肝癌疫苗研究进展

肝癌是严重威胁人类健康的一种疾病，目前，肝癌疫苗的研究已成为热点，应用肝癌细胞、肝癌相关抗原、癌基因、细胞因子等作为免疫原作用于机体，或以其冲击树突状细胞、转染载体从而构建有效的肝癌疫苗，诱导特异性免疫是其研究的主要方面。现综述肝癌疫苗研究的主要方面及其未来发展方向，为进一步研究提供依据。     

Clinical development of Listeria monocytogenes-based immunotherapies

Active immunotherapy targeting dendritic cells (DCs) has shown great promise in preclinical models and in human clinical trials for the treatment of malignant disease. Sipuleucel-T (Provenge, Dendreon, Seattle, WA), which consists of antigen-loaded dendritic cells (DCs), recently became the first targeted therapeutic cancer vaccine to be approved by the US Food and Drug Administration (FDA). However, ex vivo therapies such as Provenge have practical limitations and elicit an immune response with limited scope. By contrast, live-attenuated Listeria monocytogenes (Lm) naturally targets DCs in vivo and stimulates both innate and adaptive cellular immunity. Lm-based vaccines engineered to express cancer antigens have demonstrated striking efficacy in several animal models and have resulted in encouraging anecdotal survival benefit in early human clinical trials. Two different Lm-based vaccine platforms have advanced into phase II clinical trials in cervical and pancreatic cancer. Future Lm-based clinical vaccine candidates are expected to feature polyvalent antigen expression and to be used in combination with other immunotherapies or conventional therapies such as radiotherapy and chemotherapy to augment efficacy.     

自体肿瘤免疫激活剂诱导抗肝癌免疫的研究

目的 采用含有固定的肝细胞癌(HCC)细胞或组织碎片、粒细胞-巨噬细胞集落刺激因子(GM-CSF)和白介素-2(IL-2)的生物可降解缓释微球和结核菌素的肿瘤免疫激活剂进行皮内接种,观察对小鼠肝肿瘤的预防免疫作用和预防人HCC切除术后复发的效果.方法 动物实验:C57BL/6J小鼠尾部皮内注射Hepa 1-6肿瘤免疫激活剂两次,第2次免疫注射后7 d,左后肢皮下注射1×107活Hepa 1-6细胞,观察肿瘤的生长情况.临床研究:50例肝癌根治切除术后患者采用随机、对照的方法分为免疫激活剂接种组和对照组.结果 Hepa 1-6细胞注射同源性小鼠后,对照组(A组)18只小鼠全部发展成肝肿瘤;而接种含有固定Hepa 1-6细胞的免疫激活剂(B组)的18只小鼠中有4只无肿瘤生长;接种含有IL-2/GM-CSF微球和结核菌素(C组)的18只小鼠中有3只无肿瘤生长:而接种含有固定Hepal-6细胞和IL-2/GM-CSF微球和结核菌素(Tuberculin)的肿瘤免疫激活剂(D组)的18只小鼠中12只无肿瘤的生长,67%的小鼠获得保护.在HCC肿瘤免疫激活剂的临床试验中未见副作用.24例患者中17例出现了抗HCC迟发型超敏反应.剂量-1、-2免疫激活剂组术后1、2、3年复发率分别为25%(25%)、37.5%(37.5%)和50%(37.5%);剂量-4免疫激活剂组术后1、2年复发率分别为O%、12.5%.而对照组HCC切除术后1、2、3年复发率分别为30.8%、53.8%和61.5%.接种剂量-2、-4 HCC免疫激活剂患者的术后复发率明显低于对照组(P<0.05).结论 这种细胞因子缓释微球的肝癌免疫激活剂具有较强的抗小鼠肝肿瘤的效果;可预防肝癌切除术后复发.     

Myeloid-derived suppressor cells have a central role in attenuated Listeria monocytogenes-based immunotherapy against metastatic breast cancer in young and old mice

Background:

Myeloid-derived suppressor cells (MDSCs) are present in large numbers in blood of mice and humans with cancer, and they strongly inhibit T-cell and natural killer (NK) cell responses, at young and old age. We found that a highly attenuated bacterium Listeria monocytogenes (Listeria^at)-infected MDSC and altered the immune-suppressing function of MDSC.

Methods:

Young (3 months) and old (18 months) BALB/cByJ mice with metastatic breast cancer (4T1 model) were immunised with Listeria^at semi-therapeutically (once before and twice after tumour development), and analysed for growth of metastases and primary tumour, in relation to MDSC-, CD8 T-cell and NK cell responses.

Results:

We found that Listeria^at-infected MDSC, which delivered Listeria^at predominantly to the microenvironment of metastases and primary tumours, where they spread from MDSC into tumour cells (infected tumour cells will ultimately become a target for Listeria-activated immune cells). Immunotherapy with Listeria^at significantly reduced the population of MDSC in blood and primary tumours, and converted a remaining subpopulation of MDSC into an immune-stimulating phenotype producing IL-12, in correlation with significantly improved T-cell and NK cell responses to Listeria^at at both ages. This was accompanied with a dramatic reduction in the number of metastases and tumour growth at young and old age.

Conclusions:

Although preclinical studies show that immunotherapy is less effective at old than at young age, our study demonstrates that Listeria^at-based immunotherapy can be equally effective against metastatic breast cancer at both young and old age by targeting MDSC.     

Autologous fixed tumor vaccine: a formulation with cytokine-microparticles for protective immunity against recurrence of human hepatocellular carcinoma.

We developed a tumor vaccine consisting of fixed hepatocellular carcinoma (HCC) cells/tissue fragments, biodegradable microparticles encapsulating granulocyte-macrophage-colony stimulating factor and interleukin-2, and an adjuvant. The vaccine protected 33% of syngeneic mice from HCC cell challenge. The vaccine containing human autologous HCC fragments showed essentially no adverse effect in a phase I/IIa clinical trial and 8/12 patients developed a delayed-type hypersensitivity (DTH) response against the fragments. Although 2 of 4 DTH-response-negative patients had recurrence after curative resection, the DTH-response-positive patients had no recurrence. The time before the first recurrence in the vaccinated patients was significantly longer than that in 24 historical control patients operated in the same department (P < 0.05). This formulation is a promising candidate to prevent recurrence of human HCC.     

Silibinin efficacy against human hepatocellular carcinoma.

PURPOSE: Hepatocellular carcinoma (HCC) is one of the most common recurrent malignancies, for which, currently, there is no effective therapy. Considering the antihepatotoxic activity of silibinin, a widely used drug and supplement for various liver disorders, together with its strong preventive and anticancer efficacy against various epithelial cancers, we investigated the efficacy of silibin against human HCC cells. EXPERIMENTAL DESIGN: Silibinin effects were examined on growth, cytotoxicity, apoptosis, and cell cycle progression in two different HCC cell lines, HepG2 (hepatitis B virus negative; p53 intact) and Hep3B (hepatitis B virus positive; p53 mutated). At molecular level, cell cycle effects of silibinin were assessed by immunoblotting and in-bead kinase assays. RESULTS: Silibinin strongly inhibited growth of both HepG2 and Hep3B cells with a relatively stronger cytotoxicity in Hep3B cells, which was associated with apoptosis induction. Silibinin also caused G1 arrest in HepG2 and both G1 and G2-M arrests in Hep3B cells. Mechanistic studies revealed that silibinin induces Kip1/p27 but decreases cyclin D1, cyclin D3, cyclin E, cyclin-dependent kinase (CDK)-2, and CDK4 levels in both cell lines. In Hep3B cells, silibinin also reduced the protein levels of G2-M regulators. Furthermore, silibinin strongly inhibited CDK2, CDK4, and CDC2 kinase activity in these HCC cells. CONCLUSION: Together, these results for the first time identify the biological efficacy of silibinin against HCC cells, suggesting the importance of conducting further investigations in preclinical HCC models, especially on in vivo efficacy, to support the clinical usefulness of silibinin against hepatocellular carcinoma in addition to its known clinical efficacy as an antihepatotoxic agent.     

Neoantigen vaccine: An emerging immunotherapy for hepatocellular carcinoma

Tumor-specific neoantigens, which are expressed on tumor cells, can induce an effective antitumor cytotoxic T-cell response and mediate tumor regression. Among tumor immunotherapies, neoantigen vaccines are in early human clinical trials and have demonstrated substantial efficiency. Compared with more neoantigens in melanoma, the paucity and inefficient identification of effective neoantigens in hepatocellular carcinoma (HCC) remain enormous challenges in effectively treating this malignancy. In this review, we highlight the current development of HCC neoantigens in its generation, screening, and identification. We also discuss the possibility that there are more effective neoantigens in hepatitis B virus (HBV)-related HCC than in non-HBV-related HCC. In addition, since HCC is an immunosuppressive tumor, strategies that reverse immunosuppression and enhance the immune response should be considered for the practical exploitation of HCC neoantigens. In summary, this review offers some strategies to solve existing problems in HCC neoantigen research and provide further insights for immunotherapy.     

蛋白质组学在原发性肝癌中的研究进展

近年来,蛋白质组学作为一门新兴学科,越来越受到研究者的普遍关注。随着蛋白质组学技术日趋成熟,这种探索蛋白质结构和功能的科研方法深入到了各个疾病领域。原发性肝癌是一种以高死亡率为特征的常见癌症,运用蛋白质组学技术,可以充分了解疾病的发生、发展机制,并在寻找诊断标记物和药物靶向治疗方面产生价值。如今,世界各地的研究人员正在运用不同的蛋白质组学技术对原发性肝癌进行深入研究,并取得了相应进展。     

以AFP为靶点的肝癌树突状细胞免疫治疗的实验研究

目的探讨AFP作为肝癌基因治疗和免疫治疗靶点的可行性以及AFP基因转染的树突状细胞（AFP-DC）疫苗对表达AFP肝细胞癌的免疫治疗作用.方法构建AFP-cDNA 真核表达载体,体外转染DC,制备AFP-DC瘤苗,诱导针对表达AFP的肝癌细胞株HepG2的特异性免疫反应,MTT法检测效应细胞对靶细胞的杀伤率.结果 AFP-DC瘤苗能够分泌AFP抗原,培养上清中AFP含量为0.8805 IU/ml,与空载体组和空白对照组相比,差异显著（P〈0.05）.免疫荧光检测可见AFP-DC胞浆及胞膜有AFP抗原分子表达;活化的CTL能够对表达AFP肝癌细胞起特异性杀伤作用,杀伤效率可达84.05%,与空载体组和空白对照组比较,差异显著（P〈0.05）.结论 AFP作为靶点治疗肝癌具有可行性,AFP可作为肝癌靶向治疗的新的突破点;AFP-DC疫苗可以作为表达AFP肝癌的一种免疫治疗手段,为DC瘤苗的临床应用奠定了基础.     

The attenuated hepatocellular carcinoma-specific Listeria vaccine Lmdd-MPFG prevents tumor occurrence through immune regulation of dendritic cells

Immunotherapy is a promising treatment for liver cancer. Here, we tested the ability of the attenuated hepatocellular carcinoma-specific Listeria vaccine (Lmdd-MPFG) to treat hepatocellular carcinoma (HCC) in a mouse model. Immunization with the vaccine caused a strong anti-tumor response, especially in mice reinfused with dendritic cells (DCs). In mice that were also administered DCs, tumor suppression was accompanied by the strongest cytotoxic T lymphocyte response of all treatment groups and by induced differentiation of CD4+ T cells, especially Th17 cells. Additionally, the Lmdd-MPFG vaccine caused maturation of DCs in vitro. We demonstrated the synergistic effect of TLR4 and NLRP3 or NOD1 signaling pathways in LM-induced DC activation. These results suggest that the Lmdd-MPFG vaccine is a feasible strategy for preventing HCC.     

Isolating human antibody against human hepatocellular carcinoma by guided-selection

OBJECTIVE: With the pComb3X-displaying Fab antibody libraries, to achieve the humanization of murine HAb18 against HCC by guided selection. METHODS: With the optimized primers, the human Fd and C(L) repertoire genes were amplified by RT-PCR from PBMC of HCC patients. The Fd repertoire genes were paired with murine HAb18 C(L) gene to construct pComb3X-displaying hybrid Fab library. The recombinant HAb18GE was used as antigens to select the target antibodies and got the Fd fragments. Then the human C(L) genes were paired with the selected human Fds to construct human Fab library. After the panning, the complete human Fab antibodies were got and analyzed. RESULTS: With the murine HAb18 C(L) gene as template, the heavy chain Fd shuffling was achieved by panning the hybrid Fab library. Then with the selected Fds as template, the human Fabs were obtained through the light chain shuffling. Two of the resulting human Fabs (HuFab2 and HuFab11), with same Fd and different light chains, bound to HAb18G/CD147 specifically. The competitive ELISA, Western blotting, FCM, fluorescent cell staining and so on demonstrated that the human Fabs resembled its parental murine Fab in that they both perhaps recognized the same epitope. K(D) indicated (HuFab2=210 nm and HuFab11=280 nm) the selected Fabs had available affinity. CONCLUSION: Through guided-selection, we got the available human Fab antibodies for the subsequent research. These results suggest that guided selection is a promising strategy in murine mAb humanization.     

Preliminary result of mixed bacterial vaccine as adjuvant treatment of hepatocellular carcinoma

Mixed bacterial vaccine (MBV) was employed in the multi-modality treatment of hepatocellular carcinoma (HCC) during 1985–1988. Thirty eight patients undergoing palliative resection and cisplatin therapy (Series 1) and 48 patients with unresectable HCC who received hepatic artery ligation + intraarterial cisplatin infusion + radiotherapy (Series 2) were randomized to receive MBV or not. In series 1, the 1- and 2-year survival rates of MBV group and control were 75% vs 58% (P = 0.19) and 45% vs 39% (P = 0.23). In series 2, the 1-, 2- and 3-year survival rates were 59%, 41% and 41% for MBV group and 39%, 25% and 20% for the control, respectively (P ₁ = 0.07,P ₂ - 0.09, P₃ = 0.07). In addition, MBV improved the “second look” resection rate to 40% as compared to 17% in the control (P > 0.05). MBV could also prevent such immunosuppression as decrease of macrophage activity caused by radiotherapy. We consider MBV a potential nonspecific immunostimulant in the multimodality treatment of HCC.     

Mage-b vaccine delivered by recombinant Listeria monocytogenes is highly effective against breast cancer metastases

New therapies are needed that target breast cancer metastases. In previous studies, we have shown that vaccination with pcDNA3.1-Mage-b DNA vaccine is effective against breast cancer metastases. In the study presented here, we have further enhanced the efficacy of Mage-b vaccination through the improved delivery of the vaccine using recombinant Listeria monocytogenes (LM). Three overlapping fragments of Mage-b as well as the complete protein-encoding region of Mage-b have been expressed as a fusion protein with a truncated non-cytolytic form of listeriolysin O (LLO) in recombinant LM. These different Mage-b vaccine strains were preventively tested for their efficacy against breast cancer metastases in a syngeneic mouse tumour model 4T1. The LM-LLO-Mage-b/2nd, expressing position 311-660 of the cDNA of Mage-b, was the most effective vaccine strain against metastases in the 4T1 mouse breast tumour model. Vaccination with LM-LLO-Mage-b/2nd dramatically reduced the number of metastases by 96% compared with the saline group and by 88% compared with the vector control group (LM-LLO), and this correlated with strong Mage-b-specific CD8 T-cell responses in the spleen, after restimulation with Mage-b. However, no effect of LM-LLO-Mage-b/2nd was observed on 4T1 primary tumours, which may be the result of a complete absence of Mage-b-specific immune responses in the draining lymph nodes. Vaccination with LM-LLO-Mage-b/2nd could be an excellent follow-up after removal of the primary tumour, to eliminate metastases and residual tumour cells.     

抗肝癌单链免疫毒素hdsFv-RC-RNase的导向治疗作用

目的：观察抗肝癌重组单链免疫毒素hdsFv-RC-RNase对荷人肝癌裸鼠移植瘤的导向治疗作用，并探讨其临床应用价值。方法：将原核表达载体TIG-hdsFv-RC-RNase转化E.coli BL21（DE3）plys中，利用IPTG大量诱导表达抗肝癌hdsFv-RC-RNase重组单链免疫毒素。表达产物在非变性条件下经Ni-NTA Agarose亲合层析法纯化并体外复性，利用细胞ELISA法检测其特异性结合体外培养的人肝癌细胞的免疫活性。建立荷人肝癌裸鼠移植瘤动物模型，初步评估其对荷人肝癌裸鼠移植瘤的导向治疗作用。结果：工程菌经IPTG诱导后，出现一条相对分子质量约为41000的新生蛋白带，且主要以可溶性形式表达。纯化后表达产物的纯度达到基本均一。细胞ELISA检测结果显示，纯化产物复性后能够与体外培养的人肝癌细胞特异性结合，而对正常肝细胞的结合能力非常弱，两者具有非常显著的差异（P〈0．01）。导向治疗结果表明，其对荷人肝癌裸鼠移植瘤治疗有效率为100％，与生理盐水组相比具有非常显著的差异（P〈0．01），抑瘤率达到79．38％。结论：成功获得了特异性强的有活性的抗肝癌重组单链免疫毒素hdsFv-RC-RNase，其对荷人肝癌裸鼠移植瘤具有一定的导向治疗作用，可能成为抗肝癌导向治疗药物。     

Deferoxamine enhances anti-proliferative effect of interferon-gamma against hepatocellular carcinoma cells

BACKGROUND: Interferon-gamma (IFN-gamma) is a multifunctional cytokine, whose anti-proliferative effect is expected to be of therapeutic value against human cancer. However, hepatocellular carcinoma (HCC) shows resistance to the anti-proliferative effect of IFN-gamma, due mainly to down-regulation of IFN-gamma receptor chain 2 (IFN-gammaR2), even though IFN-gamma receptor chain 1 (IFN-gammaR1), the domain that includes the binding site of IFN-gamma, is stably expressed. The aims of this study were to investigate whether iron chelation, blocking of the human insulin-like growth factor-1 receptor (hIGF1R), or both could upregulate IFN-gammaR2 and enhance the anti-proliferative effect of IFN-gamma. METHODS: Two HCC cell lines, HuH7 and SNU449, were treated with the iron-chelating agent deferoxamine (DFO), IFN-gamma, and/or anti-hIGF1R blocking antibody. The expression of IFN-gammaR1 and IFN-gammaR2 was then evaluated by flow cytometry and Western blotting. The anti-proliferative effect of IFN-gamma was investigated by MTT assay, and the pro-apoptotic effect was investigated by annexin-V flow cytometry. RESULTS: DFO and blocking with anti-hIGF1R antibody increased the expression of IFN-gammaR2, but the effect on IFN-gammaR1 expression was less marked. DFO, anti-hIGF1R blocking antibody, or both directly enhanced the anti-proliferative effect of IFN-gamma through increased pro-apoptotic activity. CONCLUSION: The present results indicate that IFN-gamma reinforced by iron modulation could be a promising new therapeutic approach for HCC.     

Chemopreventive activity of a macrofungus Phellinus rimosus against N-nitrosodiethylamine induced hepatocellular carcinoma in rat

Chemoprevention is an important alternative approach to control cancer. Chemical substances with multiple inhibitory properties would be a welcome addition to the class of chemopreventive drugs. In this study, we investigated the antioxidant, anti-inflammatory, antimutagenic and cancer preventive activities of aqueous extract of a macrofungus Phellinus rimosus (Berk) Pilat. The extract exhibited superoxide anion (O2-), hydroxyl radical (*OH), nitric oxide (NO*) scavenging and lipid peroxidation inhibiting activities. The inhibitory concentrations required by the extract to scavenge 50% (IC50) of the superoxide anion, hydroxyl radical and nitric oxide generated were 126 +/- 5.1, 71 +/- 4.7 and 31 +/- 4.5 microg/ml respectively. The concentration required to inhibit 50% of Fe2+ induced lipid peroxidation in rat liver homogenate was 318 +/- 2.4 microg/ml. The extract showed significant (P<0.05) anti-inflammatory activity in a dose dependent manner. Extract (100 mg/kg body wt, p.o) inhibited 44.5, 45.4 and 47% carrageenen, dextran and formalin induced inflammations respectively. The antimutagenic activity was determined by the Ames' Salmonella mutagenecity assay using histidine mutant Salmonella typhimurium strains. The extract at concentration of 5 mg/plate showed antimutagenecity against benzo[a]pyrene (B[a]P) and 4-nitro-o-pheneylenediamine (NPDA) induced mutations of TA98 and TA100 respectively. Anticarcinogenic activity was evaluated using N-nitrosodiethylamine (NDEA) induced hepatocellular carcinoma (HCC) in rats. Serum gamma glutamyl transpeptidase (GGT), glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT) and alkaline phosphatase (ALP) activities and lipid peroxidation level (MDA) were elevated significantly (P<0.05) in the NDEA alone treated group of animals. Treatment of the extract (25 and 50 mg/kg body wt, p.o.) prior to the NDEA administration decreased the serum GGT, GOT, GPT and ALP activities and MDA level in a dose dependent manner. The NDEA alone treated animals showed altered serum albumin/globulin ratio (A:G ratio), hyperfibrinogenaemia, increased hepatic glutathione S-transferase (GST) activity, glutathione-peroxidsae (GPx) activity and reduced glutathione (GSH) level compared to the extract plus NDEA treated group. The extract also inhibited in vitro aniline hydroxylase (AH) activity of rat liver induced by phenobarbitone in a dose dependent manner. The results, thus suggest the significant chemopreventive properties of the aqueous extract of the Phellinus rimosus against NDEA induced hepatocellular carcinoma by its antioxidant, anti-inflammatory and antimutagenic activities.     

肝癌树突状细胞瘤苗诱导抗肿瘤作用的研究

目的：研究负载肝癌抗原的肝癌树突状细胞（dendritic cell,DC）瘤苗诱导的抗肿瘤作用。方法：于体外用rhGM-CSF和rhIL-4从肝癌患者外周血诱导DC,并用肝癌细胞抗原冲击致敏,制成负载肝癌抗原的肝癌DC瘤苗。肝癌DC瘤苗活化自体T淋巴细胞分化为细胞毒性T淋巴细胞（cytotoxic of T-lymphocytes,CTL）,采用流式细胞术检测CTL分型;乳酸脱氢酸（LDH）4 h释放法检测CTL对肝癌细胞的特异性杀伤作用。MTT法检测肝癌DC瘤苗及其活化CTL培养上清对肿瘤细胞的抑制作用;ELISA法检测肝癌DC瘤苗活化的CTL培养上清中IL-12、IFN-γ和TNF-α水平。结果：经肝癌DC瘤苗活化后的T淋巴细胞群中,CD56^＋细胞数量显著减少,CD4^＋T和CD8^＋T细胞数量增加,其中以CD8^＋T细胞增加较明显;细胞毒实验显示,该CTL对自体肝癌细胞具有较强的杀伤作用,而对与致敏DC的肝癌抗原无关的CT26结肠腺癌细胞无明显杀伤作用;单纯肝癌DC瘤苗或其激活的CTL培养上清也表现出较强的抑瘤作用,而且这种抑瘤作用具有广谱性,可抑制多种肿瘤细胞的生长;在CTL培养上清中可检测到IL-12、TNF-α和IFN-γ的含量。结论：肝癌DC瘤苗不仅诱导了对肝癌细胞的特异性CTL杀伤作用,而且可激活CD4^＋T和CD8^＋T细胞分泌IL-12、TNF-α和IFN-γ等细胞因子,以非杀伤方式直接或间接地抑制肿瘤细胞生长,发挥非特异性的抗肿瘤作用。     

PLA表位肽免疫微球诱导CTL对肝癌细胞的杀伤作用

目的〖HT5"SS〗：考察两种载肽聚乳酸（(polylatic acid, PLA)免疫微球M1（hAFP158~166）和M2（hAFP218~226）在体外诱导特异性CTL的能力及其对肝癌细胞的杀伤作用。〖HT5W〗方法： 〖HT5”SS〗制备分别荷载表位肽hAFP158~166、、hAFP218~226的PLA免疫微球M1和M2,体外刺激HLAA2+健康志愿者的外周血单个核细胞（PBMC）作为效应细胞,实验分为3组：对照组、hAFP表达组和hAFP阴性组。采用标准51Cr释放法检测CTL杀伤活性。〖HT5W〗结果：〖HT5"SS〗两种免疫微球在体外均能刺激人PBMC增殖,形成大量可见克隆;两者诱导的效应细胞对hAFP＋的荷肽T2细胞、HepG2和Alexander的杀伤率均达75％以上,均显著高于不表达hAFP的膀胱癌细胞BTT和未荷肽的T2细胞,差异非常显著（P<0.01）,而两者杀伤活性之间没有明显差异（P>0.05）。〖HT5W〗结论：〖HT5"SS〗两种载肽聚乳酸免疫微球均能在体外诱导产生特异性CTL,并对表达靶抗原的肝癌细胞有较强杀伤作用。     

Novel antiangiogenic therapies against advanced hepatocellular carcinoma (HCC)

Angiogenesis is a cornerstone in the process of hepatocarcinogenesis. In the sorafenib era, other antiangiogenic targeted drugs, such as monoclonal antibodies and a new generation of tyrosine kinase inhibitors, have been shown in phase II trials to be safe and effective in the treatment of advanced hepatocellular carcinoma. Several currently active phase III trials are testing these drugs, both in first- and second-line settings. Strategies to overcome primary and acquired resistance to antiangiogenic therapy are urgently needed. Novel biomarkers may help in improving the efficacy of drugs targeting angiogenesis.     

Preliminary result of mixed bacterial vaccine as adjuvant treatment of hepatocellular carcinoma.

Mixed bacterial vaccine (MBV) was employed in the multi-modality treatment of hepatocellular carcinoma (HCC) during 1985-1988. Thirty eight patients undergoing palliative resection and cisplatin therapy (Series 1) and 48 patients with unresectable HCC who received hepatic artery ligation + intraarterial cisplatin infusion + radiotherapy (Series 2) were randomized to receive MBV or not. In series 1, the 1- and 2-year survival rates of MBV group and control were 75% vs 58% (P = 0.19) and 45% vs 39% (P = 0.23). In series 2, the 1-, 2- and 3-year survival rates were 59%, 41% and 41% for MBV group and 39%, 25% and 20% for the control, respectively (P1 = 0.07, P2 = 0.09, P3 = 0.07). In addition, MBV improved the "second look" resection rate to 40% as compared to 17% in the control (P greater than 0.05). MBV could also prevent such immunosuppression as decrease of macrophage activity caused by radiotherapy. We consider MBV a potential nonspecific immunostimulant in the multimodality treatment of HCC.