Badran Omar, Cohen Idan, Bar-Sela Gil
Department of Oncology, Emek Medical Center, Afula 1834111, Israel.
Technion Integrated Cancer Center, Faculty of Medicine, Technion, Haifa 3525422, Israel.
Cancers (Basel). 2024 Dec 13;16(24):4156. doi: 10.3390/cancers16244156.
Iron metabolism plays a dual role in cancer, serving as an essential nutrient for cellular functions and a potential catalyst for tumor growth and immune evasion. Here, we cover the complex interplay between iron levels within the serum or in the microenvironment and cancer therapy, focusing on how iron deficiency and overload can impact immune function, tumor progression, and treatment efficacy. On the one hand, we highlight iron deficiency as a factor of primary immune responses and its adverse effects on anti-cancer immunotherapy efficacy. On the other hand, we also stress the impact of iron overload as an essential factor contributing to tumor growth, creating a suppressive tumor microenvironment that hinders immune checkpoint inhibitor immunotherapy. Overall, we emphasize the necessity of the personalized management of iron levels in oncology patients as a critical element in treatment optimization to achieve favorable outcomes. Based on these considerations, we believe that close and careful monitoring and the tailored balancing of iron supplementation strategies should be the subject of further clinical studies, and routine iron management should be implemented in oncology clinical practice and integrated into cancer therapy protocols.
铁代谢在癌症中起着双重作用，既是细胞功能所必需的营养物质，又是肿瘤生长和免疫逃逸的潜在催化剂。在此，我们探讨血清或微环境中的铁水平与癌症治疗之间的复杂相互作用，重点关注缺铁和铁过载如何影响免疫功能、肿瘤进展和治疗效果。一方面，我们强调缺铁是原发性免疫反应的一个因素及其对抗癌免疫治疗效果的不利影响。另一方面，我们也强调铁过载作为促进肿瘤生长的一个关键因素的影响，它会形成一个抑制性肿瘤微环境，阻碍免疫检查点抑制剂免疫治疗。总体而言，我们强调肿瘤患者铁水平个性化管理的必要性，这是优化治疗以取得良好疗效的关键要素。基于这些考虑，我们认为密切而仔细的监测以及铁补充策略的量身定制平衡应成为进一步临床研究的主题，并且常规铁管理应在肿瘤临床实践中实施并纳入癌症治疗方案。
