From multifaceted mechanisms to targeted strategies: advances in PANoptosomes as regulatory hubs of PANoptosis in cancer
摘要
Programmed cell death (PCD) is a fundamental barrier to tumorigenesis, but cancer cells often evolve ways to evade single-mode death pathways. PANoptosis is a newly recognized form of PCD that integrates features of pyroptosis, apoptosis, and necroptosis. PANoptosomes organize this pathway and can induce cell death even when individual PCD modes are compromised. Evidence suggests that targeting PANoptosome-mediated PANoptosis may induce immunogenic cell death, alter the tumor microenvironment (TME), and enhance the efficacy of chemotherapy, radiotherapy, and immune checkpoint blockade (ICB). By leveraging multiple cell death routes, PANoptosis may also help overcome drug resistance and immune evasion. However, clinical translation faces challenges due to pathway redundancy, systemic inflammatory toxicity, and tumor heterogeneity. Following an overview of apoptosis, pyroptosis, necroptosis, and their crosstalk, this review explores the molecular basis of PANoptosis, the organization and regulation of PANoptosomes, and the related emerging opportunities and challenges in cancer treatment. While still under development, further investigation into PANoptosome assembly and therapies targeting this pathway may offer new strategies and improve patient outcomes.