The intellectual foundation of this shift was laid by Academician Daiming Fan, chairman of the China Anti-Cancer Association, who proposed holistic integrative medicine as a medical methodology rather than a simple aggregation of therapies. The framework rests on three hierarchical goals: anticancer treatment as the foundation, tumor control as the intermediate level, and patient-centric care as the overarching orientation. Since 2025, the China Anti-Cancer Association’s Frontiers Broadcast platform has curated original Chinese studies from top-tier journals, providing the empirical backbone for the new review. Within this structure, the authors identify a three-level progressive transformation: from single molecular targets to system-level networks, from single-modality treatment to temporally coordinated multidisciplinary care, and from disease-oriented management to whole-course care spanning prevention, screening, diagnosis, treatment, and rehabilitation.

At the molecular level, the review documents a striking move from static, single-event biology toward dynamic processes and cross-system interactions. A team led by Zhu Weiguo at Shenzhen University reported in Nature that deamidation of histone H1 at asparagine residues 76 and 77 triggers a cascade that promotes acetylation at the adjacent H1K75 site, driving chromatin relaxation and recruiting DNA repair factors—recasting DNA damage response as a dynamic chromatin process rather than a static mutational event. At Sun Yat-sen University Cancer Center, the teams of Kang Tiebang and Wu Yuanzhong identified through CRISPR–Cas9 screening that ASB7 acts as a key negative regulator of H3K9me3; ASB7 amplification induces genomic instability and sensitizes tumors to PARP inhibitors, pointing to a new biomarker-defined beneficiary population. Xu Yanhui’s group at Fudan University reconstructed the full dynamic trajectory of human RNA polymerase III transcription initiation, while Yu Yang’s team at the Chinese Academy of Medical Sciences showed that distinct fusion genes, MN1–BEND2 and MN1–CXXC5, converge on the same CGTT DNA motif to initiate astrocytoma—a concept the authors call convergent oncogenesis.

Equally consequential is the reframing of tumors as ecological systems that span organs. Zhang Zemin’s team at Peking University used single-cell transcriptomic and T cell receptor sequencing of 343 surgical specimens to define five tumor immune microenvironment subtypes in non-small cell lung cancer treated with neoadjuvant anti-PD-1 therapy, linking NK cell–enriched, B cell–enriched, and effector T cell–enriched profiles to high response rates. Ji Tong and Sun Yunfan at Fudan University’s Zhongshan Hospital revealed in Cell that tumor cells activate sensory neurons through an ATF4–SLIT2 axis, remodeling immune landscapes in tumor-draining lymph nodes to escape surveillance—an inter-organ neuroimmune circuit that fuses oncology, neuroscience, and immunology. Kuang Dongming’s group showed that glucose deprivation reshapes the pulmonary immune microenvironment through exosomal TRAIL to create a pre-metastatic niche, a process reversible by TIGIT blockade, directly connecting metabolism to immune ecology.

Methodologically, Chinese teams are dissolving disciplinary boundaries. Zhao Yongxiang’s group at Guangxi Medical University engineered an oncolytic Newcastle disease virus, NDV-GT, carrying the porcine α1,3-galactosyltransferase gene; infected tumor cells display the α-Gal antigen and provoke a hyperacute rejection–like immune response borrowed from transplant immunology. Liu Chenli at the Shenzhen Institute of Advanced Technology reprogrammed bacteria with genetic circuits to selectively proliferate in tumors and revitalize antitumor immunity, while Han Shuo’s team developed the PATCH platform, using light- or ultrasound-activated nanozymes to catalyze proximity labeling of tumor antigens and amplify CD8-positive T cell responses. Tan Weihong’s team at Zhejiang Cancer Hospital introduced SPARK-seq in Science, a multimodal platform combining CRISPR perturbation with single-cell multi-omics to map aptamer–target interactions at high throughput.

The clinical tier of the paradigm shift is perhaps most vivid in nasopharyngeal carcinoma, a tumor with particular relevance to southern China. Ma Jun’s group at Sun Yat-sen University Cancer Center demonstrated in CA: A Cancer Journal for Clinicians that reduced-volume radiotherapy after induction chemotherapy does not increase recurrence while significantly cutting toxicity. The DIPPER trial in JAMA showed that adjuvant camrelizumab raised three-year disease-free survival to 87 percent in high-risk locally advanced disease, and the DIAMOND trial established toripalimab-based chemoradiotherapy that maintains efficacy while reducing cisplatin-associated toxicity—challenging the assumption that efficacy and toxicity trade off in a zero-sum relationship. In The Lancet, Zhang Li’s team reported that iza-bren, an EGFR×HER3 bispecific antibody-drug conjugate, doubled the benefit of standard chemotherapy in heavily pretreated recurrent or metastatic disease.

In lung cancer, the HARMONi-2 trial led by Zhou Caicun showed that ivonescimab, the first PD-1/VEGF bispecific antibody, extended median progression-free survival to 11.1 months versus pembrolizumab, heralding what the review calls an immunotherapy 2.0 era. The HARMONi-6 trial extended this benefit to squamous carcinoma with a grade three-or-higher hemorrhage rate of only 1.9 percent, while Zhang Li’s group showed that the Trop-2 antibody-drug conjugate sacituzumab tirumotecan outperformed docetaxel in EGFR-mutant disease, confirmed in a New England Journal of Medicine phase III trial after EGFR-TKI resistance. Chen Haiquan’s team demonstrated that mediastinal lymph node dissection can be safely omitted in ground-glass opacity–dominant early lung cancer, and the JAMA-published Aifei Plan led by Jianxing He and Wenhua Liang extended low-dose CT screening from high-risk groups to the general population, shifting intervention to the preclinical stage.

Gastrointestinal, breast, gynecologic, and hematologic oncology tell the same story of integration and de-escalation. The TaLaR trial validated transanal total mesorectal excision for low rectal cancer, the REAL trial showed robotic surgery improves long-term outcomes over laparoscopy, and the NEOTERIC trial achieved a 35.7 percent pathological complete response rate with dual immunotherapy after neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Lin Shen’s group reported the world’s first randomized trial of a Claudin 18.2-targeted CAR-T therapy, satri-cel, in advanced gastric cancer, alongside the GEMSTONE-303 trial of sugemalimab plus chemotherapy. In breast cancer, the FASCINATE-N trial showed that the HER2-targeted antibody-drug conjugate SHR-A1811 matched conventional quadruple neoadjuvant therapy in pathological complete response with better safety, and a BMJ trial found that oral mecobalamin halves the risk of severe capecitabine-induced hand–foot syndrome—a drug-repurposing strategy squarely aimed at quality of life. The PHENIX trial in NEJM showed pelvic lymphadenectomy can be omitted in sentinel-node-negative cervical cancer, and CD19 CAR-T therapy was extended for the first time to refractory autoimmune hemolytic anemia, while Wensheng Wei’s team engineered a glycan shield enabling off-the-shelf allogeneic CAR-T cells.

The review’s system-level analysis extends the framework from individual patients to population health. A nationwide Lancet cohort led by Xin Ni reported an overall five-year survival of 77.2 percent among Chinese children and adolescents with cancer, surpassing the World Health Organization’s 60 percent target, yet revealed persistent socioeconomic disparities that demand tiered allocation of healthcare resources. A CA: A Cancer Journal for Clinicians analysis projected global childhood cancer trends to 2050, underscoring health inequities between high- and low-HDI regions. Supportive care studies, including a BMJ network meta-analysis of cardiovascular toxicity from EGFR tyrosine kinase inhibitors and the PROFIT trial of HR20013 for preventing chemotherapy-induced nausea and vomiting, embody the patient-centered principle of treating the person, not merely the tumor.

The authors are candid about the challenges ahead. The boundaries of integration remain ill-defined, risking either decision paralysis or a relapse into reductionism; tools to quantify experiential judgment and patient-reported outcomes are lacking; and medical education and hospital structures remain discipline-oriented. Their proposed roadmap calls for quantitative integration through a composite integration score spanning molecular, clinical-temporal, and whole-cycle dimensions; artificial intelligence–enabled decision support with interpretability and dynamic learning; expansion from oncology to other chronic diseases; and international dissemination of the Chinese experience. The transformation, they conclude, is not a repudiation of reductionist achievement but its dialectical advancement—reductionism supplies depth, holistic integrative medicine supplies breadth, and together they mark a decisive step from treating disease toward caring for the person.

Subject of Research: Evolution of cancer research paradigms in China under the holistic integrative medicine framework

Article Title: The evolution of research paradigms in cancer research in China within the framework of holistic integrative medicine

Article References: Bai, X., & Yang, Z. (2026). The evolution of research paradigms in cancer research in China within the framework of holistic integrative medicine. Holistic Integrative Oncology, 5(1), Article 75. https://doi.org/10.1007/s44178-026-00299-0

Image Credits: AI Generated

DOI: 10.1007/s44178-026-00299-0

Keywords: holistic integrative medicine, cancer research in China, systems thinking, tumor microenvironment, immunotherapy, antibody-drug conjugates, CAR-T cell therapy, patient-centered care, paradigm shift, oncology, whole-course cancer management, multidisciplinary therapy

The newly developed scale stands out by its multidisciplinary approach, blending rigorous psychometric methodologies with deep clinical insight. Historically, cancer assessments have been predominantly reductionist, focusing on tumor biology, genetics, or symptomatology in isolation. While these approaches have propelled advances in targeted therapies, they often neglect the nuanced interplay of mental health, social context, and existential well-being—factors now recognized as critical determinants of patient outcomes. The new scale thus harnesses elements from biopsychosocial and spiritual paradigms, providing a multidimensional matrix that enables clinicians and researchers to chart a patient’s journey holistically.

This transformative instrument was shaped through an iterative process involving extensive item generation, expert consensus, and field testing with diverse patient cohorts. The development phase commenced with comprehensive literature reviews, extracting key constructs that anchor the assessment’s four domains: biological indicators, psychological states, social dynamics, and spiritual well-being. Subsequent qualitative studies with cancer patients and care providers refined these constructs, ensuring resonance with lived experiences and clinical realities. This meticulous groundwork laid the foundation for robust measurement properties, essential for both research fidelity and clinical application.

In operationalizing the scale, the investigators confronted several psychometric challenges, notably balancing comprehensiveness with usability. They employed cutting-edge statistical techniques, including exploratory and confirmatory factor analyses, to elucidate the underlying factor structure. The result was a parsimonious yet thorough tool capturing distinct but interrelated facets of health. Reliability testing demonstrated high internal consistency across all domains, while validity analyses confirmed that the scale accurately reflects intended constructs and correlates appropriately with established measures of related psychological and clinical variables.

By elevating spiritual well-being as a core component, this scale reflects a pioneering departure from conventional frameworks. Spiritual concerns, often marginalized or overlooked in biomedical settings, markedly influence coping strategies and quality of life for many cancer patients. The integration of spirituality acknowledges the profound existential questions elicited by cancer diagnoses and treatments, offering components that assess meaning, hope, faith, and connectedness. This enrichment encourages healthcare providers to engage with patients in more meaningful dialogues around purpose and resilience, fostering holistic healing environments.

The scale’s social dimension extends beyond static demographic factors, incorporating dynamic interpersonal relationships, social support mechanisms, and community engagement. Research consistently demonstrates that robust social support buffers psychological distress and improves clinical outcomes in oncology. By quantitatively assessing patients’ social ecosystems, clinicians can identify vulnerabilities and deploy targeted interventions such as counseling, peer support groups, or family therapy, thereby enhancing overall therapeutic efficacy.

The psychological domain encompasses a broad spectrum of emotional and cognitive states frequently encountered in cancer trajectories, including anxiety, depression, distress, and cognitive impairments. Unlike conventional symptom checklists, the new scale measures these parameters alongside coping mechanisms and psychological resilience, offering a granular understanding of patient mental health. This dimension aids in timely identification of psychological morbidity, guiding clinicians to recommend appropriate psychotherapeutic or pharmacologic treatments.

Biological assessments within the tool incorporate traditional clinical metrics such as disease staging, symptom burden, and treatment side effects, yet they are contextualized within the broader biopsychosocial-spiritual matrix. By positioning biological status within this multifaceted framework, the scale enables a nuanced appreciation of how physiological factors interact with psychosocial influences, conceptualizing cancer care as a lived experience rather than a purely pathological event.

The adoption of this comprehensive assessment scale carries profound implications for personalized medicine. It equips oncologists and interdisciplinary teams with actionable insights that inform tailored care planning, transcending segmentation of care into silos. By presenting a synthesized profile of patient health, the scale facilitates integration across specialties, promotes shared decision-making, and enhances patient-centered communication, ultimately fostering holistic treatment paradigms aligned with patient values and preferences.

Moreover, the scale’s capacity for longitudinal monitoring offers opportunities for dynamic care adjustments throughout the cancer continuum, from diagnosis through survivorship or end-of-life care. Repeated administrations can track evolving biopsychosocial-spiritual needs, enabling proactive interventions to mitigate distress and optimize quality of life. This adaptability is particularly salient given the fluctuating nature of cancer-related challenges, necessitating flexible and responsive assessment strategies.

From a research perspective, the tool opens fertile avenues for exploring intricate interactions among biological, psychological, social, and spiritual factors in cancer progression and recovery. Its standardized structure facilitates cross-study comparisons, meta-analyses, and the generation of robust evidence elucidating determinants of health outcomes. Consequently, it paves the way for innovations in integrative oncology, psychosocial oncology, and palliative care, underpinning evidence-based practices that embrace complexity rather than reductionism.

The scale also addresses existing gaps in health equity by incorporating culturally sensitive elements within its domains, particularly spirituality and social context, which vary widely across populations. The research team emphasized inclusivity throughout the development phases, engaging diverse populations to ensure relevance across ethnicities, socio-economic statuses, and belief systems. This emphasis bolsters the instrument’s applicability in global oncology settings, supporting equitable care delivery attuned to cultural nuances.

Envisioned beyond clinical and research settings, the assessment scale has the potential to influence policy and healthcare systems. Its comprehensive data points can inform resource allocation, program development, and quality metrics attuned to multidimensional health outcomes. Healthcare administrators might leverage aggregate data to identify systemic barriers or facilitators of holistic cancer care, driving innovations in service design that better meet patient needs within their communities.

Importantly, the scale is designed for digital integration, with user-friendly electronic platforms enabling efficient administration, scoring, and data visualization. Such technological incorporation not only streamlines workflow but also enriches patient engagement through interactive user interfaces and real-time feedback mechanisms. Digital adaptability supports telemedicine applications, a critical feature in contemporary healthcare landscapes shaped by emergent needs for remote monitoring and support.

As the oncology field increasingly embraces precision medicine, the Cancer Bio-Psycho-Social-Spiritual Comprehensive Assessment Scale represents a paradigm shift toward precision holistic care. It underscores that effective cancer management demands nuanced appreciation of human complexity, demanding tools that measure and respect the full richness of patient lives. This instrument stands as a testament to interdisciplinary innovation, reflective of evolving healthcare philosophies that honor the intertwining of body, mind, and spirit in healing processes.

Future directions envisioned by the research team include large-scale validation studies in varied clinical environments, refinement for pediatric and geriatric populations, and integration with biomarker data to enhance prognostic models. Collaborative efforts with technology developers aim to expand artificial intelligence applications for predictive analytics, further personalizing interventions based on comprehensive biopsychosocial-spiritual profiles. These initiatives promise to catalyze ongoing enhancements in patient care quality and scientific understanding.

By revealing the multifaceted reality of cancer experiences, this comprehensive scale not only augments clinical assessment but also revitalizes the ethos of compassionate care. It invites healthcare providers to attend to the totality of what it means to live with cancer—emotions, relationships, beliefs, and bodily realities in concert—and challenges the biomedical community to embrace integrative frameworks as the future of oncology. The introduction of this tool heralds a new chapter in cancer care where science meets soul, knowledge meets empathy, and measurement meets meaning.

Subject of Research: Development and comprehensive psychometric evaluation of an integrative cancer assessment tool encompassing biological, psychological, social, and spiritual dimensions.

Article Title: Development and psychometric evaluation of the cancer bio-psycho-social-spiritual comprehensive assessment scale.

Article References:
Pei, L., Zhou, M., Xu, J. et al. Development and psychometric evaluation of the cancer bio-psycho-social-spiritual comprehensive assessment scale. BMC Psychol (2025). https://doi.org/10.1186/s40359-025-03794-7

Image Credits: AI Generated