High-altitude hypoxia is closely associated with cancer initiation and progression.Hypoxia promotes tumor development through multiple mechanisms including modifying acidic microenvironment,triggering tumor angiogenesis,influencing vasculogenic mimicry,inducing epithelial-mesenchymal transition,remodeling of extracellular matrix,promoting immune escape and adaptive landscapes,maintaining cancer stem cells and inhibiting senescence.Targeting hypoxia may become a novel efficient strategy for cancer therapy.

Tumor related-inflammation is important component of tumor microenvironment. The inflammation status in tumor microenvironment may demolish immunosystem, influence signaling transduction and change the homing of normal stem cell in tumor microenvironment, which probably promote tumor development. The better understanding of molecular pathway of tumor related inflammation would be helpful for identification of novel molecular targets.

Objective To construct a new staging scheme for patients with hepatocellular carcinoma(HCC).Methods A retrospective analysis of HCC cases from 1999 to 2003 was performed.The Cox model was used for multivariate analyses.The final model was derived from 10 randomly-chosen training samples and the prognostic validity of the new staging score was assessed on the corresponding testing samples.Results A simple scoring system was produced,assigning linear scores(0/1/2) to the covariates (TNM,?-fetoprotein,and Child-Pugh).Compared with Okuda stage and CLIP score,the new staging system,structured as a five-category tool,had a greater discriminant ability.Conclusion The new staging system,accounting for both liver function and tumor characteristics,can accurately identify patients with different prognoses,particularly in the advanced phases of HCC,thus representing a useful tool in the treatment of the disease.

The conventional treatment options for advanced gastric carcinoma patients remain unsatisfactory in terms of response rate and overall survival benefit. Targeted therapy plus systemic chemotherapy now becomes a new promising therapeutic option. In this review we profiled important trials of international multicenter phase Ⅲ clinical studies in patients with advanced gastric carcinoma, including ToCA trial, EXPAND trial, LOGIC trial, AVAGAST trial, REAL3 trial, and granite-1 trial. These trials warrant the role of molecular targeted therapy in patients with advanced gastric carcinoma.

Rational microenvironment contributes actively to cancer development through multiple mechanisms including triggering genomics instability,providing shield,promoting immune escape,inducing differentiation and permissive nich.Tumorigenesis reversely promotes the form of tumor microenvironment composed of hypoxia,decreasing pH,angiogenesis and nutrition deficiency.Tumor microenvironment not only is the reasons but also results in cancer development and progression.A better understanding of how the tumor environment affects cancer progression would provide the new strategy for cancer therapy.

As semi-autonomous organelles,mitochondria are easily damaged by various factors.Mitochondrial dysfunction such as abnormal oxidative phosphorylation,metabolism alterations,apoptosis prevention,damaged mitophagy,immune escape and deregulated signaling pathway have been hypothesized to be involved in tumorigenesis.Modulated mitochondria may prevent the occurrence of tumors.

Breast cancer is a group of heterogeneous diseases.Molecular portraits provide a new insight for personalized cancer management in breast cancer.According to the molecular pathology,molecular biology and system biology,breast cancer goes through different typing methods,including four subclasses,geneexpression signature and integrated genomic classification.These major subtypes of breast cancer may provide guidance for precise therapeutics.

In patients with initially diagnosed unresectable cancers,resection of cancer sometimes becomes possible by systemic chemotherapy,and this model of chemotherapy is defined as conversion chemo-therapy. Conversion chemotherapy can improve objective response rate and resection rate,and it has shown an important value in metastatic colorectal cancer,advanced gastric cancer and unresectable hepatocellular carci-noma.

With the coming era of targeted therapy,novel criteria such as the modified response evalu-ation criteria in solid tumors (RECIST),positron emission tomography response criteria in solid tumors (PETRCIST),Choi criteria and immune-related response criteria have been proposed as standardized methods to assess therapeutic response.Biomarkers and circulating tumor cells may be considered suitable for the evalu-ation of response.These criteria may be useful for the evaluation of therapeutic response to tumors.

Cancers evolution is a process of clonal selection,cell competition and clonal expansion. Cancers evolution includes cancer memory,heterogeneity,resistance,transformation and adaption et al.This evolution enables cancer cells to adapt to any hostile environment and to survive.An understanding of cancers evolution will provide a theoretical guidance for the implementation of the precision therapy.