Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg.
Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
Curr Opin Neurol. 2023 Dec 1;36(6):544-548. doi: 10.1097/WCO.0000000000001207. Epub 2023 Sep 26.
Emerging discoveries suggest that both the central (CNS) and peripheral (PNS) nervous system are an important driver of cancer initiation, promotion, dissemination, and therapy resistance, not only in the brain but also in multiple cancer types throughout the body. This article highlights the most recent developments in this emerging field of research over the last year and provides a roadmap for the future, emphasizing its translational potential.
Excitatory synapses between neurons and cancer cells that drive growth and invasion have been detected and characterized. In addition, a plethora of paracrine, mostly tumor-promoting neuro-cancer interactions are reported, and a neuro-immuno-cancer axis emerges. Cancer cell-intrinsic neural properties, and cancer (therapy) effects on the nervous system that cause morbidity in patients and can establish harmful feedback loops receive increasing attention. Despite the relative novelty of these findings, therapies that inhibit key mechanisms of this neuro-cancer crosstalk are developed, and already tested in clinical trials, largely by repurposing of approved drugs.
Neuro-cancer interactions are manyfold, have multiple clinical implications, and can lead to novel neuroscience-instructed cancer therapies and improved therapies of neurological dysfunctions and cancer pain. The development of biomarkers and identification of most promising therapeutic targets is crucial.
综述目的：新的发现表明，中枢神经系统（CNS）和周围神经系统（PNS）不仅在大脑中，而且在全身多种癌症类型中，都是癌症发生、促进、扩散和治疗耐药性的重要驱动因素。本文重点介绍了过去一年中这一新兴研究领域的最新进展，并为未来提供了路线图，强调了其转化潜力。
最新发现：已经检测到并描述了神经元和癌细胞之间促进生长和侵袭的兴奋性突触。此外，还报道了大量旁分泌的、主要促进肿瘤的神经-癌症相互作用，并出现了一个神经-免疫-癌症轴。越来越多的人关注癌细胞内在的神经特性，以及癌症（治疗）对神经系统的影响，这些影响会导致患者出现发病率，并可能建立有害的反馈循环。尽管这些发现相对较新，但已经开发出抑制这种神经-癌症相互作用的关键机制的治疗方法，并已在临床试验中进行测试，主要是通过重新利用已批准的药物。
总结：神经-癌症的相互作用是多方面的，具有多种临床意义，并可能导致新的神经科学指导的癌症治疗方法，以及改善神经功能障碍和癌症疼痛的治疗方法。开发生物标志物和确定最有前途的治疗靶点至关重要。
