Cell chirality in cancer: Emerging roles in malignant progression and tumor metastasis

Cell chirality is a newly discovered cellular characteristic that is phenotype-specific and is associated with cell migration, cell differentiation, organelle positioning, and organ asymmetry. The maintenance of normal cellular chirality is fundamental for preserving physiological functions in organisms. In recent years, cellular chirality has been increasingly investigated in tumor research, especially metastasis. During tumor metastasis, tumor cells acquire migratory and invasive capabilities through epithelial-mesenchymal transition (EMT), a process that is intricately linked to the dynamic reprogramming of cell chirality. The alterations in the chirality of both tumor cells and other surrounding cells significantly enhance metastatic efficiency not only by regulating cell-extracellular matrix interactions, collective migration patterns, and immune escape but also by increasing vascular permeability. This article provides a comprehensive and systematic exploration of the intricate relationship between cell chirality and tumor metastasis. It meticulously summarizes the molecular mechanisms that govern cell chirality, outlines the commonly employed detection methods, and delves into the potential therapeutic strategies targeting cellular chirality. Given the pivotal role of cell chirality in regulating metastasis, further research in this area holds great promise for revolutionizing cancer treatment and is expected to pave the way for the development of novel therapeutic strategies targeting tumor metastasis.