PD-1/PD-L1通路抑制剂治疗进展期胃癌的研究进展

胃癌是危害人类健康的恶性肿瘤之一,对于早期胃癌而言,手术联合化疗效果显著,而对于进展期胃癌,其效果并不理想。程序性死亡受体-1（programmed cell death-1,PD-1）/程序性死亡受体配体-1（prorammed cell death ligand 1,PD-L1）通路的发现为进展期胃癌患者的治疗提供了希望。目前已有部分研究表明,PD-1/PD-L1抑制剂单药或联合化疗治疗可使胃癌及胃食管交界癌患者受益,预示着PD-1/PD-L1抑制剂联合手术及标准化治疗方案可能是提高胃癌患者治疗疗效的突破点。本文将对PD-1/PD-L1抑制剂治疗进展期胃癌的研究进展作一综述。     

PD-1/PD-L1治疗非小细胞肺癌的研究进展

程序性死亡受体-1（programmed cell death-1,PD-1）/程序性死亡配体-1（programmed cell death-ligand 1,PD-L1）信号通路与肿瘤免疫逃逸密切相关,针对PD-1/PD-L1通路的免疫检查点抑制剂为非小细胞肺癌（non-small cell lung cancer,NSCLC）患者提供了一种新的治疗选择,并且显示出良好的疗效和安全性。本文对PD-1/PD-L1抑制剂治疗NSCLC的临床研究进展进行综述。      

PD-1/PD-L1抑制剂在淋巴瘤治疗中的研究进展

近年来,肿瘤生物免疫治疗因其显著的疗效而迅速发展为肿瘤研究领域的热点。程序性死亡受体-1（programmed death-1,PD-1）与其配体（programmed death ligand-1,PD-L1）在多种肿瘤细胞中过表达,参与肿瘤的发生、发展及侵袭转移。因此,PD-1/PDL1信号通路成为了肿瘤免疫治疗的有效新靶点。目前,PD-1/PD-L1抑制剂在淋巴瘤治疗研究中取得了较好的疗效。本文将对该类药物的相关临床研究现状进行综述,旨在加深对PD-1/PD-L1信号通路的作用机制及相关抗体应用于淋巴瘤治疗的认识。      

PD-1/PD-L1通路在乳腺癌治疗中的作用及意义

程序性死亡受体1（programmed death-1,PD-1,CD279）为共刺激受体CD28超家族成员,主要表达在活化T细胞、B细胞、单核细胞以及自然杀伤细胞表面。程序性死亡配体1（programmed death-ligand 1,PD-L1,CD274）为PD-1的一个重要配体,广泛表达于肿瘤细胞以及抗原呈递细胞（APC）表面。以PD-1/PD-L1为靶点的肿瘤免疫治疗为肿瘤治疗开辟了新的道路。PD-1通过与PD-L1和(或)PD-L2结合,抑制T细胞活化,诱导T细胞凋亡,在肿瘤免疫逃逸中起着重要的作用。目前PD-1/PD-L1信号通路成为免疫靶向治疗的新靶点,相关研究在非小细胞肺癌、晚期黑色素瘤等多种恶性肿瘤领域有重大进展,研究发现PD-L1 在多种肿瘤细胞包括乳腺癌中表达上调,提示 PD-1/PD-L1通路可能参与肿瘤的免疫逃逸。本文将针对PD-1/PD-L1通路在乳腺癌治疗中的作用及意义进行综述。     

PD-1/PD-L1在胃癌中的研究进展

胃癌是导致癌症患者死亡的主要疾病之一,而现有的治疗手段有限。当前免疫检测点抑制剂在肿瘤的治疗中取得了突破进展,相关研究迅速覆盖到胃癌。针对免疫检查点抗程序性死亡分子1（PD-1）/PD-1配体（PD-L1）抗体的临床研究正在广泛开展。本文对胃癌发生的免疫机制,PD-1/PD-L1表达,抗PD-1/PD-L1抗体早期临床研究及抗PD-1/PD-L1抗体预测疗效的生物标志物的研究进行文献复习。     

食管鳞癌PD-1/PD-L1分子生物学特点、与治疗和预后的相关性研究进展

PD-1(programmed cell death-1,程序性死亡受体1)与其配体PD-L1(programmed cell death-ligand 1,程序性死亡配体1) 是一对共刺激分子,对机体免疫反应起负性调节作用。阻断PD-1/PD-L1信号通路可以增强T细胞免疫功能,发挥抗肿瘤作用。目前有研究显示PD-1/PD-L1自身的分子生物学特性及在食管鳞状细胞癌（esophageal squamous cell carcinoma ,ESCC）组织中的表达水平可能与患者的预后有一定的相关性,本文就PD-1/PD-L1的生物结构、分子作用机制与ESCC和治疗、预后的相关性进行探讨。     

晚期胃癌免疫检查点PD-1/PD-L1抑制剂联合治疗的研究进展

胃癌是最为常见的恶性肿瘤之一，在中国其发病率和死亡率均较高，大多数胃癌初诊即已为晚期，预后较差，目前治疗现状仍不理想。免疫逃逸是肿瘤发生发展的一主要机制，细胞程序性死亡受体-1（programmed death-1，PD-1）及细胞程序性死亡配体（programmed death-ligand 1，PD-L1）是导致免疫逃逸的重要分子，PD-1与PD-L1结合是肿瘤细胞免疫逃逸的重要发病机制之一，特异性阻断二者结合，可达到杀灭肿瘤细胞的目的。PD-1/PD-L1抑制剂可明显改善晚期胃癌患者预后，并且PD-1/PD-L1抑制剂联合化疗、靶向治疗、放疗等可进一步提高疗效。本文就PD-1/PD-L1抑制剂联合治疗在晚期胃癌中的治疗进展进行综述。      

PD-1/PD-L1抑制剂在外周T细胞淋巴瘤治疗中的研究进展#br#

外周T细胞淋巴瘤（peripheral T-cell lymphoma, PTCL）是一组高度异质性和侵袭性的非霍奇金淋巴瘤（non-Hodgkin’s lymphoma,NHL）。在目前化疗为主的治疗下,PTCL患者通常预后差,复发率高,因此需要积极探索新药来改善预后。肿瘤微环境（tumor microenvironment,TME）在多种肿瘤中发挥重要作用,程序性死亡［蛋白］-1（programmed death-1,PD-1）/程序性死亡［蛋白］配体-1（programmed death ligand-1,PD-L1）信号通路是参与肿瘤免疫逃逸的重要途径之一,针对PD-1/PD-L1通路的抑制剂在多种肿瘤中疗效显著,在PTCL的治疗上也有广阔的应用前景。研究表明在PTCL多种亚型中均有不同程度PD-1/PD-L1的表达,且PD-1单抗在部分亚型中疗效显著。现就PD-1/PD-L1在PTCL中的表达情况和其抑制剂的治疗进展作一综述。     

PD-1/PD-L1通路在髓系肿瘤中的研究进展

在免疫系统中,为防止免疫反应过度,细胞表面会有抑制免疫反应的检查点,其中程序性死亡受体-１(programmed death-1,PD-1)与其程序性死亡配体-1(programmed death-ligand 1,PD-L1）就是其中的一对免疫检查点,肿瘤细胞通过表达PD-L1与免疫细胞上的PD-1受体结合,使得肿瘤细胞可以逃避免疫细胞的攻击。研究表明,PD-1及PD-L1在多种实体肿瘤组织及免疫细胞中存在过表达现象,导致抗肿瘤细胞功能消失,并且与不良预后相关,但在髓系肿瘤中的研究较少。因此本文从PD-1/PD-L1的生物学特点,目前在髓系肿瘤中的表达情况,以及传统化疗药物对该通路的作用作一综述,旨在为髓系肿瘤的诊疗提供新的靶点。     

循环外泌体PD-L1表达水平与PD-1/PD-L1抑制剂治疗恶性肿瘤疗效的相关性研究现状

外泌体作为具有生物学功能的小囊泡,是近年肿瘤研究领域关注的热点。研究发现,肿瘤细胞分泌的外泌体表达的程序性死亡受体配体1(programmed death ligand 1,PD-L1),可在肿瘤患者外周血液中检测到,可能参与并抑制机体免疫反应。近年来,一些研究发现,外泌体PD-L1可能影响程序性死亡受体1（programmed death 1,PD-1）/PD-L1抑制剂的抑制效应。反之,亦然。应用PD-1/PD-L1抑制剂治疗,可影响外泌体PD-L1的表达水平。二者有怎样的联系和相关性？本文就循环外泌体PD-L1在不同肿瘤免疫反应及抗PD-1/PD-L1免疫治疗中的研究进展作一综述。     

PD-1/PD-L1抑制剂的困境与sPD-1/sPD-L1的标志物潜能

PD-1和PD-L1免疫检查点抑制剂是肿瘤治疗的又一个里程碑,但缺乏灵敏度和特异度高的标志物来筛选对免疫检查点抑制剂敏感的患者,导致在部分癌种和患者中有效率低;而且由于毒副作用和耐药性的存在,进一步限制了其临床应用。可溶性PD-1(sPD-1)和可溶性PD-L1(sPD-L1)是PD-1和PD-L1的溶解形式,已在多种肿瘤中被证实与肿瘤的临床病理特征、分期、疾病的严重程度、治疗敏感性及预后密切相关,可能成为免疫治疗的标志物。全文就PD-1/PD-L1抑制剂的作用机制和其在临床应用中的困境及sPD-1和sPD-L1的标志物潜能进行综述。     

RB1CC1 activates the promoter and expression of RB1 in human cancer

RB1‐inducible coiled‐coil 1 (RB1CC1, also known as FIP200) is a tumor suppressor implicated in the regulation of RB1 (retinoblastoma 1) expression. However, the molecular mechanism of RB1 regulation by RB1CC1 has not been elucidated. Here, we demonstrate that nuclear RB1CC1 binds to the RB1 promoter using chromatin immunoprecipitation assays with anti‐RB1CC1 antibody. Luciferase assays with RB1 promoter reporter plasmids revealed that RB1CC1 activated the RB1 promoter through the 201 bp upstream GC‐rich region (from the initiation ATG). Electrophoretic mobility shift assay and Western blot analysis supported RB1CC1 binding to the GC‐rich region of the RB1 promoter. In addition, the C‐terminus of RB1CC1 was required for nuclear localization and subsequent RB1 promoter activation. Furthermore, the expression levels of RB1CC1 and RB1 significantly correlated with in vivo breast cancer tissues as determined by immunohistochemical analysis. These data indicate that nuclear RB1CC1 directly activates the RB1 promoter to enhance RB1 expression in cancer cells. Evaluation of RB1CC1 in various types of human cancer tissues is expected to provide useful information for clinical practice and future therapeutic strategies. © 2009 UICC     

Genetic polymorphisms of SULT1A1 and SULT1E1 and the risk and survival of breast cancer.

We examined whether common single nucleotide polymorphisms (SNP) in SULT1A1 (c.779G>A, *14A>G, and *85C>T) and SULT1E1 (IVS1-447C>A, IVS4-1653T>C, and *959G>A) genes influenced the risk and survival of breast cancer. Our study population consisted of 989 histologically confirmed sporadic breast cancer patients and 1,054 controls without history of cancer recruited from three teaching hospitals in Seoul. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by logistic regression model. In the survival analysis for 529 breast cancer patients with completed treatments, the hazard ratios (HR) were calculated with Cox proportional hazard model. Women with the SULT1E1 *959 GA/AA genotype had a moderately decreased breast cancer risk compared with those with the GG genotypes (OR, 0.8; 95% CI, 0.70-1.00). When the haplotypes were considered, the homozygous *959 AA genotype together with the IVS4-1653 T>C base change (CTA-CCA haplotype) was associated with halved breast cancer risk (OR, 0.5; 95% CI, 0.24-0.88) compared with the wild type CTG-CTG haplotype. No other significant overall association was observed between the SULT1A1 and SULT1E1 SNPs nor haplotypes and breast cancer risk. When stratified by survival, patients with the SULT1E1 IVS4-1653 TC/CC genotypes showed a >3-fold risk of recurrence (HR, 3.2; 95% CI, 1.39-7.48) compared with those with the TT genotype. Moreover, when the haplotypes were considered, the SULT1E1 *959 G>A base change together with the IVS4-1653 T>C base change (CTG-CCA haplotype) was associated with a >4-fold risk of breast cancer (OR, 4.2; 95% CI, 1.15-15.15). These findings suggest that genetic polymorphisms of SULT1E1 are associated with increased risk and a disease free survival of breast cancer in Korean women.     

Toxicities of the anti-PD-1 and anti-PD-L1 immune checkpoint antibodies

Immune checkpoint antibodies that augment the programmed cell death protein 1 (PD-1)/PD-L1 pathway have demonstrated antitumor activity across multiple malignancies, and gained recent regulatory approval as single-agent therapy for the treatment of metastatic malignant melanoma and nonsmall-cell lung cancer. Knowledge of toxicities associated with PD-1/PD-L1 blockade, as well as effective management algorithms for these toxicities, is pivotal in order to optimize clinical efficacy and safety. In this article, we review selected published and presented clinical studies investigating single-agent anti-PD-1/PD-L1 therapy and trials of combination approaches with other standard anticancer therapies, in multiple tumor types. We summarize the key adverse events reported in these studies and their management algorithms.     

FOXM1致癌机制及其分子靶向药物

FOXM1是Fox转录因子家族中的一员,通过调节肿瘤相关基因的表达,促进肿瘤发生发展、侵袭、转移及血管生成,但关于FOXM1在肿瘤发生发展中的具体作用机制尚不完全清楚.目前,以FOXM1为靶点的抗癌药物研究处于起步阶段,积极探讨FOXM1致癌机制,研发针对FOXM1及下游信号通路相关基因的靶向药物具有广阔的临床应用前景.     

IGF-1对胃癌血红素氧合酶-1表达的影响

目的:研究胃癌患者血清中胰岛素样生长因子-1(IGF-1)和血红素氧合酶-1(HO-1)的表达相关性,并探讨IGF-1对胃癌细胞中HO-1表达的调控作用.方法:收集胃癌患者血清标本,ELISA检测血清中IGF-1和HO-1的含量;胃癌细胞株SGC7901作为体外实验载体,不同浓度IGF-1干预胃癌细胞,Real time PCR和Western blot检测胃癌细胞中HO-1 mRNA和蛋白的表达量;随后在胃癌细胞培养基中加入IGF-1阻断剂,观察应用阻断剂前后胃癌细胞HO-1表达的变化.结果:胃癌患者血清中IGF-1和HO-1的表达较正常人群明显升高,且两者的表达呈正相关性.体外培养胃癌细胞SGC7901,IGF-1可显著促进胃癌细胞HO-1的表达,且该效应呈浓度依赖性.培养基中应用IGF-1阻断剂后,胃癌细胞HO-1的表达量明显受到抑制.结论:本实验探讨胃癌中IGF-1和HO-1表达的相关性,初步阐述IGF-1对胃癌HO-1表达的正向调控作用,为HO-1参与IGF-1促进胃癌发生及发展提供了理论依据.