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Xiang Y, Shan F, Feng G, Guo K, Ruan S, Huang D. The prognostic value of 4.1 mRNA expression in non-small cell lung cancer. Transl Cancer Res 2021; 10:1216-1228. [PMID: 35116449 PMCID: PMC8798428 DOI: 10.21037/tcr-20-2501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/22/2021] [Indexed: 11/17/2022]
Abstract
Background The mechanism of 4.1 family in human cancer has not been elucidated. In this study we investigate the value as a prognostic factor of mRNA expression of 4.1 family in non-small cell lung cancer (NSCLC). Methods A survival analysis was carried out through the Kaplan-Meier plotter (KM plotter) database. KM’s method was used to estimate the prognostic value of 4.1 mRNA expression in NSCLC. Results Expression of four members are linked to overall survival (OS) in NSCLC patients, among which 4.1G, 4.1B, 4.1R are concerned with first progression (FP), and 4.1G, 4.1R are correlated with post progression survival (PPS) besides. Only 4.1B expression is associated with OS in squamous cell carcinoma, as four members with OS in adenocarcinoma. What’s more, 4.1G, 4.1N high mRNA are linked to better FP in adenocarcinoma, and 4.1R overexpression is linked to better PPS. The expression of 4.1G is associated with the prognosis in female, whereas 4.1R in male. Furthermore, 4.1G and 4.1B play as protective roles in non-smoking populations, while 4.1N overexpression is related to poorer PPS. All the four family members are associated with early stage in NSCLC 4.1G, 4.1B and 4.1R are closely related to surgical resection, yet 4.1N has no prognostic significance in patients receiving treatments. However, the results need to be verified in clinical trials further. Conclusions Our results offer new opinion about the prognostic value of 4.1 protein family in NSCLC, which may contribute to the development of new therapy for NSCLC.
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Zhang L, Sun L, Zhou Y, Yu J, Lin Y, Wasan HS, Shen M, Ruan S. Association of Survival and Immune-Related Adverse Events With Anti-PD-1/PD-L1 and Anti-CTLA-4 Inhibitors, Alone or Their Combination for the Treatment of Cancer: A Systematic Review and Meta-Analysis of 13 Clinical Trials. Front Oncol 2021; 11:575457. [PMID: 33718135 PMCID: PMC7947606 DOI: 10.3389/fonc.2021.575457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 01/04/2021] [Indexed: 12/26/2022] Open
Abstract
Background Cancer, with sustained high mortality, is a worldwide threat to public health. Despite the survival benefit over conventional therapies shown in immune checkpoint inhibitor (ICI), only a minority of patients benefit from single ICI. But combination therapy holds the promise of achieving better efficacy over monotherapy. We performed a systematic review and meta-analysis to assess the efficacy and safety of ICI-based combination therapy for cancer. Methods A search was conducted to retrieve relevant studies in electronic databases and major conferences. Two investigators independently performed data extraction, making a systematic data extraction, assembly, analysis and interpretation to compare the overall survival (OS), progression-free survival (PFS), overall response rate (ORR), all and high grade immune related adverse events (IRAEs) between combination therapy and monotherapy. Therefore, only the studies satisfying the criteria were included. Finally, we performed subgroup, sensitivity, and publication bias analysis to examine the heterogeneity and bias of resources. Results A total of 2,532 patients from thirteen studies were enrolled. Compared to ICI alone, combination therapy, with a high risk and high grade IRAEs for the majority of all, offers a better survival benefit (OS: HR: 0.86, 95% CI: 0.76 to 0.98; PFS: HR: 0.79, 95% CI: 0.69 to 0.90) and objective response (ORR: RR: 1.91, 95% CI: 1.40 to 2.60). Conclusions ICI-based combination therapy was confirmed as the optimum treatment for cancer, especially when using specific dosage and regimen to treat certain tumor types with no absolute demand for the detection of PD-L1 expression. Meanwhile, attention should also be paid on potential toxicity, especially the IRAEs.
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Feng Y, Jin H, Guo K, Xiang Y, Zhang Y, Du W, Shen M, Ruan S. Results from a Meta-analysis of Combination of PD-1/PD-L1 and CTLA-4 Inhibitors in Malignant Cancer Patients: Does PD-L1 Matter? Front Pharmacol 2021; 12:572845. [PMID: 33716732 PMCID: PMC7949479 DOI: 10.3389/fphar.2021.572845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 01/25/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Combination therapy with immune checkpoint inhibitors (ICIs) has been widely used for clinical treatment in recent years, which has a better survival benefit. However, not all patients can derive clinical benefit from combination immunotherapy. Therefore, it is necessary to explore the biomarkers of combination immunotherapy. Methods: We retrieved articles from electronic databases including PubMed, EMBASE and Cochrane. The statistical analysis was performed using RevMan software. Progression free survival (PFS), overall survival (OS) and objective response rate (ORR) were the outcome indicators. In the unselect population, we compared combination therapy with other treatments. In addition, we also conducted subgroup analysis on PFS, OS and ORR according to PD-L1 status. Results: Seven studies were included in the analysis for a total of 3,515 cases. In the unselected population, we found that combination therapy has longer PFS, OS, and better ORR than other treatments for cancer patients. The longer PFS was showed in PD-L1 ≥ 5% cases (HR = 0.64, 95% CI: 0.56–0.76; p < 0.001) than PD-L1 ≥ 1% cases (HR = 0.72, 95% CI: 0.66–0.79; p < 0.001), while ORR and OS have not related to the status of PD-L1. Conclusion: This study supported the efficacy of combination therapy with immune checkpoint inhibitors (ICIs), and also showed that PFS in patients with malignant tumors is positively correlated with PD-L1 expression. Due to the limited number of trials included, more high-quality clinical randomized controlled trials should be conducted to confirm the review findings.
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Xie J, Cao Y, Zhu Z, Ruan S, Wang M, Shi J. Transcriptomic Alterations Induced By Vemurafenib after Treatment of Melanoma: A Comprehensive Bioinformatics Analysis. Indian J Pharm Sci 2021. [DOI: 10.36468/pharmaceutical-sciences.spl.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Shan F, Sun L, Zhang L, Guo K, Yan Q, Feng G, Zhu Y, Shen M, Ruan S. Inhibition to Epithelial-Mesenchymal Transition and Metastatic Potential In Colorectal Cancer Cell By Combination of Traditional Chinese Medicine Formulation Jiedu Sangen Decoction and PD-L1 Inhibitor. Integr Cancer Ther 2020; 19:1534735420972486. [PMID: 33238770 PMCID: PMC7705286 DOI: 10.1177/1534735420972486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Jiedu Sangen Decoction (JSD), a traditional Chinese medicine formula, has been widely applied in the treatment of gastrointestinal cancer, especially in colorectal cancer. Our study mainly aimed to assess the combined efficacy of Jiedu Sangen aqueous extract (JSAE) and a PD-L1 inhibitor (PI) in colon cancer cells migration and invasion, along with epithelial-mesenchymal transition, and then provide deep insights into the potential mechanism. METHODS We explored the inhibitory effects on invasion and metastasis and the reverse effect on EMT process in CT-26 colon cancer cell via Transwell migration assay, Matrigel invasion assay and confocal laser scanning microscopy. Furthermore, regulation in expression of EMT-related proteins and molecular biomarkers and underlying signal pathway proteins were detected through Western blotting and IHC. RESULTS The combination of JSD and PD-L1 inhibitor could inhibit migration, invasive ability and EMT of CT-26 cells in a concentration-dependent manner. Meanwhile, JSD combined with PD-L1 inhibitor could also remarkably reverse EMT and metastasis in vivo. In addition, the protein expression of N-cadherin, Slug, Snail, Vimentin was down-regulated along with E-cadherin s up-regulation with the combination of JSD and PD-L1 inhibitor, while that of PI3K/AKT was notably down-regulated. CONCLUSIONS These findings indicated that JSAE and a PD-L1 inhibitor could drastically inhibit the migration and invasion of colorectal cancer by reversing EMT through the PI3K/AKT signaling pathway.
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Wang P, Ding S, Sun L, Feng Y, Guo K, Zhu Y, Huang D, Ruan S. Characteristics and differences of gut microbiota in patients with different Traditional Chinese Medicine Syndromes of Colorectal Cancer and normal population. J Cancer 2020; 11:7357-7367. [PMID: 33193900 PMCID: PMC7646174 DOI: 10.7150/jca.50318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 10/12/2020] [Indexed: 12/14/2022] Open
Abstract
Colorectal cancer (CRC) is considered to be closely associated with alteration of intestinal microorganisms. The purpose of present study was to investigate the distribution of gut microbiota in the distinction of microbiota dysbiosis between two disease syndromes called Zheng-Qi-Kui-Xu(ZQKX) and Xie-Du-Yong-Sheng (XDYS). First, From February 2019 to June 2019, CRC patients presenting to the oncology department of Zhejiang Province Hospital of TCM who met the established inclusion and exclusion criteria were enrolled in this prospective study. After fresh stool specimens of healthy volunteers and CRC patients with ZQKX or XDYS syndorme were collected, 16S rRNA gene amplification and sequencing could be used to identify the diversity and abundance of gut microbiota among groups. The results demonstrated that the composition of the microbiota in general control group was superior to those in experimental groups. At the phylum level, a significantly increased abundance of Bacteroides was observed in healthy volunteers. At the class level, Erysipelothrix decreased while Lactobacillaceae showed increased abundance in the ZQKX group compared to healthy controls. At the family level, Prevotella Shan and Collins decreased while Streptococcus significantly increased in patients with XDYS syndrome compared to healthy subjects. Five differential taxa were identified between ZQKX and XDYS syndromes. We suggest that the gut microbiota contributes to the distinction between the two TCM syndromes of CRC, which can be used as a biological basis of TCM syndrome differentiation treatment in CRC.
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Jin H, Feng Y, Guo K, Ruan S. Prognostic Nomograms for Predicting Overall Survival and Cancer-Specific Survival of Patients With Early Onset Colon Adenocarcinoma. Front Oncol 2020; 10:595354. [PMID: 33194760 PMCID: PMC7607005 DOI: 10.3389/fonc.2020.595354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 09/28/2020] [Indexed: 12/11/2022] Open
Abstract
Background The incidence of colon cancer in young patients is on the rise, of which adenocarcinoma is the most common pathological type. However, a reliable nomogram for early onset colon adenocarcinoma (EOCA) to predict prognosis is currently lacking. This study aims to develop nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) of patients with EOCA. Methods Patients diagnosed with EOCA from 2010 to 2015 were included and randomly assigned to training set and validation set. Cox regression models were used to evaluate prognosis and identify independent predictive factors, which were then utilized to establish the nomograms for predicting 3- and 5-year OS and CSS. The discrimination and calibration of nomograms were validated using the calibration plots, concordance index, receiver operating characteristics curve, and the decision curve analysis. Results A total of 2,348 patients were screened out, with 1,644 categorized into the training set and 704 into the validation set. Multivariate analysis demonstrated that gender, age, tumor size, T stage, M stage, regional node, tumor deposits, lung metastasis and perineural invasion were significantly correlated with OS and CSS. The calibration plots indicated that there was good consistency between the nomogram prediction and actual observation. The C-indices for training set of OS and CSS prediction nomograms were 0.735 (95% CI: 0.708-0.762) and 0.765 (95% CI: 0.739-0.791), respectively, whereas those for validation set were 0.736 (95% CI: 0.696-0.776) and 0.76 (95% CI: 0.722-0.798), respectively. The results of ROC analysis revealed the nomograms showed a good discriminate power. The 3- and 5-year DCA curves displayed superiority over TNM staging system with higher net benefit gains. Conclusions The nomograms established could effectively predict 3- and 5-year OS and CSS in EOCA patients, which assisted clinicians to evaluate prognosis more accurately and optimize treatment strategies.
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Guo K, Sun L, Yuan L, Wasan HS, Ruan S. Risk factors for in-hospital mortality in patients with cancer and COVID-19. Lancet Oncol 2020; 21:e406. [PMID: 32888456 PMCID: PMC7462527 DOI: 10.1016/s1470-2045(20)30426-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/05/2022]
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Feng Y, Guo K, Jin H, Xiang Y, Zhang Y, Ruan S. A Predictive Nomogram for Early Mortality in Stage IV Gastric Cancer. Med Sci Monit 2020; 26:e923931. [PMID: 32813682 PMCID: PMC7453749 DOI: 10.12659/msm.923931] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background The study was intended to establish predictive nomogram models for predicting total early mortality (the probability of surviving less than or equal to 3 months) and cancer-specific early mortality in patients with stage IV gastric cancer. This was the first study to establish prognostic survival in patients with stage IV gastric cancer. Material/Methods Patients from the SEER database were identified using inclusion and exclusion criteria. Their clinical characteristics were statistically analyzed. The Kaplan-Meier method and the log-rank test were used to compare the influences of different factors on survival time. Logistic regression models were conducted to explore the correlative factors of early mortality. A nomogram was established based on factors significant in the logistic regression model and an internal validation was performed. Results Of the 11,036 eligible patients included in the study, 4932 (44.7%) patients resulted in total early death (42.6% died of the cancer and 2.1% died of other reasons). Larger tumor size, poor differentiation, and liver metastasis were positively related to cancer-specific early mortality. Surgery was negatively related to total early mortality and cancer-specific early mortality, while cardia was only negatively associated with total early death. Predictive nomogram models for total early mortality and cancer-specific early mortality have been validated internally. The areas under the receiver operating characteristics curve were 73.5%, and 68.0%, respectively, and the decision curve analysis also proved the value of the models. Conclusions The nomogram models proved to be a suitable tool for predicting the early mortality in stage IV gastric cancer.
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Zhu Y, Sun L, Yu J, Xiang Y, Shen M, Wasan HS, Ruan S, Qiu S. Identification of biomarkers in colon cancer based on bioinformatic analysis. Transl Cancer Res 2020; 9:4879-4895. [PMID: 35117850 PMCID: PMC8797703 DOI: 10.21037/tcr-20-845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/08/2020] [Indexed: 11/06/2022]
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Zhang B, Guo K, Zheng X, Sun L, Shen M, Ruan S. Risk of Second Primary Malignancies in Colon Cancer Patients Treated With Colectomy. Front Oncol 2020; 10:1154. [PMID: 32766153 PMCID: PMC7378742 DOI: 10.3389/fonc.2020.01154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/08/2020] [Indexed: 12/25/2022] Open
Abstract
Background: Second primary malignancy (SPM) attracts a growing attention. However, the clinical features of colon cancer (CC) survivors with SPMs are not clear and could help guide clinicians to develop a better surveillance strategy. Methods: We reviewed 56,930 CC survivors treated with colectomy from the Surveillance, Epidemiology, and End Results (SEER) database during 1998–2011. Competing risk models and nomograms were conducted for predicting the risk of occurring SPMs. The clinical utility of the models was measured by decision curve analysis (DCA) using net benefit approaches. Results: Five thousand thirteen (17.1%) of male patients developed SPMs and sites of SPMs included prostate (32.2%), lung and bronchus (11.6%), urinary bladder and kidney (10.8%), colon (10.0%), and melanoma of the skin (3.9%), while 3,592 (13.0%) of female patients occurred SPMs and sites of SPMs involved breast (25.8%), lung and bronchus (13.6%), colon (11.6%), uterus (8.2%), urinary bladder, and kidney (5.6%). Survivors with a second carcinoma of lung and bronchus showed the worst prognosis. Older age increased the risk of SPMs in both male (Subdistribution hazard ratio =2.85 [95% confidence interval = 2.53–3.21]) and female (1.80 [1.59–2.04]) survivors, especially for the risk of a second prostate carcinoma in male (5.33 [4.03–7.03]). Compared with white race, black male survivors remained at higher risk to develop the second prostate carcinoma (1.98 [1.74–2.26]). Competing-risk nomograms for CC survivors were established to help clinicians predict the probabilities of overall SPMs and prostate carcinoma. Validation of nomograms showed good discrimination and accuracy, and DCAs revealed the clinical effectiveness. Conclusions: We profiled the clinical characteristics of a large population-based cohort of CC survivors with SPMs. These features may improve future follow-up management, especially for the surveillance of second prostate cancer in men and second breast cancer in women.
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Guo K, Feng Y, Yuan L, Wasan HS, Sun L, Shen M, Ruan S. Risk factors and predictors of lymph nodes metastasis and distant metastasis in newly diagnosed T1 colorectal cancer. Cancer Med 2020; 9:5095-5113. [PMID: 32469151 PMCID: PMC7367623 DOI: 10.1002/cam4.3114] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/09/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Abstract
Background Lymph nodes metastasis (LNM) and distant metastasis (DM) are important prognostic factors in colorectal cancer (CRC) and determine the following treatment approaches. We aimed to find clinicopathological factors associated with LNM and DM, and analyze the prognosis of CRC patients with T1 stage. Methods A total of 17 516 eligible patients with T1 CRC were retrospectively enrolled in the study based on the Surveillance, Epidemiology, and End Results (SEER) database during 2004‐2016. Logistic regression analysis was performed to identify risk factors for LNM and DM. Unadjusted and adjusted Cox proportional hazard models were used to identify prognostic factors for overall survival. We performed the cumulative incidence function (CIF) to further determine the prognostic role of LNM and DM in colorectal cancer‐specific death (CCSD). LNM, DM, and OS nomogram were constructed based on these models and evaluated by the C‐index and calibration plots for discrimination and accuracy, respectively. The clinical utility of the nomograms was measured by decision curve analyses (DCAs) and subgroups with different risk scores. Results Tumor grade, mucinous adenocarcinoma, and age accounted for the first three largest proportion among the LNM nomogram scores (all, P < .001), whereas N stage, carcinoembryonic antigen (CEA), and tumor size occupied the largest percentage in DM nomogram (all, P < .001). OS nomogram was formulated to visually to predict 3‐, 5‐, and 10‐ year overall survivals for patients with T1 CRC. The calibration curves showed an effectively predictive accuracy of prediction nomograms, of which the C‐index were 0.666, 0.874, and 0.760 for good discrimination, respectively. DCAs and risk subgroups revealed the clinical effectiveness of these nomograms. Conclusions Novel population‐based nomograms for T1 CRC patients could objectively and accurately predict the risk of LNM and DM, as well as OS for different stages. These predictive tools may help clinicians to make individual clinical decisions, before clinical management.
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Ruan S, Zhang H, Tian X, Zhang Z, Huang H, Shi C, Liu W, Jiang X, Huang D, Tao F. PHD Finger Protein 19 Enhances the Resistance of Ovarian Cancer Cells to Compound Fuling Granule by Protecting Cell Growth, Invasion, Migration, and Stemness. Front Pharmacol 2020; 11:150. [PMID: 32180719 PMCID: PMC7059104 DOI: 10.3389/fphar.2020.00150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 02/04/2020] [Indexed: 01/17/2023] Open
Abstract
Ovarian cancer is one of the most common gynecological malignancies in women worldwide with a poor survival rate. We have previously reported that compound fuling granule (CFG), a traditional Chinese medicinal preparation used to treat ovarian cancer in China for over 20 years, significantly promotes cell cycle arrest, apoptosis, senescence, TGFβ-induced invasion and migration, tumor growth, and distant metastasis in ovarian cancer cells. However, the underlying mechanisms are not clear. In the present study, we found that PHF19 expression in ovarian cancer cells positively correlated with their resistance ability to CFG. In addition, PHF19 overexpression increased the resistance of HEY-T30 and SKOV3 cells to CFG, while knockdown of PHF19 enhanced their sensitivity to CFG. Moreover, CFG significantly inhibited the expression of PHF19 both in mRNA and protein levels in these cells. Gain of function and loss of function experiments further proved that PHF19 is a crucial mediator involved in the ovarian cancer progression, including cell proliferation, invasion, migration, and stemness. Importantly, rescue the expression of PHF19 reverted CFG-induced suppression in ovarian cancer cell growth, EMT and stemness, while PHF19 knockdown accelerated CFG’s anti-tumor effect. Overall, our results provide a series of evidence to reveal that PHF19 is critical suppressor for CFG’s anti-tumor effect in ovarian cancer.
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Sun L, Zhang L, Yu J, Zhou Y, Shi C, Wasan HS, Ruan S, Huang D. To be or not to be: whether anti-angiogenic agent combined with immune checkpoint inhibitoris necessary in the treatment of advanced or metastatic renal cell carcinoma. Med Oncol 2020; 37:15. [PMID: 32008152 DOI: 10.1007/s12032-020-1340-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 01/22/2020] [Indexed: 12/24/2022]
Abstract
Although it's widely known that targeted therapy against angiogenesis and immunotherapy agents showed survival benefit over chemoradiotherapy in advanced or metastatic renal cell carcinoma, some patients still cannot receive a satisfied prognosis. We performed a systematic review and meta-analysis to explore the efficacy and safety of anti-angiogenic agents combined with immune checkpoint inhibitors. We conducted a search for randomized controlled trials in Pubmed, Embase, Cochrane, and major conference. Enrolled eligible studies and extracted data were completed by two investigators to compare OS, PFS, and ORR both in PD-L1 and ITT subset. Then, we calculated the pooled RR and 95% CI of all-grade and high-grade adverse effects to study its safety. Besides, we assessed the heterogeneity through subgroup and sensitivity analysis. A total of three RCTs covering 2662 patients were enrolled. In PFS analysis, the estimated HR for ITT subset was 0.74 with 95% CI of 0.65 to 0.84 and for PD-L1 subset was 0.65 with 95% CI of 0.56 to 0.76. And in OS analysis, the result was 0.74 with 95% CI of 0.53 to 1.03 in ITT subset and 0.74 with 95% CI of 0.56 to 0.96 in PD-L1 subset. As for ORR analysis, combination therapy showed advantage rather than monotherapy in ITT subset (RR 1.54; 95% CI 1.11 to 2.14), but conversely in PD-L1 positive subset (RR 1.64; 95% CI 0.94 to 2.84). Additionally, combination therapy failed to show obvious safety in most immune-related adverse events, whatever in all-grade or high grade.
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Guo K, Feng G, Yan Q, Sun L, Zhang K, Shen F, Shen M, Ruan S. CXCR4 and CXCR3 are two distinct prognostic biomarkers in breast cancer: Database mining for CXCR family members. Mol Med Rep 2019; 20:4791-4802. [PMID: 31702806 PMCID: PMC6854604 DOI: 10.3892/mmr.2019.10784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 06/04/2019] [Indexed: 01/22/2023] Open
Abstract
CXC chemokine receptors (CXCRs) and chemokines are involved in tissue development and homeostasis, including in cancer development and progression. To date, seven CXCRs have been identified. However, the expression of CXCRs and their influence on the occurrence and development of breast cancer (BC) requires further investigation. In the present study, mRNA expression levels of the seven CXCRs were compared between normal tissues and several cancer types using the Oncomine database. Highly expressed CXCRs were selected and the expression levels of these CXCRs were examined in different subtypes of BC using the Gene Expression-Based Outcome for Breast Cancer database. Finally, the prognostic value of these CXCRs was examined using Kaplan-Meier plotter. It was found that, compared with normal controls, transcripts of CXCR4 and CXCR3 were significantly overexpressed in BC samples compared with other CXCRs. Survival analysis showed that high expression of CXCR4 promoted the recurrence of BC but had no impact on overall survival (OS), while a high level of CXCR3 transcript expression was significantly associated with increased survival in patients with BC. With regards to different subtypes of BC, the present study revealed that high CXCR4 transcript expression was significantly associated with both longer relapse-free survival and OS only in basal-like BC. Furthermore, CXCR4 promoted chemosensitivity in patients with basal-like BC and induced resistance against endocrine therapy for patients with luminal A BC. Thus, CXCR4 and CXCR3 are two distinct prognostic biomarkers and further studies are required.
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Yuan L, Zhou M, Huang D, Wasan HS, Zhang K, Sun L, Huang H, Ma S, Shen M, Ruan S. Resveratrol inhibits the invasion and metastasis of colon cancer through reversal of epithelial‑ mesenchymal transition via the AKT/GSK‑3β/Snail signaling pathway. Mol Med Rep 2019; 20:2783-2795. [PMID: 31524255 PMCID: PMC6691253 DOI: 10.3892/mmr.2019.10528] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/06/2019] [Indexed: 12/31/2022] Open
Abstract
The identification of safe and effective drugs that inhibit tumor invasion and metastasis is required to improve the clinical outcome of patients with colon cancer. The present study aimed to investigate the inhibitory effects and possible mechanisms of action of resveratrol against the invasion and metastasis of colon cancer. AKT1-knockdown SW480 and SW620 colon cancer cells were used to detect the effects of resveratrol on cell invasion and metastasis, as well as changes in the expression of epithelial-mesenchymal transition (EMT) markers and serine/threonine kinase (AKT)/glycogen synthase kinase (GSK)-3β/Snail signaling pathway-related molecules in vitro. Furthermore, nude mice were inoculated with SW480 cells in the tail vein to establish an in vivo lung metastasis model of colon cancer, to investigate the effects of resveratrol on lung metastasis in colon cancer. The results revealed that resveratrol treatment and AKT1 knockdown significantly inhibited cell migration and invasion in colon cancer, and markedly increased E-cadherin expression and decreased that of N-cadherin, phospho (p)-AKT1, p-GSK-3β, and Snail in colon cancer both in vitro and in vivo. Furthermore, the effects of resveratrol were significantly weaker in the AKT1-knockdown cells. In conclusion, resveratrol may suppress the invasion and metastasis of colon cancer through reversal of EMT via the AKT/GSK-3β/Snail signaling pathway. AKT1 may therefore be a key regulator of EMT in colon cancer cells and a potential therapeutic target for this disease.
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Feng G, Guo K, Yan Q, Ye Y, Shen M, Ruan S, Qiu S. Expression of Protein 4.1 Family in Breast Cancer: Database Mining for 4.1 Family Members in Malignancies. Med Sci Monit 2019; 25:3374-3389. [PMID: 31063460 PMCID: PMC6524556 DOI: 10.12659/msm.914085] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 01/25/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The protein 4.1 family is a family of cytoskeletal proteins that play an important role in maintaining normal cell morphology and cell adhesion, migration, division, and intercellular signaling. The main aim of this study was to explore the prognostic significance of the protein 4.1 family in breast cancer (BC) patients and to provide new biomarkers and therapeutic targets for the diagnosis and treatment of BC. MATERIAL AND METHODS The expression of 4.1 family members in various tumor types was compared to normal controls using the ONCOMINE and GOBO databases. The prognostic significance of the 4.1 family in BC patients was determined by Kaplan-Meier Plotter. RESULTS EPB41L2 (4.1G) was expressed at higher levels in normal tissues compared with BC patients for all 4.1 family members. In survival analysis, 4.1G and EPB41 (4.1R) mRNA high expressions were associated with better survival in BC patients. Moreover, 4.1G high expression was significantly associated with longer overall survival (OS) in luminal A and protracted relapse-free survival (RFS) in luminal B subtype BC patients who received Tamoxifen treatment. In addition, high expression of each 4.1 family member also showed better prognostic value in different molecular subtypes of BC. CONCLUSIONS These results indicate that the protein 4.1 family can be regarded as novel biomarkers and potential therapeutic targets for BC. Further research is needed to explore the detailed biological functions.
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Yan Q, Zhang K, Guo K, Liu S, Wasan HS, Jin H, Yuan L, Feng G, Shen F, Shen M, Ma S, Ruan S. Value of tumor size as a prognostic factor in metastatic colorectal cancer patients after chemotherapy: a population-based study. Future Oncol 2019; 15:1745-1758. [PMID: 31038364 DOI: 10.2217/fon-2018-0785] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: To evaluate the relationship between tumor size and survival in metastatic colorectal cancer (mCRC) patients who received chemotherapy. Materials & methods: SEER database was accessed for eligible patients. Multivariate Cox regression analysis was performed to compare the effect of tumor size on overall survival (OS) and CRC-specific survival (CCSS). Results: Tumor size ≥5 cm was an independent risk factor for OS and CCSS in mCRC patients treated with chemotherapy. Tumor size <5 cm did not show a survival advantage in patients whose primary tumor site was rectosigmoid junction, while tumor size ≥5 cm was associated with poor OS and CCSS in left-and right-sided colorectal cancer. Conclusion: Tumor size ≥5 cm was associated with poor prognosis after receiving chemotherapy treatment and a risk factor for survival of mCRC.
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Sun L, Yu J, Wang P, Shen M, Ruan S. HIT000218960 promotes gastric cancer cell proliferation and migration through upregulation of HMGA2 expression. Oncol Lett 2019; 17:4957-4963. [PMID: 31186705 PMCID: PMC6507353 DOI: 10.3892/ol.2019.10176] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 01/31/2019] [Indexed: 12/13/2022] Open
Abstract
The aim of the present study was to elucidate whether the long non-coding RNA (lncRNA) HIT000218960 could accelerate the proliferative and migratory ability of gastric cancer (GC) cells by regulating high-mobility group AT-hook 2 (HMGA2) gene. The reverse transcription-quantitative polymerase chain reaction was used to determine HIT000218960 and HMGA2 expression levels in GC tissues and cells. The HMGA2 protein level was detected by western blotting. A χ2 test was used to determine the association between the HIT000218960 expression level and the clinical characteristics of patients with GC. GC cells were transfected with small interfering (si)-negative control, si-HIT000218960 and si-HIT000218960+pcDNA-HMGA2, prior to assessing the cell proliferative and migratory ability using the Cell Counting Kit-8 and Transwell assays, respectively. HIT000218960 and HMGA2 were highly expressed in GC tissues compared with in healthy tissues. In addition, HIT000218960 and HMGA2 were positively correlated in GC tissues. The HIT000218960 expression level was associated with tumor size, Tumor-Node-Metastasis staging and lymph node metastasis in patients with GC. HIT000218960 silencing decreased the proliferative and migratory ability of HGC27 and NCI-N87 cells; however, HMGA2 overexpression partly reversed this inhibitory effect. The results of the present study indicated that HIT000218960 could promote HGC27 and NCI-N87 cell proliferation and migration, which may be mediated by HMGA2.
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Ruan S, Zhang Z, Tian X, Huang D, Liu W, Yang B, Shen M, Tao F. Compound Fuling Granule Suppresses Ovarian Cancer Development and Progression by disrupting mitochondrial function, galactose and fatty acid metabolism. J Cancer 2018; 9:3382-3393. [PMID: 30271500 PMCID: PMC6160678 DOI: 10.7150/jca.25136] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 07/23/2018] [Indexed: 12/11/2022] Open
Abstract
Our previous studies have demonstrated that the compound fuling granule (CFG), a traditional Chinese medicine, suppresses ovarian cancer cell growth, migration and metastasis. However, the underlying mechanisms remain to be fully elucidated. In this study, we found that CFG could induce mitochondrial fragmentation, mitochondrial membrane potential reduction and cytochrome c release in ovarian SKOV3 cancer cells. In addition, both metabolomics and transcriptomics approaches were applied to illustrate the systemic mechanism of CFG on ovarian cancer formation and progression. To this end, we established two tumor-bearing mice models with subcutaneous injection or tail intravenous injection. Functionally, administration of CFG suppresses in situ tumor growth and distant lung metastasis. Subsequently, gas chromatography-mass spectrometry (GC-MS) was applied to determine the metabolic alterations among the plasma samples from these in vivo models. In the subcutaneous injection model, 26 distinguishable metabolites were identified and 12 metabolic pathways were reprogrammed. Meanwhile, 19 metabolites involved in 7 metabolic pathways showed significant differences in the tail intravenous injection model. Importantly, integrative metabolomics and transcriptomics analysis showed these metabolites were highly associated with galactose metabolism and fatty acid metabolism. This study suggests that CFG may suppress ovarian cancer cell proliferation and metastasis by regulating mitochondrion-related energy metabolisms.
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Yan Q, Guo K, Feng G, Shan F, Sun L, Zhang K, Shen F, Shen M, Ruan S. Association between the overexpression of Her3 and clinical pathology and prognosis of colorectal cancer: A meta-analysis. Medicine (Baltimore) 2018; 97:e12317. [PMID: 30212974 PMCID: PMC6156033 DOI: 10.1097/md.0000000000012317] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND This study aimed to investigate the association between the overexpression of human epidermal growth factor receptor-3 (Her3) and the clinicopathological parameters and survival of patients with colorectal cancer (CRC). METHODS Relevant studies on the overexpression of Her3 (measured by immunohistochemistry) and overall survival (OS) in patients with CRC were searched for in PubMed, EMBASE, and Cochrane Library. Published data were extracted and computed into odds ratios (ORs) for assessing the association of Her3 overexpression with tumor differentiation, tumor node metastasis (TNM) stage, position of colon cancer, sex, and age. Prognostic data were computed into hazard ratios (HRs) for OS. RESULTS Eight studies including 1716 patients with CRC were included in this meta-analysis. The results revealed a significant association between Her3 overexpression and tumor differentiation [OR = 2.38; 95% confidence interval (95% CI): 1.76-3.22; P < .001], TNM tumor stage (OR = 0.71; 95% CI: 0.53-0.96; P = .03), and position of colon cancer (OR = 1.71; 95% CI: 1.28-2.27; P < .001). While patients with Her3 overexpression demonstrated a worse tumor response (OR = 0.31; 95% CI: 0.16-0.60; P < .001) and OS after treatment with cetuximab (HR = 1.86; 95% CI: 1.24-2.79; P = .003), they demonstrated better OS after symptomatic treatment (HR = 0.65; 95% CI: 0.50-0.85; P = .002). Her3 overexpression was not associated with sex (OR = 1.03; 95% CI: 0.83-1.28; P = .79), age (OR = 0.96; 95% CI: 0.75-1.24; P = .77), colon or rectum site (OR = 0.79; 95% CI: 0.44-1.43; P = .44), and total OS (HR = 1.09; 95% CI: 0.69-1.72; P = .72). CONCLUSION Her3 expression is associated with the clinical pathology and prognosis of CRC, which explains the nonefficacy of cetuximab treatment in patients with CRC.
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Xia L, Zhang B, Yan Q, Ruan S. Effects of saponins of patrinia villosa against invasion and metastasis in colorectal cancer cell through NF-κB signaling pathway and EMT. Biochem Biophys Res Commun 2018; 503:2152-2159. [PMID: 30119890 DOI: 10.1016/j.bbrc.2018.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 08/01/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Research has indicated that Herba Patriniae can suppress the growth of Several kinds of tumor cells in vitro and in vivo, thus displaying favorable antitumor activity. However, research regarding the effect of saponins of Patrinia villosa against CRC cell has not been reported. In the current study, We have revealed that the effects of saponins of patrinia villosa on colorectal cancer (CRC) cell invasion and epithelial-mesenchymal transition (EMT) as well as its underlying mechanism. METHODS The CRC EMT model was induced through repeated TGF-β1 stimulations on human CRC cell line SW480. Effects of saponins of patrinia villosa at various concentrations on CRC SW480 cell and EMT model cell proliferation were detected using MTT method, so as to select the optimal action concentration. Meanwhile, effects on SW480 cell and EMT model cell invasion were determined through Scratch assay and Transwell assay. Moreover, changes in expression of EMT-related proteins E-cadherin, N-cadherin and NF-ΚBp65 in each group were detected through Western blotting. RESULTS Saponins of patrinia villosa at various concentrations could markedly inhibit the proliferation rate of CRC cell in an obvious concentration-dependent manner. Meanwhile, saponins of patrinia villosa at various concentrations could also remarkably suppress migration of cell developing EMT. In addition, the protein expression of E-cadherin and N-cadherin was down-regulated with the increase in saponins of patrinia villosa concentration, while that of NF-KBp65 was notably down-regulated. CONCLUSION Saponins of patrinia villosa can act against tumor invasion and metastasis through inhibiting EMT in human CRC cell line, which may be achieved through down-regulating the NF-κB signaling pathway.
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Ruan S, Zhao J, He Z, Yang H, Zhang G. Analysis of pathogenicity and immune efficacy of fowl adenovirus serotype 4 isolates. Poult Sci 2018; 97:2647-2653. [DOI: 10.3382/ps/pey113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/09/2018] [Indexed: 11/20/2022] Open
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Tao F, Tian X, Ruan S, Shen M, Zhang Z. miR-211 sponges lncRNA MALAT1 to suppress tumor growth and progression through inhibiting PHF19 in ovarian carcinoma. FASEB J 2018; 32:fj201800495RR. [PMID: 29874124 DOI: 10.1096/fj.201800495rr] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Accumulating evidence has indicated that microRNAs (miRNAs) play an important role in the occurrence and progression of ovarian cancer (OC). However, the function of miRNAs implicated in OC remains unclear. This study investigated the potential role of miR-211 in OC. Gene Expression Omnibus database analysis indicated that miR-211 expression was significantly down-regulated in OC tissues compared with normal specimens. In addition, miR-211 overexpression apparently inhibited proliferation, migration, xenograft growth, and induced apoptosis in HEY-T30 and SKOV3 cells. Moreover, PHF19, a component of the polycomb group of proteins, was found to be a direct target of miR-211 based on the luciferase reporter assay and Western blot analysis. Consistently, survival analysis indicated that high PHF19 expression was associated with shorter survival time in patients with OC. Importantly, silence of PHF19 reduced proliferation, induced cell cycle arrest, promoted apoptosis, suppressed migration, and inhibited xenograft growth in SKOV3 cells. Restoration of PHF19 expression markedly reversed the inhibitory effect of miR-211 on OC. Moreover, our results indicate that the long noncoding RNA MALAT1 could sponge miR-211 as a competing endogenous RNA and potentially up-regulate PHF19 expression, thus facilitating the OC progression. These findings suggest that the MALAT1/miR-211/PHF19 axis may act as a key mediator in OC and provide new insight into the prevention of this disease.-Tao, F., Tian, X., Ruan, S., Shen, M., Zhang, Z. miR-211 sponges lncRNA MALAT1 to suppress tumor growth and progression through inhibiting PHF19 in ovarian carcinoma.
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Samuelson D, Siggins R, Ruan S, Amedee A, Shellito J, Welsh D. Alcohol use and alcohol-associated dysbiosis increase susceptibility to pneumococcal pneumonia in a humanized murine HIV model. Alcohol 2018. [DOI: 10.1016/j.alcohol.2017.11.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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