Ferroptosis and oxidative stress crosstalk in tumor microenvironment: Mechanisms and targeting strategies

Abstract

Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, is intricately linked with oxidative stress through shared regulatory nodes and reciprocal amplification loops. Although ferroptosis and oxidative stress have each been extensively investigated, their bidirectional crosstalk, together with its consequences for the tumor microenvironment, has yet to be systematically elucidated. On this basis, this review proposes and systematically dissects a “ferroptosis-oxidative stress-tumor microenvironment” triad, focusing on its bidirectional interaction network and therapeutic translational value. We analyze the driving mechanisms underlying the mutually amplifying loop between the two processes, including iron metabolism, lipid peroxidation cascades, antioxidant defense, and organelle function. Within the tumor microenvironment, this interplay drives context-dependent remodeling of immune cell function, cancer-associated fibroblast activity, angiogenesis, and tumor heterogeneity. Furthermore, this review evaluates emerging therapeutic strategies that target ferroptosis and oxidative stress within the TME, and outlines the obstacles hindering clinical translation and future directions. A deep understanding of the “ferroptosis-oxidative stress-tumor microenvironment” triad will advance our fundamental understanding of the execution and regulatory mechanisms of ferroptosis, and lay a theoretical foundation for the future development of precision therapeutic strategies centered on ferroptosis.