胰腺癌空间构型与新辅助治疗和根治性切除术后疾病复发相关
Spatial Configuration of Pancreatic Cancer Is Associated with Disease Recurrence after Neoadjuvant Therapy and Curative-Intent Resection.
从标准H&E切片量化的残留癌-间质拓扑结构在PDAC新辅助治疗后产生独立预后信号,为空间风险提供细胞免疫相关性依据,并推动前瞻性验证及空间信息指导的辅助治疗策略。
英文原题:WT1 Cancer Vaccine in Advanced Pancreatic Cancer: A Systematic Review.
晚期胰腺癌是全球癌症相关死亡的主要原因之一。
晚期胰腺癌是全球癌症相关死亡率的重要贡献者之一。化疗,尤其是吉西他滨,通常用于晚期胰腺癌的治疗。尽管接受了治疗,晚期胰腺癌的死亡率仍然高得惊人。因此,对更好治疗方案的迫切需求使人们将目光转向了癌症疫苗。Wilms瘤基因(WT1)通常与Wilms瘤相关,但研究发现其在某些癌症中过度表达,例如胰腺癌。这一特征被利用来开发针对WT1的癌症疫苗。本综述旨在系统总结研究WT1疫苗在晚期胰腺癌患者中疗效和安全性的临床试验。我们在Medline、Web of Science、ScienceDirect和Google Scholar数据库上使用关键词“晚期胰腺癌”、“癌症疫苗”、“WT1疫苗”和“脉冲DC疫苗”进行了广泛的文献检索,并专门对结果进行了研究以构建本综述。WT1疫苗的工作原理是引入WT1蛋白的肽段,通过抗原呈递细胞触发涉及细胞毒性T淋巴细胞的免疫反应。激活后,这些淋巴细胞通过特异性靶向WT1水平升高的癌细胞来诱导其凋亡。WT1疫苗接种通常作为化疗的补充,已显示出临床积极结果和极少的副作用。然而,其广泛使用面临若干挑战,例如肿瘤的免疫抑制性质和表达的异质性。尽管存在这些局限性,癌症疫苗的风险-获益特征仍令人鼓舞,尤其是WT1疫苗在治疗晚期胰腺癌方面。考虑到其研发尚处于起步阶段,开展大规模、多中心、变量匹配、跨多样人群的广泛分析被认为是必要的。
Advanced pancreatic cancer is one of the prominent contributors to cancer-related mortality globally. Chemotherapy, especially gemcitabine, is generally used for the treatment of advanced pancreatic cancer. Despite the treatment, the fatality rate for advanced pancreatic cancer is alarmingly high. Thus, the dire need for better treatment alternatives has drawn focus to cancer vaccinations. The Wilms tumor gene (WT1), typically associated with Wilms tumor, is found to be excessively expressed in some cancers, such as pancreatic cancer. This characteristic feature is harvested to develop cancer vaccines against WT1. This review aims to systematically summarize the clinical trials investigating the efficacy and safety of WT1 vaccines in patients with advanced pancreatic cancer. An extensive literature search was conducted on databases Medline, Web of Science, ScienceDirect, and Google Scholar using the keywords "Advanced pancreatic cancer," "Cancer vaccines," "WT1 vaccines," and "Pulsed DC vaccines," and the results were exclusively studied to construct this review. WT1 vaccines work by introducing peptides from the WT1 protein to trigger an immune response involving cytotoxic T lymphocytes via antigen-presenting cells. Upon activation, these lymphocytes induce apoptosis in cancer cells by specifically targeting those with increased WT1 levels. WT1 vaccinations, which are usually given in addition to chemotherapy, have demonstrated clinically positive results and minimal side effects. However, there are several challenges to their widespread use, such as the immunosuppressive nature of tumors and heterogeneity in expression. Despite these limitations, the risk-benefit profile of cancer vaccines is encouraging, especially for the WT1 vaccine in the treatment of advanced pancreatic cancer. Considering the fledgling status of their development, large multicentric, variables-matched, extensive analysis across diverse demographics is considered essential.
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