gastric cancer

胃癌
  • 文章类型: Journal Article
    目的:癌前化生向异型增生的转变对随后的肠型胃腺癌有风险。然而,从化生向癌细胞转化的分子基础仍然知之甚少。
    方法:对与化生相关的基因进行综合分析,进行了发育不良,通过单细胞RNA测序和免疫染色在患者的胃组织中验证和表征。多个鼠标模型,包括纯合条件性敲除Klhl21-floxed小鼠,被产生以研究Klhl21缺失在干性中的作用,DNA损伤和肿瘤形成。基于质谱的蛋白质组学和核糖体测序用于阐明潜在的分子机制。
    结果:Kelch样蛋白21(KLHL21)在化生中的表达逐渐降低,发育不良和癌症。Klhl21的遗传缺失增强了Mist1细胞及其后代细胞的快速增殖。化生过程中的Klhl21损失有助于通过STAT3信号传导将受损细胞募集到细胞周期中。在缺乏KLHL21的癌细胞中证实了增加的STAT3活性,从而增强了自我更新和致瘤性。机械上,KLHL21的缺失通过稳定PABPC1-eIF4G复合物促进PIK3CBmRNA翻译,随后引起STAT3激活。TTI-101对STAT3的药理学抑制引发了抗癌作用,有效地阻碍了从化生到异型增生的过渡。在胃癌患者中,低水平的KLHL21的生存率较短,对辅助化疗的反应较差.
    结论:我们的发现强调KLHL21缺失通过PABPC1介导的PIK3CB翻译激活触发STAT3再激活,靶向STAT3可以逆转KLHL21缺陷型胃的瘤前化生。
    OBJECTIVE: Precancerous metaplasia transition to dysplasia poses a risk for subsequent intestinal-type gastric adenocarcinoma. However, the molecular basis underlying the transformation from metaplastic to cancerous cells remains poorly understood.
    METHODS: An integrated analysis of genes associated with metaplasia, dysplasia was conducted, verified and characterised in the gastric tissues of patients by single-cell RNA sequencing and immunostaining. Multiple mouse models, including homozygous conditional knockout Klhl21-floxed mice, were generated to investigate the role of Klhl21 deletion in stemness, DNA damage and tumour formation. Mass-spectrometry-based proteomics and ribosome sequencing were used to elucidate the underlying molecular mechanisms.
    RESULTS: Kelch-like protein 21 (KLHL21) expression progressively decreased in metaplasia, dysplasia and cancer. Genetic deletion of Klhl21 enhances the rapid proliferation of Mist1+ cells and their descendant cells. Klhl21 loss during metaplasia facilitates the recruitment of damaged cells into the cell cycle via STAT3 signalling. Increased STAT3 activity was confirmed in cancer cells lacking KLHL21, boosting self-renewal and tumourigenicity. Mechanistically, the loss of KLHL21 promotes PIK3CB mRNA translation by stabilising the PABPC1-eIF4G complex, subsequently causing STAT3 activation. Pharmacological STAT3 inhibition by TTI-101 elicited anticancer effects, effectively impeding the transition from metaplasia to dysplasia. In patients with gastric cancer, low levels of KLHL21 had a shorter survival rate and a worse response to adjuvant chemotherapy.
    CONCLUSIONS: Our findings highlighted that KLHL21 loss triggers STAT3 reactivation through PABPC1-mediated PIK3CB translational activation, and targeting STAT3 can reverse preneoplastic metaplasia in KLHL21-deficient stomachs.
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  • 文章类型: Journal Article
    鉴于胃癌的恶性程度,开发高效低毒的靶向药物对于延长患者生存期和改善患者预后至关重要.在这项研究中,我们基于苯并咪唑支架进行了结构优化。值得注意的是,化合物8f在MGC803细胞中表现出最有效的抗增殖活性,并在G0/G1期诱导细胞周期停滞。进一步的机制研究表明,化合物8f通过升高细胞内活性氧(ROS)水平和激活丝裂原活化蛋白激酶(MAPK)信号通路引起MGC803细胞凋亡,伴随着相应的标记变化。体内研究还验证了化合物8f对携带MGC803细胞的异种移植模型中的肿瘤生长的抑制作用,而没有明显的毒性。我们的研究表明,化合物8f有望成为开发抗胃癌药物的潜在且安全的先导化合物。
    Given the malignancy of gastric cancer, developing highly effective and low-toxic targeted drugs is essential to prolong patient survival and improve patient outcomes. In this study, we conducted structural optimizations based on the benzimidazole scaffold. Notably, compound 8 f presented the most potent antiproliferative activity in MGC803 cells and induced cell cycle arrest at the G0/G1 phase. Further mechanistic studies demonstrated that compound 8 f caused the apoptosis of MGC803 cells by elevating intracellular reactive oxygen species (ROS) levels and activating the mitogen-activated protein kinase (MAPK) signaling pathway, accompanied by corresponding markers change. In vivo investigations additionally validated the inhibitory effect of compound 8 f on tumor growth in xenograft models bearing MGC803 cells without obvious toxicity. Our studies suggest that compound 8 f holds promise as a potential and safe lead compound for developing anti-gastric cancer agents.
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  • 文章类型: Systematic Review
    预后营养指数(PNI)已成为评估患者营养状况和免疫能力的重要预测工具。它广泛用于各种癌症患者的预后评估。然而,在接受免疫检查点抑制剂(ICIs)治疗的胃癌或胃食管交界处癌(GC/GEJC)患者中,预后营养指数(PNI)的预后相关性尚不清楚.这项荟萃分析旨在确定PNI在该特定患者队列中的预后影响。
    我们进行了彻底的文献检索,涵盖诸如PubMed之类的著名数据库,Embase,WebofScience,SpringerLink,还有Cochrane图书馆.搜索从这些数据库开始到2023年12月5日。采用95%置信区间和危险比(HR),该研究系统地评估了PNI与关键预后指标之间的关系,包括客观缓解率(ORR),疾病控制率(DCR),接受ICI治疗的GC/GEJC患者的总生存期(OS)和无进展生存期(PFS).
    选择了包含813名合格患者的8项研究。有7项研究一致证明高预后营养指数(PNI)组的总生存率(OS)优于低PNI组(HR0.58,95%CI:0.47-0.71,P<0.001)。此外,来自6项研究的结果指出,低PNI与较差的无进展生存期(PFS)之间存在显着相关性(HR0.58,95%CI:0.47-0.71,P<0.001)。进行亚组分析以验证结果的稳健性。此外,我们对三项研究PNI与客观缓解率/疾病控制率(ORR/DCR)之间的相关性进行了荟萃分析,发现高PNI组的ORR/DCR显著优于高PNI组(ORR:RR:1.24,P=0.002;DCR:RR:1.43,P=0.008).
    这项荟萃分析表明,接受ICI治疗的GC/GEJC患者的低PNI与OS和PFS恶化显著相关。因此,PNI可以作为接受ICI的GC患者治疗后预后指标。需要进一步的前瞻性研究来评估这些发现的可靠性。
    https://inplasy.com/,标识符INPLASY202450133。
    UNASSIGNED: The Prognostic Nutritional Index (PNI) has become an important predictive tool for assessing patients\' nutritional status and immune competence. It is widely used in prognostic evaluations for various cancer patients. However, the prognostic relevance of the Prognostic Nutritional Index (PNI) in gastric or gastro-esophageal junction cancer patients (GC/GEJC) undergoing immune checkpoint inhibitors (ICIs) treatment remains unclear. This meta-analysis aimed to determine the prognostic impact of PNI in this specific patient cohort.
    UNASSIGNED: We conducted a thorough literature search, covering prominent databases such as PubMed, Embase, Web of Science, SpringerLink, and the Cochrane Library. The search spanned from the inception of these databases up to December 5, 2023. Employing the 95% confidence interval and Hazard Ratio (HR), the study systematically evaluated the relationship between PNI and key prognostic indicators, including the objective remission rate (ORR), disease control rate (DCR), overall survival (OS) and progression-free survival (PFS) in GC/GEJC patients undergoing ICI treatment.
    UNASSIGNED: Eight studies comprising 813 eligible patients were selected. With 7 studies consistently demonstrating superior Overall Survival (OS) in the high-Prognostic Nutritional Index (PNI) group compared to their low-PNI counterparts (HR 0.58, 95% CI: 0.47-0.71, P<0.001). Furthermore, the results derived from 6 studies pointed out that the significant correlation between he low-PNI and poorer progression-free survival (PFS) (HR 0.58, 95% CI: 0.47-0.71, P<0.001). Subgroup analyses were performed to validate the robustness of the results. In addition, we conducted a meta-analysis of three studies examining the correlation between PNI and objective response rate/disease control rate (ORR/DCR) and found that the ORR/DCR was significantly superior in the high PNI group (ORR: RR: 1.24, P=0.002; DCR: RR: 1.43, P=0.008).
    UNASSIGNED: This meta-analysis indicates that the low-PNI in GC/GEJC patients undergoing ICI treatment is significantly linked to worse OS and PFS. Therefore, PNI can serve as a prognostic indicator of post-treatment outcomes in patients with GC receiving ICIs. Further prospective studies are required to assess the reliability of these findings.
    UNASSIGNED: https://inplasy.com/, identifier INPLASY202450133.
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  • 文章类型: Journal Article
    背景:绝大多数lncRNAs具有低表达丰度,这极大地限制了它们的功能范围和影响。作为一种高表达丰度的lncRNA,FGD5-AS1在癌症中的非ceRNA生物学功能尚不清楚。
    方法:进行RNA-seq研究和染色质免疫沉淀(Chip)测定以鉴定ZEB1调节的lncRNA。RNA测序,RNA下拉,RNA免疫沉淀试验,并对FGD5-AS1在GC中的分子机制进行了研究。
    结果:作为细胞中最丰富的lncRNAs之一,FGD5-AS1已被ZEB1转录激活,因此与上皮-间质转化(EMT)信号传导密切相关。临床分析显示,FGD5-AS1过表达与淋巴结转移相关,并预测GC的存活率低。功能丧失研究证实,FGD5-AS1敲低抑制GC增殖并诱导顺铂化学敏感性,细胞衰老,和GC细胞中的DNA损伤。机械上,FGD5-AS1是一种结合YBX1的lncRNA,因为其mRNA包含三个相邻的结构基序(UAAUCCCA,ACCAGCCU,和CAGUGAGC)可以被YBX1识别和绑定。这种RNA-蛋白质相互作用延长了YBX1蛋白在GC中的半衰期。此外,拯救实验表明,FGD5-AS1通过抑制YBX1细胞衰老和ROS产生来促进GC。
    结论:FGD5-AS1是一种由ZEB1转录调控的细胞高丰度lncRNA。FGD5-AS1过表达通过结合和稳定YBX1蛋白抑制细胞衰老和ROS产生来促进GC进展。
    BACKGROUND: The vast majority of lncRNAs have low expression abundance, which greatly limits their functional range and impact. As a high expression abundance lncRNA, FGD5-AS1\'s non-ceRNA biological function in cancer is unclear.
    METHODS: RNA-seq studies and chromatin immunoprecipitation (Chip) assays were performed to identify ZEB1-regulated lncRNAs. RNA sequencing, RNA pulldown, RNA Immunoprecipitation assays, and rescue assays were conducted to explore the molecular mechanisms of FGD5-AS1 in GC.
    RESULTS: As one of the most abundant lncRNAs in cells, FGD5-AS1 has been shown to be transcriptionally activated by ZEB1, thus closely related to epithelial-mesenchymal transition (EMT) signaling. Clinical analysis showed that FGD5-AS1 overexpression was clinically associated with lymph node metastasis, and predicted poor survival in GC. Loss-of-function studies confirmed that FGD5-AS1 knockdown inhibited GC proliferation and induced cisplatin chemosensibility, cell senescence, and DNA damage in GC cells. Mechanismically, FGD5-AS1 is a YBX1-binding lncRNA due to its mRNA contains three adjacent structural motifs (UAAUCCCA, ACCAGCCU, and CAGUGAGC) that can be recognized and bound by YBX1. And this RNA-protein interaction prolonged the half-life of the YBX1 protein in GC. Additionally, a rescue assay showed that FGD5-AS1 promotes GC by repressing cell senescence and ROS production via YBX1.
    CONCLUSIONS: FGD5-AS1 is a cellular high-abundant lncRNA that is transcriptionally regulated by ZEB1. FGD5-AS1 overexpression promoted GC progression by inhibiting cell senescence and ROS production through binding and stabilizing the YBX1 protein.
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  • 文章类型: Journal Article
    在这项研究中,我们的目的是探讨中性粒细胞与淋巴细胞比率(NLR)之间的关系,血小板与淋巴细胞比率(PLR),全身免疫炎症指数(SII),淋巴细胞与单核细胞比率(LMR)和预后营养指数(PNI)与胃癌远处转移的关系,并建立了筛选远处转移患者的有效列线图。共纳入1281例胃癌住院患者,分为训练集和验证集。单变量,采用Lasso回归和多因素Logistic回归分析确定远处转移的危险因素。然后将独立预测因子纳入列线图模型。通过受试者工作特征(ROC)曲线评估列线图的预测性能和临床实用性,校准曲线和决策曲线分析。多因素Logistic回归分析确定D-二聚体,CA199、CA125、NLR和PNI为独立预测因子。基于这些因素的列线图曲线下面积在训练队列中为0.838,在验证队列中为0.811。校准图和决策曲线表明列线图在训练和验证队列中具有良好的预测性能和临床实用性。因此,我们的列线图可能是临床医生筛查有远处转移的胃癌患者的重要工具.
    In this study, We aim to explore the association between the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), lymphocyte to monocyte ratio (LMR) and prognostic nutritional index (PNI) and distant metastasis of gastric cancer and develop an efficient nomogram for screening patients with distant metastasis. A total of 1281 inpatients with gastric cancer were enrolled and divided into the training and validation set.Univariate, Lasso regression and Multivariate Logistic Regression Analysis was used to identify the risk factors of distant metastasis. The independent predictive factors were then enrolled in the nomogram model. The nomogram\'s predictive perform and clinical practicality was evaluated by receiver operating characteristics (ROC) curves, calibration curves and decision curve analysis. Multivariate Logistic Regression Analysis identified D-dimer, CA199, CA125, NLR and PNI as independent predictive factors. The area under the curve of our nomogram based on these factors was 0.838 in the training cohort and 0.811 in the validation cohort. The calibration plots and decision curves demonstrated the nomogram\'s good predictive performance and clinical practicality in both training and validation cohort. Therefore,our nomogram could be an important tool for clinicians in screening gastric cancer patients with distant metastasis.
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  • 文章类型: Journal Article
    化疗的疗效在胃癌(GC)患者中差异显著,目前尚无预测化疗结果的有效策略。在这项研究中,我们成功地从73例GC患者(78%)中建立了57例GC患者来源的类器官(PDO)。这些类器官保留了其相应的原代GC组织的组织学特征。GCPDO对不同的化疗药物显示出不同的反应。通过RNA测序,在5-氟尿嘧啶(FU)-或奥沙利铂敏感的类器官中鉴定出肿瘤抑制基因/途径的上调,而与增殖和侵袭相关的基因/途径在化疗耐药的类器官中富集。基因表达生物标志物面板,可以区分对5-FU和奥沙利铂敏感和耐药的患者(剂量反应曲线下面积[AUC]>0.8),被识别。此外,PDO的药物反应结果在基于患者来源的类器官的异种移植(PDOX)小鼠中得到验证,与91.7%(11/12)的GC患者的实际临床反应一致.评估PDO中的化学敏感性可用作筛选GC患者化疗药物的有价值的工具。
    The efficacy of chemotherapy varies significantly among patients with gastric cancer (GC), and there is currently no effective strategy to predict chemotherapeutic outcomes. In this study, we successfully establish 57 GC patient-derived organoids (PDOs) from 73 patients with GC (78%). These organoids retain histological characteristics of their corresponding primary GC tissues. GC PDOs show varied responses to different chemotherapeutics. Through RNA sequencing, the upregulation of tumor suppression genes/pathways is identified in 5-fluorouracil (FU)- or oxaliplatin-sensitive organoids, whereas genes/pathways associated with proliferation and invasion are enriched in chemotherapy-resistant organoids. Gene expression biomarker panels, which could distinguish sensitive and resistant patients to 5-FU and oxaliplatin (area under the dose-response curve [AUC] >0.8), are identified. Moreover, the drug-response results in PDOs are validated in patient-derived organoids-based xenograft (PDOX) mice and are consistent with the actual clinical response in 91.7% (11/12) of patients with GC. Assessing chemosensitivity in PDOs can be utilized as a valuable tool for screening chemotherapeutic drugs in patients with GC.
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  • 文章类型: Journal Article
    F11受体(F11R)基因编码的连接粘附分子A与胃癌(GC)和结直肠癌(CRC),其中它的作用和调节还有待进一步阐明。最近F11R也被鉴定为由作用于RNA的腺苷脱氨酶(ADAR)介导的腺苷转肌苷(A-至-I)的潜在靶标。在这里,使用RNA-Seq和实验验证,我们目前的研究揭示了一个由ADAR过度编辑的F11RRNA三核苷酸,其在四个GC和三个CRC队列中的基因表达调控和临床意义。我们的结果在AluSg中发现了一个过度编辑的AAA三核苷酸,位于F11R3'-非翻译区(3'-UTR),结果显示,在我们的研究中,所有GC和CRC队列中编辑水平与ADAR表达升高相关。ADAR在GC和CRC细胞中的过表达和敲减,然后是RNA-Seq和Sanger测序,证实了ADAR介导的F11R3'-UTR三核苷酸编辑,它可能破坏了通过交联免疫沉淀测序(CLIP-seq)鉴定的RBM45结合位点,并在荧光素酶报告基因测定中调节了F11R的表达。此外,F11R三核苷酸编辑在GC和CRC队列中对GC和CRC的诊断显示有前景的预测性能.因此,我们的发现突出了ADAR编辑的F11R三核苷酸在GC和CRC中的潜在生物学和临床意义。为其作为两种癌症的新型诊断生物标志物的应用提供了新的见解。
    The F11 receptor (F11R) gene encoding junctional adhesion molecule A has been associated with gastric cancer (GC) and colorectal cancer (CRC), in which its role and regulation remain to be further elucidated. Recently F11R was also identified as a potential target of adenosine-to-inosine (A-to-I) mediated by the adenosine deaminases acting on RNA (ADARs). Herein, using RNA-Seq and experimental validation, our current study revealed an F11R RNA trinucleotide over-edited by ADAR, with its regulation of gene expression and clinical significance in four GC and three CRC cohorts. Our results found an over-edited AAA trinucleotide in an AluSg located in the F11R 3\'-untranslated region (3\'-UTR), which showed editing levels correlated with elevated ADAR expression across all GC and CRC cohorts in our study. Overexpression and knockdown of ADAR in GC and CRC cells, followed by RNA-Seq and Sanger sequencing, confirmed the ADAR-mediated F11R 3\'-UTR trinucleotide editing, which potentially disrupted an RBM45 binding site identified by crosslinking immunoprecipitation sequencing (CLIP-seq) and regulated F11R expression in luciferase reporter assays. Moreover, the F11R trinucleotide editing showed promising predictive performance for diagnosing GC and CRC across GC and CRC cohorts. Our findings thus highlight both the potential biological and clinical significance of an ADAR-edited F11R trinucleotide in GC and CRC, providing new insights into its application as a novel diagnostic biomarker for both cancers.
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  • 文章类型: Journal Article
    背景:长链非编码RNA(lncRNA)有助于胃癌(GC)的发生和发展。这项研究的目的是研究lncRNA结直肠肿瘤差异表达(CRNDE)在通过抑制GC中的miR-136-5p调节迁移和侵袭增强子1(MIEN1)表达中的潜在作用。方法:CRNDE的生物学作用,miR-136-5p,在实验室环境中和通过临床样本检查评估GC中的MIEN1。结果:发现GC组织中CRNDE明显增加,这种上调与GC患者的预后不良有关。体外实验表明,抑制细胞生长和迁移,在促进GC细胞凋亡的同时,可以通过禁用CRNDE或MIEN1,或通过增加miR-136-5p的表达来实现。MIEN1是miR-136-5p的特定受体,miR-136-5p的抗癌作用可以通过增加MIEN1的表达来抵消。通过对临床标本的检查,已经观察到MIEN1的表达与CRNDE之间存在显着正相关。相比之下,miR-136-5p在GC组织中的表达呈负相干。结论:先前未探索的GC治疗靶标涉及CRNDE/miR-136-5p/MIEN1信号转导级联。
    Background: Long noncoding RNAs (lncRNAs) contribute to the initiation and progression of gastric cancer (GC). The purpose of this study is to examine the potential role of lncRNA colorectal neoplasia differentially expressed (CRNDE) in modulating the expression of migration and invasion enhancer 1 (MIEN1) through the suppression of miR-136-5p in GC. Methods: The biological roles of CRNDE, miR-136-5p, and MIEN1 in GC were assessed both in laboratory settings and through the examination of clinical samples. Results: CRNDE was found to be significantly increased in GC tissues, and this upregulation was associated with an unfavorable prognosis of GC patients. In vitro experiments showed that inhibiting cell growth and migration, along with promoting apoptosis in GC cells, could be achieved by either disabling CRNDE or MIEN1, or by increasing the expression of miR-136-5p. MIEN1 is a specific recipient of miR-136-5p, and the anticancer effects of miR-136-5p can be counteracted by the increased expression of MIEN1. Through the examination of clinical specimens, it has been observed that there is a significant positive correlation between the expression of MIEN1 and CRNDE. In contrast, miR-136-5p expression in GC tissues shows a negative correlation. Conclusion: A previously unexplored therapeutic target for GC involves the CRNDE/miR-136-5p/MIEN1 signal transduction cascade.
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  • 文章类型: Journal Article
    胃肠道(GI)癌症是全球主要的健康负担,占所有癌症诊断的20%和全球癌症相关死亡的22.5%。他们的侵略性和对治疗的抵抗力构成了重大挑战,5年晚期生存率低于15%。因此,迫切需要深入研究胃肠道肿瘤进展的机制并优化治疗策略.越来越多的证据强调了花生四烯酸(AA)代谢异常在各种癌症中的积极参与。AA是一种脂肪酸,主要通过三种酶代谢成不同的生物活性化合物:环氧合酶,脂氧合酶,和细胞色素P450酶。AA代谢异常及其代谢产物水平的改变可能在胃肠道癌症的发展中起关键作用。然而,潜在机制尚不清楚.这篇综述通过关注AA的异常代谢及其在胃肠道癌症中的参与,突出了一个独特的观点。我们总结了了解胃肠道癌症中AA代谢的最新进展,概述AA水平的变化及其在肝脏中的潜在作用,结直肠,胰腺,食道,胃,和胆囊癌。此外,我们还探讨了针对AA代谢异常的未来治疗的潜力,考虑到目前需要探索胃肠道癌症中的AA代谢,并概述了进一步研究的有希望的途径。最终,这些研究旨在改善胃肠道癌症患者的治疗选择,并为该领域更好的癌症管理铺平道路.
    Gastrointestinal (GI) cancers are a major global health burden, representing 20% of all cancer diagnoses and 22.5% of global cancer-related deaths. Their aggressive nature and resistance to treatment pose a significant challenge, with late-stage survival rates below 15% at five years. Therefore, there is an urgent need to delve deeper into the mechanisms of gastrointestinal cancer progression and optimize treatment strategies. Increasing evidence highlights the active involvement of abnormal arachidonic acid (AA) metabolism in various cancers. AA is a fatty acid mainly metabolized into diverse bioactive compounds by three enzymes: cyclooxygenase, lipoxygenase, and cytochrome P450 enzymes. Abnormal AA metabolism and altered levels of its metabolites may play a pivotal role in the development of GI cancers. However, the underlying mechanisms remain unclear. This review highlights a unique perspective by focusing on the abnormal metabolism of AA and its involvement in GI cancers. We summarize the latest advancements in understanding AA metabolism in GI cancers, outlining changes in AA levels and their potential role in liver, colorectal, pancreatic, esophageal, gastric, and gallbladder cancers. Moreover, we also explore the potential of targeting abnormal AA metabolism for future therapies, considering the current need to explore AA metabolism in GI cancers and outlining promising avenues for further research. Ultimately, such investigations aim to improve treatment options for patients with GI cancers and pave the way for better cancer management in this area.
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  • 文章类型: Journal Article
    抗体-药物偶联物(ADC)是胃癌靶向治疗的重要组成部分,可能改变传统的治疗模式。许多ADC已经进入基于生物学理论和临床前实验的严格临床试验。还与单克隆抗体疗法结合进行了模态试验,化疗,免疫疗法,和其他治疗方法的疗效增强药物的协调作用。然而,ADC在治疗胃癌方面表现出局限性,包括由其结构或其他因素引发的阻力。正在进行的深入研究和临床前实验正在产生改进,虽然在治疗期间药物开发过程和伴随诊断的增强积极地提高ADC功效。胃癌患者的最佳治疗策略正在不断发展。本文就ADCs治疗胃癌的临床进展作一综述,分析ADC联合治疗的机制,讨论阻力模式,并为ADC药物开发和伴随诊断的未来应用提供了有希望的前景。
    Antibody-drug conjugates (ADCs) represent a crucial component of targeted therapies in gastric cancer, potentially altering traditional treatment paradigms. Many ADCs have entered rigorous clinical trials based on biological theories and preclinical experiments. Modality trials have also been conducted in combination with monoclonal antibody therapies, chemotherapies, immunotherapies, and other treatments to enhance the efficacy of drug coordination effects. However, ADCs exhibit limitations in treating gastric cancer, including resistance triggered by their structure or other factors. Ongoing intensive researches and preclinical experiments are yielding improvements, while enhancements in drug development processes and concomitant diagnostics during the therapeutic period actively boost ADC efficacy. The optimal treatment strategy for gastric cancer patients is continually evolving. This review summarizes the clinical progress of ADCs in treating gastric cancer, analyzes the mechanisms of ADC combination therapies, discusses resistance patterns, and offers a promising outlook for future applications in ADC drug development and companion diagnostics.
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