Malignant tumors (commonly referred to as cancers) represent a major global public health challenge and contribute substantially to the global disease burden. Early screening plays a crucial role in improving detection rates, enabling timely intervention, and enhancing patient survival. However, current cancer screening guidelines primarily focus on site-specific screening, which may not fully address the need for comprehensive early detection. A scientifically rational, multi-cancer screening approach offers several advantages: it optimizes the use of biological samples, reduces the time burden for participants, enhances the efficiency and comprehensiveness of screening, and minimizes overall expenses. Moreover, this approach facilitates rational allocation of healthcare resources, ultimately helping to reduce the societal burden of cancer. To address gap, the Cancer Epidemiology Committee of the China Anti-Cancer Association has developed the Expert Consensus on Combined Screening for Common Cancers. This consensus integrates multidisciplinary expertise and synthesizes the latest domestic and international researches on cancer screening, early detection, and treatment of prevalent malignancies. Drawing upon China’s unique demographic and healthcare context and practical screening experiences, the consensus provides evidence-based recommendations on target populations, screening technologies, and procedural workflows for multi-cancer screening. These guidelines align with the principles and methodologies established by the World Health Organization (WHO), aiming to enhance the effectiveness of combined cancer screening in China, improve early detection rates, and provide a scientific foundation for national cancer prevention and control strategies.
Carbon ion radiotherapy (CIRT) is an advanced radiotherapy method with unique physical and biological properties. It increases the dose to the tumor target area while providing better protection to normal tissues. CIRT can be used for hypoxic tumors resistant to photon radiotherapy. It also has the potential superiority of inducing immune responses and can produce the "abscopal effect" when combined with different immunotherapies. Radioimmunotherapy can not only ablate tumors at the irradiated site but also partially control distant metastases at the unirradiated site. However, the underlying mechanism has not been fully elucidated. Due to the protection of the tumor microenvironment, tumors can sometimes be difficult to completely clear through CIRT-mediated anti-tumor immunity; this can also indicate functional limitations of some immune organs after CIRT. Therefore, this study reviewed the impact of CIRT on both innate and adaptive immune responses. It also examined the relationship between different radiation doses/fractions and immune protein expression, as well as compared the differences in imaging techniques between carbon ion radiotherapy and traditional radiotherapy. We have also proposed future directions to enhance the superiority of CIRT. This study aimed to provide a strong theoretical basis for improving the efficacy of CIRT and its combination therapy, ultimately benefiting more patients with cancer.
Nucleophosmin 1 (NPM1) mutation is a core molecular marker in adult acute myeloid leukemia (AML) and an ideal target for assessing subclinical disease burden (i.e., minimal residual disease [MRD]). This mutation has a significant clinical value in disease classification, treatment selection, and prognosis evaluation. In this review, we integrate the latest research advances and discuss the clinical applicability of targeted therapies, chemotherapy combined with anti-CD33 monoclonal antibodies, and allogeneic hematopoietic stem cell transplantation (allo-hematopoietic stem-cell transplantation). This review highlights the importance of dynamic MRD monitoring to optimize long-term disease management. We particularly focus on the mechanisms of drug resistance in NPM1-mutated AML (e.g., B-cell lymphoma 2 [BCL-2]/myeloid cell leukemia 1 [MCL-1] imbalance and metabolic adaptations) and characteristics of the Chinese population (mutation frequency, co-mutation profiles, and treatment response). This review aims to provide clinicians with a stratified diagnosis and treatment framework for NPM1-mutated AML as well as theoretical foundations for future research directions.
Cancer stands as a significant global public health challenge, and cancer screening serves as a pivotal strategy for reducing its mortality. Presently, only a limited number of cancer types have appropriate screening methods available. Traditional single-cancer screening approaches are fraught with limitations, including invasiveness, low accuracy, and poor patient compliance. Multi-cancer early detection (MCED) leveraging liquid biopsy technology enables non-invasive and efficient early detection of multiple cancers by analyzing biomarkers such as cell-free DNA, cell-free RNA, proteins, and metabolites in blood and other bodily fluids. This innovative approach substantially broadens the spectrum of detectable cancers and enhances population coverage, showcasing immense potential for improving existing cancer screening strategies. This expert consensus comprehensively reviews the progress of liquid biopsy-based MCED, biomarker selection and detection technologies, the criteria for cancer type selection,research design and clinical utility evaluation, as well as implementation pathways. The overarching goal of this consensus is to offer scientific guidance for further research and the widespread adoption of MCED, thereby facilitating the continuous optimization of cancer screening strategies.