Search Results (4,614)

Cervical cancer (CC) remains a major global health challenge due to chemotherapy resistance and recurrence. Mesenchymal stem cell-derived exosomes (MSC-exosomes) have dual roles, as they can act as therapeutic agents and contribute to chemoresistance. However, their role in response to chemotherapy in CC remains unclear. Therefore, our study investigated the effects of MSC-exosome pretreatment on chemotherapy sensitivity using three-dimensional spheroid models generated from HeLa and SiHa CC cell lines. Proteomic profiling of MSC-exosomes identified key proteins, including ANXA1, ANXA2, EEF2, LGALS1, and PKM2, associated with tumor regeneration and chemotherapy response. MSC-exosomes exhibited context-dependent effects in both chemoresistance and chemosensitization by modulating drug efflux, metabolic reprogramming, stress adaptation, apoptosis, DNA damage response, and integrin-mediated signaling. MSC-exosome pretreatment altered spheroid responses to paclitaxel in combination with cisplatin or carboplatin. MSC-exosomes significantly enhanced chemotherapy-induced cytotoxicity in HeLa spheroids, as evidenced by reduced cell viability, increased caspase activity, and upregulation of the pro-apoptotic marker Bax. In contrast, SiHa spheroids represented selective responses: MSC-exosome pretreatment did not enhance sensitivity to paclitaxel–cisplatin but improved responsiveness to paclitaxel–carboplatin, particularly within the spheroid core. Overall, MSC-exosome pretreatment exerts cell type and drug-specific effects in CC spheroids, supporting their potential to modulate chemotherapy response. Full article

Background: Cardiotoxicity is a major limitation of chemotherapy and radiotherapy for thoracic and systemic cancers, contributing significantly to morbidity and mortality among survivors. Early prediction and prevention are critical to balance oncologic efficacy with cardiovascular safety. Artificial intelligence (AI) offers powerful tools to improve risk stratification, enable earlier detection of subclinical injury, and guide treatment planning in cardio-oncology. Methods: We performed a comprehensive review of the literature on AI applications for cancer therapy-related cardiotoxicity. Evidence was identified from PubMed, Scopus, and Web of Science, focusing on electrocardiography, biomarkers, proteomics, extracellular vesicles, genomics, advanced imaging (echocardiography, cardiac magnetic resonance, computed tomography, nuclear imaging), and radiotherapy dose modeling (dosiomics). Translational insights from animal models and in vitro systems were also included. Methodological quality was appraised with reference to TRIPOD-AI, PROBAST-AI, and CLAIM standards. Results: AI applications span multiple domains. Machine learning models integrating biomarkers, exosomes, and extracellular vesicles show promise for noninvasive early detection. Deep learning enables automated analysis of echocardiographic strain and cardiac MRI mapping, while radiomics and dosiomics approaches combine imaging with cardiac substructure dose maps to predict and prevent late radiation-induced injury. Preclinical studies demonstrate AI-driven advances in small-animal imaging, histopathology quantification, and multi-omics data integration, supporting the discovery of translational biomarkers. Despite encouraging performance, most models remain limited by small cohorts, methodological heterogeneity, and scarce external validation. Conclusions: AI has the potential to transform cardio-oncology by shifting from reactive detection to proactive prevention of cardiotoxicity. Future research should prioritize multimodal integration, harmonized multicenter datasets, prospective validation, and guideline-based clinical trials. As emerging data are incorporated, the field is expanding rapidly—dynamic, complex, and evolving. Full article

Pancreatic neuroendocrine neoplasms (pNENs) are rare tumors with significant biological diversity. Despite significant improvements in diagnostics and a growing range of available therapies, long-term disease control remains difficult in advanced cases. The tumor microenvironment, which in pNENs adopts a predominantly immunosuppressive profile and promotes tumor development, is attracting increasing attention. A complex network of interactions dominates the tumor tissue, including M2 macrophages, regulatory T cells, and numerous pathways that inhibit effector lymphocyte activity. M2 macrophages, through the secretion of anti-inflammatory cytokines and exosome-mediated signaling, support angiogenesis while simultaneously attenuating the cytotoxic response. Simultaneously, receptors and ligands associated with immune checkpoints are overexpressed. In addition to classic molecules such as PD-1/PD-L1 and CTLA-4, the role of B7x and CD276 is increasingly being emphasized, as their presence correlates with rapid disease progression and poor prognosis. To date, attempts to use checkpoint inhibitors as monotherapy have yielded modest clinical benefits. However, approaches based on combination strategies—both in the form of dual immune blockade and in combination with chemotherapy or angiogenesis-targeted therapy—have shown significantly greater activity. Therapies using tyrosine kinase inhibitors, such as sunitinib and newer drugs (lenvatinib, surufatinib, cabozantinib), may partially normalize the tumor’s disrupted vascular architecture and thus increase its susceptibility to immunological interventions. In the coming years, it will be crucial not only to overcome the immunosuppressive nature of the TME but also to identify predictive biomarkers that will allow for more precise patient selection. This approach may open the way to more effective, personalized therapies for pNENs. Full article

Small cell lung cancer (SCLC) is a highly aggressive neuroendocrine disease marked by rapid growth, early metastatic spread, and poor outcomes. The addition of immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 axis to first-line chemotherapy has recently reshaped the treatment landscape for extensive-stage SCLC (ES-SCLC); however, the resulting survival gains remain modest compared with non-small lung cancer (NSCLC). This review explores the molecular features of the SCLC immune landscape that contribute to its predominantly “cold” tumor phenotype, including low MHC class I expression, T-cell exhaustion, and a profoundly immunosuppressive tumor microenvironment (TME). We summarize key clinical findings from landmark trials and examine mechanisms of both primary and acquired resistance against ICIs in SCLC. In addition, we have reviewed the growing role of precision medicine in SCLC, including molecular subtyping (SCLC-A, -N, -P, and -I) and the development of next-generation immunotherapies such as bispecific T-cell engagers (BiTEs), B7-H3, targeted therapy, and antibody–drug conjugates. By combining existing clinical evidence with new molecular insights, this review article presents strategies to overcome the existing therapeutic plateau and enhance personalized immunotherapy approaches in SCLC. Full article

Algal carotenoids play a promising role in handling chronic diseases due to their diverse bioactive properties, including anti-inflammatory, antioxidant, and anticancer effects. This study assesses the activity of the antioxidant xanthophyll diatoxanthin (Dt), derived from marine diatoms, against triple-negative breast cancer (TNBC) cells using in vitro models, gene expression evaluation, and explores its role in potentiating the cytotoxic effect of chemotherapy. Dt exhibited selective activity against MDA-MB-231 and BT-549 TNBC cells at concentrations ≥12.5 ng/mL, with maximal effects observed at 25 ng/mL while sparing human umbilical vein endothelial cells (HUVECs) at these doses. When combined with doxorubicin (0.1–0.5 μM), Dt enhanced the anti-tumor efficacy in both TNBC cell lines, further reducing cell viability compared with doxorubicin alone (p < 0.05–0.001). Dt also exerted its activity in inhibiting migration and chemotaxis by approximately 30–50% compared with the controls (p < 0.01) and suppressing 3D-tumor spheroid growth at day 12 (up to >50% reduction, p < 0.001). Notably, secretome analysis revealed Dt-induced changes in inflammatory, oxidative and angiogenic mediators, highlighting its ability to modulate the TNBC microenvironment. Dt also downregulated key pro-survival, pro-angiogenic and pro-tumorigenic genes in both TNBC cell lines, supporting its role in disrupting oncogenic pathways. Angiogenesis-related genes were significantly reduced. Dt also decreased the expression of angiogenic mediators in HUVECs, supporting Dt’s role in inhibiting tumor vascularization. Results on gene expression regulation were also confirmed by RNA-Seq analysis. These findings pose Dt as a promising chemopreventing candidate in the challenging fight against TNBC, a well-known type of cancer that is aggressive and resistant to conventional therapies, targeting critical pathways for tumor survival, such as inflammation, angiogenesis, tumor cell growth, and cell migration. Given its selective activity against TNBC cells, ability to enhance chemotherapy efficacy, and modulation of the tumor microenvironment, Dt holds promise as a complementary drug for cancer prevention and interception. Future studies should focus on validating these effects in vivo and exploring Dt’s potential in combinatorial treatment strategies for cancer. Full article

Malignant gliomas, including glioblastoma multiforme (GBM) and grade 4 astrocytoma, are the most common types of brain tumors in adults. Standard treatment for gliomas includes adjuvant chemotherapy, typically based on temozolomide, combined with radiotherapy. However, its effectiveness is severely hindered by the limited ability of drugs to cross the blood–brain barrier and by the hyperactivation of the canonical Wnt signaling pathway, which drives tumor cell survival. Therefore, innovative drug combinations and novel delivery strategies are crucial for overcoming these barriers. Polymeric micelles represent a promising approach for enhancing drug delivery to brain tumors. This study aimed to obtain micelles containing cannabidiol (CBD), celecoxib (CELE), and temozolomide (TMZ), as well as their combinations, and to verify their anti-glioma properties. The study involved optimizing the micelle composition, incorporating active ingredients, and assessing the temporal stability of the resulting nanocarriers under varying temperature conditions. The GBM cell line U-138 MG and astrocytoma cell line U-87 MG were used to evaluate the biologic effects of the tested micelles. Cytotoxicity was assessed using the MTT assay, and flow cytometry was used to analyze the effect of the micelles on apoptosis. Western blot analysis was employed to assess the impact of the tested nanoformulations on the Wnt/β-catenin signaling pathway. The optimized micelles demonstrated strong cytotoxic and proapoptotic effects, accompanied by attenuation of the Wnt/β-catenin pathway. These preliminary findings support the therapeutic potential of polymeric micelles for treating malignant gliomas; however, further in vitro and in vivo studies are required to confirm their clinical applicability. Full article

Immunotherapy has significantly reshaped the management of malignant pleural mesothelioma (MPM), offering new therapeutic opportunities after decades in which platinum–pemetrexed chemotherapy represented the only systemic option. However, clinical benefit remains markedly heterogeneous, with outcomes strongly influenced by histologic subtype, patient characteristics, and real-world treatment conditions. Evidence from monotherapy trials has been inconsistent, whereas combination approaches—particularly nivolumab plus ipilimumab—have demonstrated improved survival compared with chemotherapy, mainly in non-epithelioid tumors. Nevertheless, real-world data consistently show lower efficacy and higher toxicity than registrational studies, especially among elderly and unselected populations. Recent translational work has highlighted the relevance of the tumor microenvironment and recurrent genomic alterations such as BAP1, NF2, and CDKN2A in shaping immune activity and potentially modulating response to immune checkpoint inhibitors. Transcriptomic signatures and circulating biomarkers—including soluble mesothelin-related peptide—have shown prognostic associations but no validated predictive value. Overall, current evidence suggests that sensitivity to immunotherapy in MPM arises from a complex interplay of genomic, immunologic, and clinical factors, and that no biomarker is yet suitable for guiding treatment decisions. Prospective studies integrating molecular and immune profiling will be essential to refine patient selection and advance toward a more rationally personalized use of immunotherapy Full article

Background: Colorectal cancer (CRC) remains a major clinical challenge, in part due to the limited efficacy of 5-fluorouracil (5-FU)-based chemotherapy, which is often compromised by the emergence of acquired resistance. Aronia berry extract (ABE), a phenolic-rich natural compound, has gained increasing attention for its anticancer and chemosensitizing properties. This study aimed to investigate whether ABE can overcome 5-FU resistance (5-FU-R) in CRC and to elucidate the molecular mechanisms underlying its therapeutic effects. Methods: We conducted a series of in vitro experiments using 5-FU-R CRC cell lines to evaluate the synergistic effects of combined ABE and 5-FU treatment. Genome-wide transcriptomic profiling was performed to identify key regulatory pathways associated with chemoresistance and to determine potential ABE-responsive targets. Findings were further validated using patient-derived 3D organoids (PDOs). Results: Co-treatment with ABE and 5-FU significantly reduced the effective concentration of 5-FU required to inhibit 5-FU-R CRC cells, yielding a Bliss synergy score greater than 10. The combination markedly suppressed cell viability, clonogenic potential, migration, and invasion. ABE also reduced cancer stemness, as evidenced by reduced CD44, Nanog, and Oct4 expression. Functional inhibition of Toll-like receptor 3 (TLR3) impaired spheroid growth, and PDO experiments corroborated these findings, demonstrating reduced organoid growth, diminished survival, and decreased NF-κB expression following ABE treatment. Conclusions: Our findings reveal that ABE effectively overcomes 5-FU resistance in CRC by targeting the TLR3/NF-κB signaling axis. This study highlights ABE as a safe, accessible, and promising adjunctive strategy to enhance therapeutic responses in 5-FU-resistant CRC. Full article

Combination chemotherapy regimens are commonly employed to treat advanced gastric adenocarcinoma (GAC), yet median survival remains less than one year. Nab-paclitaxel has demonstrated significant antitumor activity in preclinical GAC models. Overexpression of growth factors and their receptors is prevalent in GAC and contributes to its pathophysiology, with aberrant activation of the HGF/c-Met pathway reported in up to 50% of patients. We hypothesized that merestinib, a small-molecule inhibitor of c-Met, Axl, and DDR1/2, would enhance the therapeutic response to nab-paclitaxel in GAC. In high c-Met–expressing MKN-45 peritoneal dissemination xenografts in female NOD/SCID mouse models, animal survival was 17 days in controls, 37 days with nab-paclitaxel (118% increase), 24 days with merestinib (41% increase), and 43 days with the combination (153% increase), demonstrating significantly enhanced survival compared with either monotherapy. In MKN-45 subcutaneous xenografts, tumor volumes in the control, nab-paclitaxel, merestinib, and combination groups were 503 mm³, 115 mm³, 91 mm³, and −9.7 mm³ (indicating tumor regression), respectively. In low c-Met-expressing SNU-1 xenografts, tumor volumes were 219 mm³, 105 mm³, 131 mm³, and 57 mm³, respectively. IHC analysis of tumor cell proliferation and microvessel density in MKN-45 tumors supported these findings. In vitro, nab-paclitaxel and merestinib each reduced cell proliferation in GAC-associated cells, with enhanced inhibitory effects when used in combination. In MKN-45 cells, merestinib increased the expression of pro-apoptotic proteins and decreased phosphorylation of c-Met, EGFR, IGF-1R, ERK, and AKT. These results indicate that combining merestinib with nab-paclitaxel may represent a promising therapeutic strategy to improve outcomes for patients with GAC. Full article

Background/Objectives: Ovarian cancer has the highest mortality among gynecological malignancies, with platinum resistance significantly contributing to poor prognosis. We aimed to develop a multimodal model (MMHC-OCPR) to predict platinum response and recurrence risk, enabling earlier personalized treatment and improved outcomes. Methods: This multicenter retrospective study included a combined cohort of 431 patients, comprising 1182 whole slide images (WSIs) curated from two independent datasets. The primary cohort consisted of 376 patients from the National Cancer Center (China), which was further partitioned into training, validation and internal test sets to ensure model development and evaluation. An additional external test cohort was incorporated using publicly available data from TCGA, enhancing the generalizability of our findings. We implemented a weakly supervised multiple instance learning framework to integrate histopathological imaging with clinicopathological variables, further strengthened by the incorporation of the transformer-based pretrained encoder UNI2-h, which enhanced the model’s predictive performance. Results: All patients in the primary cohort had pathology slides collected from primary ovarian tumors and metastatic tumor, along with clinical factors related to prognosis and treatment response. The baseline platinum response classifier using primary WSIs achieved an AUC of 0.896 in the internal test group and 0.876 in the external test group. Integration of metastatic WSIs and clinical data inputs yielded a superior AUC of 0.914 in the internal test set. The recurrence risk model demonstrated a C-index of 0.801, rising to 0.838 after multimodal enhancement. The model stratified patients into low-, intermediate- and high-risk groups with 2-year progression-free survival rates of 77.3%, 48.0% and 2.0%, respectively. Conclusions: Our model enables the early detection of platinum resistance, guiding timely treatment intensification. The recurrence risk stratification supports personalized management by identifying patients with favorable outcomes following surgery and chemotherapy, potentially sparing them from maintenance therapy to reduce associated toxicity, cost, and enhance quality of life. Full article

Breast cancer remains a major global health challenge despite advances in chemotherapy, endocrine therapy, targeted therapy, and radiotherapy, which are frequently constrained by therapeutic resistance, cumulative toxicity, and high costs. Accumulating preclinical and translational evidence demonstrates that plant-derived natural compounds can synergistically enhance the efficacy of conventional treatments, improve tumor response, and potentially reduce adverse effects. This review critically synthesizes in vitro, in vivo, and emerging clinical studies from 2015 to 2025, focusing on key phytochemicals, including curcumin, epigallocatechin-3-gallate, resveratrol, kaempferol, genistein, and other bioactive molecules as stand alone agents and as mechanistically validated adjuvants to chemotherapy, hormonal therapy, and radiotherapy. These compounds exert complementary actions, including the inhibition of PI3K/Akt/mTOR and NF-κB signaling, induction of apoptosis and cell-cycle arrest, suppression of epithelial–mesenchymal transition, and modulation of drug resistance pathways. Preclinical studies consistently show that combination strategies enhance tumor inhibition and may permit cytotoxic dose reduction, mitigating systemic and cardiotoxic effects. Nanocarrier-based delivery systems further optimize solubility, bioavailability, and tumor targeting. Despite robust preclinical evidence, clinical translation is limited by variability in raw materials, lack of standardization, regulatory barriers, and scarce large-scale trials. This review emphasizes both the therapeutic promise and translational challenges of integrating natural compounds as synergistic adjuvants in evidence-based breast cancer therapy. Full article

SATB2 (special AT-rich binding protein 2) functions as a chromatin-associated epigenetic regulator that modulates gene expression, in part by serving as a transcriptional cofactor. This study assessed whether SATB2 overexpression is sufficient to promote in vitro transformation of human mesothelial cells and whether SATB2 suppression in mesothelioma cancer stem cell (CSC)–enriched populations is associated with altered chemoresistance. SATB2 expression was high in human malignant pleural mesothelioma (MPM) cell lines but absent in Met5A mesothelial cells. Ectopic SATB2 expression in Met5A cells was associated with acquisition of malignant and stem cell–like phenotypes, including increased expression of stem cell markers and pluripotency-associated factors, as well as anchorage-independent growth in soft agar and spheroid formation in suspension culture. In contrast, Met5A cells transduced with an empty vector did not form colonies or mesospheres. SATB2 overexpression in Met5A cells was also associated with increased motility, migration, and invasion, accompanied by induction of epithelial–mesenchymal transition (EMT)–related transcription factors relative to empty vector controls. Conversely, shRNA-mediated SATB2 knockdown in an MPM cell line attenuated proliferation, EMT-associated features, and CSC-like characteristics. Chromatin immunoprecipitation assays identified SATB2 occupancy at promoter regions of Bcl2, XIAP, KLF4, c-Myc, NANOG, and SOX2, consistent with a role in transcriptional regulation of genes linked to transformation, pluripotency, cell survival, proliferation, and EMT. In CSC-enriched cells, SATB2 inhibition was associated with increased sensitivity to cisplatin and pemetrexed, concomitant with reduced OCT4 and SOX2 expression. Collectively, these findings support SATB2 as a candidate therapeutic target in MPM and suggest that SATB2 suppression may enhance chemotherapy response when combined with standard agents. Full article

Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer lacking estrogen, progesterone, and HER2 receptors. This characteristic limits the effectiveness of hormonal and targeted therapies, and despite advances in chemotherapy (ChT), radiotherapy (RT), surgery, targeted therapy (TT) and immunotherapy (IT), clinical outcomes remain poor, highlighting an urgent need for new therapeutic strategies. The development of advanced nanotechnology-based strategies has opened new avenues for the diagnosis and therapy of TNBC. This review focuses on photothermal therapy (PTT) combined with nanotechnology-based strategies. PTT constitutes an emerging modality for oncological treatment that leverages light irradiation, mostly in the near-infrared (NIR) spectral region, to induce the localized thermal ablation of malignant tissues. When combined with gold nanoparticles (AuNPs), PTT is significantly potentiated. AuNPs have distinctive optical and physicochemical characteristics, rendering them highly effective as multifunctional nanoplatforms. Upon irradiation, AuNPs act as efficient photothermal agents, inducing localized hyperthermia. This thermal effect disrupts cellular homeostasis and initiates a cascade of cell death pathways, including apoptosis and necrosis, culminating in tumor regression. This review describes the latest therapeutic advances of PTT and AuNPs. As this innovative approach progresses toward clinical application, future studies and trials will be crucial in determining its potential for TNBC management and improving patient outcomes. Full article

Polymer-based drug delivery systems offer robust opportunities to improve chemotherapy performance while mitigating systemic toxicity, a critical challenge in leukemia treatment. In this study, poly(ε-caprolactone) (PCL) microparticles were developed as carriers for the co-delivery of cytarabine (ARA-C), a frontline antileukemic agent, and a pecan-derived polyphenolic extract (PRE) as a complementary bioactive component. Microparticles were prepared by a double emulsion solvent evaporation method and formulated with varying drug and extract loadings. The systems were characterized in terms of morphology, particle size, colloidal properties, encapsulation efficiency, and chemical composition using optical microscopy, scanning electron microscopy, dynamic light scattering, zeta potential analysis, UV–Vis spectroscopy, Folin–Ciocalteu assay, and FTIR spectroscopy. In vitro release studies revealed sustained and formulation-dependent release profiles for both ARA-C and PRE, which were successfully fitted to kinetic models, indicating diffusion- and matrix-controlled release mechanisms. Additionally, preliminary cell viability assays using fibroblasts supported the cytocompatibility of the formulations. The results support the use of PCL-based microparticles as reproducible polymeric systems for the co-encapsulation and controlled release of cytarabine and polyphenol-rich extracts, contributing to the development of combination delivery approaches relevant to leukemia treatment. Full article

Background and aims: Aberrations in telomere length can have important implications in cancer. Using a cohort of 1007 patients, we investigated whether leukocyte telomere length (LTL) in patients with colorectal cancer (CRC) is associated with survival. We also investigated whether some telomere maintenance genes are associated with survival in these patients. Methods: The Biobank for Gastrointestinal Health Research (BGHR), an ongoing project involving collection of biospecimens at the Mayo Clinic, was utilized to obtain data from patients diagnosed with stage 2 or 3 CRC. Blood samples were collected prior to chemotherapy/radiation and DNA was extracted for measuring median LTL. The main outcome measures were overall survival (OS) and disease-free survival (DFS) by disease stage. Results: A significant inverse relationship was observed with patient age and LTL (spearman correlation coefficient (r) = −0.48, 95%; p = 1.13 × 10⁻⁵⁸). Females had significantly longer LTL than males (p = 3.97 × 10⁻⁵). The rs1317082 SNP in the TERC gene was significantly associated with both OS and DFS in combined stage II and stage III patients (p = 0.017 and p = 0.023, respectively). A statistically significant association of the OBFC1 SNP (rs9419958) was observed for OS for the combined stage II and stage III patients (p = 0.016). Importantly, LTL was significantly associated with both OS and DFS (p = 0.008 and 0.044 respectively) in combined stage II and stage III patients. Conclusions: Our results show that LTL is predictive of OS and DFS for stage II and III CRC patients, particularly over a longer follow-up, extending beyond five years after a diagnosis of CRC, and certain SNPs in genes involved in telomere maintenance are significantly associated with patient outcomes, independent of telomere length. Full article