Effect Of Chemotherapy Research Articles

Antitumor Activity of a Lectin Purified from Punica granatum Pulps against Ehrlich Ascites Carcinoma (EAC) Cells.

Lectins are carbohydrate-binding proteins with various pharmacological activities, such as antimicrobial, antidiabetic, antioxidant, and anticancer. Punica granatum fruit extract has traditional uses, however, the anti-cancer activity of purified lectin isolated from P. granatum pulp is yet to be reported. The goals of this study are purification, characterization of the lectin from P. granatum, and examination of the purified lectin's anticancer potential. Diethylaminoethyl (DEAE) ion-exchange chromatography was used to purify the lectin, and SDSPAGE was used to check the purity and homogeneity of the lectin. Spectrometric and chemical analysis were used to characterize the lectin. The anticancer activity of the lectin was examined using in vivo and in vitro functional assays. A lectin, designated as PgL of 28.0 ± 1.0 kDa molecular mass, was isolated and purified from the pulps of P. granatum and the lectin contains 40% sugar. Also, it is a bivalent ion-dependent lectin and lost its 75% activity in the presence of urea (8M). The lectin agglutinated blood cells of humans and rats, and sugar molecules such as 4-nitrophenyl-α-D-manopyranoside and 2- nitrophenyl -β- D-glucopyranoside inhibited PgL's hemagglutination activity. At pH ranges of 6.0-8.0 and temperature ranges of 30°C -80°C, PgL exhibited the highest agglutination activity. In vitro MTT assay showed that PgL inhibited Ehrlich ascites carcinoma (EAC) cell growth in a dose-dependent manner. PgL exhibited 39 % and 58.52 % growth inhibition of EAC cells in the mice model at 1.5 and 3.0 mg/kg/day (i.p.), respectively. In addition, PgL significantly increased the survival time (32.0 % and 49.3 %) of EAC-bearing mice at 1.5 and 3.0 mg/kg/day doses (i.p.), respectively, in comparison to untreated EAC-bearing animals (p < 0.01). Also, PgL reduced the tumor weight of EAC-bearing mice (66.6 versus 39.13%; p < 0.01) at the dose of 3.0 mg/kg/day treatment. Furthermore, supplementation of PgL restored the haematological parameters toward normal levels deteriorated in EAC-bearing animals by the toxicity of EAC cells. The results indicated that the purified lectin has anticancer activity and has the potential to be developed as an effective chemotherapy agent.

Red blood cell membrane-coated functionalized Cu-doped metal organic framework nanoformulations as a biomimetic platform for improved chemo-/chemodynamic/photothermal synergistic therapy

Nanoformulations for combining chemotherapy, chemodynamic therapy, and photothermal therapy have enormous potential in tumor treatment. Coating nanoformulations with cell membranes endows them with homologous cellular mimicry, enabling nanoformulations to acquire new functions and properties, including homologous targeting and long circulation in vivo, and can enhance internalization by homologous cancer cells. Herein, we fused multifunctional biomimetic nanoformulations based on Cu-doped zeolitic imidazolate framework-8 (ZIF-8). Hydroxycamptothecin (HCPT), a clinical anti-tumor drug, was encapsulated into ZIF-8, which was subsequently coated with polydopamine (PDA) and red blood cell membrane. The as-fabricated biomimetic nanoformulations showed an enhanced cell uptake in vitro and the potential to prolong blood circulation in vivo, producing effective synergistic chemotherapy, chemodynamic therapy, and photothermal therapy under the 808 nm laser irradiation. Together, the biomimetic nanoformulations showed a prolonged blood circulation and evasion of immune recognition in vivo to provide a bio-inspired strategy which may have the potential for the multi-synergistic therapy of breast cancer.

Abstract B111: Developing prognostic signatures (ep-Sigs) through epigenetic predictive markers in pancreatic ductal adenocarcinoma (PDA) – A pilot study based on The Cancer Genome Atlas (TCGA) data

Abstract Current genomic testing (mutation profiling) has not proven beneficial for optimal treatment selection or for monitoring drug resistance, which is critical for neoadjuvant therapy (NAT) in borderline resectable/resectable PDA and first-line therapy for advanced PDA. Failure to administer an effective chemotherapy combination results in early progression of the disease, life-threatening complications, and a decline in the patient’s performance status, rendering them ineligible for further anti-cancer treatment. We hypothesized that our panel of epigenetic markers (DNA-methylation changes) is a surrogate for protein/gene expression and will develop an ep-Sigs that also has predictive value. The genes in this panel have been curated from extant literature and belong to one of two broad categories: one with known prognostic value (PvG) and the other with preclinical or clinical evidence of influencing one of the drugs (DrG) used in PDA management (gemcitabine (gem), 5-fluorouracil (5FU), oxaliplatin (Ox), irinotecan (Iri), nab-paclitaxel (NP), paclitaxel (Tax), and cisplatin (Cis)). Some genes/proteins were critical for more than one drug. To accomplish this, we tested the panel in the TCGA pancreatic adenocarcinoma (PAAD) data with 182 patients. For univariate survival analysis (UVA), we used Cox regression models for each marker. For multivariate survival analysis (MVA), we used penalized Cox regression models (i.e., LASSO, Elastic-Net) for identifying marker signatures. The area under the ROC Curve (AUC) was calculated to assess each signature’s predictive performance. We identified 301 cytosines followed by guanine residue (CpG) sites among the 67 genes (gem=35, 5FU=13, 5FU+gem=10, NP=6, Cis=6, and PvG=23) in the panel with significant (p&amp;lt;0.05) association with overall survival (OS) through UVA. We identified five ep-Sigs through MVA that could predict poor OS (p&amp;lt;0.05), which are a combination of markers from PvG and DrG. The number of markers and relevant DrG in them are as follows, 15 &amp; Gem/Cis; 30 &amp; Gem/5FU/Cis/Tax/Iri; 28 &amp; Gem/5FU/NP/Cis/Tax/Iri; 23 &amp; Gem/5FU; 29 &amp; Gem/5FU/NP. We did a similar analysis for RNA-sequencing data from TCGA. We identified 17 markers and 9 signatures on UVA and MVA, respectively. Interestingly, the expression of 100/105 markers in the panel was significantly (p=4.19e-66) high in PDA compared to normal tissues, indicating this panel has diagnostic value too. We believe this project is the first step for this approach, and this concept needs to be evolved with prospective studies and larger samples. The ep-Sigs with a panel of epigenetic markers with a proven influence on resistance to frequently used drugs could help in developing meaningful models that change the approach to managing PDA, especially for NAT. Citation Format: Ashish Manne, Wancai Yang, Davendra Sohal, Ashwini Esnakula, Lianbo Yu. Developing prognostic signatures (ep-Sigs) through epigenetic predictive markers in pancreatic ductal adenocarcinoma (PDA) – A pilot study based on The Cancer Genome Atlas (TCGA) data [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr B111.

Cisplatin and doxorubicin chemotherapy alters gut microbiota in a murine osteosarcoma model.

The gut microbiota is closely associated with tumor progression and treatment in a variety of cancers. However, the alteration of the gut microbiota during the progression and chemotherapy of osteosarcoma remains poorly understood. This study aimed to explore the relationship between dysbiosis in the gut microbiota during osteosarcoma growth and chemotherapy treatment. We used BALB/c nude mice to establish osteosarcoma xenograft tumor models and administered cisplatin (CDDP) or doxorubicin (DOX) intraperitonially once every 2 days for a total of 5 times to establish effective chemotherapy models. Fecal samples were collected and processed for 16S rRNA sequencing to analyze the composition of the gut microbiota. We observed that the abundances of Colidextribacter, Lachnospiraceae_NK4A136_group, Lachnospiraceae_UCG-010, Lachnospiraceae_UCG-006, and Lachnoclostridium decreased, and the abundances of Alloprevotella and Enterorhabdus increased in the osteosarcoma mouse model group compared to those in the control group. In addition, genera, such as Lachnoclostridium and Faecalibacterium were more abundant in chemotherapy-treated mice than those in saline-treated mice. Additionally, we observed that alterations in some genera, including Lachnoclostridium and Colidextribacter in the osteosarcoma animal model group returned to normal after CDDP or DOX treatment. Furthermore, the function of the gut microbiota was inferred through PICRUSt2 (Phylogenetic Investigation of Communities by Reconstruction of Unobserved States), which indicated that metabolism-related microbiota was highly enriched and significantly different in each group. These results indicate correlations between dysbiosis of the gut microbiota and osteosarcoma growth and chemotherapy treatment with CDDP or DOX and may provide novel avenues for the development of potential adjuvant therapies.

Tumor microenvironment targeting for glioblastoma multiforme treatment via hybrid cell membrane coating supramolecular micelles

Glioblastoma multiforme (GBM) is one of the most common primary intracranial tumors in the central nervous system with poor prognosis, high invasiveness, risk of recurrence and low survival rate. Thus, it is urgent and vital to develop drug effective delivery systems that efficiently to traverse the blood–brain barrier and targeted transport therapeutic agents into the GBM tumor site for the treatment of brain tumors. Recently, amphiphilic cucurbit[7]uril-polyethylene glycol-hydrophobic Chlorin e6 (CB[7]-PEG-Ce6) polymer was designed, prepared, and self-assembled into micells (CPC) in an aqueous solution, and chemo drug methyl-triazeno-imidazole-carboxamide (MTIC), loaded into the cavity of CB[7] was subsequently coated with hybrid membrane mUMH (HMC3 membrane: macrophage membrane: U87MG membrane = 1:1:2) to afford mUMH@CPC@MTIC. The surface hybrid membrane mUMH potentially enhance the targeted delivery of CPC@MTIC to GBM tissue. Bioactive MTIC was released from the cavity of CB[7] in response to the high spermine level in GBM tumor microenvironments for effective tumor chemotherapy. The biomimetic mUMH@CPC@MTIC exhibited superior antitumor efficacy against GBM in mice. These findings provide new strategies for the design of biomimetic nanoparticle-based drug delivery systems and promising therapy of GBM.

Prevention of Bladder Cancer Recurrence With the Botanical Formula LCS103: A Case Series Study.

Despite effective chemotherapy and other available oncology treatments, recurrence rates for non-muscle invasive bladder cancer (NMIBC) remain high, with as many as 60% of patients requiring repeat intravesical treatments with BCG or other agents within a 24-month period. The botanical formula LCS103 has displayed anti-cancer activity on bladder cancer cells, though its clinical efficacy remains to be proven. A consecutive series of 30 patients with bladder cancer was examined retrospectively, of which a cohort of 20 patients (18 with NMIBC, 2 with metastatic disease) was treated with LCS103 for between 14 months and 16 years, in addition to their conventional oncology care. Only 3 patients (15%) had a single tumor recurrence after initiation of the botanical treatment, as opposed to pre-treatment recurrence reported among 11 patients (55%; range, 1-5). The majority of LCS103-treated patients reported reduced severity for urological symptoms (pain, frequency, and urgency on urination; and nocturia), as well as for weakness and fatigue, and for general wellbeing. No adverse events were associated with use of the botanical formula. Further prospective randomized trials are needed to confirm and better understand these initial findings.

Efficacy of vincristine as a rescue therapy for canine histiocytic sarcoma.

Canine histiocytic sarcoma (CHS) is a malignant tumor derived from macrophages and dendritic cells. Since effective chemotherapy is needed for CHS cases, we conducted this prospective study to evaluate the efficacy and adverse events of vincristine treatment as a rescue therapy for this disease. We administered vincristine to nine CHS cases that acquired resistance to lomustine or nimustine. Complete remission was achieved in one dog, partial remission in two dogs, stable disease in five dogs, and progressive disease in one dog. The median progression-free survival was 21 days (range: 7-71 days). Severe adverse effect was observed in one dog (Grade 3 thrombocytopenia). It is essential to establish novel effective treatments for CHS.

Unveiling insights into bovine tuberculosis: A comprehensive review.

The frequent zoonotic disease known as "bovine tuberculosis" is brought on by the Mycobacterium bovis bacteria, which can infect both people and animals. The aim of this review article is to provide an explanation of the etiology, history, epidemiology, pathogenesis, clinical symptoms, diagnosis, transmission, risk factors, public health importance, economic impact, treatment, and control of bovine tuberculosis. Primarily, bovine tuberculosis affects cattle, but other animals may also be affected. Bovine tuberculosis is present throughout the world, with the exception of Antarctica. Cattle that contract bovine tuberculosis might suffer from a persistent, crippling illness. In the early stages of the disease, there are no symptoms. The tuberculin test is the primary method for detecting bovine tuberculosis in cows. Depending on its localized site in the infected animal, M. bovis can be found in respiratory secretions, milk, urine, feces, vaginal secretions, semen, feces, and exudates from lesions (such as lymph node drainage and some skin lesions). This illness generally lowers cattle productivity and could have a negative financial impact on the livestock business, particularly the dairy industry. The most effective first-line anti-tuberculosis chemotherapy consists of isoniazid, ethambutol, rifampin, and streptomycin. Second-line drugs used against bovine tuberculosis include ethionamide, capreomycin, thioacetazone, and cycloserine. To successfully control and eradicate bovine tuberculosis, developed nations have implemented routine testing and culling of infected animals under national mandatory programs.

Inhibition of thioredoxin reductase and upregulation of apoptosis genes for effective anti-tumor sono-chemotherapy using a meso-organosilica nanomedicine.

The thioredoxin system is involved in cancer development and therefore is a promising target for cancer chemotherapy. Thioredoxin reductase (TrxR) is a key component of the thioredoxin (Trx) system, and is overexpressed in many cancers to inhibit apoptosis-related proteins. Alternatively, inhibition of thioredoxin reductase and upregulation of apoptosis factors provide a therapeutic strategy for anti-tumor treatment. In this study, an ultrasound-activatable meso-organosilica nanomedicine was prepared by integrating chloroquine (CQ) into hollow mesoporous organosilica (CQ@MOS). The meso-organosilica nanomedicine can inhibit the activity of thioredoxin reductase, elevate cellular reactive oxygen species (ROS) levels, upregulate the pro-apoptotic factors in the c-Jun N-terminal kinase (JNK) apoptosis pathway and induce autophagy inhibition, further resulting in mitochondrial membrane potential (MMP) depolarization and cellular ATP content decrease, ultimately causing significant damage to tumor cells. Moreover, CQ@MOS can efficiently deliver chloroquine into cancer cells and promote an enhanced sonodynamic effect for effective anti-tumor chemotherapy and sonodynamic therapy. This study may enlighten us on a new anti-tumor strategy and suggest its promising applications in cancer treatments.

Bioorthogonal chemistry-based prodrug strategies for enhanced biosafety in tumor treatments: current progress and challenges.

Cancer is a significant global health challenge, and while chemotherapy remains a widely used treatment, its non-specific toxicity and broad distribution can lead to systemic side effects and limit its effectiveness against tumors. Therefore, the development of safer chemotherapy alternatives is crucial. Prodrugs hold great promise, as they remain inactive until they reach the cancer site, where they are selectively activated by enzymes or specific factors, thereby reducing side effects and improving targeting. However, subtle differences in the microenvironments between tumors and normal tissue may still result in unintended cytotoxicity. Bioorthogonal reactions, known for their selectivity and precision without interfering with natural biochemical processes, are gaining attention. When combined with prodrug strategies, these reactions offer the potential to create highly effective chemotherapy drugs. This review examines the safety and efficacy of prodrug strategies utilizing various bioorthogonal reactions in cancer treatment.

Preclinical evaluation of cyclophosphamide and fludarabine combined with CD19 CAR-T in the treatment of B-cell hematologic malignancies in vivo.

Chimeric antigen receptor T (CAR-T) cell therapy has achieved marked therapeutic success in ameliorating hematological malignancies. However, there is an extant void in the clinical guidelines concerning the most effective chemotherapy regimen prior to chimeric antigen receptor T (CAR-T) cell therapy, as well as the optimal timing for CAR-T cell infusion post-chemotherapy. We employed cell-derived tumor xenograft (CDX) murine models to delineate the optimal pre-conditioning chemotherapy regimen and timing for CAR-T cell treatment. Furthermore, transcriptome sequencing was implemented to identify the therapeutic targets and elucidate the underlying mechanisms governing the treatment regimen. Our preclinical in vivo evaluation determined that a combination of cyclophosphamide and fludarabine, followed by the infusion of CD19 CAR-T cells five days subsequent to the chemotherapy, exerts the most efficacious therapeutic effect in B-cell hematological malignancies. Concurrently, RNA-seq data indicated that the therapeutic efficacy predominantly perturbs tumor cell metabolism, primarily through the inhibition of key mitochondrial targets, such as C-Jun Kinase enzyme (C-JUN). In summary, the present study offers critical clinical guidance and serves as an authoritative reference for the deployment of CD19 CAR-T cell therapy in the treatment of B-cell hematological malignancies.

A Study on Anti-Tubercular Drug Resistance Pattern in a Tertiary Care Hospital

Background: Tuberculosis is one of the oldest infectious diseases known to mankind. Archaeological evidences from ancient civilizations have shown the existence of tuberculosis in the prehistoric era. Even though effective chemotherapy for tuberculosis has been available for decades, tuberculosis still remains as a public health challenge all over the world. Over the years not only the medical implications but also the social and economic impact of tuberculosis has been enormous. AIM: To measure anti-tubercular drug resistance pattern at S.V.S. Medical College and Hospital, Mahabubnagar District. Material &amp; Methods: Prospective hospital based observational study. The study was carried out in the Department of Pulmonary Medicine, S.V.S Medical College and Hospital, Enugonda, Mahbubnagar. Mar. 2021 – Feb. 2022. Patients with both Pulmonary and Extra pulmonary tuberculosis who were attending to the study facility. study consisted of 50 subjects. 1.Collection of samples (sputum, bronchial wash, pleural fluid, synovial fluid &amp; lymph node tissue). 2. Staining method was done by Fluorescence microscopy staining procedure. 3.Grading of the slide as per WHO. 4. Culture &amp; DST was done on L-J medium and Proportionate method. Results: Among the resistant cases, isolated R resistance was observed in 10 cases (33.3%), R with H was observed in 12 cases (40%), R with S was observed in 2 cases (6.66%), R with H, S &amp; Lfx was observed in 2 cases (6.66%) and R with H &amp; S was observed in 1 case (3.33%). Conclusion: The study demonstrates that levels of R, MDR &amp; XDR are more than expected levels when compared with other studies conducted in India as per global DRS guidelines. In view of these results, Multidrug resistance continues to be a serious problem in Mahbubnagar District of TELANGANA. R resistance can be considered as a surrogate marker for MDR-TB. On the basis of these results, it is now necessary to conduct more DRS in much larger population.

Diosmin alleviates doxorubicin-induced chemobrain in rats via inhibition of oxido-inflammation, apoptosis and modulation of autophagy

Background/aimDoxorubicin (DOX) is a highly effective chemotherapy medicine commonly used to treat breast cancer; yet, despite its clinical efficacy, it usually causes chemobrain. As a result, we investigated the neuroprotective effects of Diosmin (DIOS) on DOX-induced chemobrain in male rat brains. Animals and methodsIn the experimental protocol, Rats were divided into 4 groups: group I received solvent and saline for 56 days, group II received Dios and a concomitant dose of saline for 56 days, group III received DOX intraperitoneally on 7th, 14th, 21st, 28th, 35th, 42nd, 49th and 56th days, and Group IV received DIOS (40 mg/kg P.O.) for 56 days and DOX was administered one hour after DIOS oral administration. The novel-object recognition memory test (NORT) was used to assess non-spatial memory function. Following that, brain neurochemical status were assessed. ResultsDIOS increased cognitive performance in DOX-treated rats by enhancing exploration of unfamiliar objects. DIOS protects the brain from DOX-mediated alterations in oxidative status, as well as brain metabolic enzyme indicators. It also decreased MMP-6, IL-6, IL-β1, TNF-α and COX-2 expression, reduced apoptotic markers levels, boosted mTOR protein levels, lowered beclin-1, restored brain metabolic enzyme activities, increased neurotransmitter as well as cathepsin levels, and avoided the rise in α-synuclein and PON1 enzyme activity. ConclusionIn conclusion, DIOS protects rats' brains against DOX-induced chemobrain via oxidative stress inhibition, autophagy modulation, and down-regulation of inflammatory and apoptotic markers.

Minimal Residual Disease Status Predicts Outcome in Patients With Previously Untreated Follicular Lymphoma: A Prospective Analysis of the Phase III GALLIUM Study.

We report an analysis of minimal residual/detectable disease (MRD) as a predictor of outcome in previously untreated patients with follicular lymphoma (FL) from the randomized, multicenter GALLIUM (ClinicalTrials.gov identifier: NCT01332968) trial. Patients received induction with obinutuzumab (G) or rituximab (R) plus bendamustine, or cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) or cyclophosphamide, vincristine, prednisone (CVP) chemotherapy, followed by maintenance with the same antibody in responders. MRD status was assessed at predefined time points (mid-induction [MI], end of induction [EOI], and at 4-6 monthly intervals during maintenance and follow-up). Patients with evaluable biomarker data at diagnosis were included in the survival analysis. MRD positivity was associated with inferior progression-free survival (PFS) at MI (hazard ratio [HR], 3.03 [95% CI, 2.07 to 4.45]; P < .0001) and EOI (HR, 2.25 [95% CI, 1.53 to 3.32]; P < .0001). MRD response was higher after G- versus R-chemotherapy at MI (94.2% v 88.9%; P = .013) and at EOI (93.1% v 86.7%; P = .0077). Late responders (MI-positive/EOI-negative) had a significantly poorer PFS than early responders (MI-negative/EOI-negative; HR, 3.11 [95% CI, 1.75 to 5.52]; P = .00011). The smallest proportion of MRD positivity was observed in patients receiving bendamustine at MI (4.8% v 16.0% in those receiving CHOP; P < .0001). G appeared to compensate for less effective chemotherapy regimens, with similar MRD response rates observed across the G-chemo groups. During the maintenance period, more patients treated with R than with G were MRD-positive (R-CHOP, 20.7% v G-CHOP, 7.0%; R-CVP, 21.7% v G-CVP, 9.4%). Throughout maintenance, MRD positivity was associated with clinical relapse. MRD status can determine outcome after induction and during maintenance, and MRD negativity is a prerequisite for long-term disease control in FL. The higher MRD responses after G- versus R-based treatment confirm more effective tumor cell clearance.

Isorhamnetin alleviates cisplatin-induced acute kidney injury via enhancing fatty acid oxidation

Cisplatin is an effective chemotherapy drug widely used in the treatment of various solid tumors. However, the clinical usage of cisplatin is limited by its nephrotoxicity. Isorhamnetin, a natural flavanol compound, displays remarkable pharmacological effects, including anti-inflammatory and anti-oxidation. In this study, we aimed to investigate the potential of isorhamnetin in alleviating acute kidney injury induced by cisplatin. In vitro study showed that isorhamnetin significantly suppressed the cytotoxic effects of cisplatin on human tubular epithelial cells. Furthermore, isorhamnetin exerted significantly inhibitory effects on cisplatin-induced apoptosis and inflammatory response. In acute kidney injury mice induced by a single intraperitoneal injection with 20 mg/kg cisplatin, oral administration of isorhamnetin two days before or 2 h after cisplatin injection effectively ameliorated renal function and renal tubule injury. Transcriptomics RNA-seq analysis of the mice kidney tissues suggested that isorhamnetin treatment may protect against cisplatin-induced nephrotoxicity via PGC-1α mediated fatty acid oxidation. Isorhamnetin achieved significant enhancements in the lipid clearance, ATP level, as well as the expression of PGC-1α and its downstream target genes PPARα and CPT1A, which were otherwise impaired by cisplatin. In addition, the protection effects of isorhamnetin against cisplatin-induced nephrotoxicity were abolished by a PGC-1α inhibitor, SR-18292. In conclusion, our findings indicate that isorhamnetin could protect against cisplatin-induced acute kidney injury by inducing PGC-1α-dependent reprogramming of fatty acid oxidation, which highlights the clinical potential of isorhamnetin as a therapeutic approach for the management of cisplatin-induced nephrotoxicity.

10008-CBMS-1 THE NOVEL MDM4 INHIBITOR CEP-1347 ACTIVATES THE P53 PATHWAY AND BLOCKS MALIGNANT MENINGIOMA GROWTH IN VITRO AND IN VIVO

Abstract A significant proportion of meningiomas are clinically aggressive, but there is currently no effective chemotherapy for meningiomas. An increasing number of studies have been conducted to develop targeted therapies, yet none have focused on the p53 pathway as a potential target. In this study, we aimed to determine the in vitro and in vivo effects of CEP-1347, a small-molecule inhibitor of MDM4 with known safety in humans. The effects of CEP-1347 and MDM4 knockdown on the p53 pathway in human meningioma cell lines with and without p53 mutation were examined by RT-PCR and Western blot analyses. The growth inhibitory effects of CEP-1347 was examined in vitro and in a mouse xenograft model of meningioma. In vitro, CEP-1347 at clinically relevant concentrations inhibited MDM4 expression, activated the p53 pathway in malignant meningioma cells with wild-type p53, and exhibited preferential growth inhibitory effects on cells expressing wild-type p53, which was mostly mimicked by MDM4 knockdown. CEP-1347 effectively inhibited the growth of malignant meningioma xenografts at a dose that was far lower than the maximum dose that could be safely given to humans. Our findings suggest targeting the p53 pathway with CEP-1347 represents a novel and viable approach to treating aggressive meningiomas.

Immunogenic chemotherapy: great potential for improving response rates.

The activation of anti-tumor immunity is critical in treating cancers. Recent studies indicate that several chemotherapy agents can stimulate anti-tumor immunity by inducing immunogenic cell death and durably eradicate tumors. This suggests that immunogenic chemotherapy holds great potential for improving response rates. However, chemotherapy in practice has only had limited success in inducing long-term survival or cure of cancers when used either alone or in combination with immunotherapy. We think that this is because the importance of dose, schedule, and tumor model dependence of chemotherapy-activated anti-tumor immunity is under-appreciated. Here, we review immune modulation function of representative chemotherapy agents and propose a model of immunogenic chemotherapy-induced long-lasting responses that rely on synergetic interaction between killing tumor cells and inducing anti-tumor immunity. We comb through several chemotherapy treatment schedules, and identify the needs for chemotherapy dose and schedule optimization and combination therapy with immunotherapy when chemotherapy dosage or immune responsiveness is too low. We further review tumor cell intrinsic factors that affect the optimal chemotherapy dose and schedule. Lastly, we review the biomarkers indicating responsiveness to chemotherapy and/or immunotherapy treatments. A deep understanding of how chemotherapy activates anti-tumor immunity and how to monitor its responsiveness can lead to the development of more effective chemotherapy or chemo-immunotherapy, thereby improving the efficacy of cancer treatment.

Different therapies in pancreatic cancer treatment

Pancreatic cancer is a devastating disease, which is characterized by high mortality, mainly due to advanced diagnosis and limited treatment options. Recent research has made great progress in dealing with this challenge. This has led to progress in all aspects of pancreatic cancer management, including improved screening strategies, the implementation of new assisted therapy, enhanced the results of surgical results, surgical technology, the development of more effective chemotherapy plans, optimization of radiation treatment solutions, and exploration of targeted treatments and targeting a single genetic characteristic. In addition, the continuous survey of immunotherapy may change the treatment method. However, there is still a significant gap in knowledge, especially when identifying reliable biomarkers to detect and prognosis prediction in the early stage, the customization of individual patients treatment plans and the unique microenvironment that overcomes pancreatic tumors. Despite these challenges, the continuous development landscape of pancreatic cancer has brought hope to patients and emphasizes the importance of continuing research work to improve the quality of life of people who are struggling with such powerful diseases.

A ubiquitin-proteasome system-related signature to predict prognosis, immune infiltration, and therapy efficacy for breast cancer.

The ubiquitin-proteasome system (UPS) is an essential regulatory system for maintaining homeostasis, and its dysfunction may cause various diseases. The activity of proteasome and ubiquitin-conjugating enzymes has been found to be greatly increased in breast cancer (BC), indicating that the heterogeneity of UPS may be related to the progression of BC. Gene data was obtained from The Cancer Genome Atlas and Gene Expression Omnibus databases and performed in multiple algorithms to construct a UPS-related signature for BC. Patients in the UPS low-risk group had greater overall and recurrence-free survival probability than those in the UPS high-risk group. This signature was closely associated with functional enrichment. Some high metabolism-related pathways were more active in the UPS high-risk group. The UPS low-risk group had more abundant anti-tumor immune cells, while in the UPS high-risk group, immunosuppressive cells were dominant. More importantly, we found that the UPS low-risk group was more sensitive to immunotherapy, while the UPS high-risk group responded better to radiotherapy. Drug sensitivity analysis identified more effective chemotherapy drugs in different UPS-related risk groups. This UPS-related signature may serve as a novel biomarker and independent prognostic factor for BC. It can effectively predict prognosis, immune infiltration, and therapy efficacy, providing new strategies for individualized treatment.

Cladribine Combined with Homoharringtonine and Cytarabine Achieves a High Remission Rate in Adult Patients with De Novo Acute Myeloid Leukemia, Especially for Adverse-Risk Group: A Prospective, Single Center, Single-Arm, Phase 2 Study

Background: For adult de novo acute myeloid leukemia (AML), the standard 3+7 induction regimen has approximately 60% complete remission (CR) rate. Recently, BCL-2 inhibitor plus intensive chemotherapies as novel induction regimens have shown an above 90% composite complete remission (CRc) rate, however still have limited response effect in an adverse risk group, especially for patients with specific cytogenetic abnormalities such as KMT2A rearrangements, FLT3, RAS, and TP53 mutations. Multiple studies have shown that homoharringtonine (HHT) can target leukemia diseases that have switched their anti-apoptotic dependence from BCL-2 to MCL-1. We recently demonstrated that cladribine (CdA) could eradicate BCL-2 inhibitor-resistant monocytic leukemia stem cells driven by RAS mutants and KMT2A rearrangements. (Pei S, et al. Cancer Discovery. 2023) Together, these clinical and basic findings suggest a rationale for combining CdA with HHT to treat AML patients. In this study, we report the efficacy and safety of a newly designed “CHA” regimen composed of CdA, HHT, and cytarabine (AraC) in adult patients with de novo AML. Methods: This is a prospective, single-center, single-arm phase 2 trial. Newly diagnosed AML patients aged 18-59 years were enrolled. The diagnosis, risk classification, and response evaluation were determined according to ELN 2022 criteria. All enrolled patients received the CHA regimen: CdA (5mg/m2, days 1-3), HHT (2mg/m2, days 1-5), and AraC (100mg/ m2, days 1-7) administered intravenously. The response was evaluated on day 28 via bone marrow routine and minimal residual disease (MRD) measurement by flow cytometry. The primary endpoint was CRc (CR plus CRi). Secondary endpoints were MRD, overall survival (OS), disease-free survival (DFS), event-free survival (EFS), and adverse events. Bone marrow (BM) samples on day 1 and 7 and peripheral blood (PB) samples on days 1-7 were collected for laboratory flow analysis to monitor the kinetics of leukemia reduction. We also treated primary AML specimens with single, dual, and triple combinations of CdA, HHT, and Ara-C to evaluate their anti-leukemic activity in vitro. Statistical analyses were carried out using SPSS 24.0. Survival curves were prepared using the Kaplan-Meier method. A two-tailed P value &amp;lt;0.05 was considered statistically significant. This trial is registered on ClinicalTrials.gov (NCT05906914). Results: A total of 33 patients were enrolled from August 1, 2021, to April 15, 2023. The median age was 49 years. 33% (11/33) of patients were at favorable risk, 42% (14/33) were at intermediate risk, and 24% (8/24) were at adverse risk. After one course of CHA induction therapy, the CRc rate was 87% (27 of 31 patients), and the CR rate was 84% (26 of 31 patients). The CR rates in the favorable, intermediate, and adverse-risk groups were 82% (9 of 11 patients), 75% (9 of 12 patients), and 100% (8 of 8 patients), respectively. Notably, six out of six patients with KMT2A rearrangement and ten out of ten patients with RAS mutations achieved MRD-negative CR. The overall MRD negativity was 89% (24 of 27 patients with CRc). In 31 evaluable patients, four patients did not reach CR; three of them held FLT3 mutations. 30-days treatment-related mortality (TRM) was 6% (2 of 33 patients), and both died of sepsis. The median neutrophil recovery time (from the end of chemotherapy to the neutrophil counts ≥0.5×109/L) and platelets recovery time (from the end of chemotherapy to platelets counts ≥20×109/L) were both 11 days. With a median follow-up time of 13 months (IQR: 6-17 months), the one-year OS was 86%, 1-year DFS was 89%, and the 1-year EFS was 76%. Flow cytometry analysis of serially collected PB and BM samples from nine randomly selected patients revealed that an average of 91.0% and 94.7% of leukemia burden was cleared in the PB and BM by day 7, respectively, demonstrating a rapid and effective response induced by CHA. Finally, our in vitro assay demonstrated a synergistic effect of CdA, HHT, and Ara-C on primary AML specimens including three patients with adverse-risk. Conclusion: We propose the CHA regimen as a novel, effective, and safe chemotherapy regimen for newly diagnosed adult AML patients with remarkable potency in treating adverse-risk group patients, especially those with KMT2A rearrangements and RAS mutations that are otherwise resistant to BCL-2 inhibitor-based therapies, but a limited effect on FLT3mutated AML patients.