BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after m...BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after middle age, mostly between 40and 60 years old, with an average age of about 50 years old, and only 5% of patients are under 30 years old. The incidence of male is higher than that of female.AIM To investigate the short-term efficacy and influencing factors of chemotherapy combined with irinotecan in patients with advanced gastric cancer.METHODS Eighty patients with advanced gastric cancer who were treated in our hospital from January 2019 to January 2022 were selected. The patients were divided into an observation group(n = 40) and control group(n = 40) by the envelope method.The control group was given preoperative routine chemotherapy. The observation group was treated with irinotecan in addition to the chemotherapy given to the control group. The short-term efficacy of treatment in the two groups, as well as tumor marker levels and quality of life before and after treatment were evaluated.RESULTS The short-term treatment effect in the observation group was better than that in the control group(P < 0.05), and the total effective rate was 57.50%. The age and proportion of tumor node metastasis(TNM) stage IV patients with ineffective chemotherapy in the observation group were(65.12 ± 5.71) years and 52.94%,respectively, which were notably higher than those of patients with effective chemotherapy(P < 0.05), while the Karnofsky Performance Scale score was(67.70± 3.83) points, which was apparently lower than that of patients with effective chemotherapy(P <0.05). After 3 mo of treatment, the SF-36 scale scores of physiological function, energy, emotional function, and mental health in the observation group were 65.12 ± 8.14, 54.76 ± 6.70, 47.58 ± 7.22,and 66.16 ± 8.11 points, respectively, which were considerably higher than those in the control group(P < 0.05). The incidence rates of grade Ⅲ-Ⅳ diarrhea and grade Ⅲ-Ⅳ thrombocytopenia in the observation group were 32.50% and 25.00%, respectively, which were markedly higher than those in the control group(P < 0.05).CONCLUSION Chemotherapy combined with irinotecan in patients with advanced gastric cancer has a good short-term efficacy and can significantly reduce serum tumor markers and improve the quality of life of patients. The efficacy may be affected by the age and TNM stage of the patients, and its long-term efficacy needs further study.展开更多
The increased level of chromosome instability in cancer cells,leading to aneuploidy and gross chromosomal rearrangements,is not only a driving force for oncogenesis but also can be the Achille’s heel of the disease s...The increased level of chromosome instability in cancer cells,leading to aneuploidy and gross chromosomal rearrangements,is not only a driving force for oncogenesis but also can be the Achille’s heel of the disease since many chemotherapies(CT)kill cells by inducing a non-tolerable rate of DNA damage.A wealth of published evidence showed that telomere stability can be more affected than the bulk of the genome by several conventional antineoplasic drugs.These results raise the interesting possibility that CT with genotoxic drugs preferentially target telomeres.In agreement with this view,accelerated shortening of telomere length has been described in blood lineage cells following high-dose CT(stem cell transplantation)or non-myeloablative CT.However,almost nothing is known on the consequences of this shortening in terms of telomere stability,senescence and on the development of second cancers or post-treatment aging-like syndromes in cancer survivors(cognitive defect,fertility impairment,etc.).In this article,we propose:(1)telomeres of cancer cells are preferential genomic targets of chemotherapies altering chromosome maintenance;(2)telomere functional parameters can be a surrogate marker of chemotherapy sensitivity and toxicity;(3)the use of anti-telomere molecule could greatly enhance the sensitivity to standards chemotherapies.展开更多
Emerging evidence suggests that the clinical success of conventional chemotherapy is not solely attributed to tumor cell toxicity,but also results from the restoration of immunosurveillance,which has been largely negl...Emerging evidence suggests that the clinical success of conventional chemotherapy is not solely attributed to tumor cell toxicity,but also results from the restoration of immunosurveillance,which has been largely neglected in the past preclinical and clinical research.Antitumor immune response can be primed by immunogenic cell death(ICD),a type of cell death characterized by cell-surface translocation of calreticulin(CRT),extracellular release of ATP and high mobility group box 1(HMGB1),and stimulation of type I interferon(IFN)responses.Here we summarize recent studies showing conventional chemotherapeutics as ICD inducers,which are capable of modulating tumor infiltrating lymphocytes(TILs)and reactivating antitumor immunity within an immuno-suppressive microenvironment.Such immunological effects of conventional chemotherapy are likely critical for better prognosis of cancer patients.Furthermore,combination of ICD-inducing chemotherapeutics with immunotherapy is a promising approach for improving the clinical outcomes of cancer patients.展开更多
Background:Colorectal cancer(CRC)is the second most common cause of cancer-related deaths and has the third highest incidence in the world.Almost half of the patients with CRC have metastases at the time of diagnosis....Background:Colorectal cancer(CRC)is the second most common cause of cancer-related deaths and has the third highest incidence in the world.Almost half of the patients with CRC have metastases at the time of diagnosis.However,the treatment for patients with metastatic CRC that progresses after approved conventional chemotherapy is still controversial.Chinese medicine(CM)has unique characteristics and advantages in treating metastatic CRC.Objective:To assess the effectiveness and safety of CM in patients with metastatic CRC after failure of conventional chemotherapy.Methods:The study is a multicenter prospective cohort study.A total of 384 patients with documented metastatic CRC after failure of conventional chemotherapy will be included from 9 hospitals at Beijing,Shanghai,Nanjing,and Guizhou,and assigned to three groups according to paitents'wishes:(1)integrated Chinese and Western medicine(ICM)group receiving CM herbal treatment combined with Western medicine(WM)anti-tumor therapy,(2)Chinese medicine(CM)group receiving only CM herbal treatment,and(3)WM group receiving only WM anti-tumor therapy.The primary endpoint is the overall survival(OS).Secondary endpoints include the progression free survival(PFS),quality of life(QOL)assessed by the Functional Assessment of Cancer Therapy-Colorectal(FACT-C)questionnaire,tumor control,and CM symptom score.Discussion:This prospective study will assess the effectiveness and safety of CM in treating metastatic CRC after conventional chemotherapy failure.Patients in the ICM group will be compared with those in the WM group and CM group.If certified to be effective,national provision of CM treatment in metastatic CRC will probably be advised.(Registration No.NCT02923622).展开更多
文摘BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after middle age, mostly between 40and 60 years old, with an average age of about 50 years old, and only 5% of patients are under 30 years old. The incidence of male is higher than that of female.AIM To investigate the short-term efficacy and influencing factors of chemotherapy combined with irinotecan in patients with advanced gastric cancer.METHODS Eighty patients with advanced gastric cancer who were treated in our hospital from January 2019 to January 2022 were selected. The patients were divided into an observation group(n = 40) and control group(n = 40) by the envelope method.The control group was given preoperative routine chemotherapy. The observation group was treated with irinotecan in addition to the chemotherapy given to the control group. The short-term efficacy of treatment in the two groups, as well as tumor marker levels and quality of life before and after treatment were evaluated.RESULTS The short-term treatment effect in the observation group was better than that in the control group(P < 0.05), and the total effective rate was 57.50%. The age and proportion of tumor node metastasis(TNM) stage IV patients with ineffective chemotherapy in the observation group were(65.12 ± 5.71) years and 52.94%,respectively, which were notably higher than those of patients with effective chemotherapy(P < 0.05), while the Karnofsky Performance Scale score was(67.70± 3.83) points, which was apparently lower than that of patients with effective chemotherapy(P <0.05). After 3 mo of treatment, the SF-36 scale scores of physiological function, energy, emotional function, and mental health in the observation group were 65.12 ± 8.14, 54.76 ± 6.70, 47.58 ± 7.22,and 66.16 ± 8.11 points, respectively, which were considerably higher than those in the control group(P < 0.05). The incidence rates of grade Ⅲ-Ⅳ diarrhea and grade Ⅲ-Ⅳ thrombocytopenia in the observation group were 32.50% and 25.00%, respectively, which were markedly higher than those in the control group(P < 0.05).CONCLUSION Chemotherapy combined with irinotecan in patients with advanced gastric cancer has a good short-term efficacy and can significantly reduce serum tumor markers and improve the quality of life of patients. The efficacy may be affected by the age and TNM stage of the patients, and its long-term efficacy needs further study.
基金supported by National Natural Science Foundation of China(Grant Nos.81270433,81171846,81000875)Foundation for Young Scientist in Shanghai Municipal Health Bureau in China(Grant No.2010.24)Foundation for City Star of Science and Technology in Shanghai(Grant No.11QA1404400).
文摘The increased level of chromosome instability in cancer cells,leading to aneuploidy and gross chromosomal rearrangements,is not only a driving force for oncogenesis but also can be the Achille’s heel of the disease since many chemotherapies(CT)kill cells by inducing a non-tolerable rate of DNA damage.A wealth of published evidence showed that telomere stability can be more affected than the bulk of the genome by several conventional antineoplasic drugs.These results raise the interesting possibility that CT with genotoxic drugs preferentially target telomeres.In agreement with this view,accelerated shortening of telomere length has been described in blood lineage cells following high-dose CT(stem cell transplantation)or non-myeloablative CT.However,almost nothing is known on the consequences of this shortening in terms of telomere stability,senescence and on the development of second cancers or post-treatment aging-like syndromes in cancer survivors(cognitive defect,fertility impairment,etc.).In this article,we propose:(1)telomeres of cancer cells are preferential genomic targets of chemotherapies altering chromosome maintenance;(2)telomere functional parameters can be a surrogate marker of chemotherapy sensitivity and toxicity;(3)the use of anti-telomere molecule could greatly enhance the sensitivity to standards chemotherapies.
基金supported U.S.National Institutes of Health grants(R01CA172136,R01CA203028 and R01CA201741 to L.Z.,U19AI068021 and R01CA215481 to J.Y.,P30CA047904 to the UPMC Hillman Cancer Center).
文摘Emerging evidence suggests that the clinical success of conventional chemotherapy is not solely attributed to tumor cell toxicity,but also results from the restoration of immunosurveillance,which has been largely neglected in the past preclinical and clinical research.Antitumor immune response can be primed by immunogenic cell death(ICD),a type of cell death characterized by cell-surface translocation of calreticulin(CRT),extracellular release of ATP and high mobility group box 1(HMGB1),and stimulation of type I interferon(IFN)responses.Here we summarize recent studies showing conventional chemotherapeutics as ICD inducers,which are capable of modulating tumor infiltrating lymphocytes(TILs)and reactivating antitumor immunity within an immuno-suppressive microenvironment.Such immunological effects of conventional chemotherapy are likely critical for better prognosis of cancer patients.Furthermore,combination of ICD-inducing chemotherapeutics with immunotherapy is a promising approach for improving the clinical outcomes of cancer patients.
基金Supported by the Beijing Municipal Commission of Science and Technology (No. D161100005116002)。
文摘Background:Colorectal cancer(CRC)is the second most common cause of cancer-related deaths and has the third highest incidence in the world.Almost half of the patients with CRC have metastases at the time of diagnosis.However,the treatment for patients with metastatic CRC that progresses after approved conventional chemotherapy is still controversial.Chinese medicine(CM)has unique characteristics and advantages in treating metastatic CRC.Objective:To assess the effectiveness and safety of CM in patients with metastatic CRC after failure of conventional chemotherapy.Methods:The study is a multicenter prospective cohort study.A total of 384 patients with documented metastatic CRC after failure of conventional chemotherapy will be included from 9 hospitals at Beijing,Shanghai,Nanjing,and Guizhou,and assigned to three groups according to paitents'wishes:(1)integrated Chinese and Western medicine(ICM)group receiving CM herbal treatment combined with Western medicine(WM)anti-tumor therapy,(2)Chinese medicine(CM)group receiving only CM herbal treatment,and(3)WM group receiving only WM anti-tumor therapy.The primary endpoint is the overall survival(OS).Secondary endpoints include the progression free survival(PFS),quality of life(QOL)assessed by the Functional Assessment of Cancer Therapy-Colorectal(FACT-C)questionnaire,tumor control,and CM symptom score.Discussion:This prospective study will assess the effectiveness and safety of CM in treating metastatic CRC after conventional chemotherapy failure.Patients in the ICM group will be compared with those in the WM group and CM group.If certified to be effective,national provision of CM treatment in metastatic CRC will probably be advised.(Registration No.NCT02923622).
