肥胖与癌症:一项转化科学综述
Obesity and Cancer: A Translational Science Review.
超重和肥胖与更高的癌症发病率相关,在美国每年占新发癌症诊断的10%。减重可能通过减轻肥胖的不良影响来降低癌症风险,但可能需要减重超过10%才能降低癌症风险。
英文原题:Promising Therapeutic Impact of Immune Checkpoint Inhibitors in Type II Endometrial Cancer Patients with Deficient Mismatch Repair Status.
这些结果提示免疫检查点抑制剂(抗PD-L1/PD-1抗体)可有效治疗dMMR的II型EC。
II型子宫内膜癌(EC)因其侵袭性强、发现时多为晚期以及对标准疗法高度耐受,导致了大多数子宫内膜癌相关死亡。因此,针对II型EC的新型治疗策略势在必行。对于错配修复缺陷(dMMR)肿瘤患者,免疫检查点抑制剂免疫治疗是一种有前景的治疗策略。然而,dMMR肿瘤在II型EC患者中的患病率仍不明确。在本研究中,我们采用免疫组化方法,评估了60例II型EC患者(分别为16例子宫内膜样G3、5例浆液性、17例去分化和22例癌肉瘤病例)中错配修复(MMR)蛋白、TIL(肿瘤浸润淋巴细胞)(CD8+)和免疫检查点分子(PD-L1)的表达,以探讨免疫检查点抑制剂的治疗效果。约24例(40%)存在MMR蛋白表达缺失。CD8+(p = 0.0072)和PD-L1(p = 0.0061)表达的阳性率与dMMR组显著相关。这些结果表明,免疫检查点抑制剂(抗PD-L1/PD-1抗体)可有效治疗伴有dMMR的II型EC。dMMR的存在可能是II型EC对PD-1/PD-L1免疫治疗产生阳性反应的生物标志物。
Type II endometrial cancer (EC) is responsible for most endometrial cancer-related deaths due to its aggressive nature, late-stage detection, and high tolerance to standard therapies. Thus, novel treatment strategies for type II EC are imperative. For patients with mismatch repair-deficient (dMMR) tumors, immunotherapy with immune checkpoint inhibitors represents a promising therapeutic strategy. However, the prevalence of dMMR tumors in type II EC patients remains unclear. In this study, using immunohistochemistry, we evaluated the expression of mismatch repair (MMR) proteins, tumor-infiltrating lymphocytes (CD8+), and immune checkpoint molecules (PD-L1) in 60 patients with type II EC (16, 5, 17, and 22 were endometrioid G3, serous, de-differentiated, and carcinosarcoma cases, respectively) to investigate the therapeutic effect of immune checkpoint inhibitors. Approximately 24 cases (40%) had a loss of MMR protein expression. The positivity rate of CD8+ ( p = 0.0072) and PD-L1 ( p = 0.0061) expression was significantly associated with the dMMR group. These results suggest immune checkpoint inhibitors (anti-PD-L1/PD-1 antibodies) could effectively treat type II EC with dMMR. The presence of dMMR might be a biomarker for a positive response to PD-1/PD-L1 immunotherapy in type II EC.
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