1. Introduction
Throughout the development of our project, we placed a strong emphasis on ensuring that our product and work process are responsible and beneficial to the world, thereby adhering to our core values. This was achieved by being open-minded and constantly refining our understanding, design, and actions through constructive interviews with experts in the field—researchers, doctors, and stakeholders — who frequently challenged our ideas and guided us toward making our project safer, more scientifically accurate, and ethically sound.
2. Interview with the Professor. Liu
On July 22, 2025, the YiYe-China iGEM team conducted an interview with a professor. Liu from the School of Pharmacy, Wuhan University. First, Prof. Liu identifies critical flaws in current oncology practice. Radiotherapy or chemotherapy present major flaws due to their lack of a specific target, resulting in overall damage to the body. This side effect can cause significant damage to both the physical and mental health of the patient. On the other hand, targeted therapies, such as VEGF inhibitors, frequently fail after a few years due to tumour evolution. Over 60% of breast cancers develop drug resistance within 5 years, resulting in late-stage patients having little to no effective drug options to use. Screening methods also remain inefficient. Live biopsies provide the best data, often regarded as the "gold standard"; however, it is time-consuming and usually frightening to patients, while population-wide blood tests yield low detection rates in young, low-risk groups. High-risk patients (BRCA+ carriers) face invasive preventive surgeries due to inadequate alternatives.
Next, when it comes to the inherent uncertainties of genetic medicine and precision oncology, Prof. Liu acknowledges that uncertainty is fundamental to biological systems and genetic interventions. She emphasizes that no medical treatment offers absolute certainty, drawing parallels to the probabilistic nature of the universe ("possibility is inherent to the universe"). The key limitations include trade-offs associated with targeted therapy, challenges to personalization, and concerns regarding ethical acceptability. For a new screening or treatment to gain clinical acceptance, Professor Liu emphasizes the need for rigorous, stepwise validation. She describes the current gold standard (tissue biopsy) as the definitive diagnostic, preceded by population-based screening such as annual blood tests in high-risk groups. She stresses that only after demonstrating safety, specificity, and favorable risk-benefit profiles through clinical trials and regulatory approval can a new modality be broadly implemented. There are significant translational barriers between innovative cancer research and the development of tangible treatments available to patients. Only 10% of lab discoveries reach clinical use, often halted by toxicity concerns, such as drugs triggering unrelated fatal events like heart attacks. Or regulatory delays, such as randomized controlled trials (China: 5-year vs. FDA: 10-year approval timelines). This could lead to the public perception of "useless" research. Nevertheless, Prof. Liu critiqued this narrative by emphasizing that more new treatments are being discovered each year than ever before.
Biological Complexity also plays a significant role in the halting of the development of new treatment targets (e.g., AKT), which reveal paradoxical roles when inhibited. Knockout studies can accelerate tumorigenesis, exposing knowledge gaps in signaling networks. Prof. Liu said that it is easy to identify a gene and gain a basic understanding of it, but what is complex and hinders many researchers is determining the exact mechanism behind it. The body, especially its genes, is a complex system comprising multiple interrelated aspects. Beyond molecularly targeted drugs, Prof. Liu discusses advanced physical modalities, such as proton beam therapy and theoretical "nano-robotic" tumor ablation, as conceptually appealing but technologically immature. The critical challenge, she argues, is distinguishing malignant from healthy tissue at high resolution before any physical intervention can be applied safely. She also points out how individualized gene cancer treatment might be the future of cancer treatments. Contrasts "blind" radiotherapy/chemotherapy—which indiscriminately damage healthy cells—with targeted genetic interventions.
Ultimately, Prof. Liu emphasized the importance of publishing negative results, noting that they are often just as valuable as positive findings. She explained that when unsuccessful experiments or failed hypotheses are shared, they prevent other researchers from repeating the same costly mistakes and help refine the scientific understanding of complex systems. In her view, science progresses not only through breakthroughs but also through the collective mapping of dead ends, which ultimately guides the field toward more accurate and reproducible discoveries.
In conclusion, Prof. Liu's reflections converge on a powerful truth: uncertainty is not a flaw of science but its defining condition. In breast cancer, where heterogeneity and drug resistance undermine even the most advanced therapies, the real challenge is not simply to find "the cure" but to navigate complexity with rigor and patience. Her emphasis on publishing negative results, acknowledging probabilistic outcomes, and resisting premature hype illustrates a scientific ethos that values long-term resilience over short-term triumphs. To us, a group of researchers working on gene editing and breast cancer, these cautionary stories have significant weight. Gene editing holds out massive possibilities, with the potential to correct mutations at their source or design drugs tailored to unique molecular profiles. However, Liu's cautionary stories about AKT and TEAD4 remind us that biology resists neat simplicity tenaciously. Targets will fall short, pathways will be circumvented, and laboratory triumphs will not translate into clinical success.
The path forward, then, is not to view gene editing as a silver bullet, but as part of a greater symphony of methodologies: single-cell interrogation to generate maps of tumor heterogeneity, molecular diagnostics to divide patients into groups, AI to model complex networks, and gene editing to test and refine targeted therapies. In this setting, uncertainty is managed rather than eliminated. Prof. Liu's words challenge us to place our project within this realistic yet hopeful framework. Our goal is not only technical innovation but also intellectual honesty — to ask tough questions, share both successes and setbacks, and accept the slow, steady progress of science. If we adopt this mindset, our work on breast cancer and gene editing will not only advance research but also fulfill the long-term duty of turning uncertainty into practical knowledge for patients who need it most.
3. Interview with the Professor. Zhou
On July 23, 2025, the YiYe-China iGEM team interviewed Professor Zhou from the School of Basic Medical Sciences at Wuhan University. The interview sheds light on the complexity and frontiers of breast cancer research, while also prompting deeper reflection on the role of genetic testing and gene editing in cancer treatment. Prof. Zhou not only analysed the essence and challenges of breast cancer from a researcher's perspective, but also offered insights into how artificial intelligence and interdisciplinary collaboration can accelerate medical progress.
In the beginning, Prof. Zhou mentioned, breast cancer, like many other cancers, is the result of multiple interacting factors such as genetics, environment, and age. Its most incredible difficulty lies in cellular heterogeneity; even within the same tumor, cancer cells differ, with some being highly invasive while others have limited metastatic potential. This diversity makes traditional "one-size-fits-all" treatments less effective. While surgery, chemotherapy, radiotherapy, immunotherapy, and targeted therapy have all improved, the real breakthrough will come from personalized medicine. In the future, the same breast cancer type may require entirely different treatment strategies for other patients, guided by precise molecular targets.
Prof. Zhou highlighted the potential of single-cell analysis. By distinguishing between different types of tumor cells, researchers can identify the most aggressive subpopulations and design targeted interventions. At the same time, molecular diagnostics is becoming crucial for early detection and classification. Indicators from RNA biology and non-coding RNAs may allow us to capture signals even before a tumour fully develops. Although these biomarkers are still in the exploratory phase, they hold promise as the future of breast cancer detection.
Next on genetic testing, Prof. Zhou offered a nuanced view: the results are specific, but the functional interpretation is uncertain. Mutations can be accurately detected, but whether they actually affect protein function or inevitably lead to disease remains unclear. For example, family members with the same genetic mutation may have different levels of risk. Thus, genetic testing should be viewed as a risk alert, rather than a deterministic verdict. The key lies in increased screening frequency and early intervention. Although not directly addressed in the interview, Professor Zhou's perspective on genetic testing and cancer research allows us to infer the implications for gene editing: (1) Future Prospects: CRISPR and other gene editing tools may one day repair pathogenic mutations at their root; for high-risk breast cancer populations, gene editing could be applied preventively; combined with personalized medicine, gene editing may serve as a dual approach of "targeting + repair." (2) Practical Challenges: The multi-gene, multi-pathway nature of cancer means single-gene repair is rarely sufficient; Long-term safety issues, such as off-target effects and heritable risks, remain unresolved; Ethical considerations will be a significant barrier to clinical application. Therefore, gene editing is most promising when integrated with single-cell analysis, molecular diagnostics, and artificial intelligence, forming a more precise and adaptive intervention system.
Finally, Prof. Zhou emphasized the transformative role of artificial intelligence. Protein structure prediction and drug design have already become faster and more efficient, offering new possibilities for complex diseases such as breast cancer. However, she cautioned that AI is merely a tool — real scientific thinking must come from researchers themselves. Its actual value lies in expanding the global perspective, linking clinical data, molecular diagnostics, and potential gene-editing strategies. The prevalence of breast cancer is not only a biological issue but also a social one. Many late diagnoses stem from a lack of awareness. Professor Zhou stressed that education is a vital tool for early diagnosis. When the public can recognize early symptoms and take initiative in screening, survival rates improve dramatically. For those with a family history, the combination of genetic testing and regular check-ups is the most effective way to manage risk.
Prof. Zhou's reflections remind us that the future of breast cancer research depends on linking cutting-edge scientific discoveries with the realities of clinical diagnosis and patient care. She highlighted how Nobel-level breakthroughs in molecular detection can inspire new diagnostic strategies, opening fresh possibilities for breast cancer screening and early intervention. Her message is clear: innovation gains real value only when it is translated into tools that serve patients. Equally important is her nuanced view of disease causation. While genetics plays a central role in breast cancer susceptibility, Zhou stresses that environmental exposures and psychological stress are also decisive factors. This holistic framing challenges us to see cancer not merely as a molecular defect, but as the product of complex interactions across biology, lifestyle, and society.
For our project, these insights are invaluable. By anchoring our work in established scientific milestones while also recognizing the broader determinants of disease, we can position gene editing not as a narrow fix, but as part of a wider ecosystem of solutions — spanning diagnostics, prevention, and holistic patient care. In this sense, Zhou's emphasis on integration and context is more than advice; it is a roadmap for making our research meaningful, impactful, and resilient in the face of complexity.
4. Interview with Dr. Qiu
On July 25, 2025, the YiYe-China iGEM team interviewed Dr. Qiu from the Department of Oncology, Radiotherapy, and Chemotherapy at Zhongnan Hospital of Wuhan University. This radiation oncologist is both a practitioner of science and a guardian of life. Every day, she faces not just black-and-white imaging scans, but also the fear and trust in her patients' eyes. This interview with a senior radiation oncologist specializing in breast cancer has reshaped our understanding: medicine is not merely composed of cold data and sterile instruments—it is also imbued with warm trust, unwavering perseverance, and ultimately, the art of humanity.
During the interview, Dr. Qiu mentioned that estrogen receptor-positive breast cancer is the most common type among patients. These seemingly "cold facts" reflect the gradual spread of preventive awareness and the progressive implementation of national health policies. She noted that the national "dual-screening" program has significantly increased early detection and decreased the number of advanced cases—this is evidence of the joint efforts of the medical community and rising public health literacy. However, a deeper issue persists—awareness remains the most significant challenge. Illness is a reality, while fear is a nightmare we magnify ourselves. Those who linger in hospital corridors are not just physically hesitating but are also emotionally retreating from the unknown. This avoidance often results in misdiagnosis, delayed intervention, or missed opportunities for optimal treatment—an adversary more persistent than the tumor itself.
When discussing imaging misdiagnosis and radiation from CT scans, she precisely distinguished between "imaging indications" and "pathological confirmation", embodying the scientific rigor that modern medicine demands. While she openly acknowledged the carcinogenic risks of ionizing radiation, she also emphasized the importance of appropriate clinical use, reflecting the physician's unwavering commitment to patient safety. Behind this scientific spirit is the day-to-day burden of responsibility borne by doctors. They do not promise "infallibility," but they strive to make the most reasonable decisions within the narrow space between risk and benefit. Like architects, they build a protective net for life—brick by brick, even when resources are scarce, time is tight, and the environment is uncertain.
"Providing psychological support is the doctor's responsibility." This statement reminded us of a quote from The Emperor of All Maladies: "The most important tool in a doctor's hand is not a scalpel, but language." In the complex medical system, physicians are not merely executors of treatment plans—they are also comforters of fear and sowers of hope. They must explain survival probabilities, clarify every side effect of treatment, and, through each turn of disease progression, maintain the fragile thread of trust that links patient and physician. When Dr. Qiu spoke about trust, she clearly understood that a highly cooperative patient often achieves better outcomes. Trust functions as a bridge spanning the chasm between patient and doctor—if it collapses, even the best medical plans may be washed away in a tide of emotional distress.
When asked, "When do you feel most helpless?", Dr. Qiu recounted a case she still finds unforgettable: a breast cancer patient who experienced recurrence in the other breast shortly after mastectomy, followed by ulceration of the chest wall. Despite exhausting all available therapies, the disease progressed relentlessly until the patient passed away. In her voice, we heard deep sorrow—a sorrow stemming from the vulnerability of humanity in the face of fate, and from the emotional toll of practicing medicine. Doctors are not emotionless treatment machines; they, too, experience pain, guilt, and grief. And yet, to continue offering hope to the next patient, they must learn to carry their regrets and move forward.
Throughout the interview, Dr. Qiu repeatedly mentioned "personalized treatment," "targeted therapies," and "genetic testing." This marks the transition of medicine from empirical practice to precision science. She no longer evaluates tumors solely by size or appearance, but probes the genetic codes of disease at the molecular level, striving for true "precision medicine." This transformation is both inspiring and humbling. Traditional chemotherapy is often "a double-edged sword," harming both tumor and host. In contrast, targeted therapies act on specific genetic mutations, delivering higher efficacy with fewer side effects. She also recounted how, twenty years ago, a single tablet of targeted therapy cost 500 RMB, while monthly salaries averaged only 100 RMB. Now, thanks to domestic production, the same treatment costs only a few hundred RMB per month. This is not just a price reduction, but a leap in technology and an extension of healthcare equity. Yet she acknowledged that drug resistance remains a significant challenge. Her restraint in celebrating scientific progress reflects a more profound understanding: medicine is always in pursuit, never victorious—but it has never ceased striving.
When comparing proton therapy to conventional photon therapy, we recognize that medical innovation is not solely about maximizing efficacy—it is also a matter of cost, infrastructure, and accessibility. Proton therapy boasts high precision and minimal side effects, but its equipment is expensive and complex to scale. Photon therapy, though more damaging to surrounding tissue, is more widely available and therefore the clinical mainstream. Dr. Qiu acknowledged this reality: "For now, we still mostly use photon therapy." This statement reflects both compromise and resilience. True medicine is never idealized; it is a relentless pursuit of the best possible outcome under less-than-ideal conditions.
The most poignant moment in the interview came when Dr. Qiu spoke of a 12-year-old osteosarcoma patient who lost her leg at the height of her youth, only for the cancer to metastasize to her lungs quickly. Ultimately, they were unable to save her. This story reminded us of a line: "Medicine cannot defeat death, but it can delay despair." Though she could not rescue every patient, the doctor continued to act with compassion, dignity, and a fierce sense of responsibility—that is the most incredible courage of a healer. What moved us most was her unwavering hope for the future. She firmly believes in revolutionary advances through gene therapy, immunotherapy, and individualized treatment protocols. She advocates for spreading cancer awareness through social media like Douyin and urges society to offer screening support to low-income groups, preventing tragedies born of poverty.
Medicine is not omnipotent, but it can bring warmth; doctors are not deities, but they can restore hope. Let us embrace health with reason and face illness with trust. On the long road of battling disease, we are all fellow travelers.
5. Interview with Dr. Chao
On July 25, 2025, the YiYe-China iGEM team interviewed Dr. Chao from the Department of Oncology at the Affiliated Hospital of Tongji Medical College. As an oncologist, Dr. Chao believes that Breast cancer is the most prevalent cancer among women and has once surpassed lung cancer as the leading cancer killer. This is mainly due to physiological structure and hormone levels. While men do have breast tissue, it is not as developed as in women, and most breast cancers are closely related to hormone levels. The breast tissue in women is more susceptible to hormonal changes, leading to a naturally higher incidence. Although the current treatment outcomes are relatively good, many patients still require assistance.
When it comes to the current treatment methods for breast cancer, Dr. Chao mentioned that the most significant limitation lies in the lack of a curative procedure and exact treatment plans. Traditionally, many believe that surgical removal is the best way to treat tumors, but as our understanding of tumors deepens, we find that many do not require surgery; chemotherapy and radiation therapy can also yield good results. While targeted therapy is a significant advancement, we have yet to develop a personalized treatment plan suitable for all patients. For targeted therapy, first, effective targets must be identified, and these targets must be closely related to the tumor's growth. Secondly, drugs need to be able to target these receptors and effectively inhibit their activity precisely. A large number of preliminary experiments, including cell and animal studies, must be conducted during the development process to ensure efficacy and safety.
For the surgery selection criteria in clinical practice, Dr. Chao mentioned that when choosing between total resection and breast-conserving surgery, multiple factors must be considered, including the stage of the tumor, the patient's wishes, and their fertility needs. Studies have shown that the effect of breast-conserving surgery combined with subsequent radiotherapy is comparable to that of total resection surgery. Therefore, more and more patients are willing to choose breast-conserving surgery. Ultimately, the patients' choices should also be respected, because this is their body and future. Additionally, the economic situation typically influences patients' treatment choices. Many patients choose to delay seeking medical treatment or even give up treatment due to cost issues. However, early treatment often saves on more expensive subsequent treatment costs. Therefore, when formulating a treatment plan, we must also consider the patient's economic affordability to find an appropriate solution.
When communicating with patients, their psychological state and level of knowledge must be taken into consideration. Some patients possess a strong psychological resilience and can tolerate detailed information. Some patients, however, need a milder approach. For instance, doctors can first inform them of the condition of the lump and explain that even if it is a malignant tumor, with appropriate treatment, the outcome can also be favorable. This method can help them gradually accept reality, rather than subjecting them to tremendous psychological pressure all at once.
So, for the prevention and treatment of breast cancer, early detection is vital. We need to strengthen public scientific education and encourage women to perform regular self-examinations and participate in check-ups. By increasing awareness of breast cancer among the public, we can help more women identify issues early and seek medical attention. This not only affects individual health but also contributes to the overall healthcare burden on society. If it reaches an advanced stage, the primary goal is to enhance the patient's quality of life and prolong their survival time. During the treatment process, efforts should be made to enable the patient to maintain a good quality of life, rather than merely pursuing the extension of life time, because the quality of life is equally important.
Finally, when it comes to the popularization of science about breast cancer, Dr. Chao believes that it is essential to enhance the public's understanding of health knowledge through popular science education and the utilization of various media platforms. Hospitals and doctors should also actively participate in disseminating health knowledge to help the public enhance their understanding and awareness of disease prevention. The prevention, treatment, and management of breast cancer are no longer just the responsibility of individuals and families; they require the joint efforts of the entire society.
6. Interview with Dr. Liu from CABIO Biotechnology
During the summer holiday, the YiYe-China iGEM team visited CABIO Biotechnology Co., LTD. A company that began with contract manufacturing, grew on the brink of crisis, and ultimately secured a listing on the STAR Market through technological innovation and industrial logic. This interview vividly and intensely presents the entire process of a technology-based enterprise transitioning from "the laboratory" to "industrial application." It is not only a record of corporate growth, but also a profound lesson that spans science, business, education, and national strategy.
In the past, we often regarded "technological innovation" as a fundamental driver of national development. However, a key concept repeatedly emphasized in the interview is that technology does not inherently equate to value. Whether a scientific achievement can be "commercialized," "implemented," transformed into a product, and recognized by the market involves a complex system engineering process that spans science, engineering, management, regulations, and marketing. As a senior executive at CABIO stated: "What you produce in the lab for a few thousand yuan may require millions—or even tens of millions—for engineering experiments to become a viable product." This discrepancy is particularly pronounced in the field of synthetic biology.
The path to industrialization for CABIO was far from smooth. The company experienced operational difficulties at its inception, initially opening up the market with a single protein product, and subsequently formed joint ventures with international giants. It also made significant strides in areas such as engineering, research and development (R&D), manufacturing, sales, certification, and regulation. It went on to build R&D centers, sprint for the STAR Market listing, endure delays due to the pandemic, and confront international market thresholds and patent barriers. This is a classic "from zero to one" story, full of real-world struggles and severe trials.
As described in the process of scale-up: "From a small laboratory flask to large-scale industrial equipment," every step requires precise control of physical conditions, environmental disturbances, and material variability. Thus, "engineering technology" becomes a decisive link in the innovation chain—it may lack the glamour of scientific research or the intuitiveness of marketing. Still, it ultimately determines whether a technology can be monetized. Here, we deeply realized that "industrialization" is not merely an engineering problem, but a rigorous test of team capabilities, a synthesis of lessons learned through failures, and a bridge built with cost and time.
One of the most striking aspects of this interview was CABIO's profound grasp of business logic. Their R&D never starts with "inspiration," but with "whether customers are willing to pay." As an executive said, "If you tell me a research direction is promising, first show me if a customer is willing to sign a procurement contract in advance." Under this pragmatic evaluation standard, CABIO not only avoided blind techno-optimism but also established a research decision-making framework that integrates science and business: market demand guides direction, technical decisions determine implementation, cost control measures feasibility, and patent layout secures profitability. This logic underpins every project evaluation, partner collaboration, production line setup, and talent development. CABIO's development path exemplifies a "Chinese-style innovation" model: starting with contract manufacturing to accumulate initial capital, then catching up in core technologies and building an independent platform, and ultimately achieving industrialization and integrating into the global value chain. Decades of China's manufacturing base have endowed companies like CABIO with the world's most complete supply chains and fastest engineering transformation capabilities. Simultaneously, national policy is shifting from "basic research first" to emphasizing "transformation and industrial implementation," reflecting a deeper strategic demand for integrating technology and the economy. As mentioned in the interview: "In major national R&D projects, the final task must be 'industrialization’; otherwise, the project will not be approved." This marks not only a shift in technical orientation but also a new logic in China's modernization: technology must serve industry, research must empower the economy, and talent must solve real-world problems.
An executive of CABIO admitted, "If you don't have a PhD, you likely can't do this job well." It can take a decade for a synthetic biology product to go from concept to market. For many, this means dedicating their entire career to a single product. The cyclical, complex, and high-risk nature of the biotechnological industry cannot be compared to the rapid pace of internet startups. CABIO also demonstrates strong responsibility in talent cultivation, opening laboratory platforms to high school students, guiding postgraduate students through technical challenges, and fostering a holistic awareness across R&D, engineering, marketing, legal, IP, and financial management. This reflects true entrepreneurial spirit and long-term responsibility to society.
At the end of the interview, the executive also warned: "This industry is not for speculators or those who seek quick money." This is both advice to the youth and a reminder of the essence of technological innovation: technology is complex, industrialization is more challenging, and building a platform is the most daunting task. Without a long-term commitment, concepts and funding alone cannot survive the test of time and the market.
What resonated most after this interview is that industrialization is a "game for grown-ups." It demands not only technological expertise but also resource integration, business acumen, interdisciplinary collaboration, and psychological resilience. It is a complex societal endeavor that requires determination and perseverance at every step.
For our generation, aspiring to drive innovation, we must break the illusion of the ivory tower and enter the real world—entering the enterprise front lines, conducting market research, visiting production workshops, and studying regulatory environments. Only then can we truly understand the value of technology, why scientific research is essential, and why the state emphasizes industrialization. Otherwise, no matter how good our research is, it risks becoming "academic yet useless."
The story of CABIO is both a mirror and a compass. In this era of accelerating biotechnology transformation, every young person must ask: Am I prepared to take part in this long and great relay?
7. Interview with Dr. Liu from Kindstar Global
Breast cancer early screening and precision treatment are hot topics in current medical research. On July 26, members of the IGEM team engaged in an in-depth discussion with Dr. Qiu, Director of Pathology at Kindstar Global, to explore the clinical applications and challenges of miRNA testing, imaging diagnostics, the characteristics of triple-negative breast cancer (TNBC), and CRISPR gene editing technology. This article combines insights from the interview to share the current status of breast cancer diagnosis and treatment, as well as key issues in translating research into clinical practice, providing inspiration for both basic research and clinical applications.
Although miRNAs (e.g., miR-21, miR-155) show promise in breast cancer diagnosis, the stability of detecting a single or a small number of miRNAs is insufficient. Early breast cancer metastasis follows the pattern of "carcinoma in situ → invasive carcinoma → lymphatic metastasis → hematogenous metastasis." Early screening relies on the "mammography + ultrasound" gold standard, combined with molecular biomarkers (e.g., miRNA panels) to enhance sensitivity and specificity. Experts emphasize that multi-index combined detection (e.g., integrating imaging and molecular biomarkers) can improve accuracy to over 85%, which is particularly significant for early screening.
In terms of the limitations of imaging diagnosis and clinical decision-making, the two-dimensional imaging features of techniques like CT and mammography may lead to missed diagnoses of atypical lesions, especially in highly concealed subtypes like triple-negative breast cancer (TNBC). Experts stress that collaboration between clinical and pathology departments is core to avoiding misdiagnosis. For instance, cases with unclear imaging results require comprehensive judgment based on medical history, physical examination, and laboratory data. The standardized application of the BI-RADS grading system (e.g., Level 4 subdivisions) helps distinguish between benign and malignant lesions, reducing overtreatment.
The challenges faced by triple-negative breast cancer (TNBC), which originates from breast stem cells and lacks ER/PR/HER2 targets, is challenging to detect early and has limited treatment options. Expert insights include: The stem cell properties of TNBC contribute to its high invasiveness, making it difficult to detect with traditional screening methods. Surgery combined with radiotherapy and chemotherapy remains the primary approach. While immunotherapies like PD-1 show efficacy, they face issues such as off-target effects. Exploring TNBC-specific biomarkers (e.g., TEAD4 gene) and single-cell sequencing technologies may offer new avenues for early diagnosis.
The challenges faced by CRISPR gene editing in clinical translation, although animal experiments show that CRISPR-Cas9 knockout of the TEAD4 gene can inhibit metastasis, experts point out that clinical translation must overcome multiple barriers, Technical Bottlenecks: Efficiency and safety issues with delivery systems (e.g., LNP carriers); Cost Control: Balancing cost-effectiveness from lab-scale to large-scale production; Multidisciplinary Collaboration: Integrating basic research, clinical medicine, and industry to optimize target selection and treatment plans.
Public education and screening strategies for breast cancer prevention, the first step is to enhance public awareness, national "Two-Cancer Screening" programs have significantly improved early detection rates, with a near 100% five-year survival rate for carcinoma in situ. Secondly, it is necessary to increase the frequency of screening and make differentiated plans, for the general population, once a year; for those under 50, high-risk individuals over 50 should shorten the interval to 6–8 months. Screening intervals should be adjusted based on cancer characteristics (e.g., 3–6 months for liver cancer vs. 1–2 years for breast cancer). The last point is to do a good job in psychological intervention, chronic stress may promote tumor progression through neuroendocrine mechanisms, aligning with the traditional Chinese medicine theory of "emotional factors causing breast nodules."
At last, from clinical needs to study design, make efforts in integrating multiple disciplines, transforming thinking and innovating directions. Basic research should incorporate clinical perspectives from imaging and pathology, such as using small-animal ultrasound monitoring in animal models. Focus on industrialization bottlenecks of CRISPR technology. Explore the relationship between TNBC stem cells and the TEAD4 gene. Develop new liquid biopsy biomarkers to address the limitations of current screening technologies during the window period.
This expert interview on the current status of breast cancer diagnosis and treatment has provided profound insights and reflections for our research project on TNBC. By systematically reviewing the interview content, we realized that our research can both draw valuable nutrients from clinical experience and face bottleneck issues that urgently need breakthroughs.
The multidisciplinary collaboration concept repeatedly emphasized by experts resonated deeply with us. Currently, our CRISPR gene editing research remains at the laboratory stage, disconnected from clinical diagnosis and treatment. The imaging-molecular combined diagnostic model mentioned by experts inspired me to consider incorporating imaging monitoring, such as small-animal ultrasound, into animal experiments to make the research more aligned with clinical reality. Additionally, pathologists’ experience in interpreting tissue samples could help us optimize target selection for gene editing. This deep integration of basic and clinical research is the essence of translational medicine.
On a technical level, the TNBC stem cell characteristics revealed in the interview highly align with the functions of the TEAD4 gene we discovered. This suggests we need to pay more attention to tumor stem cells, such as analyzing changes in stemness markers after TEAD4 knockout through single-cell sequencing. The shortcomings of liquid biopsy technology mentioned by experts also prompted us to consider incorporating TEAD4 detection into the development of new biomarkers, which is crucial for improving early diagnosis rates. Most thought-provoking was the experts’ analysis of the challenges in clinical translation of CRISPR therapy. We have overlooked industrialization challenges such as delivery systems and large-scale preparation. This made us realize that we must start planning for patent protection of LNP delivery technology and conduct cost-effectiveness analyses to pave the way for future clinical trials.
These interviews have broadened our research perspective. We also discovered that psychological factors can influence tumor progression through neuroendocrine mechanisms suggests we should explore the role of TEAD4 in regulating the tumor microenvironment. The traditional Chinese medicine theory of emotional factors offers a research direction that integrates Chinese and Western medicine. These interdisciplinary insights could become innovative growth points for our project.
Human practices served as a mirror, reflecting both the strengths and weaknesses of our project. In the future, we need to establish a tighter industry-academia-research-medicine collaboration network. While maintaining depth in basic research, we must enhance our ability to solve practical clinical problems. Only by ensuring that laboratory discoveries truly benefit patients will our research have lasting vitality. This research philosophy, spanning from the clinic to the lab and back to the clinic, will serve as a guiding principle for our future work.
