High-grade gliomas are the most common malignant primary central nervous system tumors with poor prognosis. The operation based on the principle of maximum safe resection of tumors, combined with radiation therapy and chemotherapy, is the primary treatment method. This treatment only delays the progression of high-grade gliomas, and almost all patients eventually develop disease progression or relapse. With the development of molecular biology, immunology, and genomics, people have a deeper understanding of the pathogenesis of gliomas. Targeted therapy, immunotherapy, and other comprehensive treatments are expected to become potential treatments for high-grade gliomas. This article reviews the current status of medical treatment of primary and recurrent high-grade gliomas, and the research progress of high-grade gliomas in targeted therapy and immunotherapy.
Lung microbiome is defined as the specific microbiota of lung. Lung microbiome can make the lung in a state of chronic inflammation through direct destruction, activation of inflammatory cells and release of inflammatory factors, and then progress to lung cancer. There are significant differences in lung microbiome between lung cancer patients and healthy people. Some specific microbial flora can be used as a diagnostic marker of lung cancer. Specific microbial communities are related to the efficacy of immunotherapy, and microbial composition may be used as a marker of immune-related adverse events. There are both challenges and opportunities for research on the relationship between lung microbiome and lung cancer. This review will focus on the significance and value of lung microbiome in the occurrence, diagnosis and immunotherapy of lung cancer, in order to provide a reference for basic and clinical researchers in related fields.
Brain metastases are the most common intracranial malignant tumors in adults. Radiotherapy isa common treatment for brain metastases. In particular, stereotactic radiosurgery can control tumors well, and can significantly reduce the impact on cognitive function compared with whole brain radiation therapy. Immune checkpoint inhibitors have less toxic side effects in the treatment of patients with advanced tumors, and show good survival advantages. This article introduces radiotherapy, immunotherapy, stereotactic radiosurgery combined with immune checkpoint inhibitors for brain metastases, discusses the mechanism of stereotactic radiosurgery combined with immune checkpoint inhibitors, and its therapeutic value and research progress in brain metastases, aiming to provide a theoretical basis for the better application of stereotactic radiosurgery combined with immune checkpoint inhibitors to brain metastases.
Neuromyelitis optica spectrum disorders (NMOSD) are a group of inflammatory disorders of the central nervous system characterized by episodes of immune-mediated demyelination and axonal damage mainly involving optic nerves and spinal cord. Neuromyelitis optica related optic neuritis (NMO-ON) is a common neuro-ophthalmic disease which often results in permanent blindness. The discovery of aquaporin 4 antibodies confirms that neuromyelitis optica is a distinct disease entity different from multiple sclerosis. In patients with NMO-ON, the correct therapeutic approach has to recognize two distinct clinical situations: treatment of the acute attacks and prevention of the relapses. With the in-depth study of the pathogenesis of NMOSD, new treatments are emerging in different targets of the disease. This review gives an update of latest treatment of NMO-ON, emphasizing both current situation and future immunotherapy strategies.
Tumor immunotherapy includes immune checkpoint inhibitor (ICI), tumor vaccines, and adoptive cell therapy. Immunotherapy, as the main systemic treatment for advanced malignant tumors, kills tumor cells by activating the immune system and prolongs the survival of patients. However, excessive immune responses can cause immune-related adverse events (irAE), causing damage to systemic tissues. ICI are the main tumor immunotherapy drugs that cause optic nerve irAE. The most common optic nerve irAE are optic neuritis, only a few patients appeared arteritic anterior ischemic optic neuropathy. Sudden painless loss of bilateral vision is the most common clinical manifestation. In severe cases, the vision decrease to no light perception. Early diagnosis and early adequate glucocorticoid treatment can improve the symptoms. Therefore, neuro-ophthalmologists and oncologists should know the clinical characteristics of optic nerve irAE, in order to diagnose and treat early and improve the prognosis.
ObjectiveTo systematically review the incidence of adverse skin reactions in lung cancer patients treated by immunotherapy. MethodsPubMed, Web of Science, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect the studies on the incidence of skin adverse reactions in lung cancer patients treated with immunotherapy from June 2011 to June 2021. Two reviewers independently screened literature, extracted data and assessed the risk bias of the included studies. Meta-analysis was then performed by using Stata 15.0 software. ResultsA total of 63 studies were included, with a total sample size of 13 386 cases. The results of meta-analysis showed that the overall incidence of adverse skin reactions in lung cancer patients was 14.0% (95%CI 11.6% to 16.5%). ConclusionCurrent evidence shows that the incidence of adverse skin reactions in lung cancer patients with immunotherapy is high. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
It is very limited that the benefit of perioperative chemotherapy in early non-small cell lung cancer (NSCLC), and the 5-year survival rate is only 5% higher than surgery. Antibodies that block programmed cell death protein 1/programmed death receptor-ligand 1 significantly improve the survival of advanced NSCLC. The value of immunotherapy in early NSCLC is also being explored. This paper firstly summarized and analyzed the progress of immunotherapy in the perioperative period of NSCLC. Secondly, the safety and feasibility of surgical resection after neoadjuvant immunotherapy were discussed. Finally, the clinical value of different therapeutic efficacy prediction indicators was summarized, in order to clarify the current status of immunotherapy in the perioperative period, so as to improve the clinical benefits of early NSCLC patients.
Objective To observe the expression of molecules on surface of dendritic cells (DC) in retinoblastoma (RB) patients, and investigate its relationship with immune function. Methods The peripheral blood of 50 normal subjects (control group) and 18 RB patients (RB group) were collected to proliferate the DC.The mixed lymphocyte reaction was performed on DC of the control and RB group to detect the antigen-presenting ability. The DC of control group was cultured in the supernate of SO-RB50 with the different concentration of 25% (group A), 50% (group B) and 75% (group C). Then the expression of HLA-DR, CD54 and CD80 on surface of DC were detected by flow cytometry (FCM). Results The Results of MLR showed that DC antigen-presenting ability was gradually enhanced with the increase of stimulation of the cell. And the DC antigen-presenting ability of the control group was superior to that of the RB group (P＜0.05). The expression of HLA-DR, CD54 and CD80 on surface of DC in the control group (12.14plusmn;2.52, 34.89plusmn;5.12, 10.93plusmn;3.1) were significantly higher than that in the RB group (7.33plusmn;2.20, 25.28plusmn;4.54, 7.89plusmn;3.75) (t=4.07, 3.96, 2.59; P＜0.05). The expression of HLA-DR, CD54 and CD80 on surface of DC in the group A, B and C (HLA-DR: 9.95plusmn;2.55, 6.48plusmn;1.82, 3.11plusmn;1.47; CD54: 34.75plusmn;4.92, 21.25plusmn;3.44,15.41plusmn;3.52; CD80: 9.15plusmn;2.18,5.05plusmn;2.01,2.90plusmn;1.10) were reduced in varying degrees compared with the control group; and with the increase of the concentration of supernate SO-RB50, the reduction was more evident (F=8.96,13.62, 20.72; P＜0.05). Conclusions The expression of molecules on surface of DC in RB patients is lower than that in the normal subjects. It is closely related to the functional deficiency of DC.
ObjectivesTo systematically review the clinical response rate of CD19 chimeric antigen receptor modified-T cells (CD19CART) in the treatment of B cell hematological malignancies.MethodsPubMed, EMbase, CNKI, WanFang Data and VIP databases were searched to collect cohort studies about CD19CART in the treatment of B cell hematological malignancies from 2000 to 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, a single rate meta-analysis was performed by R software and SPSS 16.0 software.ResultsA total of 13 prospective cohort studies were included. The results of single group rate meta-analysis showed that the overall pooled response rate of CD19 CART was 68% (95%CI 0.51 to 0.82). The 6 months and 1-year PFS after CD19 CART infused by Kaplan-Meier were 46% (95%CI 0.35 to 0.56) and 24% (95%CI 0.16 to 0.34), respectively. The median duration was 180 days (95%CI 138 to 222). The COX regression model showed lymphodepletion to be the only influence factor of PFS.ConclusionsCD19 CART has a good clinical response rate in the treatment of B cell hematological malignancies. Lymphodepletion is the only important impact on the response rate and PFS. Due to limited quality and quantity of included studies, more high quality studies are required to verify the above conclusions.
Objective To review the advance in the experimental studies and evaluate the potential therapeutic application of the mesenchymal stem cells(MSCs). Methods The related articles published in China and theother countries during the recent years were extensively reviewed and analyzed. Results The MSCs were widely used in the cell-transplantation therapy and the tissue engineering because of their pluripotency of differentiation into various kinds of cells. They were also frequently used in the gene therapy because they could stably express the transfected objective genes. Because of their immunomodulatory function, the MSCs could also be used in the immunotherapy. Conclusion The MSCs are the stem cells, which have characteristics of renewing themselves, having multipotency, and being easy to undergo amplification in vitro.The MSCs are ideal target cells for the cell therapy, tissue engineering, gene therapy, and immunotherapy.