Construction of the prognostic model for small-cell lung cancer based on inflammatory markers: A real-world study of 612 cases with eastern cooperative oncology group performance score 0-1.

OBJECTIVES: This research aimed to explore the relationship between pre-treatment inflammatory markers and other clinical characteristics and the survival of small-cell lung cancer (SCLC) patients who received first-line platinum-based treatment and to construct nomograms for predicting overall survival (OS) and progression-free survival (PFS). METHODS: A total of 612 patients diagnosed with SCLC between March 2008 and August 2021 were randomly divided into two cohorts: a training cohort (n = 459) and a validation cohort (n = 153). Inflammatory markers, clinicopathological factors, and follow-up information of patients were collected for each case. Cox regression was used to conduct univariate and multivariate analyses and the independent prognostic factors were adopted to develop the nomograms. Harrell's concordance index (C-index) and time-dependent receiver operating characteristic curve were used to verify model differentiation, calibration curve was used to verify consistency, and decision curve analysis was used to verify the clinical application value. RESULTS: Our results showed that baseline C-reactive protein/albumin ratio, neutrophil/lymphocyte ratio, NSE level, hyponatremia, the efficacy of first-line chemotherapy, and stage were independent prognostic factors for both OS and PFS in SCLC. In the training cohort, the C-index of PFS and OS was 0.698 and 0.666, respectively. In the validation cohort, the C-index of PFS and OS was 0.727 and 0.747, respectively. The nomograms showed good predictability and high clinical value. Also, our new clinical models were superior to the US Veterans Administration Lung Study Group (VALG) staging for predicting the prognosis of SCLC. CONCLUSIONS: The two prognostic nomograms of SCLC including inflammatory markers, VALG stage, and other clinicopathological factors had good predictive value and could individually assess the survival of patients.

Effects of Apatinib on the Pharmacokinetics of Nifedipine and Warfarin in Patients with Advanced Solid Tumors.

BACKGROUND AND PURPOSE: Apatinib is a small-molecule tyrosine kinase inhibitor for the treatment of recurrent or progressive advanced-stage gastric adenocarcinoma or gastroesophageal junction cancer. The in vitro inhibition studies suggested that apatinib exerted potent inhibition on CYP3A4 and CYP2C9. To evaluate the potential of apatinib as a perpetrator in CYP450-based drug-drug interactions in vivo, nifedipine and warfarin were, respectively, selected in the present study as the probe substrates of CYP3A4 and CYP2C9 for clinical drug-drug interaction studies. Since hypertension and thrombus are common adverse effects of vascular targeting anticancer agents, nifedipine and warfarin are usually coadministered with apatinib in clinical practice. METHODS: A single-center, open-label, single-arm, and self-controlled trial was conducted in patients with advanced solid tumors. The patients received a single dose of 30 mg nifedipine on Day 1/14 and a single dose of 3 mg warfarin on Day 3/16. On Day 9-21, the subjects received a daily dose of 750 mg apatinib, respectively. The pharmacokinetics of nifedipine and warfarin in the absence or presence of apatinib was, respectively, investigated. RESULTS: Compared with the single oral administration, coadministration with apatinib contributed to the significant increases of AUC0-48h and Cmax of nifedipine by 83% (90% confidence interval [CI] 1.46-2.31) and 64% (90% CI 1.34-2.01), respectively. Similarly, coadministration with apatinib contributed to the significant increases of AUC0-t and Cmax of S-warfarin by 92% (90% CI 1.68-2.18) and 24% (90% CI 1.10-1.39), respectively. CONCLUSION: Concomitant apatinib administration resulted in significant increases in systemic exposure to nifedipine and S-warfarin. Owing to the risk of pharmacokinetic drug-drug interactions based on CYP3A4/CYP2C9 inhibition by apatinib, caution is advised in the concurrent use of apatinib with either CYP2C9 or CYP3A4 substrates.

PD-L1 upregulation accompanied with epithelial-mesenchymal transition attenuates sensitivity to ATR inhibition in p53 mutant pancreatic cancer cells.

Pancreatic cancer is a highly progressive malignant tumor for which there is a critical unmet need for novel therapeutic strategies. A previous study of the authors indicated that VE-821, a selective inhibitor of the ataxia-telangiectasia-mutated and rad3-related protein (ATR), has antitumor efficacy. In this study, the effect of programmed death ligand 1 (PD-L1) on the sensitivity to VE-821 was investigated in p53 mutant pancreatic cancer cells. These results show that BxPC-3 cells exhibited higher sensitivity to VE-821 than mesenchymal PANC-1 cells, which were more migratory and had higher expressions of PD-L1 and CD44. When VE-821 was applied to two cells, epithelial-to-mesenchymal transition (EMT) was induced in PANC-1 cells with concomitant upregulation of PD-L1 and CD44, while BxPC-3 cells did not manifest these changes. Attenuation of PD-L1 expression suppressed VE-821-induced EMT, inhibited cell migration, and downregulated CD44 expression. Furthermore, PD-L1 inhibition partially reversed the activation of AKT/ERK, enhanced DNA damage, and increased VE-821 sensitivity in PANC-1 cells. Analysis of GEPIA data showed positive correlation of PD-L1 expression with EMT-related transcription factors. Taken together, these results suggest a novel function of PD-L1 in regulating response to ATR inhibition. These data highlight PD-L1 inhibition as a promising target to enhance sensitivity to ATR inhibitors in mesenchymal pancreatic cancer.

Efficacy of Thalidomide in Preventing Delayed Nausea and Vomiting Induced by Highly Emetogenic Chemotherapy: A Randomized, Multicenter, Double-Blind, Placebo-Controlled Phase III Trial (CLOG1302 study).

Purpose We examined the efficacy and safety of thalidomide (THD) for the prevention of delayed nausea and vomiting in patients who received highly emetogenic chemotherapy (HEC). Patients and Methods In a randomized, double-blind, active-controlled, phase III trial, chemotherapy-naive patients with cancer who were scheduled to receive HEC that contained cisplatin or cyclophosphamide-doxorubicin/epirubincin ≥ 50 mg/m2 regimens were randomly assigned to a THD group (100 mg twice daily on days 1 to 5) or placebo group, both with palonosetron (0.25 mg on day 1) and dexamethasone (12 mg on day 1; 8 mg on days 2 to 4). Primary end point was complete response to vomiting-no emesis or use of rescue medication-in the delayed phase (25 to 120 h). Nausea and anorexia on days 1 to 5 were evaluated by the 4-point Likert scale (0, no symptoms; 3, severe). Quality of life was assessed by the European Organization for Research and Treatment of Cancer QLQ-C30 version 3 questionnaire on days -1 and 6. Results Of 656 patients, 638 were evaluable: 317 in the THD group and 321 in the control group. Compared with placebo, delayed and overall (0 to 120 h) complete response rates to vomiting were significantly higher with THD: 76.9% versus 61.7% ( P < .001) and 66.1% versus 53.3% ( P = .001), respectively. Rates of no nausea were also higher in the THD group (delayed: 47.3% v 33.3%; P < .001; overall: 41% v 29.6%; P = .003), and mean scores of anorexia were lower overall (0.44 ± 0.717 v 0.64 ± 0.844; P = .003). Adverse effects were mild to moderate. The THD group had increased sedation, dizziness, constipation, and dry mouth, but experienced better quality of life after chemotherapy. Conclusion Thalidomide combined with palonosetron and dexamethasone significantly improved HEC-induced delayed nausea and vomiting prevention in chemotherapy-naive patients.

CD44 family proteins in gastric cancer: a meta-analysis and narrative review.

With a meta-analysis and narrative review, we evaluated the clinical and prognostic role of all CD44 family proteins in gastric cancer (GC). Literatures published up to August 2014 were searched on PubMed. Among the 37 eligible studies (6606 patients), 34 were included in meta-analysis, and 10 were subjected to narrative review. With meta-analysis, standard CD44 (CD44s) was demonstrated to predict reduced overall survival (OS) (HR = 1.93, 95% CI: 1.58-2.34, PHR = 0.0222) and disease free survival (HR = 3.13, 95% CI: 1.02-9.68, PHR = 0.0469), advanced N-stage (RR = 1.12, 95% CI: 1.04-1.21, PRR = 0.0019), and distant metastasis (RR = 2.14, 95% CI: 1.46-3.14, PRR < 0.0001) of GC. CD44 variant 6 (CD44v6) in GC might influence OS (5 studies; HR = 1.27, 95% CI: 0.75-2.14, PHR = 0.3783; 4 studies; HR = 1.52, 95% CI: 1.09-2.14, PHR = 0.0139), while significantly associated with N-stage (RR = 1.23, 95% CI: 1.03-1.48, PRR = 0.0240), M-stage (RR = 2.54, 95% CI: 1.08-6.00, PRR = 0.0333), TNM-stage (RR = 1.72, 95% CI: 1.18-2.50, PRR = 0.0045), Lauren type (RR = 0.67, 95% CI: 0.50-0.91, PRR = 0.0106), lymphatic invasion (RR = 1.13, 95% CI: 1.04-1.23, PRR = 0.0057), and liver metastasis (RR = 3.20, 95% CI: 1.94-5.27, PRR < 0.0001) of the disease. Moreover, a narrative review was performed for CD44 isoforms, such as v3, v5, v7, v8-10, and v9, in GC. In conclusion, CD44s and CD44v6 as evaluated by immunohistochemistry, respectively, predicts the prognosis and disease severity of GC.

Glutathione S-transferase M1 polymorphism and colorectal cancer risk in Chinese population.

Glutathione S-transferase M1 (GSTM1) polymorphism has been proven to be associated with risks of several cancers. However, previous studies on the association between GSTM1 polymorphism and colorectal cancer risk in Chinese population reported controversial results. We performed a meta-analysis of 13 studies which were identified through the literature search in PubMed and Wanfang databases. The strength of the association between GSTM1 polymorphism and colorectal cancer risk was measured by odds ratio (OR) with corresponding 95% confidence interval (95% CI). Overall, GSTM1 null mutation was significantly associated with a risk of colorectal cancer in Chinese population (OR = 1.37, 95% CI 1.12 to 1.68, P = 0.002). Sensitivity analyses by omitting those studies in turns did not materially alter the overall pooled ORs. The cumulative meta-analyses further showed a trend of an obvious association between GSTM1 null mutation and risk of colorectal cancer in Chinese population as information accumulated by year. The findings from our meta-analysis suggest that GSTM1 null mutation is significantly associated with a risk of colorectal cancer in Chinese population.

Insulin therapy contributes to the increased risk of colorectal cancer in diabetes patients: a meta-analysis.

BACKGROUND: Recent epidemiological studies suggest that treatment with insulin may promote cancer growth. The present systematic review and meta-analysis of published observational studies was conducted to assess the risk of cancer during treatment with insulin. MATERIALS AND METHODS: A compressive search was conducted through MEDLINE, PubMed, Web of Science, EMBASE, and Chinese Biomedical Literature databases (CBM). Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated with a random-effects model. RESULTS: A total of four studies with one case-controls study and three cohort studies comparing the insulin therapy and colorectal cancer susceptibility were identified. When all four studies were analyzed, the summary RRs were 1.61 (95% CI = 1.18-1.35) in a random-effects model for individuals with insulin therapy, compared with individuals without insulin therapy, which suggests a statistically significant association between insulin use and colorectal cancer. CONCLUSIONS: Our findings provides the evidence that insulin therapy may contribute to the risk of colorectal cancer. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9339731010859509.

The association between the PPARγ2 Pro12Ala polymorphism and nephropathy susceptibility in type 2 diabetes: a meta-analysis based on 9,176 subjects.

BACKGROUND: The polymorphism Pro12Ala in peroxisome proliferator-activated receptor-γ2 gene (PPARγ2) has been reported to be associated with diabetic nephropathy (DN) in some studies, though the results remain inconclusive. To explore this relationship between PPARγ2 Pro12Ala polymorphism and the susceptibility for DN, a cumulative meta-analysis was performed in this study. METHOD: PubMed, Medline, Embase and Web of Science databases have been systematically searched to identify relevant studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: 18 studies were included in this meta-analysis, involving 3,361 cases and 5,815 controls. The PPARγ2 Ala12 allele was significantly associated with decreased risk of DN based on dominant model (OR=0.778; 95%CI=0.618-0.981; Pheterogeneity=0.008; P=0.034). In the stratified analysis by ethnicity, significantly decreased risks were found among Caucasians for dominant model (OR=0.674; 95%CI=0.500-0.909; Pheterogeneity=0.079; P=0.010), while there was no significant association was found in Asians. CONCLUSIONS: The results from the present meta-analysis indicated that the Pro12Ala polymorphism in PPARγ2 gene is not a risk factor for DN in type 2 diabetes (T2D). Further large and well-designed studies are needed to confirm this conclusion. VIRTUAL SLIDES: The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7491348341027320.

The 677C>T (rs1801133) polymorphism in the MTHFR gene contributes to colorectal cancer risk: a meta-analysis based on 71 research studies.

BACKGROUND: The 677C>T polymorphism of methylenetetrahydrofolate reductase (MTHFR) gene is considered to have a significant effect on colorectal cancer susceptibility, but the results are inconsistent. In order to investigate the association between the MTHFR 677C>T polymorphism and the risk of colorectal cancer, a meta-analysis was held based on 71 published studies. METHODS: Eligible studies were identified through searching the MEDLINE, EMBASE, PubMed, Web of Science, Chinese Biomedical Literature database (CBM) and CNKI database. Odds ratios (OR) and 95% confidence intervals (CIs) were used to assess the association. The statistical heterogeneity across studies was examined with x(2)-based Q-test. Begg's and Egger's test were also carried out to evaluate publication bias. Sensitive and subgroup analysis were also held in this meta-analysis. RESULTS: Overall, 71 publications including 31,572 cases and 44,066 controls were identified. The MTHFR 677 C>T variant genotypes are significantly associated with increased risk of colorectal cancer. In the stratified analysis by ethnicity, significantly increased risks were also found among Caucasians for CC vs TT (OR=1.076; 95%CI= 1.008-1.150; I(2) =52.3%), CT vs TT (OR=1.102; 95%CI=1.032-1.177; I(2) =51.4%) and dominant model (OR=1.086; 95%CI=1.021-1.156; I(2) =53.6%). Asians for CC vs TT (OR  =1.226; 95%CI  =1.116-1.346; I(2)  =55.3%), CT vs TT (OR  =1.180; 95%CI  =1.079-1.291; I(2)  =36.2%), recessive (OR  =1.069; 95%CI  =1.003-1.140; I(2)  =30.9%) and dominant model (OR  =1.198; 95%CI  =1.101-1.303; I(2)  =52.4%), and Mixed populations for CT vs TT (OR  =1.142; 95%CI  =1.005-1.296; I(2)  =0.0%). However, no associations were found in Africans for all genetic models. CONCLUSION: This meta-analysis suggests that the MTHFR 677C>T polymorphism increases the risk for developing colorectal cancer, while there is no association among Africans found in subgroup analysis by ethnicity.

Establishment of immortalized human amniotic mesenchymal stem cells.

Human amniotic mesenchymal cells (HAM cells) are known to contain somatic stem cells possessing the characteristics of pluripotency. However, little is known about the biology of these somatic cells because isolated HAM cells from amniotic membrane have a limited lifespan. To overcome this problem, we attempted to prolong the lifespan of HAM cells by infecting retrovirus encoding human papillomavirus type16E6 and E7 (HPV16E6E7), bmi-1, and/or human telomerase reverse transcriptase (hTERT) genes and investigated their characteristics as stem cells. We confirmed the immortalization of the four lines of cultured HAM cells for about 1 year. Immortalized human amnion mesenchymal cells (iHAM cells) have continued to proliferate over 200 population doublings (PDs). iHAM cells were positive for CD73, CD90, CD105, and CD44 and negative for CD34, CD14, CD45, and HLA-DR. They expressed stem cell markers such as Oct3/4, Sox2, Nanog, Klf4, SSEA4, c-myc, vimentin, and nestin. They showed adipogenic, osteogenic, and chondrogenic differentiation abilities after induction. These results suggested that immortalized cell lines with characteristics of stem cells can be established. iHAM cells with an extended lifespan can be used to produce good experimental models both in vitro and in vivo.

Repeated oral treatment with polysaccharide sulfate reduces insulin resistance and dyslipidemia in diabetic dyslipidemic rat model.

Polysaccharide sulfate (PSS) is a new type of antiatherosclerotic medicine for its effects of anticoagulation, anti-thrombosis and modulation of dyslipidemia. However, it is still uncertain whether PSS could modulate the diabetic dyslipidemia or not. Here, the rat model of diabetic dyslipidemia was developed and the effects of PSS on glucose and lipid levels were investigated in this animal model. Wistar rats were iv injected with streptozotocin 20 mg x kg(-1) after feeding with high fat diet for one and a half month. Then, rats received orally PSS (30, 90, and 180 mg x kg(-1)) for 1 month. After oral treatment with PSS (90 and 180 mg x kg(-1)) for 1 month, the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) were significantly reduced and the level of high density lipoprotein-cholesterol (HDL-C) increased, compared with diabetic control rats. Moreover, PSS (30, 90, and 180 mg x kg(-1)) had a tendency to reduce glucose and insulin levels, and significantly increased insulin sensitivity index. Our results suggest that PSS could improve insulin sensitivity and relieve dyslipidemia in diabetic dyslipidemic rats.

[Effect of lead on learn and memory and release of intracellular free Ca2+ from calcium pool in dissociated mouse hippocampal neurons].

OBJECTIVE: To study effect of lead on learn and memory and the release of intracellular free Ca2+ from calcium pool in dissociated mouse hippocampal neurons. METHODS: Using a water maze we measured the ability of spatial learning of mouses. Digesting with low concentration of trypsin and gently triturating mode were used to dissociate hippocampal neurons. Using inositol 1,4,5-triphosphate (IP3) sensitive calcium store antagonist-heparine and non-IP3 sensitive calcium store (ryanodine) antagonist-procaine to stimulate hippocampal neurons, and observed the effect of Pb2+ on [Ca2+]i of hippocampal neurons by Fura-2 double wavelength fluoremetry. RESULTS: In the Morris water maze task, results indicated that mouses having drink lead water displayed significant impairment in their performance, and this extent of impairment showed in lead concentration dependent manner. Compared with control group, in condition of none of extracellular free calcium, 25 micromol x L(-1) of Pb2+ induced markedly increase of intracellular free calcium of hippocampal neurons in mouse. Heparin (IP3 sensitive calcium store antagonist) of 30 microg x ml(-1) and procaine (non-IP3 sensitive calcium store atagonist) of 0.1 mg x ml(-1) blocked the increases of [Ca2+]i in mouse hippocampal neurons elicited by 25 micromol x L(-1) of Pb2+. CONCLUSION: Chronic exposure to lead (Pb2+) reduces the ability of spatial learing and memory of mice. High level of Pb2+ facilitated release of intracellular free calcium from IP3 sensitive and non-IP3 sensitive calcium store and induced the increases of intracellular free calcium in mouse hippocampal neurons.