Frontiers in oncology
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Frontiers in oncology · Jan 2019
The Predictive Value of Tumor Mutation Burden on Efficacy of Immune Checkpoint Inhibitors in Cancers: A Systematic Review and Meta-Analysis.
Background: Despite an increasing understanding about tumor mutation burden (TMB) in cancer immunity and cancer immunotherapy, the comprehensive cognition between TMB and efficiency of immune checkpoint inhibitors (ICIs) is still lacking. A systematic review and meta-analysis was conducted to evaluate the predictive value of TMB on efficacy of ICIs. Methods: Systematic literature search was conducted on PubMed, EMBASE, Web of Science and Cochrane Library up to June 16, 2019. ⋯ Furthermore, TMB and PD-L1 expression were capable to predict improved ORR of ICIs after stratification of each other, with tiny heterogeneity. Conclusions: High tumor mutation burden predicted improved efficacy of immune checkpoint inhibitors in cancers, and targeted next generation sequencing for estimating tumor mutation burden in clinic should be standardized to eliminate heterogeneity in the future. Moreover, tumor mutation burden and programmed cell death ligand 1 expression were independent factors on predicting efficacy of immune checkpoint inhibitors.
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Frontiers in oncology · Jan 2019
Diagnostic Accuracy of Multi-Parametric Magnetic Resonance Imaging for Tumor Staging of Bladder Cancer: Meta-Analysis.
Purpose: Evaluate the diagnostic accuracy of multi-parametric magnetic resonance imaging (mp-MRI) for local staging of bladder cancer (BCa). Materials and Methods: The databases of PubMed, Web of Science, Wanfang, and CNKI were searched for related literatures about BCa diagnosed by mp-MRI from January 1, 2000 to April 12, 2019. The strict inclusion and exclusion criteria were set up to extract records. ⋯ The Begg's test (p = 0.497) and the egger's test (p = 0.337) found no publication bias. Conclusion: mp-MRI acts a good diagnostic performance for bladder cancer. It is plausible that mpMRIs can be used as an important method for bladder cancer staging.
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Frontiers in oncology · Jan 2019
ReviewUnderstanding the Mechanisms of Resistance to CAR T-Cell Therapy in Malignancies.
Taking advantage of the immune system to exert an antitumor effect is currently a novel approach in cancer therapy. Adoptive transfer of T cells engineered to express chimeric antigen receptors (CARs) targeting a desired antigen has shown extraordinary antitumor activity, especially in refractory and relapsed B-cell malignancies. ⋯ However, with the widespread use of CAR T-cell therapy, problems of resistance and relapse are starting to be considered. This review provides a comprehensive picture of the mechanisms of resistance to CAR T-cell therapy from three aspects, namely, CAR T-cell factors, tumor factors, and tumor microenvironment factors, offering insights for improving CAR T-cell therapy.
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Frontiers in oncology · Jan 2019
The Role of 5-ALA in Low-Grade Gliomas and the Influence of Antiepileptic Drugs on Intraoperative Fluorescence.
Objectives: Intraoperative tumor visualization with 5-aminolevulinic acid (5-ALA) induced protoporphyrin IX (PpIX) fluorescence is widely applied for improved resection of high-grade gliomas. However, visible fluorescence is present only in a minority of low-grade gliomas (LGGs) according to current literature. Nowadays, antiepileptic drugs (AEDs) are frequently administered to LGG patients prior to surgery. ⋯ Thus, visible fluorescence was significantly more common in patients without AEDs compared to patients with preoperative AED intake (OR = 0,15 (CI 95% 0.012-1.07), p = 0.046). Conclusions: Our study shows a markedly higher rate of visible fluorescence in a series of LGGs compared to current literature. According to our preliminary data, preoperative intake of AEDs seems to reduce the presence of visible fluorescence in such tumors and should thus be taken into account in the clinical setting.
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Frontiers in oncology · Jan 2019
Evaluation of Lymph Node Metastasis in Advanced Gastric Cancer Using Magnetic Resonance Imaging-Based Radiomics.
Objective: To develop and evaluate a diffusion-weighted imaging (DWI)-based radiomic nomogram for lymph node metastasis (LNM) prediction in advanced gastric cancer (AGC) patients. Overall Study: This retrospective study was conducted with 146 consecutively included pathologically confirmed AGC patients from two centers. All patients underwent preoperative 3.0 T magnetic resonance imaging (MRI) examination. ⋯ Meanwhile, the specificity, sensitivity, and accuracy were 0.846, 0.853, and 0.851 in internal validation cohort, and 0.714, 0.952, and 0.893 in external validation cohort, compensating for the MRI-reported N staging and MRI-derived model. DCA demonstrated good clinical use of radiomic nomogram. Conclusions: This study put forward a DWI-based radiomic nomogram incorporating the radiomic signature, minimum ADC, and MRI-reported N staging for individualized preoperative detection of LNM in patients with AGC.