1.Prediction of immunotherapy targets for chronic cerebral hypoperfusion by bioinformatics method.
Mei ZHAO ; Yanpeng XUE ; Qingqing TIAN ; He YANG ; Qing JIANG ; Mengfan YU ; Xin CHEN
Journal of Biomedical Engineering 2025;42(2):382-388
Chronic cerebral hypoperfusion (CCH) plays an important role in the occurrence and development of vascular dementia (VD). Recent studies have indicated that multiple stages of immune-inflammatory response are involved in the process of cerebral ischemia, drawing increasing attention to immune therapies for cerebral ischemia. This study aims to identify potential immune therapeutic targets for CCH using bioinformatics methods from an immunological perspective. We identified a total of 823 differentially expressed genes associated with CCH, and further screened for 9 core immune-related genes, namely RASGRP1, FGF12, SEMA7A, PAK6, EDN3, BPHL, FCGRT, HSPA1B and MLNR. Gene enrichment analysis showed that core genes were mainly involved in biological functions such as cell growth, neural projection extension, and mesenchymal stem cell migration. Biological signaling pathway analysis indicated that core genes were mainly involved in the regulation of T cell receptor, Ras and MAPK signaling pathways. Through LASSO regression, we identified RASGRP1 and BPHL as key immune-related core genes. Additionally, by integrating differential miRNAs and the miRwalk database, we identified miR-216b-5p as a key immune-related miRNA that regulates RASGRP1. In summary, the predicted miR-216b-5p/ RASGRP1 signaling pathway plays a significant role in immune regulation during CCH, which may provide new targets for immune therapy in CCH.
Humans
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Computational Biology/methods*
;
Brain Ischemia/therapy*
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Immunotherapy
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MicroRNAs/genetics*
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Signal Transduction
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Dementia, Vascular/genetics*
;
Chronic Disease
2.Tonic signaling in CAR-T therapy: the lever long enough to move the planet.
Frontiers of Medicine 2025;19(3):391-408
Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable efficacy in treating hematological malignancies and is expanding into other indications such as autoimmune diseases, fibrosis, aging and viral infection. However, clinical challenges persist in treating solid tumors, including physical barriers, tumor heterogeneity, poor in vivo persistence, and T-cell exhaustion, all of which hinder therapeutic efficacy. This review focuses on the critical role of tonic signaling in CAR-T therapy. Tonic signaling is a low-level constitutive signaling occurring in both natural and engineered antigen receptors without antigen stimulation. It plays a pivotal role in regulating immune cell homeostasis, exhaustion, persistence, and effector functions. The "Peak Theory" suggests an optimal level of tonic signaling for CAR-T function: while weak tonic signaling may result in poor proliferation and persistence, excessively strong signaling can cause T cell exhaustion. This review also summarizes the recent progress in mechanisms underlying the tonic signaling and strategies to fine-tune the CAR tonic signaling. By understanding and precisely modulating tonic signaling, the efficacy of CAR-T therapies can be further optimized, offering new avenues for treatment across a broader spectrum of diseases. These findings have implications beyond CAR-T cells, potentially impacting other engineered immune cell therapies such as CAR-NK and CAR-M.
Humans
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Immunotherapy, Adoptive/methods*
;
Receptors, Chimeric Antigen/immunology*
;
Signal Transduction/immunology*
;
T-Lymphocytes/immunology*
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Neoplasms/immunology*
;
Animals
3.Multifaceted function of B cells in tumorigenesis.
Na KANG ; Qinghui DUAN ; Xin MIN ; Tong LI ; Yuxin LI ; Ji GAO ; Wanli LIU
Frontiers of Medicine 2025;19(2):297-317
B lymphocytes (B cells) play a complex and paradoxical role in tumorigenesis. They can recognize tumor-associated antigens, present these antigens to T cells, and produce antibodies that directly target and eliminate tumor cells. This makes B cells a potentially powerful ally in combating cancer. However, B cells also exhibit immunosuppressive functions, secreting cytokines like IL-10 or generating tumor-promoting antibodies that dampen the anti-tumor immune response, and some tumor cells have even been shown to exploit B cells to promote their growth and metastasis. This dual nature of B cells presents both opportunities and challenges for tumor immunotherapy. In this review, we summarize the mechanisms underlying the multifaceted functions of B cells and their current applications in cancer immunotherapy. Furthermore, we also explore the key issues and future directions in this field, emphasizing the need for further research to fully harness the anti-tumor potential of B cells in the fight against cancer.
Humans
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B-Lymphocytes/immunology*
;
Neoplasms/therapy*
;
Carcinogenesis/immunology*
;
Immunotherapy/methods*
;
Animals
4.Development of therapeutic cancer vaccines based on cancer immunity cycle.
Jing ZHANG ; Yiyuan ZHENG ; Lili XU ; Jing GAO ; Ziqi OU ; Mingzhao ZHU ; Wenjun WANG
Frontiers of Medicine 2025;19(4):553-599
Therapeutic cancer vaccines have experienced a resurgence over the past ten years. Cancer vaccines are typically designed to enhance specific stages of the cancer-immunity cycle, primarily by activating the immune system to promote tumor regression and overcome immune resistance. In this review, we summarize the significant recent advancements in cancer immunotherapy based on the cancer-immunity cycle, including the effector cell function, infiltration, initiation, and exhaustion. We summarize the identification of tumor antigens and their delivery through cancer vaccines. We discuss how specific stages of the cancer-immunity cycle have been leveraged to augment anti-tumor immune responses and improve vaccine efficacy. Additionally, the impact of aging and myelosuppression, two prevalent forms of immunological stress, on the effectiveness of therapeutic cancer vaccines is deliberated. Finally, we summarize the current status of various therapeutic cancer vaccines at different clinical trial phases.
Humans
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Cancer Vaccines/therapeutic use*
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Neoplasms/therapy*
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Immunotherapy/methods*
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Antigens, Neoplasm/immunology*
;
Animals
5.Predictive biomarkers for immunotherapy in nasopharyngeal carcinoma: from tumor microenvironment to macroenvironment.
Saiwei HUANG ; Yelin LIANG ; Na LIU ; Jun MA
Frontiers of Medicine 2025;19(5):721-742
The introduction of PD-1 blockades to chemotherapy and radiotherapy has shown promising outcomes in patients with nasopharyngeal carcinoma, but anti-PD-1 therapies are only effective in a small proportion of patients, indicating the need for reliable predictive biomarkers of benefit from immunotherapy. Here, we summarized recent advances in immunotherapy for nasopharyngeal carcinoma and studies on potential predictors that correlated with treatment response or long-term survival after immunotherapy, including biomarkers in both the tumor microenvironment and the tumor macroenvironment. Some of these biomarkers have been validated as truly predictive of immunotherapy benefit using cohorts from randomized controlled trials, while others still require further validation of their predictive value. We also summarized the challenges and future directions of biomarker studies, hopefully facilitating the development of predictive biomarkers for immunotherapy that can eventually enter clinical practice.
Humans
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Tumor Microenvironment/immunology*
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Nasopharyngeal Carcinoma/immunology*
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Immunotherapy/methods*
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Nasopharyngeal Neoplasms/immunology*
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Biomarkers, Tumor/metabolism*
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Immune Checkpoint Inhibitors/therapeutic use*
6.Precision medicine for advanced biliary tract cancer in China: current status and future perspectives.
Zhen HUANG ; Wen ZHANG ; Yongkun SUN ; Dong YAN ; Xijie ZHANG ; Lu LIANG ; Hong ZHAO
Frontiers of Medicine 2025;19(5):743-768
Biliary tract cancer (BTC) is a rare group of malignancies that develop from the epithelial lining of the biliary tree and have a poor prognosis. Although chemotherapy is the standard of care for patients with advanced BTC in China, its clinical benefits are moderate. In recent years, the approval of targeted therapies and immunotherapies has provided new avenues for the management of advanced BTC. Nonetheless, the increasing number of personalized medicine approaches has created a challenge for clinicians choosing individualized treatment strategies based on tumor characteristics. In this article, we discuss recent progress in implementing precision medicine approaches for advanced BTC in China and examine genomic profiling studies in Chinese patients with advanced BTC. We also discuss the challenges and opportunities of using precision medicine approaches, as well as the importance of considering population-specific factors and tailoring treatment approaches to improve outcomes for patients with BTC. In addition to providing a comprehensive overview of current and emerging precision medicine approaches for the management of advanced BTC in China, this review article will support clinicians outside of China by serving as a reference regarding the role of patient- and population-specific factors in clinical decision-making for patients with this rare malignancy.
Humans
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Precision Medicine/methods*
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Biliary Tract Neoplasms/genetics*
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China
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Molecular Targeted Therapy
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Immunotherapy/methods*
7.Advances in Immunotherapy for Head and Neck Squamous Cell Carcinoma.
Acta Academiae Medicinae Sinicae 2025;47(5):850-862
Head and neck squamous cell carcinoma(HNSCC) associated with a poor prognosis and diminished quality of life for patients is the most prevalent pathological type among head and neck tumors. Currently,the standard treatment modalities comprise systemic therapies(including chemotherapy,targeted therapy,and immunotherapy) and local therapies(surgery and radiotherapy).Immunotherapy,characterized by high specificity and low toxicity,is progressively expanding from advanced palliative care to the stage of locally advanced curative treatment and has demonstrated promising efficacy.This review summarizes the latest advances in immunotherapy for HNSCC,aiming to provide reference for optimizing clinical management strategies and facilitating the clinical research.
Humans
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Immunotherapy/methods*
;
Head and Neck Neoplasms/immunology*
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Squamous Cell Carcinoma of Head and Neck/therapy*
8.The East Asian gut microbiome and its role in oncology: a narrative review.
Evelyn Yi Ting WONG ; Jonathan Wei Jie LEE ; Jeremy Fung Yen LIM ; Han Chong TOH
Singapore medical journal 2025;66(8):426-430
The field of onco-microbiome is rapidly expanding. Multiple studies have shown the crucial role of gut microbiota in the regulation of nutrient metabolism, immunomodulation and protection against pathogens. Tools for manipulating the gut microbiota include dietary modification and faecal microbiota transfer. Accumulating evidence has also documented the application of specific intestinal microbiome in cancer immunotherapy, notably in enhancing the efficacy of immune checkpoint inhibitors. The aim of this review is to focus on the East Asian microbiome and to provide a current overview of microbiome science and its clinical application in cancer biology and immunotherapy.
Humans
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Gastrointestinal Microbiome
;
Neoplasms/microbiology*
;
Immunotherapy/methods*
;
Asia, Eastern
;
Medical Oncology
;
Fecal Microbiota Transplantation
;
Immune Checkpoint Inhibitors/therapeutic use*
;
East Asian People
9.Role of radiotherapy in extensive-stage small cell lung cancer after durvalumab-based immunochemotherapy: A retrospective study.
Lingjuan CHEN ; Yi KONG ; Fan TONG ; Ruiguang ZHANG ; Peng DING ; Sheng ZHANG ; Ye WANG ; Rui ZHOU ; Xingxiang PU ; Bolin CHEN ; Fei LIANG ; Qiaoyun TAN ; Yu XU ; Lin WU ; Xiaorong DONG
Chinese Medical Journal 2025;138(17):2130-2138
BACKGROUND:
The purpose of this study was to evaluate the safety and efficacy of subsequent radiotherapy (RT) following first-line treatment with durvalumab plus chemotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC).
METHODS:
A total of 122 patients with ES-SCLC from three hospitals during July 2019 to December 2021 were retrospectively analyzed. Inverse probability of treatment weighting (IPTW) analysis was performed to address potential confounding factors. The primary focus of our evaluation was to assess the impact of RT on progression-free survival (PFS) and overall survival (OS).
RESULTS:
After IPTW analysis, 49 patients received durvalumab plus platinum-etoposide (EP) chemotherapy followed by RT (Durva + EP + RT) and 72 patients received immunochemotherapy (Durva + EP). The median OS was 17.2 months vs . 12.3 months (hazard ratio [HR]: 0.38, 95% confidence interval [CI]: 0.17-0.85, P = 0.020), and the median PFS was 8.9 months vs . 5.9 months (HR: 0.56, 95% CI: 0.32-0.97, P = 0.030) in Durva + EP + RT and Durva + EP groups, respectively. Thoracic radiation therapy (TRT) resulted in longer OS (17.2 months vs . 14.7 months) and PFS (9.1 months vs . 7.2 months) compared to RT directed to other metastatic sites. Among patients with oligo-metastasis, RT also showed significant benefits, with a median OS of 17.4 months vs . 13.7 months and median PFS of 9.8 months vs . 5.9 months compared to no RT. Continuous durvalumab treatment beyond progression (TBP) prolonged OS compared to patients without TBP, in both the Durva + EP + RT (NA vs . 15.8 months, HR: 0.48, 95% CI: 0.14-1.63, P = 0.238) and Durva + EP groups (12.3 months vs . 4.3 months, HR: 0.29, 95% CI: 0.10-0.81, P = 0.018). Grade 3 or 4 adverse events occurred in 13 (26.5%) and 13 (18.1%) patients, respectively, in the two groups; pneumonitis was mostly low-grade.
CONCLUSION
Addition of RT after first-line immunochemotherapy significantly improved survival outcomes with manageable toxicity in ES-SCLC.
Humans
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Small Cell Lung Carcinoma/therapy*
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Retrospective Studies
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Male
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Female
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Middle Aged
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Lung Neoplasms/therapy*
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Aged
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Antibodies, Monoclonal/therapeutic use*
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Adult
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Immunotherapy/methods*
;
Aged, 80 and over
10.Engineering and targeting potential of CAR NK cells in colorectal cancer.
Muhammad Babar KHAWAR ; Ali AFZAL ; Shuangshuang DONG ; Yue SI ; Haibo SUN
Chinese Medical Journal 2025;138(13):1529-1539
Colorectal cancer (CRC), a major global health concern, necessitates innovative treatments. Chimeric antigen receptor (CAR) T cells have shown promises, yet they grapple with challenges. The spotlight pivots to the rising heroes: CAR natural killer (NK) cells, offering advantages such as higher safety profiles, cost-effectiveness, and efficacy against solid tumors. Nevertheless, the specific mechanisms underlying CAR NK cell trafficking and their interplay within the complex tumor microenvironment require further in-depth exploration. Herein, we provide insights into the design and engineering of CAR NK cells, antigen targets in CRC, and success in overcoming resistance mechanisms with an emphasis on the potential for clinical trials.
Colorectal Neoplasms/immunology*
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Humans
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Killer Cells, Natural/metabolism*
;
Receptors, Chimeric Antigen/genetics*
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Immunotherapy, Adoptive/methods*
;
Tumor Microenvironment/immunology*
;
Animals

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