The major cause of cancer-associated mortality is tumor metastasis, a disease that is far from understood. Many studies have observed circulating tumor cells (CTCs) in patients' circulation systems, and a few latest investigations showed that CTC clusters have a potentially high capacity of metastasis. The capture and analysis of CTC clusters offer new insights into tumor metastasis and can facilitate the development of cancer treatments. We reviewed the research history of the CTC clusters, as well as the technologies used for detecting and isolating CTC clusters. In addition, we discuss the characteristics of CTC clusters and their roles in tumor dissemination. Clinical relevance of CTC clusters was also implicated in currently limited data. Moving forward, the next frontier in this field is to develop more efficient capture methods and decipher conundrums of characterization of CTC clusters. This will ultimately identify the clinical value of CTC clusters as a biomarker and therapeutic target.
Hepatocellular carcinoma (HCC) is a common cancer worldwide with a poor prognosis. Few strategies have been proven efficient in HCC treatment, particularly for those patients not indicated for curative resection or transplantation. Immunotherapy has been developed for decades for cancer control and is attaining more attention as a result of encouraging outcomes of new strategies such as chimeric antigen receptor T cells and immune checkpoint blockade. Right at the front of the new era of immunotherapy, we review the immunotherapy in HCC treatment, from basic research to clinical trials, covering anything from immunomodulators, tumor vaccines and adoptive immunotherapy. The mechanisms, efficacy and safety as well as the approach particulars are unveiled to assist readers to gain a concise but extensive understanding of immunotherapy of HCC.
Hostile microenvironment produced by abnormal blood vessels, which is characterized by hypoxia, low pH value and increasing interstitial fluid pressure, would facilitate tumor progression, metastasis, immunosuppression and anticancer treatments resistance. These abnormalities are the result of the imbalance of pro-angiogenic and anti-angiogenic factors (such as VEGF and angiopoietin 2, ANG2). Prudent use of anti-angiogenesis drugs would normalize these aberrant tumor vessels, resulting in a transient window of vessel normalization. In addition, use of cancer immunotherapy including immune checkpoint blockers when vessel normalization is achieved brings better outcomes. In this review, we sum up the advances in the field of understanding and application of the concept of tumor vessels normalization window to treat cancer. Moreover, we also outline some challenges and opportunities ahead to optimize the combination of anti-angiogenic agents and immunotherapy, leading to improve patients’ outcomes.
BackgroundLung cancer is the most common type of cancer throughout the world, and the morbidity of lung cancer is continuously increasing. Patients with advanced lung cancer often cannot tolerate chemoradiotherapy. The decrease of the expression of miRNA-21 can be used as an indicator of the therapeutic effect of lung cancer. In this study, the effect of Kanglaite injection on serum miRNA-21 in patients with advanced lung cancer was investigated, providing reliable and important evidences.Material/MethodsFrom March 2016 to March 2017, 120 patients with advanced lung cancer were examined; we collected detailed information and serum samples. The patients were treated by intravenous drip of Kanglaite, which was provided by Zhejiang Kanglaite Pharmaceutical Co., Ltd., China. We administered 200 ml intravenous drip once per day for a total of 21 days. Serum samples were collected from patients after treatments. In this study, 4 observation indexes were considered – KPS (Karnofsky performance score, KPS), body weight, adverse effects, and miRNA-21 level – evaluated before and after the Kanglaite treatment.ResultsAmong 120 patients with advanced lung cancer, the KPS of 75 patients (63.1%) was increased after the treatment, and body weight was increased by 55.9%. In addition, serum miRNA-21 level after the Kanglaite treatment was 2.45±0.15, which was significantly lower than before treatment (3.87±0.54), (P<0.05).ConclusionsThe effect of Kanglaite injection on serum miRNA-21 in patients with advanced lung cancer was shown to significantly reduce the expression of miRNA-21, providing objective evidence for the effect of Kanglaite injection in patients with advanced lung cancer.
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