Research in the 1970s showed that while retroviruses had been a key to identification of oncogenes, they were not actually a major cause of human cancer. Moreover, cells contained additional proto-oncogenes that did not necessarily have viral oncogene counterparts. In this excerpt from his forthcoming book, Joe Lipsick remembers the groundbreaking work on DNA transfection, chromosomal rearrangements, and gene amplification that identified the smoking guns responsible for activation of oncogenes such as RAS and revealed how translocations in immune cells produce cancer drivers like the Philadelphia chromosome.

Macrocephaly, defined as a large head size, has a very broad differential and sometimes can be challenging to differentiate as benign versus indicative of pathology. In this review, we outline a stepwise approach to improving diagnosis of neurogenetic disorders versus other causes using the example of PTEN (phosphatase and TENsin homolog) Hamartoma Tumor Syndrome (PHTS). PHTS is a multiple hamartoma syndrome with medical management implications including the need for tumor surveillance, but often cases are not diagnosed until later in adulthood. Our review emphasizes the utility of using head circumference z scores in combination with other features as a triage tool for genetic identification of disorders such as PHTS.

Hepatocyte nuclear factor 4 alpha (HNF4α) is a conserved nuclear receptor that governs epithelial identity and metabolic homeostasis across endoderm-derived tissues. In cancer, HNF4α can function as either an oncogene or a tumor suppressor. In colorectal and hepatocellular carcinoma, reduced HNF4α activity accompanies loss of differentiation and tumor progression, consistent with tumor-suppressive functions. In contrast, in pancreatic ductal adenocarcinoma, invasive mucinous adenocarcinoma, and other lineage-defined epithelial tumors, HNF4α can also participate in transcriptional programs that sustain malignant identity, metabolic adaptation, and therapeutic resistance. However, these effects are highly context-dependent and do not imply a uniformly oncogenic role in these tumor types. These divergent functions are shaped by isoform usage, chromatin state, epigenetic regulation, metabolic cues, and transcription factor networks. Rather than acting as a classical oncogene or tumor suppressor in all settings, HNF4α is better understood as a context-dependent regulator of lineage state whose activity may either restrain tumor progression or support tumor maintenance. This mini review highlights the molecular mechanisms that shape HNF4α activity, including isoform biology and epigenetic control, and discusses emerging strategies for selectively inhibiting HNF4α in dependency states or restoring its differentiation-promoting functions in tumors where it is lost.

The Muscleblind-like (MBNL) family comprises evolutionarily conserved RNA-binding proteins that interact with target RNAs via zinc finger domains. MBNLs orchestrate RNA processing, particularly alternative splicing, driving the developmental fetal-to-adult isoform switch across numerous target transcripts. This transition is a cornerstone in the process of MBNL-maintained cellular homeostasis and fails in many pathological conditions associated with deregulated expression or function of specific MBNL paralogs. This review provides current insights into the roles of MBNL genes and proteins in both health and disease. We examine their genomic architecture and protein organization and synthesize key insights from animal models to delineate the selective and compensatory functions of individual MBNL paralogs in physiology. To illustrate the roles of MBNLs in disease, we outline nucleotide repeat expansion disorders marked by their functional depletion, with a primary focus on myotonic dystrophy (DM). We also highlight selected cancer studies that have demonstrated the dual roles of MBNLs in tumorigenesis, encompassing both pro-oncogenic and tumor suppressive functions. Finally, using DM as a model, we review evidence for the therapeutic potential of endogenous MBNL gene modulation and argue that analogous strategies could be adapted and tailored to restore MBNL homeostasis in other disorders involving their dysregulation.

The Hippo/YAP signaling pathway is a key regulatory network that governs organ size, tissue homeostasis, cell proliferation, and cell polarity. Aberrant Hippo/YAP signaling contributes to the initiation and progression of multiple cancers, making this pathway an attractive therapeutic target. Although several agents targeting Hippo/YAP have shown promise in preclinical models, clinical translation has been limited. These challenges likely stem from an incomplete understanding of the upstream regulators, downstream effectors, pathway crosstalk, and context-dependent roles of Hippo/YAP across different tumor types. Continued mechanistic investigation is required to clarify these complexities and reveal new therapeutic vulnerabilities. In this review, we summarize the current knowledge of the core components of the Hippo/YAP pathway, its regulatory mechanisms and interactions with other signaling cascades, its dysregulation in cancer, the involvement of microRNAs and lncRNAs in pathway modulation, and emerging therapeutic strategies targeting Hippo/YAP.

Pancreatic ductal adenocarcinoma (PDAC) is among the most lethal solid malignancies, characterized by aggressive biology and a paucity of effective treatments. Activating mutations in KRAS occur in more than 90% of cases and are fundamental to tumor initiation, progression, therapeutic resistance, and immune exclusion, establishing KRAS as the dominant oncogenic driver in PDAC. Long considered undruggable, KRAS has recently become a viable therapeutic target with the development of allele-specific inhibitors as well as pan-RAS(ON) agents capable of broadly suppressing mutant RAS signaling. Preclinical models and early-phase clinical trials demonstrate meaningful antitumor activity, with emerging evidence of tumor microenvironment remodeling and delayed resistance. Combination strategies integrating KRAS-directed therapies with chemotherapy, vertical pathway inhibition, immunotherapy, and emerging approaches such as KRAS degradation and RNA-targeted approaches are being explored to improve the depth and durability of response. Together, these advances signal a paradigm shift toward molecularly guided treatment strategies in PDAC and offer a promising path forward in a disease with substantial unmet clinical need.

Targeted therapies have significantly transformed the management of chronic lymphocytic leukaemia (CLL), yet most recommendations continue to reflect Western practice patterns. Variations in disease biology, healthcare resources and treatment accessibility across the Asia-Pacific (APAC) necessitate region-specific guidance. The Asia-Pacific Leukaemia Consortium (APLC) therefore developed updated consensus statements to support standardised, context-appropriate care for patients with CLL.

This review outlines the molecular biology, diagnostic tools, screening strategies, and management options of Lynch syndrome (LS)-associated upper tract urothelial carcinoma (LS-UTUC).

Clonorchis sinensis, a common food-borne liver fluke in East Asia, is a Group 1 carcinogen strongly linked to cholangiocarcinoma. In recent years, molecular biology and multi-omics studies have revealed that this parasite drives chronic inflammation of the bile duct epithelium, epigenetic abnormalities, and the formation of precancerous lesions. Concurrently, circulating miRNAs, DNA methylation patterns, differential protein expression, metabolite profiles, and parasite-specific antigens have been proposed as potential early molecular biomarkers, which offers new avenues for the non-invasive detection of precancerous conditions. However, current research mainly remains at the laboratory stage and studies have small-scale cohorts, lacking multi-center, large-sample prospective validation and standardized detection protocols, which limits their clinical applicability. Furthermore, traditional imaging and histological methods exhibit limited sensitivity for early identification. This review aims to systematically summarize the molecular carcinogenic mechanisms associated with C. sinensis infection, recent advances in molecular biomarker research, and strategies for identifying precancerous lesions. It will particularly focus on discussing the major obstacles in clinical translation and future directions, with the goal of providing insights for early screening and prevention strategies.

Breast cancer (BC) is widely recognized as the most frequently diagnosed neoplasm among women worldwide. Despite significant advances, improved diagnosis and treatment of breast cancer have failed to translate into earlier detection or markedly better outcomes for patients, due to challenges including late-stage presentation, metastasis, recurrence, metabolic reprogramming, and drug resistance. Identifying reliable predictive indicators for early intervention and diagnostic markers remains a priority in breast cancer research, as this is crucial for improving patient prognosis. Circular RNAs (circRNAs), a class of non-coding RNAs (ncRNAs) abundant in various tissues and human cells, are established biomarkers for diagnosing and monitoring diseases such as those affecting the nervous, cardiovascular, and immune systems. CircRNAs contribute to tumorigenesis through the regulation of proliferation, metastasis, angiogenesis, and the tumor microenvironment. A growing body of evidence has established circRNAs as key regulators in breast cancer, elucidating their specific roles in driving tumor development and progression. Nevertheless, a more comprehensive understanding of the functional roles and molecular mechanisms of circRNAs in BC is essential and requires further research. This narrative review synthesizes the current knowledge on circRNAs encompassing their biogenesis, characteristics, methylation, tumor cell death, and selectively analyzes the translational potential of circRNAs in BC patients.

Non-invasive prenatal testing (NIPT) based on fetal free DNA is a non-invasive technique to screen for common fetal aneuploidies by analyzing cell-free fetal DNA (cffDNA) in the peripheral blood of pregnant women. This technique has opened a new era of prenatal screening for its high safety and reliability. In recent years, it has been shown that NIPT can not only screen for fetal aneuploidies, but may also reveal maternal genomic abnormalities. The incidental detection of maternal tumors has aroused widespread concern in the clinical settings. The aim of this review is to systematically summarize the research progress of NIPT technique in incidental detection of maternal tumors, and to discuss its clinical significance, technical challenges, and future development direction. It has been found that multiple chromosome aneuploidies (MCAs) in NIPT detection is one of the important biomarkers suggesting occult maternal malignant tumors. In this paper, the relevant progress of NIPT technique in the incidental discovery of maternal tumors were reviewed in order to provide a reference for individualized and standardized application of NIPT technique in maternal health monitoring.

A disintegrin and metalloprotease with thrombospondin type 1 repeats, 1 (ADAMTS1) is a metalloproteinase essential for ovarian follicle development and ovulation. It is also involved in organizing vascular and lymphatic networks within ovary. ADAMTS1 is expressed by granulosa cells in ovarian follicles, and its expression and function are regulated by gonadotropins, follicle-stimulating hormone, and luteinizing hormone. This enzyme cleaves extracellular matrix (ECM) proteins to remodel the ECM and provide the necessary space for the growing ovarian follicles. ADAMTS1 is also essential for breaking down the follicular wall by cleaving proteoglycans, thereby releasing oocytes during ovulation. Loss of ADAMTS1 impairs remodeling of the ECM and decreases ovulation in mice. Dysregulation of ADAMTS1 is also linked to pathological conditions like polycystic ovary syndrome and premature ovarian failure, highlighting the precise activity of this enzyme. This chapter discusses the known and potential functions of ADAMTS1 in ovarian biology.

Although targeted therapy has made significant advances in cancer treatment throughout these years, drug resistance still remains a major obstacle. Plenty of evidence has proved that abnormal expression of receptor tyrosine kinase AXL is associated with targeted therapy resistance and poor clinical outcomes. AXL drives drug resistance through diverse mechanisms, including altering tumor cell phenotypes, orchestrating DNA damage response process, promoting the activation of bypass signals, or interacting with other receptor tyrosine kinases. Preclinical and clinical studies have demonstrated that combined inhibition of AXL and the other target can enhance the efficacy of various targeted therapies and improve outcomes for patients with drug resistance. This review summarizes recent advances in the specific roles of AXL in targeted therapy resistance and AXL-targeted treatment strategies. It further explores the potential clinical value of combinatorial approaches involving AXL inhibition and discusses future directions for its application in developing novel targeted therapies and advancing precision oncology treatment. 
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Metabolic reprogramming is a hallmark of cancer, with the Warburg effect-driven aerobic glycolysis leading to a substantial accumulation of lactate in the tumor microenvironment. For a long time, lactate was considered a mere metabolic end product; however, recent studies have found that it acts as an important signaling molecule, profoundly influencing tumor progression by inducing a novel post-translational modification - lactylation. Lactylation, driven by lactate, occurs on both histones and non-histone proteins and is finely regulated by the 'writer' 'eraser' and 'reader' mechanisms, thereby altering the function of target proteins and gene expression. This review systematically explores the bidirectional regulatory network between glycolytic reprogramming and lactylation: on one hand, key glycolytic regulators promote lactate production, thereby increasing lactylation levels; on the other hand, lactylation can feedback to regulate the activity and expression of key glycolytic enzymes, forming a pro-tumor positive feedback loop. This interaction plays a central role in tumor proliferation, metastasis, DNA damage repair, and immune evasion. Consequently, targeting lactate production, lactate transport, or the lactylation process itself has emerged as a highly promising anti-cancer strategy and shows potential synergy with existing therapies such as immune checkpoint inhibitors. In-depth analysis of the glycolysis-lactylation axis will provide a crucial theoretical basis for developing novel cancer treatment approaches.
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First-line immunotherapy for advanced non-small cell lung cancer (NSCLC) shows significant survival benefits in patients without driver mutations, but the optimal duration of treatment remains controversial. Some studies support limiting immunotherapy to 2 years, arguing that longer treatment does not bring additional survival benefits; while other studies believe that treatment should continue until disease progression to maximize survival benefits. This article systematically reviews the current research progress on the duration of immunotherapy and discusses the potential predictive value of biomarkers such as circulating tumor DNA (ctDNA), the best efficacy response, and programmed cell death ligand 1 (PD-L1) expression levels in individualized treatment decisions. More prospective studies, especially biomarker-driven trials, are still needed to clarify the optimal duration of treatment and establish an individualized treatment strategy based on multidimensional indicators.
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Tumor-associated myeloid cells form a highly plastic and spatially organized immune compartment that plays a central role in tumor evolution, clinical outcome, and therapeutic response. Single-cell RNA sequencing has revealed extensive heterogeneity among macrophages, monocytes, neutrophils, dendritic cells, and related lineages, uncovering transcriptional programs linked to tumor promotion or immune activation. However, the dissociative nature of single-cell approaches disrupts tissue architecture, limiting insight into how myeloid cells interact with malignant, stromal, and lymphoid populations within intact tumors. Recent advances in spatial omics technologies address this limitation by preserving tissue context while enabling high-dimensional profiling of RNA and protein expression in situ. In this review, we synthesize emerging spatial proteomic and transcriptomic studies of tumor-associated myeloid cells, identify recurrent spatial architectures that govern tumorigenesis, prognosis, and treatment response, and examine analytical frameworks that translate spatial patterns into mechanistic understanding. By moving beyond descriptive spatial maps, we highlight unifying biological principles and translational opportunities that position myeloid spatial organization as a critical determinant of cancer progression and precision oncology.

Circular RNAs (circRNAs) are covalently closed, single-stranded RNAs generated via backsplicing. They are highly stable and evolutionarily conserved, making them promising candidates for cancer therapy and diagnosis. CircRNAs regulate cancer progression by modulating genome instability, angiogenesis, metastasis, stemness, and chemoresistance. They do so through mechanisms including microRNA (miRNA) sponging, protein interaction, translational templating, and transcription/translation regulation. CircRNAs play a critical role in cancer immunotherapy. They modulate immune checkpoint blockade (ICB) responses and cytokine secretion to reshape the tumor immune microenvironment (TME). CircRNAs also serve as stable platforms for neoantigen-based cancer vaccines and improve in vivo chimeric antigen receptor T cell (CAR-T) therapy by replacing unstable linear mRNA. Additionally, circRNAs are potential noninvasive biomarkers due to their abundance in body fluids and differential tumor-normal expression. Despite challenges such as unclear regulatory networks, off-target effects, and inefficient delivery, this review systematically summarizes the biogenesis of circRNAs, their functional mechanisms, their roles in cancer progression, and their applications in cancer immunotherapy. The review also highlights their utility as biomarkers and future translational directions, providing a focused overview of their potential to advance cancer immunotherapy.

The incidence of cancer increases markedly with aging, and the two processes share underlying molecular mechanisms. In the context of global population aging and rising cancer incidence, nine convergent hallmark axes have been identified: genomic instability, epigenetic drift, inflammation-immunity imbalance, microbiome dysbiosis, metabolic reprogramming, telomere attrition, stem cell exhaustion, cellular senescence, and autophagy dysfunction. These hallmarks constitute an integrated regulatory network that operates synergistically, antagonistically, or through bidirectional feedback across molecular, cellular, and microenvironmental levels. Genomic instability, epigenetic remodeling, chronic inflammation, microbiome dysbiosis, and metabolic reprogramming in aging often act synergistically to promote tumorigenesis, whereas telomere attrition and stem cell exhaustion primarily exert antagonistic, tumor-suppressive effects. Cellular senescence and autophagy dysfunction display context-dependent dual roles. Importantly, this network framework has direct relevance to cancer therapeutics. Although chemotherapy, radiotherapy, and immunotherapy effectively suppress tumor progression, they frequently induce therapy-induced senescence, characterized by cell-cycle arrest and a senescence-associated secretory phenotype, thereby accelerating functional decline and increasing long-term toxicities in older patients. The proposed "synergistic-antagonistic-dual" framework linking aging and cancer not only helps explain the disproportionate cancer burden in older adults but also supports a "one drug, two targets" therapeutic paradigm. Targeting these shared pathways has delayed aging phenotypes and suppressed tumorigenesis in preclinical studies and early clinical trials, highlighting the potential of integrated interventions that concurrently address aging and cancer.

Peto's paradox (Pp) results from the evidence that in mammals there is no obvious positive correlation between body size, lifespan, and cancer incidence. Posing the question of which mechanisms are responsible for this. Comparative studies searching for specific anticancer mechanisms as putative solutions to Pp have been undertaken in mammals. The result of these efforts are further inconsistencies leading to ad-hoc hypotheses and unnecessary complexity. In contrast to this, we present evidence that the cellular stress responses (CSRs), aimed at curtailing proteotoxic stress and assuring cell survival are necessary for enabling carcinogenesis. Yet, natural selection adjusts the performance of the CSRs according to the life history of each species and because of this, cancer is mostly delayed to the post-reproductive stage in all mammalian species, resulting in a limited impact of cancer on species fitness and viability. From this perspective, the need of evolving anticancer mechanisms, suggested by Pp is weakened or disappears and the paradox is likely resolved.

DNA methylation is a key epigenetic modification catalyzed by DNA methyltransferases (DNMTs) and predominantly occurs at cytosine-phosphate-guanine (CpG) islands, which are often located in gene promoter regions. Hypermethylation of CpG islands within gene promoters can silence tumor suppressor gene expression, thereby disrupting normal cellular functions, including maintenance of genomic stability and regulation of cell growth, and contributing to tumor initiation and progression. In contrast, global hypomethylation may promote genomic instability and oncogene activation. This review discusses the molecular mechanisms underlying DNA methylation and evaluates its functional and clinical significance in colorectal and gastric cancers, with emphasis on its potential application as a noninvasive biomarker for diagnosis.