Faculty Bibliography

Cancer pain (CP) arises from a complex interplay between the tumour and its microenvironment. Many patients experience a mixed pain phenotype that encompasses nociceptive, neuropathic and neuroinflammatory mechanisms, and vary across tumour type and disease stage. Despite decades of intensive research, the mainstay of cancer pain treatment is still non-steroidal anti-inflammatory drugs (NSAIDs) and opioids. Recent advances in cancer neuroscience have provided novel insights into the neurobiology of cancer pain. The emerging picture of cancer pain is a disorder of aberrant crosstalk between the tumour, the sensory innervation that the tumour creates and the immune cells that these nerves attract. Precision approaches to disrupt this aberrant pain signalling cascade are guided by newly recognized molecular mechanisms. Here, we review the current practice of cancer pain management and the emerging future of personalized, mechanism-driven pain therapy in oncology.

Head and neck cancer (HNC) presents significant clinical challenges due to its complex tumor biology, heterogeneous microenvironment, and limited therapeutic outcomes. Hydrogels, an innovative biopolymeric material, have gained considerable attention in both basic and translational oncology owing to their biocompatibility, biodegradability, tunable physicochemical properties, and ability to recapitulate the native tissue environment. This review provides a comprehensive overview of HNC epidemiology, molecular and cellular mechanisms, current and emerging therapeutic approaches, and the defining features of the tumor microenvironment. We then highlight diverse hydrogel systems under development, detailing their structural characteristics and biomedical applications. Hydrogel-based platforms have advanced tumor modeling by enabling three-dimensional (3D) culture systems that more accurately reflect in vivo conditions compared to conventional two-dimensional (2D) models. Cutting-edge technologies, including 3D bioprinting and tumor-on-a-chip microfluidic systems, offer new opportunities for precision modeling and drug testing in HNC. In addition, hydrogels are being engineered for therapeutic applications, such as localized and sustained drug delivery, immunomodulation, and tissue regeneration following tumor resection. Finally, we critically examine the challenges and limitations of current hydrogel-based approaches and outline future directions for their integration into HNC research and clinical practice.

Pain associated with oral cancer is debilitating. Opioids are the gold standard for cancer pain management, but tolerance and side effects limit their use. Epidermal growth factor receptor (EGFR) signaling is commonly amplified in oral tumors. Here, we found that EGFR activation contributed to both oral cancer pain and opioid tolerance by sensitizing trigeminal ganglion (TG) cells, the main sensory neurons innervating the face and mouth. EGFR ligands were secreted by oral squamous cell carcinoma (OSCC) cells and by peripheral glial cells cocultured with OSCC cells. In human OSCC and an orthotopic mouse model, EGFR was abundant in tumor-innervating TG nerves. Oral cancer pain and opioid tolerance in the mice were increased by EGFR ligands and reduced by EGFR inhibitors. In mice, the abundance of glutamate-type NMDA receptors (NMDARs) was also increased in both the TG and the brainstem. Upon activation by ligands or OSCC cell supernatant, EGFR phosphorylated the NMDAR subunit GluN2B, which increased electrical currents and sensitized pre- and postsynaptic NMDARs in the brainstem. This sensitization was also seen in the brainstems of mice receiving chronic morphine treatment and was mitigated by EGFR blockade. These findings suggest that EGFR-targeted cancer therapeutics may be repurposed to manage cancer pain and reduce opioid tolerance in patients with OSCC.

BACKGROUND:Orofacial pain, affecting 10-15% of adults, is a prevalent form of chronic pain that remains a major clinical challenge. The Schwann cell involvement in this pathophysiology is not fully understood. Low-density lipoprotein receptor-related protein 1 (LRP1) in Schwann cells has an unclear role in orofacial pain mechanisms. FINDINGS/RESULTS:mice displayed defective oxLDL uptake and excessive H₂O₂ release. Conditioned medium from LRP1 ablated Schwann cells induced orofacial hypersensitivity in vivo and robustly activated TG neurons in vitro in a TRPV1/TRPA1 dependent manner. CONCLUSIONS:Our results demonstrate that Schwann cell LRP1 safeguards mitochondrial function and supports neuron-glia metabolic coupling in the trigeminal system. The finding that LRP1 deficiency in Schwann cells drives orofacial pain in the absence of external insults highlights Schwann cells as active drivers, rather than passive amplifiers of chronic pain and identifies LRP1 as a promising target for orofacial pain management.

Perineural invasion (PNI) is a well-established factor of poor prognosis in multiple cancer types¹, yet its mechanism remains unclear. Here we provide clinical and mechanistic insights into the role of PNI and cancer-induced nerve injury (CINI) in resistance to anti-PD-1 therapy. Our study demonstrates that PNI and CINI of tumour-associated nerves are associated with poor response to anti-PD-1 therapy among patients with cutaneous squamous cell carcinoma, melanoma and gastric cancer. Electron microscopy and electrical conduction analyses reveal that cancer cells degrade the nerve fibre myelin sheets. The injured neurons respond by autonomously initiating IL-6- and type I interferon-mediated inflammation to promote nerve healing and regeneration. As the tumour grows, the CINI burden increases, and its associated inflammation becomes chronic and skews the general immune tone within the tumour microenvironment into a suppressive and exhaustive state. The CINI-driven anti-PD-1 resistance can be reversed by targeting multiple steps in the CINI signalling process: denervating the tumour, conditional knockout of the transcription factor mediating the injury signal within neurons (Atf3), knockout of interferon-α receptor signalling (Ifnar1^-/-) or by combining anti-PD-1 and anti-IL-6-receptor blockade. Our findings demonstrate the direct immunoregulatory roles of CINI and its therapeutic potential.

Perineural invasion (PNI), defined by cancer spreading or invading into the nerve, links to severe pain, recurrence, and poor prognosis. PNI contributes to nerve damage, Schwann cell activation, and sensory neuron dysfunction. Soluble tumor necrosis factor α (solTNFα) binds to TNFR1 to drive inflammation and nerve injury, playing a key role in cancer progression and pain. This study, using a mouse sciatic nerve PNI model, explored whether blocking solTNFα-TNFR1 signaling via TNFR1 knockout or pharmacological inhibition by XPro1595 could reduce PNI-associated pain. Data showed that XPro1595, but not TNFR1 knockout, reduced tumor burden, alleviated mechanical allodynia, and improved muscle function and locomotion, primarily in females. Histological analysis in females showed that XPro1595 increased the number of myelin and dendritic cells while reducing axonal damage that resulted from PNI. In the tumor zone outside the nerve truck, XPro1595 reduced T cell and increased macrophage and dendritic cell numbers. Transcriptomic analysis revealed that XPro1595 in females with PNI upregulated mitochondrial, myelination, motor function, and immune regulation gene pathways while it downregulated inflammatory, extracellular matrix, and tumor progression pathways. Overall, we demonstrated that XPro1595 exhibited antitumor, neuroprotective, and analgesic properties in female mice, likely by promoting neuronal regeneration and mitochondrial function, while reducing inflammation and extracellular remodeling.

INTRODUCTION/UNASSIGNED:G protein-coupled estrogen receptor (GPER) is a heptahelix estrogen-binding G protein-coupled receptor, and a potential therapeutic target for estrogen-related cancers and diseases. Recently, GPER has been recognized as a key mechano-regulator, but the effects on cell adhesion, spreading, morphology, migration, and differentiation are inconsistent or even contradicting in literature, due to the variations across cell lines and complex crosstalks with ER, and non-genomic actions of other hormones. Here, we focus on investigating the GPER effect on mesenchymal stem cell (MSC) mechanotransduction and differentiation. METHODS/UNASSIGNED:MSCs treated by synthetic agonist G1 and untreated cells were cultured on fibronectin-coated surfaces. Cell migration was studied by both chemokinesis and chemotaxis experiments. After two-week differentiation, MSC adipogenesis and osteogenesis were evaluated by staining lipid droplets in adipocytes with Oil-Red O and alkaline phosphatase in osteocytes with NBT/BCIP, respectively. In particular, since micropatterns have been widely used to mimic extracellular matrix (ECM) cues, modulate MSC mechanotransduction and differentiation, we investigate the GPER effect on both single-cell and sub-cellular fibronectin microline patterns prepared by microcontact printing. RESULTS/UNASSIGNED:GPER activation regulates cytoskeleton organization, with reduced cell polarization, thinner ventral stress fibers, and reduced RhoA signaling; reduces MSC migration speed; significantly promotes osteogenesis and inhibits adipogenesis. Cell elongation by micropatterns and the reduction of cell polarization by GPER coexist in a sophisticated interplay. CONCLUSIONS/UNASSIGNED:GPER directly mediates MSC mechanotransduction by RhoA inactivation, while its sustained effect on MSC differentiation promotes osteogenesis and inhibits adipogenesis despite reduced cell polarization and tension, suggesting potential mechanisms other than RhoA signaling. Our findings pave the way towards a deep understanding of GPER's role and its interplay with ECM cues in mechanotransduction and differentiation, which will be important for developing GPER as a new therapeutic target, as well as considering its important effects in stem cell therapies and hormonal therapies.

BACKGROUND:Oral squamous cell carcinoma (OSCC) is typically diagnosed at advanced stages, resulting in poor survival rates. Epigenetic alterations, especially DNA methylation, are important early and key contributors to OSCC pathogenesis, but comprehensive epigenetic analysis has traditionally been confounded by cancer tissue availability, with fresh-frozen tissues being the gold standard but difficult to obtain. METHODS:This study established and optimized a new workflow for the use of methylation capture sequencing (MC-seq) to analyze DNA methylation profiles in formalin-fixed paraffin-embedded (FFPE) tissues. Twelve OSCC patients were randomly selected from a prospective, multi-institutional study. Paired fresh-frozen and FFPE tissues were collected and processed for DNA extraction and MC-seq. Data were pre-processed using Bismark and methylKit pipelines. Methylation concordance between FFPE and fresh-frozen samples was assessed by comparing β-value correlation. RESULTS:DNA from FFPE and fresh-frozen OSCC samples showed minimal differences in fragmentation, with FFPE achieving high mapping efficiency (average 71.6%) and retaining an average of about 5 million CpG sites at 10× depth. The distributions of CpG in the methylome region, including promoter, exonic, intronic, and intergenic regions, showed similar patterns between sample types. Additionally, the methylation levels of all matched CpG sites in our 12-gene prognostic panel showed a strong correlation (r ≥ 0.97) between FFPE and fresh-frozen samples. CONCLUSION/CONCLUSIONS:Our findings indicate that FFPE samples are reliable for methylation capture sequencing, offering a new, scalable and reliable alternative to fresh-frozen samples for large-scale OSCC research.