Reassessing galectin inhibition: Lessons for context-selective drug design and translational oncology

Although the role of galectins in tumor progression is well established, this knowledge has not translated into significant clinical advances, reflecting challenges in targeting multifunctional, context-dependent proteins. We revisit this disconnect, arguing that galectins typify the difficulty of drugging multifunctional, context-dependent proteins shaped by localization, microenvironment and disease stage. Therapeutic success requires not just blocking carbohydrate recognition but also modulating activity in precise cellular and temporal contexts. Drawing lessons from history, we discuss how improved preclinical models, including resection paradigms and minimal residual disease, can bridge the translational gap. Success will also depend on developing companion biomarkers for patient stratification. Together, these considerations support a shift from uniform inhibition to context-selective modulation, which is relevant to other pleiotropic oncology targets.