Editorial: Genetic and immunological insights in solid tumors: comprehensive approaches to treatment

The high heterogeneity and complex microenvironment of solid tumors have long been the core challenges in clinical treatment. (Fu et al, 2021). Conventional therapeutic modalities, including surgery, radiotherapy and chemotherapy, often fail to achieve precise targeted therapy and maintain long -term efficacy. (Neil et al, 2019).With the progress of molecular biology and immunology, patient stratification based on genetic biomarkers, systematic analysis of the tumor immune microenvironment, and the construction of multi -dimensional prognostic models integrating clinical and molecular characteristics have gradually improved the survival benefits of tumor patients. (Jiang et al, 2022). The above advancements on basic theories has not only deepened the understanding of the biological behaviors of solid malignant tumors, but also promoted and innovated the development of individualized cancer treatment strategies.The research topic focuses on typical solid tumors such as pancreatic cancer and non-small cell lung cancer (NSCLC). From the perspectives of novel biomarker identification, construction of immune-related gene models, and analysis of real-world treatment patterns, these studies offer crucial evidence for the "genetic-immune integration" comprehensive treatment strategy and unveil the development trends and key issues in this field.Accurate identification of biomarkers is a prerequisite for the stratified treatment of solid tumors, and biomarkers considering both genetic background and immune status exhibit higher clinical translatability. Ye et al.'s research on patients suffering from locally advanced pancreatic cancer ascertained that the Monocyte-to-High-Density Lipoprotein Ratio (MHR), serving as a novel immune -inflammatory -metabolic biomarker, is capable of independently predicting the Overall Survival (OS) and validation set (1-, 3-, and 5-year AUC were 0.68, 0.72, and 0.69, respectively) and could effectively distinguish the differences in the immune microenvironment between high-risk and low-risk patients: the tumor microenvironment of high-risk patients displayed an immunosuppressive phenotype and was more sensitive to the MCL1 inhibitor AZD5991; low-risk patients had stronger immune activity and were more likely to benefit from IGF1R inhibitor treatment. This "gene model-risk stratification-treatment matching" pattern directly links genetic characteristics with drug sensitivity, providing an operable tool for personalized medication in NSCLC.Real-world studies further shed light on the clinical status and gaps in biomarker-guided treatment. Kiiskinen et al.'s multi-country observational study on RET fusion-positive NSCLC revealed that only 31% of advanced NSCLC patients underwent RET fusion testing, with significant differences in detection rates among different countries (Taiwan 8% vs. United States 67%); although RET inhibitors have been approved for clinical use, the rate of targeted therapy in this cohort was only 16%, much lower than that of traditional chemotherapy (32%). This result reflects the bottlenecks in the clinical popularization of novel genetic biomarkers, including factors such as test accessibility, physician awareness, and drug accessibility, and also suggests that the translation "from laboratory to bedside" requires the collaborative promotion of policy support and clinical education. Meanwhile, the study confirmed that RET fusion-positive NSCLC patients had a higher proportion of never-smokers and adenocarcinoma subtypes, providing a reference for population characteristics in clinical screening.In the future, the comprehensive treatment of solid tumors should move towards "multi-dimensional integration and full-cycle management". In the research field, multi-center, prospective cohort studies need to be conducted to verify the general applicability of existing biomarkers and prognostic models; combined with emerging technologies such as single-cell sequencing and spatial transcriptomics, the spatiotemporal dynamic association between genetic variations and immune cell infiltration should be analyzed to explore more specific targets. Through the application of innovative immune assessment technologies, such as the MISS score, the body's immune status is monitored across the entire treatment cycle Currently, the treatment of solid tumors has gradually shifted from the traditional "one -size -fits -all" model to a comprehensive paradigm driven by both "genetic characteristics and immune status". Paying attention to the improvement of the body's immune status during the perioperative period contributes to enhancing the efficacy of comprehensive treatment. Through multi-angle exploration, the above five studies collectively outline the core direction of this field: taking novel biomarkers as the entry point, multi-gene models as analytical tools, and real-world data as support, ultimately achieving precise, personalized, and full-cycle treatment. Despite numerous remaining challenges, with the progress of research technologies and the improvement of clinical practice, the in-depth integration of genetics and immunology will surely bring dual benefits of longer survival and higher quality of life to solid tumor patients.