Cancers最新文献

{"title":"Renal Autotransplantation for Resection of Bilateral Nephroblastoma and High-Risk Neuroblastoma in Children.","authors":"Benjamin F B Mayer, Matthias C Schunn, Cristian Urla, Lea Weinpert, Ilias Tsiflikas, Martin Ebinger, Frank Fideler, Felix Neunhoeffer, Marcus Weitz, Silvio Nadalin, Steven W Warmann, Jörg Fuchs","doi":"10.3390/cancers17060989","DOIUrl":"10.3390/cancers17060989","url":null,"abstract":"<p><strong>Background/objectives: </strong>In bilateral nephroblastoma and high-risk neuroblastoma in children with extensive tumor involvement of the renal vessels or pedicle, complete tumor resection with preservation of healthy renal tissue is not feasible with in situ nephron-sparing surgery or vascular replacement. The aim of this study was to present our experience with ante situ tumor resection and renal autotransplantation (RATX) in these children.</p><p><strong>Methods: </strong>A retrospective study of children with bilateral nephroblastoma and high-risk neuroblastoma who underwent tumor resection and RATX at an international referral center for pediatric surgical oncology between 2006 and 2024 was performed. RATX was performed by transection of renal vessels, ante situ mobilization, and perfusion of the kidney with Bretschneider's solution. Tumor resection was performed on a bloodless kidney under hypothermia.</p><p><strong>Results: </strong>Ante situ tumor resection and RATX were performed at a median age of 36 months (range 13-62) in 4 children with bilateral nephroblastoma and 4 children with high-risk neuroblastoma. Complete tumor resection was achieved in all patients. One patient with neuroblastoma died of sepsis after 14 days. The 7 surviving patients showed no evidence of disease and normal to slightly decreased glomerulofiltration rates at a median follow-up of 20 months (range 3-155). Limitations include the retrospective design, small sample size, and heterogeneity of the study population due to very rare indication.</p><p><strong>Conclusions: </strong>Ante situ tumor resection and RATX is a feasible surgical approach for children with multifocal bilateral nephroblastoma or high-risk neuroblastoma who are ineligible for in situ nephron-sparing surgery or vascular reconstruction.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basal Cell Carcinoma: An Old Friend with Multiple Faces.","authors":"Maria Chiara Sergi, Francesca Ambrogio, Mario Della Mura, Joana Sorino, Gerardo Cazzato","doi":"10.3390/cancers17060993","DOIUrl":"10.3390/cancers17060993","url":null,"abstract":"<p><p>BCC is the most prevalent form of skin cancer, characterized by diverse clinical and pathological subtypes ranging from indolent to highly aggressive forms. While the majority of BCC cases are treated effectively with surgery or local therapies, locally advanced BCC (laBCC) and metastatic BCC (mBCC) pose significant therapeutic challenges. Recent advances in HHIs and immunotherapy have transformed the treatment landscape in such cases. However, resistance and intolerance to these treatments necessitate alternative approaches, including chemotherapy. Platinum-based agents such as cisplatin and carboplatin have shown limited efficacy but remain viable options in rapidly progressive cases. Among the therapeutic innovations to be explored, further lines of immunotherapy as well as combination therapies involving immunotherapy and targeted therapy have been proposed. This review synthesizes the current understanding about BCC subtypes, risk stratification, and emerging treatments, with a particular focus on laBCC and mBCC.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Local Recurrence After Robotic-Assisted Total Mesorectal Excision (ALRITE): An International, Multicentre, Retrospective Cohort.","authors":"Ritch T J Geitenbeek, Rauand Duhoky, Thijs A Burghgraef, Guglielmo Niccolò Piozzi, Shamsul Masum, Adrian A Hopgood, Quentin Denost, Ellen van Eetvelde, Paolo Bianchi, Philippe Rouanet, Roel Hompes, Marcos Gómez Ruiz, Jim Briggs, Jim S Khan, Esther C J Consten, On Behalf Of The Alrite Study Group","doi":"10.3390/cancers17060992","DOIUrl":"10.3390/cancers17060992","url":null,"abstract":"<p><strong>Background/objectives: </strong>Rectal cancer is a major global health issue with high morbidity and mortality rates. Local recurrence (LR) significantly impacts patient outcomes, decreasing survival rates and often necessitating extensive secondary treatments. While robot-assisted total mesorectal excision (R-TME) is becoming a preferred method for rectal cancer surgery due to its improved precision and visualisation, long-term data on LR and predictors of recurrence remain limited. This study aims to determine the 3-year LR rate following R-TME and to identify predictors of recurrence to enhance patient selection and the personalisation of treatment.</p><p><strong>Methods: </strong>This retrospective international multicentre cohort study included 1039 consecutive rectal cancer patients who underwent R-TME between 2013 and 2020, with a minimum of 3 years of follow-up. Data from tertiary colorectal centres in the United Kingdom, the Netherlands, Spain, France, Italy, and Belgium were analysed. Potential predictors of LR were identified using backward elimination, and four machine learning models were evaluated for predicting LR.</p><p><strong>Results: </strong>The 3-year LR rate was 3.8%. Significant predictors of LR included advanced clinical M-staging, length of the hospital stay, postoperative ileus, postoperative complications, pathological N-staging, the completeness of resection, and the resection margin distance. The eXtreme Gradient Boosting model performed best for LR prediction, with a final accuracy of 77.1% and an AUC of 0.76.</p><p><strong>Conclusions: </strong>R-TME in high-volume centres achieves low 3-year LR rates, suggesting that robot-assisted surgery offers oncological safety and advantages in rectal cancer management. This study underscores the importance of surgical precision, patient selection, and standardised perioperative care, supporting further investment in robotic training to improve long-term patient outcomes.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ex-Vivo Drug-Sensitivity Testing to Predict Clinical Response in Non-Small Cell Lung Cancer and Pleural Mesothelioma: A Systematic Review and Narrative Synthesis.","authors":"Jenny Zipprick, Enes Demir, Hanna Krynska, Sıla Köprülüoğlu, Katharina Strauß, Marcus Skribek, Rita Hutyra-Gram Ötvös, Annica K B Gad, Katalin Dobra","doi":"10.3390/cancers17060986","DOIUrl":"10.3390/cancers17060986","url":null,"abstract":"<p><p><b>Background/objectives</b>: Non-small cell lung cancer and pleural mesothelioma are among the most lethal and therapy-resistant tumors in humans. These tumors are diagnosed late, frequently present pleural effusion and develop drug resistance, and the treatment is often inefficient and largely alliative. Therefore, there is an urgent need to refine the selection of drugs and patients for personalized treatment. <b>Methods</b>: To progress the field, we performed a systematic literature review in line with the PRISMA guidelines followed by a narrative synthesis approach to identify themes. <b>Results</b>: The literature to date shows, in general, a positive correlation between the drug-sensitivity of patient-derived cells ex vivo and the clinical outcome. However, only a handful of these studies show a numerical correlation. This, along with the vast diversity of correlated techniques and parameters makes it difficult to directly compare the findings. To build a common knowledge base for future studies, we therefore offer a comprehensive summary of the literature, identify gaps, and suggest future avenues for research. <b>Conclusions</b>: We present unified recommendations for the collection, preparation, and ex vivo sensitivity testing of samples for the future development of personalized medicine.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Surgical Management of Anterior Skull Base Meningiomas: Imaging Modalities, Key Surgical Considerations, and Risk Mitigation Strategies.","authors":"Gheorghe Ungureanu, Larisa-Nicoleta Serban, Stefan-Ioan Florian","doi":"10.3390/cancers17060987","DOIUrl":"10.3390/cancers17060987","url":null,"abstract":"<p><p>Skull base meningiomas present considerable challenges in surgical management due to their proximity to critical neurovascular structures. Anterior skull base meningiomas encompass olfactory groove, supra- and parasellar, anterior sphenoid ridge, cavernous sinus, and spheno-orbital tumors. The success of surgical resection and the likelihood of complications are influenced by several key factors, including the presence of an intact arachnoid plane, tumor size and consistency, peritumoral brain edema, cranial nerve involvement, vascular encasement, and invasion of critical areas such as the optic canal or cavernous sinus. These factors not only affect the feasibility of gross total resection but also play a pivotal role in determining functional outcomes and postoperative recovery. With the vast array of imaging modalities available, selecting the most appropriate investigations to assess these parameters and tailoring surgical strategies accordingly remain complex tasks. This review examines the critical surgical parameters, identifies the most effective imaging modalities for evaluating each, and provides key insights into how this analysis can guide surgical decision-making, mitigate risks, and minimize complications.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Insights into Breast Cancer in Northeastern Mexico: Unveiling Gene-Environment Interactions and Their Links to Obesity and Metabolic Diseases.","authors":"Hugo Leonid Gallardo-Blanco, María de Lourdes Garza-Rodríguez, Diana Cristina Pérez-Ibave, Carlos Horacio Burciaga-Flores, Víctor Michael Salinas-Torres, Moisés González-Escamilla, Rafael Piñeiro-Retif, Ricardo M Cerda-Flores, Oscar Vidal-Gutiérrez, Celia N Sanchez-Dominguez","doi":"10.3390/cancers17060982","DOIUrl":"10.3390/cancers17060982","url":null,"abstract":"<p><p><b>Background:</b> Breast cancer (BC), one of the most common cancers, has increased in Mexico during the past decade, along with other chronic and metabolic diseases. <b>Methods:</b> Herein, we analyzed 121 SNPs (85 SNPs related to BC and/or glucose-associated metabolic pathways and 36 SNP classified as ancestry markers) in 92 confirmed BC cases and 126 unaffected BC women from Northeastern Mexico. The relationship of these 121 SNPs with BC, considering BMI, menopause status, and age as cofactors, was explored using a gene-environment (G × E) interaction multi-locus model. <b>Results:</b> Twelve gene variants were significantly associated with BC: three located in exome (rs3856806 <i>PPARG</i>, rs12792229 <i>MMP8</i>, and rs5218 <i>KCNJ11-ABCC8</i>), and nine in non-coding regions, which are involved in accelerated decay of the mRNA transcripts, regulatory regions, and flanking regions (rs3917542 <i>PON1</i>; rs3750804 and rs3750805 <i>TCF7L2</i>; rs1121980 and rs3751812 <i>FTO</i>; rs12946618 <i>RPTOR</i>; rs2833483 <i>SCAF4</i>; rs11652805 <i>AMZ2P1-GNA13</i>; and rs1800955 <i>SCT-DEAF1-DRD4)</i>. <b>Conclusions:</b> This study identified an association between BC and menopause, age (above 45), obesity, and overweight status with gene variants implicated in diabetes mellitus, obesity, insulin resistance, inflammation, and remodeling of the extracellular matrix.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Techniques for Radical Trachelectomy.","authors":"Sebastian Szubert, Magdalena Nadolna, Paweł Wawrzynowicz, Agnieszka Horała, Julia Kołodziejczyk, Łukasz Koberling, Paweł Caputa, Mikołaj Piotr Zaborowski, Ewa Nowak-Markwitz","doi":"10.3390/cancers17060985","DOIUrl":"10.3390/cancers17060985","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The primary aim of this systematic review was to evaluate fertility outcomes and the oncological safety of different surgical techniques of radical trachelectomy (RT). <b>Methods</b>: The systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search on PubMed, Embase, and Google Scholar was performed between 1 November 2023 and 31 March 2024 with no limits for the time of publication. <b>Results</b>: In total, 56 studies met the inclusion criteria: 22 for abdominal RT (1712 patients), 14 for endoscopic RT (445 patients), and 22 for vaginal RT (1158 patients). Data regarding certain steps of the procedure (uterine artery preservation, autonomous nerve-sparing, abdominal cerclage, types of sutures used for the cerclage, uterine dilatation during cerclage placement, prolongation of uterine catheterization, type of uterovaginal anastomosis, antibiotic prophylaxis, and suppression of menstruation) were extracted and analyzed with regard to the obstetrical and oncological outcomes. Endoscopic RT was associated with a significantly higher pregnancy rate and a lower rate of preterm deliveries. Uterine artery preservation was associated with a higher live birth rate. Nerve-sparing RT resulted in a higher pregnancy rate, but no differences in the attempt for pregnancy and live birth rates were observed. <b>Conclusions</b>: Taking into account the obstetrical outcomes, it seems that the preferred option for radical RT is an endoscopic procedure with preservation of the uterine artery and the pelvic autonomic nerves. However, the safety of the endoscopic approach should be evaluated in prospective trials.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Indocyanine Green-Guided Lymphadenectomy During Gastrectomy on Survival: Individual Patient Data Meta-Analysis.","authors":"Matteo Calì, Alberto Aiolfi, Sho Sato, Jawon Hwang, Gianluca Bonitta, Francesca Albanesi, Giulia Bonavina, Marta Cavalli, Giampiero Campanelli, Antonio Biondi, Luigi Bonavina, Davide Bona","doi":"10.3390/cancers17060980","DOIUrl":"10.3390/cancers17060980","url":null,"abstract":"<p><strong>Background: </strong>Indocyanine green-guided (ICG-guided) lymphadenectomy during gastrectomy for cancer has been proposed to enhance the accuracy of lymphadenectomy. The impact of ICG-guided lymphadenectomy on patient survival remains debated.</p><p><strong>Methods: </strong>The findings of the systematic review were reconstructed into an individual patient data (IDP) meta-analysis with restricted mean survival time difference (RMSTD). Overall survival (OS) and disease-free (DFS) survival were primary outcomes. RMSTD, standardized mead difference (SMD), and 95% confidence intervals (CI) were used as pooled effect size measures.</p><p><strong>Results: </strong>Three studies (6325 patients) were included; 42% of patients underwent ICG-guided lymphadenectomy. The patients' age ranged from 47 to 72 years and 58% were males. Proximal, distal, and total gastrectomy were completed in 6.8%, 80.4%, and 12.8% of patients, respectively. The surgical approach was laparoscopic (62.3%) and robotic (37.7%). ICG-guided lymphadenectomy was associated with a higher number of harvested lymph nodes compared to non-ICG-guided lymphadenectomy (SMD 0.50; 95% CI 0.45-0.55). At the 42-month follow-up, OS and DFS estimates for ICG-guided vs. non-ICG-guided lymphadenectomy were 0.5 months (95% CI -0.01, 1.1) and 1.3 months (95% CI 0.39, 2.15), respectively.</p><p><strong>Conclusions: </strong>Our analysis suggests that ICG-guided lymphadenectomy offers equivalent long-term OS and DFS compared to non-ICG-guided lymphadenectomy.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre- and Postnatal Exposures to Residential Pesticides and Survival of Childhood Acute Lymphoblastic Leukemia.","authors":"Seema Desai, Libby M Morimoto, Alice Y Kang, Mark D Miller, Joseph L Wiemels, Lena E Winestone, Catherine Metayer","doi":"10.3390/cancers17060978","DOIUrl":"10.3390/cancers17060978","url":null,"abstract":"<p><p><b>Background:</b> Exposure to pesticides has been associated with an increased risk of developing childhood leukemia. However, the impact of pesticides on childhood leukemia survival has not been examined. We investigated the associations between residential pesticide use during key developmental periods and 5-year survival in children treated for acute lymphoblastic leukemia (ALL). <b>Methods:</b> Residential use of insecticides, herbicides, rodenticides, and flea control products from preconception up to 12 months prior to diagnosis and sociodemographic characteristics were collected via parental interview among 837 children diagnosed with ALL between 1995 and 2008 in California, USA. Data on clinical features were abstracted from medical records. Vital status was obtained through linkage to the National Death Index (NDI) up to 2020. Cox proportional hazards regression models were used to estimate hazard ratios (HRs), adjusting for sociodemographic factors and clinical risk group. <b>Results:</b> A total of 108 children with ALL (~13%) died within 5 years of diagnosis. Exposure to any pesticides pre- and/or postnatally was slightly higher among deceased compared to alive children (95.4% vs. 91.5%; <i>p</i> = 0.23), while use of rodenticides was significantly higher in children who died (25.0%) vs. those who survived (15.5%; <i>p</i> = 0.02). In fully adjusted models, exposure to rodenticides was associated with an increased risk of mortality (HR 1.70; 95% confidence interval (CI) 1.08-2.64; <i>p</i> = 0.02), especially when the child was exposed during pregnancy (HR 1.90; 95% CI 1.15-3.16; <i>p</i> = 0.01) and possibly 12 months before diagnosis (HR 1.60; 95% CI 0.98-2.61; <i>p</i> = 0.06). Increased hazards of death were also observed with other types of pesticides during pregnancy, but those associations were not statistically significant. <b>Conclusions:</b> This study is the first to report reduced survival among children with ALL previously exposed to rodenticides, particularly during pregnancy, underscoring the need to further evaluate mechanisms by which environmental exposures during key developmental stages may later impact cancer outcomes.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Overview of Cellular and Molecular Determinants Regulating Chemoresistance in Pleural Mesothelioma.","authors":"Lourdes Cortes-Dericks, Domenico Galetta","doi":"10.3390/cancers17060979","DOIUrl":"10.3390/cancers17060979","url":null,"abstract":"<p><p>Malignant pleural mesothelioma (PM) is a highly aggressive disease of the lung pleura associated with poor prognosis. Despite advances in improving the clinical management of this malignancy, there is no effective chemotherapy for refractory or relapsing PM. The acquisition of resistance to standard and targeted therapy in this disease is a foremost concern; therefore, a deeper understanding of the complex factors surrounding the emergence of drug resistance is deemed necessary. In this review, we will present broad insights into various cellular and molecular concepts, accounting for the recalcitrance of PM to chemotherapy, including signaling networks regulating drug tolerance, drug resistance-associated proteins, genes, and miRNAs, as well as the critical role of cancer stem cells. Identification of the biological determinants and their associated mechanisms may provide a framework for the development of appropriate treatment.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 6","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}