Circulating tumor cells (CTCs) play a pivotal role in the metastatic process, acting as precursors to distant metastasis in cancer patients. Recent studies have highlighted the mechanisms by which CTCs evade immune surveillance. For instance, Yang et al. demonstrated that CTCs shielded with extracellular vesicle-derived CD45 can evade T cell attacks, facilitating metastasis (ref: Yang doi.org/10.1038/s41392-024-01789-1/). Furthermore, Xin et al. found that CTCs capable of surviving fluid shear stress during hematogenous dissemination possess metastasis-initiating competence, characterized by traits such as stemness and enhanced migration potential (ref: Xin doi.org/10.1016/j.canlet.2024.216870/). This suggests that the ability to withstand mechanical forces in the bloodstream is a critical factor in the metastatic cascade. In addition, García-Chamé et al. introduced a microfluidic platform that mimics the endothelial barrier, allowing for the study of CTC extravasation, revealing that the adhesion properties of CTCs are influenced by the type and density of adhesion peptides (ref: García-Chamé doi.org/10.1002/anie.202318805/). These findings collectively underscore the heterogeneity of CTCs and their adaptive mechanisms that facilitate metastasis, presenting potential therapeutic targets for intervention. Moreover, the genetic and phenotypic profiling of single living CTCs has emerged as a promising approach for predicting treatment efficacy. Dong et al. developed a nanoplatform for capturing CTCs and analyzing their response to immune checkpoint inhibitors, highlighting the importance of understanding individual CTC characteristics in tailoring immunotherapy (ref: Dong doi.org/10.1073/pnas.2315168121/). This integrative approach not only enhances our understanding of CTC biology but also paves the way for personalized cancer therapies. The studies collectively emphasize the need for advanced methodologies to dissect CTC behavior and their implications in cancer progression and treatment resistance.

Liquid biopsy technologies have revolutionized cancer diagnostics and monitoring, providing minimally invasive methods for early detection and tracking of disease progression. Anagnostou et al. discussed the potential of liquid biopsies to address critical challenges in cancer care, such as early detection and monitoring therapeutic responses, while highlighting the need for convergence science to enhance clinical applications (ref: Anagnostou doi.org/10.1158/2159-8290.CD-24-0037/). The utility of circulating tumor DNA (ctDNA) as a biomarker has been further validated in various studies. For instance, Zheng et al. conducted a systematic review and meta-analysis demonstrating that postoperative ctDNA testing significantly predicts recurrence and overall survival in patients with resectable cancers, with a hazard ratio of 7.48 for recurrence (ref: Zheng doi.org/10.1016/j.ebiom.2024.105109/). This underscores the prognostic value of ctDNA in clinical settings. Additionally, the CLL2-BAAG trial by Fürstenau et al. illustrated the effectiveness of a measurable residual disease (MRD)-guided treatment strategy using ctDNA analysis in patients with relapsed/refractory chronic lymphocytic leukemia, achieving deep remissions in nearly all participants (ref: Fürstenau doi.org/10.1182/blood.2023022730/). Furthermore, Mao et al. introduced a novel diagnostic assay based on cancer-universal methylation markers in cell-free DNA, significantly improving sensitivity for detecting malignant body fluids (ref: Mao doi.org/10.1172/jci.insight.175482/). These advancements in liquid biopsy technologies not only enhance diagnostic accuracy but also facilitate real-time monitoring of treatment responses, thereby improving patient management and outcomes.

The exploration of molecular mechanisms and biomarkers in cancer has gained momentum, particularly in understanding the heterogeneity of tumor responses to therapies. Saliby et al. utilized machine learning to classify clear cell renal cell carcinoma (RCC) into distinct molecular subtypes, revealing that immune checkpoint inhibitor (ICI) therapy benefits all subtypes, thus highlighting the potential for personalized treatment strategies (ref: Saliby doi.org/10.1016/j.ccell.2024.03.002/). This classification approach could significantly enhance the precision of immunotherapy in RCC patients. In another study, Cheng et al. investigated the effects of PD-1 inhibition on high-risk pulmonary ground-glass opacity lesions, providing insights into the immune dynamics associated with early-stage lung cancer treatment (ref: Cheng doi.org/10.1038/s41392-024-01799-z/). Moreover, Chan et al. identified the loss of lncRNA LINC01056 as a mechanism contributing to sorafenib resistance in hepatocellular carcinoma (HCC), suggesting that targeting this lncRNA could restore sensitivity to treatment (ref: Chan doi.org/10.1186/s12943-024-01988-y/). The study by Sun et al. further advanced the field by developing a dual-histidine-based hydrogel for the precise capture of circulating liver cancer cells, demonstrating the importance of innovative technologies in enhancing diagnostic capabilities (ref: Sun doi.org/10.1002/adma.202402379/). Collectively, these studies underscore the critical role of molecular profiling and innovative diagnostic tools in advancing cancer treatment and improving patient outcomes.

Immunotherapy has emerged as a cornerstone in cancer treatment, with ongoing research focusing on enhancing immune responses against tumors. Sun et al. explored the immune landscape in individuals with HIV/HBV coinfection, revealing that NK cells exhibit distinct functional responses compared to those with HBV mono-infection, which could inform therapeutic strategies (ref: Sun doi.org/10.1097/HEP.0000000000000877/). This highlights the complexity of immune interactions in cancer patients with coexisting infections and the potential for tailored immunotherapeutic approaches. In the context of chronic lymphocytic leukemia (CLL), the CLL2-BAAG trial by Fürstenau et al. demonstrated the efficacy of a MRD-guided treatment regimen combining acalabrutinib, venetoclax, and obinutuzumab, achieving significant remission rates (ref: Fürstenau doi.org/10.1182/blood.2023022730/). Additionally, Hansen et al. tracked T antigen-specific CD8+ T cells in Merkel cell carcinoma patients undergoing PD-1 blockade, providing insights into the immune responses associated with this therapy (ref: Hansen doi.org/10.1172/JCI177082/). These findings emphasize the importance of understanding immune dynamics and patient-specific responses to optimize immunotherapy outcomes. Furthermore, Xia et al. introduced a novel light-driven imaging technique for detecting nucleic acids in cancer cells, which could enhance the understanding of cellular responses to therapies (ref: Xia doi.org/10.1021/jacs.3c13095/). This innovative approach underscores the potential for integrating advanced imaging technologies with immunotherapy to improve treatment efficacy and monitoring.

Extracellular vesicles (EVs) have gained attention as potential biomarkers for cancer diagnosis and monitoring due to their role in intercellular communication and tumor progression. Ricklefs et al. investigated the utility of circulating plasma EVs in glioblastoma patients, demonstrating their potential as indicators for diagnosis, prognosis, and treatment response (ref: Ricklefs doi.org/10.1093/neuonc/). This study highlights the non-invasive nature of EVs as biomarkers, offering a promising avenue for glioblastoma management. In addition, Gao et al. developed a plasma-derived exosomal microRNA signature for early detection of postmenopausal osteoporosis, showcasing the versatility of EVs in various clinical applications (ref: Gao doi.org/10.1002/ctm2.1637/). Shan et al. further advanced the field by creating macrophage cell membrane cloaked nanomedicines for glioblastoma treatment, combining immunotherapy with sonodynamic therapy to enhance therapeutic efficacy (ref: Shan doi.org/10.1016/j.jconrel.2024.04.043/). These studies collectively underscore the multifaceted roles of EVs in cancer biology, from serving as biomarkers to facilitating innovative therapeutic strategies.

The landscape of cancer treatment strategies is continually evolving, particularly in addressing drug resistance. Arffman et al. identified inflammatory and subtype-dependent serum protein signatures that predict survival in aggressive B cell lymphomas, suggesting that these biomarkers could guide treatment decisions beyond traditional methods (ref: Arffman doi.org/10.1016/j.medj.2024.03.007/). This approach emphasizes the need for personalized treatment strategies that consider the biological heterogeneity of tumors. Additionally, Lin et al. explored the evolution of T cells in the cancer-resistant naked mole-rat, providing insights into immune system adaptations that could inform cancer resistance mechanisms (ref: Lin doi.org/10.1038/s41467-024-47264-x/). The CLL2-BAAG trial by Fürstenau et al. further demonstrated the effectiveness of a MRD-guided treatment regimen in relapsed/refractory CLL, achieving deep remissions and highlighting the importance of monitoring minimal residual disease (ref: Fürstenau doi.org/10.1182/blood.2023022730/). These findings collectively underscore the significance of understanding tumor biology and immune responses in developing effective treatment strategies and overcoming drug resistance. Moreover, Sun et al. investigated the immune landscape in HBV-infected individuals, revealing distinct NK cell responses that could be leveraged for therapeutic interventions (ref: Sun doi.org/10.1097/HEP.0000000000000877/). This research highlights the potential for harnessing immune responses in the context of cancer treatment, paving the way for innovative therapeutic approaches.

Emerging biomarkers and diagnostic techniques are reshaping cancer detection and management, with a focus on enhancing sensitivity and specificity. Sivars et al. demonstrated that cell-free human papillomavirus DNA serves as a sensitive biomarker for prognosis and early detection of relapse in locally advanced cervical cancer, suggesting its potential utility in clinical practice (ref: Sivars doi.org/10.1158/1078-0432.CCR-23-3941/). This study underscores the importance of identifying reliable biomarkers for improving patient outcomes. Zheng et al. conducted a systematic review and meta-analysis on ctDNA-based molecular residual disease detection, revealing significant prognostic implications for recurrence and overall survival in resectable cancers, with a hazard ratio of 7.48 for recurrence (ref: Zheng doi.org/10.1016/j.ebiom.2024.105109/). This highlights the critical role of ctDNA in monitoring disease status and guiding treatment decisions. Additionally, Mao et al. developed a novel diagnostic assay based on cancer-universal methylation markers in cell-free DNA, significantly improving the detection of malignant body fluids (ref: Mao doi.org/10.1172/jci.insight.175482/). Furthermore, Yao et al. introduced an automated segmentation algorithm for colorectal cancer in conventional CT scans, addressing challenges in accurately identifying tumors and enhancing diagnostic capabilities (ref: Yao doi.org/10.1109/TNNLS.2024.3386610/). These advancements in emerging biomarkers and diagnostic techniques are crucial for improving cancer detection, monitoring, and treatment strategies.

The tumor microenvironment plays a critical role in cancer progression and treatment response, with recent studies highlighting its impact on therapeutic outcomes. Tsai et al. investigated the effects of metformin and statins on hepatocellular carcinoma (HCC) risk in chronic hepatitis C patients, finding that these medications significantly reduced HCC risk, particularly in non-cirrhotic patients (ref: Tsai doi.org/10.3350/cmh.2024.0038/). This suggests that modifying the tumor microenvironment through pharmacological interventions could be a viable strategy for cancer prevention. Zhu et al. focused on enhancing glioblastoma immunotherapy by re-educating tumor-associated microglia and macrophages, demonstrating that integrated chimeric antigen receptor T cells could improve therapeutic efficacy against this aggressive brain cancer (ref: Zhu doi.org/10.1021/acsnano.4c00050/). This approach highlights the potential for targeting the tumor microenvironment to enhance immune responses and overcome treatment resistance. Additionally, Li et al. explored the use of cell surface vimentin as a novel marker for circulating tumor cells in advanced gastric cancer, emphasizing the importance of understanding the tumor microenvironment in identifying and targeting CTCs (ref: Li doi.org/10.1186/s13046-024-03043-6/). These studies collectively underscore the intricate relationship between the tumor microenvironment and cancer progression, highlighting the need for innovative strategies that target both tumor cells and their surrounding microenvironment to improve treatment outcomes.