Regulated cell death (RCD) pathways function as interlinked networks, not isolated modules, presenting new chances for cancer treatment. This review focused on chemical modulation strategies for five major RCD pathways, namely apoptosis, autophagy - associated cell death, ferroptosis, pyroptosis, and cuproptosis. Druggable nodes and translational barriers are specifically emphasized. Intervention methods for each pathway are reviewed, and multi - pathway synergy is critically appraised. Compensatory crosstalk can be employed to improve the efficiency but also leads to toxicity risks. Primary translational challenges are the inadequacy of predictive biomarkers, the narrowness of therapeutic windows for emerging modalities, and the insufficiency of validation in immune - competent models. Apoptosis targeting has had clinical success in hematologic malignancies, but its effectiveness is limited in solid tumors because of compensatory buffering. Ferroptosis provides strategies to get past apoptosis resistance, and the translation to clinical use depends on biomarker - guided patient selection. Pyroptosis gives immunostimulatory vulnerabilities, while cuproptosis provides metabolic - selective ones. But both are dealing with systemic toxicity challenges that call for controllable induction ways. It is proposed that functional diagnostics, next - generation chemical tools, and network - aware trial designs be integrated to advance RCD modulation towards durable, mechanism - guided cancer therapy.
Research Article
Open Access