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BACKGROUND: Treatment of metastatic renal cell carcinoma (mRCC) remains a challenge worldwide. Here, we introduced a phase I trial of autologous RAK cell therapy in patients with mRCC whose cancers progressed after prior systemic therapy. Although RAK cells have been used in clinic for many years, there has been no dose-escalation study to demonstrate its safety and efficacy. METHODS: We conducted a phase I trial with a 3 + 3 dose-escalation design to investigate the dose-related safety and efficacy of RAK cells in patients with mRCC whose cancers have failed to response to systemic therapy (ChiCTR1900021334). RESULTS: Autologous RAK cells, primarily composed of CD8+ T and NKT cells, were infused intravenously to patients at a dose of 5 × 109, 1 × 1010 or 1.5 × 1010 cells every 28 days per cycle. Our study demonstrated general safety of RAK cells in a total of 12 patients. Four patients (33.3%) showed tumor shrinkage, two of them achieved durable partial responses. Peripheral blood analysis showed a significant increase in absolute counts of CD3+ and CD8+ T cells after infusion, with a greater fold change observed in naive CD8+ T cells (CD8+CD45RA+). Higher peak values of IL-2 and IFN-γ were observed in responders after RAK infusion. CONCLUSION: This study suggests that autologous RAK cell immunotherapy is safe and has clinical activity in previously treated mRCC patients. The improvement in peripheral blood immune profiling after RAK cell infusion highlights its potential as a cancer treatment. Further investigation is necessary to understand its clinical utility.
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Carcinoma de Células Renais , Neoplasias Renais , Humanos , Neoplasias Renais/patologia , Linfócitos T CD8-Positivos/patologia , Interleucina-2/uso terapêutico , Imunoterapia , Adjuvantes ImunológicosRESUMO
Just how heteroatomic functionalization enhances electrochemical capacity of carbon materials is a recent and widely studied field in scientific research. However, there is no consensus on whether combining with heteroatom-bearing nanostructures directly or doping amorphous elements is more advantageous. Herein, two kinds of porous carbon nanosheets were prepared from coal tar pitch through anchoring graphitic carbon nitride (PCNs/GCNs-5) or doping amorphous nitrogen element (PCNs/N). The structural characteristics and electrochemical properties of the two PCNs were revealed and compared carefully. It can be found that the amorphous nitrogen of PCNs/N will have a grievous impact on its carbon skeleton network, resulting in reduced stability in charge and discharge process, while the structural collapse of carbon network could be avoided in PCNs/GCNs-5 by the heteroatoms in the form of nanostructure. Particularly, PCNs/GCNs-5 exhibits extremely high specific capacity of 388 F g-1 at 1 A g-1, and splendid the capacitance retention rate of 98% after 10,000 cycles of charge and discharge, which are overmatch than the amorphous nitrogen doped carbon materials reported recently and PCNs/N. The combining strategy with nanostructure will inspire the design of carbon materials towards high-performance supercapacitor.
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BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) exhibits remarkable heterogeneity but still remains undiagnosed in identifying the subpopulation of DLBCL to predict the prognosis and guide clinical treatment. METHODS: Molecular subgroups were identified in gene expression data from GSE10846 by a consensus clustering algorithm. And gene set enrichment analysis, immune infiltration, and the proposed cell cycle algorithm were applied to explore the biological functions of different subtypes. Meanwhile, univariate and multivariate Cox regression analyses were used to evaluate independent prognostic factors of DLBCL. Finally, the prognostic model, including some key genes screened by Lasso regression, Random Forest algorithm, and point-biserial correlation, was constructed by an optimal classifier from seven machine learning algorithms and validated by another three external datasets (GSE34171, GSE87371, GSE31312). RESULTS: Comprehensive genomic analysis of 1,143 DLBCL samples identify 2 molecularly, prognostically relevant subtypes: immune-enriched (IME) and cell-cycle-enriched (CCE). Then a new predictive model including seven key genes (SERPING1, TIMP2, NME1, DCTPP1, RFC4, POLE2, and SNRPD1) was developed with high prediction accuracy (88.6%) and strong predictive power (AUC = 0.973) based on the Support Vector Machine (SVM) algorithm in 414 patients from GSE10846. The predictive power was similar in another three testing sets (HR > 1.400, p < 0.05). CONCLUSION: This model could evaluate survival independently with strong predictive power compared with other clinical risk factors. Our study constructed a reliable model to predict two new subtypes of DLBCL patients, which could guide the implementation of individualized treatment.
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Linfoma Difuso de Grandes Células B , Humanos , Ciclo Celular/genética , Linfoma Difuso de Grandes Células B/genética , Algoritmos , Análise por Conglomerados , Aprendizado de Máquina , PrognósticoRESUMO
Small cell lung cancer (SCLC) is one of the highly aggressive malignancies characterized by rapid growth and early metastasis, but treatment options are limited. For SCLC, carboplatin or cisplatin in combination with etoposide chemotherapy has been considered the only standard of care, but the standard first-line treatment only results in 10-month survival. The majority of patients relapse within a few weeks to months after treatment, despite the relatively sensitive response to chemotherapy. Over the past decade, immunotherapy has made significant progress in the treatment of SCLC patients. However, there have been limited improvements in survival rates for SCLC patients with the current immune checkpoint inhibitors PD-1/PD-L1 and CTLA-4. In the face of high recurrence rates, small beneficiary populations, and low survival benefits, the exploration of new targets for key molecules and signals in SCLC and the development of drugs with novel mechanisms may provide fresh hope for immunotherapy in SCLC. Therefore, the aim of this review was to explore four new targets, DLL3, TIGIT, LAG-3, and GD2, which may play a role in the immunotherapy of SCLC to find useful clues and strategies to improve the outcome for SCLC patients.
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Neoplasias Pulmonares , Carcinoma de Pequenas Células do Pulmão , Humanos , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/patologia , Neoplasias Pulmonares/tratamento farmacológico , Recidiva Local de Neoplasia , Cisplatino/uso terapêutico , Imunoterapia/métodos , Proteínas de Membrana , Peptídeos e Proteínas de Sinalização IntracelularRESUMO
BACKGROUND: The biomarkers of immune checkpoint inhibitors in the treatment of non-small cell lung cancer (NSCLC) patients have limited predictive performance. In this study we aimed to investigate the feasibility of molecular tumor burden index (mTBI) in circulating tumor DNA (ctDNA) as a predictor for immunotherapy in patients with NSCLC. METHODS: From February 2017 to November 2020, pretreatment and on-treatment (3~6 weeks after first cycle of immunotherapy) dynamic plasma ctDNA samples from NSCLC patients receiving immune monotherapy or combination therapy were analyzed by targeted capture sequencing of 1021 genes. PyClone was used to infer the mTBI. The impact of pretreatment mTBI on survival outcomes was verified in the POPLAR/OAK trials. RESULTS: We found that patients without detectable baseline ctDNA had better survival outcomes (median overall survival [OS]: not reached vs. 12.8 months; hazard ratio [HR], 0.15; p = 0.035]). RB1 and SMARCA4 mutations were remarkably associated with worse survival outcomes. Furthermore, lower pretreatment mTBI was associated with superior OS (median: not reached vs. 8.1 months; HR, 0.22; p = 0.024) and PFS (median: 32.9 vs. 5.4 months; HR, 0.35; p = 0.045), but not objective response, which was validated in the POPLAR/OAK cohort, suggesting that baseline mTBI was a prognostic factor for NSCLC immunotherapy. Early dynamic changes of mTBI (ΔmTBI) significantly distinguished responsive patients, and patients with mTBI decrease to more than 68% at the final tumor evaluation had longer OS (median: 38.2 vs. 4.0 months; HR, 0.18; p = 0.017) and PFS (median: not reached vs. 2.3 months; HR, 0.24; p = 0.030). CONCLUSION: ΔmTBI had a good sensitivity to identify potential beneficial patients based on the best effect CT scans, demonstrating that mTBI dynamics were predictive of benefit from immune checkpoint blockade.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Humanos , Carcinoma Pulmonar de Células não Pequenas/patologia , Prognóstico , Neoplasias Pulmonares/patologia , Carga Tumoral , Biomarcadores Tumorais , DNA Helicases , Proteínas Nucleares , Fatores de TranscriçãoRESUMO
Comprehensive multiplatform analysis of Luminal B breast cancer (LBBC) specimens identifies two molecularly distinct, clinically relevant subtypes: Cluster A associated with cell cycle and metabolic signaling and Cluster B with predominant epithelial mesenchymal transition (EMT) and immune response pathways. Whole-exome sequencing identified significantly mutated genes including TP53, PIK3CA, ERBB2, and GATA3 with recurrent somatic mutations. Alterations in DNA methylation or transcriptomic regulation in genes (FN1, ESR1, CCND1, and YAP1) result in tumor microenvironment reprogramming. Integrated analysis revealed enriched biological pathways and unexplored druggable targets (cancer-testis antigens, metabolic enzymes, kinases, and transcription regulators). A systematic comparison between mRNA and protein displayed emerging expression patterns of key therapeutic targets (CD274, YAP1, AKT1, and CDH1). A potential ceRNA network was developed with a significantly different prognosis between the two subtypes. This integrated analysis reveals a complex molecular landscape of LBBC and provides the utility of targets and signaling pathways for precision medicine.
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The emerging deep eutectic solvent (DES) electrolyte has great potential in realizing commercial-scale application of electric double-layer capacitors (EDLCs) served in low temperature environment. That goal, however, rests with how to design the interface structure of electrode materials for well-matching with DES electrolyte. Herein, porous carbon nanosheets (PCNs) were obtained from coal tar pitch through Friedel-Crafts acylation reaction and melting salt intercalation process. The morphology, specific surface area and porosity of porous carbon nanosheets were regulated by tailoring the abundance of the dangling-bonds grafted on the CTP molecules. Profiting from the large specific surface area, suitable pore structure and good two-dimensional structure to provide more active sites and enhance ion transport capacity, the PCNs-0.10 delivers a maximal specific capacitance of 504F g-1 at 0.1 A g-1, which is overmatch than most of previously reported for other carbon materials. As-assembled symmetrical EDLCs using K+ DES electrolyte, can be assembled to work at -40 °C to 75 °C and exhibit satisfactory energy density. The strategy proposed here has opened a new way for exploring the large-scale preparation of electrode materials suitable for ultra-low temperature capacitors.
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Many experimentally accessible, finite-sized interacting quantum systems are most appropriately described by the canonical ensemble of statistical mechanics. Conventional numerical simulation methods either approximate them as being coupled to a particle bath or use projective algorithms which may suffer from nonoptimal scaling with system size or large algorithmic prefactors. In this paper, we introduce a highly stable, recursive auxiliary field quantum Monte Carlo approach that can directly simulate systems in the canonical ensemble. We apply the method to the fermion Hubbard model in one and two spatial dimensions in a regime known to exhibit a significant "sign" problem and find improved performance over existing approaches including rapid convergence to ground-state expectation values. The effects of excitations above the ground state are quantified using an estimator-agnostic approach including studying the temperature dependence of the purity and overlap fidelity of the canonical and grand canonical density matrices. As an important application, we show that thermometry approaches often exploited in ultracold atoms that employ an analysis of the velocity distribution in the grand canonical ensemble may be subject to errors leading to an underestimation of extracted temperatures with respect to the Fermi temperature.
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Algoritmos , Termometria , Temperatura , Método de Monte CarloRESUMO
PURPOSE: The mechanism of chemo-resistance in small cell lung cancer (SCLC) is unclear. This study aims to explore the resistance-related genomic profiles of residual tumors after neo-adjuvant chemotherapy (NAC) in SCLC through the whole-exome sequencing (WES). EXPERIMENTAL DESIGN: A total of 416 limited diseases (LD) SCLC patients underwent surgery were retrospectively analyzed, of which 40 patients received NAC. Then we selected 29 patients undergoing NAC (n = 19) and chemotherapy naïve (CTN, n = 10) to perform WES sequence with formalin-fixed paraffin-embedded samples including tumor and paired para-tumor. RESULTS: In total, single nucleotide variation and mutation rate were similar between NAC and CTN groups. The mutation signatures were significantly discrepant between NAC and CTN groups, as well as among patients with partial response (PR), stable disease (SD), and progressive disease. There were more copy number variation deletions in NAC group compared with CTN group. The inactivation of TP53 and RB1 were the most significantly events in both NAC and CTN groups. RB1 nonsense mutations were recurrent in NAC group (9/19 vs. 0/9, 47.4% vs. 0%) with favorable survival, while the frame-shift deletions were frequent in CTN group (3/9 vs. 3/19, 33.3% vs.15.8%). Integrated function enrichment revealed that the frequently mutant genes were involved in cell cycle, metabolic reprogramming, and oncogenic signaling pathways in NAC group, such as BTG2 pathway, glycolysis in senescence and P53 pathway. A total of 27 genes presented frequently mutant in NAC group and might played a positive role in drug resistance. Multiple genes including BRINP3, MYH6, ST18, and PCHD15, which were associated with prognosis, occurred mutant frequently in PR and SD groups. CONCLUSION: Residual tumors after neo-adjuvant therapy exhibited different mutation signature spectrum. Multiple genes including RB1 nonsense mutations, BRINP3, MYH6, ST18, and PCHD15 were with frequent mutation in residual tumors, which might participate chemo-resistance and influenced the prognosis in patients with limited disease SCLC.
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Proteínas Imediatamente Precoces , Neoplasias Pulmonares , Carcinoma de Pequenas Células do Pulmão , Humanos , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/genética , Carcinoma de Pequenas Células do Pulmão/patologia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Estudos Retrospectivos , Exoma , Variações do Número de Cópias de DNA , Neoplasia Residual/genética , Códon sem Sentido , População do Leste Asiático , Mutação , Genômica , Proteínas Imediatamente Precoces/genética , Proteínas Supressoras de Tumor/genéticaRESUMO
Tibetan medicine is an essential part of Chinese medicine and has unique theoretical experience and therapeutic advantages. According to the development principle of inheriting the essence, sticking to the truth, and keeping innovative, the supervision department should give clear and reasonable guidance considering the characteristics of Tibetan medicine, establish a standard system for quality control, clinical verification and evaluation, and accelerate the research and commercialization of new drugs. In view of the needs of drug supply-side reform and the current situation of Tibetan medicine and new pharmaceutical research, we ponder and provide suggestions on the confusion faced by the current supervision of Tibetan drug registration, hoping to contribute to the supervision strategy of Tibetan drug registration and the high-quality development of Tibetan medicine industry.
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Medicina Tradicional Tibetana , Pesquisa Farmacêutica , Tibet , Controle de Qualidade , Indústria FarmacêuticaRESUMO
Immunotherapy brought long-term benefits for partial patients with lung squamous cell carcinoma (LUSC). The predictor of anti-PD-L1 therapy was controversial and limited in LUSC. We aimed to explore novel biomarker for LUSC immunotherapy and the potential mechanism. Five hundred and twenty-five Chinese patients (Geneplus cohort) with LUSC underwent targeted sequencing and were involved to explore the genomic profiling. TP53 and LRP1B were the most frequently recurrent genes and correlated to higher tumor mutational burden (TMB). We observed that LUSC patients with TP53 and LRP1B co-wild (co-wild type) were associated with better survival of anti-PD-L1 therapy compared with TP53 mutant or LRP1B mutant (mutant type) in POPAR/OAK cohort. Copy-number variation (CNV) and whole genome doubling (WGD) data from TCGA LUSC cohort were obtained to assess the CNV events. There were fewer CNV alterations and lower chromosome instability in patients with TP53/LRP1B co-wild compared with those with TP53/LRP1B mutant. RNA expression data from the TCGA LUSC cohort were collected to explore the differences in RNA expression and tumor immune microenvironment (TIME) between mutant and co-wild groups. The TP53/LRP1B co-wild type had a significantly increased proportion of multiple tumor-infiltrating lymphocytes (TILs), including activated CD8 T cell, activated dendritic cell (DC), and effector memory CD8 T cell. Immune-related gene sets including checkpoint, chemokine, immunostimulatory, MHC and receptors were enriched in the co-wild type. In conclusion, TP53/LRP1B co-wild LUSC conferred an elevated response rate in anti-PD-L1 therapy and improved survival, which was associated with a chromosome-stable phenotype and an activated immune microenvironment.
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BACKGROUND: Immune checkpoint inhibitors (ICIs) improved survival of partial patients with lung squamous cell carcinoma (LUSC). However, it was still insufficient of data in older patients. This study aimed to investigate the efficacy and toxicity of immunotherapy in patients with LUSC in Chinese population of real world. METHODS: A total of 185 LUSC patients underwent pathological diagnosis were involved from January 2018 to January 2022. Patients were divided into elderly group (age ≥70 years) and younger group (age <70 years). The efficacy of mono-immunotherapy or combined with chemotherapy to chemotherapy in first-line treatment was compared. The expression of programmed cell death ligand 1 (PD-L1) and tumor mutational burden (TMB) were evaluated. Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 was used to evaluate the efficacy, and Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 was used to evaluate immune-related adverse. Kaplan-Meier and Log-rank test was performed. Cox regression was used in prognostic analysis. RESULTS: Combined therapy acquired significantly higher overall response rate (ORR) compared with chemotherapy alone in elderly group (P<0.05), and also in younger group, despite the difference was not significant (P>0.05). The median progression-free survival (mPFS) and median overall survival (mOS) in elderly group were similar with younger group (P>0.05). Both combined group and immunology alone demonstrated prolonged mPFS in first-line compared with chemotherapy in elderly group. And combined group demonstrated significantly prolonged mPFS compared with chemotherapy in younger group (P<0.01). There was no difference of mOS between different regimes in two groups. Elderly LUSC patients had higher PD-L1 positive rate (≥1%) and similar TMB compared with younger group. There was no relationship between mPFS and mOS with the expression of PD-L1 and TMB. Immunology combined with chemotherapy demonstrated better mPFS compared to chemotherapy in first-line therapy with TMB-High (P<0.05), and inferior mPFS with TMB-Low despite the difference was not significant (P>0.05). Cox regression model demonstrated that clinical stage was an independent predictor and prognostic factor. The incidence of immune-related adverse was 58.0% (51/88) and grade 3 or above 25.0% (22/88). The most common grade 3 adverse events were rash, immune-associated pneumonia, and fatigue. CONCLUSIONS: Immunology combined with chemotherapy increased ORR, mPFS and mOS of Chinese patients with LUSC in first-line therapy compared with chemotherapy. There was no difference of efficacy and adverse effects rate between elderly group and younger group. The adverse effects of immunology in elderly patients with LUSC were controllable.
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Carcinoma Pulmonar de Células não Pequenas , Carcinoma de Células Escamosas , Neoplasias Pulmonares , Idoso , Antígeno B7-H1/análise , Biomarcadores Tumorais , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/tratamento farmacológico , China , Humanos , Pulmão/patologia , Neoplasias Pulmonares/patologiaRESUMO
The aim of the present study was to evaluate the effectiveness of Lycium barbarum polysaccharide (LBP) on lipid oxidation and protein degradation in Tan sheep meatballs during the frozen period. The meatballs were treated with LBP at 0.01%, 0.02%, and 0.03% and stored at -18±1°C for 0, 3, 6, 9, and 12 weeks. The effects of LBP treatment were investigated using the contents of total volatile basic nitrogen (TVB-N), texture profile (TP), thiobarbituric acid reactive substances (TBARS), colour, and pH values, compared with 0.02% butylated hydroxytoluene treatment and the blank control. The results showed that LBP treatment significantly decreased TBARS content compared with the control, which confirmed LBP to be a highly effective component in preventing lipid oxidation of Tan sheep meatballs during frozen storage, and protein degradation in Tan sheep meatballs had a significant inhibition effect because of TVB-N value reduction. In addition, the colour, TP and pH values of meatballs treated with LBP were improved dramatically. To further determine the quality changes of the blank control and all treated groups during storage, the comprehensive score evaluation equation based on principal component analysis was obtained: Y=0.51632Y1+0.29589Y2 (cumulative contribution rate=81.221%), and the 0.02% LBP-treated group had a higher comprehensive score than the other groups, and the quality of LBP-treated meatballs was better as well. In summary, LBP may reduce or inhibit lipid oxidation and protein degradation, and enhance overall quality and shelf-life in prepared meat products.
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This study aimed to investigate the performance of least-squares support vector machines to predict carcass characteristics in Tan sheep using noninvasive in vivo measurements. A total of 80 six-month-old Tan sheep (37 rams and 43 ewes) were examined. Back fat thickness and eye muscle area between the 12th and 13th ribs were measured using real-time ultrasound in live Tan sheep. All carcasses were dissected to hind leg, longissimus dorsi muscle, lean meat, fat, and bone to determine carcass composition. Multiple linear regression (MLR), partial least squares regression (PLSR), and least-squares support vector machines (LSSVM) were applied to correlate the live Tan sheep characteristics with carcass composition. The results showed that the LSSVM model had a better efficacy for estimating carcass weight, longissimus dorsi muscle weight, lean meat weight, fat weight, lean meat, and fat percentage in live lambs (R = 0.94, RMSE = 0.62; R = 0.73, RMSE = 0.02; R = 0.86, RMSE = 0.47; R = 0.78, RMSE = 0.63; R = 0.73, RMSE = 0.02; R = 0.65, RMSE = 0.03, respectively). LSSVM algorithm was a potential alternative to the conventional MLR method. The results demonstrated that LSSVM model might have great potential to be applied to the evaluation of sheep with superior carcass traits by combining with real-time ultrasound technology.
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Carne , Máquina de Vetores de Suporte , Tecido Adiposo/diagnóstico por imagem , Animais , Composição Corporal/fisiologia , Feminino , Análise dos Mínimos Quadrados , Masculino , Músculo Esquelético/diagnóstico por imagem , Ovinos , Tecnologia , Ultrassonografia/veterináriaRESUMO
BACKGROUND: The aim of this study was to estimate the efficacy and safety of bevacizumab combined with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) in advanced non-small cell lung cancer (NSCLC) patients. METHODS: We searched randomized controlled trials (RCTs) on bevacizumab combined with EGFR TKIs in the NSCLC Cochrane Library, Web of Science, PubMed and Embase. The data were extracted and assessed according to the Cochrane Handbook. We calculated the hazard ratio (HR), risk ratio (RR), and confidence interval (CI), and accomplished this meta-analysis with Stata 14 software. RESULTS: Of 1301 articles scanned, five articles were involved in this meta-analysis. We determined that compared with using EGFR TKIs alone, combination treatment significantly prolongs progression-free survival (PFS) (HR = 0.61, 95% CI = 0.52-0.70; p < 0.001), and increases the objective response rate (ORR) (RR = 1.15, 95% CI: 1.01-1.30, p = 0.10). However, there was no significant difference in overall survival (OS) between the two groups (HR = 0.95, 95% CI = 0.78-1.11; p = <0.001) and combination treatment increases the risks of serious adverse events (SAEs) (RR = 1.58, 95% CI: 1.21-2.05, p = 0.002). CONCLUSIONS: Bevacizumab combined with EGFR-TKI significantly improves PFS and ORR in patients with advanced NSCLC, but there is no substantial difference in OS and increase the risks of serious adverse events.
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Bevacizumab/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Inibidores de Proteínas Quinases/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Combinada , Receptores ErbB/antagonistas & inibidores , Humanos , Intervalo Livre de Progressão , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
BACKGROUND: The aim of this network meta-analysis (NMA) was to evaluate the efficacy and safety of PD-1/PD-L1 inhibitors, alone or in combination with chemotherapy, as first-line treatment for wild-type advanced non-small cell lung cancer. METHODS: We systematically searched databases, Clinical Trial.gov and included randomized clinical trials focusing on advanced NSCLC using PD-1/PD-L1 inhibitors as first-line treatment. Hazard ratio for overall survival and progression-free survival, odds ratio for any-cause high-adverse events (grade 3 or higher) were documented according to Bayesian NMA. Subgroup analysis was performed according to PD-L1 level and histology. RESULTS: Thirteen trials including 9154 patients were included. In the PD-L1 nonselective cohort, chemotherapy in combination with pembrolizumab and atezolizumab, respectively, were significantly better than any other treatment strategies in both OS benefit (HR = 0.63; HR = 0.85) and PFS benefit (HR = 0.52; HR = 0.63). In subgroup analysis, pembrolizumab appeared to provide the best OS benefit (HR = 0.67) as well as the best PFS benefit (HR = 0.67) in the PD-L1 ≥ 50% cohort. In contrast, pembrolizumab combined with chemotherapy exhibited the best OS benefit in the PD-L1 < 50% cohort. Furthermore, OS benefit from pembrolizumab plus chemotherapy was more obvious in nonsquamous patients (HR = 0.56). Additionally, pembrolizumab plus chemotherapy was associated with fewer adverse events than other chemotherapy combination strategies. CONCLUSIONS: In the first-line treatment, chemotherapy plus pembrolizumab or atezolizumab could enhance efficacy compared with chemotherapy alone or other PD-1/L1-based treatment strategies, especially in the nonsquamous population. Furthermore, pembrolizumab plus chemotherapy guarantees reliable security simultaneously, which may be the optimal treatment strategy for patients with major advanced NSCLC.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Antígeno B7-H1/uso terapêutico , Teorema de Bayes , Carcinoma Pulmonar de Células não Pequenas/patologia , Humanos , Neoplasias Pulmonares/patologia , Metanálise em RedeRESUMO
In recent years, only a small number of new Chinese medicines have been approved for marketing, which has embodied the bottleneck in the development of the Chinese medicine industry. To tackle this problem, the National Medical Products Administration has issued a series of regulations and technical requirements. In the context of new regulations, this study deeply explored the research and development strategies of new Chinese medicines under the guidance of the new classification of drug registration, and discussed the key technical issues in the research and development.
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Medicamentos de Ervas Chinesas , Preparações Farmacêuticas , China , Medicina Tradicional Chinesa , PesquisaRESUMO
Breast cancer (BCa) is the most common malignancy threatening the health of women worldwide, and the incidence rate has significantly increased in the last 10 years. Mammalian STE20like protein kinase 1 (MST1) is involved in the development of various types of malignant tumor. The present study aimed to investigate the role of MST1 in BCa and its potential involvement in the poor prognosis of patients with BCa. Reverse transcriptionquantitative PCR and immunohistochemistry were used to analyze the expression levels of MST1 in BCa, and the clinicopathological characteristics and prognosis of patients with BCa were further analyzed by statistical analysis. MST1 was overexpressed in BCa cell lines (MCF7, MDAMB231 and SKBR3). Cell Counting Kit8, 5ethynyl2'deoxyuridine and flow cytometry assays were used to analyze cell proliferation and apoptosis, respectively, and a wound healing assay was used to analyze cell migration. The results of the present study revealed that the downregulated expression levels of MST1 in BCa were closely associated with the poor prognosis of patients, and MST1 may be an independent risk factor for BCa. The overexpression of MST1 significantly inhibited the proliferation and migration, and promoted the apoptosis of BCa cells. In addition, the overexpression of MST1 significantly activated the Hippo signaling pathway. Treatment with XMUMP1 downregulated the expression levels of MST1 and partially reversed the inhibitory effects of MST1 on proliferation, migration and apoptosisrelated proteins, and inhibited the Hippo signaling pathway. In conclusion, the results of the present study suggested that MST1 expression levels may be downregulated in BCa and closely associated with tumor size and clinical stage, as well as the poor prognosis of affected patients. Furthermore, MST1 may inhibit the progression of BCa by targeting the Hippo signaling pathway.
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Biomarcadores Tumorais/genética , Neoplasias da Mama/genética , Proteínas Serina-Treonina Quinases/genética , Adulto , Idoso , Apoptose , Neoplasias da Mama/patologia , Movimento Celular/genética , Proliferação de Células , Progressão da Doença , Feminino , Regulação Neoplásica da Expressão Gênica , Via de Sinalização Hippo , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Células MCF-7 , Pessoa de Meia-Idade , Prognóstico , Transdução de Sinais/genéticaRESUMO
Patient mortality rates have remained stubbornly high for the past decades in small cell lung cancer (SCLC) because of having no standard targeted therapies with confirmed advantages at present. Poly [ADP-ribose] polymerase (PARP) inhibitors have shown promise in preclinical models but have had unsatisfactory clinical results in SCLC. By RNA-seq and isobaric tags for relative and absolute quantification (ITRAQ), we revealed that PARP1 inhibition led to the relocalization of forkhead box-O3a (FOXO3a) from nuclear to cytoplasm. By performing co-Immunoprecipitation (co-IP) and CRISPR-Cas9-mediated knockout plasmid we showed that FOXO3a was subject to exportin 1 (XPO1)-dependent nuclear export. We demonstrated the effects of the PARP inhibitor BMN673 on apoptosis and DNA damage were markedly enhanced by simultaneous inhibition of XPO1 in vitro. The combination of BMN673 and the XPO1 inhibitor selinexor inhibited primary SCLC cell proliferation in mini-patient-derived xenotransplants (miniPDXs) and markedly inhibited tumor growth without significant toxicity in xenograft models. The efficacy was enhanced for more than 2.5 times, compared to the single agent. Based on these findings, we further designed a novel dual PARP-XPO1 inhibitor and showed its effectiveness in SCLC. In this work, we illustrated that combining a PARP inhibitor with an XPO1 inhibitor is associated with significantly improved efficacy and tolerability. Dual PARP-XPO1 inhibition restored the FOXO3a balance and activity in SCLC. Collectively, targeting PARP1 and XPO1 opens new avenues for therapeutic intervention against SCLC, warranting further investigation in potential clinical trials.
Assuntos
Proteína Forkhead Box O3/metabolismo , Hidrazinas/administração & dosagem , Carioferinas/antagonistas & inibidores , Neoplasias Pulmonares/tratamento farmacológico , Ftalazinas/administração & dosagem , Receptores Citoplasmáticos e Nucleares/antagonistas & inibidores , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Triazóis/administração & dosagem , Transporte Ativo do Núcleo Celular/efeitos dos fármacos , Animais , Linhagem Celular Tumoral , Núcleo Celular/metabolismo , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Citoplasma/metabolismo , Sinergismo Farmacológico , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Hidrazinas/farmacologia , Neoplasias Pulmonares/metabolismo , Camundongos , Ftalazinas/farmacologia , Carcinoma de Pequenas Células do Pulmão/metabolismo , Triazóis/farmacologia , Ensaios Antitumorais Modelo de Xenoenxerto , Proteína Exportina 1RESUMO
BACKGROUND: Lung cancer is the most malignant tumor with the highest morbidity and mortality. This study aimed to investigate the role of the expression and the significance of the p42.3 gene in non-small cell lung cancer (NSCLC). METHODS: Lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) were analyzed based on the biological information data of The Cancer Genome Atlas (TCGA). Furthermore, 142 postoperative tumor tissue and normal tissue samples (70 cases of LUAD and 72 cases of LUSC) from NSCLC patients admitted to our hospital from 2005 to 2009 were retrospectively collected. Paraffin-embedded tissues were used to make the tissue microarrays (TMA), and the expression of the p42.3 protein was detected by immunohistochemical staining. RESULTS: The expression of p42.3 in both LUAD and LUSC was significantly upregulated (P<0.01) compared with the normal lung tissues. The p42.3 expression was significantly higher than that of LUAD (P<0.01) in the LUSC group. LUSC had a lower level of p42.3 DNA methylation and a higher level of p42.3 DNA amplification than LUAD. The expression rate of p42.3 protein decreased in patients 70 years or older (P=0.029). High expression of the p42.3 protein was an independent factor for worse pathological differentiation (P=0.043). CONCLUSIONS: Both genetic and epigenetic alterations contributed to dysregulated p42.3 in NSCLC. Despite the temporary absence of TCGA-LUSC (TCGA data on LUSC) survival information, we observed that the up-regulated expression of p42.3 in LUSC was significantly higher than that in LUAD by analyzing the public database and reviewing the real-world data. Furthermore, a high expression of p42.3 protein was significantly correlated with poor differentiation of tumor tissues. Therefore, the prognostic value of p42.3 in LUSC deserves further study.