gemcitabine

吉西他滨
  • 文章类型: Journal Article
    UNASSIGNED: Erythrocytes and fibroblasts in the pancreatic cancer tumor microenvironment promote tumor cell growth and invasion by providing nutrients and promoting immunosuppression. Additionally, they form a barrier against the penetration of chemotherapeutic drugs. Therefore, the search for diversified tumor-targeting materials plays an essential role in solving the above problems.
    UNASSIGNED: Physicochemical characterization of Graphene fluorescent nanoparticles (GFNPs) and nanomedicines were analyzed by transmission electron microscopy (TEM), elemental analyzers and ultraviolet fluorescence (UV/FL) spectrophotometer. Localization of GFNPs in cell and tissue sections imaged with laser confocal microscope, fluorescence scanner and small animal in vivo imager. Qualitative detection and quantitative detection of GFNPs and GFNPs-GEM were performed using High performance liquid chromatography (HPLC).
    UNASSIGNED: Based on the 3 nm average dimensions, GFNPs penetrate vascular endothelial cells and smooth muscle cells, achieve up to label 30% tumor cells and 60% cancer-associated fibroblasts (CAFs) cells, and accurately label mature red blood cells in the tumor microenvironment. In orthotopic transplanted pancreatic cancer models, the fluorescence intensity of GFNPs in tumors showed a positive correlation with the cycle size of tumor development. The differential spatial distribution of GFNPs in three typical clinical pancreatic cancer samples demonstrated their diagnostic potential. To mediate the excellent targeting properties of GFNPs, we synthesized a series of nanomedicines using popular chemotherapeutic drugs, in which complex of GFNPs and gemcitabine (GFNPs-GEM) possessed stability in vivo and exhibited effective reduction of tumor volume and fewer side effects.
    UNASSIGNED: GFNPs with multiple targeting tumor microenvironments in pancreatic cancer possess diagnostic efficiency and therapeutic potential.
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  • 文章类型: Journal Article
    由于对吉西他滨(GEM)的耐药性,胰腺癌(PC)患者通常预后差,生存率低。我们研究的目的是探索外泌体PPP3CB对PC中GEM抗性的影响,同时分析miR-298/STAT3信号通路的调控作用。
    通过透射电子显微镜(TEM)验证从PC细胞分离的外泌体,纳米粒子跟踪分析(NTA)和蛋白质印迹(WB)。PPP3CB和miR-298之间的相互作用使用双荧光素酶报告基因检测进行验证,然后使用CCK8测定法评估细胞生长和死亡,EdU染色,和流式细胞术。
    在GEM抗性PC细胞中观察到增加的PPP3CB表达。通过超高速离心成功提取PC细胞和GEM抗性PC细胞的外泌体。共聚焦显微镜显示PC细胞内化荧光素酰胺(FAM)标记的GEM抗性外泌体。PPP3CB增强GEM耐药PC细胞的增殖,抑制其凋亡,而下调PPP3CB促进PC细胞的死亡并抑制GEM抗性PC细胞的增殖,并增强PC细胞对GEM的敏感性。此外,PPP3CB通过下调miR-298正向调节PC细胞中STAT3的表达,从而促进PC细胞的生长并抑制其死亡。
    PC细胞衍生的外泌体PPP3CB通过下调miR-298,刺激细胞生长,增强STAT3表达,抑制细胞死亡,从而增加PC电池对GEM的电阻。
    UNASSIGNED: Due to resistance to gemcitabine (GEM), patients with pancreatic cancer (PC) usually have poor prognosis and low survival rate. The purpose of our research was to explore the impact of exosome PPP3CB on GEM resistance in PC, and concurrently analyze the regulatory role of the miR-298/STAT3 signaling pathway.
    UNASSIGNED: Exosomes isolated from PC cells were verified by transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA) and western blotting (WB). The interaction between PPP3CB and miR-298 was verified using dual-luciferase reporter gene assay, followed by evaluation of cell growth and death using CCK8 assay, EdU staining, and flow cytometry.
    UNASSIGNED: Increased PPP3CB expression was observed in GEM-resistant PC cells. Exosomes from PC cells and GEM-resistant PC cells were successfully extracted by ultra-high speed centrifugation. Confocal microscopy showed internalization of fluorescein amide (FAM)-labeled GEM-resistant exosomes by PC cells. PPP3CB enhanced the proliferation of GEM-resistant PC cells and inhibited their apoptosis, whereas down-regulation of PPP3CB promoted the death of PC cells and inhibited the proliferation of GEM-resistant PC cells, and enhance the susceptibility of PC cells to GEM. Additionally, PPP3CB positively regulated STAT3 expression in PC cells by down-regulating miR-298, thus promoting the growth and inhibiting the death of PC cells.
    UNASSIGNED: PC cell-derived exosome PPP3CB enhances STAT3 expression by downregulating miR-298, stimulating cell growth, and suppressing cell death, thereby increasing the resistance of PC cells to GEM.
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  • 文章类型: Journal Article
    目标:在高风险的非肌肉浸润性膀胱癌(NMIBC)中,膀胱内卡介苗(BCG)是经尿道膀胱肿瘤电切术(TURBT)后的标准辅助治疗。膀胱内吉西他滨,在卡介苗短缺的情况下用作替代或二线治疗,缺乏对韩国人口的结果研究。
    方法:对2019年至2022年TURBT术后每周接受吉西他滨膀胱治疗6周的患者进行回顾性调查。基于美国泌尿外科协会的风险分类,本研究包括拒绝膀胱切除术的高危或极高危NMIBC患者.根据其风险进行维持治疗。复发定义为随后的膀胱镜活检或TURBT的组织学确认。通过Kaplan-Meier方法评估无病生存期(DFS)。
    结果:该研究包括60名患者,包括45例高危(第1组)患者,中位年龄为76岁,15例极高危(第2组)患者,中位年龄为68岁。其中,28例患者先前接受过膀胱内BCG。在22个月的中位随访中,第1组31例和第2组11例复发.高危组和极高危组的DFS率为57.8%,1年为40%,20.7%对2年的21.3%,20.7%对3年的21.3%,分别(p=0.831)。Tis分期(p=0.042)和前列腺尿道浸润(p=0.028)是DFS的重要预测因素。癌症特异性死亡率在第1组和第2组分别为2.2%和6.7%(p=0.441)。
    结论:根据韩国的短期结果,在高风险和极高风险患者之间观察到相似的DFS结果。这一发现对于临床实践至关重要;然而,需要分析更多患者和长期结局的研究.
    OBJECTIVE: In high-risk non-muscle-invasive bladder cancer (NMIBC), intravesical Bacillus Calmette-Guérin (BCG) is the standard adjuvant therapy post-transurethral resection of bladder tumor (TURBT). Intravesical gemcitabine, used as an alternative or second-line therapy amid BCG shortages, lacks outcome studies in the Korean population.
    METHODS: Patients who received weekly intravesical gemcitabine for 6 weeks after TURBT from 2019 to 2022 were retrospectively investigated. Based on the American Urological Association risk classification, patients with high- or very high-risk NMIBC who refused cystectomy were included. Maintenance treatment was performed depending on their risk. Recurrence was defined as histologic confirmation on subsequent cystoscopic biopsies or TURBT. Disease free survival (DFS) was evaluated by the Kaplan-Meier method.
    RESULTS: The study included 60 patients, comprising 45 high-risk (group 1) patients with a median age of 76 years and 15 very high-risk (group 2) patients with a median age of 68 years. Among them, 28 patients had previously received intravesical BCG. Over a median follow-up of 22 months, recurrence occurred in 31 patients in group 1 and 11 in group 2. The DFS rates of the high-risk group and the very high-risk group were 57.8% versus 40% at 1 year, 20.7% versus 21.3% at 2 years and 20.7% versus 21.3% at 3 years, respectively (p=0.831). Tis stage (p=0.042) and prostatic urethra invasion (p=0.028) were significant predictors of DFS. Cancer-specific mortality rates were 2.2% in group 1 and 6.7% in group 2 (p=0.441).
    CONCLUSIONS: Similar DFS outcome between high-risk and very high-risk patients were observed based on short-term results in Korea. This finding is crucial for clinical practice; however, studies analyzing more patients and long-term outcomes are needed.
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  • 文章类型: Journal Article
    胰腺癌(PC)是一种高度恶性的实体瘤,对吉西他滨(GEM)化疗的耐药性是患者预后不良的主要原因。尽管众所周知,PC因营养不良而茁壮成长,其化疗耐药的潜在机制尚不清楚.目前的研究使用生物信息学工具分析了临床组织样本数据库,并观察到去泛素酶STAMBP在PC组织中的表达显着上调。功能实验表明,STAMBP敲低可显著提高PC细胞的GEM敏感性。多个组学分析表明,STAMBP在体外和体内增强有氧糖酵解并抑制线粒体呼吸以增加PC的GEM抗性。STAMBP敲低降低PDK1水平,有氧糖酵解过程的重要调节剂,在几种癌症中。机械上,STAMBP通过直接与E2F1结合并抑制其降解和泛素化来调节E2F1,从而促进PDK1介导的Warburg效应和化疗耐药性。使用三维蛋白质结构分析和药物筛选的高通量化合物库筛选确定了FDA药物entrectinib作为有效的GEM敏化剂和STAMBP抑制剂,在患者来源的异种移植(PDX)模型中增强GEM的抗肿瘤作用。总的来说,我们建立了一种新的机制,通过STAMBP-E2F1-PDK1轴,由此PC细胞在营养贫乏的肿瘤微环境中变得具有化学抗性。
    Pancreatic cancer (PC) is a highly malignant solid tumor whose resistance to gemcitabine (GEM) chemotherapy is a major cause of poor patient prognosis. Although PC is known to thrive on malnutrition, the mechanism underlying its chemotherapy resistance remains unclear. The current study analyzed clinical tissue sample databases using bioinformatics tools and observed significantly upregulated expression of the deubiquitinase STAMBP in PC tissues. Functional experiments revealed that STAMBP knockdown remarkably increases GEM sensitivity in PC cells. Multiple omics analyses suggested that STAMBP enhances aerobic glycolysis and suppresses mitochondrial respiration to increase GEM resistance in PC both in vitro and in vivo. STAMBP knockdown decreased PDK1 levels, an essential regulator of the aerobic glycolytic process, in several cancers. Mechanistically, STAMBP promoted the PDK1-mediated Warburg effect and chemotherapy resistance by modulating E2F1 via direct binding to E2F1 and suppressing its degradation and ubiquitination. High-throughput compound library screening using three-dimensional protein structure analysis and drug screening identified the FDA drug entrectinib as a potent GEM sensitizer and STAMBP inhibitor, augmenting the antitumor effect of GEM in a patient-derived xenograft (PDX) model. Overall, we established a novel mechanism, via the STAMBP-E2F1-PDK1 axis, by which PC cells become chemoresistant in a nutrient-poor tumor microenvironment.
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  • 文章类型: Journal Article
    胆管癌(CCA)是由胆管衬里的上皮细胞引起的极具侵袭性的恶性肿瘤。它提出了一个重大的全球健康问题,发病率最高,范围从40-100例/100,000个人,在东南亚发现,肝吸虫感染是地方性的。在欧洲和美国,发病率范围为0.4-2例/100,000例。全球范围内,死亡率范围为0.2-2人/100,000人年,并且在大多数国家都在增加。由于晚期诊断的选择有限,化疗是晚期CCA的主要治疗方法,但其功效受到耐药表型的阻碍。在之前的研究中,对耐药CCA细胞系(KKU‑213A‑FR和KKU‑213A‑GR)和亲本KU‑213A细胞系进行蛋白质组学分析,发现cullin3(Cul3)在耐药细胞中明显过表达。Cul3,Cul3-RING泛素连接酶复合物中的支架蛋白,对泛素化和蛋白酶体降解至关重要,然而,其在耐药CCA中的作用仍有待阐明。本研究旨在阐明Cul3在耐药CCA细胞系中的作用。逆转录定量PCR和蛋白质印迹分析证实,与亲本对照相比,耐药细胞系中Cul3mRNA和蛋白质水平显着升高。短干扰RNA介导的Cul3敲低使细胞对5-氟尿嘧啶和吉西他滨敏感,并抑制细胞增殖,菌落形成,移民和入侵。此外,Cul3敲低诱导G0/G1细胞周期阻滞和抑制关键细胞周期调控蛋白,细胞周期蛋白D,细胞周期蛋白依赖性激酶(CDK)4和CDK6。使用癌症基因组图谱数据对CCA患者样品进行的生物信息学分析显示,与正常胆管组织相比,CCA组织中的Cul3上调。对耐药CCA细胞系中上调蛋白的STRING分析确定了一个高度相互作用的Cul3网络,包括COMM结构域包含3,AriadneRBRE3泛素蛋白连接酶1,Egl9同源物1,蛋白酶体26S亚基非ATPase13,DExH盒解旋酶9和小核核糖核蛋白多肽G,与CCA组织中Cul3呈正相关。敲除Cul3显著抑制了这些基因的mRNA表达,这表明Cul3可能充当他们的上游监管者。基因本体论分析显示,这些基因中的大多数被归类为结合功能,代谢过程,细胞解剖实体,含蛋白质的复合物和蛋白质修饰酶。一起来看,这些发现强调了Cul3在CCA耐药和进展中的生物学和临床意义.
    Cholangiocarcinoma (CCA) is an extremely aggressive malignancy arising from the epithelial cells lining the bile ducts. It presents a substantial global health issue, with the highest incidence rates, ranging from 40‑100 cases/100,000 individuals, found in Southeast Asia, where liver fluke infection is endemic. In Europe and America, incidence rates range from 0.4‑2 cases/100,000 individuals. Globally, mortality rates range from 0.2‑2 deaths/100,000 person‑years and are increasing in most countries. Chemotherapy is the primary treatment for advanced CCA due to limited options from late‑stage diagnosis, but its efficacy is hindered by drug‑resistant phenotypes. In a previous study, proteomics analysis of drug‑resistant CCA cell lines (KKU‑213A‑FR and KKU‑213A‑GR) and the parental KKU‑213A line identified cullin 3 (Cul3) as markedly overexpressed in drug‑resistant cells. Cul3, a scaffold protein within CUL3‑RING ubiquitin ligase complexes, is crucial for ubiquitination and proteasome degradation, yet its role in drug‑resistant CCA remains to be elucidated. The present study aimed to elucidate the role of Cul3 in drug‑resistant CCA cell lines. Reverse transcription‑quantitative PCR and western blot analyses confirmed significantly elevated Cul3 mRNA and protein levels in drug‑resistant cell lines compared with the parental control. Short interfering RNA‑mediated Cul3 knockdown sensitized cells to 5‑fluorouracil and gemcitabine and inhibited cell proliferation, colony formation, migration and invasion. In addition, Cul3 knockdown induced G0/G1 cell cycle arrest and suppressed key cell cycle regulatory proteins, cyclin D, cyclin‑dependent kinase (CDK)4 and CDK6. Bioinformatics analysis of CCA patient samples using The Cancer Genome Atlas data revealed Cul3 upregulation in CCA tissues compared with normal bile duct tissues. STRING analysis of upregulated proteins in drug‑resistant CCA cell lines identified a highly interactive Cul3 network, including COMM Domain Containing 3, Ariadne RBR E3 ubiquitin protein ligase 1, Egl nine homolog 1, Proteasome 26S Subunit Non‑ATPase 13, DExH‑box helicase 9 and small nuclear ribonucleoprotein polypeptide G, which showed a positive correlation with Cul3 in CCA tissues. Knocking down Cul3 significantly suppressed the mRNA expression of these genes, suggesting that Cul3 may act as an upstream regulator of them. Gene Ontology analysis revealed that the majority of these genes were categorized under binding function, metabolic process, cellular anatomical entity, protein‑containing complex and protein‑modifying enzyme. Taken together, these findings highlighted the biological and clinical significance of Cul3 in drug resistance and progression of CCA.
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  • 文章类型: Journal Article
    背景:顺铂(CDDP)仍然是治疗肌肉浸润性膀胱癌(MIBC)的关键药物。然而,部分MIBC患者对化疗无反应,这可能是由于CDDP诱导的DNA损伤修复增加所致。这项研究的目的是探讨MIBC患者中参与核苷酸切除修复(NER)和跨损伤DNA合成(TLS)的蛋白质的预后价值。
    方法:这是86例MIBC患者的回顾性分析。XPA,XPF,XPG,ERCC1、POLI、在原发性膀胱肿瘤中对POLH和REV3L蛋白进行染色,并在总队列和接受吉西他滨和CDDP作为一线治疗的转移性尿路上皮癌(mUC)亚组中分析其水平。将两个队列按每种蛋白质染色阳性的癌细胞的百分比分为具有高表达和低表达的亚组。以同样的方式,NER(XPA+ERCC1+XPF+XPG)和TLS(POLI+POLH+REV3L)的组合表达,作为整个路径,被分析。
    结果:中位随访120.2个月时,死亡率为89.5%。在总队列中,肿瘤患者XPA染色阳性,与具有阴性染色的那些相比,XPG和POLI具有显著更差的总体存活(OS)[风险比(HR)分别=0.60、0.62和0.53]。在多变量分析(MVA)中,XPG和POLI均为独立的预后因素。此外,在整个队列中,NER和TLS通路表达的增加与OS恶化显著相关(HR分别为0.54和0.60).在mUC亚组中,单变量分析中,高POLI表达与OS显著恶化相关(HR=0.56),MVA显示其独立预后价值。
    结论:我们的研究表明,XPG和POLI的肿瘤表达之间存在显着相关性,以及NER和TLS作为整个途径,和劣等操作系统。因此,它们可能构成MIBC的预后生物标志物和潜在有希望的治疗靶点.然而,需要进行进一步验证的前瞻性试验,从而克服了本研究的局限性。
    BACKGROUND: Cisplatin (CDDP) remains a key agent in the treatment of muscle-infiltrating bladder carcinoma (MIBC). However, a proportion of MIBC patients do not respond to chemotherapy, which may be caused by the increased repair of CDDP-induced DNA damage. The purpose of this study was to explore the prognostic value of proteins involved in nucleotide excision repair (NER) and translesion DNA synthesis (TLS) in MIBC patients.
    METHODS: This is a retrospective analysis of 86 MIBC patients. The XPA, XPF, XPG, ERCC1, POLI, POLH and REV3L proteins were stained in primary bladder tumors and their levels were analyzed both in the total cohort and in a subgroup with metastatic urothelial carcinoma (mUC) that received gemcitabine and CDDP as a first-line therapy. Both cohorts were divided by percentage of cancer cells stained positive for each protein into subgroups with high and low expression. In the same manner, the combined expression of NER (XPA + ERCC1 + XPF + XPG) and TLS (POLI + POLH + REV3L), as the whole pathways, was analyzed.
    RESULTS: Mortality was 89.5% at the median follow-up of 120.2 months. In the total cohort, patients with tumors stained positive for XPA, XPG and POLI had significantly worse overall survival (OS) compared to those with negative staining [hazard ratio (HR) = 0.60, 0.62 and 0.53, respectively]. Both XPG and POLI were independent prognostic factors in multivariate analyses (MVA). In addition, an increase in NER and TLS pathway expression was significantly associated with worse OS in the total cohort (HR = 0.54 and 0.60, respectively). In the mUC subgroup, high POLI expression was associated with significant deterioration of OS (HR = 0.56) in univariate analyses, and its independent prognostic value was shown in MVA.
    CONCLUSIONS: Our study showed significant correlations between the tumor expression of XPG and POLI, as well as NER and TLS as the whole pathways, and inferior OS. Hence, they could constitute prognostic biomarkers and potentially promising therapeutic targets in MIBC. However, a prospective trial is required for further validation, thereby overcoming the limitations of this study.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    目的:评价新型土贝莫苷I型多功能脂质体联合吉西他滨的抗胰腺癌作用。方法:采用薄膜水化法制备脂质体,对包括封装效率(EE%)在内的参数进行评估,颗粒大小,多分散指数(PDI),zeta电位(ZP),储存稳定性,并在7天内释放。细胞摄取率,评估了体内外治疗效果以及免疫微环境调节的作用。结果:新型土贝莫苷I型多功能脂质体具有良好的稳定性,显著的抗癌活性,和免疫微环境重塑的影响。此外,它显示了安全性。结论:本研究强调了新型TubeimosideI多功能脂质体作为胰腺癌有希望的治疗选择的潜力。
    [方框:见正文]。
    Aim: To evaluate the anti-pancreatic cancer effect of novel Tubeimoside I multifunctional liposomes combined with gemcitabine.Methods: Liposomes were prepared through the thin film hydration method, with evaluations conducted on parameters including encapsulation efficiency (EE%), particle size, polydispersity index (PDI), zeta potential (ZP), storage stability, and release over a 7-day period. The cellular uptake rate, therapeutic efficacy in vitro and in vivo and the role of immune microenvironment modulation were evaluated.Results: The novel Tubeimoside I multifunctional liposomal exhibited good stability, significant anti-cancer activity, and immune microenvironment remodeling effects. Furthermore, it showed a safety profile.Conclusion: This study underscores the potential of Novel Tubeimoside I multifunctional liposomal as a promising treatment option for pancreatic cancer.
    [Box: see text].
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  • 文章类型: Journal Article
    胆管癌(CCA),侵袭性胆道癌,预后严峻,5年生存率为5%-15%。CCA的标准化疗方案,吉西他滨加顺铂(GemCis)或其最近批准的联合用药Durvalumab显示出不良的临床活性,产生12-14个月的中位生存期。增加的5-羟色胺积累和分泌与CCA的致癌活性有关。这项研究调查了泰司他乙酯(TE)的治疗效果,阻断5-羟色胺生物合成的色氨酸羟化酶抑制剂,在临床前CCA模型中与标准化疗相结合。Nab-紫杉醇(NPT)显着提高动物存活率(60%),在腹膜播散异种移植物中,超过TE(11%)或GemCis(9%)的边际效应。将TE与GemCis(26%)或NPT(68%)结合使用可进一步提高生存率。在肝内(iCCA),远端(dCCA)和肺门周围(pCCA)皮下异种移植物,与NPT(56%-69%)或GemCis(37%-58%)相比,TE表现出显著的肿瘤生长抑制(41%-53%)。TE与化疗的组合在所有三种细胞衍生的异种移植物中显示出增强的肿瘤生长抑制(67%-90%)。PDX研究显示,与GemCis(80%-86%)或NPT(57%-76%)相比,TE对肿瘤生长的抑制作用明显(40%-73%)。再一次,TE联合化疗表现出累加效应。在所有CDX和PDX肿瘤中,肿瘤细胞增殖减少与肿瘤生长抑制一致。此外,在所有治疗条件下,TE治疗一致降低了所有肿瘤中的5-羟色胺水平。这项研究决定性地证明了TE在一系列CCA临床前模型中的抗肿瘤功效,这表明涉及TE的联合疗法,特别是对于表现出血清素过度表达的患者,有希望改善临床CCA治疗。
    Cholangiocarcinoma (CCA), an aggressive biliary tract cancer, carries a grim prognosis with a 5-year survival rate of 5%-15%. Standard chemotherapy regimens for CCA, gemcitabine plus cisplatin (GemCis) or its recently approved combination with durvalumab demonstrate dismal clinical activity, yielding a median survival of 12-14 months. Increased serotonin accumulation and secretion have been implicated in the oncogenic activity of CCA. This study investigated the therapeutic efficacy of telotristat ethyl (TE), a tryptophan hydroxylase inhibitor blocking serotonin biosynthesis, in combination with standard chemotherapies in preclinical CCA models. Nab-paclitaxel (NPT) significantly enhanced animal survival (60%), surpassing the marginal effects of TE (11%) or GemCis (9%) in peritoneal dissemination xenografts. Combining TE with GemCis (26%) or NPT (68%) further increased survival rates. In intrahepatic (iCCA), distal (dCCA) and perihilar (pCCA) subcutaneous xenografts, TE exhibited substantial tumour growth inhibition (41%-53%) compared to NPT (56%-69%) or GemCis (37%-58%). The combination of TE with chemotherapy demonstrated enhanced tumour growth inhibition in all three cell-derived xenografts (67%-90%). PDX studies revealed TE\'s marked inhibition of tumour growth (40%-73%) compared to GemCis (80%-86%) or NPT (57%-76%). Again, combining TE with chemotherapy exhibited an additive effect. Tumour cell proliferation reduction aligned with tumour growth inhibition in all CDX and PDX tumours. Furthermore, TE treatment consistently decreased serotonin levels in all tumours under all therapeutic conditions. This investigation decisively demonstrated the antitumor efficacy of TE across a spectrum of CCA preclinical models, suggesting that combination therapies involving TE, particularly for patients exhibiting serotonin overexpression, hold the promise of improving clinical CCA therapy.
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  • 文章类型: Journal Article
    尽管胰腺导管腺癌(PDAC)的全身化疗取得了进展,确保长期生存仍然很困难。关于中性粒细胞与淋巴细胞比值(NLR)在预测PDAC预后中的有用性,但关于全身化疗的报道很少。我们在此研究了NLR在PDAC全身化疗中的有用性。
    对接受一线全身化疗的晚期PDAC患者进行了回顾性研究。进行Cox回归风险模型以分析基线患者特征与初始治疗反应之间的关联。总生存率(OS)。
    共纳入60例PDAC患者。在基线,NLR和糖类抗原19-9(CA19-9)有显著差异,以及联合化疗的选择率,在部分反应或疾病稳定的患者与疾病进展的患者之间。单因素和多因素分析显示NLR<3.10,联合化疗,CA19-9<1011U/mL是初始治疗反应的显著且独立的预测因素。同时,NLR<3.10和联合化疗与较长的OS独立相关。此外,无论联合化疗还是单药治疗,NLR<3.10的患者OS显著延长。基线时NLR<3.10的患者,三线化疗的转化率明显较高,总化疗持续时间较长。
    这项研究表明,NLR可能是预测一线化疗的初始治疗反应和晚期PDAC患者预后的有用标志物。
    UNASSIGNED: Although systemic chemotherapy for pancreatic ductal adenocarcinoma (PDAC) has made progress, ensuring long-term survival remains difficult. There are several reports on the usefulness of neutrophil-to-lymphocyte ratio (NLR) in predicting the prognosis of PDAC, but few reports in systemic chemotherapy. We hereby investigated the usefulness of NLR in systemic chemotherapy for PDAC.
    UNASSIGNED: A retrospective study was conducted on patients with advanced PDAC treated with first-line systemic chemotherapy. Cox regression hazards models were performed to analyze the association between baseline patient characteristics and the initial treatment response, and overall survival (OS).
    UNASSIGNED: A total of 60 patients with PDAC were enrolled. At baseline, there were significant differences in NLR and carbohydrate antigen 19-9 (CA19-9), as well as the selection rate of combination chemotherapy, between patients with partial response or stable disease and those with progressive disease. Univariate and multivariate analysis showed that NLR < 3.10, combination chemotherapy, and CA19-9 < 1011 U/mL were significant and independent predictive factors of the initial treatment response. Meanwhile, NLR < 3.10 and combination chemotherapy were independently associated with longer OS. Moreover, OS was significantly prolonged in patients with NLR < 3.10, regardless of whether combination chemotherapy or monotherapy. Patients with NLR < 3.10 at baseline had a significantly higher conversion rate to third-line chemotherapy and a longer duration of total chemotherapy.
    UNASSIGNED: This study suggests that NLR may be a useful marker for predicting the initial treatment response to first-line chemotherapy and the prognosis for patients with advanced PDAC.
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