Iron metabolism plays a dual role in cancer, serving as an essential nutrient for cellular functions and a potential catalyst for tumor growth and immune evasion. Here, we cover the complex interplay between iron levels within the serum or in the microenvironment and cancer therapy, focusing on how iron deficiency and overload can impact immune function, tumor progression, and treatment efficacy. On the one hand, we highlight iron deficiency as a factor of primary immune responses and its adverse effects on anti-cancer immunotherapy efficacy. On the other hand, we also stress the impact of iron overload as an essential factor contributing to tumor growth, creating a suppressive tumor microenvironment that hinders immune checkpoint inhibitor immunotherapy. Overall, we emphasize the necessity of the personalized management of iron levels in oncology patients as a critical element in treatment optimization to achieve favorable outcomes. Based on these considerations, we believe that close and careful monitoring and the tailored balancing of iron supplementation strategies should be the subject of further clinical studies, and routine iron management should be implemented in oncology clinical practice and integrated into cancer therapy protocols.
铁代谢在癌症中扮演双重角色，既是细胞功能必需的营养物质，又是肿瘤生长和免疫逃逸的潜在催化剂。本文系统阐述了血清及微环境中铁水平与癌症治疗之间的复杂相互作用，重点关注铁缺乏与铁过载如何影响免疫功能、肿瘤进展及治疗效果。一方面，我们强调铁缺乏作为原发性免疫应答的影响因素，及其对抗癌免疫疗法疗效的负面影响；另一方面，我们也着重探讨铁过载作为促进肿瘤生长关键因素的作用机制，其形成的抑制性肿瘤微环境会阻碍免疫检查点抑制剂疗法的实施。总体而言，我们强调肿瘤患者铁水平的个体化管理是优化治疗方案、实现良好预后的关键要素。基于这些考量，我们认为密切监测与精准调控的铁补充策略应成为未来临床研究的重点方向，常规铁管理应纳入肿瘤临床实践并整合至癌症治疗方案中。
肿瘤(癌症)患者之家