索拉非尼对人卵巢癌SKOV-3细胞凋亡的影响

目的探讨索拉非尼对人卵巢癌SKOV-3细胞凋亡的影响。方法采用MTT法,检测不同浓度索拉非尼(1.5、3.0、6.0、12.0、24.0μmol/L)作用人卵巢癌SKOV-3细胞24、48、72 h的抑制率;Hoechst染色法观察药物处理后细胞凋亡情况;应用索拉非尼与紫杉醇不同给药方式作用于SKOV-3细胞,流式细胞仪检测药物处理后细胞周期和凋亡率变化。结果索拉非尼对SKOV-3细胞增殖具有明显抑制作用,与对照组比较差异有统计学意义(P<0.05),并且呈剂量和时间依赖性;索拉非尼主要使SKOV-3细胞周期阻滞在S期,与紫杉醇联合给药后S期及G2/M期均有延长,且凋亡率较高(P<0.05)。结论索拉非尼对SKOV-3细胞增殖有显著抑制作用,且呈剂量和时间依赖性,紫杉醇序于索拉非尼给药时细胞凋亡率更高。     

CHOP在索拉菲尼联合辛二酰苯胺异羟肟酸诱导人肝癌细胞MHCC97L凋亡中的作用

目的:探讨CCAAT/增强子结合蛋白同源蛋白(CHOP)在索拉菲尼联合辛二酰苯胺异羟肟酸(SAHA)诱导人肝癌细胞MHCC97L凋亡中的作用。方法:采用CCK-8法检测索拉菲尼联合SAHA对MHCC97L细胞活力的影响;采用流式细胞术检测索拉菲尼联合SAHA对细胞周期及细胞凋亡的影响;应用Western blot法检测索拉菲尼联合SAHA对MHCC97L细胞中内质网应激相关分子葡萄糖调节蛋白78(GRP78)、蛋白激酶R样内质网激酶(PERK)、p-PERK、活化转录因子4(ATF4)及CHOP蛋白表达的影响。此外,应用CHOP siRNA沉默CHOP后,采用流式细胞术观察索拉菲尼联合SAHA对MHCC97L细胞凋亡的影响。结果:索拉菲尼联合SAHA可使MHCC97L细胞活力明显下降(P<0.05),细胞周期结果显示细胞生长被阻滞在G₁期; Western blot结果显示索拉菲尼联合SAHA可显著上调上述内质网应激凋亡通路中相关蛋白的表达,同时流式细胞术检测发现索拉菲尼联合SAHA可显著促进MHCC97L细胞凋亡(P<0.01);CHOP siRNA...     

索拉非尼联合化疗治疗原发性肝癌的临床研究

目的：探讨索拉非尼联合表阿霉素、氟尿嘧啶治疗原发性肝癌的临床疗效和安全性。方法回顾性分析我院自2003年2月～2010年2月收治的56例原发性肝癌患者,随机分为治疗组及对照组各28例。治疗组：索拉菲尼联合EF方案;对照组单用索拉菲尼,比较两组的总体疗效及不良反应发生率。结果治疗组在有效率、疾病控制率、中位无进展生存时间、中位生存期、1年生存率均优于对照组,差异有统计学意义（P＜0.05）;两组的主要不良反应均为疲乏、高血压、手足皮肤反应、腹泻等,治疗组较对照组除了白细胞减少及恶心、呕吐略差外（P＜0.05）,两组间其他不良反应差异无统计学意义（P＞0.05）。结论索拉非尼联合（EF方案）化疗治疗原发性肝癌的近期疗效高,安全性好,患者耐受性好,值得临床进一步研究。     

长期索拉菲尼暴露促进Huh7肝癌细胞上皮间质变的实验研究

目的探讨索拉菲尼耐药肝癌细胞发生上皮间质变(EMT)及侵袭、转移能力增强的机制。方法通过药物连续诱导人肝癌细胞株Huh7建立索拉菲尼耐药肝癌细胞株Huh7R,显微镜下观察细胞形态学变化;CCK-8细胞增殖试验检测Huh7R细胞增殖能力;荧光定量PCR检测ABC家族耐药基因ABCB1、ABCC1、ABCG2及EMT相关调控锌指蛋白转录因子Snail、Slug基因表达水平;Westernblot检测耐药蛋白ABCG2,EMT标记分子E-cadherin、Vimentin及N-cadherin,转录因子Snail、Slug蛋白表达水平;Transwell小室侵袭试验检测Huh7R细胞迁移、侵袭能力。结果Huh7R细胞呈细长形,伴纤维状突起,形态学上符合EMT改变;CCK-8细胞增殖试验显示在索拉菲尼作用下,Huh7R细胞生存率高于Huh7细胞;荧光定量PCR结果显示,Huh7R细胞ABCB1、ABCC1、ABCG2及Snail、Slug基因表达水平均高于Huh7细胞（均P＜0.05）;Westernblot显示,Huh7R细胞上皮标记蛋白E-cadherin表达水平低于Huh7细胞（P＜0.05）,而间质标记蛋白Vimenti、N-cadherin及Snail、Slug蛋白表达水平均高于Huh7细胞（均P＜0.05）;Transwell小室侵袭试验显示Huh7R细胞迁移、侵袭能力均较Huh7细胞增强。结论长期低剂量索拉菲尼暴露会促进肝癌细胞Snail和Slug表达,诱导肿瘤细胞发生EMT,增强其侵袭、转移能力。     

Inhibition of autophagy significantly enhances combination therapy with sorafenib and HDAC inhibitors for human hepatoma cells

AIM:To clarify whether histone deacetylase inhibitors histone deacetylase inhibitors(HDACIs)can sensitize hepatocellular carcinoma(HCC)cells to sorafenib treatment.METHODS:Bax,Bcl-2,ATG5-ATG12,p21,and p27protein levels in Hep3B,HepG2,and PLC/PRF/5 cells were examined by Western blot.CCK8 and a fluorometric caspase-3 assay were used to examine cellular viability and apoptosis levels.The effect of Beclin-1 on sensitization of HCC cells to sorafenib was examined by transfecting Beclin-1 siRNA into Hep3B,HepG2,and PLC/PRF/5 cells.RESULTS:Autophagy inhibition enhances the inhibitory effects of vorinostat and sorafenib alone or in combination on HCC cell growth.Vorinostat and sorafenib synergistically induced apoptosis and cell cycle alterations.Western blot data indicated that HDACIs and Beclin-1 knockdown increased the p53 acetylation level.The knockdown of Beclin-1 enhanced the synergistic effect of the combination of vorinostat with sorafenib.CONCLUSION:HDACIs can sensitize HCC cells to sorafenib treatment by regulating the acetylation level of Beclin-1.     

索拉非尼与顺铂的不同联合方案对肝癌HepG2细胞的作用研究

摘要：目的 探讨索拉非尼（Sorafenib，BAY 43-9006，Nexavar）联合顺铂（cisplatin，DDP）对肝癌细胞HepG2的杀伤作用。方法 单独、同时及序贯联合给药后以MTT法测定HepG2细胞的增殖，用流式细胞仪检测细胞凋亡。结果 索拉非尼及DDP单药对HepG2均有抑制作用，两药同时给药具有协同或相加作用（P<0. 05）。序贯用药DDP先用组与同时给药组相比疗效相似（P>0. 05），表现为协同或相加作用。而索拉非尼先用组疗效差于前两者(P<0. 05)，显示拮抗作用。联合用药组凋亡率均比单药组高（P<0. 05），同时给药组及DDP先用组凋亡率比索拉非尼先用组高（P<0. 05，P<0. 05）。结论　索拉非尼和顺铂对肝癌HepG2细胞有增殖抑制及促凋亡作用，同时给药表现为协同或相加作用，序贯联合用药产生单向协同或相加作用。     

索拉非尼联合国产PD-1抑制剂治疗不可手术切除的肝细胞癌的疗效及不良反应

目的研究索拉非尼联合国产程序性细胞死亡受体-1(programmed cell death receptor-1,PD-1)抑制剂在不可手术切除的肝细胞癌(hepatocellular carcinoma, HCC)中的疗效及不良反应。方法回顾性分析2019年6月至2021年1月于北京地坛医院肿瘤内科使用国产PD-1抑制剂联合索拉非尼治疗的不可手术切除的HCC患者的临床资料,资料完整且符合入组条件者共22例,其中卡瑞利珠单抗联合索拉非尼组9例,信迪利单抗联合索拉非尼组13例,随访患者,主要研究终点为统计客观缓解率(objective response rate, ORR)、疾病控制率(disease control rate, DCR)和无进展生存期(progression-free survival, PFS),次要研究终点为总生存期(overall survival, OS)和安全性。结果在可评价疗效的22例患者中,7例患者疗效评价为部分缓解(partial remission, PR),10例患者疗效评价为疾病稳定(stable disease, SD),5例患者疗效评价为疾病进展(progressive disease, PD),ORR为31.8%,DCR为77.3%。中位无进展生存期(median progression-free survival, mPFS)为8.0个月(5.4~10.6个月)。不良反应发生率为77.3%,最常见的不良反应为腹泻(27.3%)、手足综合征(22.7%)、转氨酶升高(22.7%)、疲乏(18.2%)。结论索拉非尼联合国产PD-1抑制剂治疗不可手术切除的HCC临床效果显著,不良反应可控,是一种安全、有效的治疗方案。     

Hepatocellular Carcinoma and Liver Transplantation: State of the Art

Hepatocellular carcinoma (HCC) is an aggressive tumor that often occurs in chronic liver disease and cirrhosis. The incidence of HCC is growing worldwide.With respect to any other available treatment for liver cancer, liver transplantation (LT) has the highest potential to cure. LT allows for removal at once of both the tumor (“seed”) and the damaged-hepatic tissue (“soil”) where cancerogenesis and chronic liver disorders have progressed together. The Milan criteria (MC) have been applied worldwide to select patients with HCC for LT, yielding a 4-year survival rate of 75%. These criteria represent the benchmark for patient selection and are the basis for comparison with any other suggested criteria.However, MC are often considered to be too restrictive, and recent data show that between 25% and 50% of patients with HCC are currently transplanted beyond conventional indications. Consequently, any unrestricted expansion of selection criteria will increase the need for donor organs, lengthen waiting periods, increase drop-out rates, and impair outcomes on intention-to-treat analysis. Management of HCC recurrence after LT is challenging. There are a few reports available regarding the safety and efficacy of sorafenib for HCC recurrence after LT, but the data are heterogeneous. A multi-center prospective randomized controlled trial comparing placebo with sorafenib is advised. Alternatively, a meta-analysis of patient survival with sorafenib for HCC recurrence after LT could be helpful to characterize the therapeutic benefit and safety of sorafenib.Here, we review the use of LT for HCC, with particular emphasis on the selection criteria for transplantation in patients with HCC and management of HCC recurrence after LT.     

Sorafenib for Egyptian patients with advanced hepatocellular carcinoma; single center experience

BackgroundAccording to the results of a number of phase 3 randomized studies, sorafenib is the only approved systemic therapy for advanced HCC; however the issue of high economic cost remains challenging; thus we have conducted this retrospective analysis of our HCC patients treated with sorafenib.MethodsHCC patients treated at Ain Shams University Hospitals, in the period between 2010 and 2012 were reviewed. Eligible patients were those who had received sorafenib for advanced HCC not eligible for or progressed after surgery or locoregional therapy. We investigated the impact of baseline clinicopathological factors (age, gender, child status, performance score, BCLC tumor stage, cause of chronic liver disease, median baseline alpha fetoprotein level and previous treatment received for HCC) on overall survival (OS) in an adjusted Cox regression model.Results41 patients were included in the analysis fulfilling the inclusion criteria. At a median follow up period of 13 months, the median PFS for the whole group was 4 months; the median OS for the whole group is 6.25 months. Multivariate analysis identified three baseline characteristics that were prognostic indicators for overall survival: ECOG performance status (median OS for ECOG 1 = 7.01 months and for ECOG 2 = 3.03 months), Child–Pugh status (median OS for child A = 12.04 months and for child B = 5.23 months), and median baseline levels of alpha-fetoprotein.ConclusionsIn limited resource countries like Egypt, we suggest that the use of sorafenib for the treatment of advanced HCC cases should be restricted to a highly selected subgroup of patients with good performance and child A.