Rosmarinic acid (RA), a naturally occurring polyphenolic compound, has attracted increasing attention because of its potential anticancer activity and capacity to modulate oxidative stress-associated signaling pathways. In the present study, the cytotoxic, apoptotic, and antiproliferative effects of RA, alone or in combination with gemcitabine (Gem), were investigated in OVCAR3 ovarian cancer cells and HaCaT keratinocytes using integrated two-dimensional and three-dimensional (3D) experimental models. Cell viability assays demonstrated dose- and time-dependent growth inhibition following RA and Gem treatment, while combination index (CI) analysis revealed synergistic cytotoxic activity in OVCAR3 cells. Flow cytometric analyses showed that combined treatment markedly increased apoptotic cell populations and altered cell cycle progression through enhanced S-phase and G2/M accumulation. Intracellular reactive oxygen species (ROS) levels were significantly elevated following combination treatment, and N-acetyl-L-cysteine (NAC) pretreatment partially attenuated both ROS accumulation and cytotoxicity, indicating a functional contribution of oxidative stress to the observed antitumor response. RT-qPCR analyses demonstrated increased expression of proapoptotic genes (BAX, CASP3, and CASP9) together with suppression of BCL2, MKI67, and CDK4 expression, while immunocytochemical analyses supported enhanced caspase-3 activation at the protein level. In 3D OVCAR3 tumor spheroids, the RA + Gem combination significantly reduced spheroid viability, disrupted spheroid architecture, and increased dead-cell accumulation compared with single-agent treatments. Collectively, these findings suggest that RA may enhance the anticancer activity of Gem in ovarian cancer cells through mechanisms associated with oxidative stress, apoptosis, and proliferation-related signaling pathways under both monolayer and 3D culture conditions.

WWOX and HIF1A are linked to hypoxia-driven metabolic and immune modulation in cancer. We examined whether the WWOX/HIF1A expression ratio acts as a context-dependent molecular integrator across breast cancer (BRCA) subtypes and ovarian carcinoma (OV). We analyzsed TCGA RNA-seq and clinical data from BRCA (n = 390) and OV (n = 228), using neoplasm cancer status as a proxy for disease-free survival (DFS). Patients were stratified by subtype-specific WWOX/HIF1A ratio cutpoints for exploratory Kaplan--Meier analyses, and the ratio was also modelled as a standardizsed continuous covariate in Cox regression. Transcriptomic, pathway, immune-cell and hormone-related profiles were examined in relation to ratio status, with all multivariable and cutpoint-based findings treated as hypothesis-generating. The WWOX/HIF1A ratio does not act as a uniform or strongly predictive prognostic marker but instead delineates distinct biological states whose association with DFS is modest, context-dependent and statistically fragile in TCGA. Higher ratios are linked to more favourable DFS only in basal-like and HER2-enriched BRCA, together with oxidative phosphorylation, ribosomal and reduced ADAM10-linked Notch and monocyte/macrophage signatures. In luminal A BRCA and OV, lower ratios are linked to relatively favourable DFS and coincide with cytokine/JAK-STAT signalling, cytotoxic immune signatures and coordinated metabolic-endocrine programmes, whereas luminal B shows mixed immune and metabolic patterns. In this TCGA-based analysis, the WWOX/HIF1A ratio functions as a context-dependent molecular index of hypoxia, immune and hormone-related states rather than a strong, generalisable DFS predictor. The observed subtype-specific survival trends (high-ratio favourability in basal/HER2, low-ratio favourability in luminal A,B and OV) are non-significant and exploratory, and all ratio-based survival patterns require confirmation in independent cohorts and functional studies.

Chimeric antigen receptor (CAR)-T therapy has achieved partial therapeutic efficacy in solid tumors, but its overall effectiveness remains limited. IL-21-armored CD276.CAR-T (IL21.CD276.CAR-T) represents a promising strategy to enhance anti-tumor activity against esophageal squamous cell carcinoma (ESCC). However, resistance mechanisms remain unclear. We generated IL21.CD276.CAR-T cells and evaluated their cytotoxicity in vitro and in B-NDG xenograft models. Poliovirus receptor (PVR) expression on ESCC cells was analyzed, and shRNA-mediated PVR knockdown was performed to validate its role in resistance. IL-21R expression on ESCC cells was examined to exclude direct IL-21 signaling. IL-21 enhances the cytotoxicity of CD276.CAR-T cells against ESCC. Although IL21.CD276.CAR-T exhibited potent cytotoxicity in vitro, it failed to achieve complete tumor regression, and resistant cells still emerged. Mechanistically, resistance was not caused by CD276 antigen loss or IL-21R expression, but by upregulation of PVR on cancer cell membrane after IL21.CAR-T exposure. PVR knockdown restored CAR-T sensitivity in vitro, enhanced the anti-tumor capacity of IL21.CD276.CAR-T cells, and partially improved anti-tumor efficacy in vivo without systemic toxicity. PVR may act as a mediator of resistance to IL21.CD276.CAR-T in ESCC. Targeting PVR represents a novel strategy to overcome IL21.CAR-T resistance and improve therapeutic outcomes in ESCC.

Non-small cell lung cancer (NSCLC) is the most prevalent type of lung cancer and remains a major global health burden. Comprehensive characterization of tumor microenvironment (TME) heterogeneity is critical for understanding tumor progression and clinical outcomes in NSCLC. In this study, we identified 34 transcriptionally defined cell states and 6 multicellular ecotypes using the EcoTyper framework, thereby systematically delineating the TME landscape of NSCLC. These cell states and ecotypes were further validated across 11 independent bulk transcriptomic cohorts, one single-cell RNA sequencing cohort, and one spatial transcriptomics cohort, demonstrating strong reproducibility and robustness. Prognostic analyses revealed that several cell states and ecotypes were significantly associated with patient survival outcomes in NSCLC. Transcriptional regulatory analysis further identified SP8, MAZ, and FOS as potential regulators involved in shaping NSCLC ecotypes. Collectively, this study provides a comprehensive atlas of TME-associated cell states and ecotypes in NSCLC, offering new insights into tumor heterogeneity and potential opportunities for personalized prognostic assessment and therapeutic intervention.

Cervical carcinoma is predominantly driven by high-risk human papillomavirus (HPV) infection, in which functional inactivation of p53 occurs mainly through viral oncoproteins rather than mutations in the TP53 gene. This raises questions concerning the prognostic relevance of TP53 gene status and p53 protein levels in this tumor type. This study aimed to systematically evaluate the prognostic significance of TP53 mutation status, p53 protein abundance, and selected downstream p53-regulated proteins in cervical carcinoma, with particular focus on tumors carrying wild-type TP53. Clinical and proteomic data from 162 cervical carcinoma patients were retrieved from The Cancer Genome Atlas (TCGA). Protein levels (p53, BAX, p21/CDKN1A, and TIGAR) were assessed using reverse-phase protein array (RPPA) data. Survival analyses were performed using Kaplan-Meier estimates with log-rank testing after stratification into quartile-based expression groups. The vast majority of tumors (~93%) harbored wild-type TP53, and the TP53 mutation status showed no association with patient survival. In tumors with wild-type TP53, p53 protein levels did not significantly correlate with overall survival, indicating a limited prognostic value. In contrast, elevated levels of the pro-apoptotic protein BAX showed a clear tendency to be associated with poorer overall and progression-free survival, suggesting BAX as a potential prognostic marker in this specific molecular context. The expression of p21/CDKN1A showed no prognostic relevance, while high TIGAR levels displayed a slight trend toward poorer survival, although without reaching statistical significance. In summary, in HPV-driven cervical carcinoma, neither the TP53 mutation status nor the p53 protein abundance reliably predict patient outcome. Instead, selected downstream effectors of p53 signaling-particularly BAX-may provide more informative prognostic insights in tumors retaining wild-type TP53. These findings highlight the importance of assessing functional outputs of p53 signaling rather than the p53 status alone in this disease context.

This retrospective study characterizes the complex associations between serum 1H-NMR metabolomics, clinical nutritional status, and laboratory blood parameters in men with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) in relation to 3-year disease-free survival (DFS). A total of 536 serum samples from 67 patients, collected weekly during radiotherapy or chemoradiotherapy, were analyzed to characterize the metabolic-nutritional landscape. The patients with 3-year DFS exhibited stronger biological links between elevated levels of serum lipids, phosphocholine, branched-chain amino acids (BCAAs), and clinical markers such as BMI, albumin, and prealbumin compared to those with disease recurrence. Furthermore, our findings highlight a novel pattern of disrupted correlations (metabolic decoupling) between body fat distribution, overall obesity, and lipid metabolism, as well as the links between BCAAs and nutritional status, in patients with disease recurrence. This observed breakdown of internal coordination suggests that the survival advantage associated with body fat arises not just from adiposity, but from the body's ability to metabolically coordinate fat and amino acid turnover with overall energy demands-a trait known as metabolic flexibility. In conclusion, we hypothesize that disease recurrence in men with LA-HNSCC is driven by failure of this system, manifested as a breakdown in the coordination between metabolic and nutritional profiles. The preserved metabolic-nutritional axis between fat turnover and nutrient availability is associated with 3-year disease-free survival in this patient group, although more research is required to fully elucidate the underlying mechanisms.

Colorectal cancer (CRC) remains a major cause of cancer-related mortality worldwide, largely due to the emergence of chemoresistance driven by metabolic adaptations. Among these alterations, lipid metabolic reprogramming has emerged as a critical determinant of tumor progression and therapeutic response. In particular, dysregulation of enzymes involved in phosphatidylcholine (PC) synthesis and remodeling, through the Kennedy pathway and the Lands cycle, has been associated with therapeutic resistance. Lysophosphatidylcholine acyltransferase 2 (LPCAT2), a key enzyme involved in PC remodeling, notably promotes lipid droplets (LD) accumulation in CRC cells and contributes to chemoresistance. In this context, natural compounds capable of modulating PC metabolism, such as the polyphenol resveratrol (RSV), may represent a relevant strategy to improve sensitivity to chemotherapies in chemoresistant colon tumor cells. In this study, RSV induced apoptosis and significantly reduced the proliferation of intrinsically resistant HT29 cells and SW620 cells engineered to overexpress LPCAT2. RSV also decreased the expression of key enzymes involved in the Kennedy pathway in chemoresistant CRC cell lines. These changes were accompanied by distinct time-dependent patterns of lipid droplet accumulation in the two cellular models. In addition, drug combination studies showed that RSV enhanced the response to 5-fluorouracil (5-FU), oxaliplatin (OXA) and the FOX regimen (5-FU + OXA, 1:1 ratio) with synergistic interactions for several dose combinations, together with favorable dose-reduction indices. Collectively, these in vitro findings indicate that RSV modulates PC-metabolism-related proteins and enhances chemotherapy sensitivity in resistant CRC models. Overall, our results identify RSV as a promising therapeutic strategy to target metabolic vulnerabilities associated with PC metabolism and overcome chemoresistance in CRC.

APG157DS is a multi-component investigational drug which is currently the subject of multiple cancer trials. It has shown promising efficacy in patients with head and neck cancer. We report its immuno-modulatory effect in a syngeneic mouse model of glioblastoma (GBM). Long-term treatment with APG157DS led to durable tumor remission in 50% of mice, while all vehicle-treated mice reached humane endpoints within 42 days. Mechanistically, the drug induced selective repolarization of tumor-associated macrophages (TAMs) from an immunosuppressive Arg1high/iNOSlow phenotype to a tumoricidal Arg1low/iNOShigh state, accompanied by increased intratumoral recruitment of activated (NKp46+) natural killer cells and CD8+ cytotoxic T-cells. APG157DS also suppressed vascular endothelial growth factor (VEGF) and Hypoxia-inducible factor 1-alpha (HIF-1α) expression in tumors, further impairing tumor growth. Notably, APG157DS did not elicit off-target macrophage activation in peripheral tissues such as the spleen, highlighting its selective immune targeting. These findings provide a mechanistic rationale for further clinical development of APG157DS in GBM and potentially other immune-evasive cancers.

Polyploid giant cancer cells (PGCCs) are increasingly recognized as major drivers of therapy resistance and tumor relapse, yet the conserved molecular programs underlying their persistence remain incompletely defined. To identify genes consistently deregulated across eight independent datasets, we performed an integrative transcriptomic analysis of PGCCs derived from prostate, ovarian, and breast cancers. By focusing on consistently up- or down-regulated genes that were expressed in at least five datasets and showed a concordant direction of expression across more than 70% of datasets and met a significance threshold of adjusted p < 0.05, we defined the core regulatory architecture stabilizing the PGCC state under therapeutic stress. Our analysis reveals that PGCCs exhibit a paradoxical ranscriptomic signature consistent with cytolytic activity alongside reduced immune detection. These cells activated pro-inflammatory cytokine and chemokine signaling while simultaneously engaging immune-evasion mechanisms, including PD-L1-associated and virus-like escape programs. Concurrently, PGCCs displayed transcriptional features characteristic of immune-privileged cellular states, including embryonic development, reproductive programs, senescence-associated survival, apoptosis resistance, and deep dormancy marked by coordinated suppression of major housekeeping processes. Notably, PGCCs also activated neuronal differentiation and neurodegeneration-associated pathways, including axon guidance, neurogenesis, and calcium signaling. This neuron-like, calcium-dependent stress adaptation program may further enhance immune privilege and long-term survival capacity. We propose that PGCCs represent an immune-adaptive polyploid survival state in which inflammatory and ontogenetic pathways are repurposed to support immune evasion and tumor persistence. By identifying actionable vulnerabilities within calcium signaling, neuronal mimicry, and checkpoint-associated pathways, this study provides a framework for therapeutic strategies aimed at dismantling the PGCC reservoir and preventing tumor relapse.

Melanoma is a malignant tumor that originates in pigment-producing cells called melanocytes. This type of cancer remains a major public health challenge due to its high metastatic potential and resistance to treatment. Autophagy is a catabolic process that enables the controlled degradation of damaged cellular organelles and unnecessary or abnormal macromolecules. Its primary function is to maintain intracellular homeostasis and cell survival. There are three main types of autophagy: macroautophagy, microautophagy and chaperone-mediated autophagy (CMA). The role of autophagy in oncogenesis is multifaceted and context-dependent-depending on the type of cancer and its stage of development. Autophagy can either promote tumor progression or act as a tumor-suppressive mechanism. Factors influencing the role of autophagy in cancer include inflammation, crosstalk with apoptosis and resistance to anticancer therapies. Current research is focused on the use of both autophagy inhibitors and autophagy inducers as potential strategies to improve the effectiveness of melanoma treatment.

Bacterioruberin (BR), a C50 carotenoid produced by halophilic archaea, is emerging as a bioactive molecule with potential anticancer relevance, but its activity in solid tumour and multidrug-resistant (MDR) models remains poorly defined. This in vitro study evaluated the cytotoxic, antiproliferative and growth-inhibitory effects of a chemically characterized bacterioruberin-rich carotenoid extract (BRCE) from Haloferax (H.) mediterranei in A549 lung adenocarcinoma, BT-549 triple-negative breast cancer and WM115 melanoma cells, as well as in paired sensitive/multidrug resistant (MDR) lung cancer models. Metabolic activity and proliferation were assessed by thiazolyl blue tetrazolium bromide (MTT) and carboxyfluorescein diacetate succinimidyl ester (CFDA-SE) assays, intracellular reactive oxygen species (ROS) by 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA) staining, and apoptosis-associated morphology by acridine orange/ethidium bromide (AO/EB) staining. Growth inhibition in A549/A549-CDR2 and NCI-H460/NCI-H460/R cells was analysed by sulforhodamine B (SRB) assay, while P-glycoprotein (P-gp) function and expression were examined using Rhodamine 123 (Rh123) accumulation and Western blotting. BRCE reduced metabolic activity and proliferation in a concentration- and time-dependent manner, increased intracellular ROS levels, and induced apoptosis-associated morphological changes in A549 cells. In MDR models, BRCE retained comparable growth-inhibitory activity in sensitive and resistant cells and partially attenuated P-gp-related drug efflux. These findings support further mechanistic investigation of BR in solid tumour and MDR cancer models.

Triple-negative breast cancer (TNBC) lacking androgen receptor (AR) expression defines quadruple-negative breast cancer (QNBC), which is characterized by younger age at diagnosis, high Ki-67 index, and high genomic instability, however a comprehensive description of the genomic characteristics remains poorly defined. A total of 54 TNBC cases were categorized as TNBC with 100% AR expression (TNBC AR-100%) or QNBC, TNBC with 0% AR expression (TNBC AR-0%). Clinical, molecular, and genomic parameters, specifically pathogenic/likely pathogenic (P/LP) variants in homologous recombination repair (HRR) and cancer-related pathways were measured and analyzed. The QNBC cohort exhibited a high homologous recombination deficiency (HRD) score and a greater overall incidence of copy number variants (CNVs). QNBC harbored a higher mutation rate in TP53 and MYC signaling pathway than TNBC AR-100% tumors. P/LP variants corresponding to the HRR, PI3K/AKT, and RTK/RAS pathways were exclusively identified in QNBC. These results suggest that, at both molecular and genomic levels, the two groups are distinct, holding QNBC tumors more aggressive characteristics, genomic instability, and particular impairments in HRR and cancer-related pathways. In terms of actionability, these differences could potentially be leveraged through different combinations of therapies.

Colorectal cancer represents a global health burden, being the third most frequently diagnosed cancer worldwide, accounting for about 1.9 million new cases annually, and the second leading cause of cancer-related deaths. This highlights the need for innovative and effective methods for cancer detection, improving current diagnostic approaches. In this feasibility study, two nanostructured chemoresistive gas sensors based on tin oxide-titanium oxide composites were selected to detect the metabolic patterns associated with human healthy and colorectal cancer tissues, collected from 26 patients. To further validate the biopsy-derived results, the sensors were tested on two colorectal cancer-derived cell lines, namely Caco-2 and RKO. Both sensors were able to discriminate between healthy and tumor samples by comparing the mean sensor responses, using the paired t-test (p-value = 0.00018), and by using an LDA, achieving a cross-validated accuracy of 0.73. Moreover, the ROC analysis performed on the data projected along the discriminant direction led to an AUC of 0.83. Finally, the sensors exhibited distinct response profiles to Caco-2 and RKO exhalations, as expected given their different biological features. As a proof-of-feasibility study, these findings demonstrate that these sensors could capture a characteristic volatile fingerprint distinguishing the samples, although they cannot identify the specific cancer metabolites.

Cancer stem cell (CSC) persistence drives recurrence and therapy resistance in oral squamous cell carcinoma (OSCC), but what keeps cells locked in this stem-like state is poorly understood. In this narrative review, we propose that CSC state is sustained not by any single pathway but by joint dysregulation of three interacting cell-biological systems: membrane potential (Vmem), communication between neighbouring cells through gap junctional intercellular communication (GJIC), and the Hippo-YAP pathway. We argue that these systems act together on one common point-the YAP protein, retained in the nucleus-which switches on a SOX2-centred stemness gene programme and stabilises a self-reinforcing CSC state. Drawing on evidence from cancer genomics, developmental bioelectricity, connexin biology, and OSCC-specific studies, we reconstruct how membrane depolarisation, loss of gap junction coupling, FAT1 mutation, and Hippo pathway inactivation could converge on persistent nuclear YAP, and how betel quid-the principal risk factor across South and Southeast Asia-may engage all three systems at once. Because the model holds that each input reinforces the others, it predicts that targeting several together should displace CSC state more durably than targeting any one alone. We set out the testable predictions this framework generates.

The leading-edge (LE) of hepatocellular carcinoma (HCC) is a critical region driving malignant progression and is closely associated with high patient mortality and marked intratumoral heterogeneity. Multi-omics integration identified elevated expression of SPARC and IGFBP7 in the LE region, which was associated with stromal remodeling-related transcriptional programs and an immune-depleted microenvironment. Cell-cell communication and pathway analyses further suggested potential links between LE-associated stromal states and pro-invasive signaling programs. Furthermore, we developed SpaPred, which demonstrated favorable performance in inferring the spatiotemporal heterogeneity of HCC at the spatial resolution. This model overcomes the limitations of existing algorithms in analyzing the composition of tissue spatial structures. Finally, integration of in silico trajectory-perturbation and pharmacogenomic drug-response analyses prioritized Oxaliplatin, Belinostat, and Temsirolimus as candidate compounds associated with LE-related transcriptional programs. These drug predictions are computational and require experimental validation. Collectively, SpaPred provides a hypothesis-generating framework for investigating spatial heterogeneity and candidate therapeutic vulnerabilities in HCC.

Field cancerization describes molecular alterations occurring in histologically normal tissues surrounding tumors that may contribute to cancer initiation and progression. In prostate cancer (PCa), the molecular characteristics of peritumoral tissue (PTT) remain incompletely understood. Because microRNAs (miRNAs) play key roles in gene regulation, tumor progression, and microenvironmental remodeling, we investigated miRNA expression patterns and regulatory networks across benign tissue (BT), PTT, and tumor tissue (TT). Small RNA sequencing was performed on matched formalin-fixed paraffin-embedded samples from 40 patients with PCa. Differential expression analysis was conducted using DESeq2, adjusting for age and Gleason grade, while functional enrichment analysis and weighted gene co-expression network analysis (WGCNA) were used to identify dysregulated pathways and conserved miRNA modules. PTT exhibited a molecular profile intermediate between BT and TT, consistent with a field cancerization effect. Compared with BT, 102 miRNAs were differentially expressed in TT and 57 in PTT, with 39 miRNAs (68% of the PTT-associated miRNAs) overlapping the tumor signature. Shared dysregulated pathways included PI3K-Akt, p53, and HIF-1 signaling; whereas, PTT showed additional enrichment in pathways related to epigenetic regulation (Polycomb Repressive Complex) and cellular stress responses (mitophagy, protein processing in ER) exclusively through up-regulated miRNAs; no pathways were uniquely enriched from down-regulated miRNAs in PTT. WGCNA identified conserved miRNA modules enriched for members of the let-7, miR-200, miR-103/107, and miR-106a~363 families, which have established roles in epithelial-mesenchymal transition, tumor progression, and microenvironmental remodeling. Collectively, these findings demonstrate that histologically benign peritumoral tissues harbor tumor-associated miRNA programs and regulatory networks that closely resemble those observed in prostate tumors, providing molecular evidence of field cancerization in PCa and identifying potential miRNA-mediated mechanisms relevant to disease progression and biomarker development.

Prostate adenocarcinoma is characterized by substantial inter-patient heterogeneity, limiting the clinical reliability of conventional diagnostic tools, including prostate-specific antigen testing. This limitation underscores the need for robust molecular biomarkers that may complement conventional diagnostic tools, highlighting the urgent need for biomarkers capable of enhancing diagnostic accuracy and enabling more precise risk stratification. In the present study, transcriptomic data from The Cancer Genome Atlas (TCGA) were analyzed using an integrative bioinformatics and machine learning pipeline., The proposed workflow was designed as a stepwise and reproducible biomarker prioritization framework in which differential expression analysis, functional enrichment, protein-protein interaction (PPI) based network interpretation, graph-convolutional feature selection, and hybrid ensemble machine learning were sequentially integrated. Differential gene expression analysis was combined with pathway enrichment (Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Reactome), protein-protein interaction network construction, and graph-convolutional feature selection. Multiple machine learning algorithms, including Random Forest, Gradient Boosting Machine, Support Vector Classifier, Artificial Neural Network, and AdaBoost, were systematically evaluated. A hybrid ensemble model integrating Gradient Boosting Machine and Random Forest (GBM+RF) was subsequently developed. Model performance was assessed using accuracy, sensitivity, specificity, and area under the Receiver Operating Characteristic (ROC) and externally validated using the independent GSE14206 dataset. The analysis revealed a coordinated molecular pattern characterized by dysregulated cell cycle activity and enhanced interferon-mediated immune signaling. Protein-protein interaction analysis identified STAT1 and PLK1 as highly connected network hub genes within immune-related and cell-cycle-associated modules. Among the evaluated models, the hybrid GBM+RF framework achieved the highest predictive performance on the TCGA dataset, with AUC: 0.9526; Accuracy: 97.49%. External validation using the GSE14206 dataset confirmed the robustness of this model (AUC: 0.9156; Accuracy: 91.53%). These findings support a broader multi-gene candidate signature in prostate adenocarcinoma, in which machine learning prioritized genes such as XAF1, APP, RPA3, IFIH1, UBE2D2, RSAD2, KIF2C, and PLK1, while STAT1 and PLK1 provided complementary network-level biological relevance. The proposed framework provides a robust and transferable strategy for biomarker discovery and precision oncology.

High-dose selenium (Se) as selenomethionine (SLM) and sodium selenite (SS) can improve the efficacy of cancer therapies while reducing toxicity. Se-methylselenocysteine (MSC) is effective in preclinical models but has not been evaluated in cancer trials. This phase Ib randomised, double-blinded trial explored the safety, pharmacokinetics (PK) and selected pharmacodynamic (PD) mechanisms of MSC, SLM and SS to guide future trials. Nine participants with metastatic cancer took Se 1600 μg/day for 4 weeks, then 6400 μg/day for 4 weeks, as MSC, SLM, or SS, with safety, PK, and PD assessments at baseline then every 4 weeks for 12 weeks. No dose-limiting toxicities occurred, and all adverse events were grades 1-2, mainly gastrointestinal. Total plasma Se increased after 8 weeks to mean 27.2 μM with SLM, 4.14 μM with MSC and 3.90 μM with SS. No significant changes in DNA damage or intracellular glutathione were observed in peripheral blood mononuclear cells. Mean plasma selenoprotein P (SEPP) increased from 3.74 mg/L at baseline to 4.66 mg/L and 5.13 mg/L after 4 and 8 weeks (p = 0.136 and 0.104, respectively). More detailed evaluations of safety, PK and PD mechanisms are needed to determine a recommended Se compound and dose for larger trials in combination with cancer therapies.

Multiple myeloma (MM) remains an incurable hematological malignancy in which tumor-intrinsic immune evasion limits the efficacy of immunotherapy. Here, we identify the RNA editing enzyme ADAR1 as a key regulator of innate immune suppression in MM. Integrative analyses of bulk and single-cell transcriptomic datasets, together with clinical validation, demonstrated that ADAR1 is upregulated in malignant plasma cells and is associated with adverse clinical outcomes and reduced CD8+ T-cell infiltration. Mechanistically, ADAR1 knockdown increased the association of endogenous dsRNA with melanoma differentiation-associated protein 5 (MDA5), restoring type I interferon (IFN) signaling, enhancing IFNα production and STAT1 activation, and promoting CD8+ T-cell proliferation and cytotoxic function. These effects were largely abolished by MDA5 depletion, establishing a functional ADAR1-MDA5 signaling axis in MM. In vivo, treatment with 8-azaadenosine significantly potentiated the antitumor efficacy of PD-1 blockade, resulting in reduced tumor growth, increased tumor cell apoptosis, elevated IFNα expression, and enhanced CD8+ T-cell infiltration. Together, our findings demonstrate that ADAR1-mediated RNA editing enables immune evasion by restricting MDA5-dependent sensing of endogenous dsRNA and highlight the ADAR1-MDA5-type I interferon axis as a promising therapeutic target for improving immunotherapy in multiple myeloma.

Butyrophilin-like 9 (BTNL9), a member of the immunoglobulin superfamily containing a bZIP-like domain, has a poorly defined role in cancer. Here, we identify BTNL9 as a non-canonical transcriptional regulator and investigate its function in non-small cell lung cancer (NSCLC). Coiled-coil prediction, native PAGE, and co-immunoprecipitation demonstrated BTNL9 homodimerization via its bZIP-like region, while subcellular fractionation and immunofluorescence confirmed its presence in both the nucleus and cytoplasm. Chromatin immunoprecipitation sequencing (ChIP-seq) analysis identified 9709 BTNL9-associated genomic regions, including sites proximal to transcription start sites, with enrichment of a cytosine-rich motif. Whether chromatin association reflects direct DNA binding or indirect co-regulatory interaction remains to be experimentally confirmed. Integrated transcriptomic and protein analyses revealed that BTNL9 overexpression represses genes involved in cell cycle progression and DNA replication while activating a subset of p53-associated pathways. Consistently, functional assays showed that increased BTNL9 expression induces cell cycle arrest, suppresses proliferation and clonogenicity, and inhibits tumor growth in xenograft models. In addition, cytotoxicity assays demonstrated enhanced sensitivity to bortezomib, with context-dependent effects on etoposide response. Analysis of public clinical datasets further showed that low BTNL9 expression is associated with advanced tumor stage, reduced remission rates, and poorer survival outcomes in NSCLC. These findings identify BTNL9 as a non-canonical tumor-suppressive transcriptional regulator with potential biomarker relevance in NSCLC.