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The solute carrier transporters (SLCs) family in nutrient metabolism and ferroptosis. 营养代谢和铁变态反应中的溶质载体转运体(SLCs)家族。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-09-02 DOI: 10.1186/s40364-024-00645-2
Li-Li Sun, Hai-Yan He, Wei Li, Wei-Lin Jin, Yi-Ju Wei

Ferroptosis is a novel form of programmed cell death caused by damage to lipid membranes due to the accumulation of lipid peroxides in response to various stimuli, such as high levels of iron, oxidative stress, metabolic disturbance, etc. Sugar, lipid, amino acid, and iron metabolism are crucial in regulating ferroptosis. The solute carrier transporters (SLCs) family, known as the "metabolic gating" of cells, is responsible for transporting intracellular nutrients and metabolites. Recent studies have highlighted the significant role of SLCs family members in ferroptosis by controlling the transport of various nutrients. Here, we summarized the function and mechanism of SLCs in ferroptosis regulated by ion, metabolic control of nutrients, and multiple signaling pathways, with a focus on SLC-related transporters that primarily transport five significant components: glucose, amino acid, lipid, trace metal ion, and other ion. Furthermore, the potential clinical applications of targeting SLCs with ferroptosis inducers for various diseases, including tumors, are discussed. Overall, this paper delves into the novel roles of the SLCs family in ferroptosis, aiming to enhance our understanding of the regulatory mechanisms of ferroptosis and identify new therapeutic targets for clinical applications.

铁变态反应是一种新型的程序性细胞死亡,是由于脂质过氧化物在高浓度铁、氧化应激、新陈代谢紊乱等各种刺激下积聚,导致脂膜受损而引起的。糖、脂质、氨基酸和铁的新陈代谢对调节铁变态反应至关重要。溶质载体转运体(SLCs)家族被称为细胞的 "代谢门",负责转运细胞内的营养物质和代谢产物。最近的研究强调了 SLCs 家族成员通过控制各种营养物质的转运在铁变态反应中的重要作用。在此,我们总结了 SLCs 在铁突变中受离子调控、营养物质代谢调控和多种信号通路调控的功能和机制,重点研究了主要转运葡萄糖、氨基酸、脂质、微量金属离子和其他离子五种重要成分的 SLC 相关转运体。此外,本文还讨论了针对包括肿瘤在内的各种疾病,用铁蛋白沉降诱导剂靶向 SLCs 的潜在临床应用。总之,本文深入探讨了 SLCs 家族在高铁血症中的新作用,旨在加深我们对高铁血症调控机制的理解,并为临床应用确定新的治疗靶点。
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引用次数: 0
mRNA vaccines in tumor targeted therapy: mechanism, clinical application, and development trends. mRNA 疫苗在肿瘤靶向治疗中的应用:机制、临床应用和发展趋势。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-31 DOI: 10.1186/s40364-024-00644-3
Yu Gao, Liang Yang, Zhenning Li, Xueqiang Peng, Hangyu Li

Malignant tumors remain a primary cause of human mortality. Among the various treatment modalities for neoplasms, tumor vaccines have consistently shown efficacy and promising potential. These vaccines offer advantages such as specificity, safety, and tolerability, with mRNA vaccines representing promising platforms. By introducing exogenous mRNAs encoding antigens into somatic cells and subsequently synthesizing antigens through gene expression systems, mRNA vaccines can effectively induce immune responses. Katalin Karikó and Drew Weissman were awarded the 2023 Nobel Prize in Physiology or Medicine for their great contributions to mRNA vaccine research. Compared with traditional tumor vaccines, mRNA vaccines have several advantages, including rapid preparation, reduced contamination, nonintegrability, and high biodegradability. Tumor-targeted therapy is an innovative treatment modality that enables precise targeting of tumor cells, minimizes damage to normal tissues, is safe at high doses, and demonstrates great efficacy. Currently, targeted therapy has become an important treatment option for malignant tumors. The application of mRNA vaccines in tumor-targeted therapy is expanding, with numerous clinical trials underway. We systematically outline the targeted delivery mechanism of mRNA vaccines and the mechanism by which mRNA vaccines induce anti-tumor immune responses, describe the current research and clinical applications of mRNA vaccines in tumor-targeted therapy, and forecast the future development trends of mRNA vaccine application in tumor-targeted therapy.

恶性肿瘤仍然是人类死亡的主要原因。在各种治疗肿瘤的方法中,肿瘤疫苗一直显示出疗效和巨大的潜力。这些疫苗具有特异性、安全性和耐受性等优势,其中 mRNA 疫苗是前景广阔的平台。通过将编码抗原的外源 mRNA 导入体细胞,然后通过基因表达系统合成抗原,mRNA 疫苗可有效诱导免疫反应。卡塔林-卡里科(Katalin Karikó)和德鲁-魏斯曼(Drew Weissman)因其在 mRNA 疫苗研究方面的巨大贡献而荣获 2023 年诺贝尔生理学或医学奖。与传统的肿瘤疫苗相比,mRNA 疫苗具有制备快速、减少污染、不可溶性和生物降解性高等优点。肿瘤靶向治疗是一种创新的治疗方式,它能精确靶向肿瘤细胞,最大限度地减少对正常组织的损伤,大剂量安全,疗效显著。目前,靶向治疗已成为恶性肿瘤的重要治疗手段。mRNA 疫苗在肿瘤靶向治疗中的应用正在不断扩大,许多临床试验正在进行中。我们系统地概述了mRNA疫苗的靶向传递机制和mRNA疫苗诱导抗肿瘤免疫应答的机制,描述了mRNA疫苗在肿瘤靶向治疗中的研究现状和临床应用,并预测了mRNA疫苗在肿瘤靶向治疗中应用的未来发展趋势。
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引用次数: 0
BRD4: an effective target for organ fibrosis. BRD4:器官纤维化的有效靶点。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-30 DOI: 10.1186/s40364-024-00641-6
Qun Wei, Cailing Gan, Meng Sun, Yuting Xie, Hongyao Liu, Taixiong Xue, Conghui Deng, Chunheng Mo, Tinghong Ye

Fibrosis is an excessive wound-healing response induced by repeated or chronic external stimuli to tissues, significantly impacting quality of life and primarily contributing to organ failure. Organ fibrosis is reported to cause 45% of all-cause mortality worldwide. Despite extensive efforts to develop new antifibrotic drugs, drug discovery has not kept pace with the clinical demand. Currently, only pirfenidone and nintedanib are approved by the FDA to treat pulmonary fibrotic illness, whereas there are currently no available antifibrotic drugs for hepatic, cardiac or renal fibrosis. The development of fibrosis is closely related to epigenetic alterations. The field of epigenetics primarily studies biological processes, including chromatin modifications, epigenetic readers, DNA transcription and RNA translation. The bromodomain and extra-terminal structural domain (BET) family, a class of epigenetic readers, specifically recognizes acetylated histone lysine residues and promotes the formation of transcriptional complexes. Bromodomain-containing protein 4 (BRD4) is one of the most well-researched proteins in the BET family. BRD4 is implicated in the expression of genes related to inflammation and pro-fibrosis during fibrosis. Inhibition of BRD4 has shown promising anti-fibrotic effects in preclinical studies; however, no BRD4 inhibitor has been approved for clinical use. This review introduces the structure and function of BET proteins, the research progress on BRD4 in organ fibrosis, and the inhibitors of BRD4 utilized in fibrosis. We emphasize the feasibility of targeting BRD4 as an anti-fibrotic strategy and discuss the therapeutic potential and challenges associated with BRD4 inhibitors in treating fibrotic diseases.

纤维化是组织受到反复或慢性外部刺激而诱发的过度伤口愈合反应,严重影响生活质量,主要导致器官衰竭。据报道,器官纤维化占全球全因死亡率的 45%。尽管人们在开发新的抗纤维化药物方面做出了大量努力,但药物开发的速度却跟不上临床需求。目前,只有吡非尼酮(pirfenidone)和宁替达尼(nintedanib)被美国食品及药物管理局批准用于治疗肺纤维化疾病,而肝纤维化、心纤维化和肾纤维化目前尚无可用的抗纤维化药物。纤维化的发展与表观遗传学改变密切相关。表观遗传学领域主要研究生物过程,包括染色质修饰、表观遗传读者、DNA 转录和 RNA 翻译。含溴结构域和外端结构域(BET)家族是一类表观遗传阅读器,能特异性识别乙酰化组蛋白赖氨酸残基,促进转录复合物的形成。含溴结构域蛋白 4(BRD4)是 BET 家族中研究最深入的蛋白之一。BRD4 与纤维化过程中的炎症和促纤维化相关基因的表达有关。在临床前研究中,抑制BRD4显示出了良好的抗纤维化效果;然而,目前还没有任何BRD4抑制剂被批准用于临床。本综述介绍了 BET 蛋白的结构和功能、器官纤维化中 BRD4 的研究进展以及纤维化中使用的 BRD4 抑制剂。我们强调了以BRD4为靶点作为抗纤维化策略的可行性,并讨论了BRD4抑制剂在治疗纤维化疾病方面的治疗潜力和挑战。
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引用次数: 0
A metabolite-based liquid biopsy for detection of ovarian cancer. 用于检测卵巢癌的基于代谢物的液体活检。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-28 DOI: 10.1186/s40364-024-00629-2
Johannes F Fahrmann, Seyyed Mahmood Ghasemi, Chae Y Han, Ranran Wu, Jennifer B Dennison, Jody Vykoukal, Joseph Celestino, Karen Lu, Zhen Lu, Charles Drescher, Kim-Anh Do, Samir Hanash, Robert C Bast, Ehsan Irajizad

Serial CA125 and second line transvaginal ultrasound (TVS) screening in the UKCTOCS indicated a shift towards detection of earlier stage ovarian cancer (OvCa), but did not yield a significant mortality reduction. There remains a need to establish additional biomarkers that can complement CA125 for even earlier and at a larger proportion of new cases. Using a cohort of plasma samples from 219 OvCa cases (59 stage I/II and 160 stage III/IV) and 409 female controls and a novel Sensitivity Maximization At A Given Specificity (SMAGS) method, we developed a blood-based metabolite-based test consisting of 7 metabolites together with CA125 for detection of OvCa. At a 98.5% specificity cutpoint, the metabolite test achieved sensitivity of 86.2% for detection of early-stage OvCa and was able to capture 64% of the cases with low CA125 levels (< 35 units/mL). In an independent test consisting of 65 early-stage OvCa cases and 141 female controls, the metabolite panel achieved sensitivity of 73.8% at a 91.4% specificity and captured 13 (44.8%) out of 29 early-stage cases with CA125 levels < 35 units/mL. The metabolite test has utility for ovarian cancer screening, capable of improving upon CA125 for detection of early-stage disease.

英国 CTOCS 中的连续 CA125 和二线经阴道超声(TVS)筛查表明,卵巢癌(OvCa)向早期检测转变,但并未显著降低死亡率。目前仍有必要建立更多的生物标志物来补充 CA125,以便更早地发现更多的新病例。我们利用 219 例卵巢癌病例(59 例 I/II 期,160 例 III/IV 期)和 409 例女性对照的血浆样本,并采用一种新颖的特定特异性灵敏度最大化(SMAGS)方法,开发了一种基于血液的代谢物检测方法,其中包括 7 种代谢物和 CA125,用于检测卵巢癌。在特异性切点为 98.5% 的情况下,代谢物检测对早期卵巢癌的检测灵敏度为 86.2%,并能捕获 64% 的 CA125 水平较低的病例 (
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引用次数: 0
Comparison of proton therapy and photon therapy for early-stage non-small cell lung cancer: a meta-analysis. 质子疗法与光子疗法治疗早期非小细胞肺癌的比较:一项荟萃分析。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-26 DOI: 10.1186/s40364-024-00642-5
Junyi He, Yingxin Liu, Xiaojing Zhang, Butuo Li, Linlin Yang, Haohua Wang, Shijiang Wang, Jinming Yu, Linlin Wang

The use of proton therapy (PT) in early-stage non-small cell lung cancer (ES-NSCLC) remains controversial, with insufficient evidence to determine its superiority over photon therapy (XRT). We conducted a systematic review of PT trials in ES-NSCLC, analyzing dosimetry, efficacy, and safety across to inform clinical decision-making. Our study showed that PT reduced lung and heart dosimetric parameters compared to XRT, with significant differences in lung V5, lung V10 and mean heart dose (MHD). In terms of efficacy, there were no significant differences in 1-year OS, 3-year OS and 3-year PFS between PT and XRT. For toxicity, no significant difference was observed in treatment-related adverse events (TRAEs) and radiation pneumonitis (RP). Single-arm analysis of PT found that V5, V10, V20 of lung and heart V5 were 13.4%, 11.3%, 7.9% and 0.7%, respectively. The mean lung dose and MHD were 4.15 Gy and 0.17 Gy, respectively. The single-arm pooled 1-, 2-, 3- and 5-year OS rates for PT were 95.3%, 82.5%, 81.3% and 69.3%, respectively. PFS rate and local control rate at 3 years were 68.1% and 91.2%, respectively. The rates of TRAEs of grade ≥ 3 and grade ≥ 2 were 2.8% and 19.8%, respectively. The grade ≥ 2 RP occurred at a rate of 8.7%. In conclusion, PT had acceptable efficacy and safety, and was better at protecting organs at risk than XRT in ES-NSCLC. However, the survival and safety benefit of PT was not significant compared to XRT.

质子疗法(PT)在早期非小细胞肺癌(ES-NSCLC)中的应用仍存在争议,没有足够的证据确定其优于光子疗法(XRT)。我们对 ES-NSCLC 的 PT 试验进行了系统回顾,分析了剂量测定、疗效和安全性,为临床决策提供了参考。我们的研究表明,与 XRT 相比,PT 降低了肺和心脏的剂量学参数,在肺 V5、肺 V10 和平均心脏剂量 (MHD) 方面差异显著。在疗效方面,PT和XRT在1年OS、3年OS和3年PFS方面没有明显差异。在毒性方面,治疗相关不良事件(TRAEs)和放射性肺炎(RP)无明显差异。PT 的单臂分析发现,肺部 V5、V10、V20 和心脏 V5 分别为 13.4%、11.3%、7.9% 和 0.7%。肺部平均剂量和MHD分别为4.15 Gy和0.17 Gy。PT的单臂汇总1年、2年、3年和5年OS率分别为95.3%、82.5%、81.3%和69.3%。3年的PFS率和局部控制率分别为68.1%和91.2%。TRAE ≥ 3级和≥ 2级的发生率分别为2.8%和19.8%。≥2级RP发生率为8.7%。总之,在ES-NSCLC中,PT具有可接受的疗效和安全性,在保护危险器官方面优于XRT。然而,与XRT相比,PT的生存率和安全性优势并不显著。
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引用次数: 0
Global burden of breast cancer and attributable risk factors in 204 countries and territories, from 1990 to 2021: results from the Global Burden of Disease Study 2021. 1990 年至 2021 年 204 个国家和地区的全球乳腺癌负担和可归因风险因素:2021 年全球疾病负担研究的结果。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-26 DOI: 10.1186/s40364-024-00631-8
Rui Sha, Xiang-Meng Kong, Xin-Yu Li, Ya-Bing Wang

Background and objective: Breast cancer is a leading cause of morbidity and mortality among women worldwide. This study aimed to assess the global burden of breast cancer and identify attributable risk factors across 204 countries and territories from 1990 to 2021.

Methods: Using data from the Global Burden of Disease Study 2021, we analyzed the incidence, mortality, disability-adjusted life years (DALYs), and risk factors associated with breast cancer. We obtained and analyzed the age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized DALYs rate from 1990 to 2021. We assessed geographical variations and the impact of the Socio-demographic Index (SDI) using regression analysis and stratification by SDI quintiles. Additionally, we estimated the risk factors attributable to breast cancer deaths and DALYs using the comparative risk assessment framework of the GBD study.

Results: Globally, breast cancer incident cases increased from 875,657 in 1990 to 2,121,564 in 2021. The ASIR rose from 16.42 to 26.88 per 100,000 (95% CI: 1.54-1.60). High SDI regions showed the highest ASIR (66.89 per 100,000 in 2021), while Low SDI regions had the lowest (6.99 per 100,000 in 2021). The global ASDR decreased from 10.42 to 8.54 per 100,000, and the age-standardized DALYs rate decreased from 313.36 to 261.5 per 100,000 between 1990 and 2021. However, these improvements were not uniform across SDI regions. Risk factors included high body-mass index, alcohol use, tobacco, and high fasting plasma glucose, with variations across SDI regions.

Conclusion: The global burden of breast cancer has increased significantly from 1990 to 2021, with disparities observed across SDI regions. While high SDI areas show improvements in mortality and DALYs, lower SDI regions face increasing burdens. Targeted interventions addressing modifiable risk factors and improving healthcare access in less developed regions are crucial for reducing the global impact of breast cancer.

背景和目的:乳腺癌是全球妇女发病和死亡的主要原因。本研究旨在评估乳腺癌的全球负担,并确定 1990 年至 2021 年期间 204 个国家和地区的可归因风险因素:利用《2021 年全球疾病负担研究》(Global Burden of Disease Study 2021)的数据,我们分析了乳腺癌的发病率、死亡率、残疾调整生命年(DALYs)和相关风险因素。我们获得并分析了 1990 年至 2021 年的年龄标准化发病率(ASIR)、年龄标准化死亡率(ASDR)和年龄标准化残疾调整生命年率。我们利用回归分析和社会人口指数五分法对地域差异和社会人口指数(SDI)的影响进行了评估。此外,我们还利用 GBD 研究的比较风险评估框架估算了导致乳腺癌死亡和残疾调整寿命年数的风险因素:全球乳腺癌发病病例从 1990 年的 875,657 例增加到 2021 年的 2,121,564 例。每 10 万人的 ASIR 从 16.42 上升至 26.88(95% CI:1.54-1.60)。高 SDI 地区的 ASIR 最高(2021 年为每 100 000 人 66.89),而低 SDI 地区最低(2021 年为每 100 000 人 6.99)。1990 年至 2021 年期间,全球年龄标准化残疾调整寿命年数从每 10 万人 10.42 例降至 8.54 例,年龄标准化残疾调整寿命年数从每 10 万人 313.36 例降至 261.5 例。然而,这些改善在各 SDI 地区并不一致。风险因素包括高体重指数、酗酒、吸烟和高空腹血浆葡萄糖,各 SDI 地区之间存在差异:结论:从 1990 年到 2021 年,全球乳腺癌的负担显著增加,不同 SDI 地区之间存在差异。虽然高 SDI 地区的死亡率和残疾调整寿命年数有所改善,但低 SDI 地区的负担却在增加。在欠发达地区,针对可改变的风险因素采取有针对性的干预措施,并改善医疗服务的可及性,对于减少乳腺癌对全球的影响至关重要。
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引用次数: 0
Current status and future perspectives of platelet-derived extracellular vesicles in cancer diagnosis and treatment. 血小板源性细胞外囊泡在癌症诊断和治疗中的应用现状和未来展望。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-26 DOI: 10.1186/s40364-024-00639-0
Tongtao Zhuang, Shenrong Wang, Xiaoqian Yu, Xiaoyun He, Hongbin Guo, Chunlin Ou

Platelets are a significant component of the cell population in the tumour microenvironment (TME). Platelets influence other immune cells and perform cross-talk with tumour cells, playing an important role in tumour development. Extracellular vesicles (EVs) are small membrane vesicles released from the cells into the TME. They can transfer biological information, including proteins, nucleic acids, and metabolites, from secretory cells to target receptor cells. This process affects the progression of various human diseases, particularly cancer. In recent years, several studies have demonstrated that platelet-derived extracellular vesicles (PEVs) can help regulate the malignant biological behaviours of tumours, including malignant proliferation, resistance to cell death, invasion and metastasis, metabolic reprogramming, immunity, and angiogenesis. Consequently, PEVs have been identified as key regulators of tumour progression. Therefore, targeting PEVs is a potential strategy for tumour treatment. Furthermore, the extensive use of nanomaterials in medical research has indicated that engineered PEVs are ideal delivery systems for therapeutic drugs. Recent studies have demonstrated that PEV engineering technologies play a pivotal role in the treatment of tumours by combining photothermal therapy, immunotherapy, and chemotherapy. In addition, aberrant changes in PEVs are closely associated with the clinicopathological features of patients with tumours, which may serve as liquid biopsy markers for early diagnosis, monitoring disease progression, and the prognostic assessment of patients with tumours. A comprehensive investigation into the role and potential mechanisms of PEVs in tumourigenesis may provide novel diagnostic biomarkers and potential therapeutic strategies for treating human tumours.

血小板是肿瘤微环境(TME)细胞群的重要组成部分。血小板会影响其他免疫细胞,并与肿瘤细胞进行交叉对话,在肿瘤发生发展过程中发挥着重要作用。细胞外囊泡 (EV) 是细胞释放到肿瘤微环境中的小膜泡。它们可以将生物信息(包括蛋白质、核酸和代谢物)从分泌细胞传递到目标受体细胞。这一过程会影响人类各种疾病,尤其是癌症的进展。近年来,多项研究表明,血小板衍生的细胞外囊泡(PEVs)有助于调节肿瘤的恶性生物学行为,包括恶性增殖、抵抗细胞死亡、侵袭和转移、代谢重编程、免疫和血管生成。因此,PEVs 已被确定为肿瘤进展的关键调控因子。因此,靶向 PEVs 是一种潜在的肿瘤治疗策略。此外,纳米材料在医学研究中的广泛应用表明,工程 PEV 是治疗药物的理想输送系统。最近的研究表明,PEV 工程技术在结合光热疗法、免疫疗法和化疗治疗肿瘤方面发挥着举足轻重的作用。此外,PEV 的异常变化与肿瘤患者的临床病理特征密切相关,可作为液体活检标志物用于肿瘤患者的早期诊断、疾病进展监测和预后评估。全面研究 PEVs 在肿瘤发生中的作用和潜在机制,可为治疗人类肿瘤提供新的诊断生物标记物和潜在的治疗策略。
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引用次数: 0
Oncological characteristics, treatments and prognostic outcomes in MMR-deficient colorectal cancer. MMR缺陷型大肠癌的肿瘤学特征、治疗方法和预后结果。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-26 DOI: 10.1186/s40364-024-00640-7
Wen-Xuan Fan, Fei Su, Yan Zhang, Xiao-Ling Zhang, Yun-Yi Du, Yang-Jun Gao, Wei-Ling Li, Wen-Qing Hu, Jun Zhao

Colorectal cancer (CRC) ranks as the third most prevalent cancer globally. It's recognized that the molecular subtype of CRC, characterized by mismatch repair deficiency (dMMR) or microsatellite instability-high (MSI-H), plays a critical role in determining appropriate treatment strategies. This review examines the current molecular classifications, focusing on dMMR/MSI-H CRC and its subtypes: Lynch syndrome (LS), Lynch-like syndrome (LLS), and sporadic cases. Despite advances in understanding of these genetic backgrounds, clinical trials have not conclusively differentiated the efficacy of immune checkpoint inhibitors among these subgroups. Therefore, while this review details the molecular characteristics and their general implications for treatment and prognosis, it also highlights the limitations and the need for more refined clinical studies to ascertain tailored therapeutic strategies for each subtype. Furthermore, this review summarizes completed and ongoing clinical studies, emphasizing the importance of developing treatments aligned more closely with molecular profiles. By discussing these aspects, the review seeks to provide a comprehensive analysis of oncological characteristics, presenting a detailed understanding of their implications for treatment and prognosis in dMMR/MSI-H CRC.

结直肠癌(CRC)是全球发病率第三高的癌症。人们认识到,以错配修复缺陷(dMMR)或微卫星不稳定性高(MSI-H)为特征的 CRC 分子亚型在确定适当的治疗策略方面起着至关重要的作用。本综述研究了当前的分子分类,重点关注 dMMR/MSI-H CRC 及其亚型:林奇综合征(LS)、林奇样综合征(LLS)和散发性病例。尽管对这些遗传背景的了解有所进展,但临床试验并未最终区分免疫检查点抑制剂在这些亚群中的疗效。因此,本综述在详细介绍分子特征及其对治疗和预后的一般影响的同时,也强调了临床研究的局限性和对更精细化临床研究的需求,以确定针对每种亚型的定制治疗策略。此外,本综述还总结了已完成和正在进行的临床研究,强调了开发更符合分子特征的治疗方法的重要性。通过对这些方面的讨论,本综述力图对肿瘤学特征进行全面分析,详细了解这些特征对 dMMR/MSI-H CRC 治疗和预后的影响。
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引用次数: 0
CAR Macrophages: a promising novel immunotherapy for solid tumors and beyond. CAR 巨噬细胞:一种治疗实体瘤及其他肿瘤的前景广阔的新型免疫疗法。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-23 DOI: 10.1186/s40364-024-00637-2
Jialin Lu, Yuqing Ma, Qiuxin Li, Yihuan Xu, Yiquan Xue, Sheng Xu

With the advent of adoptive cellular therapy, chimeric antigen receptor (CAR)-T cell therapy has gained widespread application in cancer treatment and has demonstrated significant efficacy against certain hematologic malignancies. However, due to the limitations of CAR-T cell therapy in treating solid tumors, other immune cells are being modified with CAR to address this issue. Macrophages have emerged as a promising option, owing to their extensive immune functions, which include antigen presentation, powerful tumor phagocytosis, and particularly active trafficking to the tumor microenvironment. Leveraging their unique advantages, CAR-macrophages (CAR-M) are expected to enhance the effectiveness of solid tumor treatments as a novel form of immunotherapy, potentially overcoming major challenges associated with CAR-T/NK therapy. This review outlines the primary mechanism underlying CAR-M and recent progressions in CAR-M therapy, while also discussing their further applications.

随着采用性细胞疗法的出现,嵌合抗原受体(CAR)-T 细胞疗法在癌症治疗中得到了广泛应用,对某些血液系统恶性肿瘤有显著疗效。然而,由于 CAR-T 细胞疗法在治疗实体瘤方面的局限性,人们正在用 CAR 改造其他免疫细胞来解决这一问题。巨噬细胞具有广泛的免疫功能,包括抗原呈递、强大的肿瘤吞噬能力和特别活跃的肿瘤微环境转运能力,因此成为一种很有前景的选择。利用其独特优势,CAR-巨噬细胞(CAR-M)有望作为一种新型免疫疗法提高实体瘤治疗的有效性,并有可能克服与 CAR-T/NK 疗法相关的主要挑战。这篇综述概述了CAR-M的主要机制和CAR-M疗法的最新进展,同时还讨论了它们的进一步应用。
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引用次数: 0
Targeted protein degradation in hematologic malignancies: clinical progression towards novel therapeutics. 血液恶性肿瘤中的靶向蛋白降解:新型疗法的临床进展。
IF 9.5 2区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-08-21 DOI: 10.1186/s40364-024-00638-1
Yupiao Feng, Xinting Hu, Xin Wang

Targeted therapies, such as small molecule kinase inhibitors, have made significant progress in the treatment of hematologic malignancies by directly modulating protein activity. However, issues such as drug toxicity, drug resistance due to target mutations, and the absence of key active sites limit the therapeutic efficacy of these drugs. Targeted protein degradation (TPD) presents an emergent and rapidly evolving therapeutic approach that selectively targets proteins of interest (POI) based on endogenous degradation processes. With an event-driven pharmacology of action, TPD achieves efficacy with catalytic amounts, avoiding drug-related toxicity. Furthermore, TPD has the unique mode of degrading the entire POI, such that resistance derived from mutations in the targeted protein has less impact on its degradation function. Proteolysis-targeting chimeras (PROTACs) and molecular glue degraders (MGDs) are the most maturely developed TPD techniques. In this review, we focus on both preclinical experiments and clinical trials to provide a comprehensive summary of the safety and clinical effectiveness of PROTACs and MGDs in hematologic malignancies over the past two decades. In addition, we also delineate the challenges and opportunities associated with these burgeoning degradation techniques. TPD, as an approach to the precise degradation of specific proteins, provides an important impetus for its future application in the treatment of patients with hematologic malignancies.

小分子激酶抑制剂等靶向疗法通过直接调节蛋白质活性,在治疗血液系统恶性肿瘤方面取得了重大进展。然而,药物毒性、靶点突变导致的耐药性以及关键活性位点的缺失等问题限制了这些药物的疗效。靶向蛋白质降解(TPD)是一种新兴且发展迅速的治疗方法,它根据内源性降解过程选择性地靶向感兴趣的蛋白质(POI)。通过事件驱动的药理学作用,TPD 以催化量实现疗效,避免了与药物相关的毒性。此外,TPD 具有降解整个 POI 的独特模式,因此靶蛋白突变产生的抗药性对其降解功能的影响较小。蛋白水解靶向嵌合体(PROTACs)和分子胶降解器(MGDs)是目前发展最为成熟的 TPD 技术。在这篇综述中,我们将重点关注临床前实验和临床试验,全面总结过去二十年来 PROTACs 和 MGDs 在血液恶性肿瘤中的安全性和临床有效性。此外,我们还阐述了与这些新兴降解技术相关的挑战和机遇。TPD作为一种精确降解特定蛋白质的方法,为其未来在血液恶性肿瘤患者治疗中的应用提供了重要的推动力。
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Biomarker Research
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