PANoptosis in cancer: bridging molecular mechanisms to therapeutic innovations

PANoptosis, a newly defined inflammatory programmed cell death, plays key roles in tumor development and progression. This process involves the assembly of PANoptosome complexes under various stimuli, which activate multiple cell death pathways simultaneously. By integrating key sensors and effector molecules, PANoptosis enhances immunogenic cell death while counteracts immune evasion mechanisms. This review focuses on current research of PANoptosis in cancer. Clinically, PANoptosis-related signatures show clinical value for predicting patient survival, discerning tumor immune microenvironment (TIME) characteristics and evaluating the therapeutic response. Mechanistically, complex signaling networks regulate PANoptosis, which in turn influences tumor behavior through dynamic interactions with TIME components. Therapeutically, targeting PANoptosis-related pathways, including nanomedicine approaches, demonstrate encouraging preclinical results. Particularly, combining PANoptosis modulation with radiotherapy, chemotherapy, or immunotherapy enhances anti-tumor efficacy. These findings position PANoptosis as a promising therapeutic target for reshaping TIME, overcoming treatment resistance, and improving cancer outcomes. Future research will focus on elucidating context-dependent PANoptosome regulation and translating these insights into precision oncology strategies.