RNF43 p.G659fs 通过 PI3K/AKT/mTOR 信号通路和 HLA-E 上调导致 MSI-high 结直肠癌中 NK 细胞功能障碍
RNF43 p.G659fs leads to natural killer cell dysfunction in MSI-high colorectal cancer through PI3K/AKT/mTOR signaling and HLA-E up-regulation.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Efficacy and safety of natural killer cells injection combined with XELOX chemotherapy in postoperative patients with stage III colorectal cancer in China: a prospective randomised controlled clinical trial study protocol.
Efficacy and safety of natural killer cells injection combined with XELOX chemotherapy in postoperative patients with stage III colorectal cancer in China: a prospective randomised controlled clinical trial study protocol.
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结直肠癌(CRC)是中国第二大常见诊断癌症,也是癌症相关死亡的第五大原因。然而,术后对多种化疗药物的耐药导致CRC主要治疗失败。自然杀伤(NK)细胞是先天细胞毒性淋巴细胞,对肿瘤细胞表现出强大的细胞毒性活性。基于NK细胞的治疗,无论是单独使用还是与化疗联合,均已取得良好结果,并有望解决CRC患者术后复发和转移问题。方法与分析:这是一项前瞻性、随机对照临床试验,旨在评估白细胞介素2激活的NK细胞注射液联合以XELOX(卡培他滨加奥沙利铂)为基础的化疗对术后CRC患者的疗效和安全性。参与者将被随机分为治疗组和对照组,每组包括40例患者。治疗组还将接受NK细胞(5 10 9)联合以XELOX为基础的化疗,而对照组仅接受以XELOX为基础的化疗。该治疗将重复八个周期(6个月)。随访期持续约3年,在此期间将进行CEA、CA19-9、CA125、增强CT和结肠镜检查。本研究的主要终点是无进展生存期和总生存期,次要终点是安全性(不良事件的数量和严重程度)。此外,我们旨在识别外周血中的癌症干细胞以及预测性生物标志物(NK细胞分泌的细胞因子和NK细胞的活化标志物),以指示获得有效应答的患者。伦理与传播:本研究已获得我院临床研究伦理委员会批准(批准号 2023LLSC006)及中国临床试验注册。研究将按照《赫尔辛基宣言》进行。所有参与者将获得书面知情同意。研究结果将提交至同行评审期刊发表。
BACKGROUND: Colorectal cancer (CRC) is the second most frequently diagnosed cancer and the fifth leading cause of cancer-related death in China. However, resistance to multiple chemotherapeutics after surgery leads to failure of the main therapy to CRC. Natural killer (NK) cells are innate cytotoxic lymphocytes that exhibit strong cytotoxic activity against tumour cells. NK cell-based therapy, either alone or in combination with chemotherapy, has achieved favourable results and holds promise for addressing recurrence and metastasis in CRC patients after surgery. METHODS AND ANALYSIS: This is a prospective, randomised controlled clinical trial to evaluate efficacy and safety of interleukin 2 activated NK cells injection combined with XELOX (capecitabine plus oxaliplatin)-based chemotherapy for postoperative CRC patients. Participants will be randomly divided into treatment group and control group, and every group includes 40 patients. The treatment group will also receive NK cells (5 10 9 ) with+XELOX-based chemotherapy, while the control group will receive only XELOX-based chemotherapy. This treatment will be repeated for eight cycles (6 months). The follow-up period lasts about 3 years, during which CEA, CA19-9, CA125, enhancement CT and colonoscopy will be conducted. The primary endpoints of this study are progression-free survival and overall survival, while the secondary endpoint is safety (number and severity of adverse events). Additionally, we aim to identify cancer stem cells in peripheral blood and predictive biomarkers (cytokines secreted by NK cells and activated markers of NK cells) that indicate patients who achieve an effective response. ETHICS AND DISSEMINATION: The study has been approved by the Clinical Research Ethics Committee of our hospital (approval number 2023LLSC006) and the Chinese Clinical Trials. It will be conducted in accordance with the Declaration of Helsinki. Written informed consent will be obtained from all participants. The study findings will be submitted to peer-reviewed journals for publication. TRIAL REGISTRATION NUMBER: Chinese Clinical Trials Registry (ChiCTR2300075861).
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