Advances in anti-tumor mechanism and clinical application of Astragalus polysaccharides
TMR Cancer. 2020, 3 (2): 44-51.
Astragalus polysaccharide is one of the main components of astragalus. It is a natural extract with a variety of effects and has a specific therapeutic effect on patients with malignant tumors. Astragalus polysaccharides can exert antitumor effects in a variety of ways, such as reducing the side effects of radiation therapy, chemotherapy, immunotherapy and targeted therapy, and also play a synergistic role in combination therapy. Astragalus polysaccharide has shown sound anti-tumor effects, and its mechanism is related to directly inhibiting the growth of tumor cells, promoting apoptosis, inhibiting tumor angiogenesis and enhancing cellular immunity.
Astragalus polysaccharide has the beneficial effect of Qi-deficiency, and it also has several anti-tumor mechanisms, including pharmacological actions and clinical functions. Through literature review, this work concluded anti-tumor mechanism and clinical application of astragalus polysaccharide, which was of considerable significance to expand and optimize its anti-tumor function and clinical application.
Progress in the treatment of gastrointestinal stromal tumors
TMR Cancer. 2020, 3 (2): 52-61.
Gastrointestinal stromal tumor is one of the most common mesenchymal tumors of the digestive tract. Due to too many factors related to gastrointestinal stromal tumors, there is no uniform prognostic standard. From the perspective of molecular biology, the author summarizes the recent advances in the diagnosis and treatment of gastrointestinal stromal tumors. To provide normative ideas for clinical treatment of gastrointestinal stromal tumors.
Gastrointestinal stromal tumor (GIST) is a type of tumor that originates from the mesenchymal tissue of the digestive tract and accounts for most interstitial tumors of the gastrointestinal tract. Present studies demonstrate that GIST is mainly driven by a mutated c-KIT or platelet-derived growth factor receptor alpha gene. Histologically, GIST is usually composed of spindle cells, epithelioid cells, or pleomorphic cells in a bundle or diffuse pattern. GIST cells are generally immunohistochemically positive for CD34, CD117, or DOG-1 expression. GIST is similar to interstitial cells of Cajal around the myenteric plexus of the gastrointestinal tract, and both have a positive c-KIT gene, CD117, and CD34 expression. At present, gastroscopy, colonoscopy, computed tomography, nuclear magnetic resonance and other means are the primary means to diagnosis GIST. At the same time, for unidentified GIST, biopsy is also a necessary means of examination. However, for the treatment of gastrointestinal stromal tumors, oral Gleevec and surgery are present primary treatment methods, which is still limited. However, not all patients are suitable for Gleevec. For some gene mutated sites, Gleevec treatment is ineffective. With the increase of cases of gastrointestinal stromal tumors, targeted therapies for GISTs with different gene loci mutations are urgently needed.
Hyperthermic intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: a meta-analysis
TMR Cancer. 2020, 3 (2): 62-73.
Gastric cancer accounts for the fourth-highest incidence of tumors worldwide and the second-highest mortality rate. And gastric cancer is highly heterogeneous, and the disease progresses rapidly. Most patients with gastric cancer are diagnosed as advanced at the time of initial diagnosis. Peritoneal hyperthermia chemotherapy (HIPEC) is a new technique that combines intraperitoneal chemotherapy with hyperthermia and peritoneal lavage. HIPEC combined with cytoreductive surgery (CRS) has unique advantages in the treatment of abdominal cancer and malignant ascites. The prognosis of gastric cancer peritoneal carcinomatosis (GCPC) remains poor despite recent advances in systemic chemotherapy. Current evidence supporting the treatment of HIPEC for GCPC is limited. The authors performed a meta-analysis of the efficacy and safety of HIPEC in GCPC treatment.
Objective: To evaluate the efficacy and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of gastric cancer with peritoneal carcinomatosis. Methods: The relevant clinical controlled studies were retrieved from the databases of PubMed, Cochrane Library, Embase. Risk ratio (RR), as well as the respective 95% confidence interval (CI), was used as a statistical indicator. 1-year survival, 2-year survival, and safety were analyzed. Results: Two randomized controlled trials (RCTs) and 10 high-quality non-randomized controlled trials (NRCTs) were included, enrolling 837 patients (438 in the HIPEC group and 415 in the control group). Compared with the control group, HIPEC group turned out to be of greater improvement in long-term efficacy: 1-year survival rate (1y-os) and 2-year survival rate (2y-os). Subgroup analysis of different treatment modes in NRCTs showed that, in terms of 1-year survival rate, (1) HIPEC combined with cytoreductive surgery (CRS) compared with CRS alone, RR = 0.68, 95% CI: (0.53, 0.85); (2) HIPEC combined with intravenous chemotherapy ± CRS versus chemotherapy alone, RR = 0.54, 95% CI: (0.39, 0.74); (3) HIPEC combined with palliative gastrectomy versus palliative gastrectomy, RR = 0.37, 95% CI: (0.22, 0.63). As for safety,there were no significant differences in adverse events between two groups. Conclusion: HIPEC can prolong the survival of gastric cancer patients with peritoneal carcinomatosis, and the incidences of adverse events were not increased.
Advances in biological immunotherapy for gastric cancer: a mini-review
TMR Cancer. 2020, 3 (2): 74-83.
Gastric cancer is a malignant tumor that originates in the gastric mucosa. Due to various factors, the treatment effect of gastric cancer patients is not ideal and appears younger. Gastric cancer immunotherapy refers to the use of biotechnology to mobilize immune functions so that people have natural anti-cancer capabilities. This article summarizes the research progress of biological immunotherapy for gastric cancer.
Gastric cancer immunotherapy refers to the use of biological technology to mobilize the immune function so that the body has a natural anti-cancer ability. It can be induced in vitro by collecting immune cells and cancer cells from patients with gastric cancer to form specific immune cell groups. Besides, a large number of these immune cell groups are cultured, separated, and then reinfused into patients, to achieve high efficiency, eliminate tumors and mobilize immune mechanisms in patients. In theory, this method can cure tumors because the principle of immunotherapy is to stimulate the body's autoimmune response. However, for some special populations, there may be more severe side effects. At present, the prediction, prevention, and treatment of this severe side effect are not complete. The immunotherapy of gastric cancer has not yet reached the full promotion, but it is a good treatment direction. It can be used clinically with chemotherapy and radiotherapy, surgery and traditional Chinese medicine cooperate, thereby achieving significant curative effects, and even curing gastric cancer.
Advances in targeted therapies for gastric cancer: a mini-review
TMR Cancer. 2020, 3 (2): 84-93.
Gastric cancer is a common gastrointestinal malignant tumor, accounting for the fourth place in the global incidence of malignant tumors, and the third place in cancer mortality. Although chemotherapy is the main treatment for patients with advanced gastric cancer, adverse reactions are more prominent. With the deepening of scientific research, there are more and more targeted therapies for gastric cancer. The author introduces the relevant targets and targeted drugs for targeted treatment of advanced gastric cancer, hoping to provide a reference for clinically targeted treatment of advanced gastric cancer.
The incidence of gastric cancer ranks 4th in malignant tumors, and the mortality rate ranks 3rd in malignant tumors. Most patients with gastric cancer are already at the advanced stage when diagnosed. Although chemotherapy is the main treatment for patients with advanced gastric cancer, it can extend the overall survival. But adverse reactions are more prominent. With the rise of targeted therapy, the molecular mechanism of gastric cancer occurrence and development continues to develop, and molecular targeted therapy of gastric cancer has gradually emerged. The current targets for gastric cancer mainly include endothelial growth factor receptor, HER2, vascular endothelium growth factor, vascular endothelium growth factor receptor, mammalian rapamycin receptor, hepatocellular growth factor, et al., but the clinical efficacy is still not satisfactory. At present, most of the studies on molecular targeted drugs for gastric cancer have ended in failure. The heterogeneity between patients and the prognosis of tumors in different parts may be different. It is suggested that screening targeted drugs according to the patient's pathological characteristics and molecular typing, and individualized treatment is the inevitable way of targeted treatment of gastric cancer.