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Updated: Aug 25, 2026

Revealing the Ferroptotic Phenotype of Medulloblastoma
Published on: March 15, 2024
Targeting ferroptosis to overcome drug resistance in gastrointestinal cancers
Chenbin Cao1,2, He Qi1,2, Weishi Qian3,4
1School of Medical Laboratory, Shandong Second Medical University, Weifang, 261053, People's Republic of China.
Abstract:
Gastrointestinal cancers, broadly defined to include malignancies arising from the digestive system and associated organs, including gastric, colorectal, pancreatic, and hepatocellular carcinomas, remain among the leading causes of cancer-related mortality worldwide, while the efficacy of conventional therapies continues to be limited by systemic toxicity and acquired resistance. Ferroptosis is an iron-dependent form of regulated cell death characterized by lethal lipid peroxidation and impaired glutathione peroxidase 4 (GPX4)-mediated antioxidant defense. In gastrointestinal cancers, ferroptosis is regulated by the solute carrier family 7 member 11 (SLC7A11)-glutathione (GSH)-GPX4 axis, nuclear factor erythroid 2-related factor 2 (NRF2)-mediated stress adaptation, iron metabolism, and lipid metabolic reprogramming. However, the regulatory landscape and therapeutic potential of ferroptosis across gastrointestinal malignancies remain incompletely understood. In this review, we provide an updated overview of ferroptosis regulation in these cancers, focusing on disrupted iron metabolism, the SLC7A11-GSH-GPX4 antioxidant axis, NRF2-mediated stress adaptation, and lipid metabolic reprogramming. We further discuss emerging evidence regarding ferroptosis-mediated immune modulation, nanotechnology-based therapeutic strategies, and potential biomarkers for patient stratification. Despite encouraging preclinical findings, clinical translation remains hindered by off-target toxicity, insufficient predictive biomarkers, and tumor-context-dependent resistance mechanisms. We propose that ferroptosis-targeted therapies represent a promising adjunctive approach to current treatment modalities; however, successful clinical implementation will require rational combination strategies and biomarker-guided patient selection.
Insights
Ferroptosis, an iron-dependent cell death, offers a novel therapeutic strategy for gastrointestinal cancers. Targeting ferroptosis, particularly the SLC7A11-GPX4 axis, shows promise but requires overcoming resistance and toxicity for clinical use.
Area of Science:
- Oncology
- Cell Death Mechanisms
- Biochemistry
Background:
- Gastrointestinal cancers are leading causes of cancer mortality globally.
- Conventional therapies face limitations due to toxicity and resistance.
- Ferroptosis, a regulated cell death form, presents a potential therapeutic avenue.
Purpose of the Study:
- To review ferroptosis regulation in gastrointestinal cancers.
- To explore therapeutic strategies targeting ferroptosis.
- To discuss challenges and future directions for clinical translation.
Main Methods:
- Literature review focusing on ferroptosis mechanisms in gastrointestinal malignancies.
- Analysis of key regulatory pathways including iron metabolism, antioxidant defense, and lipid reprogramming.
- Examination of emerging therapeutic approaches and biomarkers.
Main Results:
- Ferroptosis is modulated by iron metabolism, the SLC7A11-glutathione-GPX4 axis, NRF2 adaptation, and lipid reprogramming in gastrointestinal cancers.
- Ferroptosis influences immune responses and can be targeted by nanotechnology.
- Preclinical data show promise, but clinical translation is limited by toxicity and resistance.
Conclusions:
- Ferroptosis-targeted therapies are a promising adjunctive strategy for gastrointestinal cancers.
- Clinical success necessitates combination therapies and biomarker-guided patient selection.
- Further research is needed to address toxicity and resistance mechanisms.
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