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Chinese Expert Consensus on Oncology Multimorbidity Management (2025 Edition)

Cancer Research on Prevention and Treatment.2025;52(11):879-912. doi:10.3971/j.issn.1000-8578.2025.25.0771

Against the backdrop of accelerated population aging, the prevalence of comorbidities in patients with malignant tumors has risen by 0.54% annually, presenting a significant challenge to clinical oncology. Currently, the awareness of oncology multimorbidities varies significantly among specialists at different levels of healthcare institutions nationwide, and a comprehensive management workflow for patients with cancer and multimorbidities is lacking. Therefore, the Chinese Society of Clinical Oncology Committee of Experts on Cancer Supportive and Rehabilitation Therapy convened a multidisciplinary panel of experts to develop the Chinese Expert Consensus on Oncology Multimorbidity Management (2025 Edition). Aimed at frontline clinicians involved in the diagnosis and treatment of malignant tumors, the consensus addresses 29 core issues in multimorbidities management and guides the standardized, comprehensive management of oncology multimorbidities.

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Developing Effective Strategies to Overcome Immunotherapy Resistance in Non-Small Cell Lung Cancer by Directly Targeting Cancer Cells

Qing HUANG ; Jiaqi XIAO ; Sheng HU ; Qian CAI

Cancer Research on Prevention and Treatment.2025;52(11):913-925. doi:10.3971/j.issn.1000-8578.2025.25.0508

The development of novel point-to-point drugs targeting resistance mechanisms is a critical and popular research field; nevertheless, success remains challenging. Therefore, given the short survival time and heightened expectations of patients with advanced NSCLC, the design of various combination therapy strategies––integrating preclinical, clinical, and real-world evidence (such as radiotherapy, chemotherapy, targeted therapy, antibody–drug conjugates, oncolytic viruses, and cell therapy)––may be a wise and practical choice to address the disease. Resistance to immunotherapy involves almost all cell types in the body, primarily cancer cells and T cells involved in immune surveillance. As a result of space limitations, this article focuses on the progress and challenges of various combined strategies for directly eliminating cancer cells. We also emphasize the realignment of treatment goals, shifting from primarily focusing on eliminating cancer cells (via chemotherapy and radiotherapy) to fully utilizing immune regulation to overcome resistance to immune checkpoint inhibitors.

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Strategies to Overcome Immunotherapy Resistance in Non-Small Cell Lung Cancer: Targeting Non-Cancer Cells

Runzhi CHEN ; Chang XUE ; Xiaoyu LI ; Yuanxiang LI ; Sheng HU

Cancer Research on Prevention and Treatment.2025;52(11):926-936. doi:10.3971/j.issn.1000-8578.2025.25.0506

One of the key mechanisms underlying resistance against immunotherapy is the reduction in the abundance and functional capacity of immune cells within the tumor microenvironment (TME). Accordingly, the development of novel antibodies and small-molecule agents that target multiple co-inhibitory molecules—whether employed as monotherapies or in combination—holds promise for reinvigorating exhausted T cells and restoring antitumor immune responses. In addition, exploring agonists targeting co-stimulatory molecules represents a promising strategy to enhance the secondary signals necessary for T cell activation and thereby facilitates tumor eradication. However, careful attention must be given to potential toxicities associated with these agents. Furthermore, this review highlights the emerging therapeutic potential of cancer vaccines, oncolytic viruses, diverse cellular therapies, and other innovative strategies designed to augment the efficacy of immunotherapy in non-small cell lung cancer (NSCLC). Moreover, we discuss therapeutic strategies targeting non-proliferating TME components, including cancer-associated fibroblasts (CAFs) and the extracellular matrix (ECM), and hypoxia-alleviating agents and immune homeostasis-supporting probiotics, all aimed at enhancing anti-tumor immunity. In summary, this article emphasizes the critical importance of integrating therapeutics with complementary mechanisms of action while maintaining the balance between efficacy and tolerability in the advancement of precise and effective immunotherapy in NSCLC to an unprecedented level.

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Resistance to Immunotherapy in Non-Small Cell Lung Cancer: Intricate Mechanisms

Jingyi WU ; Xiaoyan ZHANG ; Sheng HU ; Yi ZHONG

Cancer Research on Prevention and Treatment.2025;52(11):937-944. doi:10.3971/j.issn.1000-8578.2025.25.0507

Since the beginning of the new century, advances in understanding the intricate interactions between oncology and the immune system have accelerated the rapid development of immune checkpoint inhibitors for the treatment of non-small cell lung cancer. However, resistance to immunotherapy is inevitable. Therefore, uncovering the mechanisms of immunotherapy resistance, proposing strategies to overcome resistance, and identifying future research directions are imperative. Given the limitations of space in each article, this review will explore the complex mechanisms underlying immunotherapy resistance. These mechanisms involve almost all cell types within the body, excluding foreign cancer cells. Notably, these cells serve as recipients (either inhibitory or stimulatory, or both) and producers of signals, playing different roles in various contexts. At the molecular level, these mechanisms include genetic and epigenetic abnormalities in all cells within the microenvironment, as well as the influence of a variety of protein kinase, growth factors, and cytokines with temporal and spatial heterogeneity. At the macroscopic level, host factors such as nutritional metabolism, comorbidities, and microbiota within the organs, as well as neuro-psychological regulation, influence the efficacy of immunotherapy.

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Clinical Effects of Intercostal Nerve Block Analgesia and Patient Controlled Intravenous Analgesia in Enhanced Recovery After Minimally Invasive Surgery for Lung Cancer: A Prospective Randomized Controlled Trial

Ziyi ZHAO ; Yun YE ; Xi CHEN ; Long TIAN ; Xi ZHENG ; Guowei CHE

Cancer Research on Prevention and Treatment.2025;52(11):945-950. doi:10.3971/j.issn.1000-8578.2025.25.0278

Objective To compare the analgesic effects and adverse reactions between intercostal nerve block (ICNB) and patient controlled intravenous analgesia (PCIA). Methods From August 2022 to January 2023, 180 patients with lung cancer who underwent thoracoscopic surgery were randomly divided into two groups: ICNB group (n=90) and PCIA group (n=90). The postoperative pain degree (VAS), location, nature; adverse events, such as nausea, vomiting, and dizziness; and other clinical symptoms were analyzed. Results The most common site of postoperative pain in both groups was surgical incision, and the nature of pain was distending pain. At 12 and 24 h after the operation, the pain degree in the ICNB group (1.10±0.91, 3.12±1.29) was markedly lower than that in PCIA group (1.44±0.86, 4.32±1.30, P=0.010, P<0.001). The incidence of nausea, vomiting, and dizziness in the ICNB group (5.56%, 23.33%) was noticeably lower than that in the PCIA group (35.56%, 51.11%, P<0.001, P<0.001). Total hospitalization expense in the ICNB group (41 043.16±10 885.63 yuan) was significantly lower than that in PCIA group (45 283.99±11 036.36 yuan, P=0.010). Conclusion The analgesic effect of intercostal nerve block is better than that of patient-controlled intravenous analgesia pump in patients with lung cancer after minimally invasive surgery, and the incidence of adverse reactions is low.

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From Immune Microenvironment to Targeted Precision Therapy: New Strategies for Treatment of Pancreatic Cancer

Haiyan YU ; Huojun ZHANG

Cancer Research on Prevention and Treatment.2025;52(11):951-958. doi:10.3971/j.issn.1000-8578.2025.25.0358

Pancreatic cancer is a highly lethal malignancy that is usually diagnosed at an advanced stage because of its absence of early symptoms and lack of effective screening tools. Although existing treatments (e.g., surgery, chemotherapy, and radiotherapy) can provide temporary relief, the therapeutic effect of pancreatic cancer remains limited, with major issues related to drug resistance and recurrence. In recent years, immunotherapy and targeted therapy have provided renewed hope to the treatment of pancreatic cancer. The immune microenvironment of pancreatic cancer is complex and strongly immunosuppressive. Immune cells such as tumor-associated macrophages and regulatory T cells can weaken the antitumor function of the immune system by secreting inhibitory factors, thereby enabling the tumor to evade immune surveillance. Meanwhile, immune escape is exacerbated by the infiltration of hypo-immune cells and the role of tumor-associated fibroblasts in the tumor microenvironment of pancreatic cancer. In response to these immune escape mechanisms, combining immunotherapy with targeted therapy has emerged as a focal point of current research. This review compiles the characteristics of the immune microenvironment in pancreatic cancer based on current literature, aiming to provide a basis and insights for related drug development.

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Diagnostic Treatment and Challenges of Combined Invasive Fungal Infections After Hematopoietic Stem Cell Transplantation for Hematological Neoplasms in Children

Zhi GUO

Cancer Research on Prevention and Treatment.2025;52(12):959-965. doi:10.3971/j.issn.1000-8578.2025.25.0766

Invasive fungal disease (IFD) has a high incidence in patients with hematologic malignancies who have undergone hematopoietic stem cell transplantation, particularly in children. IFD increases mortality and presents multiple challenges in diagnosis and treatment. Among these fungi, Aspergillus, Candida, and Trichoderma are the main pathogens. Infections caused by these fungi usually present with nonspecific symptoms such as fever and dyspnea, further complicating the diagnosis. Invasive Candida infections can manifest as candidemia or chronic disseminated candidiasis (eg. involving the liver and spleen). The latter condition can be accompanied by localized symptoms such as right upper quadrant tenderness and abdominal pain, which further complicates the early diagnosis of IFD. The early diagnosis and effective treatment of IFD after hematopoietic stem cell transplantation for pediatric hematologic neoplasms require multiple tools to overcome clinical challenges and improve patient prognosis.

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Current Status and Analysis of Multidisciplinary Team Model for Lung Cancer in China

Zixiao MA ; Zhijie WANG ; Jie WANG

Cancer Research on Prevention and Treatment.2025;52(12):966-972. doi:10.3971/j.issn.1000-8578.2025.25.0492

Objective To investigate the current status of multidisciplinary team (MDT) approaches in lung cancer management in China to provide a basis for the further promotion and enhancement of the MDT model. Methods From April 2023 to November 2023, physicians engaged in the clinical diagnosis and treatment of lung cancer were selected as the research objects. Questionnaires were distributed online and offline to investigate the cognition of MDT mode, MDT operating mode of their hospital, challenges faced, and direction of improvement. Descriptive analysis was conducted on the survey results. Results A total of 1137 questionnaires were collected, covering 816 general and cancer hospitals in 31 provinces and cities across the country. A total of 88.1% of doctors believe that the current MDT model is feasible, effective, and is of great value in benefiting patients’ survival, improving diagnosis and treatment efficiency, promoting diagnosis and treatment level and standardization, and increasing clinical research enrollment. Meanwhile, 83.5% of doctors state that their hospital has established an MDT team, including a chair and a coordinator, to ensure the smooth operation of the MDT and follow-up. The frequency of MDT is low and the time is long, usually 1–2 times a month and more than 30 minutes discussion time for each case. In addition, 50.1% of doctors indicate MDT cases account for less than 25% of annual diagnosis and treatment cases. Time coordination challenges and lack of administrative support and incentives are the difficulties affecting the operation of MDT. Having well-defined patient criteria is frequently cited as a key area for optimization that could remarkably enhance MDT efficiency. Conclusion After more than a decade of exploration and practice, the MDT model for lung cancer in China has been widely promoted and applied. Optimizing the selection, diagnosis, and treatment of MDT cases and providing administrative support and incentives are the key to enhancing the efficiency of MDT and expanding their benefits to a great number of patients with cancer.

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Advancements in Cell Membrane–Based Biomimetic Carriers for Antitumor Therapy

Jiahe WU ; Nan WANG ; Jianqing GAO ; Nengming LIN

Cancer Research on Prevention and Treatment.2025;52(12):973-979. doi:10.3971/j.issn.1000-8578.2025.25.0550

Drug delivery technologies are crucial components in drug development, greatly enhancing drug bioavailability and therapeutic efficacy and reducing toxic side effects. Cell membrane-based biomimetic carriers have attracted considerable interest owing to their intrinsic biointeractive capability derived from source cells in vivo. This review summarizes the fundamental properties and functional attributes of cell membrane–based biomimetic carriers from different cellular sources and discusses their advancements in tumor-targeted drug delivery and role in the activation of antitumor immunity. Ultimately, the discussion focuses on the prospects and potential challenges in employing cell membrane-based biomimetic carriers for antitumor treatment.

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Application and Prospects of BCL-2 Inhibitors in Acute Myeloid Leukemia

Zhen YAO ; Zheng LI ; Shengli XUE

Cancer Research on Prevention and Treatment.2025;52(12):980-987. doi:10.3971/j.issn.1000-8578.2025.25.0668

Research into the molecular biology of acute myeloid leukemia (AML) has facilitated the identification of therapeutic targets and the development of corresponding molecularly targeted drugs. The advent of the BCL-2 inhibitor venetoclax (VEN) concludes 50 years of stagnant clinical progress in AML and ushered in a new era of targeted therapy for this disease. Treatment regimens based on VEN had been applied to older patients and individuals unsuitable for intensive chemotherapy initially, but extensive studies on intensive and non-intensive clinical regimens incorporating VEN have confirmed its potential applicability to a broader patient demographic. This article systematically reviews the mechanism of action, resistance mechanisms, and optimization strategies of VEN in the context of AML.

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