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Zhang J, Pan Y, Shi Q, Zhang G, Jiang L, Dong X, Gu K, Wang H, Zhang X, Yang N, Li Y, Xiong J, Yi T, Peng M, Song Y, Fan Y, Cui J, Chen G, Tan W, Zang A, Guo Q, Zhao G, Wang Z, He J, Yao W, Wu X, Chen K, Hu X, Hu C, Yue L, Jiang D, Wang G, Liu J, Yu G, Li J, Bai J, Xie W, Zhao W, Wu L, Zhou C. Paclitaxel liposome for injection (Lipusu) plus cisplatin versus gemcitabine plus cisplatin in the first-line treatment of locally advanced or metastatic lung squamous cell carcinoma: A multicenter, randomized, open-label, parallel controlled clinical study. Cancer Commun (Lond) 2022; 42:3-16. [PMID: 34699693 PMCID: PMC8753311 DOI: 10.1002/cac2.12225] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/02/2021] [Accepted: 09/23/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Lipusu is the first commercialized liposomal formulation of paclitaxel and has demonstrated promising efficacy against locally advanced lung squamous cell carcinoma (LSCC) in a small-scale study. Here, we conducted a multicenter, randomized, phase 3 study to compare the efficacy and safety of cisplatin plus Lipusu (LP) versus cisplatin plus gemcitabine (GP) as first-line treatment in locally advanced or metastatic LSCC. METHODS Patients enrolled were aged between 18 to 75 years, had locally advanced (clinical stage IIIB, ineligible for concurrent chemoradiation or surgery) or metastatic (Stage IV) LSCC, had no previous systemic chemotherapy and at least one measurable lesion as per the Response Evaluation Criteria in Solid Tumors (version 1.1) before administration of the trial drug. The primary endpoint was progression-free survival (PFS). The secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety profiles. To explore the possible predictive value of plasma cytokines for LP treatment, plasma samples were collected from the LP group at baseline and first efficacy evaluation time and were then subjected to analysis by 45-Plex ProcartaPlex Panel 1 to detect the presence of 45 cytokines using the Luminex xMAP technology. The correlation between treatment outcomes and dynamic changes in the levels of cytokines were evaluated in preliminary analyses. RESULTS The median duration of follow-up was 15.4 months. 237 patients in the LP group and 253 patients in the GP group were included in the per protocol set (PPS). In the PPS, the median PFS was 5.2 months versus 5.5 months in the LP and GP group (hazard ratio [HR]: 1.03, P = 0.742) respectively. The median OS was 14.6 months versus 12.5 months in the LP and GP group (HR: 0.83, P = 0.215). The ORR (41.8% versus 45.9%, P = 0.412) and DCR (90.3% versus 88.1%, P = 0.443) were also similar between the LP and GP group. A significantly lower proportion of patients in the LP group experienced adverse events (AEs) leading to treatment interruptions (10.9% versus 26.4%, P < 0.001) or treatment termination (14.3% versus 23.1%, P = 0.011). The analysis of cytokine levels in the LP group showed that low baseline levels of 27 cytokines were associated with an increased ORR, and 15 cytokines were associated with improved PFS, with 14 cytokines, including TNF-α, IFN-γ, IL-6, and IL-8, demonstrating an overlapping trend. CONCLUSION The LP regimen demonstrated similar PFS, OS, ORR and DCR as the GP regimen for patients with locally advanced or metastatic LSCC but had more favorable toxicity profiles. The study also identified a spectrum of different cytokines that could be potentially associated with the clinical benefit in patients who received the LP regimen.
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Affiliation(s)
- Jie Zhang
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, 200433, P. R. China
| | - Yueyin Pan
- Department of Chemotherapy, Anhui Provincial Hospital, Hefei, Anhui, 230001, P. R. China
| | - Qin Shi
- Department of Oncology, Fuzhou Pulmonary Hospital of Fujian, Fuzhou, Fujian, 350008, P. R. China
| | - Guojun Zhang
- Department of Respiratory Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, P. R. China
| | - Liyan Jiang
- Department of Respiration, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, P. R. China
| | - Xiaorong Dong
- Cancer Center, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, P. R. China
| | - Kangsheng Gu
- Department of Medical Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230032, P. R. China
| | - Huijuan Wang
- Department of Respiration, Henan Cancer Hospital, Zhengzhou, Henan, 450008, P. R. China
| | - Xiaochun Zhang
- Department of Medical Oncology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266000, P. R. China
| | - Nong Yang
- Department of Medical Oncology, Hunan Cancer Hospital, Changsha, Hunan, 410013, P. R. China
| | - Yuping Li
- Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Wenzhou Medical College, Shangcai village, Wenzhou, Zhejiang, 325000, P. R. China
| | - Jianping Xiong
- Department of Medical Oncology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, P. R. China
| | - Tienan Yi
- Department of Medical Oncology, Xiang Yang Central Hospital, Xiangyang, Hubei, 441021, P. R. China
| | - Min Peng
- Department of Medical Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, P. R. China
| | - Yong Song
- Department of Respiration, General Hospital of Eastern Theater Command of Chinese People's Liberation Army, Nanjing, Jiangsu, 210002, P. R. China
| | - Yun Fan
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, 310022, P. R. China
| | - Jiuwei Cui
- Cancer Center, the First Bethune Hospital of Jilin University, Changchun, Jilin, 130021, P. R. China
| | - Gongyan Chen
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, P. R. China
| | - Wei Tan
- Department of Respiratory Medicine, Weifang People's Hospital, Weifang, Shandong, 261000, P. R. China
| | - Aimin Zang
- Department of Medical Oncology, Affiliated Hospital of Hebei University, Baoding, Hebei, 071030, P. R. China
| | - Qisen Guo
- Department of Internal Medicine, Shandong Cancer Hospital & Institute, Jinan, Shandong, 250117, P. R. China
| | - Guangqiang Zhao
- Department of Thoracic Surgery, the Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650118, P. R. China
| | - Ziping Wang
- Department of Medical Oncology, Beijing Cancer Hospital, Beijing, 100142, P. R. China
| | - Jianxing He
- Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P. R. China
| | - Wenxiu Yao
- Department of Chemotherapy, Sichuan Cancer Hospital & Institute, Chengdu, Sichuan, 610041, P. R. China
| | - Xiaohong Wu
- Department of Medical Oncology, the Fourth People's Hospital of Wuxi, Wuxi, Jiangsu, 214062, P. R. China
| | - Kai Chen
- Department of Medical Oncology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, P. R. China
| | - Xiaohua Hu
- Department of Medical Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, P. R. China
| | - Chunhong Hu
- Department of Medical Oncology, the Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, P. R. China
| | - Lu Yue
- Department of Medical Oncology, Qingdao Municipal Hospital, Qingdao, Shandong, 266071, P. R. China
| | - Da Jiang
- Department of Medical Oncology, the 4th Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050010, P. R. China
| | - Guangfa Wang
- Department of Respiratory Medicine, Peking University First Hospital, Beijing, 100034, P. R. China
| | - Junfeng Liu
- Department of Thoracic Surgery, the 4th Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050010, P. R. China
| | - Guohua Yu
- Department of Medical Oncology, Weifang People's Hospital, Weifang, Shandong, 261000, P. R. China
| | - Junling Li
- Cancer Hospital Chinese Academy of Medical Sciences, Beijing, 100021, P. R. China
| | - Jianling Bai
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, P. R. China
| | - Wenmin Xie
- Nanjing Luye Pharmaceutical Co., Ltd, Nanjing, Jiangsu, 210061, P. R. China
| | - Weihong Zhao
- Nanjing Luye Pharmaceutical Co., Ltd, Nanjing, Jiangsu, 210061, P. R. China
| | - Lihong Wu
- Genecast Biotechnology Co., Ltd, Wuxi, Jiangsu, 214104, P. R. China
| | - Caicun Zhou
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, 200433, P. R. China
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Xu L, Xie X, Luo Y. The role of macrophage in regulating tumour microenvironment and the strategies for reprogramming tumour-associated macrophages in antitumour therapy. Eur J Cell Biol 2021; 100:151153. [PMID: 33476912 DOI: 10.1016/j.ejcb.2021.151153] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 01/07/2023] Open
Abstract
Tumour-associated macrophages (TAMs) that present abundantly in the tumour microenvironment (TME) exhibit a protumour property, such as promoting genetic instability, tumour metastasis and immunosuppression. Macrophage-targeted therapeutic approaches hence have been applied and shown their significances in the process of tumour immune treatment, including blocking TAM recruitment, depleting or transforming TAMs that already exist in the tumour site. Here, we summarized the functional regulation of TAMs in the respects of hypoxia environment, metabolism in the tumour microenvironment and the transcription factors involved. We reviewed the strategies for transforming TAMs, including immune stimuli targeting TAMs, inhibitors against TAMs, pathogen or irradiation stimulation on TAMs, and the application of natural compounds in TAMs. Furthermore, we also discussed the macrophage-targeted therapies in the clinical studies. Taken together, this review tries to shed light on the TAM regulation and the main strategies of TAM reprogramming for an enhanced immune surveillance.
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Affiliation(s)
- Liping Xu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, PR China; Medical School, Kunming University of Science and Technology, Kunming, 650500, PR China
| | - Xiaoli Xie
- Medical School, Kunming University of Science and Technology, Kunming, 650500, PR China
| | - Ying Luo
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, PR China; Guizhou Provincial Key Laboratory & Drug Development on Common Disease, School of Basic Medicine, Guizhou Medical University, Guiyang, Guizhou, China.
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Zheng H, Zeltsman M, Zauderer MG, Eguchi T, Vaghjiani RG, Adusumilli PS. Chemotherapy-induced immunomodulation in non-small-cell lung cancer: a rationale for combination chemoimmunotherapy. Immunotherapy 2019; 9:913-927. [PMID: 29338609 DOI: 10.2217/imt-2017-0052] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Spurred by the survival benefits seen with the use of checkpoint blockade in non-small-cell lung cancer (NSCLC), there has been a growing interest in the potential applications of immunotherapy. Despite this, the objective response rate for single-agent immunotherapy remains ≤20% in patients with advanced NSCLC. A combinatorial approach that utilizes both chemotherapy and immunotherapy is a potential strategy to increase antitumor efficacy. Accumulating evidence has shown that the immunomodulatory effects of chemotherapeutic agents can be exploited in a combinational approach. Herein, we review the influence of specific chemotherapeutic agents on the tumor immune microenvironment in preclinical and clinical studies, and establish the rationale for combination chemoimmunotherapy for the treatment of NSCLC.
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Affiliation(s)
- Hua Zheng
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, NY, USA.,Department of Oncology, Beijing Chest Hospital, Capital Medical University, 97 Machang, Tongzhou District, Beijing, China
| | - Masha Zeltsman
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, NY, USA
| | - Marjorie G Zauderer
- Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, NY, USA
| | - Takashi Eguchi
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, NY, USA
| | - Raj G Vaghjiani
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, NY, USA
| | - Prasad S Adusumilli
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, NY, USA.,Center for Cell Engineering, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.,Deputy Chief, Translational & Clinical Research, Thoracic Service, Department of Surgery; Associate Attending, Thoracic Service, Department of Surgery; Director, Mesothelioma Program; Memorial Sloan Kettering Cancer Center, 1275 York Avenue, NY 10065, USA
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Cai B, Wan P, Sun H, Chen D, Chen H, Chen X, Pan J. Protective Effects of Enteral Nutrition Supplemented with Crassostrea hongkongensis Polysaccharides Against 5-Fluorouracil-Induced Intestinal Mucosal Damage in Rats. J Med Food 2018; 21:348-355. [PMID: 29432052 DOI: 10.1089/jmf.2017.4025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Chemotherapeutics, including 5-fluorouracil (5-FU), often damage the intestinal mucosal barrier and cause intestinal mucositis (IM). Supplementation with immunoregulatory polysaccharides from Crassostrea hongkongensis has been shown to positively influence the effectiveness and toxicity of 5-FU. Therefore, we studied the effects of oyster polysaccharides on 5-FU-induced intestinal mucosal damage in rats. The C30-60% ethanol-precipitated fraction of polysaccharides promoted IEC-6 cell proliferation and exhibited a maximal effect at a 0.0195 mg/mL concentration. Moreover, treatment with C30-60% polysaccharide-based nutrition formula (OPNF) partially prevented the 5-FU-induced degenerative changes in the histology and ultrastructure of small intestinal mucosa. In addition, the endotoxin level of rats fed with 5-FU and OPNF decreased to the normal control level. Furthermore, the 5-FU-induced increase of proinflammatory cytokine interleukin (IL)-2 and the decrease of anti-inflammatory cytokine IL-10 level in the peripheral blood were significantly attenuated by OPNF administration. In conclusion, Oyster C30-60% polysaccharides can ameliorate 5-FU-induced IM by partially preventing mucosal damage, reducing inflammation, and promoting immunity.
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Affiliation(s)
- Bingna Cai
- 1 Key Laboratory of Tropical Marine Bio-Resources and Ecology/Guangdong Key Laboratory of Marine Materia Medica, South China Sea Institute of Oceanology , Chinese Academy of Sciences, Guangzhou, China
| | - Peng Wan
- 1 Key Laboratory of Tropical Marine Bio-Resources and Ecology/Guangdong Key Laboratory of Marine Materia Medica, South China Sea Institute of Oceanology , Chinese Academy of Sciences, Guangzhou, China
| | - Huili Sun
- 1 Key Laboratory of Tropical Marine Bio-Resources and Ecology/Guangdong Key Laboratory of Marine Materia Medica, South China Sea Institute of Oceanology , Chinese Academy of Sciences, Guangzhou, China
| | - Deke Chen
- 1 Key Laboratory of Tropical Marine Bio-Resources and Ecology/Guangdong Key Laboratory of Marine Materia Medica, South China Sea Institute of Oceanology , Chinese Academy of Sciences, Guangzhou, China
| | - Hua Chen
- 1 Key Laboratory of Tropical Marine Bio-Resources and Ecology/Guangdong Key Laboratory of Marine Materia Medica, South China Sea Institute of Oceanology , Chinese Academy of Sciences, Guangzhou, China
| | - Xin Chen
- 2 School of Environment and Chemical Engineering, Foshan University , Foshan, China
| | - Jianyu Pan
- 1 Key Laboratory of Tropical Marine Bio-Resources and Ecology/Guangdong Key Laboratory of Marine Materia Medica, South China Sea Institute of Oceanology , Chinese Academy of Sciences, Guangzhou, China
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