Pilot study of a specific dietary supplement in tumor-bearing mice and in stage IIIB and IV non-small cell lung cancer patients

Nutrient supplements from selected botanicals mediated immune modulation of the tumor microenvironment and antitumor mechanism

Specific extracts of selected vegetables (SV) have been shown to benefit the survival of stage IIIb/IV non-small cell lung cancer patients in phase I/II studies and is currently in a phase III trial. However, the underlying mechanism of SV-mediated antitumor immune responses has not been elucidated. Our results indicate that SV modulated the NK and adoptive T cell immune responses in antitumor efficacy. Furthermore, antitumor effects of SV were also mediated by innate myeloid cell function, which requires both TLR and β-glucan signaling in a MyD88/TRIF and Dectin-1-dependent manner, respectively. Additionally, SV treatment reduced granulocytic myeloid-derived suppressor cell (MDSC) infiltration into the tumor and limited monocytic MDSC toward the M2-like functional phenotype. Importantly, SV treatment enhanced antigen-specific immune responses by augmenting the activation of antigen-specific TH1/TH17 cells in secondary lymphoid organs and proliferative response, as well as by reducing the Treg population in the tumor microenvironment, which was driven by SV-primed activated M-MDSC. Our results support the idea that SV can subvert immune-tolerance state in the tumor microenvironment and inhibit tumor growth. The present study suggests that features, such as easy accessibility, favorable clinical efficacy, no detectable side effects and satisfactory safety make SV a feasible, appealing and convincing adjuvant therapy for the treatment of cancer patients and prevent tumor recurrence and/or metastases.

Circulating Tumour Cells (CTCs) in NSCLC: From Prognosis to Therapy Design

Designing optimal (neo)adjuvant therapy is a crucial aspect of the treatment of non-small-cell lung carcinoma (NSCLC). Standard methods of chemotherapy, radiotherapy, and immunotherapy represent effective strategies for treatment. However, in some cases with high metastatic activity and high levels of circulating tumour cells (CTCs), the efficacy of standard treatment methods is insufficient and results in treatment failure and reduced patient survival. CTCs are seen not only as an isolated phenomenon but also a key inherent part of the formation of metastasis and a key factor in cancer death. This review discusses the impact of NSCLC therapy strategies based on a meta-analysis of clinical studies. In addition, possible therapeutic strategies for repression when standard methods fail, such as the administration of low-toxicity natural anticancer agents targeting these phenomena (curcumin and flavonoids), are also discussed. These strategies are presented in the context of key mechanisms of tumour biology with a strong influence on CTC spread and metastasis (mechanisms related to tumour-associated and -infiltrating cells, epithelial–mesenchymal transition, and migration of cancer cells).

Crabp2 Promotes Metastasis of Lung Cancer Cells via HuR and Integrin β1/FAK/ERK Signaling

Increased Crabp2 levels have been found in various types of cancer, and are associated with poor patients’ survival. Although Crabp2 is found to be overexpressed in lung cancer, its role in metastasis of lung cancer is unclear. In this study, Crabp2 was overexpressed in high-metastatic C10F4 than low-metastatic lung cancer cells. Analysis of clinical samples revealed that high CRABP2 levels were correlated with lymph node metastases, poor overall survival, and increased recurrence. Knockdown of Crabp2 decreased migration, invasion, anoikis resistance, and in vivo metastasis. Crabp2 was co-immunoprecipitated with HuR, and overexpression of Crabp2 increased HuR levels, which promoted integrin β1/FAK/ERK signaling. Inhibition of HuR or integrin β1/FAK/ERK signaling reversed the promoting effect of Crabp2 in migration, invasion, and anoikis resistance. Knockdown of Crabp2 further inhibited the growth of cancer cells as compared with that by gemcitabine or irinotecan alone. The expression of Crabp2 in human lung tumors was correlated with stress marker CHOP. In conclusion, our findings have identified the promoting role of Crabp2 in anoikis resistance and metastasis. CRABP2 may serve as a prognostic marker and targeting CRABP2 may be exploited as a modality to reduce metastasis.

Prognostic value of alcohol consumption and some other dietary habits for survival in a cohort of Chinese men with lung cancer

Background

Alcohol consumption and some other dietary habits are thought to be associated with lung cancer incidence. However, the effects of these habits on lung cancer prognosis have been studied rarely. The purpose of this study was to address these gaps in knowledge.

Methods

We studied a cohort of 1052 Chinese men in Hong Kong who were diagnosed with primary lung cancer. Cox proportional hazards models were used to determine the prognostic values of consumption of alcohol, fresh fruits or vegetables, meat, and fried or preserved food.

Results

Compared with never drinkers, men who drank alcohol 1–3 days per week had a more favorable lung cancer prognosis (hazard ratio [HR]: 0.82, 95% confidence interval [CI] 0.68–0.97); however, this survival advantage was not significant in men who drank alcohol more frequently (HR: 0.91, 95% CI 0.73–1.14). Compared with men who consumed preserved or fried food only occasionally, men who consumed these foods frequently had a higher risk of lung cancer mortality (HR: 1.20, 95% CI 1.00–1.42).

Conclusions

Occasional consumption of alcohol was a favorable survival factor for Chinese men with lung cancer. However, this survival benefit did not exist for frequent drinkers of alcohol. Chinese men with lung cancer who were frequent consumers of fried or preserved food had a worse prognosis than those who consumed these foods only occasionally.

Coumestrol from the national cancer Institute's natural product library is a novel inhibitor of protein kinase CK2

Background

Casein kinase 2 (CK2) is involved in various cellular events such as proliferation, apoptosis, and the cell cycle. CK2 overexpression is associated with multiple human cancers and may therefore be a promising target for cancer therapy. To identity novel classes of inhibitors for CK2, we screened a natural product library obtained from National Cancer Institute.

Methods

The quantitative luminescent kinase assay ADP-Glo™ was used to screen CK2 inhibitors from the natural product library. The same assay was used to determine cell-free dose-dependent response of CK2 inhibitors and conduct a kinetic study. Docking was performed to predict the binding patterns of selected CK2 inhibitors. Western blot analysis was used to evaluate Akt phosphorylation specific to CK2 and apoptosis effect. The cell viability assay CellTiter-Glo® was used to evaluate the inhibition effects of CK2 inhibitors on cancer cells.

Results

We identified coumestrol as a novel reversible ATP competitive CK2 inhibitor with an IC₅₀ value of 228 nM. Coumestrol is a plant-derived compound that belongs to the class of phytoestrogens, natural compounds that mimic the biological activity of estrogens. In our study, coumestrol showed high selectivity among 13 kinases. The hydrogen bonds formed between coumestrol and the amino acids in the ATP binding site were first reviewed by a molecular docking study that suggested a possible interaction of coumestrol with the hinge region of ATP site of CK2. In addition, coumestrol inhibited cancer cell growth partially through down-regulation of CK2-specific Akt phosphorylation. Finally, coumestrol exerted strong inhibition effects on the growth of three cancer cell lines.

Conclusion

Our study shows that coumestrol, a novel ATP competitive and cell permeable CK2 inhibitor with submicromolar IC50, had inhibition effects on the growth of three cancer cell lines and may represent a promising class of CK2 inhibitors.

Nutrition and physical activity guidelines for cancer survivors

Cancer survivors are often highly motivated to seek information about food choices, physical activity, and dietary supplements to improve their treatment outcomes, quality of life, and overall survival. To address these concerns, the American Cancer Society (ACS) convened a group of experts in nutrition, physical activity, and cancer survivorship to evaluate the scientific evidence and best clinical practices related to optimal nutrition and physical activity after the diagnosis of cancer. This report summarizes their findings and is intended to present health care providers with the best possible information with which to help cancer survivors and their families make informed choices related to nutrition and physical activity. The report discusses nutrition and physical activity guidelines during the continuum of cancer care, briefly highlighting important issues during cancer treatment and for patients with advanced cancer, but focusing largely on the needs of the population of individuals who are disease free or who have stable disease following their recovery from treatment. It also discusses select nutrition and physical activity issues such as body weight, food choices, food safety, and dietary supplements; issues related to selected cancer sites; and common questions about diet, physical activity, and cancer survivorship.

Immunostimulation-Mediated Anti-tumor Activity of Bamboo (Sasa senanensis) Leaf Extracts Obtained Under 'Vigorous' Condition

Traditional Japanese medicine uses the leaves of Kumaizasa bamboo extracted in hot water at 100°C. For this study, we developed a new, 'vigorous' extraction method involving steps at 100, 121 and 196°C. This procedure not only yielded greater amounts of extract but also with significant increase in immunostimulating activity, which induces activation of human natural killer (NK) cells, macrophages and potent induction of IL-2, IL-12 and IFN-γ in tumor bearing mice. The efficacy of the extract to facilitate phagocytosis and nitric oxide production by mouse peritoneal macrophages was determined and compared with that of 1,3-β-glucan. Anti-tumor activity was evaluated in vivo in several mouse tumor models (S-180, C38 and Meth-A). Oral administration of the extracts was carried out when tumor reached size of approximately 6 mm at concentrations of 0.05% or higher. The extracts significantly suppressed tumor growth in S-180 and C38 tumor models. Overall survival was significantly prolonged in the treatment group than that of control. Activation of macrophages and NK cells by the extracts suggests that the anti-tumor efficacy of the extract is mediated by immunopotentiation. The extracts resolved into three major fractions (F-I, F-II and F-III) in Sephadex gel chromatography. Fraction F-I consists of 1,3-β-glucan and stimulated both macrophages and NK cells suggesting that it may be the primary immunopotentiating factor in suppressing cancer. Fraction F-III has potent free radical scavenging effects and may play an important role in cancer prevention. These results warrant further translation and clinical investigations.

Anticancer Potentials of Root Extract of Polygala senega and Its PLGA Nanoparticles-Encapsulated Form

Ethanolic extract of Polygala senega (EEPS) had little or no cytotoxic effects on normal lung cells, but caused cell death and apoptosis to lung cancer cell line A549. In the present paper, ethanolic root extract of P. senega (EEPS) was nanoencapsulated (size: 147.7 nm) by deploying a biodegradable poly-(lactic-co-glycolic) acid (PLGA). The small size of the NEEPS resulted in an enhanced cellular entry and greater bioavailability. The growth of cancer cells was inhibited better by NEEPS than EEPS. Both EEPS and NEEPS induced apoptosis of A549 cells, which was associated with decreased expression of survivin, PCNA mRNA, and increased expression of caspase-3, p53 mRNAs of A549 cells. The results show that the anticancer potential of the formulation of EEPS-loaded PLGA nanoparticles was more effective than EEPS per se, probably due to more aqueous dispersion after nanoencapsulation. Therefore, nanoencapsulated ethanolic root extract of P. senega may serve as a potential chemopreventive agent against lung cancer.

[Changes of exercise and the clinical effects among eldly non-small cell lung cancer survivors]

背景与目的

运动对健康有重要影响，可以提高癌症生存者的心血管系统功能、肌力和幸福感等，并减少乏力、焦虑、抑郁等。但目前关于肺癌患者治疗后运动能力的改变及其与肿瘤复发的关系目前尚不明了。本研究拟探讨老年非小细胞肺癌生存者体能锻炼行为模式的改变和临床意义。

方法

采用回顾分析方法，调查包括手术后、化放疗后病情稳定者和服用酪氨酸激酶抑制剂行靶向治疗的老年肺癌生存者，记录其诊断前、积极治疗3个月和1年的运动量和每周运动频率，了解患者运动动机和偏好，探讨运动与肿瘤复发的关系。

结果

调查了58例老年肺癌生存者，发现治疗期间老年肺癌生存者的体能锻炼参与比例下降，但1年后平均轻度体力活动较治疗前有增加。1年后运动基本达标的患者占75.9%（44/58），肺癌复发/进展率为20.0%（7/35），不达标的患者占24.1%（14/58），复发/进展率为35.7%（5/14），运动不达标时肿瘤复发/进展的风险比（risk ratio, RR）为2.14（95%CI:0.81-5.68, P=0.26）。肿瘤生存者运动的动机主要有改善健康、增加体能，维持正常生活方式、增加免疫力等，而最常见的障碍是疲乏、不舒服和缺少动机等。

结论

治疗期间老年肺癌生存者的体能锻炼参与比例降到原有的10%以下，而且即便是治疗完成后也不能恢复到诊断前的水平，运动不达标时和运动达标时患者肿瘤复发/进展的情况无明显差异，运动与肿瘤复发的关系有待进一步研究。

Toona sinensis extracts induced cell cycle arrest and apoptosis in the human lung large cell carcinoma

Toona sinensis extracts have been shown to exhibit anti-cancer effects in human ovarian cancer cell lines, human promyelocytic leukemia cells and human lung adenocarcinoma. Its safety has also been confirmed in animal studies. However, its anti-cancer properties in human lung large cell carcinoma have not been studied. Here, we used a powder obtained by freeze-drying the supernatant of centrifuged crude extract from Toona sinensis leaves (TSL-1) to treat the human lung carcinoma cell line H661. Cell viability was evaluated by the 3-(4-,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide assay. Flow cytometry analysis revealed that TSL-1 blocked H661 cell cycle progression. Western blot analysis showed decreased expression of cell cycle proteins that promote cell cycle progression, including cyclin-dependent kinase 4 and cyclin D1, and increased the expression of proteins that inhibit cell cycle progression, including p27. Furthermore, flow cytometry analysis showed that TSL-1 induced H661 cell apoptosis. Western blot analysis showed that TSL-1 reduced the expression of the anti-apoptotic protein B-cell lymphoma 2, and degraded the DNA repair protein, poly(ADP-ribose) polymerase. TSL-1 shows potential as a novel therapeutic agent or for use as an adjuvant for treating human lung large cell carcinoma.

Nutrition and Orthomolecular Supplementation in Lung Cancer Patients

This article reviews updates and provides some data related to nutritional and orthomolecular supplementation in oncology patients with an emphasis on lung cancer, a commonly diagnosed tumor with significant nutritional disturbances. Cancer and its treatment play a significant role in nutritional imbalance which likely has negative impact on the patient both in terms of quality and quantity of life. Nutritional supplementation may correct these imbalances with significant clinical benefit both physiologically and psychologically. This review will help assist in providing clinically useful data to assess the cancer patient’s nutritional status and to guide nutritional intervention to assist these patients’ recovery.

Does high intake of fruit and vegetables improve lung cancer survival?

The objective of the study was to examine the prognostic effect of dietary intake of fruit and vegetables on lung cancer patients. We used data on 57,053 participants in the Danish prospective cohort study, 'Diet, Cancer and Health'. Patients in whom lung cancer was diagnosed constituted the final study cohort and were followed from the date of diagnosis until the date of death or 11 March 2004. A total of 353 participants had lung cancer. Increasing levels of intake of fruit and vegetables show a tendency toward decreased hazard of dying: the Cox proportional hazard model estimated a hazard ratio (HR) of 0.84 (95% confidence interval [CI], 0.59-1.21) for high intake of vegetables by current smokers and an HR of 0.81 (95% CI, 0.58-1.15) for high intake of fruits with low intake as the reference. In contrast, high intake of potatoes increased the hazard of dying (HR, 1.51; 95% CI, 1.12-2.23). Our study suggests that high intake of fruit and vegetables might have a favourable effect on the prognosis of lung cancer patients, but a high intake of potatoes appears to increase the hazard of dying.

Complementary and alternative medicine: opportunities and challenges for cancer management and research

Given the widespread use of diverse complementary and alternative medicine (CAM) approaches by cancer patients, research to establish their safety and efficacy is critical as is improved patient-physician communication about their possible risks and benefits. The mission of the National Center for Complementary and Alternative Medicine (NCCAM) is to support exacting research and disseminate clear and compelling information on CAM. Although many of the challenges facing such research are not unique to CAM, these approaches do present unique challenges, but the opportunities are many for prevention, palliation, and even treatment. Using the current research portfolio of NCCAM to illustrate how the field may mature, this report summarizes the challenges facing CAM investigators, the most fruitful areas for exploration, and existing information resources.