简介:AbstractGastric cancer, which has a high incidence and poor prognosis, remains a therapeutic challenge. Recently, neoadjuvant therapy has attracted increasing attention due to high recurrence rate and low survival rate after resection in most patients with advanced stage. Clinical trials show that neoadjuvant approaches confer a significant survival advantage for resectable locally advanced gastric cancer. The specific advantages of chemoradiotherapy compared with chemotherapy have not been clarified; optimal regimens and cycles, particularly in the preoperative setting, should be studied further; and trials aimed at determining the role of targeted and immunological therapies should be conducted.
简介:AbstractThe management of pancreatic cancer has dramatically changed since the first major randomized trial published in 2001 by the European Study Group for Pancreatic Cancer (ESPAC) stimulated the development of multimodality oncosurgical therapies. ESPAC-1 demonstrated a survival improvement from upfront surgery of only 8%, increasing to 21% 5-year survival for 5-fluorouracil/folinic acid but only 10.8% for chemoradiotherapy. ESPAC-4 has shown a 5-year survival rate of 30% for all patients without restriction of 30% using a combination of gemcitabine and capecitabine, rising to 40% in those with an R0 resection margin, or nearly 50% in those with N0 lymph node status. In selected patients with favorable prognostic features mFOLFIRINOX can produce a 50% 5-year survival rate but with added toxicity. While a positive resection margin is associated with an increased likelihood of local recurrence, this of itself is not the contributor to reduced survival, but rather reflects the increased probability of systemic disease. Thus, strategies aimed at local control, may reduce subsequent local progression, but will not improve overall survival. Neoadjuvant chemotherapy is increasingly utilized in cases of borderline resectable or locally advanced pancreatic cancer, but there is still a lack of proof of concept studies. High-quality evidence from randomized controlled trials to identify the indications and benefits of neoadjuvant therapy in pancreatic cancer are required. The use of patient-derived tumor organoids may predict response to chemotherapy which could open a new opportunity in pancreatic cancer treatment, stratifying patients into treatment groups based on their response to these therapies in the laboratory.
简介:基因治疗为癌症的治疗提供一条新途径。编码immunostimulatorycytokines的基因的转移与显著成功被使用了在动物消除癌症。然而,在有这策略的病人的临床的试用限制了功效。因此,基因转移向量系统的改进是必要的。混合病毒的向量,与鼠科的IL-12或记者LacZ基因由SFVreplicon组成,被构造。这混合向量在vitro并且在vivo在HCC显示出表示的特性和高水平。在一个老鼠orthotropic肝肿瘤模型,没有伴随毒性,由有mIL-12基因的混合向量的确定的肿瘤的治疗导致了一项强壮的反肿瘤活动。随后,助手依赖者侵入人体气管粘膜的病菌包含mifepristone(RU486)的向量可诱导的系统被构造为控制并且人的interleukin的肝特定的表示12(hIL-12)(HD-Ad/RUhIL-12)并且鼠标IL-12(mIL-12)(HD-Ad/RUmIL-12)。数据证明hIL-12的高、支撑的浆液层次能被继续RU486的管理达到每12或24h。hIL-12的重复正式就职能被获得在上,至少在HD-Ad/RUhIL-12的单个注射以后的48个星期的一个时期。肝转移与的处理HD-Ad/RUmIL-12,正RU846在所有动物导致了完全的肿瘤回归。然后,不同cytokine基因被插入到有条件的replicative侵入人体气管粘膜的病菌向量(也叫的oncolytic侵入人体气管粘膜的病菌)。在肿瘤房间的侵入人体气管粘膜的病菌的复制将杀死肿瘤房间和版本病毒,它感染包围肿瘤房间。由oncolytic侵入人体气管粘膜的病菌的cytopathic效果和transgene的生物效果的联合将施加强壮的反肿瘤活动。向量的这些新类型可以为癌症基因治疗提供一个有势力和安全工具。
简介:Inthepastdecade,anincreasedamountofclinically-orientedresearchinvolvingimmunotoxinshasbeenpublished.Immunotoxinsareagroupofartificially-madecytotoxicmoleculestargetingcancercells.Thesemoleculescomposedofatargetingmoiety,suchasaligandoranantibody,linkedtotoxinmoiety,whichisatoxinwitheithertruncatedordeletedcell-bindingdomainthatpreventsitfrombindingtonormalcells.Immunotoxinscanbedividedintotwocategories:chemicallyconjugatedimmunotoxinsandrecombinantones.Theimmunotoxinsofthefirstcategoryhaveshownlimitedefficacyinclinicaltrialsinpatientswithhematologicmalignanciesandsolidtumors.Withinthelastfewyears,single-chainimmunotoxinsprovideenhancedtherapeuticefficacyoverconjugatedformsandresultinimprovedantitumoractivity.Inthisreview,webrieflyillustratethedesignoftheimmunotoxinsandtheirapplicationsinclinicaltrials.Cellular&MolecularImmunology.2005;2(2):106-112.
简介:IntroductionThereisnowanewwaytotreathypercholesterolemia,usingamonoclonalantibody(Evolocumab)thatbindstoandinhibitsPCSKA9.MostphysiciansknowthetermPCSK9buthavenoideawhatPCSK9standsfor(includingme).MypurposeforwritingthiseditorialistoeducatemyselfonwhatPCSK9isandwhatitdoes.MyhopeisthatIcanperhapseducatethosereadingthisdocumentaswell.
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简介:Coronaryarterydisease(CAD)istheleadingcauseofdeathworldwide,butbecauseofseveralfactors,oneofwhichisantiplatelettherapy,themortalityrateshavesteadilydeclined.However,womencontinuetoexperiencehigherCADmortalityratesthanmen.Thismaybeexplainedbydifferencesincomorbidities,increasedtimetopresentation,higherbleedingrates,anddifferencesinmanagement.Therearenumerouslandmarktrialsinthefieldofantiplatelettherapy;however,womenareconsistentlyunderrepresentedinthesetrials.Theresultsofthesetrialsrevealthatwomenexperiencethesamebenefitasmenfromantiplatelettherapybutexperiencehigherbleedingrates;thereforebleeding-reductionstrategiesareimperativeinthispatientpopulation.ThisreviewprovidesanoverviewoftheavailableevidenceonCADinwomenanditsimplicationsforantiplateletmedications.
简介:Wehavereviewedthegenetherapyingastrointestinaldiseases^[1].GastriccanceriscommoninChina^(2-20),anditsearlydiagnosisandtreatmentarestilldifficultuptonow^(13-36).Theex-pressionofanexogenousgeneintroducedbygenetherapyintopa-tientswithgliomascanbemonitorednon-invasivelybypositron-emissiontornography^[4].
简介:质子放射疗法在hepatocellular癌(HCC)的治疗看见了一个增加的角色。历史上,外部横梁放射疗法由于毒性的高发生在HCC起了一个很有限的作用到包围正常结构。把放射的高剂量送到肿瘤的能力是在在HCC改进结果的一个关键因素。在光子放射疗法的进展改进了剂量一致并且允许剂量逐步上升到肿瘤。然而,尽管有这些进展,仍然有一个大量正常的肝,在处理期间收到可观的放射剂量。一旦他们进入身体,质子横梁没沿着横梁路径有出口剂量。质子放射疗法的固有的物理属性提供一个方法当避免过多的放射到留下的肝时,经由剂量逐步上升最大化肿瘤控制,因此增加的生物有效性。在这评论,我们在HCC为质子放射疗法讨论物理属性和基本原理。我们也关于为HCC的处理使用质子放射疗法的临床的结果考察最近的文学。
简介:Advancedagebringsahigherincidenceofthrombosis-relateddiseases.Althoughantithrombotictherapysignificantlyreducestheriskofischemicevents,relativelyhigherbleedingratesresultinincreasedmortalityandworseprognosisintheelderly.Thusthebenefitsandharmsofantithromboticdrugsshouldtobecarefullyevaluated.Inthisreview,wesummarizecurrentevidenceandupdatedguidelinesregardingantithrombotictherapyintheagingpopulation.
简介:ChinahasrecognizedthethreatofHIVtoitspopulationandrespondedwithanationalantiretroviraltreatment(ART)program.However,highARTfailureratesandthespreadofresistancewithinpopulationsareimportantrealitiestoconsiderwhendevelopingandmanagingARTprogramsinChinaandworldwide.Conceptswhichwilldefinetreatmentsuccessandlocalandnationalprogrammaticgoalsare1)accesstoART,2)durabilityofARTatthepatientlevel,3)scalabilityoftreatmentmodalities,andthe4)sustainabilityoftheprogramatthecommunityornationallevel.Inthefaceoflimitedresources,ChinamustalsoconsiderwhentostartARVtherapy,whichagentstouse,whentoswitchthem,andhowtotreathighlyexperiencedpatientswithdrugresistance.TheoptimalARVregimentostartwithischangingfrequentlywiththeintroductionofnewagentsandthepresentationofnewdata.Currently,aregimenincludingtenofovir,emtricitabineorlamivudineandanonnucleosidereversetranscriptaseinhibitorappearstohaveoptimalcharacteristicstotreatHIV/AIDSinChina.However,criticaltoallofthesechoicesistheevaluationofprogramsimplementedtoinsurewidescalesuccess.Chinahaswiselybegunthisprocessofevaluatingtheperformanceoflocalprogramsthroughsystematicmonitoringandevaluationoftreatmentoutcomes.Thiswillallowregimensandprogramsthatworktobeexpanded,andprogramswithhighfailureratestobeeliminated.Intheend,evidencebaseddatasupportingtreatmentstrategieswillallowChinatosuccessfullyconfrontitsAIDSepidemicearlyandpreventitstragicconsequences
简介:AbstractIncreasing numbers of targeted drugs are used in hormone receptor (HR)-positive metastatic breast cancer (MBC) to overcome or delay resistance to endocrine therapy. This study will systemically review the progress made in endocrine therapy combined with targeted therapy in the treatment of HR-positive MBC. From the "AI (aromatase inhibitor) era" represented by aromatase inhibitors, we have gradually entered the "post-AI era" represented by fulvestrant. Under the guidance of research on the molecular mechanism of endocrine therapy resistance, the "combination of endocrine therapy and targeted therapy" era is approaching. The development of drugs that target endocrine therapy resistance has concentrated on cyclin-dependent kinase 4/6 inhibitors, histone deacetylase inhibitors, and inhibitors of drug targets in the phosphatidylinositol 3 kinase-protein kinase B-mammalian target of rapamycin (PI3K-AKT-mTOR) pathway, providing new strategies for HR-positive MBC. Exploring biomarkers to guide the more precise use of targeted drugs in endocrine therapy for MBC is the focus of current and future research.
简介:AIM:Toinvestigatetheefficacyofneoadjuvantchemoradiotherapy(NACRT)forresectabilityoflocallyadvancedgastriccancer(LAGC).METHODS:BetweenNovember2007andJanuary2014,29patientswithLAGC(clinicallyT3withdistalesophagusinvasion/T4orbulkyregionalnodemetastasis)thatweretreatedwithNACRTfollowedbyD2gastrectomywereincludedinthisstudy.ResectabilitywasevaluatedwithradiologicandendoscopicexamsbeforeandafterNACRT.Usingthreedimensionalconformalradiotherapy,patientsreceived45Gy,withadailydoseof1.8Gy.Theentiretumorextentandtheregionalmetastaticlymphnodeswereincludedinthegrosstumorvolume.PatientspresentingwitharesectabletumorafterNACRTreceivedatotalorsubtotalgastrectomywithD2dissection.ThepathologictumorresponsewasevaluatedusingJapaneseGastricCancerAssociationhistologicevaluationcriteria.PostoperativemorbiditywasevaluatedusingtheNationalCancerInstitute-CommonTerminologyCriteriaforAdverseEventsversion4.0.Overallsurvival(OS)andprogression-freesurvival(PFS)rateswereestimatedusingaKaplan-Meieranalysisandcomparedusingthelog-ranktest.RESULTS:Allpatientswereassessedasunresectablecases.Twenty-fourpatients(24/29;82.8%)showedLAGConpositronemissiontomography-computedtomography(CT)andcontrast-enhancedCT,whereasfourpatients(4/29;13.8%)withvagueinvasionorabutmenttoanadjacentorganunderwentdiagnosticlaparoscopy.Onepatient(1/29;3.4%),initiallyassessedasaresectablecase,underwentan'openandclosure'afterthetumorwasfoundtobeunresectable.Abutmenttoanadjacentorgan(34.5%)wasthemostcommonreasonforNACRT.TheclinicalresponserateonemonthafterNACRTwas44.8%.AfterNACRT,69%(20/29)ofpatientshadaresectabletumor.Ofthe20patientswitharesectabletumor,18patients(62.1%)underwentaD2gastrectomy.TheR0resectionratewas94.4%andtwopatients(2/18;11.1%)showedacompleteresponse.Themedianfollow-updurationwas13.5mo.Theone-yearOSandPFS
简介:尽管免疫系统拥有工具对癌症作出回应,它经常没能控制恶意的传播。尽管如此,装备内长的免疫释放强壮的antitumor回答比常规治疗有重要优点。这评论探索一些可得到的选择完成这,在有刺激免疫系统并且授权更强壮的antitumor回答的肿瘤抗原的种痘上集中第一。我们然后比较并且形成对照声发有用淋巴细胞转移的T的采纳治疗的记录得好的药品潜力的种痘的有限临床的成功。最后,我们用与受体一起利用allogeneicT房间全部剧目的房间受体(TCR)基因转移策略为定义MHC/peptide联合在vitro选择了的T加亮新奇途径,作为癌症的抗原特定的基因治疗的一个基础。
简介:AbstractBismuth-containing quadruple therapy (BQT) has long been recommended for Helicobacter pylori (H. pylori) eradication in China. Meanwhile, in the latest national consensus in China, dual therapy (DT) comprising an acid suppressor and amoxicillin has also been recommended. In recent years, the eradication rate of H. pylori has reached >90% using DT, which has been used not only as a first-line treatment but also as a rescue treatment. Compared with BQT, DT has great potential for H. pylori eradication; however, it has some limitations. This review summarizes the development of DT and its application in H. pylori eradication. The H. pylori eradication rates of DT were comparable to or even higher than those of BQT or standard triple therapy, especially in the first-line treatment. The incidence of adverse events associated with DT was lower than that with other therapies. Furthermore, there were no significant differences in the effects of dual and quadruple therapies on gastrointestinal microecology. In the short term, H. pylori eradication causes certain fluctuations in the gastrointestinal microbiota; however, in the long term, the gastrointestinal microbiota eventually returns to its normal state. In the penicillin-naïve population, patients receiving DT have a high eradiation rate, better compliance, lower incidence of adverse reactions, and lower primary and secondary resistance to amoxicillin. These findings suggest the safety, efficacy, and potential of DT for H. pylori eradication.
简介:ThisarticleprovidesexplanationstohowdistanceexternalQitherapyworksbyquotingvariousrigorouslydesignedcontrolledexperimentsconductedatvariouspartsoftheworld.Italsointroducesanewmethodoftherapy,Informationtherapythatreliesontheentanglementofinformationcarriedbylowhissingsoundplaybackwithmp3playertoentanglewiththeinformationofsubjectsexhibitedbythefacialphotowiththewholesystemplacedinasealedcarton.Preliminaryresultshaveshownhugepotentialforinformationtherapytobeappliedonneurologicalcases,particularlyonautismanddementia.
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