Analysis of patient-reported outcomes from the LUME-Lung 1 trial: A randomised,double-blind,placebo-controlled,Phase III study of second-line nintedanib in patients with advanced non-small cell lung cancer

IntroductionThe LUME-Lung 1 trial (NCT00805194; Study 1199.13) demonstrated a significant overall survival (OS) advantage for nintedanib plus docetaxel compared with placebo plus docetaxel as second-line therapy for patients with advanced non-small cell lung cancer (NSCLC) and adenocarcinoma histology. Patient-reported outcomes (PROs) for symptoms and health-related quality of life (QoL) are reported here.MethodsPROs were assessed at screening, on Day 1 of each 21-day treatment cycle, at the end of active treatment, and at the first follow-up visit. PRO instruments were the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Lung Cancer-13 supplement, and the EuroQol disease-generic questionnaire (EQ-5D and EQ-VAS). Analyses of PRO items for lung cancer-specific symptoms of cough, dyspnoea and pain were prespecified.ResultsRates of questionnaire completion were high. There was no significant difference in time to deterioration of global health status/QoL, or symptoms of cough, dyspnoea or pain, between the treatment groups for both the overall study population and the adenocarcinoma population. Time to deterioration of some gastrointestinal events was shorter with nintedanib versus placebo. Longitudinal analysis for the adenocarcinoma population showed comparable changes between the groups in symptom scores over time, with numerical differences in favour of nintedanib for cough and pain scales, and significant reductions in some pain items with nintedanib versus placebo. There was no statistically significant difference in EQ-5D or EQ-VAS between the groups.ConclusionThe significant OS benefit observed with the addition of nintedanib to docetaxel therapy was achieved with no detrimental effect on patient self-reported QoL.     

New anti-angiogenesis agents: review of the clinical experience with carboxyamido-triazole (CAI), thalidomide, TNP-470 and interleukin-12

Angiogenesis was postulated to be a critical prognostic factor and therapeutic focus for malignancy more than two decades ago. Recent studies indicate quantitative assessments of microvessel count to be an independent prognostic variable for disease-free and overall survival in a wide variety of tumors, and that angiogenesis may be a feasible target against which to intervene pharmacologically. Several new and old agents have been found to have anti-angiogenic activity and have reached clinical trial. This review will focus on four agents under investigation in the US: carboxyamido-triazole (CAI), thalidomide, TNP-470 and interleukin (IL)-12. CAI, originally identified for its anti-invasive capacity, has been shown to inhibit tumor and endothelial cell proliferation by inhibition of calcium uptake. It is administered orally, is generally well tolerated, and has been shown to induce disease stabilization and occasional reductions in tumor mass. Thalidomide was shown to inhibit growth factor-induced neovessel formation, a process that can also explain its earlier devastating clinical toxicity. It is administered orally, and is currently in phase II clinical trials for prostate cancer, glioblastoma multiforme and breast cancer. TNP-470 is a fumagillin analog that has been shown in in vivo models to be a potent inhibitor of angiogenesis at concentrations that are cytostatic to endothelial cells and tumor cells. Lastly, IL-12 may exert its anti-angiogenic effects through activation of interferon- to up-regulate interferon-inducible protein-10, an anti-angiogenic cytokine. Phase I clinical trials of IL-12 have shown disease stabilization in several tumor types in response to s.c. administration or using genetically engineered IL-12-expressing patient fibroblasts. These promising new agents join the matrix metalloproteinase inhibitors as important new drugs in the anti-cancer armamentarium.     

Gold nanoparticles in ophthalmology

Many research projects are underway to improve the diagnosis and therapy in ophthalmology. Indeed, visual acuity deficits affect 285 million people worldwide and different strategies are being developed to strengthen patient care. One of these strategies is the use of gold nanoparticles (GNP) for their multiple properties and their ability to be used as both diagnosis and therapy tools. This review exhaustively details research developing GNPs for use in ophthalmology. The toxicity of GNPs and their distribution in the eye are described through in vitro and in vivo studies. All publications addressing the pharmacokinetics of GNPs administered in the eye are extensively reviewed. In addition, their use as biosensors or for imaging with optical coherence tomography is illustrated. The future of GNPs for ophthalmic therapy is also discussed. GNPs can be used to deliver genes or drugs through different administration routes. Their antiangiogenic and anti-inflammatory properties are of great interest for different ocular pathologies. Finally, GNPs can be used to improve stereotactic radiosurgery, brachytherapy, and photothermal therapy because of their many properties.     

探讨肿瘤抗血管生成治疗存在的问题及治疗分析

目的：对肿瘤抗血管生成治疗中存在的问题和解决的措施进行具体分析。方法从我院2012年12月-2014年12月接受抗血管生成治疗的肿瘤患者中随机选取60例作为研究对象,对他们的临床资料进行回顾性分析,总结治疗过程存在的问题,并探讨对应的解决措施。结果经分析,肿瘤抗血管生成治疗中,32例（53.33%）需重复使用大剂量给药或长期治疗,18例（30%）因肿瘤类型不同而无法判断疗效,23例（38.33%）缺乏固定的治疗方案,38例（63.33%）因其他合并症会增加血栓性疾病发生的概率,还有9例（15%）无法直接检查用药后的治疗效果。结论对于肿瘤抗血管生成治疗中存在的问题要采取针对性的解决措施,才能提高肿瘤的药物治疗效果。     

Oridonin exhibits anti-angiogenic activity in human umbilical vein endothelial cells by inhibiting VEGF-induced VEGFR-2 signaling pathway

Oridonin has been found to be a potential anti-angiogenesis agent. However, its functional targets and the underlying mechanisms are still vague. In vitro studies we found that oridonin not only inhibited VEGF-induced cell proliferation, migration and tube formation but also caused G2/M phase arrest and triggered cellular apoptosis in HUVECs. In mechanistic studies revealed that oridonin exhibited the anti-angiogenic potency, at least in part, through the down-regulation of VEGFR2-mediated FAK/MMPs, mTOR/PI3K/Akt and ERK/p38 signaling pathways which led to reduced invasion, migration, and tube formation in HUVECs. Our results could provide evidence that oridonin exerts strong anti-angiogenesis activities via specifically targeting VEGFR2 and its signaling pathway.     

通络活血虫类中药在抗恶性肿瘤血管生成中的研究现状

血管生成在恶性肿瘤细胞的增殖和侵袭转移中具有重要作用,抗血管生成药物在恶性肿瘤内科治疗中已取得一定疗效。中医药在肿瘤治疗方面具有多成分、多靶点、多环节且不良反应小的优势,用络病理论阐释肿瘤血管生成病机乃是近年来中医药的研究热点之一。基于络病理论“通络”治则提出的“通络活血”治法在临床中被广泛应用,且通络活血虫类药物也是经方中较为峻猛、能除疴疾的重要中药。     

可溶性血管内皮生长因子受体1真核克隆表达及其对血管内皮细胞增殖的影响

本研究旨在构建可溶性血管内皮生长因子(vascular endothelial growth factor,VEGF)受体1(soluble fmslike tyosine kinase-1,sFlt-1)的真核表达质粒pcDNA3.1-sFlt-1,并观察sFlt-1对血管内皮细胞增殖的影响。提取人脐静脉内皮细胞(human umbilical vein endothelial cells,HUVECs)总RNA,扩增Flt-1基因胞外1-3结构域,构建真核表达质粒pcDNA3.1-sFlt-1,测序鉴定基因序列。将重组质粒转染Lewis肺癌细胞,采用RT-PCR和SDS-PAGE检测sFlt-1在基因及蛋白水平的表达情况。MTT法检测sFlt-1对VEGF诱导的HUVECs生长的影响。结果显示:①插入片段序列正确;②sFlt-1在基因水平成功表达且转染后的Lewis肺癌细胞能分泌表达sFlt-1;③含sFlt-1的细胞上清液可明显抑制VEGF诱导的HUVECs增殖。本研究成功构建了真核表达质粒pcDNA3.1-sFlt-1,sFlt-1,在基因和蛋白水平均获得有效表达,且表达的蛋白可明显抑制由VEGF诱导...     

抗血管生成因子Angiostatin与Endostatin作用下肿瘤血管生成的二维数值模拟

目的数值模拟抗血管生成因子Angiostatin和Endostatin对肿瘤血管生成的影响。方法建立肿瘤内外血管生成的二维离散数学模型。模型耦合两种抗血管生成因子Angiostatin和Endostatin的抑制效应,数值模拟在促血管生成因子诱导下肿瘤微血管网生成,讨论血管生成抑制因子的影响。结果抗血管生成因子Angiostatin对肿瘤内外血管网络生成的速度和成熟度有抑制作用。抗血管生成因子Angiostatin和Endostatin耦合作用时,在肿瘤血管生成的早期有明显的抑制效应;在肿瘤血管生成的中后期,它们可以降低肿瘤血管化程度。结论本文模型能够较好的模拟抗血管生成因子Angiostatin和Endostatin对内皮细胞迁移和增殖的抑制作用。     

~(99m)Tc-HL91乏氧显像对胃癌血管正常化窗口的判断

目的 探讨~(99m)Tc-HL91乏氧显像在胃癌血管正常化窗口(NWTV)的监测与判断中的价值.方法 使用~(99m)Tc-HL91对40只裸鼠肿瘤组织行乏氧显像,随机将裸鼠分成治疗组(n=20)按400 μg/每次腹腔注射DC101与对照组(n=20)注射同体积的生理盐水,利用感兴趣区(ROI)技术计算出注射后5 min到8 h的靶和非靶组织放射性比值(T/NT),取最大T/NT代表肿瘤乏氧状态,与对照组比较动态监测抗鼠血管内皮细胞生长因子受体2的单克隆抗体(DC101)治疗后1～14 d的胃癌乏氧变化并定位NWTV.结果 对照组开始显影时间和达到最大T/NT时间在第1～14天间无明显区别,治疗组第1天肿瘤显影时间为(30.12±0.11)min,T/NT峰值时间为(6.26±0.36)h.第2天起肿瘤显像时间和T/NT峰值时间逐渐减少,至第5天后与对照组间无明显区别.与对照组肿瘤乏氧逐渐缓慢增加不同,治疗组肿瘤乏氧呈波浪式增加.DC101治疗后第2天肿瘤乏氧(6.23±0.26)下降,到第5天肿瘤乏氧(0.24±0.14)几乎消失,在第8天(6.36±0.14)再次开始逐渐增加,NWTV出现在DC101治疗后第2天至第8天.结论 ~(99m)Tc-HL91乏氧显像能无损伤性监测抗血管生成治疗后肿瘤的乏氧变化,精确定位胃癌的NWTV.     

Inhibitory Effects of Corni Fructus Extract on Angiogenesis and Adipogenesis

Natural products in Chonnam, Korea were screened via anti-angiogenesis experiments, and 1 candidate product was identified, Corni fructus, which exerted dose-dependent inhibitory effects against angiogenesis, adipogenesis, and cell adhesion. C. fructus extract (CFE) exhibits an angiogenesis inhibitory effect superior to that of the EGCG from green tea leaves. The expression level of angiogenesis and adipogenesis-related signal molecules in the western blotting was reduced by increasing the amount of added CFE. Moreover, a diet supplemented with CFE was deemed more effective in inducing weight loss in LB mice than a representative synthetic diet drug, orlistat, which incidently caused the side effect of denuding the mice of their hair. These results indicate that C. fructus may prove to be a useful anti-adipogenic compound, and these in vitro results may be reflected later under in vivo conditions.