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14 pages, 548 KiB  
Review
Carboxypeptidase A4: A Biomarker for Cancer Aggressiveness and Drug Resistance
by Adeoluwa A. Adeluola, Md. Sameer Hossain and A. R. M. Ruhul Amin
Cancers 2025, 17(15), 2566; https://doi.org/10.3390/cancers17152566 - 4 Aug 2025
Abstract
Carboxypeptidase A4 (CPA4) is an exopeptidase that cleaves peptide bonds at the C-terminal domain within peptides and proteins. It preferentially cleaves peptides with terminal aromatic or branched chain amino acid residues such as phenylalanine, tryptophan, or leucine. CPA4 was first discovered in prostate [...] Read more.
Carboxypeptidase A4 (CPA4) is an exopeptidase that cleaves peptide bonds at the C-terminal domain within peptides and proteins. It preferentially cleaves peptides with terminal aromatic or branched chain amino acid residues such as phenylalanine, tryptophan, or leucine. CPA4 was first discovered in prostate cancer cells, but it is now known to be expressed in various tissues throughout the body. Its physiologic expression is governed by latexin, a noncompetitive endogenous inhibitor of CPA4. Nevertheless, the overexpression of CPA4 has been associated with the progression and aggressiveness of many malignancies, including prostate, pancreatic, breast and lung cancer, to name a few. CPA4’s role in cancer has been attributed to its disruption of many cellular signaling pathways, e.g., PI3K-AKT-mTOR, STAT3-ERK, AKT-cMyc, GPCR, and estrogen signaling. The dysregulation of these pathways by CPA4 could be responsible for inducing epithelial--mesenchymal transition (EMT), tumor invasion and drug resistance. Although CPA4 has been found to regulate cancer aggressiveness and poor prognosis, no comprehensive review summarizing the role of CPA4 in cancer is available so far. In this review, we provide a brief description of peptidases, their classification, history of CPA4, mechanism of action of CPA4 as a peptidase, its expression in various tissues, including cancers, its role in various tumor types, the associated molecular pathways and cellular processes. We further discuss the limitations of current literature linking CPA4 to cancers and challenges that prevent using CPA4 as a biomarker for cancer aggressiveness and predicting drug response and highlight a number of future strategies that can help to overcome the limitations. Full article
(This article belongs to the Special Issue Insights from the Editorial Board Member)
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5 pages, 476 KiB  
Correction
Correction: Cloître et al. Spatial Distribution of Recurrence and Long-Term Toxicity Following Dose Escalation to the Dominant Intra-Prostatic Nodule for Intermediate–High-Risk Prostate Cancer: Insights from a Phase I/II Study. Cancers 2024, 16, 2097
by Minna Cloître, Sofian Benkhaled, Sarah Boughdad, Niklaus Schaefer, John O. Prior, Michele Zeverino, Dominik Berthold, Thomas Tawadros, Jean-Yves Meuwly, Paul Martel, Chantal Rohner, Leonie Heym, Frederic Duclos, Véronique Vallet, Massimo Valerio, Jean Bourhis and Fernanda G. Herrera
Cancers 2025, 17(15), 2496; https://doi.org/10.3390/cancers17152496 - 29 Jul 2025
Viewed by 110
Abstract
In the original publication [...] Full article
2 pages, 246 KiB  
Correction
Correction: Jeong et al. WBP5 Expression Influences Prognosis and Treatment Response in Head and Neck Squamous Cell Carcinoma. Cancers 2025, 17, 587
by Eun-jeong Jeong, Eunjeong Kim, Kwang-Yoon Jung, Seung-Kuk Baek and Yeon Soo Kim
Cancers 2025, 17(15), 2493; https://doi.org/10.3390/cancers17152493 - 29 Jul 2025
Viewed by 120
Abstract
In the original publication [...] Full article
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18 pages, 2051 KiB  
Article
Chemotherapy (Etoposide)-Induced Intermingling of Heterochromatin and Euchromatin Compartments in Senescent PA-1 Embryonal Carcinoma Cells
by Marc Bayer, Jaroslava Zajakina, Myriam Schäfer, Kristine Salmina, Felikss Rumnieks, Juris Jansons, Felix Bestvater, Reet Kurg, Jekaterina Erenpreisa and Michael Hausmann
Cancers 2025, 17(15), 2480; https://doi.org/10.3390/cancers17152480 - 26 Jul 2025
Viewed by 371
Abstract
Background: Often, neoadjuvant therapy, which relies on the induction of double-strand breaks (DSBs), is used prior to surgery to shrink tumors by inducing cancer cell apoptosis. However, recent studies have suggested that this treatment may also induce a fluctuating state between senescence [...] Read more.
Background: Often, neoadjuvant therapy, which relies on the induction of double-strand breaks (DSBs), is used prior to surgery to shrink tumors by inducing cancer cell apoptosis. However, recent studies have suggested that this treatment may also induce a fluctuating state between senescence and stemness in PA-1 embryonal carcinoma cells, potentially affecting therapeutic outcomes. Thus, the respective epigenetic pathways are up or downregulated over a time period of days. These fluctuations go hand in hand with changes in spatial DNA organization. Methods: By means of Single-Molecule Localization Microscopy in combination with mathematical evaluation tools for pointillist data sets, we investigated the organization of euchromatin and heterochromatin at the nanoscale on the third and fifth day after etoposide treatment. Results: Using fluorescently labeled antibodies against H3K9me3 (heterochromatin tri-methylation sites) and H3K4me3 (euchromatin tri-methylation sites), we found that the induction of DSBs led to the de-condensation of heterochromatin and compaction of euchromatin, with a peak effect on day 3 after the treatment. On day 3, we also observed the co-localization of euchromatin and heterochromatin, which have marks that usually occur in exclusive low-overlapping network-like compartments. The evaluation of the SMLM data using topological tools (persistent homology and persistent imaging) and principal component analysis, as well as the confocal microscopy analysis of H3K9me3- and H3K4me3-stained PA-1 cells, supported the findings that distinct shifts in euchromatin and heterochromatin organization took place in a subpopulation of these cells during the days after the treatment. Furthermore, by means of flow cytometry, it was shown that the rearrangements in chromatin organization coincided with the simultaneous upregulation of the stemness promotors OCT4A and SOX2 and senescence promotors p21Cip1 and p27. Conclusions: Our findings suggest potential applications to improve cancer therapy by inhibiting chromatin remodeling and preventing therapy-induced senescence. Full article
(This article belongs to the Special Issue Insights from the Editorial Board Member)
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12 pages, 262 KiB  
Editorial
Procedural Physician-Scientists as Catalysts for Innovation in Team Science and Clinical Care
by Sajid A. Khan, Kurt S. Schultz and Nita Ahuja
Cancers 2025, 17(15), 2468; https://doi.org/10.3390/cancers17152468 - 25 Jul 2025
Viewed by 190
Abstract
Procedural physician-scientists have made significant contributions to medicine and science, with twelve proceduralists receiving a Nobel Prize. Unfortunately, several systemic challenges have jeopardized the existence, let alone the flourishing, of procedural physician-scientists: the widening gap in the National Institutes of Health salary cap, [...] Read more.
Procedural physician-scientists have made significant contributions to medicine and science, with twelve proceduralists receiving a Nobel Prize. Unfortunately, several systemic challenges have jeopardized the existence, let alone the flourishing, of procedural physician-scientists: the widening gap in the National Institutes of Health salary cap, decreasing funding from nonfederal public and private agencies, and shifting priorities among U.S. hospitals, payers, and policymakers toward relative value unit productivity-based compensation and fee-for-service models. Additional pressures include prolonged training pathways and the need to maintain clinical continuity. Adopting a team science approach may offer a powerful strategy to mitigate these competing demands, support rigorous scientific inquiry, and address the growing complexity of biomedical research. Concerted efforts by the federal government, policymakers, corporations, institutions, and procedural departments will also be crucial to restoring the vitality of this diminishing workforce. Full article
(This article belongs to the Special Issue Insights from the Editorial Board Member)
7 pages, 168 KiB  
Correction
Correction: Nadelmann et al. Acral Melanoma in Skin of Color: Current Insights and Future Directions: A Narrative Review. Cancers 2025, 17, 468
by Emily R. Nadelmann, Ajay K. Singh, Matteo Abbruzzese, Oluwaseyi O. Adeuyan, Divya B. Kenchappa, Katherine Kovrizhkin, Michelle Lightman, Avishai Samouha, Kevin L. Tao, Jaewon Yun, Tian R. Zhu, Beth N. McLellan and Yvonne M. Saenger
Cancers 2025, 17(15), 2458; https://doi.org/10.3390/cancers17152458 - 25 Jul 2025
Viewed by 150
Abstract
In the published publication [...] Full article
15 pages, 3627 KiB  
Article
Epigenetic Treatment Alters Immune-Related Gene Signatures to Increase the Sensitivity of Anti PD-L1 Drugs
by Chonji Fukumoto, Pritam Sadhukhan, Masahiro Shibata, Muhammed T. Ugurlu, Rachel Goldberg, David Sidransky, Luigi Marchionni, Fenna C. M. Sillé and Mohammad Obaidul Hoque
Cancers 2025, 17(15), 2431; https://doi.org/10.3390/cancers17152431 - 23 Jul 2025
Viewed by 254
Abstract
Background/Objectives: Head and neck squamous cell carcinoma (HNSCC) is the seventh most prevalent cancer worldwide. Despite intensive treatments, the prognosis is unfavorable. Recently, immunotherapy has emerged as a novel therapeutic strategy, and several immune-checkpoint blockade blockers provide clinical benefits to patients. However, the [...] Read more.
Background/Objectives: Head and neck squamous cell carcinoma (HNSCC) is the seventh most prevalent cancer worldwide. Despite intensive treatments, the prognosis is unfavorable. Recently, immunotherapy has emerged as a novel therapeutic strategy, and several immune-checkpoint blockade blockers provide clinical benefits to patients. However, the response rates of these antibodies are limited, and there is a pressing need to increase the efficacy of immunotherapy for HNSCC patients. Epigenetic treatment is emerging as a promising combination approach able to change immune-related gene signatures in tumors and potentially increase the efficacy of immunotherapy. In this study, we sought to elucidate further immune-related gene signatures altered through epigenetic treatment and explored whether epigenetic drugs can increase the efficacy of anti PD-L1 treatment in HNSCC. Methods: At first, we treated six HNSCC cell lines with 5-azacytidine and romidepsin and analyzed gene expression patterns by microarray and TaqMan arrays analysis. We then explored the therapeutic efficacy of epigenetic treatment with an anti PD-L1 antibody in a syngeneic mouse model. Results: Our microarray analysis revealed the differential expression of immune-related genes in cell lines treated with epigenetic drugs, as compared to untreated controls. Most importantly, these array analyses showed a significant change in the transcription of some immune related-and biologically relevant genes, such as HLA-DRA, HMOX1, IFI6, IL12A, IRF7, NFKB2, RPL3L, STAT1, STAT3, CSF1, CSF2, FAS, OASL, and PD-L1, after epigenetic treatment. Furthermore, the combination of epigenetic treatment with an anti PD-L1 antibody significantly suppressed tumor growth in a syngeneic mouse model. In vivo tumors treated with epigenetic drugs expressed higher STAT1, STAT3, and PD-L1 compared to untreated tumors. Increased PD-L1 expression is postulated to increase the efficacy of anti PD-L1 treatment. Conclusions: Our results highlight the importance of a combinational strategy employing both epigenetic and immunotherapy in HNSCC. Full article
(This article belongs to the Special Issue Insights from the Editorial Board Member)
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28 pages, 1528 KiB  
Review
Is Human Chorionic Gonadotropin a Reliable Marker for Testicular Germ Cell Tumor? New Perspectives for a More Accurate Diagnosis
by Nunzio Marroncelli, Giulia Ambrosini, Andrea Errico, Sara Vinco, Elisa Dalla Pozza, Giulia Cogo, Ilaria Cristanini, Filippo Migliorini, Nicola Zampieri and Ilaria Dando
Cancers 2025, 17(14), 2409; https://doi.org/10.3390/cancers17142409 - 21 Jul 2025
Viewed by 356
Abstract
Testicular germ cell tumors (TGCTs) are the most common malignancies affecting young men between the ages of 14 and 44, accounting for about 95% of all testicular cancers. Despite being relatively rare compared to other cancers (~3.0 cases per 100,000 population, with high [...] Read more.
Testicular germ cell tumors (TGCTs) are the most common malignancies affecting young men between the ages of 14 and 44, accounting for about 95% of all testicular cancers. Despite being relatively rare compared to other cancers (~3.0 cases per 100,000 population, with high worldwide variability), TGCTs’ incidence is increasing, particularly in industrialized countries. The initial phase of TGCT diagnosis is performed by detecting in the blood the presence of three proteins, i.e., alpha-fetoprotein (AFP), lactate dehydrogenase (LDH), and human chorionic gonadotropin (hCG). Despite these proteins being defined as markers of TGCTs, they present limitations in specificity. Indeed, AFP is not elevated in pure seminomas; LDH serum levels can be elevated in other conditions, such as liver disease or tissue damage, and hCG can be elevated in both seminomas and non-seminomas, reducing its ability to differentiate between tumor types. However, the existence of hCG variants, characterized by distinct glycosylation profiles that are differentially expressed in TGCT types and subtypes, may increase the diagnostic and prognostic potential of this hormone. Furthermore, emerging molecular biomarkers, including miRNAs and tumor cells-related epigenetic status, may offer new promising alternatives to improve diagnostic accuracy. Nonetheless, standardized diagnostic protocols still need to be implemented. Finally, understanding the biological roles of hCG isoforms and their “canonical” (e.g., LHCGR) and “non-canonical” (e.g., TGF-βR) receptor interactions may help in understanding tumor biology and therapeutic targeting. Full article
(This article belongs to the Special Issue Insights from the Editorial Board Member)
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4 pages, 3729 KiB  
Correction
Correction: Afjei et al. A New Nrf2 Inhibitor Enhances Chemotherapeutic Effects in Glioblastoma Cells Carrying p53 Mutations. Cancers 2022, 14, 6120
by Rayhaneh Afjei, Negar Sadeghipour, Sukumar Uday Kumar, Mallesh Pandrala, Vineet Kumar, Sanjay V. Malhotra, Tarik F. Massoud and Ramasamy Paulmurugan
Cancers 2025, 17(14), 2408; https://doi.org/10.3390/cancers17142408 - 21 Jul 2025
Viewed by 195
Abstract
In the original publication [...] Full article
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16 pages, 2015 KiB  
Systematic Review
Immunotherapy and Advanced Vulvar Cancer: A Systematic Review and Meta-Analysis of Survival and Safety Outcomes
by Mauro Francesco Pio Maiorano, Vera Loizzi, Gennaro Cormio and Brigida Anna Maiorano
Cancers 2025, 17(14), 2392; https://doi.org/10.3390/cancers17142392 - 19 Jul 2025
Viewed by 525
Abstract
Background: Advanced and recurrent vulvar squamous cell carcinoma (VSCC) presents a major therapeutic challenge with limited treatment options and poor outcomes. Immune checkpoint inhibitors (ICIs) have shown efficacy in other HPV-associated malignancies, but their role in VSCC remains poorly defined due to [...] Read more.
Background: Advanced and recurrent vulvar squamous cell carcinoma (VSCC) presents a major therapeutic challenge with limited treatment options and poor outcomes. Immune checkpoint inhibitors (ICIs) have shown efficacy in other HPV-associated malignancies, but their role in VSCC remains poorly defined due to the rarity of the disease and limited clinical trial data. Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines and registered in PROSPERO (CRD420251067565). A comprehensive literature search identified prospective clinical trials evaluating ICIs in patients with advanced, unresectable, recurrent, or metastatic VSCC. The primary outcomes included objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety. Risk of bias was assessed using the MINORS tool. Meta-analyses were performed using random-effects models, with subgroup analyses based on PD-L1 status and treatment regimens (monotherapy vs. combination therapy). Results: Six non-randomized single-arm trials involving 181 patients were included. The pooled ORR was 21%, with higher response rates observed in combination therapy (46%) compared to monotherapy (11%), though not statistically significant. Median PFS and OS were 2.2 months and 6.4 months, respectively. ORRs were similar between PD-L1-positive and PD-L1-negative subgroups. A safety analysis showed treatment-related adverse events (AEs) in 73% of patients and grade ≥ 3 AEs in 23%. The incidence of treatment-related death was 3%. Conclusions: ICIs demonstrate modest but durable efficacy and an acceptable safety profile in advanced VSCC. The current evidence supports their use in selected patients. However, response variability and the lack of reliable predictive biomarkers, such as PD-L1 or HPV status, underscore the need for biomarker-driven clinical trials and improved patient selection strategies. Full article
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4 pages, 779 KiB  
Correction
Correction: Hung et al. Cul4A Modulates Invasion and Metastasis of Lung Cancer through Regulation of ANXA10. Cancers 2019, 11, 618
by Ming-Szu Hung, Yi-Chuan Chen, Paul-Yann Lin, Ya-Chin Li, Chia-Chen Hsu, Jr-Hau Lung, Liang You, Zhidong Xu, Jian-Hua Mao, David M. Jablons and Cheng-Ta Yang
Cancers 2025, 17(14), 2377; https://doi.org/10.3390/cancers17142377 - 17 Jul 2025
Viewed by 194
Abstract
In the original publication [...] Full article
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2 pages, 142 KiB  
Correction
Correction: Jarahian et al. Re-Expression of Poly/Oligo-Sialylated Adhesion Molecules on the Surface of Tumor Cells Disrupts Their Interaction with Immune-Effector Cells and Contributes to Pathophysiological Immune Escape. Cancers 2021, 13, 5203
by Mostafa Jarahian, Faroogh Marofi, Marwah Suliman Maashi, Mahnaz Ghaebi, Abdolrahman Khezri and Martin R. Berger
Cancers 2025, 17(14), 2362; https://doi.org/10.3390/cancers17142362 - 16 Jul 2025
Viewed by 183
Abstract
There was an error in the original publication [...] Full article
(This article belongs to the Special Issue Feature Paper from Journal Reviewers)
11 pages, 587 KiB  
Article
Real World Outcomes of Patients with Aggressive Lymphoma and Autoimmune Disease Treated with CART
by Nicole J. Altomare, Megan M. Herr, Nisha M. Nair, Deborah M. Stephens, Jonathon B. Cohen, Narendranath Epperla, Matthew Cortese, Rahul Bhansali, Tamara K. Moyo, Vaishalee Kenkre, Thomas Ollila, Brian Hess, Lindsey Fitzgerald, Geoffrey Shouse, James A. Davis, Christy Jesme, Ari Pelcovits, Jonathan Moreira, Adam Lin, Shuo Ma, Jane N. Winter, Alexey Danilov, Stefan K. Barta, Leo I. Gordon, Jason Romancik, Natalie S. Grover and Reem Karmaliadd Show full author list remove Hide full author list
Cancers 2025, 17(14), 2358; https://doi.org/10.3390/cancers17142358 - 16 Jul 2025
Viewed by 341
Abstract
Autoimmune diseases (AIDs) have been shown to be a risk factor for the development of non-Hodgkin lymphoma (NHL), with more than 15 million Americans diagnosed with AIDs between 2011 and 2022 [...] Full article
(This article belongs to the Special Issue The Development of Immunotherapies to Treat Lymphoma)
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22 pages, 322 KiB  
Article
New Approach for Enhancing Survival in Glioblastoma Patients: A Longitudinal Pilot Study on Integrative Oncology
by Massimo Bonucci, Maria Pia Fuggetta, Lorenzo Anelli, Diana Giannarelli, Carla Fiorentini and Giampietro Ravagnan
Cancers 2025, 17(14), 2321; https://doi.org/10.3390/cancers17142321 - 12 Jul 2025
Viewed by 1643
Abstract
Background: Glioblastoma (GBM IDH-wildtype WHO 2021) is an aggressive central nervous system malignancy with a poor prognosis despite standard therapy. Integrative oncology approaches involving natural compounds have shown potential in preclinical studies to enhance the efficacy of chemoradiotherapy. Methods: This prospective, [...] Read more.
Background: Glioblastoma (GBM IDH-wildtype WHO 2021) is an aggressive central nervous system malignancy with a poor prognosis despite standard therapy. Integrative oncology approaches involving natural compounds have shown potential in preclinical studies to enhance the efficacy of chemoradiotherapy. Methods: This prospective, longitudinal observational pilot study, lacking a randomized control group, followed 72 newly diagnosed glioblastoma patients (diagnosed by histological examination and MGMT promoter molecular study alone, grade 4 glioma patients) treated with the STUPP protocol. This group could voluntarily opt to receive integrative therapy (IT), which included polydatin, curcumin, and Boswellia serrata, in addition to standard care. Survival outcomes were compared between IT-adherent and non-adherent patients. Multivariate Cox regression was employed to adjust for potential confounders, including age, extent of surgical resection, and corticosteroid use. Results: The median overall survival (OS) for the entire cohort was 13.3 months. Patients who adhered to IT (n = 60) had a median OS of 25.4 months, which increased to 34.4 months for those who underwent gross total resection. The non-IT group (n = 12) exhibited a median OS of 10.6 months. Multivariate analysis confirmed that IT adherence and the extent of resection were independent predictors of prolonged survival (p < 0.05). No severe adverse events were reported with IT. Conclusions: Integrative therapy combining polydatin, curcumin, and Boswellia serrata with standard treatment would appear to be associated with prolonged survival in glioblastoma patients, particularly among those who underwent gross total resection. However, the small size of the control group, the absence of randomization, and the inclusion solely of primary glioblastoma limit the generalizability of these findings. These results underscore the need for further investigation through randomized controlled trials. Full article
(This article belongs to the Topic Advances in Glioblastoma: From Biology to Therapeutics)
3 pages, 159 KiB  
Editorial
The Importance of a Definite Diagnosis for Rational Treatment and Prognosis of Head and Neck Tumors
by Alfio Ferlito, Alfons Nadal, Göran Stenman, Nina Zidar, Henrik Hellquist, Piet J. Slootweg, Roderick H. W. Simpson and Antonio Cardesa
Cancers 2025, 17(14), 2311; https://doi.org/10.3390/cancers17142311 - 11 Jul 2025
Viewed by 236
Abstract
Benign and malignant head and neck tumors are common worldwide and cause mortality and morbidity with variations in population prevalence [...] Full article
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