Unraveling the complexity of pyroptosis in esophageal cancer: from underlying mechanisms to targeted therapies

Pyroptosis is a form of programmed cell death mediated by caspases, characterized by the activation of Gasdermin proteins, which leads to cell membrane rupture and the release of inflammatory mediators, thereby inducing local inflammation. In recent years, pyroptosis has emerged as an important player in tumorigenesis and progression, particularly in esophageal cancer (EC). EC is a highly malignant digestive system tumor, often diagnosed at advanced stages due to its subtle early symptoms, resulting in a poor prognosis. Studies have shown that pyroptosis not only regulates the immune response in EC but also influences tumor proliferation, invasion, and drug resistance. Activating pyroptosis may help overcome drug resistance in cancer cells, offering potential therapeutic targets for novel drug development and providing new directions for prognostic evaluation in EC. This review summarizes the mechanisms of pyroptosis and its role in EC, aiming to provide a theoretical basis for clinical treatment and drug development.