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Zhang YN, Chen YP, Li JB, Lu TX, Han F, Chen CY. Concurrent chemotherapy using taxane plus cisplatin versus cisplatin alone in high-risk nasopharyngeal carcinoma patients with suboptimal response to induction chemotherapy. Ther Adv Med Oncol 2023; 15:17588359231177016. [PMID: 37323188 PMCID: PMC10262618 DOI: 10.1177/17588359231177016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 05/03/2023] [Indexed: 06/17/2023] Open
Abstract
Background Detectable Epstein-Barr virus (EBV) DNA levels and unsatisfactory tumor response to induction chemotherapy (IC) could be used to guide the risk-adapted treatment strategy of locoregionally advanced nasopharyngeal carcinoma (LANPC) before concurrent chemoradiotherapy. We aim to compare the efficacy and safety of concurrent chemotherapy using taxane plus cisplatin [double-agent concurrent chemotherapy (DACC) group] with those of cisplatin alone [single-agent concurrent chemotherapy (SACC) group] in high-risk LANPC. Methods Overall, 197 LANPC patients with detectable EBV DNA or stable disease (SD) after IC were retrospectively included. Potential confounders between the DACC and SACC groups were adjusted by propensity score matching. Short-term efficacy and long-term survival were assessed in the two groups. Results Although the objective response rate of the DACC group was marginally higher than that of the SACC group, the difference was not significant (92.7% versus 85.3%, p = 0.38). Concerning long-term survival, DACC did not show superiority to SACC after patient matching: 3-year progression-free survival: 87.8% versus 81.7%, p = 0.80; overall survival: 97.6% versus 97.3%, p = 0.48; distant metastasis-free survival: 87.8% versus 90.5%, p = 0.64, and; locoregional relapse-free survival: 92.3% versus 86.9%, p = 0.77. The incidence of grade 1-4 hematological toxicities was significantly higher in the DACC group. Conclusion Due to the small sample size, we do not have sufficient evidence that concurrent chemotherapy using taxane plus cisplatin provides additional survival benefits in LANPC patients with an unfavorable response (detectable EBV DNA levels or SD) after IC. But concurrent taxane and cisplatin chemotherapy is associated with a higher rate of hematologic adverse events. Further clinical trials will be required to establish evidence and identify more effective treatment modalities for high-risk LANPC patients.
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Affiliation(s)
| | | | - Ji-Bin Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, China
- United Laboratory of Frontier Radiotherapy Technology of Sun Yat-sen University & Chinese Academy of Sciences Ion Medical Technology Co., Ltd
| | - Tai-Xiang Lu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, China
- United Laboratory of Frontier Radiotherapy Technology of Sun Yat-sen University & Chinese Academy of Sciences Ion Medical Technology Co., Ltd
| | - Fei Han
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, China
- United Laboratory of Frontier Radiotherapy Technology of Sun Yat-sen University & Chinese Academy of Sciences Ion Medical Technology Co., Ltd
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Fei Z, Xu T, Hong H, Xu Y, Chen J, Qiu X, Ding J, Huang C, Li L, Liu J, Chen C. PET/CT standardized uptake value and EGFR expression predicts treatment failure in nasopharyngeal carcinoma. Radiat Oncol 2023; 18:33. [PMID: 36814303 PMCID: PMC9945369 DOI: 10.1186/s13014-023-02231-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE This study inventively combines epidermal growth factor receptor (EGFR) expression of the primary lesion and standardized uptake value (SUV) of positron emission tomography and computed tomography (PET/CT) to predict the prognosis of nasopharyngeal carcinoma (NPC). This study aimed to evaluate the predictive efficacy of maximum standard uptake value (SUVmax) and EGFR for treatment failure in patients with NPC. METHODS This retrospective study reviewed the results of EGFR expression and pretreatment 18F-FDG PET/CT of 313 patients with NPC. Time-dependent receiver operator characteristics was used for analyzing results and selecting the optimal cutoff values. Cox regression was used to screen out multiple risk factors. Cumulative survival rate was calculated by Kaplan-Meier. RESULTS The selected cutoff value of SUVmax-T was 8.5. The patients were categorized into four groups according to EGFR expression and SUVmax-T. There were significant differences in the 3-year local recurrence-free survival (LRFS) (p = 0.0083), locoregional relapse-free survival (LRRFS) (p = 0.0077), distant metastasis-free survival (DMFS) (p = 0.013), and progression-free survival (PFS) (p = 0.0018) among the four groups. Patients in the EGFR-positive and SUVmax-T > 8.5 group had the worst survival, while patients in the EGFR-negative and SUVmax-T ≤ 8.5 group had the best prognosis. Subsequently, patients with only positive EGFR expression or high SUVmax-T were classified as the middle-risk group. There were also a significant difference in 3-year overall survival among the three risk groups (p = 0.034). SUVmax-T was associated with regional recurrence-free survival and LRRFS in multivariate analysis, whereas EGFR was an independent prognostic factor for LRRFS, DMFS, and PFS. CONCLUSION The combination of SUVmax-T and EGFR expression can refine prognosis and indicate clinical therapy.
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Affiliation(s)
- Zhaodong Fei
- grid.256112.30000 0004 1797 9307Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014 Fujian People’s Republic of China
| | - Ting Xu
- grid.256112.30000 0004 1797 9307Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014 Fujian People’s Republic of China
| | - Huiling Hong
- grid.256112.30000 0004 1797 9307Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014 Fujian People’s Republic of China
| | - Yiying Xu
- grid.256112.30000 0004 1797 9307Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014 Fujian People’s Republic of China
| | - Jiawei Chen
- grid.256112.30000 0004 1797 9307Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014 Fujian People’s Republic of China
| | - Xiufang Qiu
- grid.256112.30000 0004 1797 9307Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014 Fujian People’s Republic of China
| | - Jianming Ding
- grid.256112.30000 0004 1797 9307Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014 Fujian People’s Republic of China
| | - Chaoxiong Huang
- grid.256112.30000 0004 1797 9307Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014 Fujian People’s Republic of China
| | - Li Li
- grid.256112.30000 0004 1797 9307Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014 Fujian People’s Republic of China
| | - Jing Liu
- grid.256112.30000 0004 1797 9307Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014 Fujian People’s Republic of China
| | - Chuanben Chen
- Department of Radiation Oncology, Fujian Cancer Hospital, Clinical Oncology School of Fujian Medical University, Fuma Road, Fuzhou, 350014, Fujian, People's Republic of China.
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Wang S, Jiang T, Hu X, Hu H, Zhou X, Wei Y, Mao X, Zhao Z. Can the combination of DWI and T2WI radiomics improve the diagnostic efficiency of cervical squamous cell carcinoma? Magn Reson Imaging 2022; 92:197-202. [PMID: 35842193 DOI: 10.1016/j.mri.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/27/2022] [Accepted: 07/11/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND To investigate the value of MRI multi-sequence imaging model in differentiation of cervical squamous cell carcinoma (CSCC). METHODS A total of 104 CSCC patients confirmed with pathology were retrospectively enrolled. All patients underwent conventional MRI examination before treatment. The lesions were segmented using ITK-SNAP software manually and radiomics features were extracted by Artificial Intelligence Kit (AK) software. 396 tumor texture features were obtained and then the mRMR and Lasso algorithms were used to reduce the feature dimension. Three models including T2WI model, DWI model and Joint model (combined TWI and DWI) were constructed in training group and evaluated in validation group. and the receiver operator characteristics and calibration curve were used to evaluate the model performance. RESULTS The Joint model and T2WI model both showed a better diagnostic efficacy than single DWI model in differentiation of CSCC in training group (Joint model: AUC = 0.841; T2WI model: AUC = 0.804; DWI model: AUC = 0.732) and validation group (Joint model: AUC = 0.822; T2WI model: AUC = 0.791; DWI model: AUC = 0.724). But there was no statistical difference between Joint model and T2WI model by Delong test(P > 0.05). CONCLUSIONS The study suggested that the conventional T2WI sequence may be more suitable for prognosis evaluation of CSCC, which can provide a potential tool to facilitate the differential diagnosis of low-differentiation and high-differentiation CSCC.
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Affiliation(s)
- Subo Wang
- Department of Radiology, Shaoxing Hospital of Trational medicine, Shaoxing 312000, Zhejiang Province, China.
| | - Tingchong Jiang
- Department of Radiology, Shaoxing Hospital of Trational medicine, Shaoxing 312000, Zhejiang Province, China
| | - Xi Hu
- Department of Radiology, Sir Run Run Shaw Hospital Affiliated to Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Hongjie Hu
- Department of Radiology, Sir Run Run Shaw Hospital Affiliated to Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Xiaoxuan Zhou
- Department of Radiology, Sir Run Run Shaw Hospital Affiliated to Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | | | - Xiaoming Mao
- Department of Radiology, Shaoxing Hospital of Trational medicine, Shaoxing 312000, Zhejiang Province, China.
| | - Zhenhua Zhao
- Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City, China.
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Nomogram for distant metastasis-free survival in patients with locoregionally advanced nasopharyngeal carcinoma. Strahlenther Onkol 2022; 198:828-837. [PMID: 35384452 DOI: 10.1007/s00066-022-01926-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/02/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To develop and validate a nomogram to predict distant metastasis-free survival of patients with locoregionally advanced nasopharyngeal carcinoma. METHODS We collected the total clinical data of 820 nasopharyngeal carcinoma (NPC) patients, of whom 482 formed the training cohort from one hospital and 328 made up the validation cohort from another hospital. By analyzing the prognosis of all patients after intensity-modulated radiotherapy by univariate and multivariate Cox regression models, a nomogram related to DMFS was created in the training cohort. The discriminatory and calibration power of the nomogram was successively assessed in the training and validation cohorts by the C‑index and calibration curve. The predictive ability for 3‑year DMFS was compared between the nomogram and TNM stage using ROC curves. Patients were divided into different risk groups based on scores calculated from the nomogram. RESULTS Age, lymph node gross tumor volume (GTVnd), and gross tumor volume of the nasopharynx (GTVnx) were the factors included in the nomogram. The C‑index of the nomogram was 0.721 in the training cohort and 0.750 in the validation cohort. The calibration curves were satisfactory. Patients in the high-risk group were more likely to develop metastases. CONCLUSION A nomogram incorporating age, GTVnd, and GTVnx showed good performance for predicting DMFS in patients with locoregionally advanced NPC.
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Nasopharyngeal Carcinoma: The Role of the EGFR in Epstein-Barr Virus Infection. Pathogens 2021; 10:pathogens10091113. [PMID: 34578147 PMCID: PMC8470510 DOI: 10.3390/pathogens10091113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 01/24/2023] Open
Abstract
Epstein-Barr virus (EBV), a type 4 γ herpes virus, is recognized as a causative agent in nasopharyngeal carcinoma (NPC). Incidence of EBV-positive NPC have grown in recent decades along with worse outcomes compared with their EBV-negative counterparts. Latent membrane protein 1 (LMP1), encoded by EBV, induces NPC progression. The epidermal growth factor receptor (EGFR), a member of the ErbB family of receptor tyrosine kinases (RTK), is a driver of tumorigenesis, including for NPC. Little data exist on the relationship between EGFR and EBV-induced NPC. In our initial review, we found that LMP1 promoted the expression of EGFR in NPC in two main ways: the NF-κB pathway and STAT3 activation. On the other hand, EGFR also enhances EBV infection in NPC cells. Moreover, activation of EGFR signalling affects NPC cell proliferation, cell cycle progression, angiogenesis, invasion, and metastasis. Since EGFR promotes tumorigenesis and progression by downstream signalling pathways, causing poor outcomes in NPC patients, EGFR-targeted drugs could be considered a newly developed anti-tumor drug. Here, we summarize the major studies on EBV, EGFR, and LMP1-regulatory EGFR expression and nucleus location in NPC and discuss the clinical efficacy of EGFR-targeted agents in locally advanced NPC (LA NPC) and recurrent or metastatic NPC (R/M NPC) patients.
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Li M, Peng F, Wang G, Liang X, Shao M, Chen Z, Chen Y. Coupling of Cell Surface Biotinylation and SILAC-Based Quantitative Proteomics Identified Myoferlin as a Potential Therapeutic Target for Nasopharyngeal Carcinoma Metastasis. Front Cell Dev Biol 2021; 9:621810. [PMID: 34178975 PMCID: PMC8219959 DOI: 10.3389/fcell.2021.621810] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/30/2021] [Indexed: 12/28/2022] Open
Abstract
Distant metastasis is a major cause of treatment failure in nasopharyngeal carcinoma (NPC) patients. Cell surface proteins represent attractive targets for cancer diagnosis or therapy. However, the cell surface proteins associated with NPC metastasis are poorly understood. To identify potential therapeutic targets for NPC metastasis, we isolated cell surface proteins from two isogenic NPC cell lines, 6-10B (low metastatic) and 5-8F (highly metastatic), through cell surface biotinylation. Stable isotope labeling by amino acids in cell culture (SILAC) based proteomics was applied to comprehensively characterize the cell surface proteins related with the metastatic phenotype. We identified 294 differentially expressed cell surface proteins, including the most upregulated protein myoferlin (MYOF), two receptor tyrosine kinases(RTKs) epidermal growth factor receptor (EGFR) and ephrin type-A receptor 2 (EPHA2) and several integrin family molecules. These differentially expressed proteins are enriched in multiple biological pathways such as the FAK-PI3K-mTOR pathway, focal adhesions, and integrin-mediated cell adhesion. The knockdown of MYOF effectively suppresses the proliferation, migration and invasion of NPC cells. Immunohistochemistry analysis also showed that MYOF is associated with NPC metastasis. We experimentally confirmed, for the first time, that MYOF can interact with EGFR and EPHA2. Moreover, MYOF knockdown could influence not only EGFR activity and its downstream epithelial–mesenchymal transition (EMT), but also EPHA2 ligand-independent activity. These findings suggest that MYOF might be an attractive potential therapeutic target that has double effects of simultaneously influencing EGFR and EPHA2 signaling pathway. In conclusion, this is the first study to profile the cell surface proteins associated with NPC metastasis and provide valuable resource for future researches.
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Affiliation(s)
- Maoyu Li
- Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, China.,NHC Key Laboratory of Cancer Proteomics, Xiangya Hospital, Central South University, Changsha, China
| | - Fang Peng
- NHC Key Laboratory of Cancer Proteomics, Xiangya Hospital, Central South University, Changsha, China
| | - Guoqiang Wang
- NHC Key Laboratory of Cancer Proteomics, Xiangya Hospital, Central South University, Changsha, China
| | - Xujun Liang
- NHC Key Laboratory of Cancer Proteomics, Xiangya Hospital, Central South University, Changsha, China
| | - Meiying Shao
- NHC Key Laboratory of Cancer Proteomics, Xiangya Hospital, Central South University, Changsha, China
| | - Zhuchu Chen
- Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, China.,NHC Key Laboratory of Cancer Proteomics, Xiangya Hospital, Central South University, Changsha, China
| | - Yongheng Chen
- Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, China.,NHC Key Laboratory of Cancer Proteomics, Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Medical Genetics and College of Life Sciences, Central South University, Changsha, China
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7
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Ding RB, Chen P, Rajendran BK, Lyu X, Wang H, Bao J, Zeng J, Hao W, Sun H, Wong AHH, Valecha MV, Yang EJ, Su SM, Choi TK, Liu S, Chan KI, Yang LL, Wu J, Miao K, Chen Q, Shim JS, Xu X, Deng CX. Molecular landscape and subtype-specific therapeutic response of nasopharyngeal carcinoma revealed by integrative pharmacogenomics. Nat Commun 2021; 12:3046. [PMID: 34031426 PMCID: PMC8144567 DOI: 10.1038/s41467-021-23379-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/16/2021] [Indexed: 02/04/2023] Open
Abstract
Nasopharyngeal carcinoma (NPC) is a malignant head and neck cancer type with high morbidity in Southeast Asia, however the pathogenic mechanism of this disease is poorly understood. Using integrative pharmacogenomics, we find that NPC subtypes maintain distinct molecular features, drug responsiveness, and graded radiation sensitivity. The epithelial carcinoma (EC) subtype is characterized by activations of microtubule polymerization and defective mitotic spindle checkpoint related genes, whereas sarcomatoid carcinoma (SC) and mixed sarcomatoid-epithelial carcinoma (MSEC) subtypes exhibit enriched epithelial-mesenchymal transition (EMT) and invasion promoting genes, which are well correlated with their morphological features. Furthermore, patient-derived organoid (PDO)-based drug test identifies potential subtype-specific treatment regimens, in that SC and MSEC subtypes are sensitive to microtubule inhibitors, whereas EC subtype is more responsive to EGFR inhibitors, which is synergistically enhanced by combining with radiotherapy. Through combinational chemoradiotherapy (CRT) screening, effective CRT regimens are also suggested for patients showing less sensitivity to radiation. Altogether, our study provides an example of applying integrative pharmacogenomics to establish a personalized precision oncology for NPC subtype-guided therapies.
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Affiliation(s)
- Ren-Bo Ding
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Ping Chen
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.488387.8Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan China
| | - Barani Kumar Rajendran
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Xueying Lyu
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Haitao Wang
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Jiaolin Bao
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Jianming Zeng
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Wenhui Hao
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Heng Sun
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Ada Hang-Heng Wong
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Monica Vishnu Valecha
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Eun Ju Yang
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Sek Man Su
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Tak Kan Choi
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Shuiming Liu
- grid.507998.a0000 0004 0639 5728Kiang Wu Hospital, Macau SAR, China
| | - Kin Iong Chan
- grid.507998.a0000 0004 0639 5728Kiang Wu Hospital, Macau SAR, China
| | - Ling-Lin Yang
- grid.488387.8Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan China
| | - Jingbo Wu
- grid.488387.8Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan China
| | - Kai Miao
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068MOE Frontier Science Centre for Precision Oncology, University of Macau, Macau SAR, China
| | - Qiang Chen
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068MOE Frontier Science Centre for Precision Oncology, University of Macau, Macau SAR, China
| | - Joong Sup Shim
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068MOE Frontier Science Centre for Precision Oncology, University of Macau, Macau SAR, China
| | - Xiaoling Xu
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068MOE Frontier Science Centre for Precision Oncology, University of Macau, Macau SAR, China
| | - Chu-Xia Deng
- grid.437123.00000 0004 1794 8068Cancer Centre, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068Centre for Precision Medicine Research and Training, Faculty of Health Sciences, University of Macau, Macau SAR, China ,grid.437123.00000 0004 1794 8068MOE Frontier Science Centre for Precision Oncology, University of Macau, Macau SAR, China
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Zhang L, Ye Z, Ruan L, Jiang M. Pretreatment MRI-Derived Radiomics May Evaluate the Response of Different Induction Chemotherapy Regimens in Locally advanced Nasopharyngeal Carcinoma. Acad Radiol 2020; 27:1655-1664. [PMID: 33004261 DOI: 10.1016/j.acra.2020.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 01/04/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate and compare the performance of radiomics in predicting induction chemotherapy response treated with two different regimens in patients with advanced nasopharyngeal carcinoma. MATERIALS AND METHODS A total of 265 patients with pathologically confirmed locally advanced nasopharyngeal carcinoma (stage II-IV), including 115 treated with gemcitabine plus cisplatin (GP group) and 150 treated with docetaxel plus cisplatin (TP group) were retrospectively enrolled. Radiomics features were extracted from the volume of interest delineated in multi-MR sequences on a 3T scanner. After random stratified grouping (training and validation cohorts) and logistic regression based on selected features, the association between the radiomics signature and the early response to induction chemotherapy were established for GP and TP regiments, respectively. RESULTS Clinical factors showed no significant difference between the response and non-response groups for the GP and TP regiments (all p > 0.05). The accuracy of the radiomics signature consisting of selected features from the joint T1, T2, and T1C in the GP group (0.852 in the training cohort vs. 0.853 in the validation cohort) was significantly higher than that in the TP group (0.774 vs 0.727). The overall performance of the GP model was steady, with efficiency to distinguish responders from nonresponders with an AUC reaching 0.907 (95% confidence interval [CI] [0.843-0.970]) in the training cohort and 0.886 (95% CI [0.772-0.998]) in the validation cohort, while leveling at 0.800 (95% CI [0.712-0.888]) in the training cohort and 0.863 (95% CI [0.758-0.967]) in the validation cohort in the TP group. CONCLUSION Pretreatment MR radiomics signature can better predict the early response to IC in the GP regimen than the TP regimen, which may be helpful to guide IC management.
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Affiliation(s)
- Lei Zhang
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, China; Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China; Department of Radiology, Cancer Hospital of the University of Chinese Academy of Sciences, China
| | - Zhimin Ye
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, China; Department of Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China; Department of Radiology, Cancer Hospital of the University of Chinese Academy of Sciences, China
| | - Lei Ruan
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, China; Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China; Department of Radiology, Cancer Hospital of the University of Chinese Academy of Sciences, China
| | - Mingxiang Jiang
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, China; Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China; Department of Radiology, Cancer Hospital of the University of Chinese Academy of Sciences, China.
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9
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Fei Z, Xu T, Li M, Chen T, Li L, Qiu X, Chen C. Effectiveness and cost-effectiveness analysis of nimotuzumab for the radiotherapy of locoregionally advanced nasopharyngeal carcinoma. Radiat Oncol 2020; 15:230. [PMID: 33008416 PMCID: PMC7530954 DOI: 10.1186/s13014-020-01674-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/24/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND This study aimed to assess the effectiveness and cost-effectiveness of nimotuzumab in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC). METHODS LA-NPC patients treated between October 2013 and December 2016 were retrospectively reviewed. A well-balanced cohort of patients who received nimotuzumab in addition to standard treatment (n = 50) and patients who did not receive nimotuzumab (n = 100) was selected using propensity score-matching method (1:2 ratio) for the cost-effectiveness analysis. RESULTS Compared with concurrent chemoradiotherapy (CCRT) alone, addition of nimotuzumab to CCRT significantly improved the 3-year overall survival (OS) (98.00% vs. 91.00%, P = 0.032). On multivariate analysis, nimotuzumab (hazard ratio = 0.124, 95% confidence interval: 0.017-0.902, P = 0.039) showed prognostic significance for OS. No serious treatment-related adverse events were observed in the nimotuzumab group (P > 0.05). Cost-effectiveness analysis revealed that addition of nimotuzumab increased the average treatment costs by $14,364.63. The additional cost for every one percent increase in OS rate was $ 2,052.09. CONCLUSION Addition of nimotuzumab to CCRT for LA-NPC confers significant survival benefits; however, it is not cost-effective.
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Affiliation(s)
- Zhaodong Fei
- Department of Radiotherapy, Fujian Medical University Cancer Hospital and Fujian Cancer Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Ting Xu
- Fujian Medical University, Fuzhou, People's Republic of China
| | - Mengying Li
- Fujian Medical University, Fuzhou, People's Republic of China
| | - Taojun Chen
- Department of Radiotherapy, Fujian Medical University Cancer Hospital and Fujian Cancer Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Li Li
- Department of Radiotherapy, Fujian Medical University Cancer Hospital and Fujian Cancer Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Xiufang Qiu
- Fujian Medical University, Fuzhou, People's Republic of China
| | - Chuanben Chen
- Department of Radiotherapy, Fujian Medical University Cancer Hospital and Fujian Cancer Hospital, Fujian Medical University, Fuzhou, People's Republic of China. .,Department of Radiation Oncology, Fujian Medical University Cancer Hospital and Fujian Cancer Hospital, Fuma Road, Fuzhou, 350014, Fujian, People's Republic of China.
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10
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Li H, Xing S, Xu J, He Y, Lai Y, Wang Y, Zhang G, Guo S, Deng M, Zeng M, Liu W. Aptamer-based CRISPR/Cas12a assay for the ultrasensitive detection of extracellular vesicle proteins. Talanta 2020; 221:121670. [PMID: 33076176 DOI: 10.1016/j.talanta.2020.121670] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/24/2020] [Accepted: 09/12/2020] [Indexed: 12/15/2022]
Abstract
Tumor-derived extracellular vesicles (TEVs) have emerged as promising sources of diagnostic and prognostic biomarkers for nasopharyngeal carcinoma (NPC). However, the lack of high-sensitivity analytic methods for ultratrace membrane proteins on TEVs hamper their clinical application of TEVs. Herein, by combining aptamers that specifically bind to protein targets on TEVs, PCR-based exponential amplification and CRISPR/Cas12a real-time DNA detection, we developed a novel technique, termed the aptamer-CRISPR/Cas12a assay, to detect CD109+ and EGFR+ TEVs from cell lines and complex biofluids. The platform enables highly sensitive detection of CD109+ and EGFR+ TEVs at as low as 100 particles/mL with a linear range spanning 6 orders of magnitude (102-108 particles/mL), which was found to be sufficient to effectively detect TEV proteins directly in low-volume (50 μl) samples. Furthermore, clinical serum sample analysis verified that the combination of serum CD109+ and EGFR+ TEV levels yielded high diagnostic accuracy, with an AUC of 0.934 (95% CI: 0.868-1.000), a sensitivity of 84.1% and a specificity of 85.0%, in discriminating NPC from healthy controls. Moreover, the dramatic decrease in both biomarkers in responders after radiotherapy indicated their potential roles in radiotherapy surveillance. Given that the aptamer-CRISPR/Cas12a assay rapidly and conveniently detects ultralow concentrations of CD109+ and EGFR+ TEVs directly in serum, it could be useful in NPC diagnosis and prognosis.
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Affiliation(s)
- Huilan Li
- Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, PR China
| | - Shan Xing
- Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, PR China
| | - Jianhua Xu
- Laboratory of Oncology Science and Molecular Biology, ShunDe Hospital of the Guangzhou University of Chinese Medicine, No. 12 Jinsha Avenue, Shunde District, Foshan, 528333, PR China
| | - Yi He
- Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, PR China
| | - Yanzhen Lai
- Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, PR China; Heyuan People's Hospital, Heyuan, China
| | - Yu Wang
- Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, PR China
| | - Ge Zhang
- School of Pharmaceutical Sciences, Sun Yat-sen University, No. 132 Waihuandong Road, University Town, Guangzhou, 510006, PR China
| | - Songhe Guo
- School of Pharmaceutical Sciences, Sun Yat-sen University, No. 132 Waihuandong Road, University Town, Guangzhou, 510006, PR China
| | - Min Deng
- Affiliated Cancer Hospital & Institute of Guangzhou Medical University, No. 78, Hengzhigang Road, Guangzhou, 510095, PR China.
| | - Musheng Zeng
- Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, PR China.
| | - Wanli Liu
- Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, PR China.
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11
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Yang H, Liu Y, Zhang R, Ye Y, Chen Q, Qin Q, Huang L, Li X, Cai R, Tang H, Jiang W. Prognostic value of the tumor volume reduction rate after neoadjuvant chemotherapy in patients with locoregional advanced nasopharyngeal carcinoma. Oral Oncol 2020; 110:104897. [PMID: 32679404 DOI: 10.1016/j.oraloncology.2020.104897] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/06/2020] [Accepted: 07/04/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE Aim of this study was to evaluate the prognostic value of the tumor volume reduction rate (TVRR) of neoadjuvant chemotherapy (NACT) in patients with locoregional advanced nasopharyngeal carcinoma (NPC). METHODS We collected the clinical data of 263 patients with locoregional advanced NPC receiving NACT and subsequent radiotherapy from two hospitals: a training cohort (n = 130) was obtained from one hospital and a validation cohort was obtained the other hospital (n = 133). By follow-up and calculating the TVRR of all patients, the prognostic value of the TVRR was analyzed though a univariate and multivariate Cox regression model. A cut-off point of the TVRR relating to survival was explored by means of the Youden index, and the prognostic value of the TNM stage plus TVRR was measured by creating receiver operating characteristic (ROC) curves. RESULTS 12.6%, a cut-off point of TVRR, was found to best predict DFS. Patients with a TVRR > 12.6% had better DFS (hazard ratio, 0.160, 95% confidence interval 0.072-0.354; P < 0.001), LRRFS (0.064, 0.013-0.310; 0.001) and DMFS (0.274, 0.106-0.711; 0.008) than patients with a TVRR ≤ 12.6%. The TVRR was a significant independent prognostic factor for OS, DFS, LRRFS and DMFS. Combining the TVRR and TNM stage enhanced the ability to predict DFS and LRRFS. CONCLUSIONS The TVRR of NACT is an independent prognostic factor for patients with locoregional advanced NPC receiving radiotherapy. Adding the TVRR to the original TNM staging system improves the prognostic value for locoregional advanced NPC.
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Affiliation(s)
- Huiyun Yang
- Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, PR China
| | - Yuanyuan Liu
- Department of Radiation Oncology, Wuzhou Red Cross Hospital, Wuzhou 543002, PR China
| | - Rongjun Zhang
- Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, PR China
| | - Yaomin Ye
- Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, PR China
| | - Qiuqiu Chen
- Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, PR China
| | - Qinghua Qin
- Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, PR China
| | - Liying Huang
- Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, PR China
| | - Xi Li
- Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, PR China
| | - Rui Cai
- Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, PR China
| | - Huaying Tang
- Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, PR China
| | - Wei Jiang
- Department of Radiation Oncology, Guilin Medical University Affiliated Hospital, Guilin 541001, PR China; Department of Oncology, People's Hospital of Gongcheng Yao Autonomous County, Guilin 542500, PR China.
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12
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Liu C, Li Y, Qin X, Yang Z, Luo J, Zhang J, Gray B, Pak KY, Xu X, Cheng J, Zhang Y. Early prediction of tumor response after radiotherapy in combination with cetuximab in nasopharyngeal carcinoma using 99m Tc-duramycin imaging. Biomed Pharmacother 2020; 125:109947. [PMID: 32058215 DOI: 10.1016/j.biopha.2020.109947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/11/2020] [Accepted: 01/23/2020] [Indexed: 01/09/2023] Open
Abstract
PURPOSE 99mTc-duramycin imaging enables specific visualization of cell death qualitatively and quantitatively. This study aimed to investigate the potential of 99mTc-duramycin imaging in the early prediction of the curative effect of radiotherapy in combination with or without cetuximab in a nasopharyngeal carcinoma (NPC) model. METHODS Male BALB/c mice bearing NPC xenografts were randomized into four groups (six mice each group). Group 1 received radiotherapy (RT, 15 Gy/mouse) in combination with cetuximab (CTX, 2 mg/mouse), group 2 received RT (15 Gy/mouse), group 3 was treated using CTX (2 mg/mouse), and group 4, the control group, was treated using a vehicle. 99mTc-duramycin imaging was performed before treatment and 24 h after treatment to evaluate tumor response. Tumor uptake of 99mTc-duramycin was validated ex vivo using γ-counting. Treatment response was further validated by cleaved caspase-3 (CC3) and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL). Another four groups were treated parallelly under the same conditions to observe treatment response by tumor volume changes. RESULTS After 24 h treatment, 99mTc-duramycin uptake in the NPC tumor models were significantly higher in group 1 than in group 2 (P < 0.05), group 3 (P < 0.05), or group 4 (P < 0.05); the uptake also increased notably in comparison with baseline values (P < 0.05). Compared with group 4, group 2 and group 3 both showed significant 99mTc-duramycin uptake in the tumors (P < 0.05). Although the 99mTc-duramycin uptake of group 2 was moderately higher than group 3, there were no significant differences between these two groups (P >0.05). There was a strong positive correlation between tumor 99mTc-duramycin uptake and CC3 (r = 0.893, p < 0.0001) and TUNEL (r = 0.918, P < 0.0001). Tumor volume decreased remarkably in the RT in combination with CTX group on day 5, in the RT alone group on day 7, and was inhibited on day 8 in the CTX alone group, whereas the tumors grew continuously in the control group. CONCLUSIONS We demonstrated that RT in combination with CTX treatment significantly improved disease control in a NPC xenograft model compared with monotherapy with either. 99mTc-duramycin imaging might be able to reliably identify response to RT in combination with CTX as early as 24 h after therapy initiation in NPC xenograft models. This might help to isolate non-responding patients in a timely manner and avoid unnecessary side effects in the clinic in the future.
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Affiliation(s)
- Cheng Liu
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Center for Biomedical Imaging, Fudan University, Shanghai 200032, China; Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China; Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai 200433, China
| | - Yi Li
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Center for Biomedical Imaging, Fudan University, Shanghai 200032, China; Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China; Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai 200433, China
| | - Xiaojia Qin
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Center for Biomedical Imaging, Fudan University, Shanghai 200032, China; Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China; Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai 200433, China
| | - Ziyi Yang
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Center for Biomedical Imaging, Fudan University, Shanghai 200032, China; Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China; Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai 200433, China
| | - Jianmin Luo
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Center for Biomedical Imaging, Fudan University, Shanghai 200032, China; Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China; Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai 200433, China
| | - Jianping Zhang
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Center for Biomedical Imaging, Fudan University, Shanghai 200032, China; Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China; Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai 200433, China
| | - Brian Gray
- Molecular Targeting Technologies, Inc., West Chester, PA, 19380, USA
| | - Koon Y Pak
- Molecular Targeting Technologies, Inc., West Chester, PA, 19380, USA
| | - Xiaoping Xu
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Center for Biomedical Imaging, Fudan University, Shanghai 200032, China; Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China; Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai 200433, China.
| | - Jingyi Cheng
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Center for Biomedical Imaging, Fudan University, Shanghai 200032, China; Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China; Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai 200433, China.
| | - Yingjian Zhang
- Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai 201321, China; Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Center for Biomedical Imaging, Fudan University, Shanghai 200032, China; Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China; Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai 200433, China
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13
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Lu Y, Chen D, Liang J, Gao J, Luo Z, Wang R, Liu W, Huang C, Ning X, Liu M, Huang H. Administration of nimotuzumab combined with cisplatin plus 5-fluorouracil as induction therapy improves treatment response and tolerance in patients with locally advanced nasopharyngeal carcinoma receiving concurrent radiochemotherapy: a multicenter randomized controlled study. BMC Cancer 2019; 19:1262. [PMID: 31888551 PMCID: PMC6937916 DOI: 10.1186/s12885-019-6459-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 12/12/2019] [Indexed: 01/21/2023] Open
Abstract
Background Nimotuzumab (NTZ) is an anti-EGFR monoclonal antibody. However,the effect of targeted drugs combined with induction therapy in locally advanced nasopharyngeal carcinoma remains unclear. The aim of this study is to investigate the safety and efficacy of NTZ combined with cisplatin plus 5-fluorouracil (PF) as induction regimen in locally advanced nasopharyngeal carcinoma (NPC) patients receiving concurrent radiochemotherapy. Methods This was a multicenter randomized controlled study performed in eight Guangxi hospitals in 2015–2017. Eligible patients with NPC were randomized into nimotuzumab/PF (NPF group) and docetaxel/PF (DPF group) regimens, respectively, as induction therapy. After 2 cycles of induction therapy, all patients received cisplatin and concurrent intensity modulated radiation therapy (IMRT). Then, the two groups were compared for safety and efficacy. Results A total of 118 patients with stage III-IVa NPC were assessed, with 58 and 60 in the NPF and DPF groups, respectively. Compared with DPF treatment, NPF induction therapy showed a more pronounced effect on cervical lymph nodes (P = 0.036), with higher response rate (RR) (81% vs 60%). Compared with the DPF group, the NPF group showed significantly reduced leukopenia, neutropenia and gastrointestinal reactions (all P < 0.05); rash only appeared in the NPF group, but all cases were grade 1. During concurrent treatment with radiotherapy and chemotherapy, the NPF group showed better tolerance to radiotherapy and chemotherapy; neutropenia, anemia, gastrointestinal reactions, oral mucositis and radiation dermatitis in the NPF group were significantly reduced (P < 0.05). The expression rate of EGFR was 94.9% (112/118). Compared with the DPF group, patients with EGFR expression in the NPF group showed better response (77.8% vs 63.0%, P = 0.033). Conclusion For locally advanced NPC patients receiving follow-up cisplatin and IMRT, nimotuzumab/PF for induction therapy has better lymph node response rate and milder adverse reactions than the DPF regimen. In addition, the patients have better tolerance in subsequent concurrent radiotherapy and chemotherapy; however, long-term efficacy needs further follow-up evaluation. Trial registration The registration number of the clinical trial is ChiCTR-OIC-16008201 and retrospectively registered on March 31, 2016.
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Affiliation(s)
- Ying Lu
- Department of Oncology, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Dagui Chen
- Department of Oncology, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Jinhui Liang
- Department of Radiotherapy, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Jianquan Gao
- Department of Radiotherapy, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Zhanxiong Luo
- Department of Radiotherapy, Liuzhou People's Hospital, Liuzhou, China
| | - Rensheng Wang
- Department of Radiotherapy, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wenqi Liu
- Department of Radiotherapy, the Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Changjie Huang
- Department of Oncology, the Second People's Hospital of Nanning, Nanning, China
| | - Xuejian Ning
- Department of Oncology, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, China
| | - Meilian Liu
- Department of Radiotherapy, the Affiliated Hospital of Guilin Medical College, Guilin, China
| | - Haixin Huang
- Department of Oncology, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China.
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14
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Gondhowiardjo SA, Adham M, Kodrat H, Tobing DL, Haryoga IM, Dwiyono AG, Kristian YA. Current Immune-Related Molecular Approach in Combating Nasopharyngeal Cancer. World J Oncol 2019; 10:157-161. [PMID: 31636788 PMCID: PMC6785271 DOI: 10.14740/wjon1214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 07/04/2019] [Indexed: 12/24/2022] Open
Abstract
Nasopharyngeal cancer is a cancer closely related to Epstein-Barr virus (EBV) infection. EBV protein has been shown to be related to various oncogenic development. Suppression of tumor suppressor genes, upregulating molecules to prevent immune attack, downregulating pro-apoptotic proteins, and stimulating local immune suppressive environment are among some roles that EBV proteins can exert on host cells. All those factors combined together with underlying genetic susceptibility of host cells further increase the chance of nasopharyngeal cancer development. Approach targeting those carcinogenesis pathways has been tested with marginal benefit. A newer approach boosting immune cells to increase recognition of tumor antigen and promoting cytotoxic T cell attack has shown promising clinical benefit. Further combination of those immunotherapies with other modality, in particular radiotherapy, has resulted in amplification of cancer killing.
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Affiliation(s)
- Soehartati A Gondhowiardjo
- Faculty of Medicine - University of Indonesia, Jl. Salemba Raya No. 6, Jakarta 10430, Indonesia.,Department of Radiotherapy Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia
| | - Marlinda Adham
- Faculty of Medicine - University of Indonesia, Jl. Salemba Raya No. 6, Jakarta 10430, Indonesia.,Department of ENT, Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia
| | | | - Henry Kodrat
- Faculty of Medicine - University of Indonesia, Jl. Salemba Raya No. 6, Jakarta 10430, Indonesia.,Department of Radiotherapy Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia
| | - Demak Lumban Tobing
- Department of Clinical Pathology, Dharmais Cancer Hospital, Jl. Letjen Jend. S. Parman No.84-86 Jakarta 11420, Indonesia
| | | | - I Made Haryoga
- Faculty of Medicine - University of Indonesia, Jl. Salemba Raya No. 6, Jakarta 10430, Indonesia.,Department of Radiotherapy Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia
| | - Agustinus Gatot Dwiyono
- Faculty of Medicine - University of Indonesia, Jl. Salemba Raya No. 6, Jakarta 10430, Indonesia.,Department of Radiotherapy Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia
| | - Yoseph Adi Kristian
- Faculty of Medicine - University of Indonesia, Jl. Salemba Raya No. 6, Jakarta 10430, Indonesia.,Department of Radiotherapy Cipto Mangunkusumo Hospital, Jl. Diponegoro No. 71, Jakarta 10430, Indonesia
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15
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Cetuximab in the management of nasopharyngeal carcinoma - a narrative review. The Journal of Laryngology & Otology 2019; 133:843-855. [PMID: 31506113 DOI: 10.1017/s0022215119001853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Concurrent chemotherapy with radiotherapy is the standard treatment for locoregionally advanced nasopharyngeal cancer. Cetuximab can be used in the treatment of head and neck squamous cell carcinoma. However, the randomised studies that led to approval for its use in this setting excluded nasopharyngeal cancer. In the context of limited data for the use of cetuximab in nasopharyngeal cancer in the medical literature, this review aimed to summarise the current evidence for its use in both primary and recurrent or metastatic disease. METHOD A literature search was performed using the keywords 'nasopharyngeal neoplasm', 'cetuximab' and 'Erbitux'. RESULTS Twenty studies were included. There were no randomised phase III trials, but there were nine phase II trials. The use of cetuximab in the treatment of nasopharyngeal carcinoma has been tested in various settings, including in combination with induction chemotherapy and concurrent chemoradiotherapy, and in the palliative setting. CONCLUSION There is no evidence of benefit from the addition of cetuximab to standard management protocols, and there is some evidence of increased toxicity. There is more promise for its use in metastatic or locally recurrent settings. This review draws together the existing evidence and could provide a focus for future studies.
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16
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Lin L, Liang W, Li CF, Huang XD, Lv JW, Peng H, Wang BY, Zhu BW, Sun Y. Development and implementation of a dynamically updated big data intelligence platform from electronic health records for nasopharyngeal carcinoma research. Br J Radiol 2019; 92:20190255. [PMID: 31430186 DOI: 10.1259/bjr.20190255] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To develop a big data intelligence platform for secondary use of electronic health records (EHRs) data to facilitate research for nasopharyngeal cancer (NPC). METHODS This project was launched in 2015 and carried out by the cooperation of an academic cancer centre and a technology company. Patients diagnosed with NPC at Sun Yat-sen University Cancer Centre since January 2008 were included in the platform. Standard data elements were established to defined 981 variables for the platform. For each patient, data from 13 EHRs systems were extracted, integrated, structurized and normalized. Eight functional modules were constructed for the platform to facilitate the investigators to identify eligible patients, establish research projects, conduct statistical analysis, track the follow-up, search literature, etc. RESULTS From January 2008 to December 2018, 54,703 patients diagnosed with NPC were included. Of these patients, 39,058 (71.4%) were male, and 15,645 (28.6%) were female; median age was 47 (interquartile range, 39-55) years. Of 981 variables, 341 were obtained from data structurization and normalization, of which 68 were generated by interacting multiple data sources via well-defined logical rules. The average precision rate, recall rate and F-measure for 341 variables were 0.97 ± 0.024, 0.92 ± 0.030, and 0.94 ± 0.027 respectively. The platform is regularly updated every seven days to include new patients and add new data for existing patients. Up to now, eight big data-driven retrospective studies have been published from the platform. CONCLUSION Our big data intelligence platform demonstrates the feasibility of integrating EHRs data of routine healthcare, and offers an important perspective on real-world study of NPC. The continued efforts may be focus on data sharing among multiple hospitals and publicly releasing of data files. ADVANCES IN KNOWLEDGE Our big data intelligence platform is the first disease-specific data platform for NPC research. It incorporates comprehensive EHRs data from routine healthcare, which can facilitate real-world study of NPC in risk stratification, decision-making and comorbidities management.
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Affiliation(s)
- Li Lin
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Wei Liang
- YiduCloud Technology Ltd, Beijing, China
| | - Chao-Feng Li
- Department of Information Technology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Xiao-Dan Huang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Jia-Wei Lv
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Hao Peng
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | | | - Bo-Wei Zhu
- YiduCloud Technology Ltd, Beijing, China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
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Zong D, Jiang N, Xu JH, Wang DJ, Zhu HF, Wu LR, Chen C, Yin L, He X. ZNF488 is an independent prognostic indicator in nasopharyngeal carcinoma and promotes cell adhesion and proliferation via collagen IV/FAK/AKT/Cyclin D1 pathway. Cancer Manag Res 2019; 11:5871-5882. [PMID: 31303793 PMCID: PMC6605772 DOI: 10.2147/cmar.s200001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 05/17/2019] [Indexed: 12/22/2022] Open
Abstract
Background: ZNF488 acts as an oncogene which promotes cell invasion and endows tumor cells stem cell capacity in nasopharyngeal carcinoma (NPC), but its correlation with clinicopathologic characteristics and patients' survival in NPC remain undefined. Methods: In this study, 158 cases of confirmed NPC were subjected to immunohistochemistry staining for evaluating endogenous expression. Kaplan-Meier method and log-rank test were used to estimate the survival rates. The relationship between ZNF488 and clinicopathological characteristics was statistically calculated by chi-squared test, univariate and multivariate analysis. In addition, adhesion assay, MTT and colony formation assays were performed for measuring adhesion and proliferation capacity. Cell cycle analysis via flow cytometry was conducted to explore cell cycle distribution. Western blot was used to detect pathway protein levels, and the pFAK (Y397) kit was used for focal adhesion kinase (FAK) activation. Results: We demonstrated that high expression of ZNF488 was significantly correlated with locoregional failure (P=0.018) and distant metastasis (P=0.001). Patients with high ZNF488 expression had poorer overall survival (P<0.001), loco-regional recurrence-free survival (P<0.001), distance metastasis-free survival (P<0.001) and progression-free survival (P<0.001) than those with low ZNF488 group. Multivariate analysis showed that ZNF488 expression was an independent prognostic indicator for predicting NPC patients' survival (HR, 3.314; 95% CI, 1.489-7.386; P=0.003). Additionally, ZNF488-induced collagen IV/FAK/AKT to enhance adhesion ability meanwhile led to the upregulation of Cyclin D1 to facilitate cell proliferation through promoting cell cycle progression and inhibition of apoptosis through caspase-independent way. Conclusion: These results reveal that ZNF488, as an independent prognostic indicator, promotes cell adhesion and proliferation through collagen IV/FAK/AKT/Cyclin D1 pathway in NPC.
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Affiliation(s)
- Dan Zong
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210009, People's Republic of China
| | - Ning Jiang
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210009, People's Republic of China
| | - Jian-Hua Xu
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210009, People's Republic of China
| | - De-Jun Wang
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210009, People's Republic of China
| | - Huan-Feng Zhu
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210009, People's Republic of China
| | - Li-Rong Wu
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210009, People's Republic of China
| | - Cheng Chen
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210009, People's Republic of China
| | - Li Yin
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210009, People's Republic of China
| | - Xia He
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210009, People's Republic of China
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18
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Lv T, Wang Y, Ou D, Liu P, Qin S, Liu L, Lou P, Wang X. IMRT combined with S-1 concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma: a prospective phase II study. Invest New Drugs 2019; 37:352-359. [DOI: 10.1007/s10637-018-00720-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 12/25/2018] [Indexed: 01/20/2023]
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