Cancer treatment

癌症治疗
  • 文章类型: Journal Article
    抗体-药物缀合物(ADC)已经成为一类有前途的抗癌剂。目前,美国食品和药物管理局已经批准了12种化合物,2后来退出。此外,其他几种化合物目前正在不同阶段的临床开发中。尽管在不同类型的肿瘤中观察到了大量的抗肿瘤活性,不良事件和耐药性的发展是其使用中的重大挑战。在过去的几年里,越来越多的临床试验已经测试这些药物与其他抗癌剂的不同组合,比如传统的化疗,免疫检查点抑制剂,单克隆抗体,和小目标特工,报告基于可能的协同作用和不同肿瘤类型之间改善治疗结果的潜力的有希望的结果.在这里,我们将回顾ADC与其他抗肿瘤剂的组合,旨在描述当前的技术水平和未来的方向。
    Antibody-drug conjugates (ADCs) have emerged as a promising class of anticancer agents. Currently, the Food and Drug Administration has granted approval to 12 compounds, with 2 later undergoing withdrawal. Moreover, several other compounds are currently under clinical development at different stages. Despite substantial antitumoral activity observed among different tumor types, adverse events and the development of resistance represent significant challenges in their use. Over the last years, an increasing number of clinical trials have been testing these drugs in different combinations with other anticancer agents, such as traditional chemotherapy, immune checkpoint inhibitors, monoclonal antibodies, and small targeted agents, reporting promising results based on possible synergistic effects and a potential for improved treatment outcomes among different tumor types. Here we will review combinations of ADCs with other antitumor agents aiming at describing the current state of the art and future directions.
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  • 文章类型: Journal Article
    免疫检查点抑制剂(ICI)被认为是某些癌症的新型治疗方式。由于其显著的功效和对生存率的影响,它们可能很快被广泛使用,甚至作为癌症治疗的一线选择。特别是在晚期转移性癌症的病例中。值得注意的是,这些药物可能揭示新的自身免疫性疾病,并导致先前存在的自身免疫性疾病的爆发。近年来,该领域的数据已经积累。早期检测和协作方法是,因此,对于患有任何这些疾病的患者的管理至关重要。在这里,我们报道了1例诊断为转移性肾细胞癌的患者,其在nivolumab治疗期间表现为主动脉血管炎.在这种情况下,我们的目的是根据文献提高风湿病学家对ICI相关血管炎的认识。
    Immune-checkpoint inhibitors (ICIs) are considered as the novel treatment modality in certain cancers. They may soon be used widely even as the first-line option for cancer treatment due to their remarkable efficacies and impacts on survival rates, particularly in cases of advanced metastatic cancer. Of note, these agents might unveil new autoimmune diseases as well as causing flare-ups of a pre-existing autoimmune disease. Data in this field have been accumulated during recent years. Early detection and a collaborative approach are, therefore, crucial in the management of a patient who presents with any of these conditions. Herein, we report a patient with a diagnosis of metastatic renal cell cancer presented with vasculitis involvement in the aorta during nivolumab treatment. Our aim with this case is to increase the awareness of ICI-related vasculitis involvement among rheumatologists in the light of literature.
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  • 文章类型: Journal Article
    缺氧诱导因子2α(HIF-2α)是在缺氧条件下调节细胞反应的关键转录因子。在氧气供应不足或VonHippel-Lindau(VHL)突变的患者中,HIF-2α积累并与芳基烃受体核转运蛋白形成异二聚体复合物(ARNT,或HIF-β)。该复合物进一步与共激活因子p300结合,并与下游靶基因DNA上的缺氧反应元件(HREs)相互作用,调节多种基因的转录(例如VEGFA,CCND1,CXCR4,SLC2A1等)参与各种过程,如血管生成,线粒体代谢,细胞增殖,和转移。靶向HIF-2α对于有效解决与异常氧传感通路和缺氧机制相关的实体瘤具有巨大的前景。具有广阔的应用前景。在这次审查中,我们概述了HIF-2α调节剂如抑制剂的最新进展(2009-2024年),激动剂,和癌症治疗的降解剂。此外,我们详细讨论了关于HIF-2α调节剂的挑战和未来方向。
    Hypoxia-inducible factor 2α (HIF-2α) is a critical transcription factor that regulates cellular responses under hypoxic conditions. In situations of insufficient oxygen supply or patients with Von Hippel-Lindau (VHL) mutations, HIF-2α accumulates and forms a heterodimeric complex with aryl hydrocarbon receptor nuclear translocator (ARNT, or HIF-β). This complex further binds to coactivator p300 and interacts with hypoxia response elements (HREs) on the DNA of downstream target genes, regulating the transcription of a variety of genes (e.g. VEGFA, CCND1, CXCR4, SLC2A1, etc) involved in various processes like angiogenesis, mitochondrial metabolism, cell proliferation, and metastasis. Targeting HIF-2α holds great promise for effectively addressing solid tumors associated with aberrant oxygen-sensing pathways and hypoxia mechanisms, offering broad application prospects. In this review, we provide an overview of recent advancements (2009-2024) in HIF-2α modulators such as inhibitors, agonists, and degraders for cancer therapy. Additionally, we discuss in detail the challenges and future directions regarding HIF-2α modulators.
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  • 文章类型: Journal Article
    关于保留生育力的立场声明是通过儿科血液学/肿瘤学护士协会之间的合作努力产生的,加拿大肿瘤学护士协会/加拿大协会。
    The position statement on fertility preservation was produced through collaborative efforts among the Association of Pediatric Hematology/Oncology Nurses, Canadian Association of Nurses in Oncology/Association canadienne des.
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  • 文章类型: Journal Article
    简介:协同用药,癌症治疗的关键治疗策略,涉及结合多种药物以增强治疗效果和减轻副作用。当前的研究主要采用深度学习模型从细胞系和癌症药物结构数据中提取特征。然而,这些方法往往忽略了数据中复杂的非线性关系,忽略基因表达数据在多维空间中的分布特征和加权概率密度。它也未能充分利用癌症药物的结构信息和药物分子之间的潜在相互作用。方法:为了克服这些挑战,我们引入了专门为癌症药物量身定制的创新端到端学习模式,图协同表示网络(DKPEGraphSYN)的双核密度和位置编码(DKPE)。该模型被设计用于改进癌症中药物组合协同作用的预测。DKPE-GraphSYN利用双核密度估计和位置编码技术,有效捕获基因表达的加权概率密度和空间分布信息,同时通过图神经网络探索癌症药物分子之间的相互作用和潜在关系。结果:实验结果表明,我们的预测模型在全面的癌症药物和细胞系协同数据集上预测药物协同作用方面取得了显着的性能增强,实现0.969的AUPR和0.976的AUC。讨论:这些结果证实了我们的模型在预测癌症药物组合方面的卓越准确性,为癌症的临床用药策略提供了一种支持方法。
    Introduction: Synergistic medication, a crucial therapeutic strategy in cancer treatment, involves combining multiple drugs to enhance therapeutic effectiveness and mitigate side effects. Current research predominantly employs deep learning models for extracting features from cell line and cancer drug structure data. However, these methods often overlook the intricate nonlinear relationships within the data, neglecting the distribution characteristics and weighted probability densities of gene expression data in multi-dimensional space. It also fails to fully exploit the structural information of cancer drugs and the potential interactions between drug molecules. Methods: To overcome these challenges, we introduce an innovative end-to-end learning model specifically tailored for cancer drugs, named Dual Kernel Density and Positional Encoding (DKPE) for Graph Synergy Representation Network (DKPEGraphSYN). This model is engineered to refine the prediction of drug combination synergy effects in cancer. DKPE-GraphSYN utilizes Dual Kernel Density Estimation and Positional Encoding techniques to effectively capture the weighted probability density and spatial distribution information of gene expression, while exploring the interactions and potential relationships between cancer drug molecules via a graph neural network. Results: Experimental results show that our prediction model achieves significant performance enhancements in forecasting drug synergy effects on a comprehensive cancer drug and cell line synergy dataset, achieving an AUPR of 0.969 and an AUC of 0.976. Discussion: These results confirm our model\'s superior accuracy in predicting cancer drug combinations, providing a supportive method for clinical medication strategy in cancer.
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  • 文章类型: Journal Article
    背景:免疫检查点抑制剂(ICI)通常用于晚期透明细胞肾细胞癌(ccRCC)。然而,大量患者对ICI治疗无反应.辐射是增加ICI应答率的有希望的方法,因为它可以产生抗肿瘤免疫。靶向放射性核素治疗(TRT)是一种全身放射治疗,非常适合转移癌症的精确照射。因此,本研究的目的是探索联合TRT的潜力,靶向在ccRCC中过表达的碳酸酐酶IX(CAIX),使用[177Lu]Lu-DOTA-hG250和ICI治疗ccRCC。方法:在本研究中,我们评估了[177Lu]Lu-DOTA-hG250联合aPD-1/a-CTLA-4ICI的治疗和免疫学作用。首先,在携带Renca-CAIX或CT26-CAIX肿瘤的BALB/cAnNRj小鼠中研究了[177Lu]Lu-DOTA-hG250的生物分布。Renca-CAIX和CT26-CAIX肿瘤的特征是T细胞浸润差和广泛的T细胞浸润,PD-L1表达同质和异质。分别。通过剂量学估计肿瘤吸收的辐射剂量。随后,[177Lu]通过监测肿瘤生长和存活来评估有和没有ICI的Lu-DOTA-hG250TRT功效。通过收集治疗前和治疗后5或8天的肿瘤组织来研究治疗诱导的肿瘤微环境变化,并通过免疫组织化学进行分析。流式细胞术,和RNA分析。结果:生物分布研究显示[177Lu]Lu-DOTA-hG250在两种肿瘤模型中的高肿瘤摄取。Renca-CAIX荷瘤小鼠的剂量递增治疗研究表明[177Lu]Lu-DOTA-hG250的剂量依赖性抗肿瘤功效和显着的治疗协同作用,包括假定的亚治疗TRT剂量时的完全缓解(4MBq,作为单一疗法没有明显疗效)与aPD-1+aCTLA-4联合使用。对于4MBq[177Lu]Lu-DOTA-hG250+a-PD1,在CT26-CAIX模型中获得了类似的结果。治疗肿瘤的离体分析显示DNA损伤,T细胞浸润,并调节联合治疗后TME中的免疫信号通路。结论:亚治疗[177Lu]Lu-DOTA-hG250联合ICI显示出更好的治疗效果,并显着改变了TME。我们的结果强调了在临床环境中对晚期ccRCC患者进行这种联合治疗的重要性。进一步的研究应集中在未来如何最佳地应用联合疗法。
    Background: Immune checkpoint inhibitors (ICI) are routinely used in advanced clear cell renal cell carcinoma (ccRCC). However, a substantial group of patients does not respond to ICI therapy. Radiation is a promising approach to increase ICI response rates since it can generate anti-tumor immunity. Targeted radionuclide therapy (TRT) is a systemic radiation treatment, ideally suited for precision irradiation of metastasized cancer. Therefore, the aim of this study is to explore the potential of combined TRT, targeting carbonic anhydrase IX (CAIX) which is overexpressed in ccRCC, using [177Lu]Lu-DOTA-hG250, and ICI for the treatment of ccRCC. Methods: In this study, we evaluated the therapeutic and immunological action of [177Lu]Lu-DOTA-hG250 combined with aPD-1/a-CTLA-4 ICI. First, the biodistribution of [177Lu]Lu-DOTA-hG250 was investigated in BALB/cAnNRj mice bearing Renca-CAIX or CT26-CAIX tumors. Renca-CAIX and CT26-CAIX tumors are characterized by poor versus extensive T-cell infiltration and homogeneous versus heterogeneous PD-L1 expression, respectively. Tumor-absorbed radiation doses were estimated through dosimetry. Subsequently, [177Lu]Lu-DOTA-hG250 TRT efficacy with and without ICI was evaluated by monitoring tumor growth and survival. Therapy-induced changes in the tumor microenvironment were studied by collection of tumor tissue before and 5 or 8 days after treatment and analyzed by immunohistochemistry, flow cytometry, and RNA profiling. Results: Biodistribution studies showed high tumor uptake of [177Lu]Lu-DOTA-hG250 in both tumor models. Dose escalation therapy studies in Renca-CAIX tumor-bearing mice demonstrated dose-dependent anti-tumor efficacy of [177Lu]Lu-DOTA-hG250 and remarkable therapeutic synergy including complete remissions when a presumed subtherapeutic TRT dose (4 MBq, which had no significant efficacy as monotherapy) was combined with aPD-1+aCTLA-4. Similar results were obtained in the CT26-CAIX model for 4 MBq [177Lu]Lu-DOTA-hG250 + a-PD1. Ex vivo analyses of treated tumors revealed DNA damage, T-cell infiltration, and modulated immune signaling pathways in the TME after combination treatment. Conclusions: Subtherapeutic [177Lu]Lu-DOTA-hG250 combined with ICI showed superior therapeutic outcome and significantly altered the TME. Our results underline the importance of investigating this combination treatment for patients with advanced ccRCC in a clinical setting. Further investigations should focus on how the combination therapy should be optimally applied in the future.
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  • 文章类型: Journal Article
    骨肉瘤是最常见的原发性恶性骨肿瘤。尽管化疗最近取得了进展,但播散性疾病患者的预后仍然很差。此外,目前的治疗方案具有严重副作用的显著风险.因此,对于具有改善的安全性的有效疗法存在未满足的临床需求.牛磺罗定是一种抗菌剂,已显示可在不同类型的癌细胞系中诱导细胞死亡。
    在这项研究中,我们研究了牛磺罗定在骨肉瘤动物模型中的抗肿瘤和抗血管生成作用。注射K7M2鼠骨肉瘤细胞,肌内和腹膜内,在第0天进入60只BALB/c小鼠。然后将动物随机接受2%牛磺罗定(800mg/kg)治疗,牛磺罗定1%(400毫克/千克),或通过静脉内或腹膜内给药的NaCl0.9%对照7天。
    35天后,小鼠被安乐死,并收集肿瘤进行分析。18只小鼠由于并发症被排除在分析之外。从第9天至第21天,2%牛磺罗定腹膜内治疗组中的体重显著降低,与该组中的死亡率升高一致。与对照组相比,1%(p=0.003)和2%(p=0.006)腹膜内牛磺罗定治疗组中的腹膜内肿瘤重量显著更低。对肌内肿瘤或静脉内施用牛磺罗定没有观察到抗肿瘤作用。治疗组之间的微血管密度或有丝分裂率没有显着差异。2%牛磺罗定腹膜内组的体重减轻和死亡率升高表明,较低的1%剂量是优选的。
    总而言之,没有抗血管生成活性的证据,牛磺罗定对骨肉瘤的抗肿瘤作用是有限的。此外,其毒性特征给予进一步评估。鉴于这些观察,需要进一步研究完善牛磺罗定在骨肉瘤治疗中的应用。
    UNASSIGNED: Osteosarcoma is the most common malignant primary bone tumor. The prognosis for patients with disseminated disease remains very poor despite recent advancements in chemotherapy. Moreover, current treatment regimens bear a significant risk of serious side effects. Thus, there is an unmet clinical need for effective therapies with improved safety profiles. Taurolidine is an antibacterial agent that has been shown to induce cell death in different types of cancer cell lines.
    UNASSIGNED: In this study, we examined both the antineoplastic and antiangiogenic effects of taurolidine in animal models of osteosarcoma. K7M2 murine osteosarcoma cells were injected, both intramuscular and intraperitoneal, into 60 BALB/c mice on day zero. Animals were then randomized to receive treatment with taurolidine 2% (800 mg/kg), taurolidine 1% (400 mg/kg), or NaCl 0.9% control for seven days by intravenous or intraperitoneal administration.
    UNASSIGNED: After 35 days, mice were euthanized, and the tumors were harvested for analysis. Eighteen mice were excluded from the analysis due to complications. Body weight was significantly lower in the 2% taurolidine intraperitoneal treatment group from day 9 to 21, consistent with elevated mortality in this group. Intraperitoneal tumor weight was significantly lower in the 1% (p = 0.003) and 2% (p = 0.006) intraperitoneal taurolidine treatment groups compared to the control. No antineoplastic effects were observed on intramuscular tumors or for intravenous administration of taurolidine. There were no significant differences in microvessel density or mitotic rate between treatment groups. Reduced body weight and elevated mortality in the 2% taurolidine intraperitoneal group suggest that the lower 1% dose is preferable.
    UNASSIGNED: In conclusion, there is no evidence of antiangiogenic activity, and the antitumor effects of taurolidine on osteosarcoma observed in this study are limited. Moreover, its toxic profile grants further evaluation. Given these observations, further research is necessary to refine the use of taurolidine in osteosarcoma treatment.
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  • 文章类型: Journal Article
    粘着斑激酶(FAK)是一种细胞质非受体酪氨酸激酶,在多种恶性肿瘤中过度表达,与粘附等多种细胞功能相关。转移和增殖。越来越多的证据表明,FAK是通过调节FAK下游途径设计抑制剂的有希望的治疗靶标。这里,我们更新了设计概述,根据我们以前的工作,从2017年到现在的化学治疗FAK抑制剂(FAKIs)的合成和构效关系。我们希望我们的努力能够拓宽对FAKI的理解,并从药物化学的角度为未来的癌症治疗提供新的思路和见解。
    UNASSIGNED: Focal adhesion kinase (FAK) is a cytoplasmic non-receptor tyrosine kinase over-expressed in various malignancies which is related to various cellular functions such as adhesion, metastasis and proliferation.
    UNASSIGNED: There is growing evidence that FAK is a promising therapeutic target for designing inhibitors by regulating the downstream pathways of FAK. Some potential FAK inhibitors have entered clinical phase research.
    UNASSIGNED: FAK could be an effective target in medicinal chemistry research and there were a variety of FAKIs have been patented recently. Here, we updated an overview of design, synthesis and structure-activity relationship of chemotherapeutic FAK inhibitors (FAKIs) from 2017 until now based on our previous work. We hope our efforts can broaden the understanding of FAKIs and provide new ideas and insights for future cancer treatment from medicinal chemistry point of view.
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  • 文章类型: Journal Article
    随着癌症患者数量的增加,重要的是要了解人们如何在癌症和癌症之后生活得很好。在澳大利亚,被诊断患有癌症的原住民在医疗服务可及性方面存在生存差异,并且缺乏对文化需求和生活经验的了解。这项研究旨在扩大受癌症影响的原住民的声音,并促进文化知情护理途径的发展。本性主义的研究方法指导了本研究的关系和变革方法。参与者包括不同的癌症专家,包括患有癌症和癌症后生活良好的原住民,卫生专业人员,研究人员,和政策制定者。通过在线Yarning圈子收集数据,并根据归纳主题方法进行分析。原住民在癌症和癌症之后生活得很好的经历与家庭密不可分。整个主题包括希望,家庭,文化和四个优先领域包括:对癌症的基于力量的理解,癌症信息,获得医疗保健和支持,和整体癌症服务。对文化的尊重贯穿始终。生存护理模式需要整合以家庭为中心的癌症护理,以全面支持原住民的整个癌症之旅。
    As the number of people living with cancer increases, it is important to understand how people can live well with and after cancer. First Nations people diagnosed with cancer in Australia experience survival disparities relating to health service accessibility and a lack of understanding of cultural needs and lived experiences. This study aimed to amplify the voices of First Nations individuals impacted by cancer and advance the development of a culturally informed care pathway. Indigenist research methodology guided the relational and transformative approach of this study. Participants included varied cancer experts, including First Nations people living well with and after cancer, health professionals, researchers, and policy makers. Data were collected through online Yarning circles and analysed according to an inductive thematic approach. The experience of First Nations people living well with and after cancer is inextricably connected with family. The overall themes encompass hope, family, and culture and the four priority areas included the following: strength-based understanding of cancer, cancer information, access to healthcare and support, and holistic cancer services. Respect for culture is interwoven throughout. Models of survivorship care need to integrate family-centred cancer care to holistically support First Nations people throughout and beyond their cancer journey.
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  • 文章类型: Journal Article
    CD147在癌症中上调,包括激进的T-ALL。T-ALL的传统治疗通常会带来严重的副作用和复发的风险。强调需要更有效的疗法。ADCP通过增强吞噬细胞在抗体结合后吞噬癌细胞的能力而有助于抗肿瘤反应。我们旨在改造CD147KOTHP-1细胞,并评估其与野生型相比的分化特性。人源化抗CD147抗体,HuM6-1B9也被构建用于在JurkatT细胞的吞噬作用中投资由HuM6-1B9介导的CD147KOTHP-1细胞的吞噬功能。CD147KOTHP-1通过CRISPR/Cas9产生并保持偏振分布。HuM6-1B9在CHO-K1细胞中产生,并以高结合亲和力(KD:2.05±0.30×10-9M)有效结合CD147。此外,HuM6-1B9通过CD147KOTHP-1衍生的LPS激活的巨噬细胞(M-LPS)增强JurkatT细胞的吞噬作用,没有自我ADCP。THP-1衍生的mMDSC的形成在CD147KOTHP-1细胞中受到限制,强调CD147缺失的显著影响。维持CD147KOTHP-1巨噬细胞中的表达标记和吞噬功能支持诱导多能干细胞衍生巨噬细胞的未来工程和应用。HuM6-1B9和CD147KO单核细胞衍生的巨噬细胞的组合有望作为T-ALL的替代策略。
    CD147 is upregulated in cancers, including aggressive T-ALL. Traditional treatments for T-ALL often entail severe side effects and the risk of relapse, highlighting the need for more efficacious therapies. ADCP contributes to the antitumor response by enhancing the ability of phagocytic cells to engulf cancer cells upon antibody binding. We aimed to engineer CD147KO THP-1 cells and evaluated their differentiation properties compared to the wild type. A humanized anti-CD147 antibody, HuM6-1B9, was also constructed for investing the phagocytic function of CD147KO THP-1 cells mediated by HuM6-1B9 in the phagocytosis of Jurkat T cells. The CD147KO THP-1 was generated by CRISPR/Cas9 and maintained polarization profiles. HuM6-1B9 was produced in CHO-K1 cells and effectively bound to CD147 with high binding affinity (KD: 2.05 ± 0.30 × 10-9 M). Additionally, HuM6-1B9 enhanced the phagocytosis of Jurkat T cells by CD147KO THP-1-derived LPS-activated macrophages (M-LPS), without self-ADCP. The formation of THP-1-derived mMDSC was limited in CD147KO THP-1 cells, highlighting the significant impact of CD147 deletion. Maintaining expression markers and phagocytic function in CD147KO THP-1 macrophages supports future engineering and the application of induced pluripotent stem cell-derived macrophages. The combination of HuM6-1B9 and CD147KO monocyte-derived macrophages holds promise as an alternative strategy for T-ALL.
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