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1.
J Control Release ; 375: 47-59, 2024 Sep 04.
Article in English | MEDLINE | ID: mdl-39222794

ABSTRACT

In the prodrug-based self-assembled nanoassemblies, prodrugs usually consist of drug modules, response modules, and modification modules. Modification modules play a critical role in regulating the nano-assembly ability of the prodrugs. Herein, we carried out a "fatty alcoholization" strategy and chose various lengths of aliphatic alcohol chains (AC) as modification modules to construct disulfide bond bridged paclitaxel (PTX) prodrug nanoassemblies. The PTX-AC prodrugs would self-assemble into nanoassemblies (PTX-AC PNs) with higher drug loading, stability, and tumor selectivity than commercial preparations. After comprehensive exploration, we found the chain length (AC12, AC16, AC20, AC24) of modification modules affected the assembly of PTX-AC PNs, further leading to disparate in vivo fate and antitumor efficacy. With the increase of the chain length of the modification modules (from AC12 to AC20), the assembly ability of the nanoassemblies was improved, attributed to the appropriate enhancement of hydrophobic force. When the chain length was further increased to AC24, the excessive hydrophobic force will lead to the aggregation of prodrugs and weaken the assembly ability. Therefore, PTX-AC20 PNs with proper chain length may solve the paradox of efficacy and tolerance in 4 T1 breast tumor owing to their optimal nano-assembly stability and modest redox-sensitivity. In short, this work highlighted the importance of screening optimal modification modules in developing prodrug nanoassemblies.

2.
J Colloid Interface Sci ; 677(Pt A): 941-952, 2024 Aug 05.
Article in English | MEDLINE | ID: mdl-39128288

ABSTRACT

Prodrug nanoassemblies combine the advantages of prodrug strategies and nanotechnology have been widely utilized for delivering antitumor drugs. These prodrugs typically comprise active drug modules, response modules, and modification modules. Among them, the modification modules play a critical factor in improving the self-assembly ability of the parent drug. However, the impact of the specific structure of the modification modules on prodrug self-assembly remains elusive. In this study, two gemcitabine (GEM) prodrugs are developed using 2-octyl-1-dodecanol (OD) as flexible modification modules and cholesterol (CLS) as rigid modification modules. Interestingly, the differences in the chemical structure of modification modules significantly affect the assembly performance, drug release, cytotoxicity, tumor accumulation, and antitumor efficacy of prodrug nanoassemblies. It is noteworthy that the prodrug nanoassemblies constructed with flexible modifying chains (OD) exhibit improved stability, faster drug release, and enhanced antitumor effects. Our findings elucidate the significant impact of modification modules on the construction of prodrug nanoassemblies.

3.
Neural Netw ; 179: 106540, 2024 Jul 14.
Article in English | MEDLINE | ID: mdl-39079377

ABSTRACT

West syndrome is an epileptic disease that seriously affects the normal growth and development of infants in early childhood. Based on the methods of brain topological network and graph theory, this article focuses on three clinical states of patients before and after treatment. In addition to discussing bidirectional and unidirectional global networks from the perspective of computational principles, a more in-depth analysis of local intra-network and inter-network characteristics of multi-partitioned networks is also performed. The spatial feature distribution based on feature path length is introduced for the first time. The results show that the bidirectional network has better significant differentiation. The rhythmic feature change trend and spatial characteristic distribution of this network can be used as a measure of the impact on global information processing in the brain after treatment. And localized brain regions variability in features and differences in the ability to interact with information between brain regions have potential as biomarkers for medication assessment in WEST syndrome. The above shows specific conclusions on the interaction relationship and consistency of macro-network and micro-network, which may have a positive effect on patients' treatment and prognosis management.

4.
J Biomed Mater Res B Appl Biomater ; 112(5): e35410, 2024 May.
Article in English | MEDLINE | ID: mdl-38728112

ABSTRACT

The dissipative particle dynamics (DPD) simulation was used to study the morphologies and structures of the paclitaxel-loaded PLA-b-PEO-b-PLA polymeric micelle. We focused on the influences of PLA block length, PLA-b-PEO-b-PLA copolymer concentration, paclitaxel drug content on morphologies and structures of the micelle. Our simulations show that: (i) with the PLA block length increase, the self-assemble structure of PLA-b-PEO-b-PLA copolymers with paclitaxel vary between onion-like structure (core-middle layer-shell) to spherical core-shell structure. The PEO shell thins and the size of the PLA core increases. The onionlike structures are comprised of the PEO hydrophilic core, the PLA hydrophobic middle layer, and the PEO hydrophilic shell, the distribution of the paclitaxel drug predominantly occurs within the hydrophobic intermediate layer; (ii) The system forms a spherical core-shell structure when a small amount of the drug is added, and within a certain range, the size of the spherical structure increases as the drug amount increases. When the drug contents (volume fraction) cdrug = 10%, it can be observed that the PLA4-b-PEO19-b-PLA4 spherical structures connect to form rod-shaped structures. With the length of PLA block NPLA = 8, as the paclitaxel drug concentrations cdrug = 4%, PEO has been insufficient to completely encapsulate the PLA and paclitaxel drug beads. To enhance drug loading capacity while maintaining stability of the system in aqueous solution, the optimal composition for loading paclitaxel is PLA4-b-PEO19-b-PLA4; the drug content is not higher than 4%; (iii) The paclitaxel-loaded PLA4-b-PEO19-b-PLA4 micelle undergo the transition from onionlike (core-middle layer-shell) to spherical (core-shell) to rod-shaped and lamellar structure as the PLA4-b-PEO19-b-PLA4 copolymer concentration increases from ccp = 10% to 40%.


Subject(s)
Micelles , Paclitaxel , Polyesters , Polyethylene Glycols , Paclitaxel/chemistry , Paclitaxel/pharmacokinetics , Polyethylene Glycols/chemistry , Polyesters/chemistry , Hydrophobic and Hydrophilic Interactions , Molecular Dynamics Simulation , Drug Carriers/chemistry
5.
Acta Pharm Sin B ; 14(3): 1400-1411, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38486988

ABSTRACT

The self-assembly prodrugs are usually consisted of drug modules, activation modules, and assembly modules. Keeping the balance between efficacy and safety by selecting suitable modules remains a challenge for developing prodrug nanoassemblies. This study designed four docetaxel (DTX) prodrugs using disulfide bonds as activation modules and different lengths of branched-chain fatty alcohols as assembly modules (C16, C18, C20, and C24). The lengths of the assembly modules determined the self-assembly ability of prodrugs and affected the activation modules' sensitivity. The extension of the carbon chains improved the prodrugs' self-assembly ability and pharmacokinetic behavior while reducing the cytotoxicity and increased cumulative toxicity. The use of C20 can balance efficacy and safety. These results provide a great reference for the rational design of prodrug nanoassemblies.

6.
Front Immunol ; 15: 1356268, 2024.
Article in English | MEDLINE | ID: mdl-38348051

ABSTRACT

Tracheal small cell carcinoma (SCC) is a rare malignancy, for which the optimal treatment strategy has yet to be determined. Currently, treatment largely aligns with the therapeutic guidelines established for small cell lung cancer, although numerous unresolved issues remain. This paper details a case study of a patient with Stage IIIB primary tracheal SCC, who was treated with an immune-combined etoposide-platinum(EP) regimen. This treatment offers valuable insights into innovative approaches for managing such malignancies. Furthermore, the study includes a comprehensive literature review to better contextualize the findings. The patient, admitted on May 2, 2023, had been experiencing persistent symptoms of airway discomfort for 15 days. A bronchoscopy performed on May 4 revealed tracheal SCC, classified as T4N2M0, IIIB. Following the CAPSTONE-1 study's methodology, the patient underwent six cycles of PD-L1(adebrelimab) combined with EP therapy, leading to significant relief of symptoms and the eventual disappearance of the tracheal mass.


Subject(s)
Carcinoma, Small Cell , Lung Neoplasms , Small Cell Lung Carcinoma , Humans , Carcinoma, Small Cell/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Etoposide/therapeutic use , Small Cell Lung Carcinoma/drug therapy , Lung Neoplasms/pathology
7.
IEEE Trans Biomed Eng ; 71(4): 1332-1344, 2024 Apr.
Article in English | MEDLINE | ID: mdl-37983148

ABSTRACT

OBJECTIVE: In this paper, a novel extended form of multivariate variational mode decomposition (MVMD) method to multigroup data named as grouped MVMD (GMVMD) is proposed. GMVMD is distinct from MVMD as it extracts common frequencies with strong correlations among regional channels. METHODS: Firstly, GMVMD utilizes a new clustering algorithm named as frequencies grouping algorithm to classify the nearest common frequencies among all channels to specified groups. Secondly, a generic variational optimization model which is extended from MVMD is formulated. Thirdly, alternating direction method of multipliers (ADMM) is utilized to obtain optimal solution of GMVMD model. RESULTS: The proposed method introduces an extra parameter to decide the number of clusterings which need to be specified by the user. The effectiveness and superiority of the algorithm are demonstrated on a series of experiments. The utility of GMVMD is verified by grouping real-world electroencephalogram (EEG) data having similar center frequencies successfully. CONCLUSION: GMVMD outperforms MVMD in mode-alignment, signal reduction error and et al. Significance: GMVMD can obtain more accurate center frequencies and less signal reduction error than MVMD.


Subject(s)
Algorithms , Electroencephalography , Cluster Analysis
8.
Adv Mater ; 36(4): e2310633, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37983894

ABSTRACT

Homodimeric prodrug nanoassemblies (HDPNs) hold promise for improving the delivery efficiency of chemo-drugs. However, the key challenge lies in designing rational chemical linkers that can simultaneously ensure the chemical stability, self-assembly stability, and site-specific activation of prodrugs. The "in series" increase in sulfur atoms, such as trisulfide bond, can improve the assembly stability of HDPNs to a certain extent, but limits the chemical stability of prodrugs. Herein, trithiocarbonate bond (─SC(S)S─), with a stable "satellite-type" distribution of sulfur atoms, is developed via the insertion of a central carbon atom in trisulfide bonds. ─SC(S)S─ bond effectively addresses the existing predicament of HDPNs by improving the chemical and self-assembly stability of homodimeric prodrugs while maintaining the on-demand bioactivation. Furthermore, ─SC(S)S─ bond inhibits antioxidant defense system, leading to up-regulation of the cellular ROS and apoptosis of tumor cells. These improvements of ─SC(S)S─ bond endow the HDPNs with in vivo longevity and tumor specificity, ultimately enhancing the therapeutic outcomes. ─SC(S)S─ bond is, therefore, promising for overcoming the bottleneck of HDPNs for efficient oncological therapy.


Subject(s)
Antineoplastic Agents , Nanoparticles , Prodrugs , Thiones , Prodrugs/pharmacology , Prodrugs/chemistry , Cell Line, Tumor , Antineoplastic Agents/pharmacology , Polymers , Sulfur , Nanoparticles/chemistry , Drug Liberation
9.
Nano Lett ; 24(1): 394-401, 2024 Jan 10.
Article in English | MEDLINE | ID: mdl-38147432

ABSTRACT

The prodrug-based nanoassemblies offer an alternative to settle the deficiencies of traditional chemotherapy drugs. In this nanosystem, prodrugs typically comprise drug modules, modification modules, and response modules. The response modules are crucial for facilitating the accurate conversion of prodrugs at specific sites. In this work, we opted for differentiated disulfide bonds as response modules to construct docetaxel (DTX) prodrug nanoassemblies. Interestingly, a subtle change in response modules leads to a "U-shaped" conversion rate of DTX-prodrug nanoassemblies. Prodrug nanoassemblies with the least carbon numbers between the disulfide bond and ester bond (PDONα) offered the fastest conversion rate, resulting in powerful treatment outcomes with some unavoidable toxic effects. PDONß, with more carbon numbers, possessed a slow conversion rate and poor antitumor efficacy but good tolerance. With most carbon numbers in PDONγ, it demonstrated a moderate conversion rate and antitumor effect but induced a risk of lethality. Our study explored the function of response modules and highlighted their importance in prodrug development.


Subject(s)
Antineoplastic Agents , Nanoparticles , Prodrugs , Docetaxel , Prodrugs/chemistry , Cell Line, Tumor , Disulfides/chemistry , Carbon , Antineoplastic Agents/pharmacology , Nanoparticles/chemistry
10.
Ultrason Sonochem ; 101: 106673, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37931343

ABSTRACT

Insect protein has gradually attracted wide attention from the international research community as a promising source of high-quality protein that can replace traditional protein sources. The larvae of the housefly, a prevalent and widespread species, contain high levels of protein with beneficial properties, namely, anti-fatigue, anti-radiation, and anti-aging functions, as well as liver protection and immunity enhancement. This work thoroughly examined the impact of high-intensity ultrasound (HIUS) on the structural and functional characteristics of housefly larval concentrate protein (HLCP). HLCP samples were sonicated for 20 min at a frequency of 20 kHz with varying energies (0, 100, 200, 300, 400, and 500 W). The findings demonstrated that sonication considerably altered the secondary and tertiary structures of HLCP but had no effect on molecular weight. With an increase in ultrasonic power, HLCP's particle size shrank, more hydrophobic groups were exposed, more free sulfhydryl groups were present, the solution's stability improved, and HLCP's solubility rose. In addition, HLCP's emulsification and foaming abilities were improved by HIUS treatment. It is anticipated that this study's findings will offer fresh insights into the implementation of HLCP in the food sector.


Subject(s)
Houseflies , Animals , Larva , Particle Size , Hydrophobic and Hydrophilic Interactions , Solubility
11.
J Virol ; 97(11): e0120923, 2023 Nov 30.
Article in English | MEDLINE | ID: mdl-37843366

ABSTRACT

IMPORTANCE: Porcine epidemic diarrhea caused by porcine coronaviruses remains a major threat to the global swine industry. Fatty acids are extensively involved in the whole life of the virus. In this study, we found that docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) significantly reduced the viral load of porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), and porcine delta coronavirus (PDCoV) and acted on the replication of the viruses rather than attachment and entry. We further confirmed that DHA and EPA inhibited PEDV replication by alleviating the endoplasmic reticulum stress. Meanwhile, DHA and EPA alleviate PEDV-induced inflammation and reactive oxygen species (ROS) levels and enhance the cellular antioxidant capacity. These data indicate that DHA and EPA have antiviral effects on porcine coronaviruses and provide a molecular basis for the development of new fatty acid-based therapies to control porcine coronavirus infection and transmission.


Subject(s)
Coronavirus Infections , Coronavirus , Docosahexaenoic Acids , Eicosapentaenoic Acid , Swine Diseases , Animals , Coronavirus/physiology , Coronavirus Infections/drug therapy , Coronavirus Infections/veterinary , Docosahexaenoic Acids/pharmacology , Eicosapentaenoic Acid/pharmacology , Porcine epidemic diarrhea virus/physiology , Swine , Swine Diseases/drug therapy , Transmissible gastroenteritis virus/physiology , Virus Replication/drug effects , Endoplasmic Reticulum Stress/drug effects
12.
Front Psychol ; 14: 1238788, 2023.
Article in English | MEDLINE | ID: mdl-37727745

ABSTRACT

Recent years have witnessed increasing attention to personality strength (grit) due to its merit in goal-seeking language learning processes. Two facets of grit, namely perseverance of effort (PE) and consistency of interest (CI), play a critical role in overcoming learning difficulties and strengthening willpower to pursue learning goals. The current review seeks to explore various issues related to grit, including its factor structure, the relationship between grit and frequently associated factors, as well as the utility of PE and CI in facilitating language learning. This exploration is based on the findings of 32 empirical articles published between 2017 and 2022 from three databases. The results indicate that although research which examines the role of grit has entered a fast growth phase since 2020, there is still a need for expansion and diversification in scopes, participants, research methods, and language contexts. Moreover, previous studies have not adequately addressed the critical issue of grit's conceptualization and factor structure. Finally, this study suggests that future researchers should impartially assess the factor structure and nature of PE and CI, to provide more robust evidence to clarify the relationship between grit and diverse emotions and positive institutions, in order to advance understanding of grit in second language learning.

13.
Oncol Rep ; 50(4)2023 Oct.
Article in English | MEDLINE | ID: mdl-37654232

ABSTRACT

Following the publication of this paper, it was drawn to the Editor's attention by a concerned reader that the cell formation assay data shown in Figs. 3D, 4D, 8D and 9D were strikingly similar to data that had already appeared in another article written by different authors at different research institutes [Wang Z, Jiang C, Chen W, Zhang G, Luo D, Cao Y Wu J, Ding Y and Liu B: Baicalein induces apoptosis and autophagy via endoplasmic reticulum stress in hepatocellular carcinoma. Biomed Res Int: 732516, 2014]. Owing to the fact that the contentious data in the above article had already been published prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 38: 2078­2086, 2017; DOI: 10.3892/or.2017.5854].

14.
N Z J Educ Stud ; 58(1): 225-242, 2023.
Article in English | MEDLINE | ID: mdl-37520070

ABSTRACT

This study utilises the Identity Triangle Model (Dugas in Teach Dev 25(3):243-262, 2021, 10.1080/13664530.2021.1874500) to examine the experiences of one particular novice non-native Mandarin Chinese teacher at a university in New Zealand. A case study design was employed to track the identity negotiations of this European non-native Chinese speaker during 12 weeks of her first semester of teaching. Analysis of the data revealed nine subcategories within the psychological, behavioural, and relational domains according to the Identity Triangle Model. The findings suggest that this new non-native speaker teacher viewed her as an accidental teacher, exploring a teaching career without a strong instrumentalist aspiration or a clear career path in language teaching. Instead, she was more motivated by a desire for personal growth and the opportunity to reinvent themselves in a new cultural context. The results of this study offer theoretical implications for the adoption of a unified framework in future research on the identity of first-time language teachers, and practical implications for developing sustainable strategies aimed at recruiting and retaining non-native speaker teachers in foreign language education.

16.
J Control Release ; 360: 784-795, 2023 08.
Article in English | MEDLINE | ID: mdl-37451544

ABSTRACT

The clinical application of cabazitaxel (CTX) is restricted by severe dose-related toxicity, failing to considering therapeutic efficacy and safety together. Self-assembled prodrugs promote new drug delivery paradigms as they can self-deliver and self-formulate. However, the current studies mainly focused on the use of straight chains to construct self-assembled prodrugs, and the role of branched chains in prodrug nanoassemblies remains to be clarified. In this study, we systematically explored the structure-function relationship of prodrug nanoassemblies using four CTX prodrugs that contained branched chain aliphatic alcohols (BAs) with different alkyl lengths. Overall, CTX-SS-BA20 NPs with the proper alkyl length exhibited significant improvements in both antitumor efficacy and biosafety. Furthermore, compared with straight chain (SC) modified prodrug nanoassemblies (CTX-SS-SC20 NPs), CTX-SS-BA20 NPs still hold great therapeutic promise due to its good biosafety. These findings illustrated the significance of BAs as modified chains in designing prodrug nanoassemblies for narrowing the efficacy-to-safety gap of cancer therapy.


Subject(s)
Nanoparticles , Prodrugs , Drug Delivery Systems , Taxoids , Cell Line, Tumor
17.
Nano Lett ; 23(8): 3549-3557, 2023 04 26.
Article in English | MEDLINE | ID: mdl-37053460

ABSTRACT

Prodrug-based nanoassemblies have been developed to solve the bottlenecks of chemotherapeutic drugs. The fabricated prodrugs usually consist of active drug modules, response modules, and modification modules. Among three modules, the response modules play a vital role in controlling the intelligent drug release at tumor sites. Herein, various locations of disulfide bond linkages were selected as response modules to construct three Docetaxel (DTX) prodrugs. Interestingly, the small structural difference caused by the length of response modules endowed corresponding prodrug nanoassemblies with unique characteristic. α-DTX-OD nanoparticles (NPs) possessed the advantages of high redox-responsiveness due to their shortest linkages. However, they were too sensitive to retain the intact structure in the blood circulation, leading to severe systematic toxicity. ß-DTX-OD NPs significantly improved the pharmacokinetics of DTX but may induce damage to the liver. In comparison, γ-DTX-OD NPs with the longest linkages greatly ameliorated the delivery efficiency of DTX as well as improved DTX's tolerance dose.


Subject(s)
Antineoplastic Agents , Nanoparticles , Prodrugs , Docetaxel , Prodrugs/chemistry , Nanoparticles/chemistry , Drug Liberation , Antineoplastic Agents/chemistry , Cell Line, Tumor , Drug Carriers/chemistry
18.
Pathogens ; 12(2)2023 Jan 28.
Article in English | MEDLINE | ID: mdl-36839472

ABSTRACT

Colorectal cancer (CRC) is a malignancy with a very high incidence and mortality rate worldwide. Fusobacterium nucleatum bacteria and their metabolites play a role in inducing and promoting CRC; however, no studies on the exchange of information between Fusobacterium nucleatum extracellular vesicles (Fnevs) and CRC cells have been reported. Our research shows that Fusobacterium nucleatum ATCC25586 secretes extracellular vesicles carrying active substances from parental bacteria which are endocytosed by colon cancer cells. Moreover, Fnevs promote the proliferation, migration, and invasion of CRC cells and inhibit apoptosis; they also improve the ability of CRC cells to resist oxidative stress and SOD enzyme activity. The genes differentially expressed after transcriptome sequencing are mostly involved in the positive regulation of tumor cell proliferation. After detecting differential metabolites using liquid chromatography-tandem mass spectrometry, Fnevs were found to promote cell proliferation by regulating amino acid biosynthesis in CRC cells and metabolic pathways such as central carbon metabolism, protein digestion, and uptake in cancer. In summary, this study not only found new evidence of the synergistic effect of pathogenic bacteria and colon cancer tumor cells, but also provides a new direction for the early diagnosis and targeted treatment of colon cancer.

19.
ACS Chem Neurosci ; 14(6): 1095-1106, 2023 03 15.
Article in English | MEDLINE | ID: mdl-36812493

ABSTRACT

Accumulating evidence has revealed an association between depression and disordered intestinal microecology. The discovery of psychobiotics has provided a promising perspective for studying the treatment of psychiatric disorders. Here, we aimed to investigate the antidepressant abilities of Lactocaseibacillus rhamnosus zz-1 (LRzz-1) and elucidate the underlying mechanisms. The viable bacteria (2 × 109 CFU/day) were orally supplemented to depressed C57BL/6 mice induced by chronic unpredictable mild stress (CUMS), and the behavioral, neurophysiological, and intestinal microbial effects were assessed, with fluoxetine used as a positive control. The treatment with LRzz-1 effectively mitigated the depression-like behavioral disorders of depressed mice and reduced the expression of inflammatory cytokine mRNA (IL-1ß, IL-6, and TNF-α) in the hippocampus. In addition, LRzz-1 treatment also improved tryptophan metabolic disorder in the mouse hippocampus, as well as its peripheral circulation. These benefits are associated with the mediation of microbiome-gut-brain bidirectional communication. CUMS-induced depression impaired the intestinal barrier integrity and microbial homeostasis in mice, neither of which was restored by fluoxetine. LRzz-1 prevented intestinal leakage and significantly ameliorated epithelial barrier permeability by up-regulating tight-junction proteins (including ZO-1, occludin, and claudin-1). In particular, LRzz-1 improved the microecological balance by normalizing the threatened bacteria (e.g., Bacteroides and Desulfovibrio), exerting beneficial regulation (e.g., Ruminiclostridium 6 and Alispites), and modifying short-chain fatty acid metabolism. In summary, LRzz-1 showed considerable antidepressant-like effects and exhibited more comprehensive intestinal microecological regulation than other drugs, which offers novel insights that can facilitate the development of depression therapeutic strategies.


Subject(s)
Depression , Fluoxetine , Mice , Animals , Depression/metabolism , Fluoxetine/pharmacology , Fluoxetine/therapeutic use , Brain-Gut Axis , Mice, Inbred C57BL , Antidepressive Agents/pharmacology , Antidepressive Agents/therapeutic use , Dietary Supplements
20.
J Immunother Cancer ; 11(2)2023 02.
Article in English | MEDLINE | ID: mdl-36759013

ABSTRACT

BACKGROUND: The standard neoadjuvant treatments in patients with esophageal squamous cell carcinoma (ESCC) still have either poor safety or efficacy. Better therapies are needed in China. METHODS: This was an open-label, single-arm, phase 2 trial. Patients with potentially resectable ESCC (cT1b-3, Nany, M0 or T4a, N0-1, or M0) received preoperative intravenous sintilimab plus triplet chemotherapy (liposomal paclitaxel, cisplatin, and S-1) every 3 weeks for two cycles. The primary endpoints were safety and surgical feasibility; the secondary endpoint was major pathological response (MPR) rate. Genomic biomarkers (genetic mutations, tumor mutational burden (TMB), circulating tumor DNA status and immune microenvironment) in baseline tumor samples were investigated. RESULTS: All 30 patients completed two cycles of neoadjuvant treatment and underwent surgical resection. Grade 3-4 treatment-related adverse events (TRAEs) occurred in 36.7% (11/30) of patients. The most frequent TRAEs were decreased white cell count (76.7%), anemia (76.7%), and decreased neutrophil count (73.3%). All TRAEs were hematological toxicities; none caused ≥30 days surgical delay. The MPR and pathological complete response (pCR) rates were 50.0% (15/30; 95% CI 33.2 to 66.9) and 20.0% (6/30; 95% CI 9.5 to 37.3), respectively. Patients with higher TMB and more clonal mutations were more likely to respond. ERBB2 alterations and ctDNA high-releaser status have a negative correlation with neoadjuvant ICI response. No significant difference was observed between therapeutic response and tumor immune microenvironment. CONCLUSIONS: Neoadjuvant sintilimab plus platinum-based triplet chemotherapy appeared safe and feasible, did not delay surgery and induced a pCR rate of 20.0% in patients with potentially resectable ESCC. TRIAL REGISTRATION NUMBER: NCT03946969.


Subject(s)
Esophageal Neoplasms , Esophageal Squamous Cell Carcinoma , Humans , Esophageal Squamous Cell Carcinoma/therapy , Neoadjuvant Therapy/adverse effects , Esophageal Neoplasms/drug therapy , Esophageal Neoplasms/pathology , Treatment Outcome , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Tumor Microenvironment
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