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Review
. 2025 Apr;25(4):293-315.
doi: 10.1038/s41568-024-00788-2. Epub 2025 Feb 20.

Defining a 'cells to society' research framework for appendiceal tumours

Affiliations
Review

Defining a 'cells to society' research framework for appendiceal tumours

Andreana N Holowatyj et al. Nat Rev Cancer. 2025 Apr.

Abstract

Tumours of the appendix - a vestigial digestive organ attached to the colon - are rare. Although we estimate that around 3,000 new appendiceal cancer cases are diagnosed annually in the USA, the challenges of accurately diagnosing and identifying this tumour type suggest that this number may underestimate true population incidence. In the current absence of disease-specific screening and diagnostic imaging modalities, or well-established risk factors, the incidental discovery of appendix tumours is often prompted by acute presentations mimicking appendicitis or when the tumour has already spread into the abdominal cavity - wherein the potential misclassification of appendiceal tumours as malignancies of the colon and ovaries also increases. Notwithstanding these diagnostic difficulties, our understanding of appendix carcinogenesis has advanced in recent years. However, there persist considerable challenges to accelerating the pace of research discoveries towards the path to improved treatments and cures for patients with this group of orphan malignancies. The premise of this Expert Recommendation article is to discuss the current state of the field, to delineate unique challenges for the study of appendiceal tumours, and to propose key priority research areas that will deliver a more complete picture of appendix carcinogenesis and metastasis. The Appendix Cancer Pseudomyxoma Peritonei (ACPMP) Research Foundation Scientific Think Tank delivered a consensus of core research priorities for appendiceal tumours that are poised to be ground-breaking and transformative for scientific discovery and innovation. On the basis of these six research areas, here, we define the first 'cells to society' research framework for appendix tumours.

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Conflict of interest statement

Competing interests: A.N.H. is Chair of the Scientific Advisory Board for the Appendix Cancer Pseudomyxoma Peritonei (ACPMP) Research Foundation and is on the American Joint Committee on Cancer Lower Gastrointestinal Tract Expert Panel and the Peritoneal Surface Malignancies Consortium. A.N.H. reports receiving grants from the National Institutes of Health, American Cancer Society, ACPMP Research Foundation, Dalton Family Foundation and Pfizer. A.N.H. also reports receiving consulting fees from MJH Life Sciences and Bayer outside the submitted work. M.J.O. and K.I.V. are Scientific Advisory Board members for the ACPMP Research Foundation. M.J.O. reports receiving research funding from Takeda, Roche, Lilly, Merck, Medimmune, Bristol–Myers Squibb (BMS), Nouscom and Phanes. M.J.O. also reports consulting fees from Roche, Astellas, Medimmune, Merck, Amgen, Takeda, Janssen, Pfizer, Array, Gritstone, Simcere, Atreca and Bayer. K.I.V. reports receiving grants from the National Institutes of Health and ACPMP Research Foundation. K.I.V. also reports financial interests as the Chief Executive Officer and Founder of Applied Organoids. A.M.L. is a Medical Advisory Board member for the ACPMP Research Foundation and reports receiving grants from the Levine Family Chancellor’s Endowed Chair in Surgical Oncology, National Institutes of Health, and Department of Defense, as well as generous gifts from the estate of Elisabeth and Ad Creemers, the Euske Family Foundation, the Gastrointestinal Cancer Research Fund and the Peritoneal Metastasis Research Fund at the University of California, San Diego. P.W. reports receiving grants from the Pittsburgh Foundation and the ACPMP Research Foundation. R.M.G. reports personal fees from Adaptimmune, AstraZeneca, Bayer, Compass Therapeutics, Focal Medical, G1 Therapeutics, Genentech, GlaxoSmithKline, Haystack Oncology, Innovative Cellular Therapeutics, Merck, Sorrento Therapeutics, Taiho Oncology, Takeda, Valar Technologies and Wolters Kluwer Health outside the submitted work. R.M.G. also reports owning stock options in Focal Medical, Haystack Oncology and Compass Therapeutics. D.B.J. has served on advisory boards or as a consultant for AstraZeneca, BMS, The Jackson Laboratory, Mallinckrodt, Merck, Mosaic ImmunoEngineering, Novartis, Pfizer, Targovax and Teiko; has received funding from BMS and Incyte; and has patents pending for the use of MHC-II as a biomarker for immune checkpoint inhibitor response and for abatacept as treatment for immune-related adverse events. A.S. has served on advisory boards for Merus, Guardant, Pfizer, Regeneron/Sanofi and Catalyst Pharmaceuticals. A.S. also reports receiving funding (to the University of Chicago Medical Center) from Hutchison MediPharma, Takeda, Merck, Verastem Oncology, Turning Point Therapeutics, Gritstone, Bolt Therapeutics, BMS, Pfizer, Astellas, Oncologie, Macogenics, Seattle Genetics, Amgen, Daiichi, Lilly, Jacobio, Astrazeneca, Jazz Pharma and Agenus. N.C.Z. reports receiving grants from the National Institutes of Health, Department of Defense, and Eli Lilly and Company. D.S. is a volunteer Executive Director and Board member for the ACPMP Research Foundation. W.C.F., C.E., M.K.W., M.H., K.I. and E.W. declare no competing interests.

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