• 文章类型: Systematic Review
    近年来,由于高死亡率和令人沮丧的五年生存率,治疗非小细胞肺癌(NSCLC)的重要性日益增加。免疫检查点抑制剂(ICI)是一种有前途的方法,由于细胞的抗原性,在NSCLC中具有出色的结果。相反,ICI对免疫系统的过度刺激是一把双刃剑,可导致从轻度到危及生命的各种负面影响。这篇综述探讨了基于纳米粒子的ICI的当前突破及其局限性。PubMed,检查了Scopus和WebofScience的相关出版物。分析中包括38项试验(N=16,781)。量化治疗效果的混合效果分析对ICI治疗效果研究中的亚组做出了显着贡献。模型证实,与常规治疗方案相比,ICI对治疗效果的影响更大,且降低了受访者的死亡率。由于ICI已被证明的有效性和安全性,ICI可能被用作一线治疗。
    Treating non-small-cell lung cancer (NSCLC) has gained increased importance in recent years due to the high mortality rate and dismal five-year survival rate. Immune checkpoint inhibitors (ICI) are a promising approach with exceptional outcomes in NSCLC thanks to the antigenic nature of cells. Conversely, immune system over-stimulation with ICI is a double-edged sword that can lead to various negative effects ranging from mild to life-threatening. This review explores current breakthroughs in nanoparticle-based ICI and their limitations. The PubMed, Scopus and Web of Science were examined for relevant publications. Thirty-eight trials (N = 16,781) were included in the analyses. The mixed effects analyses on quantifying the treatment effect contributed significantly to the subgroups within studies for ICI treatment effect. Models confirmed ICI\'s higher impact on treatment effectivity and the decrease in respondents\' mortality compared to conventional treatment regiments. ICI might be used as first-line therapy due to their proven effectiveness and safety profile.
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  • 文章类型: Journal Article
    晚期膀胱癌的治疗涉及多学科方法,但许多患者的预后仍然较差。免疫系统在这种疾病中起着至关重要的作用,影响肿瘤的发展和对治疗的反应,利用免疫系统对抗肿瘤可能是破坏肿瘤细胞的有价值的策略。这是卡介苗(BCG)使用的生物学原理,最近,免疫检查点抑制剂(ICIs),如PD-1(程序性死亡-1)/PD-L1(程序性死亡-配体1)抑制剂。事实上,研究最好的免疫检查点之一是由PD-1/PD-L1轴代表,这是肿瘤膀胱细胞采用的众所周知的免疫逃逸系统。PD-L1表达与较高的病理分期相关,并在膀胱癌中显示出预后价值。有趣的是,高级别膀胱癌倾向于表达更高水平的PD-1和PD-L1,提示此类轴在介导疾病进展中的潜在作用.因此,PD-1和PD-L1抑制剂的免疫治疗已成为一种有价值的治疗选择,并已在晚期膀胱癌患者中显示出疗效。PD-L1高表达水平与更好的治疗反应相关。我们的综述旨在全面概述PD-L1在晚期膀胱癌中的作用。重点关注其对治疗决策和治疗反应预测的影响。总的来说,我们的工作旨在有助于理解PD-L1作为一种预测性生物标志物,并强调其在形成晚期膀胱癌治疗方法中的作用.
    The management of advanced bladder carcinoma involves a multidisciplinary approach, but the prognosis remains poor for many patients. The immune system plays a crucial role in this disease, influencing both tumor development and response to treatment, and exploiting the immune system against the tumor can be a valuable strategy to destroy neoplastic cells. This is the biological principle underlying Bacillus Calmette-Guérin (BCG) use and, more recently, immune checkpoint inhibitors (ICIs), like PD-1 (programmed death-1)/PD-L1 (programmed death-ligand 1) inhibitors. In fact, one of the best studied immune checkpoints is represented by the PD-1/PD-L1 axis, which is a well-known immune escape system adopted by neoplastic bladder cells. PD-L1 expression has been associated with a higher pathologic stage and has shown prognostic value in bladder carcinoma. Interestingly, high-grade bladder cancers tend to express higher levels of PD-1 and PD-L1, suggesting a potential role of such an axis in mediating disease progression. Immunotherapy with PD-1 and PD-L1 inhibitors has therefore emerged as a valuable treatment option and has shown efficacy in advanced bladder cancer patients, with high PD-L1 expression levels associated with better treatment responses. Our review aims to provide a comprehensive overview of the role of PD-L1 in advanced bladder cancer, focusing on its implications for treatment decisions and the prediction of treatment response. Overall, our work aims to contribute to the understanding of PD-L1 as a predictive biomarker and highlight its role in shaping therapeutic approaches for advanced bladder cancer.
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  • 文章类型: Journal Article
    CAR-T细胞疗法为延长癌症缓解提供了一种有希望的方法,特别是在血癌的情况下。然而,其在实体瘤治疗中的应用仍面临诸多局限。这篇综述文章全面概述了与CAR-T细胞治疗实体肿瘤相关的挑战和策略。专注于妇科癌症。这项研究讨论了CAR-T疗法用于实体瘤治疗的局限性,比如T细胞衰竭,基质屏障,和抗原脱落。此外,它提出了增加实体肿瘤中CAR-T功效的可能方法,包括检查点抑制剂和化疗的联合治疗,以及将CAR-T与溶瘤病毒疗法相结合的新方法。鉴于缺乏对CAR-T联合疗法治疗妇科癌症的全面研究,这篇综述旨在为实体瘤联合治疗的现状提供见解,并强调这种方法在妇科中的潜力。
    CAR-T cell therapy offers a promising way for prolonged cancer remission, specifically in the case of blood cancers. However, its application in the treatment of solid tumors still faces many limitations. This review paper provides a comprehensive overview of the challenges and strategies associated with CAR-T cell therapy for solid tumors, with a focus on gynecological cancer. This study discusses the limitations of CAR-T therapy for solid tumor treatment, such as T cell exhaustion, stromal barrier, and antigen shedding. Additionally, it addresses possible approaches to increase CAR-T efficacy in solid tumors, including combination therapies with checkpoint inhibitors and chemotherapy, as well as the novel approach of combining CAR-T with oncolytic virotherapy. Given the lack of comprehensive research on CAR-T combination therapies for treating gynecological cancers, this review aims to provide insights into the current landscape of combination therapies for solid tumors and highlight the potential of such an approach in gynecology.
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  • 文章类型: Journal Article
    由于其快速进展到晚期和高度转移特性,胃癌(GC)是最具侵袭性的恶性肿瘤之一,也是全球癌症相关死亡的第四大原因。转移过程包括局部侵袭,转移开始,在遥远的地方移民,和逃避免疫反应。肿瘤生长涉及与免疫反应相关的抑制信号的激活,也被称为免疫检查点,包括PD-1/PD-L1(程序性死亡1/程序性死亡配体1),CTLA-4(细胞毒性T细胞抗原4),TIGIT(具有Ig和ITIM结构域的T细胞免疫受体),和其他人。免疫检查点分子(ICPM)是调节先天和适应性免疫应答的蛋白质。虽然它们在免疫细胞上的表达很突出,主要是抗原呈递细胞(APC)和其他类型的细胞,它们也在肿瘤细胞上表达。受体与配体的结合对于抑制或刺激免疫细胞至关重要,这是癌症免疫疗法的一个极其重要的方面。这篇叙述性综述探讨了免疫治疗,关注GC中的ICPM和免疫检查点抑制剂。我们还总结了当前正在评估ICPM作为GC治疗靶标的临床试验。
    Due to its rapid progression to advanced stages and highly metastatic properties, gastric cancer (GC) is one of the most aggressive malignancies and the fourth leading cause of cancer-related deaths worldwide. The metastatic process includes local invasion, metastasis initiation, migration with colonisation at distant sites, and evasion of the immune response. Tumour growth involves the activation of inhibitory signals associated with the immune response, also known as immune checkpoints, including PD-1/PD-L1 (programmed death 1/programmed death ligand 1), CTLA-4 (cytotoxic T cell antigen 4), TIGIT (T cell immunoreceptor with Ig and ITIM domains), and others. Immune checkpoint molecules (ICPMs) are proteins that modulate the innate and adaptive immune responses. While their expression is prominent on immune cells, mainly antigen-presenting cells (APC) and other types of cells, they are also expressed on tumour cells. The engagement of the receptor by the ligand is crucial for inhibiting or stimulating the immune cell, which is an extremely important aspect of cancer immunotherapy. This narrative review explores immunotherapy, focusing on ICPMs and immune checkpoint inhibitors in GC. We also summarise the current clinical trials that are evaluating ICPMs as a target for GC treatment.
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  • 文章类型: Journal Article
    最近的研究表明,较高的体重指数(BMI)可能与改善对黑色素瘤治疗的反应有关。特别是免疫检查点抑制剂(ICIs),尽管肥胖与癌症风险增加和死亡率增加有一般关联。这篇综述通过探索黑色素瘤患者的分子联系来研究BMI与临床结果之间的矛盾关系。免疫治疗的疗效,和患者生存结果。我们在PubMed和Embase数据库中进行的全面文献检索显示出一致的模式:在接受ICI治疗的黑色素瘤患者中,BMI增加与更好的预后相关。这种“肥胖悖论”可以解释为肥胖的代谢和免疫变化,这可以增强免疫疗法治疗黑色素瘤的有效性。研究结果强调了肥胖和黑色素瘤之间相互作用的复杂性,这表明脂肪组织可以有利地调节免疫反应和治疗敏感性。我们的综述强调了需要考虑患者代谢谱的个性化治疗策略,并呼吁进一步研究以验证BMI作为临床环境中的预后因素。这种针对黑色素瘤肥胖悖论的微妙方法可能会极大地影响治疗计划和患者管理。
    Recent studies indicate that a higher body mass index (BMI) might correlate with improved responses to melanoma treatment, especially with immune checkpoint inhibitors (ICIs), despite the general association of obesity with an increased risk of cancer and higher mortality rates. This review examines the paradoxical relationship between BMI and clinical outcomes in melanoma patients by exploring molecular links, the efficacy of immunotherapy, and patient survival outcomes. Our comprehensive literature search across the PubMed and Embase databases revealed a consistent pattern: increased BMI is associated with a better prognosis in melanoma patients undergoing ICI treatment. This \"obesity paradox\" might be explained by the metabolic and immunological changes in obesity, which could enhance the effectiveness of immunotherapy in treating melanoma. The findings highlight the complexity of the interactions between obesity and melanoma, suggesting that adipose tissue may modulate the immune response and treatment sensitivity favorably. Our review highlights the need for personalized treatment strategies that consider the metabolic profiles of patients and calls for further research to validate BMI as a prognostic factor in clinical settings. This nuanced approach to the obesity paradox in melanoma could significantly impact treatment planning and patient management.
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  • 文章类型: Journal Article
    Chimeric antigen receptor T (CAR-T) cell therapy is a rapidly developing new immunotherapy in recent years. Compared with other therapies, CAR-T has significant advantages for high-risk and relapsed/refractory B cell non-Hodgkin\'s lymphoma (B-NHL) patients. Currently, a variety of anti-CD19 CAR-T cells have been approved by the FDA for the treatment of B-NHL, such as axicabtagene ciloleucel, tisagenlecucel, lisocababtagene maraleucel and brexucabtagene autoleucel. In addition, many studies are actively exploring and developing different targeted CAR-T cells, which show great potential in B-NHL. This review briefly summarized the latest research progress on the application of CAR-T in common B-NHL.
    UNASSIGNED: CAR-T细胞免疫疗法在B细胞非霍奇金淋巴瘤中的应用进展.
    UNASSIGNED: 嵌合抗原受体T(CAR-T)细胞疗法是近年来迅速发展的免疫治疗新方法。相对于其他疗法,CAR-T疗法在高危及复发/难治性B细胞非霍奇金淋巴瘤(B-NHL)患者中具有显著优势。目前多种抗CD-19 CAR-T细胞已被FDA批准用于B-NHL的治疗,如阿基仑赛、司利弗明、利基迈仑赛、贝林妥欧单抗。除此之外,许多研究正在积极探索和开发不同靶点的CAR-T细胞,它们在B-NHL的治疗中表现出巨大的潜力。本文就CAR-T在常见B-NHL中的最新应用研究进展作一综述。 .
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  • 文章类型: Journal Article
    Multiple myeloma (MM) is an incurable malignant plasma cell diseases, the incidence of which is increasing year by year. The application of immunomodulators drugs, proteasome inhibitors, anti-CD38 antibodies, CAR-T, and HSCT have significantly improved the prognosis of patients with MM, however new therapeutic tools need to be developed to improve the prognosis of patients with relapsed/refractory after conventional regimens treatment. Bispecific antibodies are a novel immunotherapeutic approach that generates immune synapses by binding to targets on malignant plasma cells and cytotoxic immune effector cells (T cells/natural killer cells), leading to T/NK cells activation and malignant plasma cell lysis. Several preclinical and phase I clinical studies have shown good efficacy, bringing new possibilities for patients with relapsed/refractory MM to improve their prognosis in the future in combination with the rest of the treatment options. This article summarizes the classification of bispecific antibodies developed in recent years, and the results of preclinical and clinical trials, which will provide some reference for treating MM.
    UNASSIGNED: 双特异性抗体在多发性骨髓瘤治疗中的研究进展.
    UNASSIGNED: 多发性骨髓瘤(MM)是一种难以治愈的恶性浆细胞疾病,其发病率逐年增加,免疫调节剂、蛋白酶体抑制剂、抗 CD38 抗体、CAR-T、造血干细胞移植的应用明显改善了MM患者的预后,对于传统方案治疗后复发/难治的患者,需开发新的治疗手段改善其预后。双特异性抗体是一种新型免疫治疗方法,通过结合恶性浆细胞和细胞毒性免疫效应细胞(T细胞/NK细胞)上的靶标产生免疫突触,导致T/NK细胞活化和恶性浆细胞裂解。多项临床前及I期临床研究显示出良好的疗效,为复发/难治MM患者带来新的希望,未来与其他治疗方案联合可改善患者的预后。本文总结了近年来开发的双特异性抗体的分类、临床前及临床实验结果,为治疗MM提供参考。.
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  • 文章类型: Journal Article
    使用经过验证的工具来评估癌症患者的营养状况,为其营养评估提供了保证的准确性和可靠性。确保信息准确并反映患者的情况。这项研究的目的是确定有效且可靠的工具,以评估诊断为接受抗肿瘤治疗(化学疗法和/或免疫疗法)的实体瘤的癌症患者的营养状况。进行了范围审查,以搜索英文在科学期刊上发表的原始文章,西班牙语,或者过去五年的葡萄牙语。为了识别潜在的相关文件,在以下数据库中进行了搜索:SCOPUS,WOS,CINAHL,MEDLINE,BVS,和pubmed。使用DECS-MeSH描述符和布尔运算符。此外,Arksey和O\'Malley协议,乔安妮·布里格斯研究所(JBI)方法,以及系统评价和荟萃分析的首选信息元素的流程图,被称为PRISMA,被跟踪。最初的搜索策略确定了总共164个参考文献,连续检查,留下十项研究的最终选择。发现用于营养评估的最常用的工具是患者生成的主观整体评估(PG-SGA)。其他问卷也很突出,如迷你营养评估(MNA),营养不良通用筛查工具(MUST),营养风险筛查(NRS2002),和厌食症/恶病质治疗的功能评估(FAACT)。所用工具的变化范围从主观评估到客观测量,因此强调需要采取全面和个性化的方法。
    The use of validated tools to evaluate the nutritional status of the cancer patient provides guaranteed precision and reliability in their nutritional evaluation, ensuring that the information is accurate and reflects the patient\'s situation. The aim of this study was to identify the valid and reliable instruments in the evaluation of the nutritional status of cancer patients with a diagnosis of solid tumor undergoing antineoplastic treatment (chemotherapy and/or immunotherapy). A scoping review was conducted to search for original articles published in scientific journals in English, Spanish, or Portuguese in the past five years. In order to identify potentially relevant documents, searches were performed in the following databases: SCOPUS, WOS, CINAHL, MEDLINE, BVS, and PUBMED. DECS-MeSH descriptors and Boolean operators were used. In addition, the Arksey and O\'Malley protocol, the Joanne Briggs Institute (JBI) method, and the flow chart of the Preferred Information Elements for Systematic Reviews and Meta-Analyses, known as PRISMA, were followed. The initial search strategy identified a total of 164 references, which were examined successively, leaving a final selection of ten studies. It was found that the most used instrument for nutritional evaluation was the Patient-Generated Subjective Global Assessment (PG-SGA). Other questionnaires also stood out such as the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Screening (NRS 2002), and the Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The variation in the tools used ranges from subjective assessments to objective measurements, thus underlining the need for a comprehensive and individualized approach.
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  • 文章类型: Journal Article
    肝细胞癌(HCC)由于其相当大的发病率和死亡率,对全球医疗保健系统构成了重大负担。最近的趋势表明,全球范围内代谢功能障碍相关的脂肪变性肝病(MASLD)的发病率增加和HCC的病因转变。MASLD取代乙型肝炎病毒作为肝癌新病例的主要贡献者。与病毒HCC相比,MASLD相关的HCC表现出不同的特征,包括独特的免疫细胞谱,导致整体更具免疫抑制或耗尽的肿瘤微环境。此外,MASLD相关的HCC经常在年龄较大的人群和心脏代谢合并症患者中发现。此外,与病毒病因相比,非肝硬化患者中MASLD相关HCC病例的比例更高,阻碍早期检测。然而,目前的临床实践指南对MASLD患者的HCC筛查缺乏具体建议.HCC管理的不断发展的景观提供了一系列治疗选择,从手术干预和局部治疗到全身治疗,对于不同阶段的患者。尽管正在进行辩论,目前的证据不支持基于病因的最佳治疗方式的差异.在这项研究中,我们旨在提供有关趋势的当前文献的全面概述,特点,临床意义,和MASLD相关HCC的治疗方式。
    Hepatocellular carcinoma (HCC) represents a significant burden on global healthcare systems due to its considerable incidence and mortality rates. Recent trends indicate an increase in the worldwide incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) and a shift in the etiology of HCC, with MASLD replacing the hepatitis B virus as the primary contributor to new cases of HCC. MASLD-related HCC exhibits distinct characteristics compared to viral HCC, including unique immune cell profiles resulting in an overall more immunosuppressive or exhausted tumor microenvironment. Furthermore, MASLD-related HCC is frequently identified in older age groups and among individuals with cardiometabolic comorbidities. Additionally, a greater percentage of MASLD-related HCC cases occur in noncirrhotic patients compared to those with viral etiologies, hindering early detection. However, the current clinical practice guidelines lack specific recommendations for the screening of HCC in MASLD patients. The evolving landscape of HCC management offers a spectrum of therapeutic options, ranging from surgical interventions and locoregional therapies to systemic treatments, for patients across various stages of the disease. Despite ongoing debates, the current evidence does not support differences in optimal treatment modalities based on etiology. In this study, we aimed to provide a comprehensive overview of the current literature on the trends, characteristics, clinical implications, and treatment modalities for MASLD-related HCC.
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  • 文章类型: Journal Article
    免疫检查点抑制剂形式的癌症免疫疗法已导致肺癌患者在所有阶段的生存率显着增加。在过去的十年里,该领域经历了快速成熟;然而,一些挑战继续使患者管理复杂化.这篇综述旨在强调导致实践中这一戏剧性转变的数据,并关注关键挑战。这些包括确定最佳治疗持续时间,管理虚弱的患者或脑转移患者,应对免疫相关不良事件带来的挑战,并定义了对免疫疗法的临床和放射学反应的各种模式。
    Cancer immunotherapy in the form of immune checkpoint inhibitors has led to a dramatic increase in the survival of patients with lung cancer across all stages. Over the past decade, the field has experienced rapid maturation; however, several challenges continue to complicate patient management. This review aims to highlight the data that led to this dramatic shift in practice as well as to focus on key challenges. These include determining the optimal therapy duration, managing frail patients or those with brain metastases, addressing the challenges posed by immune-related adverse events, and defining the various patterns of clinical and radiological responses to immunotherapy.
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