SPOCK1 is a matricellular proteoglycan with dual roles in normal physiology and cancer pathology. Structurally, SPOCK1 is an extracellular matrix protein with calcium-binding domains and protease inhibitory activity, though it can also localize intracellularly near mitochondria and in the nucleus 1. In normal tissues, SPOCK1 is expressed at low levels and may contribute to cell-cell and cell-matrix interactions, particularly in neural tissues including synapses and neuromuscular junctions 2. Pathologically, SPOCK1 functions as a critical oncogenic mediator across multiple cancer types. In prostate cancer, SPOCK1 overexpression promotes cell viability, colony formation, and metastasis by modulating cell cycle progression and apoptosis 3. Similarly, in pancreatic cancer, SPOCK1 activates NF-κB signaling via IκBα interaction to drive epithelial-mesenchymal transition (EMT) and metastasis 4. In hepatocellular carcinoma, SPOCK1 inhibits apoptosis and promotes proliferation through MAPK and Src family kinase pathways 1. SPOCK1 also mediates therapeutic resistance: in lung adenocarcinoma, RBM15-dependent m6A modification of SPOCK1 mRNA promotes osimertinib resistance through EMT activation 5, while in colorectal cancer, SPOCK1 drives 5-FU resistance via PRRX1 regulation 6. Clinically, SPOCK1 represents a promising biomarker and therapeutic target, with expression correlating with poor prognosis, metastasis, and drug resistance across malignancies 7.