Therapy Response of Chinese Herbal Medicine in Advanced Liver Cancer： A Retrospective Observational Clinical Trial

Aiming at starting the ball rolling and contributing humble effort to promote CTM （Chinese traditional medicine）, we performed the present study to assess the therapy response of Chinese herbal decoction compared to conventional therapy on critical ill patients of advanced liver cancer. A total of 6 patients （1 female and 5 males） with histologically confirmed liver cancer were included in this retrospective observational clinical trial. We administered Chinese medicine （Gan Decoction, mixed with a variety of effective herbal components） to help them to recover from poor condition. In the meantime, conventional treatment of surgical resection and artery catheterization chemotherapy was applied in cases compared. In 3 cases of CTM combined treatment, the tumor marker level decreased. Residual intrahepatic metastatic sites reduced according to ultrasonography/CT imaging, and the patients felt free from the complaint of abdominal discomfort. The quality of life has been improved, we managed to have prolonged the PFS （Progression-Free-Survival） and TTP （Time-to-Progression） from the onset to date. While in 3 cases with conventional treatment only of surgical resection and artery catheterization chemotherapy, we were not able to decrease the level of tumor marker, metastatic lesions increased according to ultrasonography/CT imaging, and the patient＇s condition worsen more. We failed in having prolonged the PFS and TTP in the compared cases of conventional treatment only. The retrospective clinical study showed no OS （overall survival） benefit for liver cancer patients treated with Gan Decoction, while the QOL （quality of life） evaluation seemed to predict survival better. Chinese herbs might be an additional choice with its better benefits and tolerability in the treatment of primary liver cancer.

Monitoring of Tumor Response to Neoadjuvant Radio-Chemotherapy of Esophageal Carcinoma by F-18-FDG-PET

Introduction: For clinical assessment of neoadjuvant radiochemotherapy of esophageal cancer reliable in-vivo methods are necessary. Therefore, the capabilities of F-18-Fluorodesoxyglucose-PET in comparison to histomorphological grading of tumor regression were studied. Methods: In 33 patients with locally advanced esophageal carcinoma (uT3, uN0-1, cM0) F-18-FDG-PET was performed before and 2 weeks after radiochemotherapy. All tumors were resected by transthoracic en-bloc esophagectomy 3–4 weeks after induction therapy. A subgroup of 11 patients underwent weekly PET scan during neoadjuvant therapy. PET was performed in a dedicated scanner 1.3 h after administration of 370 MBq F-18-FDG. Data analysis based on maximum SUV data derived from individual regions of interest in pre- and posttherapeutic images. PET data were compared to histomorphological grading parameters for tumor regression whithin the resected tissues. Results: The comparison of histopathological tumor regression after neoadjuvant therapy and PET SUV di?erences showed a signi?cant χ2 P -value of 0.006. There was a signi?cant decrease 五笔字型计算机汉字输入技术 of the SUV data from 9.1±3.5 to 4.3±1.9 (P <0.0001). In therapy responders SUV was diminished by 59 % and in non-responders by 34 %. Longitudinal SUV measurement during neoadjuvant therapy showed a strong SUV decrease already after one and two weeks (P =0.021 and 0.003). Conclusion: The recent data of the FDG-PET follow-up after neoadjuvant therapy show that PET is able to predict therapy response. Longitudinal PET data advocate that it may be possible to recognize response also very early during radiochemotherapy.

Hepatitis C virus in the new era:Perspectives in epidemiology,prevention,diagnostics and predictors of response to therapy

Despite the great successes achieved in the fields of virology and diagnostics,several difficulties affect improvements in hepatitis C virus(HCV)infection control and eradication in the new era.New HCV infections still occur,especially in some of the poorest regions of the world,where HCV is endemic and long-term sequelae have a growing economic and health burden.An HCV vaccine is still no available,despite years of researches and discoveries about the natural history of infection and host-virus interactions:several HCV vaccine candidates have been developed in the last years,targeting different HCV antigens or using alternative delivery systems,but viral variability and adaption ability constitute major challenges for vaccine development.Many new antiviral drugs for HCV therapy are in preclinical or early clinical development,but different limitations affect treatment validity.Treatment predictors are important tools,as they provide some guidance for the management of therapy in patients with chronic HCV infection:in particular,the role of host genomics in HCV infection outcomes in the new era of direct-acting antivirals may evolve for new therapeutic targets,representing a chance for modulated and personalized treatment management,when also very potent therapies will be available.In the present review we discuss the most recent data about HCV epidemiology,the new perspectives for the prevention of HCV infection and the most recent evidence regarding HCV diagnosis,therapy and predictors of response to it.

Novel technologies in cfDNA analysis and potential utility in clinic

The profiling of plasma cell-free DNA(cfDNA)is becoming a valuable tool rapidly for tumor diagnosis,monitoring and prognosis.Diverse plasma cfDNA technologies have been in routine or emerging use,including analyses of mutations,copy number alterations,gene fusions and DNA methylation.Recently,new technologies in cfDNA analysis have been developed in laboratories,and potentially reflect the status of epigenetic modification,the immune microenvironment and the microbiome in tumor tissues.In this review,the authors discuss the principles,methods and effects of the current cfDNA assays and provide an overview of studies that may inform clinical applications in the near future.

Circulating tumor DNAs and non-coding RNAs as potential biomarkers for hepatocellular carcinoma diagnosis, prognosis and response to therapy

Hepatocellular carcinoma(HCC)is the second leading cause of cancer-related deaths worldwide and despite improvement in therapeutic approaches,prognosis remains poor.This can be partly attributed to the fact that the majority of HCCs are diagnosed at intermediate or advanced stages.Availability of circulating biomarkers able to detect HCC at early stages could improve patients'prognosis.At present,however,alpha fetoprotein or des-g-carboxyprothrombin are unable to reliably detect HCC at early stages and better circulating biomarkers are needed.Circulating tumor DNA(ctDNA)and non-coding RNAs(ncRNAs)are emerging as promising biomarkers to achieve the goal.Genetic and epigenetic alterations in ctDNA allow to pinpoint tumor-specific biomarkers,reveal tumor heterogeneity,help monitor tumor evolution over time and assess therapy efficacy.It remains to be fully evaluated the possibility of detecting these biomarkers at early tumor stages.Circulating ncRNAs are quantitative biomarkers with potential use in diagnostic,prognostic and predictive clinical settings.They may help to reveal HCC at early stages.However,because of heterogeneous and sometimes conflicting reported results,they still require validation and standardization of pre-analytical and analytical approaches before clinical applications could be envisaged.

Patient-derived bladder cancer organoid model to predict sensitivity and feasibility of tailored precision therapy

Background:Bladder cancer is a common and highly heterogeneous malignant tumor with a relatively poor prognosis.Thus,personalized treatment strategies for bladder cancer are essential for improving patient outcomes.Materials and methods:We developed an efficient 3-dimensional in vitro organoid culture system for bladder cancer organoids(BCOs),which maintains the homology with the original patient tumors and the heterogeneity between different individuals.In addition,we constructed chimeric antigen receptor(CAR)-T cells targeting B7H3 and evaluated the antitumor function of CAR-T cells by coculturing them with BCOs.Results:The BCOs closely resembled the characteristics of human tumors and were used to test individual sensitivity to platinum-based drugs and olaparib therapy.Coculture with CAR-T cells demonstrated specific antigen recognition and immune activation,indicating their potential in immunotherapy.Conclusions:Our study highlights the potential of BCOs to facilitate the development of personalized medicine for bladder cancer and improve the efficiency of drug discovery for bladder cancer therapy.

Complex interplay between tumor microenvironment and cancer therapy

Tumor microenvironment （TME） is comprised of cellular and non-cellular components that exist within and around the tumor mass. The TME is highly dynamic and its importance in different stages of cancer progression has been well recognized. A growing body of evidence suggests that TME also plays pivotal roles in cancer treatment responses. TME is significantly remodeled upon cancer therapies, and such change either enhances the responses or induces drug resistance. Given the importance of TME in tumor progression and therapy resistance, strategies that remodel TME to improve therapeutic responses are under developing. In this review, we provide an overview of the essential components in TME and the remodeling of TME in response to anti-cancer treatments. We also summarize the strategies that aim to enhance therapeutic efficacy by modulating TME.