Sara De Martino , Biagio Capasso , Luca Cis , Laura D’Orsi , Giulia Canali , Pasquale Capasso , Andrea De Gaetano , Paolo Mercantini , Domenico Mascagni , Carlo Gaetano , Antonella Farsetti , Elena Lo Presti
{"title":"Role of innate immunity in tumor microenvironment of HPV-associated anal cancer: The hypothetical beneficial role of γδ T cells.","authors":"Sara De Martino , Biagio Capasso , Luca Cis , Laura D’Orsi , Giulia Canali , Pasquale Capasso , Andrea De Gaetano , Paolo Mercantini , Domenico Mascagni , Carlo Gaetano , Antonella Farsetti , Elena Lo Presti","doi":"10.1016/j.critrevonc.2025.104771","DOIUrl":"10.1016/j.critrevonc.2025.104771","url":null,"abstract":"<div><div>HPV infection plays a crucial role in the formation of the tumor microenvironment, especially in tumors associated with the genital tract, anus, and oropharyngeal region. In this manuscript, we will discuss the main genetic characteristics of HPV and its transmission mechanisms, with a specific focus on the expression of the oncogenes E6 and E7. We will also address the major tumors HPV can generate and their associated epidemiology. In particular, persistent HPV infection induces the release of pro-inflammatory cytokines (such as IL-6 and IL-8), which promote angiogenesis and the recruitment of immunosuppressive immune cells. We will describe on the immune response to the infection, specifically in adaptive immunity, where the virus reduces the expression of MHC class I molecules on infected cells, preventing recognition by cytotoxic T cells. The innate immune response against HPV infection is often ineffective, allowing the virus to persist and contribute to tumor progression. The focus of this work will be on the innate response mediated by γδ T lymphocytes, a subset of CD3 + T cell. Indeed, they recognize HPV-infected cells without the need for antigen presentation by MHC molecules, secrete pro-inflammatory cytokines like IFN-γ and TNF-α, and directly kill HPV-infected cells through cytotoxic mechanisms. In summary, γδ T lymphocytes play an important role in the innate and adaptive immune response against HPV, but the effectiveness of their action can be reduced by the immune evasion mechanisms mediated by the virus. This may occur through the creation of an immunosuppressive environment with the release of immunosuppressive cytokines (such as IL-10 and TGF-β) that inhibit the function of these cells, allowing the virus to persist and contribute to tumor progression. This mechanism has not been well studied in the emerging anal cancer induced by HPV infection, so tracing the state of the art on these aspects could lead to an increase in research in this area and promote the creation of specific immunotherapies that enhance the role of these cells.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"212 ","pages":"Article 104771"},"PeriodicalIF":5.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silvia Belloni , Cristina Arrigoni , Arianna Magon , Chiara Giacon , Maria Helena Ceruso , Marco Alfredo Arcidiacono , Gianluca Conte , Rosario Caruso
{"title":"Symptomatologic outcomes of gut microbiota modifiers (probiotics, prebiotics and synbiotics) in cancer care: A scoping review of randomized controlled trials","authors":"Silvia Belloni , Cristina Arrigoni , Arianna Magon , Chiara Giacon , Maria Helena Ceruso , Marco Alfredo Arcidiacono , Gianluca Conte , Rosario Caruso","doi":"10.1016/j.critrevonc.2025.104779","DOIUrl":"10.1016/j.critrevonc.2025.104779","url":null,"abstract":"<div><h3>Background</h3><div>Microbiota modifiers offer potential benefits for improving the wide spectrum of symptoms and clinical outcomes in individuals with cancer. However, there is a lack of comprehensive literature mapping to determine which specific cancer and treatment-related symptoms have been investigated as potential targets for gut microbiota modifiers. This scoping review aims to systematically analyze clinical trials on microbiota modifiers in managing cancer and treatment-related symptoms in adults.</div></div><div><h3>Methods</h3><div>We conducted a scoping review of randomized controlled trials (RCTs) across four databases up to May 2025, following our published protocol and JBI principles with PRISMA 2020 guidelines.</div></div><div><h3>Results</h3><div>The literature review identified 33 eligible studies, primarily involving patients with pelvic cancers. The most common outcomes examined in the clinical trials were gastrointestinal symptoms. Other studies focused on patients with head, neck, and breast cancer, examining quality of life, mucositis, fatigue, anxiety, depression, and the use of rescue drugs.</div></div><div><h3>Conclusion</h3><div>Despite evidence of potential benefits for gastrointestinal symptoms, inconsistent findings across studies warrant further well-designed, large-scale research to understand probiotics' effectiveness and mechanisms.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"212 ","pages":"Article 104779"},"PeriodicalIF":5.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Radiosensitization strategies for hepatocellular carcinoma: Mechanisms, therapeutic advances, and clinical perspectives","authors":"Jiahui Yang , Rong Chen","doi":"10.1016/j.critrevonc.2025.104773","DOIUrl":"10.1016/j.critrevonc.2025.104773","url":null,"abstract":"<div><div>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, with treatment efficacy limited by late-stage diagnosis, frequent recurrence, and therapeutic resistance. Radiotherapy is a key local treatment for HCC; however, its efficacy is frequently limited by intrinsic tumor radioresistance. This review discusses strategies to improve the therapeutic response of HCC to radiotherapy. Targeting DNA repair mechanisms can block tumor cells from recovering after radiation-induced damage, whereas modulating cell cycle arrest and programmed cell death pathways (e.g., apoptosis, autophagy) diminishes their survival capacity. Furthermore, remodeling the tumor microenvironment—through hypoxia alleviation, metabolic reprogramming, oxidative stress regulation, and immune activation—may potentiate radiotherapy efficacy. Technological advances, such as stereotactic body radiotherapy and nanomaterial-based approaches, have also improved the precision and effectiveness of radiotherapy. Clinically, combining radiotherapy with systemic therapies (e.g., immune checkpoint inhibitors and antiangiogenic agents) has demonstrated preliminary promise in enhancing treatment outcomes. However, translating preclinical findings into clinical practice remains challenging due to tumor heterogeneity, normal tissue toxicity, and the lack of predictive biomarkers for treatment selection. Future research should focus on integrating molecular profiling with multimodal therapies to enable personalized radiosensitization and bridge the gap between mechanistic insights and clinical outcomes.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"213 ","pages":"Article 104773"},"PeriodicalIF":5.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Immunotherapy in microsatellite-stable colorectal cancer: Strategies to overcome resistance","authors":"Engeng Chen, Wei Zhou","doi":"10.1016/j.critrevonc.2025.104775","DOIUrl":"10.1016/j.critrevonc.2025.104775","url":null,"abstract":"<div><div>Colorectal cancer (CRC) is among the foremost causes of cancer-related mortality worldwide; however, individuals with microsatellite-stable (MSS) disease—who constitute most CRC diagnoses—derive limited benefit from existing immunotherapeutic approaches. Here, we outline emerging methods designed to address the inherent resistance of MSS CRC to immune checkpoint inhibitors (ICIs). Recent findings emphasize how the immunosuppressive tumor microenvironment (TME) in MSS CRC, marked by diminished immunogenicity and high levels of regulatory T cells and myeloid-derived suppressor cells, restricts effective antitumor immune activity. Combination regimens that merge ICIs with chemotherapy, anti-angiogenic agents, or targeted blockade of pathways such as TGF-β and VEGF have shown encouraging early outcomes, including enhanced antigen presentation and T-cell penetration. Novel immunomodulatory platforms—such as epigenetic modifiers, oncolytic viruses, and engineered probiotic vaccines—are under assessment to further reprogram the TME and boost therapeutic efficacy. Concurrently, progress in adoptive cell therapies (for example, chimeric antigen receptor (CAR) T cells) and the development of cancer vaccines targeting tumor-associated and neoantigens promise to extend immune control over MSS CRC. In parallel, improving patient selection through predictive biomarkers—from circulating tumor DNA (ctDNA) to gene expression signatures and specific molecular subtypes—could refine individualized treatment strategies. Finally, interventions that alter the gut microbiome, including probiotics and fecal transplantation, serve as complementary tools to strengthen ICI responses. Taken together, these insights and combined treatment strategies lay the foundation for more successful immunotherapeutic interventions in MSS CRC, ultimately aiming to provide sustained clinical benefits to a broader spectrum of patients.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"212 ","pages":"Article 104775"},"PeriodicalIF":5.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Immunotherapy in primary hormone-receptor positive breast cancer: A systematic review","authors":"Maria-Theodora Melissari , Alkistis Papatheodoridi , Athanasios Argyriadis , Maria Kaparelou , Meletios Athanasios Dimopoulos , Flora Zagouri","doi":"10.1016/j.critrevonc.2025.104768","DOIUrl":"10.1016/j.critrevonc.2025.104768","url":null,"abstract":"<div><div>Hormone-receptor positive (HR+), HER2 negative breast cancer (BC) is considered immunologically silent, thus investigation of immunotherapy in this subtype has evolved slower. This systematic review offers an overview of the clinical trials investigating the safety and efficacy of ICI in primary HR+ /HER2- BC. Literature search was conducted up to October 30, 2022 to identify immunotherapy trials with checkpoint inhibitors in non-metastatic HR+ /HER2- breast cancer. 39 trials were identified, mainly in early-phase clinical trials. None of the trials investigate ICI monotherapy and only 2 Phase 3 clinical trials are ongoing. Most trials investigate the use of ICI in the neoadjuvant setting in combination with chemotherapy. 18 trials have reported results and 6 of them efficacy results specifically for HR+ /HER2- BC. ICI could be a promising therapeutic strategy for HR+ /HER2- BC, however clinical benefit is restricted to subgroups of patients, depending on tumor molecular profile.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"212 ","pages":"Article 104768"},"PeriodicalIF":5.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eman H. Yousef , Amal M. El Gayar , Nada F. Abo El-Magd
{"title":"Insights into Sorafenib resistance in hepatocellular carcinoma: Mechanisms and therapeutic aspects","authors":"Eman H. Yousef , Amal M. El Gayar , Nada F. Abo El-Magd","doi":"10.1016/j.critrevonc.2025.104765","DOIUrl":"10.1016/j.critrevonc.2025.104765","url":null,"abstract":"<div><div>The most prevalent primary hepatic cancer, hepatocellular carcinoma (HCC), has a bad prognosis. HCC prevalence and related deaths have increased in recent decades. Food and Drug Administration (FDA) has licensed Sorafenib as a first-line treatment for individuals with advanced HCC. Despite this, some clinical studies indicate that a significant percentage of liver cancer patients exhibit insensitivity to sorafenib. Furthermore, the overall effectiveness of sorafenib is far from adequate, and the number of patients who benefit from therapy is low. In recent years, many researchers have focused on the mechanisms underlying sorafenib resistance. Acquired resistance to sorafenib in HCC cells has been reported to be facilitated by dysregulation of signal transducer and activator of transcription 3 (STAT3) activation, angiogenesis, autophagy, hypoxia-induced pathways, epithelial-mesenchymal transition (EMT), cancer stem cells (CSCs), ferroptosis, and non-coding RNAs (ncRNAs). Recent clinical trials, including comparisons of sorafenib with immune checkpoint inhibitors like tislelizumab, have shown promise in improving patient outcomes. Additionally, combination therapies targeting complementary pathways are under investigation to overcome resistance and enhance treatment efficacy. The limitation of Sorafenib's effectiveness has been partially but not completely clarified. Furthermore, while certain regimens have demonstrated positive results, more clinical trials are required to confirm them. Future research should focus on identifying predictive biomarkers for therapy response, targeting the tumor microenvironment, and exploring novel therapeutic agents and personalized medicine strategies. A deeper understanding of these mechanisms will be essential for developing more effective therapeutic approaches and improving the prognosis of patients with advanced HCC. This article discusses strategies that may be employed to enhance the success of treatment and summarizes new research on the possible pathways that lead to sorafenib resistance.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"212 ","pages":"Article 104765"},"PeriodicalIF":5.5,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Glioblastoma: Molecular features, emerging molecular targets and novel therapeutic strategies","authors":"Anastasios Politis , Lampis Stavrinou , Aristotelis Kalyvas , Efstathios Boviatsis , Christina Piperi","doi":"10.1016/j.critrevonc.2025.104764","DOIUrl":"10.1016/j.critrevonc.2025.104764","url":null,"abstract":"<div><div>Glioblastomas (GBMs) constitute the most common malignant tumors of the Central Nervous System (CNS) with a complex molecular, genetic and histological profile and extensive heterogenicity. GBMs are notoriously difficult to treat, with morbidity and mortality rate that remain high and practically unchanged, despite the aggressive and multimodal treatment strategies. Keeping up with current research and emerging scientific data is of primary importance for the detection of new molecular targets, enabling the design of novel therapeutic strategies. Herein, we discuss current data on the cellular and molecular features that contribute to GBM pathophysiological mechanisms in an effort to reveal emerging molecular targets with therapeutic potential as well as effective immunotherapeutic approaches, including chimeric antigen receptor (CAR) T-cell therapy and adaptive immune modulation with immune checkpoint inhibitors. Enhanced drug delivery strategies such as ultrasound-assisted technologies to overcome drug resistance are also discussed, aiming to provide an overall translational perspective that bridges molecular insights with practical therapeutic implications.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"212 ","pages":"Article 104764"},"PeriodicalIF":5.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caique Mariano Pedroso , Mariana de Pauli Paglioni , Ana Gabriela Costa Normando , Aline Lauda Freitas Chaves , Luiz Paulo Kowalski , Gilberto de Castro Júnior , Leandro Luongo Matos , William Nassib Willian Junior , Thiago Bueno de Oliveira , Pedro de Marchi , Guilherme Harada , Milena Perez Mak , Carmen Silvia Passos Lima , Gustavo Arruda Viani , Fabio Ynoe Moraes , Andre Guimaraes Gouveia , Alan Roger Santos-Silva , Gustavo Nader Marta , On behalf of Latin American Cooperative Oncology Group (LACOG) - Head and Neck and Brazilian Group of Head and Neck Cancer (GBCP)
{"title":"Preoperative neoadjuvant chemotherapy or immunotherapy in head and neck cancer: A systematic review and meta-analysis of surgical risk and pathologic response","authors":"Caique Mariano Pedroso , Mariana de Pauli Paglioni , Ana Gabriela Costa Normando , Aline Lauda Freitas Chaves , Luiz Paulo Kowalski , Gilberto de Castro Júnior , Leandro Luongo Matos , William Nassib Willian Junior , Thiago Bueno de Oliveira , Pedro de Marchi , Guilherme Harada , Milena Perez Mak , Carmen Silvia Passos Lima , Gustavo Arruda Viani , Fabio Ynoe Moraes , Andre Guimaraes Gouveia , Alan Roger Santos-Silva , Gustavo Nader Marta , On behalf of Latin American Cooperative Oncology Group (LACOG) - Head and Neck and Brazilian Group of Head and Neck Cancer (GBCP)","doi":"10.1016/j.critrevonc.2025.104742","DOIUrl":"10.1016/j.critrevonc.2025.104742","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review and meta-analysis aimed to evaluate surgical complications, pathologic responses, and disease progression in patients with head and neck squamous cell carcinoma treated with neoadjuvant chemotherapy or immunotherapy.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conduct across four databases (PubMed, Embase, Cochrane Library, and Scopus) and grey literature sources to identify neoadjuvant therapies in head and neck cancer patients. Only prospective clinical trials were included. The certainty of evidence was appraised using GRADE tool.</div></div><div><h3>Results</h3><div>A total of 12 clinical trials me the inclusion criteria, comprising, six studies on neoadjuvant chemotherapy (Cisplatin and 5-FU) and six on immunotherapy (Nivolumab, Nivolumab plus Ipilimumab, Pembrolizumab) were analyzed. The mean time from drug administration to surgery ranged from 18 to 29 days. The overall surgical complication rate was 32.8 %, with the lowest observed in the Pembrolizumab group (9 %) and the highest in the Nivolumab plus Ipilimumab group (36.7 %). However, risk ratios for surgical complications were not statistically significant for Nivolumab (RR = 1.68, p = 0.078) or chemotherapy (RR = 1.1, p = 0.70). The complete pathologic response (pCR) rate was low (4 %), highest in the Cisplatin and 5-FU group (11 %). In contrast, the partial pathologic response (pPR) rate reached 58 % with Nivolumab plus Ipilimumab. Disease progression after surgery occurred in 19.4 %, with the lowest progression rate observed in the Nivolumab plus Ipilimumab group (7.7 %). The certainty of evidence was rated as very low for chemotherapy and low for immunotherapy.</div></div><div><h3>Conclusion</h3><div>Combination immunotherapy, particularly Nivolumab with Ipilimumab, demonstrated favorable pPR rates and reduced disease progression but was increased surgical complications. The overall low pCR across all regimen treatments highlight the need for improved therapeutic strategies.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"212 ","pages":"Article 104742"},"PeriodicalIF":5.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xinyun Chu , Ning Pu , Xue Yang , Yuqi Xie , Liang Liu , Yun Jin
{"title":"Subtypes of tumor-associated neutrophils and their roles in cancer immunotherapy","authors":"Xinyun Chu , Ning Pu , Xue Yang , Yuqi Xie , Liang Liu , Yun Jin","doi":"10.1016/j.critrevonc.2025.104763","DOIUrl":"10.1016/j.critrevonc.2025.104763","url":null,"abstract":"<div><div>Neutrophils are essential components of the innate immune system. Tumor-associated neutrophils (TANs) are shaped by tumor microenvironment (TME), leading to significant heterogeneity in biological characteristics and functions. Recent advances in single-cell sequencing have revealed a wide array of TAN subtypes, while a comprehensive classification system is still lacking. This review aims to summarize the alterations observed in TAN subgroups following cancer immunotherapy, and identify the distinctions and commonalities between pro-tumor and anti-tumor subgroups. Current progress of preclinical and clinical studies is also highlighted, involving novel therapies targeting TANs.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"212 ","pages":"Article 104763"},"PeriodicalIF":5.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}