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Management of oligometastatic and oligoprogressive epidermal growth factor receptor mutated non-small cell lung cancer patients: state of the art of a combined approach 少转移和少进展表皮生长因子受体突变非小细胞肺癌患者的管理:联合方法的最新进展
Pub Date : 2024-05-17 DOI: 10.37349/etat.2024.00228
F. Di Pressa, F. Perrone, Anna Benini, Frank Lohr, Marcello Tiseo, A. Bruni
Recently, the development of targeted therapy approaches such as those based on tyrosine kinase inhibitor (TKI) greatly improved the clinical outcomes of patients affected by oncogene addicted advanced non-small cell lung cancer (NSCLC). Similarly, the improvement of radiation therapy techniques has permitted to deliver high radiation doses to a limited number of metastatic target lesions (oligopersistent or oligoprogressive), with limited high-dose normal tissue exposure that leads to low severe toxicity rates. The aim of this narrative review was to provide an overview of the currently established definition of oligometastatic and oligoprogressive disease, to define first line and subsequent lines targeted therapies and the role of consolidative non-invasive local ablative treatments (LATs) in these settings. The potential benefit of local treatment (LT) such as radiotherapy (RT) or surgery might be represented by an overall reduction of switching to subsequent systemic treatments lowering the risk of further systemic dissemination. Further randomized clinical trials will clarify the role of LT and their correct timing in relation to systemic targeted therapies.
最近,基于酪氨酸激酶抑制剂(TKI)等靶向治疗方法的发展大大改善了受癌基因影响的晚期非小细胞肺癌(NSCLC)患者的临床治疗效果。同样,放疗技术的改进也允许向数量有限的转移性靶病灶(少持续性或少进展性)投放高剂量放射线,同时限制高剂量正常组织照射,从而降低了严重毒性。本综述旨在概述目前已确定的少转移和少进展性疾病的定义,界定一线和后续靶向疗法,以及巩固性非侵入性局部消融治疗(LATs)在这些情况下的作用。放疗(RT)或手术等局部治疗(LT)的潜在益处可能体现在总体上减少了后续全身治疗的转换,降低了进一步全身扩散的风险。进一步的随机临床试验将明确局部治疗的作用及其与全身性靶向治疗相关的正确时机。
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引用次数: 0
Improving the quality of patient care in lung cancer: key factors for successful multidisciplinary team working 提高肺癌患者护理质量:多学科团队成功工作的关键因素
Pub Date : 2024-03-21 DOI: 10.37349/etat.2024.00217
Alessandro Morabito, Edoardo Mercadante, Paolo Muto, A. Manzo, G. Palumbo, Vincenzo Sforza, A. Montanino, C. Sandomenico, R. Costanzo, Giovanna Esposito, G. Totaro, R. De Cecio, Carmine Picone, Annamaria Porto, Nicola Normanno, Arturo Capasso, M. Pinto, Maura Tracey, Giuseppe Caropreso, Giacomo Pascarella
International Guidelines as well as Cancer Associations recommend a multidisciplinary approach to lung cancer care. A multidisciplinary team (MDT) can significantly improve treatment decision-making and patient coordination by putting different physicians and other health professionals “in the same room”, who collectively decide upon the best possible treatment. However, this is not a panacea for cancer treatment. The impact of multidisciplinary care (MDC) on patient outcomes is not univocal, while the effective functioning of the MDT depends on many factors. This review presents the available MDT literature with an emphasis on the key factors that characterize high-quality patient care in lung cancer. The study was conducted with a bibliographic search using different electronic databases (PubMed Central, Scopus, Google Scholar, and Google) referring to multidisciplinary cancer care settings. Many key elements appear consolidated, while others emerge as prevalent and actual, especially those related to visible barriers which work across geographic, organizational, and disciplinary boundaries. MDTs must be sustained by strategic management, structured within the entity, and cannot be managed as a separate care process. Furthermore, they need to coordinate with other teams (within and outside the organization) and join with the broad range of services delivered by multiple providers at various points of the cancer journey or within the system, with the vision of integrated care.
国际指南和癌症协会建议采用多学科方法治疗肺癌。多学科团队(MDT)可以将不同的医生和其他医疗专业人员 "集中 "在一起,共同决定最佳治疗方案,从而大大改善治疗决策和患者协调。然而,这并不是治疗癌症的灵丹妙药。多学科治疗(MDC)对患者预后的影响并不明确,而多学科治疗小组的有效运作取决于许多因素。本综述介绍了现有的多学科治疗小组文献,重点关注肺癌患者高质量治疗的关键因素。本研究使用不同的电子数据库(PubMed Central、Scopus、Google Scholar 和 Google)对癌症多学科治疗环境进行了文献检索。结果显示,许多关键因素得到了巩固,而其他因素则普遍存在,尤其是那些与跨越地域、组织和学科界限的明显障碍有关的因素。多学科小组必须通过战略管理来维持,并在实体内构建,不能作为单独的护理流程来管理。此外,他们还需要与其他团队(组织内部和外部)进行协调,并在癌症治疗过程的不同阶段或系统内与多个医疗服务提供者提供的广泛服务相结合,以实现综合治疗的愿景。
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引用次数: 0
Potential of targeting signal-transducing adaptor protein-2 in cancer therapeutic applications 靶向信号转导适配蛋白-2在癌症治疗中的应用潜力
Pub Date : 2024-03-07 DOI: 10.37349/etat.2024.00216
Taiga Maemoto, Yuto Sasaki, Fumiya Okuyama, Yuichi Kitai, K. Oritani, Tadashi Matsuda
Adaptor proteins play essential roles in various intracellular signaling pathways. Signal-transducing adaptor protein-2 (STAP-2) is an adaptor protein that possesses pleckstrin homology (PH) and Src homology 2 (SH2) domains, as well as a YXXQ signal transducer and activator of transcription 3 (STAT3)-binding motif in its C-terminal region. STAP-2 is also a substrate of breast tumor kinase (BRK). STAP-2/BRK expression is deregulated in breast cancers and enhances STAT3-dependent cell proliferation. In prostate cancer cells, STAP-2 interacts with and stabilizes epidermal growth factor receptor (EGFR) after stimulation, resulting in the upregulation of EGFR signaling, which contributes to cancer-cell proliferation and tumor progression. Therefore, inhibition of the interaction between STAP-2 and BRK/EGFR may be a possible therapeutic strategy for these cancers. For this purpose, peptides that interfere with STAP-2/BRK/EGFR binding may have great potential. Indeed, the identified peptide inhibitor successfully suppressed the STAP-2/EGFR protein interaction, EGFR stabilization, and cancer-cell growth. Furthermore, the peptide inhibitor suppressed tumor formation in human prostate- and lung-cancer cell lines in a murine xenograft model. This review focuses on the inhibitory peptide as a promising candidate for the treatment of prostate and lung cancers.
适配蛋白在各种细胞内信号通路中发挥着至关重要的作用。信号转导适配蛋白-2(STAP-2)是一种适配蛋白,具有pleckstrin homology(PH)和Src homology 2(SH2)结构域,其C端区域还具有YXXQ信号转导和激活转录3(STAT3)结合基团。STAP-2 还是乳腺肿瘤激酶(BRK)的底物。STAP-2/BRK 在乳腺癌中表达失调,会增强 STAT3 依赖性细胞增殖。在前列腺癌细胞中,STAP-2 受刺激后与表皮生长因子受体(EGFR)相互作用并使其稳定,导致 EGFR 信号上调,从而促进癌细胞增殖和肿瘤进展。因此,抑制 STAP-2 与 BRK/EGFR 之间的相互作用可能是治疗这些癌症的一种策略。为此,干扰 STAP-2/BRK/EGFR 结合的多肽可能具有很大的潜力。事实上,所发现的多肽抑制剂成功地抑制了 STAP-2/EGFR 蛋白相互作用、表皮生长因子受体稳定和癌细胞生长。此外,该多肽抑制剂还抑制了小鼠异种移植模型中人类前列腺癌和肺癌细胞系的肿瘤形成。本综述将重点介绍这种抑制肽,将其作为治疗前列腺癌和肺癌的有望候选药物。
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引用次数: 0
The oncogenic role of hepatitis B virus X gene in hepatocarcinogenesis: recent updates 乙型肝炎病毒 X 基因在肝癌发生中的致癌作用:最新进展
Pub Date : 2024-02-20 DOI: 10.37349/etat.2024.00209
A. Agustiningsih, M. R. Rasyak, Turyadi, Sri Jayanti, Caecilia Sukowati
Hepatocellular carcinoma (HCC) is the most prevalent form of primary liver cancers with high mortality rate. Among its various etiological factors, one of the major risk factors for HCC is a chronic infection of hepatitis B virus (HBV). HBV X protein (HBx) has been identified to play an important role in the HBV-induced HCC pathogenesis since it may interfere with several key regulators of many cellular processes. HBx localization within the cells may be beneficial to HBx multiple functions at different phases of HBV infection and associated hepatocarcinogenesis. HBx as a regulatory protein modulates cellular transcription, molecular signal transduction, cell cycle, apoptosis, autophagy, protein degradation pathways, and host genetic stability via interaction with various factors, including its association with various non-coding RNAs. A better understanding on the regulatory mechanism of HBx on various characteristics of HCC would provide an overall picture of HBV-associated HCC. This article addresses recent data on HBx role in the HBV-associated hepatocarcinogenesis.
肝细胞癌(HCC)是原发性肝癌中最常见的一种,死亡率很高。在各种病因中,慢性乙型肝炎病毒(HBV)感染是导致 HCC 的主要风险因素之一。HBV X 蛋白(HBx)已被确定在 HBV 诱导的 HCC 发病机制中扮演重要角色,因为它可能干扰许多细胞过程的几个关键调节因子。HBx 在细胞内的定位可能有利于 HBx 在 HBV 感染和相关肝癌发生的不同阶段发挥多种功能。HBx 作为一种调控蛋白,通过与各种因素的相互作用,包括与各种非编码 RNA 的关联,调节细胞转录、分子信号转导、细胞周期、细胞凋亡、自噬、蛋白质降解途径和宿主基因稳定性。更好地了解 HBx 对 HCC 各种特征的调控机制将有助于全面了解 HBV 相关 HCC。本文探讨了有关 HBx 在 HBV 相关性肝癌发生中作用的最新数据。
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引用次数: 0
Role of STAT3 in pancreatic cancer STAT3 在胰腺癌中的作用
Pub Date : 2024-01-17 DOI: 10.37349/etat.2024.00202
Zachary Hamel, Sierra Sanchez, D. Standing, S. Anant
Pancreatic cancer remains a serious and deadly disease, impacting people globally. There remain prominent gaps in the current understanding of the disease, specifically regarding the role of the signal transducer and activator of transcription (STAT) family of proteins in pancreatic tumors. STAT proteins, particularly STAT3, play important roles in pancreatic cancer, especially pancreatic ductal adenocarcinoma (PDAC), which is the most prevalent histotype. The role of STAT3 across a continuum of molecular processes, such as PDAC tumorigenesis and progression, immune escape, drug resistance and stemness, and modulation of the tumor microenvironment (TME), are only a tip of the iceberg. In some ways, the role of STAT3 in PDAC may hold greater importance than that of oncogenic Kirsten rat sarcoma virus (KRAS). This makes STAT3 a highly attractive target for developing targeted therapies for the treatment of pancreatic cancer. In this review, the current knowledge of STAT3 in pancreatic cancer has been summarized, particularly relating to STAT3 activation in cancer cells, cells of the TME, and the state of targeting STAT3 in pre-clinical and clinical trials of PDAC.
胰腺癌仍然是一种严重的致命疾病,影响着全球人民。目前人们对这种疾病的认识仍然存在很大差距,特别是信号转导和转录激活因子(STAT)家族蛋白在胰腺肿瘤中的作用。STAT 蛋白,尤其是 STAT3,在胰腺癌,特别是胰腺导管腺癌(PDAC)中发挥着重要作用,而胰腺导管腺癌是最常见的组织类型。STAT3 在一系列分子过程中的作用,如 PDAC 的肿瘤发生和发展、免疫逃逸、耐药性和干性以及肿瘤微环境(TME)的调节,只是冰山一角。在某些方面,STAT3 在 PDAC 中的作用可能比致癌的 Kirsten 大鼠肉瘤病毒(KRAS)更为重要。这使得 STAT3 成为开发治疗胰腺癌靶向疗法的一个极具吸引力的靶点。本综述总结了目前有关 STAT3 在胰腺癌中作用的知识,特别是有关 STAT3 在癌细胞、TME 细胞中的激活,以及在 PDAC 临床前和临床试验中靶向 STAT3 的情况。
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引用次数: 0
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Exploration of Targeted Anti-tumor Therapy
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