Volume 03 · Issue 05 · 2025

2025年，中华医学会（CMA）迎来成立110周年的重要里程碑。这个成立于1915年的医学组织，历经百年沧桑，始终秉承“团结医学专业人士，推进医学科学技术”的使命，已成为中国医学发展的核心动力之一。¹2024年爱思唯尔高被引中国研究者榜于2025年3月发布，我很荣幸连续第五年入选该榜单。²这一荣誉不仅代表了对我学术生涯的高度认可，也充分展示了CMA作为支持中国肿瘤学科发展和人才培养的平台的强大能力。作为主编癌症发病机制与治疗作为中国医学科学院北京协和医学院的终身教授，我在肿瘤学领域深耕40多年，与CMA的发展紧密相连、同步。

Breast cancer remains one of the leading causes of cancer-related morbidity and mortality among women worldwide, necessitating the development of novel therapeutic strategies. Phytoconstituents, naturally plant-derived bioactive compounds, have emerged as promising agents for breast cancer therapy due to their multifaceted mechanisms of action. This review examines the role of phytoconstituents in inducing apoptosis, inhibiting breast cancer cell proliferation, and suppressing metastasis. Furthermore, the anti-angiogenic effects of these compounds are discussed, highlighting their potential to disrupt tumor vascularization. We also summarize the in vitro and in vivo study-derived preclinical evidence supporting the efficacy of phytoconstituents. The synergistic potential of phytoconstituents with conventional therapies is also explored, emphasizing their ability to enhance treatment efficacy while minimizing adverse effects. We also address the challenges and limitations in the clinical application of phytoconstituents, paving the way for future research. This review provides insights into the therapeutic potential of phytoconstituents in breast cancer and their underlying mechanisms, advocating for their integration into existing treatment regimens.

Collagen contributes to extracellular matrix formation and stiffness, providing a three-dimensional framework that supports the development and growth of solid tumors. By interacting with specific tumor cell receptors, collagen influences tumor cell signaling pathways, promoting cancer progression and drug resistance. Recent advancements in understanding the tumor extracellular matrix have underscored collagen's role in fostering an immunosuppressive tumor microenvironment (TME) and acting as a barrier to immunotherapy. Understanding the immunosuppressive mechanisms of collagen in the TME has revealed novel therapeutic targets and opportunities. This review highlights the immunoregulatory functions of collagen in the TME and provides a comprehensive overview of integrating collagen scores with traditional immunoscore-based immunotyping methods to enhance response prediction. Additionally, we discuss recent therapeutic developments in collagen targeting and their clinical potential for enhancing anti-cancer immunity.

Breast cancer metastasis and relapse remain uncontrollable despite significant advancements in early diagnosis and treatment, resulting in increased mortality. Breast cancer is the most frequently diagnosed cancer in women worldwide and has become the leading cause of cancer-related deaths. Cancer stem cells (CSCs) may play significant roles in tumor initiation, maintenance, invasion, relapse, metastasis, and therapy resistance. Although this small, highly heterogeneous, and restricted population of CSCs has been extensively studied, their cellular and molecular physiology remains unclear. Nonetheless, CSCs have increasingly become an attractive therapeutic target for combating advanced, treatment-resistant cancers. This necessitates the development of effective and reliable methods for their isolation and enrichment. This review provides an overview of the key characteristics of breast cancer stem cells (BCSCs) and illustrates their role in therapeutic resistance. Furthermore, it highlights various mechanisms underlying cancer cell adaptability and therapy-induced resistance across different breast cancer subtypes. The commonly used methods for BCSC isolation and identification are also discussed, as they could facilitate a deeper understanding of tumorigenesis, metastasis, resistance, and relapse, consequently contributing to the development of more effective therapeutic strategies for breast cancer.

Oral cancer pathogenesis is significantly influenced by Candida species, especially C. albicans, through chronic inflammation and cellular dysregulation. Epidemiological studies highlight a strong correlation between persistent Candida infections and oral carcinogenesis. Experimental evidence has identified key biomolecular mechanisms, including biofilm formation, epithelial invasion, and immune evasion. Chronic inflammation induced by Candida fosters a pro-tumorigenic environment characterized by oxidative stress, cytokine imbalance, and genomic instability. Animal models of Candida-induced oral lesions offer insights into premalignant conditions, and case series studies further support the association between fungal infections and oral cancer. This review critically examines the role of Candida, particularly C. albicans, in oral squamous cell carcinoma (OSCC) pathogenesis by analyzing epidemiological, experimental, and mechanistic data. We emphasize the importance of early detection and therapeutic strategies, including antifungal prophylaxis, to manage Candida colonization in cancer patients. A comprehensive literature search of studies published between 2015 and 2025 was conducted using Pub Med, Scopus, and Web of Science. Key findings were synthesized to understand the relationship between Candida infections and OSCC. The persistent Candida infections create a pro-tumorigenic microenvironment that accelerates dysplastic changes and malignant progression, particularly in high-risk individuals. While the direct causative relationship is complex, the combined effects of Candida, tobacco, alcohol use, and immunosuppression are significant in oral carcinogenesis. Early detection, antifungal treatments, and personalized therapies are essential to improving patient outcomes. A multidisciplinary approach involving oncologists, microbiologists, and immunologists is crucial for developing integrated strategies to manage both Candida infections and cancer. Future research should focus on dual-action therapies targeting both Candida-induced inflammation and tumor progression.

Volatile organic compounds (VOCs) are carbon-based chemicals characterized by high vapor pressure and low boiling points under standard temperature and pressure conditions. VOCs are categorized as exogenous or endogenous, depending on their source. Endogenous VOCs are metabolic byproducts eliminated via respiration. These compounds serve as indicators of human metabolic activity, reflecting differences in tumors compared to normal cell metabolism and the body's response to tumors. Examination of exhaled breath provides a noninvasive approach for assessing metabolic status by comparing VOC levels. Consequently, VOCs are increasingly studied as novel biomarkers for cancer screening, diagnosis, and treatment efficacy prediction. This review outlines VOC production mechanisms, their presence in tumor types, detection methodologies, and their implications for tumor screening, diagnosis, and prognosis. Nonetheless, challenges remain in the utilization of VOCs for cancer diagnosis and predicting treatment outcomes. Furthermore, this review discusses unresolved issues requiring attention to improve malignant tumor assessment, providing insights into their diagnosis, treatment, and prognosis.

Colorectal cancer (CRC) is a complex, heterogeneous disease characterized by frequent relapses and metastasis. Previous studies have reported that the invasion and progression of CRC in several cases can be controlled by targeting fusion genes. This study aimed to screen for potent fusion transcripts as potential molecular biomarkers and therapeutic targets for metastatic CRC (mCRC) using an in silico approach.

RNA sequencing (RNA-seq) data from 18 patients with primary CRC and matched normal and mCRC samples were derived from the same patient set. Novel fusion transcripts were screened using the Kallisto and Pizzly software, followed by Gene Ontology (GO), pathway analysis, transcription factor enrichment, and survival for functional enrichment analysis. Furthermore, the fusion transcripts’ utility as biomarkers was evaluated using a pan-cancer analysis.

In total, 32 fusion genes unique to mCRC were identified. Hub gene analysis identified 17 novel fusion transcripts, and GO analysis revealed that these genes were enriched in different biological and molecular functions. Pathways significantly correlated with CRC included the complement and coagulation cascades, ferroptosis, interleukin-17 (IL-17) signaling pathway, and estrogen signaling pathway. We identified albumineukaryotic translation elongation factor 1 alpha 1 (ALB-EEF1A1) as unique to mCRC based on significant gene expression and survival outcomes. Moreover, its utility as a prognostic biomarker was confirmed using a pancancer analysis.

ALB-EEF1A1 may play a pivotal role in the metastatic transformation of primary CRC and significantly increase the risk of death. The identified ALB-EEF1A1 fusion transcripts are promising novel molecular targets that may serve as prognostic and diagnostic biomarkers and treatment targets for mCRC in the future.

The health-related quality of life (HRQoL), economic burden, and diagnostic and treatment status of Chinese patients with mycosis fungoides (MF) and Sézary syndrome (SS) remain largely unknown. This study assessed patient characteristics, HRQoL, and economic burden among Chinese patients with MF and SS through a cross-sectional survey.

Eligible patients were aged ≥18 years with a pathologically confirmed diagnosis of MF or SS and were either currently receiving or had received disease-specific treatment within the past year. Patients completed a paper-based quantitative survey covering four components: patient demographics, diagnosis and treatment journey, economic burden, and HRQoL instrument.

Between July 21, 2022, and October 24, 2022, 61 eligible patients participated in this study, of whom 91.8% (56/61) had MF and 8.2% (5/61) had SS. The total cost for patients with MF and SS was Chinese Yuan (CNY) 86,729 (US Dollar [USD] 12,425). The total cost for patients with early-stage disease was significantly lower than that for patients with advanced-stage disease (CNY 43,379 vs. 128,681, P < 0.001). The direct cost for MF and SS patients was CNY 72,467 (USD 10,382). The direct cost for patients with early-stage disease was significantly lower than that for patients with advanced-stage disease (CNY 29,018 vs. 114,514, P < 0.001). The direct medical cost for MF and SS patients was CNY 65,524 (USD 9387). The direct medical cost for patients with early-stage disease was significantly lower than that for patients with advanced-stage disease (CNY 23,069 vs. 106,609, P < 0.001). Regarding HRQoL, the mean (standard deviation [SD]) score of Chinese time trade-off values for 5-level EQ-5D (EQ-5D-5L) health states was 0.79 (0.18) for all respondents. The mean utility score for advanced-stage patients was significantly lower than that of early-stage patients (advanced-stage: 0.73 [0.18] vs. early-stage: 0.84 [0.16], P = 0.010). On the Functional Assessment of Cancer Therapy-General (FACT-G) scale, the mean (SD) score for all patients with MF or SS was 61.3 (12.4). Advanced-stage patients had lower mean scores than early-stage patients, indicating poorer HRQoL (early-stage: 65.50 [13.48] vs. advanced-stage: 57.26 [9.96], P = 0.009). For the Skindex-29 instrument, the mean (SD) score was 43.4 (24.2).

Chinese patients with MF or SS, especially advanced-stage patients, experience high economic burden and compromised HRQoL, which underscore the need for improved access to affordable treatments and supportive care measures to reduce the financial burden and enhance the well-being of these patients. Healthcare policies and interventions should prioritize early diagnosis and effective management to improve the treatment outcome and reduce its associated costs.

Stereotactic body radiotherapy (SBRT) is an effective treatment for early-stage non-small cell lung cancer. However, patient breathing can affect treatment accuracy. Therefore, this study aimed to develop a bi-polar (BP) gated motion management strategy for SBRT and evaluate its feasibility geometrically and dosimetrically.

The BP strategy involved instructing patients to hold their breath briefly at the end of both inhalation (EI) and exhalation (EE), with radiation delivered only during these breath-holding periods. Eight volunteers were included to evaluate breathing stability, repeatability, and patient comfort. Additionally, 15 patients were retrospectively studied to evaluate the geometric and dosimetric efficiency of BP in intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) modes. BP plans were compared with four common breathing strategies: free breathing (FB), gating at the end of inhalation (GI), gating at the end of exhalation (GE), and real-time tracking (RT).

Volunteers could comfortably hold their breath for >3 minutes, demonstrating good stability and repeatability. Geometrically, the ratio of BP's internal target volume (ITV) to GI's ITV was the smallest at 0.65, compared to 1.89 for FB, 1.05 for GE, and 0.68 for RT. In the dosimetric evaluation of IMRT plans, the lung V_20Gy ratio for BP to GI was the smallest at 0.89. Similar trends were observed for VMAT plans.

The BP strategy is a feasible option for lung SBRT, offering reduced treatment volumes and normal tissue toxicity, with a high duty cycle and less technical complexity than other RT-based methods.

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