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08 December 2021, Volume 48 Issue 12 Previous Issue    Next Issue

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Effects of silencing PD-L1 expression on biological behaviors of gastric cancer cells Zhao Lili, Zhao Wenwen, Feng Qingqing, Zhao Wenfei, Zhang Xue, Jing Wenjun, Wei Hongmei 2021, 48 (12):  705-710.  doi: 10.3760/cma.j.cn371439-20210813-00140 Abstract ( 255 )   HTML ( 35 )   PDF (14759KB) ( 151 )   Save Objective To investigate the effects of programmed death-ligand 1 (PD-L1) expression on the biological behaviors of gastric cancer cell line MKN45. Methods The PD-L1 gene of gastric cancer cell line MKN45 was silenced by RNA interference technique. MKN45 cells were divided into blank control group, si-NC group (transfected with siRNA-NC) and si-PD-L1 group (transfected with siRNA-PD-L1). Quantitative real-time PCR was used to detect the mRNA expressions of PD-L1 and epithelial-mesenchymal transformation (EMT)-related proteins E-cadherin, Vimentin and Snail in MKN45 cells, and Western blotting was used to detect the expression levels of PD-L1 protein in MKN45 cells of each group. Transwell migration test, Transwell invasion test and MTT test were used to detect the migration, invasion and adhesion abilities of MKN45 cells. Results The relative expression levels of PD-L1 mRNA in the blank control group, si-NC group and si-PD-L1 group were 1.002±0.092, 1.005±0.121 and 0.237±0.017, respectively, with a statistically significant difference (F=75.61, P<0.001). The protein expression levels of PD-L1 in the three groups were 0.944±0.028, 1.008±0.088 and 0.269±0.015, respectively, with a statistically significant difference (F=172.99, P<0.001). The mRNA and protein expression levels of PD-L1 in the si-PD-L1 group were lower than those in the other two groups (all P<0.001), but there were no statistically significant differences between the blank control group and si-NC group (all P>0.05). The cell migration rates of the blank control group, si-NC group and si-PD-L1 group were (1.000±0.020)%, (1.012±0.084)% and (0.488±0.050)%, respectively, with a statistically significant difference (F=80.73, P<0.001). The cell invasion rates of the three groups were (0.929±0.087)%, (0.924±0.208)% and (0.300±0.100)%, respectively, with a statistically significant difference (F=19.37, P<0.001), and the cell adhesion rates of the three groups were (100.000±5.407)%, (99.280±4.845)% and (59.723±2.674)%, respectively, with a statistically significant difference (F=79.87, P<0.001). Compared with the blank control group and si-NC group, the migration, invasion and adhesion abilities of MKN45 cells in the si-PD-L1 group decreased significantly (all P<0.001). The expression levels of E-cadherin mRNA of the three groups were 1.000±0.023, 0.981±0.051, 3.618±0.201, the expression levels of Vimentin mRNA were 1.000±0.043, 1.108±0.150, 0.328±0.011, the expression levels of Snail mRNA were 1.061±0.103, 1.090±0.110, 0.304±0.043, respectively, with statistically significant differences (F=477.17, P<0.001; F=65.97, P<0.001; F=72.70, P<0.001). Compared with the blank control group and si-NC group, the mRNA expression levels of Vimentin and Snail of MKN45 cells in the si-PD-L1 group decreased, while the expression level of E-cadherin mRNA increased, with statistically significant differences (all P<0.001). Conclusion Silencing the expression of PD-L1 can reduce the migration, invasion and adhesion abilities of MKN45 cells, and the mechanism may be related to the effect of PD-L1 on the EMT pathway of gastric cancer. Figures and Tables | References | Related Articles | Metrics

IWR-1-endo affects the migration and proliferation of hepatocarcinoma cells by inhibiting the Wnt pathway Xiong Lin, Zhang Xiuyun, Zhang Xiaoyu, Li Yue, Xu Ximing 2021, 48 (12):  711-715.  doi: 10.3760/cma.j.cn371439-20210514-00141 Abstract ( 266 )   HTML ( 25 )   PDF (29054KB) ( 130 )   Save Objective To investigate the effects and mechanisms of Wnt pathway inhibitor IWR-1-endo on the biological behaviors of human hepatocarcinoma cell Huh7. Methods Human hepatocellular carcinoma cell Huh7 was cultured in vitro, and Huh7 cells were treated with IWR-1-endo at different concentrations (0, 20, 40, 80, 160, 320 μmol/L). Scratch test was used to detect changes in cell migration ability at diffe-rent drug concentrations, plate cloning was used to detect changes in cell proliferation, Western blotting was used to detect changes in the expression of Wnt pathway related protein β-catenin, and immunofluorescence staining was used to detect the expression of β-catenin in cytoplasm and nucleus. Results The results of the scratch test showed that the 24 h scratch healing rates of Huh7 cells treated with 0, 20, 40, 80, 160, 320 μmol/L IWR-1-endo were (20.55±0.05)%, (12.10±0.08)%, (9.36±0.10)%, (3.62±0.09)%, (0.62±0.04)% and (0.23±0.02)%, respectively, and there was a statistically significant difference (F=230.87, P<0.001). Further pair comparison showed that there were statistically significant differences in 24 h scratch healing rates among different concentrations (all P<0.001). The 48 h scratch healing rates were (34.77±0.08)%, (17.69±0.05)%, (11.60±0.04)%, (5.68±0.07)%, (2.66±0.04)% and (1.75±0.02)%, respectively, and there was a statistically significant difference (F=589.68, P<0.001). Further pair comparison showed that there were statistically significant differences in 48 h scratch healing rates among different concentrations (all P<0.001). After treatment with IWR-1-endo at the concentration of 0, 20, 40, 80, 160, 320 μmol/L, the clone formation rates of Huh7 cells were (61.67±0.21)%, (57.33±0.11)%, (50.00±0.25)%, (36.67±0.28)%, (23.33±0.12)% and (15.00±0.08)%, respectively, and there was a statistically significant difference (F=403.56, P<0.001). Further pair comparison showed that there were statistically significant differences in clone formation rates among different concentrations (all P<0.001). After treatment with 0, 20, 40, 80, and 160 μmol/L IWR-1-endo for 24 h, the relative expression levels of β-catenin in Huh7 cells were 0.30±0.08, 0.25±0.07, 0.22±0.05, 0.15±0.01 and 0.06±0.02, respectively, and there was a statistically significant difference (F=247.00, P<0.001). Compared with 0 μmol/L, the relative expression levels of β-catenin treated with 80 and 160 μmol/L had statistical significance (P=0.014; P=0.008). Compared with 0 mol/L, immunofluorescence showed that the expressions of β-catenin in cytoplasm and nucleus were reduced after 80 μmol/L IWR-1-endo treatment. Conclusion Wnt pathway inhibitor IWR-1-endo can inhibit the migration and proliferation of hepatocarcinoma cells Huh7 by inhibiting the activity of Wnt pathway. The above inhibitory effects are dose-dependent. Figures and Tables | References | Related Articles | Metrics

GLDC regulates proliferation and apoptosis of ovarian cancer cells through PI3K/Akt/mTOR pathway Li Zhefeng, Li Jie, Zhao Xiaoting, Yue Wentao 2021, 48 (12):  716-722.  doi: 10.3760/cma.j.cn371439-20210514-00142 Abstract ( 267 )   HTML ( 23 )   PDF (32671KB) ( 185 )   Save Objective To explore the mechanism of glycine dehydrogenase (GLDC) regulating the proliferation and apoptosis of ovarian cancer cells through PI3K/Akt/mTOR pathway. Methods RNA interference method was used to silence the expression of GLDC in ovarian cancer cell lines HEY and SK-OV-3. The HEY and SK-OV-3 cells were divided into si-control group (transfected with siRNA-control), si-GLDC#1 group (trans-fected with siRNA-GLDC#1) and si-GLDC#2 group (transfected with siRNA-GLDC#2). The expression level of GLDC and the protein phosphorylation level of PI3K/Akt/mTOR were detected by Western blotting. Cell proli-feration, migration and apoptosis were detected by CCK-8 method, Transwell chamber test, cell scratch test and flow cytometry. Results The relative expression levels of GLDC in the si-control group, si-GLDC#1 group amd si-GLDC#2 group of HEY cells were 1.00±0.01, 0.68±0.10, 0.80±0.08, and there was a statistically significant difference (F=13.80, P=0.006). The relative expression levels of GLDC in the si-control group, si-GLDC#1 group and si-GLDC#2 group of SK-OV-3 cells were 1.02±0.01, 0.58±0.17, 0.60±0.25, and there was a statistically significant difference (F=6.08, P=0.036). The absorbance (A) values in the si-control group, si-GLDC#1 group and si-GLDC#2 group of HEY cells were 1.04±0.03, 0.91±0.02, 0.82±0.01 at 24 h after transfection, 1.53±0.13, 1.30±0.03, 1.29±0.07 at 48 h after transfection, 1.44±0.08, 1.25±0.01, 1.15±0.03 at 72 h after transfection, and there were statistically significant differences (F=83.14, P<0.001; F=8.96, P=0.007; F=29.55, P<0.001). Further pairwise comparison showed that the proliferation abilities of the si-GLDC#1 and si-GLDC#2 group at 24, 48 and 72 h were significantly lower than those of the si-control group (all P<0.05). In HEY cells, the migration numbers of cells in the si-control group, si-GLDC#1 group and si-GLDC#2 group were 57.33±6.43, 27.67±5.13 and 30.67±2.31, and there was a statistically significantly difference (F=32.88, P=0.001). The migration numbers of cells in the si-GLDC#1 group and si-GLDC#2 group were significantly lower than that in the si-control group (P<0.001; P=0.001). Similar results were also observed in SK-OV-3 cells. In SK-OV-3 cells, the scratch healing rates in the si-control group, si-GLDC#1 group and si-GLDC#2 group were (51.27±1.59)%, (26.35±2.94)% and (26.34±7.69)%, and there was a statistically significant difference (F=26.54, P=0.001). The scratch healing rates in the si-GLDC#1 group and si-GLDC#2 group were significantly lower than that in the si-control group (both P=0.001). In HEY cells, the apoptosis rates in the si-control group, si-GLDC#1 group and si-GLDC#2 group were (7.11±0.82)%, (10.44±1.50)%, (17.39±1.55)%, and there was a statistically significantly difference (F=46.52, P<0.001). The apoptosis rates in the si-GLDC#1 group and si-GLDC#2 group were significantly higher than that in the si-control group (P=0.022; P<0.001). Similar results were also observed in SK-OV-3 cells. In HEY cells, there was no significant difference in total PI3K protein in the si-control group, si-GLDC#1 group and si-GLDC#2 group (F=0.54, P=0.631), but there were significant differences in pAkt/Akt and pmTOR/mTOR levels (F=22.14, P=0.016; F=10.57, P=0.044). The pAkt/Akt and pmTOR/mTOR levels in the si-GLDC#1 group and si-GLDC#2 group were significantly lower than those in the si-control group (P=0.015, P=0.008; P=0.039, P=0.023). Similar results were also observed in SK-OV-3 cells. Conclusion In ovarian cancer cells, GLDC silencing can inhibit cell proliferation and promote apoptosis by inhibiting the PI3K/Akt/mTOR pathway. Figures and Tables | References | Related Articles | Metrics

Prediction model of HBV infection-related liver cancer recurrence after liver transplantation Bai Xue, Meng Qingqing, Chen Yong1, Li Jing 2021, 48 (12):  723-728.  doi: 10.3760/cma.j.cn371439-20210121-00143 Abstract ( 198 )   HTML ( 17 )   PDF (3526KB) ( 98 )   Save Objective To investigate the risk factors for recurrence after liver transplantation in patients with hepatitis B virus (HBV) infection-related hepatocellular carcinoma (HCC), and to further construct a predictive model. Methods The clinical data of 106 patients with HCC undergoing liver transplantation in the First Affiliated Hospital of Hebei North University from January 2015 to May 2020 were retrospec-tively analyzed. The χ 2 test was used to analyze the factors influencing HCC recurrence, and multivariate logistic regression was used to analyze the influencing factors of HCC recurrence. According to the selected risk factors, the predictive model of HCC recurrence was constructed, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive model. Results Of the 106 HCC patients, 23 had recurrence, with a recurrence rate of 21.70%, and 20 died. Tumor differentiation (χ 2=6.066, P=0.014), maximum tumor diameter (χ 2=4.916, P=0.027), with or without envelope invasion (χ 2=5.543, P=0.019), preoperative alpha fetoprotein (AFP) (χ 2=5.458, P=0.019), HBV-DNA (χ 2=5.446, P=0.020), neutrophil lymphocyte ratio (NLR) (χ 2=12.161, P<0.001), the expressions of miR-424 (χ 2=4.400, P=0.036), chromodomain helicase DNA-binding protein 8 (CHD8) (χ 2=10.561, P=0.001), T-cadherin (T-cad) (χ 2=48.723, P<0.001), laminin (LN) (χ 2=18.506, P<0.001) and hepatocyte growth factor (HGF) (χ 2=11.178, P=0.001) were related to the recurrence of HCC. Multivariate logistic regression analysis showed that the maximum tumor diameter≥6.5 cm (OR=1.69, 95%CI: 1.25-3.17, P=0.002), preoperative AFP>400 ng/ml (OR=1.38, 95%CI: 1.09-1.92, P=0.038), positive CHD8 (OR=0.77, 95%CI: 0.52-0.89, P=0.021), positive T-cad (OR=0.84, 95%CI: 0.68-0.92, P=0.006), positive LN (OR=1.22, 95%CI: 1.03-1.50, P=0.013) were the risk factors of HCC recurrence. According to the results of logistic analysis, the regression equation logit(P)=0.262+0.523X1+0.326X2-0.259X3-0.286X4+0.203X5 was constructed, where X1, X2, X3, X4, X5 were the maximum tumor diameter, AFP, CHD8, T-cad and LN. ROC curve analysis showed that the area under the curve for predicting HCC recurrence was 0.849 (95%CI: 0.763-0.894, P<0.001), the accuracy rate was 83.02%, the sensitivity was 86.96%, the specificity was 81.93%, and the cut-off value was 0.736. According to the logit(P) function model, P=1/(1+e - Y), where Y=0.262+0.523X1+0.326X2-0.259X3-0.286X4+0.203X5. One patient was randomly selected. According to his clinical data, P=0.564, which was less than the cut-off value (0.736). It could be considered that this patient would not have HCC recurrence with an accuracy rate of 83.02%. Conclusion Tumor maximum diameter, preoperative AFP, CHD8, T-cad, LN expression are related to the recurrence of HCC after liver transplantation. The prediction model constructed based on this can effectively predict the risk of HCC recurrence. Figures and Tables | References | Related Articles | Metrics

Evaluation of the efficacy and safety of adjuvant mFOLFOX6 combined with bevacizumab regimen in the treatment of colorectal cancer liver metastases after radiofrequency ablation Li Jia, Ma Xiaojie, Wang Yuxiang 2021, 48 (12):  729-734.  doi: 10.3760/cma.j.cn371439-20210416-00144 Abstract ( 259 )   HTML ( 20 )   PDF (3928KB) ( 154 )   Save Objective To explore the clinical efficacy and adverse reaction of the adjuvant modified FOLFOX6 (mFOLFOX6, oxaliplatin + leucovorin + 5-fluorouracil) combined with bevacizumab regimen after radiofrequency ablation (RFA) in KRAS and BRAF V600E mutant postoperative colorectal cancer patients with inoperable resection of liver metastases. Methods KRAS, BRAF V600E mutant colorectal liver metastasis (CRLM) patients diagnosed by Shanxi Provincial Cancer Hospital from January 2016 to June 2020 were selec-ted as the research objects. According to the random number table method, they were divided into control group and study group, 40 cases in each group. The patients in the control group were treated with mFOLFOX6 combined with bevacizumab for 6 cycles of 14 days. The patients in the study group were treated with mFOLFOX6 combined with bevacizumab after RFA treatment. One patient in the control group withdrew from the study due to grade 4 neutropenia and one patient due to grade 4 gastrointestinal reaction. In the study group, two patients withdrew from the study due to grade 4 neutropenia and one patient due to grade 4 liver function abnormalities. The short-term efficacy, median overall survival (OS), median progression-free survival (PFS), changes in serum tumor markers CEA and CA199 levels and the occurrence of adverse reactions were compared between the two groups. Results The objective response rate (ORR) and disease control rate (DCR) in the study group were 54.05% (20/37) and 83.78% (31/37), respectively, which were higher than 28.95% (11/38) and 60.53% (23/38) in the control group, with statistically significant differences (χ 2=4.873, P=0.027; χ 2=5.030, P=0.025). The median OS and median PFS in the study group were 23.5 months and 14.6 months, respectively, which were longer than 19.2 months and 10.5 months in the control group, with statistically significant differences (χ 2=7.863, P=0.015; χ 2=7.016, P=0.019). Serum tumor markers CEA and CA199 in the study group after treatment were (4.6±1.1) ng/ml and (35.6±5.3) U/ml, respectively, which were lower than (9.5±1.5) ng/ml and (46.6±6.2) U/ml in the control group, with statistically significant differences (t=8.532, P=0.016; t=7.561, P=0.023). The incidences of bone marrow suppression, gastrointestinal reaction, infection, bleeding and fatigue in the study group were 56.76% (21/37), 75.68% (28/37), 5.41% (2/37), 8.11% (3/37), 51.35% (19/37), and 50.00% (19/38), 65.79% (25/38), 2.63% (1/38), 2.63% (1/38), 42.11% (16/38) in the control group, with no statistically significant differences (χ 2=0.344, P=0.558; χ 2=0.884, P=0.347; χ 2=0.001, P=0.981; χ 2=0.293, P=0.588; χ 2=0.644, P=0.422). The incidence of abnormal liver function in the study group was 35.14% (13/37), which was higher than 13.16% (5/38) in the control group, with a statistically significant difference (χ 2=4.964, P=0.026). Conclusion The adjuvant mFOLFOX6 combined with bevacizumab after RFA is effective in KRAS, BRAF V600E mutant colorectal cancer patients with unresectable liver metas-tases after surgery, which can effectively prolong survival, and the adverse reactions are controllable and tolerable. Figures and Tables | References | Related Articles | Metrics

Study on expression relationship of DNA methyltransferase 1 and forkhead box O3a in colon cancer Liu Jin, Chen Xiang, Ma Qun, Tong Dongdong 2021, 48 (12):  735-738.  doi: 10.3760/cma.j.cn371439-20201119-00145 Abstract ( 198 )   HTML ( 12 )   PDF (2967KB) ( 98 )   Save Objective To analyze the relationship between DNA methyltransferase 1 (DNMT1) and forkhead box O3a (FOXO3a) in colon cancer and the diagnostic efficacy of combined detection in predicting the occurrence of colon cancer by detecting the levels of DNMT1 and FOXO3a in serum of colon cancer patients. Methods A total of 105 patients with colon cancer diagnosed and treated in Xi'an International Medical Center Hospital from September 2019 to September 2020 were selected as the colon cancer group, and 65 patients with colon polyps diagnosed by biopsy during the same period were selected as control group. The levels of DNMT1 and FOXO3a in serum of patients were detected by real-time fluorescence quantitative PCR. Pearson correlation coefficient method was used to analyze the correlation between the levels of DNMT1 and FOXO3a in serum of patients with colon cancer. Subject operating characteristic curve was used to evaluate the diagnostic values of DNMT1 and FOXO3a levels in colon cancer. Results The serum levels of DNMT1 in the control group and colon cancer group were 0.93±0.28 and 1.34±0.35, compared with the control group, the level of DNMT1 in the colon cancer group was significantly higher, with a statistically significant difference (t=7.990, P<0.001). The serum levels of FOXO3a were 1.04±0.39 and 0.69±0.18, compared with the control group, the level of FOXO3a in the colon cancer group was significantly lower, with a statistically significant difference (t=7.940, P=0.001). The serum levels of DNMT1 and FOXO3a in patients with colon cancer were negatively correlated (r=-0.687, P<0.001). The area under the curve (AUC) of DNMT1 predicting colon cancer was 0.843, the sensitivity was 71.40%, and the specificity was 90.80%. The AUC of FOXO3a predicting colon cancer was 0.812, the sensitivity was 88.60%, and the specificity was 67.70%. The AUC of the two combined predicting colon cancer was 0.859, the sensitivity was 89.50%, and the specificity was 92.30%. Compared with FOXO3a single detection, the predictive value of combined detection of DNMT1 and FOXO3a were higher (Z=1.982, P=0.047). Conclusion The level of DNMT1 in the serum of patients with colon cancer is increased, while the level of FOXO3a is decreased. There is a negative correlation between them in the serum of patients with colon cancer. The combined detection of the DNMT1 and FOXO3a can effectively improve the diagnostic value of colon cancer. Figures and Tables | References | Related Articles | Metrics

Reviews

Role of JAK2-STAT3 signaling pathway in tumorigenesis and development Luo Pan, Zeng Yan, Wu Weili 2021, 48 (12):  739-742.  doi: 10.3760/cma.j.cn371439-20210428-00146 Abstract ( 820 )   HTML ( 56 )   PDF (2921KB) ( 365 )   Save JAK2-STAT3 signaling pathway, as the main chain of intracellular signal transmission, plays an important role in cell proliferation, apoptosis, invasion, migration and immune response. Triggered by cytokines and interferon, this pathway can quickly transduce extracellular signals into the nucleus, and it has abnormal expression in various tumors, such as squamous cell carcinoma of the head and neck, lung cancer, esophageal cancer, gastric cancer, liver cancer, breast cancer and myeloproliferative neoplasms. Further understanding of the carcinogenic mechanism of JAK2-STAT3 signaling pathway can provide new ideas for clinical treatment of tumors and prognosis. References | Related Articles | Metrics

Prognostic values of immune efficacy biomarkers in the treatment of nasopharyngeal carcinoma Luo Wenxiao, Wu Dehua, Cai Longmei 2021, 48 (12):  743-746.  doi: 10.3760/cma.j.cn371439-20201120-00147 Abstract ( 291 )   HTML ( 28 )   PDF (3007KB) ( 157 )   Save Immunotherapy has achieved objective response rates of 20%-30% in patients with recurrent or metastatic nasopharyngeal carcinoma, but fewer people are benefiting. Studies have shown that patients with nasopharyngeal carcinoma carrying high expression of programmed death-1/programmed death-ligand 1 and/or high tumor mutation burden have a significant response to immunotherapy. Biomarkers of the tumor microenvironment, especially tumor infiltrating lymphocyte, are abundant in nasopharyngeal carcinoma, varying from different Epstein-Barr virus states, which can also play a predictive role of immunotherapy efficacy. Other biomarkers, such as mismatch repair-deficient, have a low incidence in nasopharyngeal carcinoma and limited predictive power. Combined detection of different types of immunotherapeutic biomarkers is more helpful to identify suitable populations for immunotherapy. References | Related Articles | Metrics

Application of immune checkpoint inhibitors in the treatment of small cell lung cancer Cao Chun, He Wenqi, Yan Jun 2021, 48 (12):  747-750.  doi: 10.3760/cma.j.cn371439-20210305-00148 Abstract ( 182 )   HTML ( 24 )   PDF (2991KB) ( 166 )   Save The emergence of immune checkpoint inhibitors (ICIs) have changed the pattern of anti-tumor therapy and brought new hope to the treatment of small cell lung cancer (SCLC). Currently, ICIs are most widely studied mainly include programmed death-1/ligand-1 and cytotoxic T-lymphocyte antigen-4. Altezumab is recommended for the first-line treatment of extensive SCLC, while pebrizizumab is recommended for the third-line treatment of extensive SCLC. There has been no breakthrough in the second-line and maintenance treatment of SCLC with ICIs. References | Related Articles | Metrics

Clinical influencing factors of immunotherapy for non-small cell lung cancer Liu Chaoxing, Yan Xuebing, Yang Mengxue, Mao Haiyan, Tong Jiandong 2021, 48 (12):  751-754.  doi: 10.3760/cma.j.cn371439-20210927-00149 Abstract ( 185 )   HTML ( 19 )   PDF (3034KB) ( 119 )   Save In the treatment of non-small cell lung cancer (NSCLC), immunotherapies represented by immune checkpoint inhibitors are developing rapidly. It is the premise of precise treatment to clarify the influencing factors of NSCLC immunotherapy. In the course of immunotherapy for advanced NSCLC, elderly patients can obtain specific effect from immunotherapy; male patients benefit more from monotherapy; when steroid hormones are used for related symptoms caused by tumors, they are poor prognostic factors for patients. The occurrence of immune-related adverse events is a favorable prognostic factor while driving gene mutations and the use of antibiotics will reduce the efficacy of immunotherapy. References | Related Articles | Metrics

Progression in the therapies of relapse or metastatic esophageal squamous cell carcinoma Chi Xiuying, Wang Hongbiao, Li Zhifeng, Lin Yingcheng 2021, 48 (12):  755-759.  doi: 10.3760/cma.j.cn371439-20210924-00150 Abstract ( 262 )   HTML ( 21 )   PDF (3659KB) ( 146 )   Save Relapse or metastatic esophageal squamous cell carcinoma (ESCC) has poor prognosis and limited treatment options. Chemotherapy based on platinum agents combined with fluorouracil or taxanes is the standard first-line treatment for it. Molecular-targeting agents, mainly epidermal growth factor receptor inhibitors including cetuximab, panitumumab, nimotuzumab and gefitinib, have failed to improve the survival of patients with advanced ESCC. Anlotinib, one of the small molecule multi-target tyrosine kinase inhibitors, can prolong the median progression free survival in patients treated with above the second line. Compared with chemotherapy, immune checkpoint inhibitors (including nivolumab, pembrolizumab and camrelizumab) significant improve overall survival times in patients with ESCC who fail to the first line chemotherapy, and can be selected as the standard second line treatment. Immunotherapy combined with chemotherapy or anti-angiogenic therapy for first-line treatment of advanced ESCC is also being studied. References | Related Articles | Metrics