Transarterial Chemoembolization Modulates the Exosomal miR-32-5p/cGAS-STING Axis Mediated Macrophage Ferroptosis, Triggers Immune Remodeling, and Enhances Anti-PD-1/L1 Efficacy in HCC.

ABSTRACT: Hepatocellular carcinoma (HCC) is a cancer type that causes a high rate of cancer death in the world. The standard therapy plan of intermediate and advanced stages of the HCC is transarterial chemoembolization (TACE). The treatment effectiveness is, however, limited because of the heterogeneity of tumors and the resistance to drugs. This paper shows that the HCC patients with TACE resistance alter their tumor immune homeostasis by reducing the secretion of exosomal miR-32-5p, which has a negative relationship with the population of CD68⁺ macrophages. Both in-cellular and animal studies show that exosomal miR-32-5p leads to ferroptotic cell death in tumor-associated macrophages (TAMs) characterized by augmented lipid oxidation, iron buildup, depletion of glutathione, and mitochon

SUBMITTER: Tang B 

PROVIDER: S-EPMC12835496 | biostudies-literature | 2026

REPOSITORIES: biostudies-literature