Primary pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare subtype of non-small cell lung cancer characterized by pronounced regional clustering and high PD-L1 expression. Although early studies suggest that first-line immunotherapy combined with chemotherapy has application potential, we still lack large-sample systematic reviews and cross-high-incidence-area real-world validation.

Benzosuberone is a promising scaffold with a remarkably varied pharmacological profile that has been attracting significant interest in the potential development of anticancer agents. This review focuses on the historical interest, diversity of chemical structures, and different medicinal applications of benzosuberone derivatives, particularly as agents with potential anticancer activity. We investigated the relationship between structure modification and biological activity by focusing on the molecular hybrids of the present hit with various functionalities or heterocycles, which led to improved cytotoxicity against several cancer cell lines, and miscellaneous biological activities such as antimicrobial, antiviral, neurological, antiparasitic, anti-diabetic, and antitubercular activities. Detailed in vitro analyses showed promising cytotoxicity against breast, lung, and colon cancers, presenting IC50 values in the low micromolar and submicromolar ranges and low toxicity profiles concerning normal cells. Novel approaches, including the hybrid molecule, combinatory therapy, and nano-formulation, are suggested to go beyond the current obstacles and expand the applications of benzosuberone-based derivatives toward clinical applications. This combined study demonstrates that the benzosuberone scaffold is a privileged structure in the search for miscellaneous biological drugs with high therapeutic potential.

Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication associated with antiresorptive and antiangiogenic therapies, particularly following tooth extraction. Platelet-rich fibrin (PRF) has been proposed as a biologically active adjunct capable of enhancing tissue repair and potentially reducing the risk of MRONJ. This systematic review and meta-analysis evaluated the effectiveness of PRF in preventing MRONJ and improving postoperative healing in patients undergoing tooth extraction while receiving these medications.

The sirtuin family proteins SIRT5 and SIRT7, as NAD⁺-dependent lysine desuccinylases, exert critical yet context-dependent roles in cancer progression. Mitochondrial SIRT5 functions as a metabolic rheostat, desuccinylating key enzymes in the TCA cycle, glutaminolysis, and fatty acid oxidation to maintain redox balance and bioenergetic output. Conversely, nuclear SIRT7 acts as an epigenetic modulator, regulating chromatin architecture and DNA damage repair via histone and non-histone desuccinylation. These compartmentalized activities converge to coordinate a metabolic-epigenetic axis that drives tumor adaptation to metabolic stress, evasion of immune surveillance, and therapeutic resistance. Given this functional duality, biomarker-guided therapeutic strategies are imperative. This review synthesizes the emerging roles of SIRT5/7-mediated desuccinylation in cancer metabolism, immunity, and drug resistance, highlighting their potential as targets for synergistic metabolic-immunotherapy interventions.

Therapeutic resistance is a major barrier to durable cancer control in contemporary oncology practice. Despite extensive studies on individual cell death pathways and mitochondrial stress responses, a comprehensive framework describing how mitochondrial organization contributes to the coordination of multiple regulated cell death programs and therapeutic resistance remains insufficiently defined. This review examines resistance as malignant cells evade regulated cell death and adapt to mitochondrial stress. Mitochondria are framed as integrative hubs that link bioenergetics, redox regulation, metabolic flexibility, and stress signaling to apoptotic competence. It also describes how apoptosis connects with other death programs through mitochondrial compartmentalization. Signals from the matrix, inner membrane, and cristae, intermembrane space, and outer membrane influence ferroptosis, necroptosis, mitochondrial permeability transition-driven necrosis, and immunogenic cell death. Stress-response pathways are highlighted as interfaces between mitochondrial dysfunction and fate decisions, including the OMA1-DELE1-heme-regulated inhibitor kinase axis that activates the integrated stress response and ATF4-dependent transcription. Translationally, the review proposes a co-targeting framework that pairs apoptosis-directed therapies, especially BH3 mimetics, with interventions that destabilize mitochondrial homeostasis or tune stress signaling. Examples include electron transport chain inhibitors, integrated stress response modulators, and compartment-targeted strategies that alter cristae remodeling, calcium flux, or cardiolipin oxidation.

Doxorubicin (DOX)-induced cardiotoxicity remains a major limitation of cancer therapy. Incretin-based therapies are established cardiometabolic agents with pleiotropic cardiovascular effects; however, their potential role in mitigating DOX-related cardiac injury has not been systematically synthesized. We conducted a PRISMA 2020-compliant systematic review to evaluate the effects of incretin-based therapies on DOX-induced cardiotoxicity, with a focus on functional, structural, biomarker, and mechanistic outcomes. PubMed/MEDLINE, Embase, Web of Science, and Scopus were searched through 20 October 2025. Eligible studies included in vivo rodent models of DOX cardiotoxicity and any clinical studies directly evaluating incretin-based therapy during DOX exposure; in vitro studies, non-DOX models, combination-treatment studies, studies not focused on cardiotoxicity, gene therapy-based interventions, and reviews/editorials were excluded. Risk of bias and certainty of evidence were assessed using the SYRCLE tool and GRADE adapted for preclinical research. Thirteen rodent studies were included, and no eligible human study was identified. Investigated agents included liraglutide (n = 4), exenatide/exendin-4 (n = 4), semaglutide (n = 2), and tirzepatide (n = 3). In chronic cumulative-dose DOX models, incretin-based therapies were generally associated with preservation of left ventricular systolic function, with between-study improvements of approximately 7-20 percentage points in left ventricular ejection fraction, along with reductions in injury biomarkers. These effects were accompanied by attenuation of oxidative stress, inflammation, apoptosis, and, in some studies, ferroptosis. In contrast, findings were less consistent in acute single-dose models. Co-treatment during DOX exposure showed the most reproducible protective signal, whereas isolated pretreatment with liraglutide or tirzepatide and post-treatment with exenatide did not show a clear additional benefit. The evidence base is limited by exclusive reliance on small heterogeneous animal studies, predominantly male models, variable dosing/timing protocols, and low-to-very-low certainty of evidence. Overall, incretin-based therapies show biologically plausible cardioprotective effects in preclinical DOX cardiotoxicity, but these findings should be regarded as hypothesis-generating until confirmed in carefully designed clinical studies.

MAPK-pathway inhibitors including BRAF, MEK, and type II RAF inhibitors are now integral to treatment of pediatric low-grade glioma (pLGG), BRAF V600-mutant glioma, NF1-associated tumors, and melanoma brain metastases. Intratumoral and intracranial hemorrhage has emerged as a clinically relevant safety signal, but drug-specific incidence estimates, phenotypic definitions, and contributing mechanisms remain incompletely characterized. We systematically reviewed the evidence and synthesized contributing mechanisms.

This expert opinion review is intended to provide guidelines for diagnosis and management of intraocular inflammation (IOI) and vasculitis following pegcetacoplan.

Gastrointestinal (GI) cancers remain a major global health burden, with high incidence and mortality despite advances in multimodal therapies. Tertiary lymphoid structures (TLSs), ectopic lymphoid aggregates within the tumour microenvironment (TME), have emerged as key regulators of antitumour immunity and potential predictors of immunotherapy response. However, a focused synthesis of TLS biology specific to GI malignancies is still lacking.

Animal venoms represent an extraordinary, yet largely untapped, biochemical reservoir for oncological drug discovery. This review provides a comprehensive analysis of venom-derived enzyme inhibitors as emerging anticancer agents, emphasizing their chemical diversity, structure-activity relationships (SAR), molecular targets, and mechanistic pathways. Venom-derived peptides and proteins exhibit exceptional binding affinity and structural rigidity, characteristics frequently enforced by conserved disulfide networks. This specific architecture allows them to selectively modulate critical cancer-associated enzymes, including matrix metalloproteinases, phospholipases A2, serine proteases, and kinases. Inhibiting these highly specific targets successfully disrupts tumour angiogenesis, extracellular matrix remodelling, and metastatic dissemination, while simultaneously inducing apoptosis through unique pathways such as reactive oxygen species generation. Modern computational approaches, encompassing deep learning algorithms, molecular docking, and molecular dynamics simulations, are substantially accelerating and transforming the discovery pipeline by rapidly mapping intricate peptide-receptor interactions and guiding rational drug design. Translating these potent molecules into clinical therapeutics remains heavily challenged by pharmacokinetic instability, rapid proteolytic degradation, and systemic toxicity. The integration of computationally optimized scaffolds with advanced targeted delivery platforms, such as nanocarriers and liposomal encapsulation, offers a highly viable strategy to overcome these barriers, ultimately paving the way for next-generation, venom-inspired cancer therapies.

Silicon is among the most abundant elements on Earth, yet its incorporation into organic molecules is atypical in most biological contexts. However, the strategic introduction of silicon, in line with the demonstrated success of the incorporation of other bio-orthogonal elements, has emerged as a powerful approach in medicinal chemistry, enabling access to small molecules with unique chemical, physical, and biological properties that offer improved potency, stability, tolerability, or bioavailability profiles for the discovery and development of anticancer therapeutics. In this review, we describe the direct connection between reactivity and physiochemical paradigms of different classes of organosilicon-containing functional groups and their strategic deployment in small molecule design, including silanes, silyl ethers, siloxanes, and organosilicates. Specifically, we aimed to demonstrate how these strategies can be informed by first principles of reactivity in organosilicon containing functional groups, in both synthetic small molecules and bioactive natural products. Particular emphasis is placed on how silicon replacement and addition can be leveraged beyond simple isosteric carbon replacement, and how consequent structure-activity relationships arising from installation of diverse organosilicon motifs can also serve a unique role in unveiling new aspects of biological mechanism and function. Ultimately, the growing body of literature in applications of organosilicon-containing anticancer small molecules and the increasing sophistication and selectivity of synthetic methods used to construct these motifs will undoubtedly continue to expand the appreciation of organosilicon-based functional groups in the medicinal chemist's toolbox.

Tumor microenvironment influences the process of tumorigenesis, with hypoxia being a characteristic of many solid tumors and an adverse prognostic factor. Carbonic anhydrases (CAs) are highly efficient zinc-containing enzymes that are overexpressed in many cancers, particularly under acidic and hypoxic conditions. CA IX expression promotes cancer cell proliferation, migration, and invasion. Vascular endothelial growth factor receptor-2 (VEGFR-2) is a tyrosine transmembrane (ΤΜ) protein regulating embryonic development, angiogenesis, tissue homeostasis and cancer. Blocking VEGFR-2 signaling is one of the most promising approaches to hindering angiogenesis and growth of cancer cells. The epidermal growth factor receptor (EGFR) is a member of the ERBB family of receptor tyrosine kinases and plays a key role in cancer progression. EGFR is uniquely found in some brain, lung and other cancers. Development of novel strategies to regulate these factors is important for the treatment of tumors. Multifunctional drugs that act on multiple pathways offer a promising approach, improving therapeutic effectiveness while reducing side effects. The present review focuses on novel compounds that inhibit CA IX and target VEGFR-2 or EGFR.

Triple-negative breast cancer (TNBC), particularly when associated with breast cancer susceptibility gene 1/2 (BRCA1/2) alterations or homologous recombination deficiency (HRD), remains therapeutically challenging because DNA repair vulnerabilities coexist with molecular heterogeneity, resistance, and toxicity constraints. This narrative review synthesizes mechanistic, preclinical, clinical, and translational evidence on DNA damage response (DDR)-targeted and synthetic lethality-based strategies in TNBC. We summarize TNBC biological heterogeneity, current biomarker-guided treatment options, mechanisms of poly(ADP-ribose) polymerase (PARP) inhibition and resistance, and emerging DDR targets, including ataxia telangiectasia and Rad3-related/checkpoint kinase 1 (ATR/CHK1), WEE1, DNA-dependent protein kinase (DNA-PK), RAD51, DNA polymerase theta (POLQ), neddylation-related pathways, and targeted protein degradation. The review highlights that PARP inhibitors and platinum agents provide clinically validated examples of exploiting HRD in selected populations, whereas most next-generation DDR inhibitors remain preclinical, investigational, or in early clinical trials. Resistance mechanisms, including BRCA reversion, homologous recombination restoration, replication fork stabilization, and checkpoint adaptation, limit durable benefit. Safety, target selectivity, overlapping toxicities, and the lack of standardized functional biomarkers further constrain translation. Future progress will require prospective biomarker validation, dynamic HRD assessment, rational scheduling of combinations, and medicinal chemistry approaches that improve therapeutic index rather than a broad application of DDR inhibition across all TNBC.

Survivin (BIRC5) is a key inhibitor of apoptosis that is highly overexpressed in many cancers, where it promotes tumour cell survival, mitotic progression, and resistance to therapy. Because survivin is largely absent from normal adult tissues, it represents a selective and promising target for cancer treatment. Antisense oligonucleotides (ASOs) provide a precise approach to silence survivin by targeting its transcripts. Preclinical studies have shown that ASO-mediated reduction of survivin is associated with increased cancer cell death, inhibition of tumour growth, and enhanced sensitivity to other treatments. Early-phase clinical trials of survivin-targeting ASOs have shown evidence of target engagement but ultimately failed to demonstrate consistent clinical benefit and/or encountered dose-limiting toxicities, which hindered their further development. This review outlines survivin's central role in cancer biology, the principles of ASO therapeutics (sequence design, mechanisms of action, chemical modifications, and delivery strategies), and the progress in preclinical and clinical development of survivin-targeting ASOs, while also discussing key challenges that may contribute to their clinical limitations, including inefficient delivery, off-target effects, and systemic toxicities. Collectively, the current status of survivin-targeting ASOs underscores the need for synergistic optimization of delivery platforms and molecular chemistry to improve efficacy and safety, thereby enabling their use in personalised and combination cancer treatment approaches.

More than 20 years after the discovery of lunasin, a clear shift in lunasin research is observable-from an initial focus on its direct in vitro anticancer effects toward strategies aimed at improving its bioavailability and repositioning it as a potential adjunct in cancer therapy. Lunasin, a soy-derived bioactive peptide, has been extensively studied for its antineoplastic properties. However, its limited oral bioavailability restrains its efficacy in clinical trials. Therefore, recent research on lunasin points towards the possibility of using it as an adjunct in cancer treatment, rather than as a stand-alone nutraceutical in humans. In preclinical models, in vitro and in vivo, lunasin can enhance the effects of standard anticancer drugs in breast and colon cancers. Research suggests that lunasin can potentiate the effects of drugs, such as tamoxifen, aspirin, cisplatin, and oxaliplatin, by sensitizing cancer cells to apoptosis, modulating cell cycle progression, reducing metastatic potential, and attenuating drug-resistance pathways, including PI3K/Akt, FAK/MAPK1/NF-κB, and integrin-mediated signaling. In combination with those drugs, lunasin exerts significant anticancer effects at concentrations substantially lower than those proven as effective in monotherapy, suggesting a potential role in dose reduction in conventional agents and, subsequently, mitigation of their adverse effects. Although the enhanced effect of those combinations has been shown in preclinical models, there is a distinct lack of human clinical trials in this matter. Available evidence supports a promising concept of lunasin as a molecular "priming" agent that might complement cytotoxic therapies rather than replace them. This combination-oriented paradigm may represent a shift in lunasin research and offer a novel direction for the use of bioactive peptides in precision oncology; however, further studies exploring this possibility, including human clinical trials, are needed to elucidate lunasin's role in nutraceutical-assisted cancer therapy.

Malignant gliomas are highly aggressive primary brain tumors for which the therapeutic efficacy of cisplatin is frequently limited by intrinsic or acquired drug resistance. Despite advances in adjuvant therapies, overcoming chemoresistance remains a major challenge in the treatment of these malignancies. Emerging evidence indicates that long non-coding RNAs (lncRNAs), a class of non-protein-coding transcripts involved in gene regulation, play important roles in modulating treatment responses. Several lncRNAs, including differentiation antagonizing non-protein-coding RNA (DANCR), HOXD antisense growth-associated long non-coding RNA (HOXD-AS1), MEG3, MALAT1, and HOTAIR, have been implicated in pathways associated with glioma progression and therapeutic resistance. In particular, DANCR has been reported to promote cisplatin resistance in glioma cells through suppression of apoptosis and activation of pro-survival signaling pathways. This review summarizes current evidence regarding the roles of lncRNAs in cisplatin resistance, highlighting mechanisms such as regulation of drug transport, DNA damage repair, apoptosis, cancer stem-cell maintenance, and signaling pathways associated with treatment adaptation. We also discuss current limitations, challenges for clinical translation, and gaps in the existing evidence. A better understanding of lncRNA-mediated resistance mechanisms may facilitate the identification of novel therapeutic targets and inform future studies aimed at overcoming cisplatin resistance in malignant gliomas.

Immune checkpoint inhibitors (ICIs) have transformed cancer therapy by restoring anti-tumor immunity, but immune activation can disrupt ocular immune homeostasis and induce ophthalmic immune-related adverse events (OirAEs). Although uncommon, OirAEs may involve nearly all ocular compartments and can cause irreversible visual impairment or interruption of effective anticancer therapy. The 2025 international consensus criteria now provide a standardized framework for defining and classifying OirAEs. This review integrates current evidence on ICI-associated ocular toxicity, with emphasis on tissue-specific immune mechanisms and their clinical implications. Blockade of the PD-1/PD-L1 and CTLA-4 pathways may impair ocular immune privilege, expand autoreactive T-cell subsets, alter cytokine and chemokine networks, and amplify autoantibody-mediated retinal injury. These processes provide a plausible framework for understanding diverse phenotypes, including uveitis, ocular surface disease, optic neuritis, orbital inflammation, ocular myopathy, and retinopathy. We also outline a mechanism-informed management approach that balances visual preservation with maintenance of systemic anti-tumor immunity. Local corticosteroid therapy, cautious systemic immunosuppression, and selected steroid-sparing biologics should be individualized according to severity, anatomical involvement, and the oncologic context. Together, these insights support a consensus-based and mechanism-informed framework for recognizing and managing OirAEs while preserving systemic anti-tumor immunity.

Ovarian cancer (OVC) is a leading cause of gynecological cancer mortality due to late-stage diagnosis and chemoresistance. Among the multiple molecular mediators, oncogenic epidermal growth factor receptor (EGFR) signaling has emerged as a key regulator of tumor progression and drug resistance, ultimately governing cancer survival. Therefore, this review focused on the molecular mechanisms of aberrant EGFR signaling to promote chemoresistance in ovarian cancer through multiple interlinking pathways, including the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of the rapamycin (mTOR), mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK), and Janus kinase (JAK)/signal transducer and activator of transcription (STAT) signaling cascades. These pathways act in concert to confer resistance, including proliferation, antiapoptotic effects, cancer stem cell maintenance, and facilitating epithelial-mesenchymal transition (EMT), which function together to decrease sensitivity towards platinum-based and taxane chemotherapies. Furthermore, we incorporate novel evidence regarding EGFR cross-talk with extracellular matrix (ECM) and metabolic reprogramming, especially their relevance to immune evasion mechanisms, hypoxia, and extracellular vesicles (EVs)-mediated signaling. In addition, we elaborated on the limitation of the current EGFR targeting therapy, which will be beneficial for further designing new combinatorial treatment approaches by using EGFR inhibitors with immunotherapy, nanocarriers, and microbiota modulators. Overall, this review highlights the updated role of EGFR signaling as a key regulator of chemoresistance in ovarian cancer, providing insights for developing targeted therapies to overcome drug resistance and improve patient survival.

KRAS is one of the most frequently mutated oncogenes in human cancer and has long been considered an "undruggable" therapeutic target because of its high affinity for guanine nucleotides and limited druggable binding pockets. Recent advances in structural biology and molecular pharmacology have transformed this paradigm, leading to the successful development of KRAS G12C inhibitors such as sotorasib and adagrasib. These agents established proof-of-concept for direct KRAS inhibition and marked an important advance in precision oncology. However, intrinsic and acquired resistance mechanisms, adaptive signaling reactivation, and tumor heterogeneity continue to limit the durability of clinical responses. Therapeutic development has rapidly expanded beyond KRAS G12C toward broader strategies including KRAS G12D inhibitors, pan-RAS and RAS(ON) inhibitors, degraders, and biomarker-guided combination approaches. In parallel, circulating tumor DNA (ctDNA) and other biomarker-driven strategies are increasingly enabling dynamic monitoring of treatment response, minimal residual disease, and resistance evolution. In this review, we summarize the molecular biology and conformational regulation of KRAS signaling, recent advances in allele-specific and pan-RAS therapeutic strategies, mechanisms of resistance, and emerging precision oncology frameworks for KRAS-mutant cancers.

p53 tumor suppressor evolved as a critical player in navigating the response to environmental stresses such as DNA or oxidative damage and drives cell fate by governing life and death decisions. The p53 protein is encoded by the most commonly mutated gene in human cancers. TP53 gene mutations are associated with worse prognosis and refractory and relapsed disease. The most prevalent mutations are of the missense type and often result in disruption of the DNA-binding capacity and transcription activity. In healthy cells, p53 protein is tightly regulated by its E3 ubiquitin ligase, MDM2 (HDM2), its own transcription target. Mutant p53, therefore, escapes the regulation by the negative feedback loop and is often found upregulated in cancer cells. The efforts to exploit wild-type and mutant p53 for precision oncology have been ongoing in the last two decades yet have not been successful. A recently reported strategy to target TP53-mutant cancers leverages induced proximity, utilizing the high cellular abundance of mutant p53 as a scaffold to concentrate a small-molecule inhibitor against an essential survival protein. This strategy relies on the Regulated Induced Proximity TArgeting Chimera (RIPTAC). Given the recent FDA approval of the first chimeric drug, vepdegestrant, killing by proximity might turn out to be a promising medical advancement for precision oncology.