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PD-L1 and VEGF dual blockade enhances anti-tumor effect on brain metastasis in hematogenous metastasis model. PD-L1和血管内皮生长因子双重阻断增强血行转移模型中脑转移的抗肿瘤效果
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-05 DOI: 10.1007/s10585-024-10309-y
Chinami Masuda, Shinichi Onishi, Keigo Yorozu, Mitsue Kurasawa, Mamiko Morinaga, Daiko Wakita, Masamichi Sugimoto

Immunotherapy improves survival outcomes in cancer patients, but there is still an unmet clinical need in the treatment of brain metastases. Here, we used a mouse model to investigate the antitumor effect of programmed death-ligand 1 (PD-L1) and vascular endothelial growth factor (VEGF) dual blockade on metastatic brain tumors and evaluated immune responses during treatment. After establishing hematogenous brain metastasis by transplanting murine bladder carcinoma MBT2 cells stably expressing secNLuc reporter via the internal carotid artery of C3H/HeNCrl mice, we observed the formation of metastases not only in the brain parenchyma but also in the ventricles. The observed pathological areas showed that metastases in the ventricle were histologically larger than that in the brain parenchyma. Regarding the total tumor burden in the whole brain as revealed by Nluc activities, the combination of anti-PD-L1 antibody and anti-VEGF antibody showed a stronger anti-tumor effect than each single agent. Anti-PD-L1 antibody alone enhanced CD8+ T cell priming in regional lymph nodes, increased the proportion of activated CD8+ T cells in whole brain, and increased the density of CD8+ cells in the brain parenchyma. Furthermore, anti-VEGF antibody alone decreased microvessel density (MVD) in ventricular metastases, and the combination treatment increased intratumoral CD8+ cell density in the brain parenchyma and ventricular metastases. These results suggest that PD-L1 blockade enhanced cancer immunity not only in brain metastases lesions but also in the regional lymph nodes of the metastases, and that the addition of VEGF blockade increased the antitumor effect by increasing the infiltration of activated CD8+ T cell and decreasing MVD.

免疫疗法能改善癌症患者的生存预后,但在治疗脑转移瘤方面仍有未满足的临床需求。在此,我们利用小鼠模型研究了程序性死亡配体1(PD-L1)和血管内皮生长因子(VEGF)双重阻断对转移性脑肿瘤的抗肿瘤作用,并评估了治疗过程中的免疫反应。通过C3H/HeNCrl小鼠的颈内动脉移植稳定表达secNLuc报告基因的小鼠膀胱癌MBT2细胞,建立血源性脑转移后,我们观察到转移瘤不仅在脑实质中形成,而且在脑室中也形成。观察到的病理区域显示,脑室转移灶的组织学大小大于脑实质转移灶。就 Nluc 活性显示的全脑总肿瘤负荷而言,抗 PD-L1 抗体和抗血管内皮生长因子抗体的联合抗肿瘤效果强于单药。单用抗PD-L1抗体可增强区域淋巴结中CD8+T细胞的引诱作用,提高全脑中活化CD8+T细胞的比例,并增加脑实质中CD8+细胞的密度。此外,单用抗血管内皮生长因子抗体可降低脑室转移灶的微血管密度(MVD),而联合治疗可增加脑实质和脑室转移灶的瘤内CD8+细胞密度。这些结果表明,PD-L1 阻断不仅能增强脑转移灶病灶的癌症免疫力,还能增强转移灶区域淋巴结的癌症免疫力,而加入血管内皮生长因子阻断则能通过增加活化的 CD8+ T 细胞浸润和降低 MVD 增加抗肿瘤效果。
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引用次数: 0
Efficacy and safety of PARPis combined with an ICIs for advanced or metastatic triple-negative breast cancer: a single-arm meta-analysis. PARPis 联合 ICIs 治疗晚期或转移性三阴性乳腺癌的有效性和安全性:单臂荟萃分析。
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1007/s10585-024-10307-0
Qiao Zheng, Tiecheng Zhou, Weijun Ding

Although the intervention for triple-negative breast cancer (TNBC) patients has improved and survival time has increased, the combination of immune checkpoint inhibitors(ICIs) and PARP inhibitors (Poly ADP-Ribose Polymerase inhibitors, PARPis) is still controversial. Previous studies revealed that the combined use of ICIs and PARPis led to increased antitumor activity. However, most of these combined regimens are nonrandomized controlled trials with small sample sizes. The purpose of this meta-analysis was to evaluate the efficacy and safety of ICIs combined with PARPis in patients with advanced or metastatic TNBC. The PubMed, Embase, Cochrane Library and Web of Science databases were systematically searched. The results including the objective remission rate (ORR), disease control rate (DCR), progression-free survival (PFS) and adverse events (AEs), were subjected to further analysis. Four studies involving 110 subjects were included in this meta-analysis. The combined ORR and DCR were 23.6% and 53.6%, respectively; while the ORR and DCR of BRCAmut patients were 38.1% and 71.4%, respectively. The median PFS of the patients was 4.29 months. As for safety, the most common AEs were nausea (49.0%), anemia (44.3%) and fatigue (40.6%). Most of them were grade 1 or 2, and the incidence of adverse events ≥ III was obviously low. Except for anemia, the incidence of AEs ≥ III was < 10%. This meta-analysis revealed that the combination of ICIs and PARPis has good efficacy and safety for advanced or metastatic TNBC patients.

尽管对三阴性乳腺癌(TNBC)患者的干预有所改善,生存时间也有所延长,但免疫检查点抑制剂(ICIs)和PARP抑制剂(Poly ADP-Ribose Polymerase inhibitors,PARPis)的联合使用仍存在争议。以往的研究表明,联合使用 ICIs 和 PARPis 可提高抗肿瘤活性。然而,这些联合治疗方案大多是样本量较小的非随机对照试验。本荟萃分析旨在评估 ICIs 与 PARPis 联用对晚期或转移性 TNBC 患者的疗效和安全性。我们系统地检索了 PubMed、Embase、Cochrane Library 和 Web of Science 数据库。结果包括客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)和不良事件(AEs),并对这些结果进行了进一步分析。本次荟萃分析共纳入了四项研究,涉及 110 名受试者。合并 ORR 和 DCR 分别为 23.6% 和 53.6%;而 BRCAmut 患者的 ORR 和 DCR 分别为 38.1% 和 71.4%。患者的中位生存期为4.29个月。在安全性方面,最常见的不良反应是恶心(49.0%)、贫血(44.3%)和疲劳(40.6%)。这些不良反应大多为 1 级或 2 级,≥ III 级的不良反应发生率明显较低。除贫血外,不良反应发生率≥ III 级的有
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引用次数: 0
Cell blebbing novel therapeutic possibilities to counter metastasis. 细胞凋亡是对抗转移的新疗法。
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-09-02 DOI: 10.1007/s10585-024-10308-z
Weiyi Jia, Marcus Czabanka, Thomas Broggini

Cells constantly reshape there plasma membrane and cytoskeleton during physiological and pathological processes (Hagmann et al. in J Cell Biochem 73:488-499, 1999). Cell blebbing, the formation of bulges or protrusions on the cell membrane, is related to mechanical stress, changes in intracellular pressure, chemical signals, or genetic anomalies. These membrane bulges interfere with the force balance of actin filaments, microtubules, and intermediate filaments, the basic components of the cytoskeleton (Charras in J Microsc 231:466-478, 2008). In the past, these blebs with circular structures were considered apoptotic markers (Blaser et al. in Dev Cell 11:613-627, 2006). Cell blebbing activates phagocytes and promotes the rapid removal of intrinsic compartments. However, recent studies have revealed that blebbing is associated with dynamic cell reorganization and alters the movement of cells in-vivo and in-vitro (Charras and Paluch in Nat Rev Mol Cell Biol 9:730-736, 2008). During tumor progression, blebbing promotes invasion of cancer cells into blood, and lymphatic vessels, facilitating tumor progression and metastasis (Weems et al. in Nature 615:517-525, 2023). Blebbing is a dominant feature of tumor cells generally absent in normal cells. Restricting tumor blebbing reduces anoikis resistance (survival in suspension) (Weems et al. in Nature 615:517-525, 2023). Hence, therapeutic intervention with targeting blebbing could be highly selective for proliferating pro-metastatic tumor cells, providing a novel therapeutic pathway for tumor metastasis with minimal side effects. Here, we review the association between cell blebbing and tumor cells, to uncover new research directions and strategies for metastatic cancer therapy. Finaly, we aim to identify the druggable targets of metastatic cancer in relation to cell blebbing.

细胞在生理和病理过程中不断重塑其质膜和细胞骨架(Hagmann 等人,J Cell Biochem 73:488-499, 1999)。细胞裂隙(细胞膜上隆起或突起的形成)与机械应力、细胞内压力变化、化学信号或基因异常有关。这些膜隆起会干扰细胞骨架的基本组成部分肌动蛋白丝、微管和中间丝的力平衡(Charras,载于《显微镜杂志》231:466-478,2008 年)。过去,这些具有环状结构的斑点被认为是细胞凋亡的标志物(Blaser 等人,发表于 Dev Cell 11:613-627, 2006)。细胞出血可激活吞噬细胞,并促进内在分区的快速清除。然而,最近的研究发现,细胞吸血与动态细胞重组有关,并改变了体内和体外细胞的运动(Charras 和 Paluch,Nat Rev Mol Cell Biol 9:730-736, 2008)。在肿瘤进展过程中,出血会促进癌细胞侵入血液和淋巴管,从而促进肿瘤进展和转移(Weems 等人,发表于《自然》615:517-525,2023 年)。溢血是肿瘤细胞的主要特征,正常细胞一般不存在溢血现象。限制肿瘤出血会降低抗逆转性(在悬浮液中存活)(Weems 等,发表于《自然》615:517-525, 2023)。因此,靶向凋亡的治疗干预可以高度选择性地针对增殖的促转移肿瘤细胞,为肿瘤转移提供一种副作用最小的新型治疗途径。在此,我们回顾了细胞凋亡与肿瘤细胞之间的关联,以揭示转移性癌症治疗的新研究方向和策略。最后,我们旨在确定与细胞漂白相关的转移性癌症的可药物靶点。
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引用次数: 0
Targeting PADI2 as a potential therapeutic strategy against metastasis in oral cancer via suppressing EMT-mediated migration and invasion and CCL3/5-induced angiogenesis. 通过抑制 EMT 介导的迁移和侵袭以及 CCL3/5 诱导的血管生成,以 PADI2 为靶点作为抗口腔癌转移的潜在治疗策略。
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-31 DOI: 10.1007/s10585-024-10310-5
Shih-Kai Hung, Chih-Chia Yu, Hon-Yi Lin, Wen-Yen Chiou, Moon-Sing Lee, Ru-Inn Lin, Ming-Chi Lu

Oral squamous cell carcinoma (OSCC) is a prevalent and aggressive malignancy, with metastasis being the leading cause of death in patients. Unfortunately, therapeutic options for metastatic OSCC remain limited. Peptidylarginine deiminases (PADI) are implicated in various tumorigenesis and metastasis processes across multiple cancers. However, the role of PADI2, a type of PADI, in OSCC is not well understood. This study aimed to explore the impact of PADI2 on epithelial-mesenchymal transition (EMT), angiogenesis, and OSCC metastasis. The effect of PADI2 on EMT was evaluated using cell lines by Western blot analysis with shRNA targeting PADI2. In addition, the selective PADI2 inhibitor AFM32a was used to assess the effect of PADI2 on cancer metastasis and angiogenesis in animal models. Our findings indicated that PADI2 expression correlated with EMT changes, and PADI2 knockdown reversed these changes, reducing cell proliferation, cell migration, and invasion. PADI2 inhibition also diminished tube formation in HUVECs and decreased secretion of angiogenesis-related chemokines CCL3, CCL5 and CCL20. In a mouse model, AFM32a markedly reduced lung metastasis and production of CCL3 and CCL5. Our in vitro and in vivo studies suggested inhibiting PADI2 could prevent OSCC metastasis by impeding EMT and angiogenesis via AKT/mTOR signaling pathway. These results highlight PADI2 as a potential therapeutic target for combating OSCC metastasis.

口腔鳞状细胞癌(OSCC)是一种常见的侵袭性恶性肿瘤,转移是导致患者死亡的主要原因。遗憾的是,转移性 OSCC 的治疗方案仍然有限。肽基精氨酸脱氨酶(PADI)与多种癌症的各种肿瘤发生和转移过程有关。然而,PADI2(PADI的一种)在OSCC中的作用尚不十分清楚。本研究旨在探讨PADI2对上皮-间质转化(EMT)、血管生成和OSCC转移的影响。研究利用细胞系,通过针对PADI2的shRNA进行Western印迹分析,评估了PADI2对EMT的影响。此外,还使用选择性PADI2抑制剂AFM32a评估了PADI2对动物模型中癌症转移和血管生成的影响。我们的研究结果表明,PADI2的表达与EMT变化相关,而PADI2的敲除可逆转这些变化,减少细胞增殖、细胞迁移和侵袭。抑制 PADI2 还能减少 HUVECs 中的管形成,并减少血管生成相关趋化因子 CCL3、CCL5 和 CCL20 的分泌。在小鼠模型中,AFM32a 能显著减少肺转移以及 CCL3 和 CCL5 的产生。我们的体外和体内研究表明,抑制 PADI2 可通过 AKT/mTOR 信号通路阻碍 EMT 和血管生成,从而防止 OSCC 转移。这些结果突显了PADI2是对抗OSCC转移的潜在治疗靶点。
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引用次数: 0
Multiple myeloma: clinical characteristics, current therapies and emerging innovative treatments targeting ribosome biogenesis dynamics. 多发性骨髓瘤:临床特征、现有疗法和针对核糖体生物生成动力学的新兴创新疗法。
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-20 DOI: 10.1007/s10585-024-10305-2
Mohamed H Elbahoty, Bhavyasree Papineni, Rajeev S Samant

Multiple myeloma (MM) is a clinical disorder characterized by aberrant plasma cell growth in the bone marrow microenvironment. Globally, the prevalence of MM has been steadily increasing at an alarming rate. In the United States, more than 30,000 cases will be diagnosed in 2024 and it accounts for about 2% of cancer diagnoses and more than 2% of cancer deaths, more than double the worldwide figure. Both symptomatic and active MM are distinguished by uncontrolled plasma cell growth, which results in severe renal impairment, anemia, hypercalcemia, and bone loss. Multiple drugs have been approved by the FDA and are now widely used in clinical practice for MM. Although triplet and quadruplet induction regimens, autologous stem cell transplantation (ASCT), and maintenance treatment are used, MM continues to be an incurable illness characterized by relapses that may occur at various phases of its progression. MM patients with frailty, extramedullary disease, plasma cell leukemia, central nervous system recurrence, functional high risk, and the elderly are among those with the greatest current unmet needs. The high cost of care is an additional challenge. MM cells are highly protein secretary cells and thus are dependent on the activation of certain translation pathways. MM also has a high chance of altering ribosomal protein-encoding genes like MYC mutation. In this article we discuss the importance of ribosome biogenesis in promoting MM and RNA polymerase I inhibition as an upcoming treatment with potential promise for MM patients.

多发性骨髓瘤(MM)是一种以骨髓微环境中浆细胞异常生长为特征的临床疾病。在全球范围内,多发性骨髓瘤的发病率正以惊人的速度稳步上升。在美国,2024 年确诊的病例将超过 3 万例,约占癌症确诊病例的 2%,占癌症死亡病例的 2%,是全球数字的两倍多。无症状和活动性 MM 的特征都是浆细胞生长失控,导致严重的肾功能损害、贫血、高钙血症和骨质流失。美国食品和药物管理局已批准多种药物,目前已广泛用于 MM 的临床治疗。虽然三联和四联诱导方案、自体干细胞移植(ASCT)和维持治疗已被采用,但MM仍是一种不治之症,其特点是在病情发展的不同阶段都可能复发。患有虚弱、髓外疾病、浆细胞白血病、中枢神经系统复发、功能性高风险和老年人的 MM 患者,是目前需求尚未得到满足的最大群体。高昂的治疗费用也是一项挑战。MM 细胞是高度蛋白质秘书细胞,因此依赖于某些翻译途径的激活。MM也很有可能改变核糖体蛋白编码基因,如MYC突变。在这篇文章中,我们讨论了核糖体生物发生在促进 MM 方面的重要性,以及 RNA 聚合酶 I 抑制作为一种即将出现的治疗方法对 MM 患者的潜在前景。
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引用次数: 0
Tumor microenvironment dynamics in oral cancer: unveiling the role of inflammatory cytokines in a syngeneic mouse model. 口腔癌的肿瘤微环境动力学:揭示炎性细胞因子在合成小鼠模型中的作用。
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-10 DOI: 10.1007/s10585-024-10306-1
Ayano Tobe-Nishimoto, Yoshihiro Morita, Junya Nishimura, Yukiko Kitahira, Shun Takayama, Satoko Kishimoto, Yuka Matsumiya-Matsumoto, Kazuhide Matsunaga, Tomoaki Imai, Narikazu Uzawa

The process of cervical lymph node metastasis is dependent on the phenotype of the tumor cells and their interaction with the host microenvironment and immune system; conventional research methods that focus exclusively on tumor cells are limited in their ability to elucidate the metastatic mechanism. In cancer tissues, a specialized environment called the tumor microenvironment (TME) is established around tumor cells, and inflammation in the TME has been reported to be closely associated with the development and progression of many types of cancer and with the response to anticancer therapy. In this study, to elucidate the mechanism of metastasis establishment, including the TME, in the cervical lymph node metastasis of oral cancer, we established a mouse-derived oral squamous cell carcinoma cervical lymph node highly metastatic cell line and generated a syngeneic orthotopic transplantation mouse model. In the established highly metastatic cells, epithelial-mesenchymal transition (EMT) induction was enhanced compared to that in parental cells. In the syngeneic mouse model, lymph node metastasis was observed more frequently in tumors of highly metastatic cells than in parental cells, and Cyclooxygenase-2 (COX-2) expression and lymphatic vessels in primary tumor tissues were increased, suggesting that this model is highly useful. Moreover, in the established highly metastatic cells, EMT induction was enhanced compared to that in the parent cell line, and CCL5 and IL-6 secreted during inflammation further enhanced EMT induction in cancer cells. This suggests the possibility of a synergistic effect between EMT induction and inflammation. This model, which allows for the use of two types of cells with different metastatic and tumor growth potentials, is very useful for oral cancer research involving the interaction between cancer cells and the TME in tumor tissues and for further searching for new therapeutic agents.

宫颈淋巴结转移的过程取决于肿瘤细胞的表型及其与宿主微环境和免疫系统的相互作用;传统的研究方法只关注肿瘤细胞,在阐明转移机制方面能力有限。据报道,肿瘤微环境中的炎症与多种癌症的发生、发展以及抗癌治疗的反应密切相关。在本研究中,为了阐明口腔癌颈淋巴结转移中包括TME在内的转移建立机制,我们建立了小鼠来源的口腔鳞状细胞癌颈淋巴结高转移细胞系,并生成了一个同种异体正位移植小鼠模型。在已建立的高转移细胞中,与亲代细胞相比,上皮-间质转化(EMT)诱导增强。在合成小鼠模型中,与亲代细胞相比,高转移细胞的肿瘤中淋巴结转移更频繁,原发肿瘤组织中环氧化酶-2(COX-2)表达和淋巴管增加,这表明该模型非常有用。此外,在已建立的高度转移细胞中,EMT诱导作用比亲代细胞系更强,炎症过程中分泌的CCL5和IL-6进一步增强了癌细胞的EMT诱导作用。这表明 EMT 诱导和炎症之间可能存在协同效应。该模型允许使用两种具有不同转移潜能和肿瘤生长潜能的细胞,对于涉及癌细胞与肿瘤组织中 TME 之间相互作用的口腔癌研究以及进一步寻找新的治疗药物非常有用。
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引用次数: 0
Isolated hyperthermic perfusions for cutaneous melanoma in-transit metastasis of the limb and uveal melanoma metastasis to the liver. 孤立的高温灌注治疗肢体转移中的皮肤黑色素瘤和肝脏转移的葡萄膜黑色素瘤。
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2023-10-16 DOI: 10.1007/s10585-023-10234-6
Anne Huibers, Danielle K DePalo, Matthew C Perez, Jonathan S Zager, Roger Olofsson Bagge

Patients with cutaneous melanoma can develop in-transit metastases (ITM), most often localized to limbs. For patients with uveal melanoma that develop metastatic disease, the overall majority develop isolated liver metastases. For these types of metastases, regional cancer therapies have evolved as effective treatments. Isolated limb perfusion (ILP), isolated limb infusion (ILI), isolated hepatic perfusion (IHP) and percutaneous hepatic perfusion (PHP) achieve a high local concentration of chemotherapy with minimal systemic exposure. This review discusses the mechanism and available literature on locoregional treatment modalities in the era of modern immunotherapy.

皮肤黑色素瘤患者可发展为转移瘤(ITM),最常见的是局限于四肢。对于发展为转移性疾病的葡萄膜黑色素瘤患者,总体上大多数发展为孤立的肝转移。对于这些类型的转移,区域癌症疗法已经发展成为有效的治疗方法。孤立肢体灌注(ILP)、孤立肢体输注(ILI)、孤立肝灌注(IHP)和经皮肝灌注(PHP)在最小的全身暴露下实现高局部浓度的化疗。这篇综述讨论了现代免疫疗法时代局部治疗模式的机制和现有文献。
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引用次数: 0
Stereotactic body radiotherapy for spinal oligometastases: a survey on patterns of practice on behalf of the Italian Association of Clinical Oncology and Radiotherapy (AIRO). 脊柱少见转移灶的立体定向体放射治疗:代表意大利临床肿瘤学和放射治疗协会(AIRO)进行的实践模式调查。
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 DOI: 10.1007/s10585-024-10304-3
Francesco Cuccia, Ciro Franzese, Serena Badellino, Paolo Borghetti, Manuela Federico, Giulia Marvaso, Giampaolo Montesi, Antonio Pontoriero, Giuseppe Ferrera, Filippo Alongi, Marta Scorsetti

Background: The Study Group for the Biology and Treatment of the OligoMetastatic Disease on behalf of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) has conducted a national survey with the aim to depict the current patterns of practice of stereotactic body radiotherapy (SBRT) for spinal oligometastases.

Methods: The Surveymonkey platform was used to send a 28-items questionnaire focused on demographic, clinical and technical aspects related to SBRT for spinal oligometastases. All the AIRO members were invited to fill the questionnaire. Data were then centralized to a single center for analysis and interpretation.

Results: 53 radiation oncologists from 47 centers fulfilled the survey. A complete agreement was observed in proposing SBRT for spinal oligometastases, with the majority considering up to 3 concurrent spine oligometastases feasible for SBRT (73.5%), regardless of spine site (70%), vertebral segment (85%) and morphological features of the lesion (71.7%). Regarding dose prescription, fractionated regimens resulted as the preferred option, either in 3 (58.4%) or five sessions (34%), with a substantial agreement in applying a PTV-margin larger than 1 mm (almost 90% of participants), and ideally using both MRI and PET imaging to improve target volume and organs-at-risk delineation (67.9%).

Conclusions: This national italian survey illustrates the patterns of practice and the main issues for the indication of SBRT for spinal oligometastases. A substantial agreement in the numerical cut-off and vertebral segment involved for SBRT indication was reported, with a slight heterogeneity in terms of dose prescription and fractionation schemes.

背景:寡转移性疾病的生物学和治疗研究小组代表意大利放射治疗和临床肿瘤学协会(AIRO)进行了一项全国性调查,旨在了解当前脊柱寡转移瘤立体定向体放射治疗(SBRT)的实践模式:方法:使用 Surveymonkey 平台发送了一份包含 28 个项目的调查问卷,内容主要涉及与脊柱少见转移瘤 SBRT 相关的人口、临床和技术方面。邀请所有 AIRO 成员填写问卷。然后将数据集中到一个中心进行分析和解读:结果:来自 47 个中心的 53 位放射肿瘤学家完成了问卷调查。大多数人认为最多可同时对3个脊柱少见转移灶进行SBRT治疗(73.5%),而不论脊柱部位(70%)、椎段(85%)和病灶形态特征(71.7%)。在剂量处方方面,3次(58.4%)或5次(34%)的分次疗法是首选方案,在应用大于1毫米的PTV边缘(近90%的参与者)以及理想情况下同时使用MRI和PET成像来改善靶体积和危险器官的划定(67.9%)方面存在很大的一致性:这项意大利全国性调查说明了脊柱少转移灶 SBRT 适应症的实践模式和主要问题。据报道,在SBRT适应症的数字临界值和所涉及的椎体节段方面存在很大的一致性,但在剂量处方和分型方案方面略有差异。
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引用次数: 0
Personalized therapy in oncology: melanoma as a paradigm for molecular-targeted treatment approaches. 肿瘤学中的个性化疗法:黑色素瘤是分子靶向治疗方法的典范。
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-06-27 DOI: 10.1007/s10585-024-10291-5
Kevin B Kim

In recent decades, the field of systemic cancer treatment has seen remarkable changes due to advancements in the understanding of cancer's biology, immunology, and genetic makeup. As a result, individuals with late-stage cancers are now achieving survival rates that were previously unattainable. The goal of personalized cancer therapy is to enhance clinical outcomes by customizing drug treatments to suit the unique genetic and/or epigenetic profiles of each patient's tumor. This approach aims to reduce the side effects commonly associated with ineffective treatments. Advances in genetic sequencing and molecular cytogenetics have been instrumental in identifying cancer-driving mutations and epigenetic irregularities, leading to the development of specific molecular therapies. This review article highlights the progress and success of targeted molecular therapies in treating malignant melanoma, illustrating the concept of personalized cancer treatment.

近几十年来,由于对癌症生物学、免疫学和基因构成的认识不断进步,系统性癌症治疗领域发生了显著变化。因此,晚期癌症患者的生存率达到了以前无法企及的水平。个性化癌症疗法的目标是根据每位患者肿瘤的独特基因和/或表观遗传特征定制药物治疗方案,从而提高临床疗效。这种方法旨在减少无效治疗常见的副作用。基因测序和分子细胞遗传学的进步有助于确定致癌突变和表观遗传学异常,从而开发出特定的分子疗法。这篇综述文章重点介绍了靶向分子疗法在治疗恶性黑色素瘤方面取得的进展和成功,诠释了个性化癌症治疗的概念。
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引用次数: 0
Immune responses and immunotherapeutic approaches in the treatment against cancer. 治疗癌症的免疫反应和免疫疗法。
IF 4.2 3区 医学 Q2 ONCOLOGY Pub Date : 2024-08-01 Epub Date: 2024-08-18 DOI: 10.1007/s10585-024-10300-7
Stanley P Leong

Cancer cells within a population are heterogeneous due to genomic mutations or epigenetic changes. The immune response to cancer especially the T cell repertoire within the cancer microenvionment is important to the control and growth of cancer cells. When a cancer clone breaks through the surveillance of the immune system, it wins the battle to overcome the host's immune system. In this review, the complicated profile of the cancer microenvironment is emphasized. The molecular evidence of immune responses to cancer has been recently established. Based on these molecular mechanisms of immune interactions with cancer, clinical trials based on checkpoint inhibition therapy against CTLA-4 and/or PD-1 versus PD-L1 have been successful in the treatment of melanoma, lung cancer and other types of cancer. The diversity of the T cell repertoire is described and the tumor infiltrating lymphocytes within the cancer may be expanded ex vivo and infused back to the patient as a treatment modality for adoptive immunotherapy.

由于基因组突变或表观遗传学变化,群体中的癌细胞具有异质性。对癌症的免疫反应,尤其是癌症微环境中的 T 细胞复合物对癌细胞的控制和生长非常重要。当癌细胞克隆突破免疫系统的监控时,它就赢得了战胜宿主免疫系统的战斗。本综述强调了癌症微环境的复杂性。癌症免疫反应的分子证据最近已经确立。基于这些免疫与癌症相互作用的分子机制,以针对 CTLA-4 和/或 PD-1 与 PD-L1 的检查点抑制疗法为基础的临床试验已成功治疗了黑色素瘤、肺癌和其他类型的癌症。本文介绍了 T 细胞编队的多样性,癌症内的肿瘤浸润淋巴细胞可在体外扩增,并输回患者体内,作为一种采用性免疫疗法的治疗方式。
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Clinical & Experimental Metastasis
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