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1.
Oncogene ; 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38890429

RESUMO

The role of tumor-resident microbiota in modulating tumor immunity remains unclear. Here, we discovered an abundance of intra-tumoral bacteria, such us E.coli, residing and resulting in Colorectal cancer liver metastasis (CRLM). E.coli enhanced lactate production, which mediated M2 macrophage polarization by suppressing nuclear factor-κB -gene binding (NF-κB) signaling through retinoic acid-inducible gene 1 (RIG-I) lactylation. Lactylation of RIG-I suppressed recruitment of NF-κB to the Nlrp3 promoter in macrophages, thereby reducing its transcription. This loss of Nlrp3 affected the immunosuppressive activities of regulatory T cells (Tregs) and the antitumor activities of and CD8+ T cells. Small-molecule compound screening identified a RIG-I lactylation inhibitor that suppressed M2 polarization and sensitized CRLM to 5-fluorouracil (5-FU). Our findings suggest that tumor-resident microbiota may be a potential target for preventing and treating CRLM.

2.
Nat Commun ; 15(1): 4656, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38821970

RESUMO

While digital computers rely on software-generated pseudo-random number generators, hardware-based true random number generators (TRNGs), which employ the natural physics of the underlying hardware, provide true stochasticity, and power and area efficiency. Research into TRNGs has extensively relied on the unpredictability in phase transitions, but such phase transitions are difficult to control given their often abrupt and narrow parameter ranges (e.g., occurring in a small temperature window). Here we demonstrate a TRNG based on self-oscillations in LaCoO3 that is electrically biased within its spin crossover regime. The LaCoO3 TRNG passes all standard tests of true stochasticity and uses only half the number of components compared to prior TRNGs. Assisted by phase field modeling, we show how spin crossovers are fundamentally better in producing true stochasticity compared to traditional phase transitions. As a validation, by probabilistically solving the NP-hard max-cut problem in a memristor crossbar array using our TRNG as a source of the required stochasticity, we demonstrate solution quality exceeding that using software-generated randomness.

3.
Magn Reson Med ; 92(3): 1064-1078, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38726772

RESUMO

PURPOSE: This study aims to develop and evaluate a novel cardiovascular MR sequence, MyoFold, designed for the simultaneous quantifications of myocardial tissue composition and wall motion. METHODS: MyoFold is designed as a 2D single breathing-holding sequence, integrating joint T1/T2 mapping and cine imaging. The sequence uses a 2-fold accelerated balanced SSFP (bSSFP) for data readout and incorporates electrocardiogram synchronization to align with the cardiac cycle. MyoFold initially acquires six single-shot inversion-recovery images, completed during the diastole of six successive heartbeats. T2 preparation (T2-prep) is applied to introduce T2 weightings for the last three images. Subsequently, over the following six heartbeats, segmented bSSFP is performed for the movie of the entire cardiac cycle, synchronized with an electrocardiogram. A neural network trained using numerical simulations of MyoFold is used for T1 and T2 calculations. MyoFold was validated through phantom and in vivo experiments, with comparisons made against MOLLI, SASHA, T2-prep bSSFP, and the conventional cine. RESULTS: In phantom studies, MyoFold exhibited a 10% overestimation in T1 measurements, whereas T2 measurements demonstrated high accuracy. In vivo experiments revealed that MyoFold T1 had comparable accuracy to SASHA and precision similar to MOLLI. MyoFold demonstrated good agreement with T2-prep bSSFP in myocardial T2 measurements. No significant differences were observed in the quantification of left-ventricle wall thickness and function between MyoFold and the conventional cine. CONCLUSION: MyoFold presents as a rapid, simple, and multitasking approach for quantitative cardiovascular MR examinations, offering simultaneous assessment of tissue composition and wall motion. The sequence's multitasking capabilities make it a promising tool for comprehensive cardiac evaluations in clinical settings.


Assuntos
Algoritmos , Coração , Imagem Cinética por Ressonância Magnética , Imagens de Fantasmas , Humanos , Coração/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética/métodos , Masculino , Miocárdio , Processamento de Imagem Assistida por Computador/métodos , Eletrocardiografia , Reprodutibilidade dos Testes , Feminino , Adulto , Interpretação de Imagem Assistida por Computador/métodos
4.
Nature ; 628(8008): 515-521, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38509374

RESUMO

The convergence of topology and correlations represents a highly coveted realm in the pursuit of new quantum states of matter1. Introducing electron correlations to a quantum spin Hall (QSH) insulator can lead to the emergence of a fractional topological insulator and other exotic time-reversal-symmetric topological order2-8, not possible in quantum Hall and Chern insulator systems. Here we report a new dual QSH insulator within the intrinsic monolayer crystal of TaIrTe4, arising from the interplay of its single-particle topology and density-tuned electron correlations. At charge neutrality, monolayer TaIrTe4 demonstrates the QSH insulator, manifesting enhanced nonlocal transport and quantized helical edge conductance. After introducing electrons from charge neutrality, TaIrTe4 shows metallic behaviour in only a small range of charge densities but quickly goes into a new insulating state, entirely unexpected on the basis of the single-particle band structure of TaIrTe4. This insulating state could arise from a strong electronic instability near the van Hove singularities, probably leading to a charge density wave (CDW). Remarkably, within this correlated insulating gap, we observe a resurgence of the QSH state. The observation of helical edge conduction in a CDW gap could bridge spin physics and charge orders. The discovery of a dual QSH insulator introduces a new method for creating topological flat minibands through CDW superlattices, which offer a promising platform for exploring time-reversal-symmetric fractional phases and electromagnetism2-4,9,10.

5.
J Hepatol ; 80(1): 82-98, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37838036

RESUMO

BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) is among the most prevalent and lethal cancers worldwide. The tumor microenvironment (TME) contributes to the poor response of patients with HCC to current therapies, while tumor vascular endothelial cells (ECs) are fundamental TME components that significantly contribute to tumor progression. However, the specific functions and mechanisms of tumor vascular ECs in HCC remain unclear. METHODS: We screened and validated diacylglycerol kinase gamma (DGKG) hyper-expression specifically in HCC tumor vascular ECs. Single-cell RNA-sequencing, cytometry by time-of-flight, and in vitro and in vivo studies were performed to investigate the functions of endothelial DGKG. Multiplexed immunohistochemistry staining and flow cytometry were used to evaluate changes in the TME. RESULTS: Functionally, endothelial DGKG promotes tumor angiogenesis and immunosuppressive regulatory T-cell differentiation in HCC. Of significance, we found that HIF-1α activates DGKG transcription by directly binding to its promoter region under hypoxia. Upregulated DGKG promotes HCC progression by recruiting ubiquitin specific peptidase 16 to facilitate ZEB2 deubiquitination, which increases TGF-ß1 secretion, thus inducing tumor angiogenesis and regulatory T-cell differentiation. Importantly, targeting endothelial DGKG potentiated the efficiency of dual blockade of PD-1 and VEGFR-2. CONCLUSION: Hypoxia-induced EC-specific DGKG hyper-expression promotes tumor angiogenesis and immune evasion via the ZEB2/TGF-ß1 axis, suggesting EC-specific DGKG as a potential therapeutic target for HCC. IMPACT AND IMPLICATIONS: Here, we reported that hypoxia-induced endothelial cell-specific DGKG hyper-expression promotes angiogenesis and immune evasion in HCC by recruiting USP16 for K48-linked deubiquitination and inducing the subsequent stabilization of ZEB2, leading to increased TGF-ß1 secretion. Most importantly, endothelial DGKG inhibition greatly improved the efficacy of the dual combination of anti-VEGFR2 and anti-PD-1 treatment in a mouse HCC model, significantly inhibiting the malignant progression of HCC and improving survival. This preclinical study supports the targeting of endothelial DGKG as a potential strategy for precision HCC treatment.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Camundongos , Animais , Humanos , Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/patologia , Fator de Crescimento Transformador beta1/metabolismo , Células Endoteliais/metabolismo , Evasão da Resposta Imune , Angiogênese , Linhagem Celular Tumoral , Neovascularização Patológica/metabolismo , Hipóxia/metabolismo , Modelos Animais de Doenças , Microambiente Tumoral
6.
Nat Commun ; 14(1): 7168, 2023 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-37935672

RESUMO

Van der Waals (vdW) ferroelectrics have attracted significant attention for their potential in next-generation nano-electronics. Two-dimensional (2D) group-IV monochalcogenides have emerged as a promising candidate due to their strong room temperature in-plane polarization down to a monolayer limit. However, their polarization is strongly coupled with the lattice strain and stacking orders, which impact their electronic properties. Here, we utilize four-dimensional scanning transmission electron microscopy (4D-STEM) to simultaneously probe the in-plane strain and out-of-plane stacking in vdW SnSe. Specifically, we observe large lattice strain up to 4% with a gradient across ~50 nm to compensate lattice mismatch at domain walls, mitigating defects initiation. Additionally, we discover the unusual ferroelectric-to-antiferroelectric domain walls stabilized by vdW force and may lead to anisotropic nonlinear optical responses. Our findings provide a comprehensive understanding of in-plane and out-of-plane structures affecting domain properties in vdW SnSe, laying the foundation for domain wall engineering in vdW ferroelectrics.

7.
Patterns (N Y) ; 4(11): 100863, 2023 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-38035192

RESUMO

Significant acceleration of the future discovery of novel functional materials requires a fundamental shift from the current materials discovery practice, which is heavily dependent on trial-and-error campaigns and high-throughput screening, to one that builds on knowledge-driven advanced informatics techniques enabled by the latest advances in signal processing and machine learning. In this review, we discuss the major research issues that need to be addressed to expedite this transformation along with the salient challenges involved. We especially focus on Bayesian signal processing and machine learning schemes that are uncertainty aware and physics informed for knowledge-driven learning, robust optimization, and efficient objective-driven experimental design.

8.
Sci Rep ; 13(1): 14092, 2023 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-37640741

RESUMO

Approximately 25-30% of those affected by colorectal cancer (CRC), the most prevalent gastrointestinal malignancy, develop metastases. The survival rate of patients with liver metastasis of CRC (CRLM) remains low owing to its unpredictability and a lack of biomarkers that can be applied to distinguish groups at higher risk for CRLM among patients with CRC. Therefore, our study aimed to find biomarkers that can predict the risk of CRLM. Screening of the Gene Expression Omnibus database, supported by an analysis of clinically obtained tissue and serum data using qPCR and ELISA, in an attempt to identify relevant biomarkers, enabled us to determine that orosomucoid 1 (ORM1) was differentially expressed in liver metastases and primary tumors of patients with CRC. Functionally, overexpression of ORM1 promoted the epithelial-mesenchymal transition and the proliferative, migratory, and invasive activities of MC38 cells and activated the PI3K/AKT signaling pathway. Moreover, MC38 cells overexpressing ORM1 enhanced the tumor immune microenvironment by promoting macrophage M2 polarization and elevating interleukin-10 (IL-10) expression. In vivo experiments further confirmed in vitro results, indicating that liver metastases elevated by ORM1 were partially attenuated by the depletion of macrophages or IL-10. Considered together, ORM1 promotes CRC progression and liver metastasis by regulating tumor cell growth and inducing macrophage M2 polarization, which mediates tumor immune tolerance, and thus acts as a potential predictive marker and therapeutic target in CRLM.


Assuntos
Neoplasias Colorretais , Neoplasias Hepáticas , Humanos , Orosomucoide , Interleucina-10 , Fosfatidilinositol 3-Quinases , Proteínas Proto-Oncogênicas c-akt , Processos Neoplásicos , Neoplasias Hepáticas/genética , Macrófagos , Neoplasias Colorretais/genética , Microambiente Tumoral
9.
Magn Reson Med ; 90(5): 1979-1989, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37415445

RESUMO

PURPOSE: To develop and evaluate a deep neural network (DeepFittingNet) for T1 /T2 estimation of the most commonly used cardiovascular MR mapping sequences to simplify data processing and improve robustness. THEORY AND METHODS: DeepFittingNet is a 1D neural network composed of a recurrent neural network (RNN) and a fully connected (FCNN) neural network, in which RNN adapts to the different number of input signals from various sequences and FCNN subsequently predicts A, B, and Tx of a three-parameter model. DeepFittingNet was trained using Bloch-equation simulations of MOLLI and saturation-recovery single-shot acquisition (SASHA) T1 mapping sequences, and T2 -prepared balanced SSFP (T2 -prep bSSFP) T2 mapping sequence, with reference values from the curve-fitting method. Several imaging confounders were simulated to improve robustness. The trained DeepFittingNet was tested using phantom and in-vivo signals, and compared to the curve-fitting algorithm. RESULTS: In testing, DeepFittingNet performed T1 /T2 estimation of four sequences with improved robustness in inversion-recovery T1 estimation. The mean bias in phantom T1 and T2 between the curve-fitting and DeepFittingNet was smaller than 30 and 1 ms, respectively. Excellent agreements between both methods was found in the left ventricle and septum T1 /T2 with a mean bias <6 ms. There was no significant difference in the SD of both the left ventricle and septum T1 /T2 between the two methods. CONCLUSION: DeepFittingNet trained with simulations of MOLLI, SASHA, and T2 -prep bSSFP performed T1 /T2 estimation tasks for all these most used sequences. Compared with the curve-fitting algorithm, DeepFittingNet improved the robustness for inversion-recovery T1 estimation and had comparable performance in terms of accuracy and precision.


Assuntos
Coração , Imageamento por Ressonância Magnética , Imageamento por Ressonância Magnética/métodos , Coração/diagnóstico por imagem , Redes Neurais de Computação , Algoritmos , Ventrículos do Coração , Imagens de Fantasmas , Reprodutibilidade dos Testes
10.
Cell Metab ; 35(6): 912-927.e7, 2023 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-37071992

RESUMO

Metabolic reprogramming plays a crucial role in the development of hepatocellular carcinoma (HCC). However, the key drivers of metabolic reprogramming underlying HCC progression remain unclear. Using a large-scale transcriptomic database and survival correlation screening, we identify thymidine kinase 1 (TK1) as a key driver. The progression of HCC is robustly mitigated by TK1 knockdown and significantly aggravated by its overexpression. Furthermore, TK1 promotes the oncogenic phenotypes of HCC not only through its enzymatic activity and production of deoxythymidine monophosphate (dTMP) but also by promoting glycolysis via binding with protein arginine methyltransferase 1 (PRMT1). Mechanistically, TK1 directly binds PRMT1 and stabilizes it by interrupting its interactions with tripartite-motif-containing 48 (TRIM48), which inhibits its ubiquitination-mediated degradation. Subsequently, we validate the therapeutic capacity of hepatic TK1 knockdown in a chemically induced HCC mouse model. Therefore, targeting both the enzyme-dependent and -independent activity of TK1 may be therapeutically promising for HCC treatment.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Animais , Camundongos , Carcinoma Hepatocelular/metabolismo , Neoplasias Hepáticas/metabolismo , Timidina Quinase/genética , Timidina Quinase/metabolismo , Ubiquitinação , Linhagem Celular Tumoral
11.
Adv Mater ; 35(26): e2210894, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36959753

RESUMO

Thin ferroelectric materials hold great promise for compact nonvolatile memory and nonlinear optical and optoelectronic devices. Herein, an ultrathin in-plane ferroelectric material that exhibits a giant nonlinear optical effect, group-IV monochalcogenide SnSe, is reported. Nanometer-scale ferroelectric domains with ≈90°/270° twin boundaries or ≈180° domain walls are revealed in physical-vapor-deposited SnSe by lateral piezoresponse force microscopy. Atomic structure characterization reveals both parallel and antiparallel stacking of neighboring van der Waals ferroelectric layers, leading to ferroelectric or antiferroelectric ordering. Ferroelectric domains exhibit giant nonlinear optical activity due to coherent enhancement of second-harmonic fields and the as-resulted second-harmonic generation was observed to be 100 times more intense than monolayer WS2 . This work demonstrates in-plane ferroelectric ordering and giant nonlinear optical activity in SnSe, which paves the way for applications in on-chip nonlinear optical components and nonvolatile memory devices.

12.
Nanotechnology ; 34(25)2023 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-36958026

RESUMO

Addressing respiratory infectious diseases remains one of the main priorities due to the increased risk of exposure caused by population growth, increasing international travel and commerce, and most recently, the COVID-19 outbreak. In the war against respiratory diseases, facemasks are powerful tools to obstruct the penetration of microorganisms, thereby protecting the wearer from infections. Nonetheless, the intercepted microorganisms on the surface of facemasks may proliferate and lead to secondary infection. To solve this problem, atomic layer deposition is introduced to deposit uniform and mechanically robust ZnO layers on polypropylene (PP) nonwoven fabrics, a widely used raw material in fabricating facemasks. The loading of ZnO demonstrates no adverse effects on the separation performance of facemasks, and the filtration efficiency of the facemasks towards different types of nanoparticles remains higher than 98.9%. Moreover, the modified PP nonwoven fabrics are granted with excellent antibacterial activity and photocatalytic sterilization ability, which can inactivate both germ-negative and germ-positive bacteria (E. coliandS. aureus) effectively with and without light illumination. Therefore, the modified PP nonwoven fabrics are potential candidates to be used as the outer layer on facemasks and endow them with photocatalytic antibacterial activity.


Assuntos
COVID-19 , Óxido de Zinco , Humanos , Polipropilenos , Máscaras , Antibacterianos
13.
Nano Lett ; 23(6): 2287-2294, 2023 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-36898060

RESUMO

Strong coupling between light and mechanical strain forms the foundation for next-generation optical micro- and nano-electromechanical systems. Such optomechanical responses in two-dimensional materials present novel types of functionalities arising from the weak van der Waals bond between atomic layers. Here, by using structure-sensitive megaelectronvolt ultrafast electron diffraction, we report the experimental observation of optically driven ultrafast in-plane strain in the layered group IV monochalcogenide germanium sulfide (GeS). Surprisingly, the photoinduced structural deformation exhibits strain amplitudes of order 0.1% with a 10 ps fast response time and a significant in-plane anisotropy between zigzag and armchair crystallographic directions. Rather than arising due to heating, experimental and theoretical investigations suggest deformation potentials caused by electronic density redistribution and converse piezoelectric effects generated by photoinduced electric fields are the dominant contributors to the observed dynamic anisotropic strains. Our observations define new avenues for ultrafast optomechanical control and strain engineering within functional devices.

15.
Nat Commun ; 14(1): 513, 2023 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-36720869

RESUMO

The hydrogenation of CO2 or CO to single organic product has received widespread attentions. Here we show a highly efficient and selective catalyst, Mo3S4@ions-ZSM-5, with molybdenum sulfide clusters ([Mo3S4]n+) confined in zeolitic cages of ZSM-5 molecular sieve for the reactions. Using continuous fixed bed reactor, for CO2 hydrogenation to methanol, the catalyst Mo3S4@NaZSM-5 shows methanol selectivity larger than 98% at 10.2% of carbon dioxide conversion at 180 °C and maintains the catalytic performance without any degeneration during continuous reaction of 1000 h. For CO hydrogenation, the catalyst Mo3S4@HZSM-5 exhibits a selectivity to C2 and C3 hydrocarbons stably larger than 98% in organics at 260 °C. The structure of the catalysts and the mechanism of COx hydrogenation over the catalysts are fully characterized experimentally and theorectically. Based on the results, we envision that the Mo3S4@ions-ZSM-5 catalysts display the importance of active clusters surrounded by permeable materials as mesocatalysts for discovery of new reactions.

17.
Nat Commun ; 13(1): 7677, 2022 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-36509766

RESUMO

Programmed death receptor-1 (PD-1) blockade have achieved some efficacy but only in a fraction of patients with hepatocellular carcinoma (HCC). Programmed cell death 1 ligand 1 (PD-L1) binds to its receptor PD1 on T cells to dampen antigen-tumor immune responses. However, the mechanisms underlying PD-L1 regulation are not fully elucidated. Herein, we identify that tumoral Prdm1 overexpression inhibits cell growth in immune-deficient mouse models. Further, tumoral Prdm1 overexpression upregulates PD-L1 levels, dampening anti-tumor immunity in vivo, and neutralizes the anti-tumor efficacy of Prdm1 overexpression in immune-competent mouse models. Mechanistically, PRDM1 enhances USP22 transcription, thus reducing SPI1 protein degradation through deubiquitination, which enhances PD-L1 transcription. Functionally, PD-1 mAb treatment reinforces the efficacy of Prdm1-overexpressing HCC immune-competent mouse models. Collectively, we demonstrate that the PRDM1-USP22-SPI1 axis regulates PD-L1 levels, resulting in infiltrated CD8+ T cell exhaustion. Furthermore, PRDM1 overexpression combined with PD-(L)1 mAb treatment provides a therapeutic strategy for HCC treatment.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Camundongos , Animais , Antígeno B7-H1 , Receptor de Morte Celular Programada 1 , Evasão da Resposta Imune , Linfócitos T CD8-Positivos , Fator 1 de Ligação ao Domínio I Regulador Positivo/genética , Fator 1 de Ligação ao Domínio I Regulador Positivo/metabolismo
18.
Front Endocrinol (Lausanne) ; 13: 1081585, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36568117

RESUMO

Colorectal cancer (CRC) is the third most common malignancy and the second most common cause of cancer-related mortality worldwide. A total of 20% of CRC patients present with distant metastasis. The hepatic portal venous system, responsible for collecting most intestinal blood, makes the liver the most common site of CRC metastasis. The formation of liver metastases from colorectal cancer is a long and complex process. It involves the maintenance of primary tumors, vasculature invasion, distant colonization, and metastasis formation. In this review, we serve on how the CRC cells acquire stemness, invade the vascular, and colonize the liver. In addition, we highlight how the resident cells of the liver and immune cells interact with CRC cells. We also discuss the current immunotherapy approaches and challenges we face, and finally, we look forward to finding new therapeutic targets based on novel sequencing technologies.


Assuntos
Neoplasias Colorretais , Neoplasias Hepáticas , Humanos , Neoplasias Colorretais/terapia , Neoplasias Colorretais/patologia
19.
Nat Commun ; 13(1): 6916, 2022 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-36376323

RESUMO

A double-edged sword in two-dimensional material science and technology is optically forbidden dark exciton. On the one hand, it is fascinating for condensed matter physics, quantum information processing, and optoelectronics due to its long lifetime. On the other hand, it is notorious for being optically inaccessible from both excitation and detection standpoints. Here, we provide an efficient and low-loss solution to the dilemma by reintroducing photonics bound states in the continuum (BICs) to manipulate dark excitons in the momentum space. In a monolayer tungsten diselenide under normal incidence, we demonstrated a giant enhancement (~1400) for dark excitons enabled by transverse magnetic BICs with intrinsic out-of-plane electric fields. By further employing widely tunable Friedrich-Wintgen BICs, we demonstrated highly directional emission from the dark excitons with a divergence angle of merely 7°. We found that the directional emission is coherent at room temperature, unambiguously shown in polarization analyses and interference measurements. Therefore, the BICs reintroduced as a momentum-space photonic environment could be an intriguing platform to reshape and redefine light-matter interactions in nearby quantum materials, such as low-dimensional materials, otherwise challenging or even impossible to achieve.

20.
Front Oncol ; 12: 909035, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35712486

RESUMO

Purpose: Immune checkpoint inhibitors plus antiangiogenic tyrosine kinase inhibitors may offer a first-line treatment for advanced hepatocellular carcinoma (HCC). In this phase 2 trial [registered with clinicaltrials.gov (NCT04052152)], we investigated the safety and efficacy of first-line anti-PD-1 antibody sintilimab plus antiangiogenic TKI anlotinib for advanced HCC. Methods and Materials: Pathologically-proven advanced HCC patients received sintilimab (200 mg) on day 1 and anlotinib (12 mg) once daily on days 1 to 14 every 3 weeks, with a safety run-in for the first six participants to assess dose-limiting toxicities (DLTs). The primary endpoints were safety and objective response rate (ORR) per RECIST v1.1. Results: Twenty advanced HCC patients were enrolled. No DLTs occurred in the safety run-in. All patients had treatment-related adverse events (TRAEs). Grade 3 TRAEs occurred in 8 (40.0%) patients, the most common being decreased platelet count (10.0%) and increased γ-glutamyl transferase (10.0%). No grade 4/5 TRAEs occurred. Five (25%) patients developed immune-related AEs. The ORR was 35.0% (95%CI 15.4%-59.2%) per RECIST v1.1 and 55.0% (95%CI 31.5%-76.9%) per modified RECIST. At data cutoff (March 31, 2021), the median progression-free survival was 12.2 months (95%CI, 3.8 to not reached). The median PFS was significantly longer in patients with lower LDH levels (not reached [NR], 95% CI, 8.7 to NR vs. higher LDH levels 5.2 months, 95% CI 3.4 to NR; P=0.020) and a CONUT score ≤2 (NR, 95% CI 5.1 to NR vs. CONUT score >2 6.2 months, 95% CI 1.8 to NR; P=0.020). Furthermore, patients showing tumor response had a significantly higher median proportion of CD16+CD56+ NK cells than patients who had stable or progressive disease (21.6% vs. 14.6%; P=0.026). Conclusion: Sintilimab plus anlotinib showed promising clinical activities with manageable toxicity as first-line treatment of advanced HCC.

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