viral,tumor-associated,and neoantigens—and the innovative use of mRNA to encode immunomodulators to reprogram the TME.Finally,we address key considerations for clinical translation,including manufacturing,stability,safety,and combination strategies with immunotherapies.By synthesizing these developments,this review underscores the potential of mRNA vaccines to realize personalized cancer immunotherapy and outlines future directions for the field.
基金the financial support from Henan Province Natural Science Foundation(No.252300420583)Henan Provincial Science and Technology Research Project(Nos.242102310455,242102310473,242102310517)the Key Project of Science and Technology Research funded by the Henan Provincial Department of Education(No.24A350002)。
文摘Liver cancer is the fourth cause of cancer-related deaths and the primary cause of death in patients with compensated cirrhosis.In recent years,the role of traditional Chinese medicine in the treatment of liver cancer has attracted more and more attention and recognition.Luteolin(LUT)and glycyrrhetinic(GA)are natural compounds extracted from Chinese herbal medicine.LUT exhibits various biological activity including anti-inflammatory,antibacterial,antiviral,anti-tumor,and neuroprotective effects.GA significantly inhibits the growth and metastasis of cancer cells.However,the low water solubility of both compounds hinders their clinical applications.In this study,rod-shaped nanoparticles(NPs)self-assembled from LUT and GA were designed to enhance drug solubility and tumor-targeting capability.We verified that the assembly mechanism of the NPs was π-π stacking.These NPs significantly inhibited the proliferation of liver cancer cells while had no significant effect on normal liver cells.In a mouse model of liver cancer,these NPs demonstrated superior tumor-targeting ability due to the enhanced permeability and retention effect,and the affinity of GA for liver cancer cells,resulting in better therapeutic efficacy with lower systemic toxicity.Results of network pharmacology analysis showed that LUT and GA respectively targeted estrogen receptor 1(ESR1)protein and cyclin-dependent kinase 1(CDK1)protein to corporately induce tumor cell cycle arrest,which induced the inhibition of tumor cell proliferation.In conclusion,this study provides a novel reference for the treatment of liver cancer.
