Aidi injection as adjunctive treatment to gemcitabine-based chemotherapy for advanced non-small cell lung cancer: a systematic review and meta-analysis

ContextAidi injection is one of the most commonly use antitumor Chinese medicine injections for advanced non-small cell lung cancer (NSCLC). It is made from the extraction of Astragalus, Eleutherococcus senticosus, Ginseng, and Cantharis.ObjectiveTo evaluate the efficacy and safety of Aidi injection in combination with gemcitabine-based chemotherapy (GBC) for advanced NSCLC.Materials and methodsPubMed, Embase, Cochrane Library, Chinese Biological Medicine, China National Knowledge Infrastructure, Wanfang, and VIP were searched for relevant randomised controlled trials (RCTs) comparing Aidi injection plus GBC treatment with GBC alone in NSCLC, from inception up to October 2020. The primary outcomes were objective response rate (ORR), and disease control rate (DCR). Secondary outcomes were quality of life (QOL) and adverse drug reactions (ADRs). The quality of evidence was rated using the GRADE approach. This study was registered with PROSPERO: CRD42021221225.ResultsIn total, 54 RCTs involving 4318 NSCLC patients were included in this meta-analysis. Compared with GBC alone, Aidi injection plus GBC significantly improve ORR (risk ratios [RR] = 1.38, 95% confidence interval [CI] 1.29–1.48), DCR (RR = 1.15, 95% CI 1.12–1.19), QOL (RR = 1.71, 95% CI 1.54–1.89), and reduced the risk of gastrointestinal toxicity, thrombocytopenia, neutropenia, liver injury, renal injury, and anaemia. The evaluation results of the evidence ranged from moderate to low.ConclusionsCurrent moderate evidence revealed that Aidi injection as an adjunctive treatment to GBC was associated with superior benefits in patients with advanced NSCLC and alleviate toxicities. High-quality RCTs are needed to further confirm the results.     

PI3K/Akt信号转导通路在非小细胞肺癌中的作用

肺癌是当今世界严重威胁人类健康和生命的疾病,其中85%是非小细胞肺癌(NSCLC)。PI3K/Akt通路在NSCLC的发生、发展中具有重要的作用,可以调控细胞存活、增殖、抗凋亡、血管生成等影响肿瘤的发生发展,而且某些蛋白的表达还是NSCLC不良预后的标志。在此我们对PI3K/Akt通路在NSCLC中的分子机制进行总结,并进一步讨论NSCLC的多靶点治疗。     

Caffeine inhibits the proliferation of liver cancer cells and activates the MEK/ERK/EGFR signalling pathway

Caffeine has been reported to prevent hepatocarcinogenesis. We investigated the molecular mechanisms by which caffeine inhibits the growth of hepatocellular carcinoma (HCC) cells. We found that caffeine inhibited the proliferation of HCC cells via cell cycle arrest independent of apoptosis. We revealed a novel signalling axis for caffeine involving activation of the mitogen-activated ERK-regulating kinase (MEK)/extracellular signal-regulated kinase (ERK) pathway that resulted in the downstream up-regulation of epidermal growth factor receptor (EGFR), although the MEK/ERK/EGFR signalling pathway was not involved in the growth inhibitory effect of caffeine. Our data reveal that caffeine could be a promising candidate for the treatment of patients with HCC.     

MUC15 promotes growth and invasion of glioma cells by activating Raf/MEK/ERK pathway

MUC15 is a novel mucin associated with the cell membrane that is overexpressed in human gliomas. Its function in glioma is unclear. In this study, high MUC15 levels were detected in glioma tissues and cells. We found that transfection with MUC15 siRNA in U251 and T98G cells reduced MUC15 expression and decreased cell proliferation, invasion, and migration (P < .05). After transfecting U251 and T98G cells with pcDNA3.1-myc-His-MUC15 plasmid to overexpress MUC15, MUC15 expression was significantly upregulated and cell proliferation, invasion, and migration were increased (P < .05). MUC15 activated the Raf/MEK/ERK signalling pathway and the ERK inhibitor PD98059 partly reversed MUC15-enhanced proliferation, invasion, and migration of glioma cells (P < .05). The results indicate that MUC15 plays a part in glioma tumorigenesis, and the Raf/MEK/ERK signalling is involved in the regulation of MUC15 on glioma cell activity.     

Retracted: KIF20A silence inhibits the migration,invasion and proliferation of non-small cell lung cancer and regulates the JNK pathway

An increasing number of studies have shown that kinesin family member 20A (KIF20A) was overexpressed in several types of cancer, and its overexpression correlated with the oncogenesis and prognosis of cancers. However, little is known about the roles of KIF20A in human non-small cell lung cancer (NSCLC). Thus, the aim of the present study was to demonstrate the expression of KIF20A in human NSCLC and reveal its biological functions and the underlying mechanisms. qRT-PCR, western blot and immunohistochemistry were used to assess the expression of NSCLC patient specimens and NSCLC cell lines. The functions of KIF20A in migration and invasion were determined using Transwell assay. Cell proliferation capacity was performed by CKK-8 assay. We demonstrated that KIF20A was overexpressed in NSCLC specimens compared with the adjacent non-tumorous specimens, and high expression of KIF20A was associated with clinical stage and metastasis in NSCLC. Decreased expression of KIF20A inhibited NSCLC cells migration, invasion and proliferation. Most importantly, further experiments demonstrated that decreased the expression of KLF20A significantly downregulated expression of p-JNK and MMP7, which indicated that knockdown of KIF20A alters lung cancer cell phenotype and regulates JNK pathways. These results suggest that KIF20A may act as a putative oncogene and a potential therapeutic target in NSCLC.     

榄香烯抑制Raf/MEK/ERK信号通路诱导人源胶质瘤U87细胞凋亡

目的探讨莪术提取物榄香烯体外诱导胶质瘤细胞凋亡的机制。方法采用流式细胞术、West-ern印迹等方法,分别检测不同浓度榄香烯对人源U87胶质瘤细胞的凋亡诱导及其对U87细胞Raf-1、ERK、癌基因Bcl-2蛋白质表达的影响。结果榄香烯对人源U87胶质瘤细胞具有明显的凋亡诱导作用,该增殖抑制效应呈时间依赖性。榄香烯可明显下调U87细胞的磷酸化Raf-1、ERK、Bcl-2表达。结论体外榄香烯对胶质瘤细胞具有明显的凋亡诱导作用(呈时间依赖性),抑制Raf/MEK/ERK信号通路,从而下调其下游信号癌基因Bcl-2的表达,最终启动凋亡程序可能是榄香烯诱导U87细胞凋亡的机制。     

Qiangli Wuhu mixture alleviates LPS-induced pneumonia by inhibiting the TLR4/NF-κB/NLRP3 pathway: a study based on network pharmacology

ContextQiangli Wuhu (QLWH) mixture is a concoction approved and registered by Ningxia Medical Products Administration. It has therapeutic effects on various types of pneumonia.ObjectiveTo clarify the mechanisms of QLWH in treating pneumonia.Materials and methodsThe potential targets of QLWH in the treatment of pneumonia were predicted by network pharmacology. Male, Institute of Cancer Research (ICR) mice were randomly divided into five groups of 12 mice, control, vehicle, QLWH (10 and 20 mg/kg) and dexamethasone (DXM), and orally treated twice daily with normal saline, QLWH or DXM. The pneumonia model was established by tracheal instillation of lipopolysaccharide (LPS). After treatment five days, ELISA, H&E staining and Western blot were used to investigate protective effects of QLWH.ResultsNine hundred and ninety-four active ingredients were found through network pharmacology, corresponding to 135 targets for the treatment of pneumonia; compared to the vehicle group, QLWH (10 and 20 mg/kg) significantly decreased the levels of TNF-α (14.3% and 28.8%), IL-1β (23.9% and 42.8%) and IL-6 (13.2% and 16.1%), increased the levels of IL-10 (134.3% and 172.9%); in terms of mechanism, QLWH down-regulated TLR4/NF-κB/NLRP3 axis related proteins in lung tissue of pneumonia model mice (p < 0.05).Discussion and conclusionsThis study combined network pharmacology and animal experiments, providing effective evidence for the clinical promotion of QLWH. Meanwhile, it is of significance for further development.     

阿司匹林联合阿托伐他汀协同抑制非小细胞肺癌细胞增殖及其机制研究

目的 研究阿司匹林联合阿托伐他汀对非小细胞肺癌细胞A549和NCI-H460细胞增殖的影响及其作用机制.方法 采用MTS法检测阿司匹林、阿托伐他汀以及二者联合对A549和NCI-H460细胞抗增殖活性,细胞划痕实验检测A549和NCI-H460细胞的迁移和侵袭活性,Western blotting法检测NCI-H460...     

Twist基因在非小细胞肺癌中的表达及意义

目的：探讨转录调节因子Twist在非小细胞肺癌（NSCLC）组织中的表达及临床意义。方法：应用兔抗人Twist多克隆抗体采用SP免疫组织化学方法检测45例NSCLC组织及12例癌旁正常肺组织中Twist蛋白表达情况。结果：在45例肺癌组织标本中,Twist基因阳性表达为31例（68．9％）,癌旁组织中为2例（16．7％）,两者比较差异有统计学意义（Х^2=10．599,P〈0．01）。Twist高表达与肺癌分化程度相关（P〈0．05）。结论：NSCLC组织中存在Twist基因的高表达,Twist基因表达的上调,对肿瘤的发生、发展起着重要作用。     

Oridonin-induced A431 cell apoptosis partially through blockage of the Ras/Raf/ERK signal pathway

We have reported that oridonin, a diterpenoid isolated from the plant Rabdosia rubescens, had apoptosis-inducing activities in many cell lines (e.g., human melanoma A375-S2, human cervical cancer HeLa, human breast adenocarcinoma MCF-7, and murine fibrosarcoma L929). In this study, we further investigated signaling events involved in oridonin-induced apoptosis in human epidermoid carcinoma A431 cells. It was found that the total tyrosine kinase activity was inhibited and the protein expressions of epidermal growth factor receptor (EGFR) and phosphorylated EGFR were decreased in oridonin-induced A431 cell apoptosis. Expression of EGFR downstream effector proteins, Grb2, Ras, Raf-1, and extracellular signal-regulated kinase (ERK), was also downregulated by oridonin. Moreover, the oridonin-induced apoptosis was augmented by the Ras inhibitor manumycin A, Raf-1 inhibitor GW5074, or ERK inhibitor PD98059, suggesting that inactivation of Ras, Raf, or ERK participates in oridonin-induced apoptosis. Taken together, oridonin-induced apoptosis in A431 cells might be through blocking EGFR and its downstream Ras/Raf/ERK signal pathway.     

Pyronaridine induces apoptosis in non-small cell lung cancer cells by upregulating death receptor 5 expression and inhibiting epidermal growth factor receptor

Lung cancer is the leading cause of cancer death. Pyronaridine, a synthetic drug of artemisinin, has been used in China for over 30 years for the treatment of malaria, but its effect on non-small cell lung cancer (NSCLC) cells is rarely reported. In this study, we determined the efficacy of pyronaridine in four different NSCLC cell lines and explored its mechanism in H1975. The data showed that pyronaridine could upregulate the expression of TNF-related apoptosis-inducing ligand (TRAIL)-mediated death receptor 5 to promote cellular apoptosis. Meanwhile, the JNK (c-Jun N-terminal kinase) level was detected to be significantly increased after treating with pyronaridine. We used JNK inhibitor and found that it could partially inhibit cell apoptosis. The results showed that epidermal growth factor receptor (EGFR), PI3K, and AKT were downregulated after the treatment of pyronaridine. In summary, pyronaridine can selectively kill NSCLC by regulating TRAIL-mediated apoptosis and downregulating the protein level of EGFR. It is a promising anticancer drug for NSCLC.     

Reviewing the safety of erlotinib in non-small cell lung cancer

Importance of the field: Erlotinib, a potent inhibitor of EGFR activity, is approved as a monotherapy for the treatment of advanced NSCLC and in combination with gemcitabine for advanced pancreatic cancer. The oral administration and manageable toxicity of erlotinib, along with its similar efficacy to chemotherapy, make it an important option as either maintenance therapy or in second-/third-line for patients with NSCLC who have previously received first-line chemotherapy. It is also an emerging option in other treatment settings in NSCLC.

Areas covered in this review: This review summarizes safety data from major clinical trials of erlotinib in patients with advanced NSCLC, as well as post-marketing data obtained in the 5 years since this drug was first approved.

What the reader will gain: An understanding of the common toxicities expected with erlotinib in patients with advanced NSCLC.

Take home message: Erlotinib is a well-tolerated treatment option for patients with advanced NSCLC. The main adverse events of rash and diarrhea are typically mild or moderate in severity, and rarely lead to treatment withdrawal. When necessary, rash and diarrhea can be easily managed prophylactically, by active intervention or through dose reduction.     

肿瘤自噬效应及其在非小细胞肺癌分子靶向治疗中的潜在应用

目前针对非小细胞肺癌(NSCLC)的手术、放化疗等治疗手段临床疗效仍很不足,相应的分子靶向治疗药物随着临床抗药性的产生疗效也明显下降。自噬对肿瘤进展具有双重影响作用。在NSCLC临床治疗的各个阶段都应充分考虑自噬效应所起的作用,对其进行合理调节和利用,从而提高各种治疗手段的临床疗效。     

Osimertinib for the treatment of non-small cell lung cancer

Introduction: The T790 M mutation of the epidermal growth factor receptor (EGFR) gene is the most common mechanism underlying resistance to first- or second-generation EGFR tyrosine kinase inhibitors (TKIs) in patients with non-small cell lung cancer (NSCLC). Osimertinib, a third-generation EGFR TKI, shows robust clinical efficacy in patients with T790 M-mutated lung cancer.

Areas covered: We analyzed and reviewed clinical data for which patients who experienced acquired resistance to first- or second-generation EGFR TKIs. In addition, we briefly reviewed the potential role of osimertinib as a first-line therapy.

Expert opinion: Osimertinib was recently licensed for use in NSCLC patients with acquired resistance to other EGFR TKIs due to a T790 M mutation. However, unresolved issues surrounding the optimal application of osimertinib remain, specifically the development of a plasma-based mutation test to overcome the difficulty of repeat biopsy, the efficacy of osimertinib for brain or leptomeningeal metastases, the development of resistance to osimertinib, and the use of osimertinib therapy as a first-line treatment. Many ongoing studies are currently exploring these issues.     

The effects of chronic aluminum exposure on learning and memory of rats by observing the changes of Ras/Raf/ERK signal transduction pathway

Objective

To investigate the effects of chronic aluminum (Al) exposure on learning and memory function of rats by observing the changes of Ras/Raf/ERK (Ras/ERK) signaling pathway.

Methods

Eighty weaned Wistar rats were divided into four groups ad libitum, 20 rats in each group. The four groups were fed with drinking water containing 0% (control), 0.2%, 0.4% and 0.6% (Al exposure) AlCl₃ for 3 months individually to set up aluminum exposure models. The laboratory was maintained at 18–23 °C and 45–55% relative humidity. Graphite furnace atomic absorption spectrometry was used to detect the content of Al in brain and blood. Western blot and real-time PCR (RT-PCR) were used to determine the protein and mRNA expression levels for Ras, Raf1, ERK2 and CREB.

Results

Chronic Al exposure increased the content of Al in rats’ blood and brain. It increased expression of Ras in the hippocampi compared with the control but the expression decreased along the Al exposure groups (p < 0.05). Similarly, Raf1, ERK2 and CREB expressions decreased compared to the control in a dose-dependent manner (p < 0.05).

Conclusion

Chronic Al exposure may affect learning and memory through impact on Ras/ERK signal pathway.     

Yang-Yin-Jie-Du decoction overcomes gefitinib resistance in non-small cell lung cancer via down-regulation of the PI3K/Akt signalling pathway

ContextYang-Yin-Jie-Du Decoction (YYJDD) was used to improve gefitinib efficacy in our clinical practice, but its mechanism remains unclear.ObjectiveThis study explored if YYJDD could reverse gefitinib resistance.Materials and methodsH1975 cells were exposed to control, 10 μM gefitinib, 3.2 mg/mL YYJDD or combination treatment. Cell viability was detected by MTT during 0–96 h. Apoptosis and the PI3K/Akt proteins were tested by flow cytometry and western-blot at 24 h. LY294002 was applied to further determine the role of the PI3K/Akt. 23 BALB/c nude xenograft mice received normal saline (n = 5), 80 mg/kg gefitinib (n = 6), 2.35 g/kg lyophilised powder of YYJDD (n = 6) or combination treatment (n = 6) by gavage for 4 weeks and submitted to TUNEL, immunohistochemistry, and western-blot.ResultsIn vitro, gefitinib (IC₅₀: 20.68 ± 2.06 μM) and YYJDD (IC₅₀: 6.6 ± 0.21 mg/mL) acted in a moderate synergistic way. Combination treatment inhibited cell viability from 100% to 25.66%. Compared to gefitinb (33.23 ± 3.99%), cell apoptosis was increased with combination treatment (54.11 ± 7.32%), accompanied by down-regulation of the PI3K/Akt. LY294002 further inhibited cell viability, increased apoptosis, and down-regulated p-Akt/Akt. In vivo, the tumour sizes in the combination group (1165.13 ± 157.79 mm³) were smaller than gefitinib alone (1630.66 ± 208.30 mm³). The positive rate of TUNEL staining was increased by combination treatment (22.33 ± 2.75%) versus gefitinib (7.37 ± 0.87%), while the PI3K/Akt was down-regulated.Discussion and conclusionYYJDD has potential to overcome gefitinib resistance. Future investigations should be focussed on its specific targets.