1 3811 99 INTRATUMORAL HETEROGENEITY: CLONAL COOPERATION IN EPITHELIAL-TO-MESENCHYMAL TRANSITION AND METASTASIS. ALTHOUGH PHENOTYPIC INTRATUMORAL HETEROGENEITY WAS FIRST DESCRIBED MANY DECADES AGO, THE ADVENT OF NEXT-GENERATION SEQUENCING HAS PROVIDED CONCLUSIVE EVIDENCE THAT IN ADDITION TO PHENOTYPIC DIVERSITY, SIGNIFICANT GENOTYPIC DIVERSITY EXISTS WITHIN TUMORS. TUMOR HETEROGENEITY LIKELY ARISES BOTH FROM CLONAL EXPANSIONS, AS WELL AS FROM DIFFERENTIATION HIERARCHIES EXISTENT IN THE TUMOR, SUCH AS THAT ESTABLISHED BY CANCER STEM CELLS (CSCS) AND NON-CSCS. THESE DIFFERENTIATION HIERARCHIES MAY ARISE DUE TO GENETIC MUTATIONS, EPIGENETIC ALTERATIONS, OR MICROENVIRONMENTAL INFLUENCES. AN ADDITIONAL DIFFERENTIATION HIERARCHY WITHIN EPITHELIAL TUMORS MAY ARISE WHEN ONLY A FEW TUMOR CELLS TRANS-DIFFERENTIATE INTO MESENCHYMAL-LIKE CELLS, A PROCESS KNOWN AS EPITHELIAL-TO-MESENCHYMAL TRANSITION (EMT). AGAIN, THIS PROCESS CAN BE INFLUENCED BY BOTH GENETIC AND NON-GENETIC FACTORS. IN THIS REVIEW WE DISCUSS THE EVIDENCE FOR CLONAL INTERACTION AND COOPERATION FOR TUMOR MAINTENANCE AND PROGRESSION, PARTICULARLY WITH RESPECT TO EMT, AND FURTHER ADDRESS THE FAR-REACHING EFFECTS THAT TUMOR HETEROGENEITY MAY HAVE ON CANCER THERAPY. 2015 2 737 39 CANCER STEM CELLS. THERE IS AN INCREASING EVIDENCE SUPPORTING THE CANCER STEM CELL HYPOTHESIS. NORMAL STEM CELLS IN THE ADULT ORGANISM ARE RESPONSIBLE FOR TISSUE RENEWAL AND REPAIR OF AGED OR DAMAGED TISSUE. A SUBSTANTIAL CHARACTERISTIC OF STEM CELLS IS THEIR ABILITY FOR SELF-RENEWAL WITHOUT LOSS OF PROLIFERATION CAPACITY WITH EACH CELL DIVISION. THE STEM CELLS ARE IMMORTAL, AND RATHER RESISTANT TO ACTION OF DRUGS. THEY ARE ABLE TO DIFFERENTIATE AND FORM SPECIFIC TYPES OF TISSUE DUE TO THE INFLUENCE OF MICROENVIRONMENTAL AND SOME OTHER FACTORS. STEM CELLS DIVIDE ASYMMETRICALLY PRODUCING TWO DAUGHTER CELLS -- ONE IS A NEW STEM CELL AND THE SECOND IS PROGENITOR CELL, WHICH HAS THE ABILITY FOR DIFFERENTIATION AND PROLIFERATION, BUT NOT THE CAPABILITY FOR SELF-RENEWAL. CANCER STEM CELLS ARE IN MANY ASPECTS SIMILAR TO THE STEM CELLS. IT HAS BEEN PROVEN THAT TUMOR CELLS ARE HETEROGENEOUS COMPRISING RARE TUMOR INITIATING CELLS AND ABUNDANT NON-TUMOR INITIATING CELLS. TUMOR INITIATING CELLS -- CANCER STEM CELLS HAVE THE ABILITY OF SELF-RENEWAL AND PROLIFERATION, ARE RESISTANT TO DRUGS, AND EXPRESS TYPICAL MARKERS OF STEM CELLS. IT IS NOT CLEAR WHETHER CANCER STEM CELLS ORIGINATE FROM NORMAL STEM CELLS IN CONSEQUENCE OF GENETIC AND EPIGENETIC CHANGES AND/OR BY REDIFFERENTIATION FROM SOMATIC TUMOR CELLS TO THE STEM-LIKE CELLS. PROBABLY BOTH MECHANISMS ARE INVOLVED IN THE ORIGIN OF CANCER STEM CELLS. DYSREGULATION OF STEM CELL SELF-RENEWAL IS A LIKELY REQUIREMENT FOR THE DEVELOPMENT OF CANCER. ISOLATION AND IDENTIFICATION OF CANCER STEM CELLS IN HUMAN TUMORS AND IN TUMOR CELL LINES HAS BEEN SUCCESSFUL. TO DATE, THE EXISTENCE OF CANCER STEM CELLS HAS BEEN PROVEN IN ACUTE AND CHRONIC MYELOID LEUKEMIA, IN BREAST CANCER, IN BRAIN TUMORS, IN LUNG CANCER AND GASTROINTESTINAL TUMORS. CANCER STEM CELL MODEL IS ALSO CONSISTENT WITH SOME CLINICAL OBSERVATIONS. ALTHOUGH STANDARD CHEMOTHERAPY KILLS MOST CELLS IN A TUMOR, CANCER STEM CELLS REMAIN VIABLE. DESPITE THE SMALL NUMBER OF SUCH CELLS, THEY MIGHT BE THE CAUSE OF TUMOR RECURRENCE, SOMETIMES MANY YEARS AFTER THE "SUCCESSFUL" TREATMENT OF PRIMARY TUMOR. GROWTH OF METASTASES IN DISTINCT AREAS OF BODY AND THEIR CELLULAR HETEROGENEITY MIGHT BE CONSEQUENCE OF CANCER STEM CELL DIFFERENTIATION AND/OR DEDIFFERENTIATION AND ASYMMETRIC DIVISION OF CANCER STEM CELLS. FURTHER CHARACTERIZATION OF CANCER STEM CELLS IS NEEDED IN ORDER TO FIND WAYS TO DESTROY THEM, WHICH MIGHT CONTRIBUTE SIGNIFICANTLY TO THE THERAPEUTIC MANAGEMENT OF MALIGNANT TUMORS. 2005 3 736 32 CANCER STEM CELLS--NEW APPROACH TO CANCEROGENENSIS AND TREATMENT. RECENTLY, THERE IS AN INCREASING EVIDENCE SUPPORTING THE THEORY OF CANCER STEM CELLS NOT ONLY IN LEUKEMIA BUT ALSO IN SOLID CANCER. TO DATE, THE EXISTENCE OF CANCER STEM CELLS HAS BEEN PROVEN IN ACUTE AND CHRONIC MYELOID LEUKEMIA, IN BREAST CANCER, IN BRAIN TUMORS, IN LUNG CANCER AND GASTROINTESTINAL TUMORS. THIS REVIEW IS FOCUSING ON THE RECENT DISCOVERY OF STEM CELLS IN LEUKEMIA, HUMAN BRAIN TUMORS AND BREAST CANCER. A SMALL POPULATION OF CELLS IN THE TUMOR (LESS THAN 1%) SHOWS THE POTENTIAL TO GIVE RISE TO THE TUMOR AND ITS GROWTH. THESE CELLS HAVE A SUBSTANTIAL CHARACTERISTIC OF STEM CELLS--ABILITY FOR SELF-RENEWAL WITHOUT LOSS OF PROLIFERATION CAPACITY WITH EACH CELL DIVISION. FURTHERMORE THEY ARE IMMORTAL, RATHER RESISTANT TO TREATMENT AND EXPRESS TYPICAL MARKERS OF STEM CELLS. THE ORIGIN OF THESE RESIDENT CANCER STEM CELLS IS NOT CLEAR. WHETHER THE CANCER STEM CELLS ORIGINATE FROM NORMAL STEM CELLS IN CONSEQUENCE OF GENETIC AND EPIGENETIC CHANGES AND/OR REDIFFERENTIATION FROM SOMATIC TUMOR CELLS TO THE STEM-LIKE CELLS REMAINS TO BE INVESTIGATED. WE PROPOSE THE IDEA OF THE RELATION BETWEEN NORMAL TISSUE STEM CELLS AND CANCER STEM CELLS AND THEIR POPULATIONS--PROGENITOR CELLS. BASED ON THIS WE HIGHLIGHT ONE OF THE MAJOR CHARACTERISTIC OF STEM CELL--PLASTICITY, WHICH IS EQUALLY IMPORTANT IN THE PHYSIOLOGICAL REGENERATION PROCESS AS WELL AS CARCINOGENESIS. FURTHERMORE, WE CONSIDER THE MICROENVIRONMENT AS A LIMITING FACTOR FOR TUMOR GENESIS IN AML, BREAST CANCER AND BRAIN TUMORS. THUS THE BIOLOGICAL PROPERTIES OF CANCER STEM CELLS ARE JUST BEGINNING TO BE REVEALED, THE CONTINUATION OF THESE STUDIES SHOULD LEAD TO THE DEVELOPMENT OF CANCER STEM CELLS TARGET THERAPIES FOR CANCER TREATMENT. 2008 4 1918 39 ENVIRONMENTAL CARCINOGENESIS AND TRANSGENERATIONAL TRANSMISSION OF CARCINOGENIC RISK: FROM GENETICS TO EPIGENETICS. THE DOMINANT PATHOGENIC MODEL, SOMATIC MUTATION THEORY (SMT), CONSIDERS CARCINOGENESIS AS A 'GENETIC ACCIDENT' DUE TO THE ACCUMULATION OF 'STOCHASTIC' DNA MUTATIONS. THIS MODEL WAS PROPOSED AND ACCEPTED BY THE SCIENTIFIC COMMUNITY WHEN CANCER MAINLY AFFECTED THE ELDERLY, BUT IT DOES NOT EXPLAIN THE EPIDEMIOLOGICAL OBSERVATION OF THE CONTINUOUS INCREASE IN CANCER INCIDENCE AMONG CHILDREN AND YOUNG ADULTS. SOMATIC MUTATION THEORY HAS BEEN PROPOSED FOR A REVISION BASED ON THE EMERGING EXPERIMENTAL EVIDENCE, AS IT DOES NOT FULLY ADDRESS SOME ISSUES THAT HAVE PROVEN TO BE CRUCIAL FOR CARCINOGENESIS, NAMELY: THE INFLAMMATORY CONTEXT OF CANCER; THE KEY ROLE PLAYED BY THE STROMA, MICROENVIRONMENT, ENDOTHELIAL CELLS, ACTIVATED MACROPHAGES, AND SURROUNDING TISSUES; AND THE DISTORTED DEVELOPMENTAL COURSE FOLLOWED BY THE NEOPLASTIC TISSUE. FURTHERMORE, SMT IS OFTEN NOT ABLE TO CONSIDER EITHER THE EXISTENCE OF SPECIFIC MUTATIONS RESULTING IN A WELL-DEFINED CANCER TYPE, OR A CLEAR RELATIONSHIP BETWEEN MUTATIONS AND TUMOR PROGRESSION. MOREOVER, IT DOES NOT EXPLAIN THE MECHANISM OF ACTION OF THE NON-MUTAGENIC AND ENVIRONMENTAL CARCINOGENS. IN THE LAST DECADE, CANCER RESEARCH HAS HIGHLIGHTED THE PROMINENT ROLE OF AN ALTERED REGULATION OF GENE EXPRESSION, SUGGESTING THAT CANCER SHOULD BE CONSIDERED AS A RESULT OF A POLYCLONAL EPIGENETIC DISRUPTION OF STEM/PROGENITOR CELLS, MEDIATED BY TUMOUR-INDUCING GENES. THE MATERNAL AND FETAL EXPOSURE TO A WIDE RANGE OF CHEMICALS AND ENVIRONMENTAL CONTAMINANTS IS RAISING THE ATTENTION OF THE SCIENTIFIC COMMUNITY. INDEED, THE MOST POWERFUL PROCARCINOGENIC MECHANISMS OF ENDOCRINE DISRUPTORS AND OTHER POLLUTANTS IS LINKED TO THEIR POTENTIAL TO INTERFERE EPIGENETICALLY WITH THE EMBRYO-FETAL PROGRAMMING OF TISSUES AND ORGANS, ALTERING THE REGULATION OF THE GENES INVOLVED IN THE CELL CYCLE, CELL PROLIFERATION, APOPTOSIS, AND OTHER KEY SIGNALING PATHWAYS. THE EMBRYO-FETAL EXPOSURE TO ENVIRONMENTAL, STRESSFUL, AND PROINFLAMMATORY TRIGGERS (FIRST HIT), SEEMS TO ACT AS A 'DISEASE PRIMER', MAKING FETAL CELLS AND TISSUES MORE SUSCEPTIBLE TO THE SUBSEQUENT ENVIRONMENTAL EXPOSURES (SECOND HIT), TRIGGERING THE CARCINOGENIC PATHWAYS. FURTHERMORE, EVEN AT THE MOLECULAR LEVEL, IN CARCINOGENESIS, 'EPIGENETICS PRECEDES GENETICS' AS GLOBAL DNA HYPOMETHYLATION, AND THE HYPERMETHYLATION OF TUMOR SUPPRESSOR GENES ARE COMMON BOTH IN CANCEROUS AND IN PRECANCEROUS CELLS, AND GENERALLY PRECEDE MUTATIONS. THESE EPIGENETIC MODELS MAY BETTER EXPLAIN THE INCREASE OF CANCER AND CHRONIC/DEGENERATIVE DISEASES IN THE LAST DECADES AND COULD BE USEFUL TO ADOPT APPROPRIATE PRIMARY PREVENTION MEASURES, ESSENTIALLY BASED ON THE REDUCTION OF MATERNAL-FETAL AND CHILD EXPOSURE TO SEVERAL PROCARCINOGENIC AGENTS AND FACTORS DISPERSED IN THE ENVIRONMENT AND IN THE FOOD-CHAINS, AS RECENTLY SUGGESTED BY THE WORLD HEALTH ORGANIZATION. 2018 5 3694 48 INFLAMMATORY COMPONENTS OF THE THYROID CANCER MICROENVIRONMENT: AN AVENUE FOR IDENTIFICATION OF NOVEL BIOMARKERS. THE INCIDENCE OF THYROID CANCER IN THE UNITED STATES IS ON THE RISE WITH AN APPRECIABLY HIGH DISEASE RECURRENCE RATE OF 20-30%. ANAPLASTIC THYROID CANCER (ATC), ALTHOUGH RARE IN OCCURRENCE, IS AN AGGRESSIVE FORM OF CANCER WITH LIMITED TREATMENT OPTIONS AND BLEAK CURE RATES. THIS CHAPTER USES DISCUSSIONS OF IN VITRO MODELS THAT ARE REPRESENTATIVE OF PAPILLARY, ANAPLASTIC, AND FOLLICULAR THYROID CANCER TO EVALUATE THE CROSSTALK BETWEEN SPECIFIC CELLS OF THE TUMOR MICROENVIRONMENT (TME), WHICH SERVES AS A HIGHLY HETEROGENEOUS REALM OF SIGNALING CASCADES AND METABOLISM THAT ARE ASSOCIATED WITH TUMORIGENESIS. THE CELLULAR CONSTITUENTS OF THE TME CARRY OUT VARYING CHARACTERISTIC IMMUNOMODULATORY FUNCTIONS THAT ARE DISCUSSED THROUGHOUT THIS CHAPTER. THE AFOREMENTIONED CELL TYPES INCLUDE CANCER-ASSOCIATED FIBROBLASTS (CAFS), ENDOTHELIAL CELLS (ECS), AND CANCER STEM CELLS (CSCS), AS WELL AS SPECIFIC IMMUNE CELLS, INCLUDING NATURAL KILLER (NK) CELLS, DENDRITIC CELLS (DCS), MAST CELLS, T REGULATORY (TREG) CELLS, CD8+ T CELLS, AND TUMOR-ASSOCIATED MACROPHAGES (TAMS). TAM-MEDIATED INFLAMMATION IS ASSOCIATED WITH A POOR PROGNOSIS OF THYROID CANCER, AND THE MOLECULAR BASIS OF THE CELLULAR CROSSTALK BETWEEN MACROPHAGES AND THYROID CANCER CELLS WITH RESPECT TO INDUCING A METASTATIC PHENOTYPE IS NOT YET KNOWN. THE DYNAMIC NATURE OF THE PHYSIOLOGICAL TRANSITION TO PATHOLOGICAL METASTATIC PHENOTYPES WHEN ESTABLISHING THE TME ENCOMPASSES A WIDE RANGE OF CHARACTERISTICS THAT ARE FURTHER EXPLORED WITHIN THIS CHAPTER, INCLUDING THE ROLES OF SOMATIC MUTATIONS AND EPIGENETIC ALTERATIONS THAT DRIVE THE GENETIC HETEROGENEITY OF CANCER CELLS, ALLOWING FOR SELECTIVE ADVANTAGES THAT AID IN THEIR PROLIFERATION. INDUCTION OF THESE PROLIFERATING CELLS IS TYPICALLY ACCOMPLISHED THROUGH INFLAMMATORY INDUCTION, WHEREBY CHRONIC INFLAMMATION SETS UP A CONSTANT PHYSIOLOGICAL STATE OF INFLAMMATORY CELL RECRUITMENT. THE SECRETIONS OF THESE INFLAMMATORY CELLS CAN ALTER THE GENETIC MAKEUP OF PROLIFERATING CELLS, WHICH CAN IN TURN, PROMOTE TUMOR GROWTH.THIS CHAPTER ALSO PRESENTS AN IN-DEPTH ANALYSIS OF MOLECULAR INTERACTIONS WITHIN THE TME, INCLUDING SECRETORY CYTOKINES AND EXOSOMES. SINCE THE EXOSOMAL CARGO OF A CELL IS A REFLECTION AND FINGERPRINT OF THE ORIGINATING PARENTAL CELLS, THE PROFILING OF EXOSOMAL MIRNA DERIVED FROM THYROID CANCER CELLS AND MACROPHAGES IN THE TME MAY SERVE AS AN IMPORTANT STEP IN BIOMARKER DISCOVERY. IDENTIFICATION OF A DISTINCT SET OF TUMOR SUPPRESSIVE MIRNAS DOWNREGULATED IN ATC-SECRETED EXOSOMES INDICATES THEIR ROLE IN THE REGULATION OF TUMOR SUPPRESSIVE GENES THAT MAY INCREASE THE METASTATIC PROPENSITY OF ATC. ADDITIONALLY, THE HIGH EXPRESSION OF PRO-INFLAMMATORY CYTOKINES IN STUDIES LOOKING AT THYROID CANCER AND ACTIVATED MACROPHAGE CONDITIONED MEDIA SUGGESTS THE EXISTENCE OF AN INFLAMMATORY TME IN THYROID CANCER. NEW FINDINGS ARE SUGGESTIVE OF THE PRESENCE OF A METASTATIC NICHE IN ATC TISSUES THAT IS INFLUENCED BY THYROID TUMOR MICROENVIRONMENT SECRETOME-INDUCED EPITHELIAL TO MESENCHYMAL TRANSITION (EMT), MEDIATED BY A RECIPROCAL INTERACTION BETWEEN THE PRO-INFLAMMATORY M1 MACROPHAGES AND THE THYROID CANCER CELLS. THUS, TARGETING THE METASTATIC THYROID CARCINOMA MICROENVIRONMENT COULD OFFER POTENTIAL THERAPEUTIC BENEFITS AND SHOULD BE EXPLORED FURTHER IN PRECLINICAL AND TRANSLATIONAL MODELS OF HUMAN METASTATIC THYROID CANCER. 2021 6 4966 29 PATHOGENOMICS OF ENDOMETRIOSIS DEVELOPMENT. FOR OVER 100 YEARS, ENDOMETRIOSIS, AS A CHRONIC, ESTROGEN-DEPENDENT, INFLAMMATORY, HERITABLE DISEASE AFFECTING APPROXIMATELY 5(-)10% OF WOMEN IN REPRODUCTIVE AGE HAS BEEN THE FOCUS OF CLINICIANS AND SCIENTISTS. IN SPITE OF NUMEROUS ENVIRONMENTAL, GENETIC, EPIGENETIC, ENDOCRINE, AND IMMUNOLOGICAL STUDIES, OUR KNOWLEDGE OF ENDOMETRIOSIS IS STILL FRAGMENTARY, AND ITS PRECISE PATHOPHYSIOLOGY AND PATHOGENOMICS REMAIN A MYSTERY. THE IMPLEMENTATION OF NEW TECHNOLOGIES HAS PROVIDED TREMENDOUS PROGRESS IN UNDERSTANDING THE MANY INTRINSIC MOLECULAR MECHANISMS IN THE DEVELOPMENT OF ENDOMETRIOSIS, WITH PROGENITOR AND STEM CELLS (SCS) OF THE EUTOPIC ENDOMETRIUM AS THE STARTING PLAYERS AND ENDOMETRIOTIC LESIONS AS THE FINAL PATHOMORPHOLOGICAL TRAIT. NOVEL DATA ON THE MOLECULAR, GENETIC, AND EPIGENETIC MECHANISMS OF THE DISEASE ARE BRIEFLY OUTLINED. WE HYPOTHESIZE THE EXISTENCE OF AN ENDOMETRIOSIS DEVELOPMENT GENETIC PROGRAM (EMDP) THAT GOVERNS THE ORIGIN OF ENDOMETRIUM STEM CELLS PROGRAMMED FOR ENDOMETRIOSIS (1), THEIR TRANSITION (METAPLASIA) INTO MESENCHYMAL SCS (2), AND THEIR INVASION OF THE PERITONEUM AND PROGRESSION TO ENDOMETRIOTIC LESIONS (3). THE PROS AND CONS OF THE RECENT UNIFYING THEORY OF ENDOMETRIOSIS ARE ALSO DISCUSSED. COMPLEX GENOMIC AND EPIGENETIC INTERACTIONS AT DIFFERENT STAGES OF THE ENDOMETRIOSIS PROCESS RESULT IN DIFFERENT FORMS OF THE DISEASE, WITH SPECIFIC FEATURES AND CLINICAL MANIFESTATIONS. THE SIGNIFICANCE OF THE EMDP IN ELABORATING A NEW STRATEGY FOR ENDOMETRIOSIS PREDICTION, PREVENTION, AND TREATMENT IS DISCUSSED. 2018 7 2813 29 FIBROBLAST REPROGRAMMING IN GASTROINTESTINAL CANCER. GASTROINTESTINAL CANCERS ARE A SIGNIFICANT CAUSE OF CANCER MORTALITY WORLDWIDE AND HAVE BEEN STRONGLY LINKED WITH CHRONIC INFLAMMATION. CURRENT THERAPIES FOCUS ON EPITHELIAL/CANCER CELLS; HOWEVER, THE IMPORTANCE OF THE TUMOR MICROENVIRONMENT IN THE DEVELOPMENT AND TREATMENT OF THE DISEASE IS ALSO NOW WELL ESTABLISHED. CANCER-ASSOCIATED FIBROBLASTS (CAFS) ARE A MAJOR COMPONENT OF THE TUMOR MICROENVIRONMENT, AND ARE ACTIVELY PARTICIPATING IN TUMOR INITIATION, PROMOTION AND METASTASIS. THEY STRUCTURALLY AND FUNCTIONALLY AFFECT CANCER CELL PROLIFERATION, TUMOR IMMUNITY, ANGIOGENESIS, EXTRACELLULAR MATRIX REMODELING AND METASTASIS THROUGH A VARIETY OF SIGNALING PATHWAYS. CAFS ORIGINATE PREDOMINANTLY FROM RESIDENT MESENCHYMAL CELLS, WHICH ARE ACTIVATED AND REPROGRAMMED IN RESPONSE TO CUES FROM CANCER CELLS. IN RECENT YEARS, CHRONIC INFLAMMATION OF THE GASTROINTESTINAL TRACT HAS ALSO PROVEN AN IMPORTANT DRIVER OF MESENCHYMAL CELL ACTIVATION AND SUBSEQUENT CAF DEVELOPMENT, WHICH IN TURN ARE CAPABLE OF REGULATING THE TRANSITION FROM ACUTE TO CHRONIC INFLAMMATION AND CANCER. IN THIS REVIEW, WE WILL PROVIDE A CONCISE OVERVIEW OF THE MECHANISMS THAT DRIVE FIBROBLAST REPROGRAMMING IN CANCER AND THE RECENT ADVANCES ON THE DOWNSTREAM SIGNALING PATHWAYS THAT REGULATE THE FUNCTIONAL PROPERTIES OF THE ACTIVATED MESENCHYME. THIS NEW MECHANISTIC INSIGHT COULD PAVE THE WAY FOR NEW THERAPEUTIC STRATEGIES AND BETTER PROGNOSIS FOR CANCER PATIENTS. 2020 8 4666 35 NEW INSIGHTS AND OPTIONS INTO THE MECHANISMS AND EFFECTS OF COMBINED TARGETED THERAPY AND IMMUNOTHERAPY IN PROSTATE CANCER. CHRONIC INFLAMMATION IS BELIEVED TO DRIVE PROSTATE CARCINOGENESIS BY PRODUCING REACTIVE OXYGEN SPECIES OR REACTIVE NITROGEN SPECIES TO INDUCE DNA DAMAGE. THIS EFFECT MIGHT SUBSEQUENTLY CAUSE EPIGENETIC AND GENOMIC ALTERATIONS, LEADING TO MALIGNANT TRANSFORMATION. ALTHOUGH ESTABLISHED THERAPEUTIC ADVANCES HAVE EXTENDED OVERALL SURVIVAL, TUMORS IN PATIENTS WITH ADVANCED PROSTATE CANCER ARE PRONE TO METASTASIS, TRANSFORMATION INTO METASTATIC CASTRATION-RESISTANT PROSTATE CANCER, AND THERAPEUTIC RESISTANCE. THE TUMOR MICROENVIRONMENT (TME) OF PROSTATE CANCER IS INVOLVED IN CARCINOGENESIS, INVASION AND DRUG RESISTANCE. A PLETHORA OF PRECLINICAL STUDIES HAVE FOCUSED ON IMMUNE-BASED THERAPIES. UNDERSTANDING THE INTRICATE TME SYSTEM IN PROSTATE CANCER MAY HOLD MUCH PROMISE FOR DEVELOPING NOVEL THERAPIES, DESIGNING COMBINATIONAL THERAPEUTIC STRATEGIES, AND FURTHER OVERCOMING RESISTANCE TO ESTABLISHED TREATMENTS TO IMPROVE THE LIVES OF PROSTATE CANCER PATIENTS. IN THIS REVIEW, WE DISCUSS NONIMMUNE COMPONENTS AND VARIOUS IMMUNE CELLS WITHIN THE TME AND THEIR PUTATIVE ROLES DURING PROSTATE CANCER INITIATION, PROGRESSION, AND METASTASIS. WE ALSO OUTLINE THE UPDATED FUNDAMENTAL RESEARCH FOCUSING ON THERAPEUTIC ADVANCES OF TARGETED THERAPY AS WELL AS COMBINATIONAL OPTIONS FOR PROSTATE CANCER. 2023 9 4800 30 OBESITY AND INFLAMMATION: COLORECTAL CANCER ENGINES. THE PREVALENCE OF OBESITY CONTINUES TO INCREASE TO THE EXTENT THAT IT BECAME A WORLDWIDE PANDEMIC. AN ACCUMULATING BODY OF EVIDENCE HAS ASSOCIATED OBESITY WITH THE DEVELOPMENT OF DIFFERENT TYPES OF CANCER, INCLUDING COLORECTAL CANCER, WHICH IS A NOTORIOUS DISEASE WITH A HIGH MORTALITY RATE. AT THE MOLECULAR LEVEL, COLORECTAL CANCER IS A HETEROGENOUS DISEASE CHARACTERIZED BY A MYRIAD OF GENETIC AND EPIGENETIC ALTERATIONS ASSOCIATED WITH VARIOUS FORMS OF GENOMIC INSTABILITY (DETAILED IN SUPPLEMENTARY MATERIALS). RECENTLY, THE MICROENVIRONMENT HAS EMERGED AS A MAJOR FACTOR IN CARCINOGENESIS. OUR AIM IS TO DEFINE THE DIFFERENT MOLECULAR ALTERATIONS LEADING TO THE DEVELOPMENT OF COLORECTAL CANCER IN OBESE PATIENTS WITH A FOCUS ON THE ROLE OF THE MICROENVIRONMENT IN CARCINOGENESIS. WE ALSO HIGHLIGHT ALL EXISTENT MOLECULES IN CLINICAL TRIALS THAT TARGET THE ACTIVATED PATHWAYS IN OBESITY-ASSOCIATED COLORECTAL CANCER, WHETHER USED AS SINGLE TREATMENTS OR IN COMBINATION. OBESITY PREDISPOSES TO COLORECTAL CANCER VIA CREATING A STATE OF CHRONIC INFLAMMATION WITH DYSREGULATED ADIPOKINES, INFLAMMATORY MEDIATORS, AND OTHER FACTORS SUCH AS IMMUNE CELL INFILTRATION. A UNIFYING THEME IN OBESITY-MEDIATED COLORECTAL CANCER IS THE ACTIVATION OF THE PI3K/AKT, MTOR/MAPK, AND STAT3 SIGNALING PATHWAYS. DIFFERENT INHIBITORY MOLECULES TOWARDS THESE PATHWAYS EXIST, INCREASING THE THERAPEUTIC CHOICE OF OBESITY-ASSOCIATED COLON CANCER. HOWEVER, OBESE PATIENTS ARE MORE LIKELY TO SUFFER FROM CHEMOTHERAPY OVERDOSING. PREVENTING OBESITY THROUGH MAINTAINING A HEALTHY AND ACTIVE LIFESTYLE REMAINS TO BE THE BEST REMEDY. 2022 10 391 37 AN INTRODUCTION TO THE MATHEMATICAL MODELING IN THE STUDY OF CANCER SYSTEMS BIOLOGY. BACKGROUND: FREQUENTLY OCCURRING IN CANCER ARE THE ABERRANT ALTERATIONS OF REGULATORY ONCO-METABOLITES, VARIOUS ONCOGENES/EPIGENETIC STOCHASTICITY, AND SUPPRESSOR GENES, AS WELL AS THE DEFICIENT MISMATCH REPAIR MECHANISM, CHRONIC INFLAMMATION, OR THOSE DEVIATIONS BELONGING TO THE OTHER CANCER CHARACTERISTICS. HOW THESE ABERRATIONS THAT EVOLVE OVERTIME DETERMINE THE GLOBAL PHENOTYPE OF MALIGNANT TUMORS REMAINS TO BE COMPLETELY UNDERSTOOD. DYNAMIC ANALYSIS MAY HAVE POTENTIAL TO REVEAL THE MECHANISM OF CARCINOGENESIS AND CAN OFFER NEW THERAPEUTIC INTERVENTION. AIMS: WE INTRODUCE SIMPLIFIED MATHEMATICAL TOOLS TO MODEL SERIAL QUANTITATIVE DATA OF CANCER BIOMARKERS. WE ALSO HIGHLIGHT AN INTRODUCTORY OVERVIEW OF MATHEMATICAL TOOLS AND MODELS AS THEY APPLY FROM THE VIEWPOINT OF KNOWN CANCER FEATURES. METHODS: MATHEMATICAL MODELING OF POTENTIALLY ACTIONABLE GENOMIC PRODUCTS AND HOW THEY PROCEED OVERTIME DURING TUMORIGENESIS ARE EXPLORED. THIS REPORT IS INTENDED TO BE INSTINCTIVE WITHOUT BEING OVERLY TECHNICAL. RESULTS: TO DATE, MANY MATHEMATICAL MODELS OF THE COMMON FEATURES OF CANCER HAVE BEEN DEVELOPED. HOWEVER, THE DYNAMIC OF INTEGRATED HETEROGENEOUS PROCESSES AND THEIR CROSS TALKS RELATED TO CARCINOGENESIS REMAINS TO BE RESOLVED. CONCLUSIONS: IN CANCER RESEARCH, OUTLINING MATHEMATICAL MODELING OF EXPERIMENTALLY OBTAINED DATA SNAPSHOTS OF MOLECULAR SPECIES MAY PROVIDE INSIGHTS INTO A BETTER UNDERSTANDING OF THE MULTIPLE BIOCHEMICAL CIRCUITS. RECENT DISCOVERIES HAVE PROVIDED SUPPORT FOR THE EXISTENCE OF COMPLEX CANCER PROGRESSION IN DYNAMICS THAT SPAN FROM A SIMPLE 1-DIMENSIONAL DETERMINISTIC SYSTEM TO A STOCHASTIC (IE, PROBABILISTIC) OR TO AN OSCILLATORY AND MULTISTABLE NETWORKS. FURTHER RESEARCH IN MATHEMATICAL MODELING OF CANCER PROGRESSION, BASED ON THE EVOLVING MOLECULAR KINETICS (TIME SERIES), COULD INFORM A SPECIFIC AND A PREDICTIVE BEHAVIOR ABOUT THE GLOBAL SYSTEMS BIOLOGY OF VULNERABLE TUMOR CELLS IN THEIR EARLIER STAGES OF ONCOGENESIS. ON THIS FOOTING, NEW PREVENTIVE MEASURES AND ANTICANCER THERAPY COULD THEN BE CONSTRUCTED. 2018 11 6143 29 THE EVOLVING LANDSCAPE OF CANCER STEM CELLS AND WAYS TO OVERCOME CANCER HETEROGENEITY. CANCER STEM CELLS (CSCS) WITH THERAPEUTIC RESISTANCE AND PLASTICITY CAN BE FOUND IN VARIOUS TYPES OF TUMORS AND ARE RECOGNIZED AS ATTRACTIVE TARGETS FOR TREATMENTS. AS CSCS ARE DERIVED FROM TISSUE STEM OR PROGENITOR CELLS, AND/OR DEDIFFERENTIATED MATURE CELLS, THEIR SIGNAL TRANSDUCTION PATHWAYS ARE CRITICAL IN THE REGULATION OF CSCS; CHRONIC INFLAMMATION CAUSES THE ACCUMULATION OF GENETIC MUTATIONS AND ABERRANT EPIGENETIC CHANGES IN THESE CELLS, POTENTIALLY LEADING TO THE PRODUCTION OF CSCS. HOWEVER, THE NATURE OF CSCS APPEARS TO BE STRONGER THAN THE TREATMENTS OF THE PAST. TO IMPROVE THE TREATMENTS TARGETING CSCS, IT IS IMPORTANT TO INHIBIT SEVERAL MOLECULES ON THE SIGNALING CASCADES IN CSCS SIMULTANEOUSLY, AND TO OVERCOME CANCER HETEROGENEITY CAUSED BY THE PLASTICITY. TO SELECT SUITABLE TARGET MOLECULES FOR CSCS, WE HAVE TO EXPLORE THE LANDSCAPE OF CSCS FROM THE PERSPECTIVE OF CANCER STEMNESS AND SIGNALING SYSTEMS, BASED ON THE CURATED DATABASES OF CANCER-RELATED GENES. WE HAVE BEEN STUDYING THE INTEGRATION OF A BROAD RANGE OF KNOWLEDGE AND EXPERIENCES FROM CANCER BIOLOGY, AND ALSO FROM OTHER INTERDISCIPLINARY BASIC SCIENCES. IN THIS REVIEW, WE HAVE INTRODUCED THE CONCEPT OF DEVELOPING NOVEL STRATEGIES TARGETING CSCS. 2019 12 1237 37 CURCUMIN AND COLORECTAL CANCER: AN UPDATE AND CURRENT PERSPECTIVE ON THIS NATURAL MEDICINE. COLORECTAL CANCER (CRC) IS ONE OF MOST COMMON MALIGNANCIES WORLDWIDE AND ITS INCIDENCE IS STILL GROWING. IN SPITE OF RECENT ADVANCES IN TARGETED THERAPIES, THEIR CLINICAL EFFICACY HAS BEEN LIMITED, NON-CURATIVE AND UNAFFORDABLE. A GROWING BODY OF LITERATURE INDICATES THAT CRC IS A MULTI-MODAL DISEASE, WHERE A VARIETY OF FACTORS WITHIN THE TUMOR MICROENVIRONMENT PLAY A SIGNIFICANT ROLE IN ITS PATHOGENESIS. FOR INSTANCE, IMBALANCE IN GUT MICROBIAL PROFILES AND IMPAIRED INTESTINAL BARRIER FUNCTION CONTRIBUTE TO THE OVERALL INTESTINAL INFLAMMATION AND INITIATION OF CRC. MOREOVER, PERSISTENT CHRONIC INFLAMMATION FAVORS A TUMOR MICROENVIRONMENT FOR THE GROWTH OF CANCER. IN ADDITION, AUTOPHAGY OR 'SELF-EATING' IS A SURVEILLANCE MECHANISM INVOLVED IN THE DEGRADATION OF CELLULAR CONSTITUENTS THAT ARE GENERATED UNDER STRESSFUL CONDITIONS. CANCER STEM CELLS (CSCS), ON THE OTHER HAND, ENGAGE IN THE ONSET OF CRC AND ARE ABLE TO ENDOW CANCER CELLS WITH CHEMO-RESISTANCE. FURTHERMORE, THE ABERRANT EPIGENETIC ALTERATIONS PROMOTE CRC. THESE EVIDENCES HIGHLIGHT THE NEED FOR MULTI-TARGETED APPROACHES THAT ARE NOT ONLY SAFE AND INEXPENSIVE BUT OFFER A MORE EFFECTIVE ALTERNATIVE TO CURRENT GENERATION OF TARGETED DRUGS. CURCUMIN, DERIVED FROM THE PLANT CURCUMA LONGA, REPRESENTS ONE SUCH OPTION THAT HAS A LONG HISTORY OF ITS USE FOR A VARIETY OF CHRONIC DISEASE INCLUDING CANCER, IN INDIAN AYURVEDIC AND TRADITIONAL CHINESE MEDICINE. SCIENTIFIC EVIDENCE OVER THE PAST FEW DECADES HAVE OVERWHELMINGLY SHOWN THAT CURCUMIN EXHIBITS A MULTITUDE OF ANTI-CANCER ACTIVITIES ORCHESTRATED THROUGH KEY SIGNALING PATHWAYS ASSOCIATED WITH CANCER. IN THIS ARTICLE, WE WILL PRESENT A CURRENT UPDATE AND PERSPECTIVE ON THIS NATURAL MEDICINE - INCORPORATING THE BASIC CELLULAR MECHANISMS IT EFFECTS AND THE CURRENT STATE OF CLINICAL EVIDENCE, CHALLENGES AND PROMISE FOR ITS USE AS A CANCER PREVENTATIVE AND POTENTIAL ADJUNCT TOGETHER WITH MODERN THERAPIES FOR CRC PATIENTS. 2022 13 3110 34 GENOTYPE- OR PHENOTYPE-TARGETING ANTICANCER THERAPIES? LESSONS FROM TUMOR EVOLUTIONARY BIOLOGY. DESPITE THE EFFICACY OF MOST CANCER THERAPIES, DRUG RESISTANCE REMAINS A MAJOR PROBLEM IN THE CLINIC. THE ERADICATION OF THE ENTIRE TUMOR AND THE CURE OF THE PATIENT BY CHEMOTHERAPY ALONE ARE RARE, IN PARTICULAR FOR ADVANCED DISEASE. FROM AN EVOLUTIONARY PERSPECTIVE, THE SELECTIVE PRESSURE EXERTED BY CHEMOTHERAPY LEADS TO THE EMERGENCE OF RESISTANT CLONES WHERE RESISTANCE CAN BE ASSOCIATED WITH MANY DIFFERENT FUNCTIONAL MECHANISMS AT THE SINGLE CELL LEVEL OR CAN INVOLVE CHANGES IN THE TUMOR MICRO-ENVIRONMENT. IN THE LAST DECADE, TUMOR GENOMICS HAS CONTRIBUTED TO THE IMPROVEMENT OF OUR UNDERSTANDING OF TUMORIGENESIS AND HAS LED TO THE IDENTIFICATION OF NUMEROUS CELLULAR TARGETS FOR THE DEVELOPMENT OF NOVEL THERAPIES. HOWEVER, SINCE TUMORS ARE BY NATURE EXTREMELY HETEROGENEOUS, THE DRUG EFFICACY AND ECONOMICAL SUSTAINABILITY OF THIS APPROACH IS NOW DEBATABLE. IMPORTANTLY, TUMOR CELL HETEROGENEITY DEPENDS NOT ONLY ON GENETIC MODIFICATIONS BUT ALSO ON NON-GENETIC PROCESSES INVOLVING EITHER STOCHASTIC EVENTS OR EPIGENETIC MODIFICATIONS MAKING GENETIC BIOMARKERS OF UNCERTAIN UTILITY. IN THIS REVIEW, WE WISH TO HIGHLIGHT HOW EVOLUTIONARY BIOLOGY CAN IMPACT OUR UNDERSTANDING OF CARCINOGENESIS AND RESISTANCE TO THERAPIES. WE WILL DISCUSS NEW APPROACHES BASED ON APPLIED ECOLOGY AND EVOLUTION DYNAMICS THAT CAN BE USED TO CONVERT THE CANCER INTO A CHRONIC DISEASE WHERE THE DRUGS WOULD CONTROL TUMOR GROWTH. FINALLY, WE WILL DISCUSS THE WAY METABOLIC DYSFUNCTION OR PHENOTYPIC CHANGES CAN HELP DEVELOPING NEW DELIVERY SYSTEMS OR PHENOTYPETARGETED DRUGS AND HOW EXPLORING NEW SOURCES OF ACTIVE COMPOUNDS CAN CONDUCT TO THE DEVELOPMENT OF DRUGS WITH ORIGINAL MECHANISMS OF ACTION. 2016 14 1006 30 CHRONIC VIRAL INFECTION AND PRIMARY CENTRAL NERVOUS SYSTEM MALIGNANCY. PRIMARY CENTRAL NERVOUS SYSTEM (CNS) TUMORS CAUSE SIGNIFICANT MORBIDITY AND MORTALITY IN BOTH ADULTS AND CHILDREN. WHILE SOME OF THE GENETIC AND MOLECULAR MECHANISMS OF NEURO-ONCOGENESIS ARE KNOWN, MUCH LESS IS KNOWN ABOUT POSSIBLE EPIGENETIC CONTRIBUTIONS TO DISEASE PATHOPHYSIOLOGY. OVER THE LAST SEVERAL DECADES, CHRONIC VIRAL INFECTIONS HAVE BEEN ASSOCIATED WITH A NUMBER OF HUMAN MALIGNANCIES. IN PRIMARY CNS MALIGNANCIES, TWO FAMILIES OF VIRUSES, NAMELY POLYOMAVIRUS AND HERPESVIRUS, HAVE BEEN DETECTED WITH VARIED FREQUENCIES IN A NUMBER OF PEDIATRIC AND ADULT HISTOLOGICAL TUMOR SUBTYPES. HOWEVER, ESTABLISHING A LINK BETWEEN CHRONIC VIRAL INFECTION AND PRIMARY CNS MALIGNANCY HAS BEEN AN AREA OF CONSIDERABLE CONTROVERSY, DUE IN PART TO VARIATIONS IN DETECTION FREQUENCIES AND METHODOLOGIES USED AMONG RESEARCHERS. SINCE A LATENT VIRAL NEUROTROPISM CAN BE SEEN WITH A VARIETY OF VIRUSES AND A WIDESPREAD SEROPOSITIVITY EXISTS AMONG THE POPULATION, IT HAS BEEN DIFFICULT TO ESTABLISH AN ASSOCIATION BETWEEN VIRAL INFECTION AND CNS MALIGNANCY BASED ON EPIDEMIOLOGY ALONE. WHILE DIRECT EVIDENCE OF A ROLE OF VIRUSES IN NEURO-ONCOGENESIS IN HUMANS IS LACKING, A MORE PLAUSIBLE HYPOTHESIS OF NEURO-ONCOMODULATION HAS BEEN PROPOSED. THE OVERALL GOALS OF THIS REVIEW ARE TO SUMMARIZE THE MANY HUMAN INVESTIGATIONS THAT HAVE STUDIED VIRAL INFECTION IN PRIMARY CNS TUMORS, DISCUSS POTENTIAL NEURO-ONCOMODULATORY MECHANISMS OF VIRAL-ASSOCIATED CNS DISEASE AND PROPOSE FUTURE RESEARCH DIRECTIONS TO ESTABLISH A MORE FIRM ASSOCIATION BETWEEN CHRONIC VIRAL INFECTIONS AND PRIMARY CNS MALIGNANCIES. 2010 15 2897 27 GASTRIC TUMOR MICROENVIRONMENT. A COMPELLING BODY OF EVIDENCE HAS DEMONSTRATED THAT GASTRIC CANCER HAS A VERY PARTICULAR TUMOR MICROENVIRONMENT, A SIGNATURE VERY SUITABLE TO PROMOTE TUMOR PROGRESSION AND METASTASIS. RECENT INVESTIGATIONS HAVE PROVIDED NEW INSIGHTS INTO THE MULTIPLE MOLECULAR MECHANISMS, DEFINED BY GENETIC AND EPIGENETIC MECHANISMS, SUPPORTING A VERY ACTIVE CROSS TALK BETWEEN THE COMPONENTS OF THE TUMOR MICROENVIRONMENT AND THUS DEFINING THE FATE OF TUMOR PROGRESSION. IN THIS REVIEW, WE INTEND TO HIGHLIGHT THE ROLE OF VERY ACTIVE CONTRIBUTORS AT GASTRIC CANCER TME, PARTICULARLY CANCER-ASSOCIATED FIBROBLASTS, BONE MARROW-DERIVED CELLS, TUMOR-ASSOCIATED MACROPHAGES, AND TUMOR-INFILTRATING NEUTROPHILS, ALL OF THEM SURROUNDED BY AN OVERTIME CHANGING EXTRACELLULAR MATRIX. IN ADDITION, THE VERY ACTIVE CROSS TALK BETWEEN THE COMPONENTS OF THE TUMOR MICROENVIRONMENT, DEFINED BY GENETIC AND EPIGENETIC MECHANISMS, THUS DEFINING THE FATE OF TUMOR PROGRESSION, IS ALSO REVIEWED. 2020 16 6675 28 USING EPIGENETIC THERAPY TO OVERCOME CHEMOTHERAPY RESISTANCE. IT HAS BEEN KNOWN FOR DECADES THAT AS CANCER PROGRESSES, TUMORS DEVELOP GENETIC ALTERATIONS, MAKING THEM HIGHLY PRONE TO DEVELOPING RESISTANCE TO THERAPIES. CLASSICALLY, IT HAS BEEN THOUGHT THAT THESE ACQUIRED GENETIC CHANGES ARE FIXED. THIS HAS LED TO THE PARADIGM OF MOVING FROM ONE CANCER THERAPY TO THE NEXT WHILE AVOIDING PAST THERAPIES. HOWEVER, EMERGING DATA ON EPIGENETIC CHANGES DURING TUMOR PROGRESSION AND USE OF EPIGENETIC THERAPIES HAVE SHOWN THAT EPIGENETIC MODIFICATIONS LEADING TO CHEMOTHERAPY RESISTANCE HAVE THE POTENTIAL TO BE REVERSIBLE WITH EPIGENETIC THERAPY. IN FACT, PROMISING CLINICAL DATA EXIST THAT TREATMENT WITH EPIGENETIC AGENTS CAN DIMINISH CHEMOTHERAPY RESISTANCE IN A NUMBER OF TUMOR TYPES INCLUDING CHRONIC MYELOGENOUS LEUKEMIA, COLORECTAL, OVARIAN, LUNG AND BREAST CANCER. THE POTENTIAL FOR EPIGENETIC-MODIFYING DRUGS TO ALLOW FOR TREATMENT OF RESISTANT DISEASE IS EXCITING AND CLINICAL TRIALS HAVE JUST BEGUN TO EVALUATE THIS AREA. 2016 17 6733 27 WHAT CAN CHEMICAL CARCINOGENESIS SHED LIGHT ON THE LNT HYPOTHESIS IN RADIATION CARCINOGENESIS? TO PROTECT THE PUBLIC'S HEALTH FROM EXPOSURE TO PHYSICAL, CHEMICAL, AND MICROBIOLOGICAL AGENTS, IT IS IMPORTANT THAT ANY POLICY BE BASED ON RIGOROUS SCIENTIFICALLY BASED RESEARCH. THE CONCEPT OF "LINEAR NO-THRESHOLD" (LNT) HAS BEEN IMPLEMENTED TO PROVIDE GUIDELINE EXPOSURES TO THESE AGENTS. THE PRACTICAL LIMITATION TO TESTING THIS HYPOTHESIS IS TO PROVIDE SUFFICIENT SAMPLES FOR EXPERIMENTAL OR EPIDEMIOLOGICAL STUDIES. WHILE THERE IS NO UNIVERSALLY ACCEPTED UNDERSTANDING OF MOST HUMAN DISEASES, THERE SEEMS TO BE BETTER UNDERSTANDING OF CANCER THAT MIGHT HELP RESOLVE THE "LNT" MODEL. THE PUBLIC'S CONCERN, AFTER BEING EXPOSED TO RADIATION, IS THE POTENTIAL OF PRODUCING CANCER. THE MOST RIGOROUS HYPOTHESIS OF HUMAN CARCINOGENESIS IS THE "MULTISTAGE, MULTIMECHANISM" CHEMICAL CARCINOGENESIS MODEL. THE RADIATION CARCINOGENESIS LNT MODEL, RARELY, IF EVER, BUILT IT INTO THEIR SUPPORT. IT WILL BE ARGUED THAT THIS MULTISTAGE, MULTIMECHANISM MODEL OF CARCINOGENESIS, INVOLVING THE "INITIATION" OF A SINGLE CELL BY A MUTAGEN EVENT, FOLLOWED BY CHRONIC EXPOSURE TO THRESHOLD LEVELS OF EPIGENETIC AGENTS OR CONDITIONS THAT STIMULATE THE CLONAL EXPANSION OF THE "INITIATED" CELL, CAN CONVERT THESE BENIGN CELLS TO BECOME INVASIVE AND METASTATIC. THIS "PROMOTION" PROCESS CAN BE INTERRUPTED, THEREBY PREVENTING THESE INITIATED CELLS FROM TRANSITIONING TO THE "PROGRESSION" PROCESS OF INVASION AND METASTASIS. 2019 18 5290 23 PROSTATE CANCER PREVENTION: AGENT DEVELOPMENT STRATEGIES. DESPITE ADVANCES IN SURGERY, RADIATION, AND MEDICAL THERAPY OVER THE PAST DECADE AND THE WIDESPREAD ADOPTION OF PSA SCREENING, PROSTATE CANCER CONTINUES TO BE THE SECOND LEADING CAUSE OF CANCER DEATH IN MEN IN THE UNITED STATES. INVASIVE CANCER IS THE END RESULT OF CARCINOGENESIS, A CHRONIC PROCESS OCCURRING OVER MANY YEARS DRIVEN BY GENETIC AND EPIGENETIC ALTERATIONS. THE PROTRACTED NATURE OF THIS TRANSFORMATION TO THE MALIGNANT PHENOTYPE PROVIDES AN OPPORTUNITY TO INTERVENE PHARMACOLOGICALLY TO PREVENT, REVERSE, OR DELAY CARCINOGENESIS, I.E. CHEMOPREVENTION. HEREIN, WE DESCRIBE THE UNIQUE FEATURES OF CANCER PREVENTION, AS OPPOSED TO CANCER TREATMENT, AGENT DEVELOPMENT CLINICAL TRIALS, AND PROVIDE A SUMMARY OF THE ONGOING RESEARCH IN THIS FIELD BEING SUPPORTED BY THE NATIONAL CANCER INSTITUTE. 2014 19 6466 34 TISSUE STEM CELLS AND CANCER STEM CELLS: POTENTIAL IMPLICATIONS FOR GASTRIC CANCER. GASTRIC CANCER REMAINS THE SECOND LEADING CAUSE OF DEATH IN THE WORLD TODAY, MAKING THE SEARCH FOR ITS MOLECULAR AND CELLULAR BASIS AN IMPORTANT PRIORITY. THOUGH RECOGNITION OF THE TIGHT LINK BETWEEN INFLAMMATION AND TUMORIGENESIS IS CENTURIES OLD, ONLY RECENTLY ARE THE PIECES OF THE ETIOLOGICAL PUZZLE BEGINNING TO FALL TOGETHER. RECENT ADVANCES IN GASTRIC STEM CELL BIOLOGY APPEAR TO BE CENTRAL TO THIS SLOWLY RESOLVING PUZZLE. AT LEAST TWO TYPES OF STEM CELLS MAY BE IMPORTANT. RESIDENT ADULT OR TISSUE STEM CELLS MAY, IN A CHRONICALLY INFLAMED ENVIRONMENT, SLOWLY ACQUIRE A SERIES OF GENETIC AND EPIGENETIC CHANGES THAT LEAD TO THEIR EMERGENCE AS ''CANCER STEM CELLS''. THIS SCENARIO HAS NOT YET BEEN PROVEN EXPERIMENTALLY, ALTHOUGH THE FIRST STEP, PROSPECTIVE RECOGNITION OF A GASTRIC STEM CELL HAS RECENTLY BEEN CONQUERED. ALTERNATIVELY, THE SETTING OF CHRONIC INFLAMMATORY STRESS AND INJURY MAY LEAD TO LOSS OF THE INDIGENOUS GASTRIC STEM CELLS FROM THEIR NICHES; BONE MARROW DERIVED STEM CELLS MAY THEN BE RECRUITED TO AND ENGRAFT INTO THE GASTRIC EPITHELIUM. SUCH RECRUITED CELLS HAVE THE POTENTIAL TO CONTRIBUTE TO THE TUMOR MASS. INDEED, EVIDENCE SUPPORTING THIS SCENARIO HAS BEEN PUBLISHED. HERE, WE REVIEW THESE RECENT FINDINGS AND DISCUSS IMPLICATIONS FOR THE FUTURE. 2008 20 2881 25 FUTURE PERSPECTIVES OF PERSONALIZED WEIGHT LOSS INTERVENTIONS BASED ON NUTRIGENETIC, EPIGENETIC, AND METAGENOMIC DATA. AS OBESITY HAS BECOME A MAJOR GLOBAL PUBLIC HEALTH CHALLENGE, A LARGE NUMBER OF STUDIES HAVE ANALYZED DIFFERENT STRATEGIES AIMED AT INDUCING A NEGATIVE ENERGY BALANCE AND, CONSEQUENTLY, BODY WEIGHT LOSS. HOWEVER, MOST EXISTING WEIGHT LOSS PROGRAMS ARE GENERALLY UNSUCCESSFUL, SO SEVERAL INTERVENTIONS HAVE BEEN CARRIED OUT TO IDENTIFY PHYSIOLOGIC AND BEHAVIORAL FACTORS CONCERNING THIS VARIABILITY IN ORDER TO IMPLEMENT MORE PERSONALIZED TREATMENT. NOWADAYS, AN INDIVIDUALIZED APPROACH IS BEING PROPOSED THROUGH SO-CALLED PERSONALIZED NUTRITION, WHEREBY NOT ONLY THE PHENOTYPE BUT ALSO THE GENOTYPE IS USED FOR CUSTOMIZED NUTRITION TREATMENT. REGARDING BODY WEIGHT REGULATION, APPROXIMATELY 70 POLYMORPHISMS HAVE BEEN IDENTIFIED IN OR NEAR GENES RELATED TO ENERGY EXPENDITURE, APPETITE, ADIPOGENESIS, INSULIN RESISTANCE, AND LIPID METABOLISM. ALTHOUGH PERSONALIZED NUTRITION REFERS MAINLY TO GENETIC MAKEUP, RECENT ADVANCES IN THE INVESTIGATION OF THE EPIGENOME AND THE MICROBIOME OPEN THE DOOR TO IMPLEMENT MORE PERSONALIZED RECOMMENDATIONS FOR BODY WEIGHT MANAGEMENT. IN THIS CONTEXT, RECENT STUDIES HAVE DEMONSTRATED THE EXISTENCE OF SEVERAL EPIGENETIC MARKERS THAT MAY MODIFY GENE EXPRESSION AND COULD BE INVOLVED IN THE OUTCOME OF WEIGHT LOSS INTERVENTIONS. MOREOVER, DIFFERENT STUDIES HAVE SHOWN THAT DIETARY INTERVENTIONS COULD AFFECT THE COMPOSITION OF GUT MICROBIOTA AND HAVE AN IMPACT ON BODY WEIGHT. THE INTEGRATION OF NUTRIGENETIC, EPIGENETIC, AND METAGENOMIC DATA MAY LEAD TO THE DESIGN OF MORE PERSONALIZED DIETARY TREATMENTS TO PREVENT CHRONIC DISEASES AND TO OPTIMIZE THE INDIVIDUAL'S RESPONSE TO DIETARY INTERVENTIONS. 2015