BUFFALO, NY- July 10, 2024 – A new #research paper was #published in Aging (listed by MEDLINE/PubMed as "Aging (Albany NY)" and "Aging-US" by Web of Science) Volume 16, Issue 12, entitled, “Aging exacerbates oxidative stress and liver fibrosis in an animal model of Down Syndrome.”

Down Syndrome (DS) is a common genetic disorder characterized by an extra copy of chromosome 21, leading to dysregulation of various metabolic pathways. Oxidative stress in DS is associated with neurodevelopmental defects, neuronal dysfunction, and a dementia onset resembling Alzheimer's disease. Additionally, chronic oxidative stress contributes to cardiovascular diseases and certain cancers prevalent in DS individuals.

In this new study, researchers Sebastiano Giallongo, Jessica Ferrigno, Rosario Caltabiano, Giuseppe Broggi, Amer M. Alanazi, Alfio Distefano, Emanuela Tropea, Antonella Tramutola, Marzia Perluigi, Giovanni Li Volti, Eugenio Barone, and Ignazio Alberto Barbagallo from the University of Catania, King Saud University, and Sapienza University of Rome investigated the impact of aging on oxidative stress and liver fibrosis using a DS murine model (Ts2Cje mice). 

“Our results show that DS mice show increased liver oxidative stress and impaired antioxidant defenses, as evidenced by reduced glutathione levels and increased lipid peroxidation.” 

DS liver exhibited an altered inflammatory response and mitochondrial fitness as the researchers showed by assaying the expression of HMOX1, CLPP, and the heat shock proteins Hsp90 and Hsp60. DS liver also displayed dysregulated lipid metabolism, indicated by altered expression of PPARα, PPARγ, FATP5, and CTP2. Consistently, these changes might contribute to non-alcoholic fatty liver disease development, a condition characterized by liver fat accumulation. Consistently, histological analysis of DS liver revealed increased fibrosis and steatosis, as showed by Col1a1 increased expression, indicative of potential progression to liver cirrhosis. Therefore, their findings suggest an increased risk of liver pathologies in DS individuals, particularly when combined with the higher prevalence of obesity and metabolic dysfunctions in DS patients.

“These results shed a light on the liver's role in DS-associated pathologies and suggest potential therapeutic strategies targeting oxidative stress and lipid metabolism to prevent or mitigate liver-related complications in DS individuals.”

DOI - https://doi.org/10.18632/aging.205970

Corresponding author - Giovanni Li Volti - livolti@unict.it

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Keywords - aging, Down Syndrome, oxidative stress, liver

About Aging-US

The mission of the journal is to understand the mechanisms surrounding aging and age-related diseases, including cancer as the main cause of death in the modern aged population.

The journal aims to promote 1) treatment of age-related diseases by slowing down aging, 2) validation of anti-aging drugs by treating age-related diseases, and 3) prevention of cancer by inhibiting aging. (Cancer and COVID-19 are age-related diseases.)

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Aging (Aging-US)

Aging Exacerbates Oxidative Stress and Liver Fibrosis in an Animal Model of Down Syndrome

BUFFALO, NY – June 20, 2025 – A new #review was #published in Volume 16 of Oncotarget on June 10, 2025, titled “Beyond DNA damage response: Immunomodulatory attributes of CHEK2 in solid tumors.”

In this paper, led by first author Helen Qian and corresponding author Crismita Dmello from Northwestern University Feinberg School of Medicine, researchers compiled growing evidence that the CHEK2 gene, long known for its role in repairing DNA damage, may also influence how tumors respond to immunotherapy. Their analysis suggests that problems in CHEK2 function might make cancer cells more vulnerable to immune system attacks, highlighting a new opportunity to improve treatment outcomes in solid tumors.

Immune checkpoint inhibitors (ICIs) have transformed cancer treatment; however, they are effective in only a subset of patients. This review suggests that tumors with reduced CHEK2 activity may accumulate more mutations that produce signals the immune system can recognize. These signals, known as neoantigens, help immune cells identify and destroy cancer cells more effectively. The review connects this process not only to CHEK2’s established role in the DNA damage response but also to a newly proposed function in shaping the immune environment of tumors.

CHEK2 normally helps maintain genomic stability by enabling precise DNA repair. When this function is lost, cells rely on more error-prone repair methods, leading to additional mutations. These mutations can increase tumor mutational burden, which has been linked to better outcomes with immunotherapy. Beyond DNA repair, the review highlights a second mechanism: activation of the cGAS-STING pathway. This pathway detects fragments of damaged DNA and triggers inflammation that attracts immune cells to the tumor.

The authors highlight studies where CHEK2-deficient tumors responded better to PD-1 inhibitors, a common type of immune checkpoint inhibitor. In both lab models and early-stage clinical settings, CHEK2 loss was associated with increased infiltration of CD8+ T cells—immune cells essential for attacking cancer cells. In cancers such as glioblastoma and renal cell carcinoma, which are typically resistant to immunotherapy, reduced CHEK2 expression was linked with more favorable immune activity and higher expression of interferon-related genes.

The compiled evidence points to CHEK2 as a potential biomarker for identifying patients likely to respond to immunotherapy. In addition, combining CHEK2 inhibitors with existing immunotherapies may enhance anti-tumor effects, particularly in cancers with limited treatment options. The review notes that some clinical trials using the CHEK1/2 inhibitor prexasertib alongside immune checkpoint therapies have already shown promising early results.

“The initial results from this Phase I clinical trial support the immunomodulatory role of CHEK2 expression and even suggest CHEK2 potentiates immunosuppression.”

Although more research is needed to confirm these mechanisms and improve treatment approaches, this review underscores the expanding role of DNA repair genes like CHEK2—not only in maintaining genome integrity but also in helping the immune system fight cancer.

DOI - https://doi.org/10.18632/oncotarget.28740

Correspondence to - Crismita Dmello - stellacpak@outlook.com

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CHEK2 Identified as a Potential Target to Improve Immunotherapy in Solid Tumors

BUFFALO, NY — June 24, 2025 — A new #research paper was #published in Aging (Aging-US) Volume 17, Issue 5, on May 20, 2025, titled “Short-term moderate caloric restriction in the rhesus macaque attenuates markers of ovarian aging in select populations.”

In this study, led by first author Emma S. Gargus and corresponding author Francesca E. Duncan from Feinberg School of Medicine at Northwestern University, researchers explored how dietary changes impact ovarian aging in female rhesus macaques. They found that a three-year moderate reduction in caloric intake preserved a youthful distribution of ovarian follicles and reduced age-related tissue stiffness. These findings are relevant to women’s health as they suggest that caloric restriction (CR) may help delay the decline in reproductive function associated with aging.

Ovarian aging, which leads to reduced fertility and hormone production, is one of the earliest signs of aging in women. This study investigated whether a 30% reduction in caloric intake could protect the ovaries from age-related damage in nonhuman primates (NHP), whose reproductive biology closely mirrors that of humans. Ovaries were collected from young (10–13 years) and old (19–26 years) rhesus macaques who were either on a diet of moderate caloric restriction or a control diet for three years.

“To test the effect of CR on follicle number, follicles were analyzed in histological sections from animals across experimental cohorts: Young Control, Young CR, Old Control, Old CR (n = 4–8/group).”

Although total follicle numbers still declined with age, caloric restriction helped maintain the types of follicles most associated with reproductive potential. In older monkeys who were still cycling, even if irregularly, caloric restriction preserved more primordial follicles, the key indicators of ovarian reserve, than in those on a normal diet.

The benefits of caloric restriction were also seen in the structure of ovarian tissue. Normally, aging leads to fibrosis, a stiffening of the ovarian environment caused by increased collagen and decreased hyaluronic acid. This study showed that caloric restriction reduced this fibrotic process, suggesting a more supportive environment for maintaining reproductive health.

While the diet did not stop the overall loss of follicles with age, it improved the proportion of younger, more viable follicles in aging ovaries. The timing of the dietary intervention also appeared to matter. Positive effects were more noticeable in older animals with irregular cycles than in those who had completely stopped cycling. This indicates that starting caloric restriction at a certain point in the reproductive lifespan may yield the best results.

This research is an important step to identifying lifestyle-based strategies that can extend reproductive longevity. Although further studies are needed to test these findings in humans, the work supports the potential of moderate dietary changes to delay ovarian aging and help preserve fertility later in life.

DOI - https://doi.org/10.18632/aging.206253

Corresponding author - Francesca E. Duncan - f-duncan@northwestern.edu

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Moderate Caloric Restriction May Slow Ovarian Aging in Primates

BUFFALO, NY – June 24, 2025 – A new precision #oncology paper was #published in Volume 16 of Oncotarget on June 17, 2025, titled “Case Report WIN-MTB-2023001 WIN International Molecular Tumor Board A 62-year-old male with metastatic colorectal cancer with 5 prior lines of treatment.”

In this report, led by Alberto Hernando-Calvo from Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology; Razelle Kurzrock from WIN Consortium and Medical College of Wisconsin; Oncotarget Editor-in-Chief Wafik S. El-Deiry from WIN Consortium and Legorreta Cancer Center at Brown University; and corresponding author Shai Magidi, also from WIN Consortium, along with colleagues, describe the case of a 62-year-old man with metastatic colorectal cancer who underwent multiple lines of therapy. After analysis, the WIN International Molecular Tumor Board proposed different personalized treatment plans based on the tumor’s unique genetic mutations. This case highlights the growing role of precision oncology in guiding therapies for patients with treatment-resistant cancers.

Colorectal cancer is one of the deadliest cancers worldwide, and managing advanced cases remains a significant challenge. This patient had already received five prior treatment regimens, including chemotherapy and targeted therapies. Although some treatments were initially beneficial, the cancer eventually developed resistance. Molecular analysis revealed key mutations in genes such as BRAF, MET, APC, TP53, and NRAS, which are often linked to aggressive tumor behavior and reduced treatment effectiveness.

With limited standard options left, the patient’s case was presented and reviewed by the WIN International Molecular Tumor Board, a global panel of cancer experts. The team analyzed the clinical history and genetic profile to design new treatment approaches. These involved off-label drug combinations tailored to the specific mutations found in the tumor. For example, one approach combined trametinib, a drug that blocks cancer cell growth signals, with amivantamab, an antibody that attacks cancer-related proteins MET and EGFR, and regorafenib, which helps cut off blood supply to tumors and may counteract effects from APC and TP53 mutations.

“Another option was trametinib at 1 mg daily, cetuximab (EGFR antibody), 250 mg/m² IV every two-weeks, and cabozantinib (MET and VEGFR inhibitor), 40 mg po daily.”

This case reflects a shift in cancer care from standardized protocols to precision approaches, where therapy is selected based on a tumor’s molecular features. Such strategies aim to delay resistance and slow disease progression more effectively. The WIN International Molecular Tumor Board also discussed practical challenges, including access to medications, combining off-label drugs, and the difficulties of enrolling patients in clinical trials after multiple prior treatments.

Although the ultimate treatment decision remained with the patient’s physician, this report shows how international collaboration and precision oncology can expand options for patients facing limited alternatives. It also emphasizes the value of repeat genetic analysis during disease progression to monitor new mutations in the tumor that may impact treatment.

While the patient ultimately died from cancer progression, this case serves as a model for how molecular analysis and expert input can be used to guide treatment even in complex and metastatic colorectal cancer. As personalized cancer strategies continue to evolve, they may offer potential pathways for patients who have exhausted standard treatment options.

DOI - https://doi.org/10.18632/oncotarget.28744

Correspondence to - Shai Magidi - shai.magidi@winconsortium.org

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WIN International Molecular Tumor Board Recommends Tailored Treatment for Advanced Colorectal Cancer

BUFFALO, NY — June 25, 2025 — A new #research paper was #published in Aging (Aging-US) Volume 17, Issue 5, on May 28, 2025, titled “Investigating telomere length in progeroid syndromes: implications for aging disorders.”

In this study, led by first author Luma Srour and corresponding authors Yosra Bejaoui and Nady El Hajj, from Hamad Bin Khalifa University, Qatar Foundation, researchers investigated whether shortened telomeres, a marker of cellular aging, are present across various rare genetic disorders that mimic early aging, known as progeroid syndromes. The study found that telomere shortening, also called telomere attrition, is not a shared characteristic of all these disorders. This finding is important because it challenges the belief that telomere loss is a common thread in premature aging and could help refine how these syndromes are studied and treated.

Progeroid syndromes are rare conditions that cause individuals to display symptoms of aging far earlier than expected. While some of these syndromes share signs of typical aging, others arise from very different genetic alterations. Researchers focused on comparing telomere length in individuals with several of these syndromes to better understand how aging develops at the cellular level. Telomeres are protective ends of chromosomes that shorten as cells divide, acting as a biological clock linked to aging and disease.

Using DNA methylation data from blood samples, the team analyzed telomere length in patients with six progeroid syndromes: Werner Syndrome, Hutchinson-Gilford Progeria Syndrome, Berardinelli-Seip Congenital Lipodystrophy type 2, Dyskeratosis Congenita, Cerebroretinal Microangiopathy with Calcifications and Cysts, and Wiedemann-Rautenstrauch Syndrome. They found significant telomere shortening only in classical Werner Syndrome, Berardinelli-Seip Congenital Lipodystrophy type 2, and Dyskeratosis Congenita. Other syndromes, including the widely studied Hutchinson-Gilford Progeria Syndrome, did not show this pattern.

“To investigate whether progeroid syndromes have telomere attrition, we calculated telomere length using the DNAmAge web-based calculator.”

The findings suggest that telomere shortening cannot be used as a universal marker for all forms of premature aging. In fact, some syndromes linked to DNA repair problems showed telomere damage, while others with different genetic mutations did not. These results indicate that the underlying biology of each syndrome is crucial in determining whether telomere shortening plays a role. Researchers also compared telomere lengths in people with genetic variants known to protect against age-related diseases. Those with protective genes had longer telomeres than people with progeroid syndromes.

This study challenges assumptions about aging in rare disorders and highlights the need for more personalized approaches in aging research. By identifying which syndromes involve telomere attrition, it opens new avenues for treating or delaying aging-related symptoms. Future research may explore other biological factors behind premature aging and how genetic differences influence the aging process.

DOI - https://doi.org/10.18632/aging.206255

Corresponding authors - Yosra Bejaoui - yob4003@qatar-med.cornell.edu, and Nady El Hajj - nelhajj@hbku.edu.qa

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New Research Finds Telomere Shortening Not Consistent Across Premature Aging Disorders

Recent discoveries in #aging research reveal a powerful insight: the biological changes that lead to chronic #diseases begin far earlier than most people realize—often in midlife, well before symptoms appear. This early phase offers a valuable opportunity for prevention. As highlighted in a recent editorial by Marco Demaria, Editor-in-Chief of Aging and a researcher at the European Research Institute for the Biology of Ageing (ERIBA), University Medical Center Groningen, and the University of Groningen (RUG), the aging process itself – not just the diseases it produces – can and should be a primary focus of healthcare. 

The Problem with Traditional Medicine

While modern healthcare has extended lifespan and improved treatment for many diseases, it tends to be insufficient in addressing the complex needs of aging populations. Older individuals frequently experience multiple chronic conditions simultaneously, such as cardiovascular disease, diabetes, cancer, and neurodegenerative disorders. This state of multimorbidity complicates care, increases the use of multiple medications, and reduces quality of life. The dominant traditional healthcare system, which typically begins only after symptoms appear, is costly and insufficient for addressing the interconnected nature of these conditions.

A New Model for Healthcare: Insights from the Editorial

In his recent editorial, “Rethinking healthcare through aging biology,” published in Aging Volume 17, Issue 5, Dr. Demaria outlines a shift from disease-specific treatment to targeting the biological mechanisms of aging itself, a more integrated and forward-looking approach. He presents three evolving healthcare models.

Full blog - https://aging-us.org/2025/06/a-new-vision-for-healthcare-addressing-aging-before-disease-begins/

Paper DOI - https://doi.org/10.18632/aging.206262

Corresponding author - Marco Demaria - m.demaria@umcg.nl

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Keywords - aging, healthcare, senolytics, epigenetics, medical education

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A New Vision for Healthcare: Addressing Aging Before Disease Begins

BUFFALO, NY – June 27, 2025 – A new #research paper was #published in Volume 16 of Oncotarget on June 17, 2025, titled “Molecular landscape of HER2-mutated non-small cell lung cancer in Northeastern Brazil: Clinical, histopathological, and genomic insights.”

In this study, researchers led by first authors Cleto Dantas Nogueira from the Federal University of Ceará and Argos Pathology Laboratory and Samuel Frota from Argos Pathology Laboratory, along with corresponding author Fabio Tavora from the previously mentioned institutions and Messejana Heart and Lung Hospital, investigated how HER2 gene mutations appear in cases of non-small cell lung cancer (NSCLC) in Northeastern Brazil. The team found that HER2 mutations showed significant genetic diversity and were often associated with other cancer-related genetic changes. These findings revealed diagnostic and treatment challenges in a population that is rarely studied, emphasizing the need for expanded access to molecular testing and targeted therapies.

HER2 mutations are a known factor in several cancers, including breast and gastric cancers. In lung cancer—particularly NSCLC—these mutations are less common but remain clinically significant. Most existing research on HER2-mutated lung cancer focuses on high-income countries, leaving important gaps in knowledge about underrepresented regions such as Latin America. This study helps fill that gap by analyzing 13 patients with HER2-mutated NSCLC using clinical, pathological, and genomic data.

The patients ranged in age from 34 to 82 years, and more than half were women. About half had never smoked. Their tumors often displayed complex genetic profiles, including additional mutations in genes such as TP53, KRAS, and STK11. The most common HER2 mutation identified was an insertion in exon 20, a known hotspot for activating mutations.

“Trastuzumab deruxtecan (T-DXd) is the first HER2-targeted agent to show clinical efficacy in HER2-mutant non-small cell lung cancer (HER2m NSCLC).”

Treatment strategies among the patients varied. Only one individual received HER2-targeted therapy. Most were treated with surgery, chemotherapy, immunotherapy, or a combination of these approaches. Outcomes also differed, with some patients surviving for years and others dying within months of diagnosis. These findings reinforce the need for early diagnosis and improved access to advanced treatments, particularly in low-resource settings.

The study emphasizes the value of comprehensive molecular profiling in NSCLC. Because HER2 mutations often occur alongside other genetic alterations, full genomic analysis is crucial for guiding treatment decisions. Yet, such testing is not always available. The researchers propose a tiered diagnostic approach, beginning with basic screening and expanding to more advanced tests when necessary, to enhance patient care.

This study provides valuable insights into the molecular characteristics of HER2-mutated NSCLC in a Brazilian population, highlighting the complexity and clinical relevance of these alterations. Larger studies are needed to clarify the prevalence and prognostic significance of HER2 mutations, as well as their impact on treatment response and survival. This knowledge is essential for advancing effective HER2-targeted therapies. The findings also support broader implementation of international clinical guidelines in Latin America and highlight the critical need to include underrepresented populations in cancer research.

DOI - https://doi.org/10.18632/oncotarget.28737

Correspondence to - Fabio Tavora - stellacpak@outlook.com

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HER2-Mutated NSCLC in Brazil Shows Diverse Genetic Patterns and Treatment Gaps

BUFFALO, NY — July 1, 2025 — A new #research paper, featured on the #cover of Aging (Aging-US) Volume 17, Issue 6, was #published on June 4, 2025, titled “DoliClock: a lipid-based aging clock reveals accelerated aging in neurological disorders.”

This study, led by first author Djakim Latumalea from the National University of Singapore and Hanze University of Applied Sciences, with corresponding author Brian K. Kennedy from the National University of Singapore, introduces DoliClock, a biological aging clock based on lipid profiles in the human brain. The researchers found that individuals with autism, schizophrenia, and Down syndrome show signs of accelerated brain aging compared to individuals without these conditions. The discovery offers a new approach to measuring brain aging using lipid markers instead of traditional DNA-based methods.

The team developed DoliClock using lipidomic data from post-mortem prefrontal cortex samples. Lipids are fat-like molecules that play a key role in brain health. Changes in lipid patterns can reflect the biological age of brain tissue. The study focused on a specific class of lipids called dolichols, which increase gradually with age. The DoliClock model was trained to predict biological age by analyzing levels of dolichols and other lipid molecules. It accurately estimated brain age and revealed higher aging rates in individuals with neurological disorders.

One notable finding was a sharp increase in lipid profile variability—also known as entropy—around the age of 40. This suggests a disruption in lipid metabolism during midlife, possibly caused by changes in the mevalonate pathway, a critical biological process involved in producing lipids like cholesterol and dolichol. These disruptions may contribute to aging-related brain decline.

The study also found that dolichol levels could serve as reliable biomarkers of aging. Their consistent increase with age and strong influence on DoliClock’s predictions make them especially useful. In individuals with autism, schizophrenia, and Down syndrome, the clock indicated more advanced biological brain aging than expected, supporting the idea that these conditions are associated with premature aging.

DoliClock offers a new perspective in aging research, complementing existing biological clocks based on DNA or protein markers. Because it relies on lipids, it may detect aspects of aging that other tools cannot. While the current model is based on brain tissue samples, future research may examine whether similar lipid patterns can be identified in more accessible fluids such as blood or cerebrospinal fluid.

“These findings suggest that lipidomics can provide valuable insights into the molecular mechanisms of brain aging and neurological disorders.”

This study highlights the growing potential of lipidomics in the study of aging and neurological disorders. It opens the door to new biomarkers that could help researchers and clinicians better monitor brain aging and develop more targeted interventions for age-related and neurodevelopmental diseases.
DOI - https://doi.org/10.18632/aging.206266

Corresponding author - Brian K. Kennedy - bkennedy@nus.edu.sg

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New Lipid-Based Aging Clock Reveals Faster Brain Aging in Autism, Schizophrenia, and Down Syndrome

BUFFALO, NY – July 1, 2025 – A new #review was #published in Volume 16 of Oncotarget on June 17, 2025, titled “Optimizing enfortumab vedotin plus pembrolizumab therapy.”

First authors Elias Antoine Karam of the Gustave Roussy and Saint-Joseph University of Beirut and Yaghi César Céline from  the Saint-Joseph University of Beirut, along with their colleagues, reviewed recent developments about treating advanced urothelial carcinoma (aUC), an aggressive form of bladder cancer. Their review highlights how combining enfortumab vedotin and pembrolizumab as a first-line treatment offers a major improvement for patients with limited options and poor prognoses.

Advanced urothelial cancer has traditionally been treated with platinum-based chemotherapy, which often causes serious side effects and offers limited long-term benefit. Many patients are even ineligible for it due to underlying health conditions. The new combination presents a more effective and better-tolerated alternative, as shown in recent clinical trials reviewed by the authors.

Enfortumab vedotin targets Nectin-4, a protein present in most urothelial cancer cells, delivering a cancer-killing agent directly into tumors. Pembrolizumab helps the immune system detect and destroy cancer cells. Together, they have shown strong results in extending survival with fewer serious side effects than chemotherapy. These findings led to FDA approval in 2023 for use in a broad range of patients, including those unable to tolerate traditional treatments.

“In the phase II KEYNOTE-052 study, pembrolizumab demonstrated significant efficacy as initial therapy in patients with aUC who were ineligible for a cisplatin-based regimen.”

The review also compares this new approach with other evolving strategies, such as therapies using nivolumab and chemotherapy combinations. Among current first-line options, enfortumab vedotin and pembrolizumab have produced the most promising outcomes. However, the best course of action following disease progression remains unclear.

Other important challenges raised in the review include the high cost of the new therapies, limited patient access to them, and the absence of reliable biomarkers to predict individual response. The authors call for further studies to refine treatment strategies and explore blood-based tools that could guide therapy decisions and minimize side effects.

This review offers a clear summary of how recent clinical advances are reshaping the treatment of aUC. It reflects a shift away from traditional chemotherapy toward immunotherapy and targeted, personalized treatments that aim to extend survival and improve quality of life.

DOI - https://doi.org/10.18632/oncotarget.28741

Correspondence to - Elias Antoine Karam - eliaskaram18@gmail.com

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Keywords - cancer, advanced urothelial carcinoma (aUC), enfortumab vedotin, pembrolizumab, treatment strategies, bladder cancer

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New Drug Combination Redefines First-Line Treatment for Advanced Urothelial Cancer

BUFFALO, NY — July 2, 2025 — A new #research perspective was #published in Aging (Aging-US) Volume 17, Issue 6, on May 29, 2025, titled “Peto’s paradox’s relevance is off the scale.”

In this perspective, Dr. Mirre J.P. Simons from the University of Sheffield argues that Peto’s paradox—a well-known concept in cancer biology—remains a vital framework for understanding cancer resistance in large animals. Dr. Simons challenges recent claims that dismiss the paradox and emphasizes that the unexpectedly low cancer rates in large species still require explanation. This insight is especially relevant for aging and cancer research.

Peto’s paradox highlights a puzzling observation: larger animals like elephants and whales, despite having far more cells than smaller animals, do not have proportionally higher cancer rates. If each cell had an equal chance of turning cancerous, bigger animals should develop cancer much more frequently. But in reality, they do not. This suggests that evolution has equipped these animals with powerful biological defenses against cancer.

“The field of comparative biology into ageing and cancer was given a strong impetus when Peto identified that humans have substantially more cells than mice, but do not have substantially larger incidence of cancer.”

Dr. Simons explains that recent studies showing small increases in cancer with body size do not disprove the paradox. The expected increase, based on basic mathematical models, would be massive—many times greater than what is observed. Instead of rejecting Peto’s paradox, the field should focus on understanding how large animals suppress cancer so effectively.

The author points out that the key to resolving this paradox may lie in traits that evolved alongside body size, such as tissue environments or specialized cell-control mechanisms. These features might reduce the probability of cancer developing, even in animals with millions or billions more cells than humans.

Importantly, this perspective underscores the clinical potential of studying species that resist cancer naturally. Studying these natural defenses may help researchers uncover new ways to understand, prevent, or manage cancer. Because cancer risk increases with age in most species, understanding how some animals limit both aging and cancer may also help explain how these two processes are connected.

Dr. Simons cautions against oversimplifying cancer biology by focusing only on genetic mutations. Instead, understanding how cells interact with their environment, known as the tissue microenvironment, may offer deeper insight into how cancer develops or is prevented.

By reaffirming the importance of Peto’s paradox, this research perspective encourages the scientific community to explore the evolutionary tools nature uses to fight cancer. These insights could improve our understanding of cancer and inspire new strategies to support healthier aging.

DOI - https://doi.org/10.18632/aging.206258

Corresponding author - Mirre J.P. Simons - m.simons@sheffield.ac.uk

Video short - https://www.youtube.com/watch?v=sDaq07zX2TM

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Keywords - aging, cancer, evolution

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Why Big Animals Do Not Get More Cancer: Revisiting Peto’s Paradox

Liver cancer, especially hepatocellular carcinoma (HCC), remains a major health concern worldwide. In Latin America, the situation becomes more difficult due to limited access to advanced treatments and the high prevalence of underlying liver diseases. A recent research paper, published in Volume 16 of Oncotarget by researchers from Argentina, Brazil, Chile, and Colombia, offers valuable insights into how patients in the region respond to a widely used immunotherapy regimen. This real-world study explores both the effectiveness of treatment and the risks of immune-related side effects.

Understanding Hepatocellular Carcinoma: Why It is So Difficult to Treat

Hepatocellular carcinoma is often diagnosed at an advanced stage and frequently occurs in people with pre-existing liver conditions such as cirrhosis. Standard treatments like surgery or local therapies are not always possible in these cases. In recent years, the combination of two drugs—atezolizumab and bevacizumab—has shown promise in extending survival. However, most of the evidence comes from controlled clinical trials that may not represent the realities faced by healthcare providers and patients in Latin America.

The Study: Immunotherapy for Hepatocellular Carcinoma in Latin America

In a multicenter study titled “Immune-mediated adverse events following atezolizumab and bevacizumab in a multinational Latin American cohort of unresectable hepatocellular carcinoma,” led by Leonardo Gomes da Fonseca from Hospital das Clínicas, Universidade de São Paulo, Brazil, and Federico Piñero from Hospital Universitario Austral, Argentina, researchers aimed to fill that gap. The study included 99 patients with advanced HCC from Argentina, Brazil, Chile, and Colombia. All patients received the combination of atezolizumab and bevacizumab. The main objectives were to assess how frequently immune-related side effects, known as immune-related adverse events (irAEs), occurred and whether these events affected overall survival.

Full blog - https://www.oncotarget.org/2025/07/02/immunotherapy-safety-for-hepatocellular-carcinoma-in-latin-america-insights-from-a-real-world-study/

Paper DOI - https://doi.org/10.18632/oncotarget.28721

Correspondence to - Federico Piñero - fpinerof@cas.austral.edu.ar

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Keywords - cancer, liver cancer, immunotherapy, adverse events, immunology, real-world 

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Immunotherapy Safety for Hepatocellular Carcinoma in Latin America: Insights from a Real-World Study

Cancer and aging are two sides of age-related tumorigenesis.

The mission of the journal is to understand the mechanisms surrounding aging and age-related diseases, including cancer as the main cause of death in the modern aged population.

The journal aims to promote 1) treatment of age-related diseases by slowing down aging, 2) validation of anti-aging drugs by treating age-related diseases, and 3) prevention of cancer by inhibiting aging. (Cancer and COVID-19 are age-related diseases.)

Read about the Aging (Aging-US) Scientific Integrity Process: https://aging-us.com/scientific-integrity

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