Surgery remains as the primary definitive therapy for resectable non-small cell lung cancer (NSCLC) currently. However, quite a few NSCLC patients, especially in the later stage, suffered tumor recurrence after resection. Safer and more effective perioperative treatment is urgently needed to reduce the recurrence risk after NSCLC surgery. Immune checkpoint inhibitors can effectively prevent tumor immune evasion and have been shown to be a feasible, safe and effective neoadjuvant therapy for resectable NSCLC. Nevertheless, certain crucial problems, including the final effect on NSCLC recurrence, the selection of beneficial group and optimal treatment protocol are yet unsolved. Fortunately, several phase Ⅲ randomized controlled trials are ongoing to answer these questions and will hopefully provide stronger evidence.
In December 2019, an outbreak of pneumonia associated with the coronavirus disease 2019 (COVID-19) occurred in Wuhan, China. The lung imaging finding is like that of the lung cancer immune checkpoint inhibitors (ICI) associated pneumonia. Therefore, we speculated that they may have similar pathogenesis and treatment strategies, which is reviewed in this article in order to provide some reference to timely and effectively reduce the fatality rate of COVID-19.
Hepatocellular carcinoma (HCC) is one of the most prevalent malignant tumors worldwide. Although surgery remains the key approach for achieving long-term survival, the majority of patients are ineligible for surgery at the time of initial diagnosis, resulting in suboptimal overall treatment outcomes. This paper reviews the current treatment strategies for HCC, with a particular focus on comprehensive treatment plans centered around surgery. It explores the status and advancements in multidisciplinary treatment approaches, including preoperative conversion therapy, minimally invasive surgery, and postoperative adjuvant therapies. Through the adoption of rational comprehensive treatment strategies, it is anticipated that the therapeutic outcomes and quality of life for HCC patients can be improved.
ObjectiveTo recognize the latest research progress of immunotherapy for advanced gastric cancer (AGC). MethodThe domestic and international literature on immunotherapy for AGC in recent years were retrieved and reviewed. ResultsThe immunotherapy for AGC mainly focused on immune checkpoint inhibitors (ICIs), cellular immunity, and antitumor vaccines. The most immunotherapy researched was ICIs, especially for programmed death protein-1 / programmed death protein ligand 1, cytotoxic T lymphocyte associated antigen 4, and lymphocyte activating gene 3. The cellular immunotherapy and tumor vaccine therapy were less relatively. Although immunotherapy alone did not have a particularly good effect, its therapeutic effect was not inferior to that of chemotherapy alone and the incidence of adverse reactions was lower. Moreover, most studies had concluded that the use of immunotherapy in combination with other therapy had shown a good clinical efficacy, especially in combination with anti-human epidermal growth factor receptor 2 antibody, and chimeric antigen receptor T cells targeting Claudin 18.2 site had promising results in the AGC. ConclusionsWith the development of immunotherapy research, the strategies of immunotherapy for AGC are also constantly improving. Precision medicine is important in the process of immunotherapy. Targeted screening suitable patients and adopting precise treatment can further benefit the survival of patients with AGC.
ObjectiveTo analyze the CT features of immune checkpoint inhibitor-related pneumonia (CIP) and improve the diagnostic accuracy of CIP. MethodsAmong patients with malignant tumor treated with immune checkpoint inhibitors, those who developed pneumonia and rule out other causes of disease were identified. Chest CT Imaging were reviewed to assess special signs, distribution characteristics, severity of pneumonia and radiographic patterns of CIP. ResultsA total of 28 patients were enrolled, including 26 males and 2 females. CT features include ground-glass opacity, centrilobular nodularity, reticular opacity, consolidation, traction bronchiectasis, honeycomb, etc. The lesions predominant involved peripheral lung zone (17/28), lower lung zone (18/28) and posterior lung zone (18/28), with a diffuse distribution (23/28). In most cases the disease involved both lungs (23/28), and a few involved unilateral or single lobe. The most common affected lobes were the lower lobe of the right lung (25/28) and the lower lobe of the left lung (20/28), followed by the upper lobe of the right lung (18/28). Mean pneumonia severity score was 5.5, standard deviation was 3.8, and range was 1 - 15. The most common radiographic patterns of CIP were nonspecific interstitial pneumonia (11/28) and hypersensitivity pneumonia (10/28). The second was organizing pneumonia (6/28). ConclusionsThe CT manifestations of CIP have certain specificity. Combined with the history of drug treatment and clinical symptoms of patients, the early and correct diagnosis can be obtained.
ObjectiveTo summarize the latest research progress in immune checkpoint inhibitors (ICIs) treatment and efficacy prediction biomarkers for gastric cancer. MethodsRelevant studies on ICIs treatment and efficacy prediction biomarkers for gastric cancer in recent years at home and abroad were collected and summarized. ResultsICIs combined with chemotherapy, ICIs combined with targeted therapy, chemotherapy combined with ICIs and anti-angiogenic drugs, ICIs dual immunotherapy, etc. in the first-line treatment of gastric cancer, as well as ICIs monotherapy, ICIs combined with anti-angiogenic drugs or addition of chemotherapy in the second-line treatment, have become important first- and second-line treatment methods for gastric cancer. Emerging immune checkpoints such as lymphocyte activation gene-3 and V-domain immunoglobulin suppressor of T-cell activation factor also have good clinical prospects. In recent years, researches on new biomarkers such as Epstein-Barr virus, helicobater pylori, tumor-infiltrating lymphocytes, liquid biopsy biomarkers have also made some progresses. ConclusionsIn the future, through multi-dimensional or dynamic biomarker detection, gastric cancer immunotherapy can move towards precision and individualization, maximizing the survival benefits of gastric cancer patients.
Lung cancer is the leading cause of cancer-related deaths worldwide. Although improvement has been achieved in platinum-based chemotherapy and tyrosine kinase inhibitors-based molecular targeted therapy, they still have limitations. Immunotherapy has recently emerged as a very effective new treatment, and there is now growing enthusiasm in cancer immunotherapy worldwide. We summarized the effects of immune checkpoint inhibitors in clinical trials, and the current status and progress of anti programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) agents in lung cancer treatment. Attention has been paid to finding out the factors which influence the therapeutic effect of anti-PD-1/PD-L1 therapy and reducing the occurrence of adverse events.
ObjectiveTo construct a prognostic model of esophageal squamous cell carcinoma (ESCC) based on immune checkpoint-related genes and explore the potential relationship between these genes and the tumor microenvironment (TME). Methods The transcriptome sequencing data and clinical information of immune checkpoint genes of samples from GSE53625 in GEO database were collected. The difference of gene expression between ESCC and normal paracancerous tissues was evaluated, and the drug sensitivity of differentially expressed genes in ESCC was analyzed. We then constructed a risk model based on survival-related genes and explored the prognostic characteristics, enriched pathway, immune checkpoints, immune score, immune cell infiltration, and potentially sensitive drugs of different risk groups. ResultsA total of 358 samples from 179 patients were enrolled, including 179 ESCC samples and 179 corresponding paracancerous tissues. There were 33 males and 146 females, including 80 patients≤60 years and 99 patients>60 years. 39 immune checkpoint genes were differentially expressed in ESCC, including 14 low expression genes and 25 high expression genes. Drug sensitivity analysis of 8 highly expressed genes (TNFRSF8, CTLA4, TNFRSF4, CD276, TNFSF4, IDO1, CD80, TNFRSF18) showed that many compounds were sensitive to these immunotherapy targets. A risk model based on three prognostic genes (NRP1, ICOSLG, HHLA2) was constructed by the least absolute shrinkage and selection operator analysis. It was found that the overall survival time of the high-risk group was significantly lower than that of the low-risk group (P<0.001). Similar results were obtained in different ESCC subtypes. The risk score based on the immune checkpoint gene was identified as an independent prognostic factor for ESCC. Different risk groups had unique enriched pathways, immune cell infiltration, TME, and sensitive drugs. Conclusion A prognostic model based on immune checkpoint gene is established, which can accurately stratify ESCC and provide potential sensitive drugs for ESCC with different risks, thus providing a possibility for personalized treatment of ESCC.
Objective To summarize the research progress of immunotherapy for metastatic breast cancer. Method Literatures about immunotherapy for metastatic breast cancer were reviewed by searching the literatures in domestic and foreign database. Results In recent years, immunotherapy had been initially attempted in patients with metastatic breast cancer and showed its unique value. It provided a new way to improve the therapeutic effect and prolong the survival time of patients with metastatic breast cancer. ConclusionsImmunotherapy is the most effective in triple-negative metastatic breast cancers. The immuno-oncology needs to be developed to improve the clinical benefits of immunotherapy for breast cancer.
Objective To summarize the research status and prospect of immunotherapy for biliary tract cancer (BTC). Method The literatures about immunotherapy of BTC at home and abroad in recent years were reviewed. Results Surgical resection was still the first choice and only radical treatment for BTC. However, the recurrence rate of BTC was high, and most of the patients were in the middle and late stage with metastasis and lose the opportunity of operation. Patients with local progression, metastasis or recurrence could only receive chemotherapy and other comprehensive treatment, but they could not get satisfactory results. The continuous update of targeted drugs brings new hope for drug therapy of BTC, and immunotherapy had become a new treatment of tumor targeted therapy following radiotherapy and chemotherapy. ConclusionImmunotherapy can be used as an option for the treatment of advanced BTC and its postoperative recurrence and metastasis, and has attracted more and more attention.