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Article: Editorial: Unveiling the Impact of Local or Systemic Therapeutic Strategies on the Tumor Microenvironment.

Chen, Yun-Wang / Jiang, Jia-Hong / Chen, Zhe-Ling / Yang, Liu

2022 Volume 11, Page(s) 832036

Language	English
Publishing date	2022-01-25
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2021.832036
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Article: Third-line treatment options in metastatic pancreatic cancer patients: a real-world study.

Lu, Hong-Rui / Zhu, Peng-Fei / Deng, Ya-Ya / Chen, Zhe-Ling / Yang, Liu

Frontiers in oncology

2023 Volume 13, Page(s) 1251258

Abstract: Background: There are currently no standard therapy regimens for the third-line treatment of metastatic pancreatic cancer (mPC) patients. The aim of the present study was to compare the efficacy and safety of different third-line therapy regimens for ... ...

Abstract	Background: There are currently no standard therapy regimens for the third-line treatment of metastatic pancreatic cancer (mPC) patients. The aim of the present study was to compare the efficacy and safety of different third-line therapy regimens for mPC in the real-world. Methods: This study retrospectively analyzed mPC patients admitted to Zhejiang Provincial People's Hospital between June 2013 and January 2023. All patients' diagnoses were pathologically confirmed and their treatment was continued after the second-line therapy failed. The primary study endpoints included median overall survival (mOS), median progression-free survival (mPFS), and disease control rate (DCR). Results: A total of 72 patients were enrolled in the study. Of these, 36 patients received chemotherapy alone, 16 received chemotherapy combined with targeted therapy or immunotherapy, 14 received chemotherapy-free antitumor therapy, and six received palliative care. The mPFS value for these groups was 4.40 months, 5.20 months, 2.33 months, and 0.80 months, respectively. The mOS value was 6.90 months, 5.90 months, 3.33 months, and 0.80 months, respectively. The DCR was 33.4%, 31.3%, 21.4%, and 0.0%, respectively. Overall, there were significant differences in prognosis between the palliative care group and the other treatment groups (mOS, Conclusions: Third-line antitumor therapy can prolong the survival time of patients with mPC. Targeted therapy or immunotherapy failed to further improve survival benefits based on chemotherapy results. Patients who underwent the third-line treatment with good physical status and family history of cancer were independent prognostic factors for longer mOS. The sequencing of fluorouracil and gemcitabine in the front-line therapy did not affect third-line mOS.
Language	English
Publishing date	2023-09-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1251258
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Article ; Online: Predictive value of NLR and PLR for immune-related adverse events: a systematic review and meta-analysis.

Lu, Hong-Rui / Zhu, Peng-Fei / Deng, Ya-Ya / Chen, Zhe-Ling / Yang, Liu

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico

2023 Volume 26, Issue 5, Page(s) 1106–1116

Abstract: Background: Currently, there is a lack of affordable and accessible indicators that can accurately predict immune-related adverse events (irAEs) resulting from the use of immune checkpoint inhibitors (ICIs). In order to address this knowledge gap, our ... ...

Abstract	Background: Currently, there is a lack of affordable and accessible indicators that can accurately predict immune-related adverse events (irAEs) resulting from the use of immune checkpoint inhibitors (ICIs). In order to address this knowledge gap, our study explore the potential predictive value of two ratios, namely the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), for irAEs in cancer patients. Methods: A systematic search was performed in PubMed, Embase, and the Cochrane library. Studies involving NLR or PLR with irAEs were included. Quality and risk of bias of the selected studies were assessed. Forest plots were created based on Cox model analysis. Random effects meta-analyses were conducted to estimate odds ratio (OR) and its 95% confidence interval (CI). Results: After screening 594 studies, a total of 7 eligible studies with 1068 cancer patients were included. Analysis based on Cox regression showed that low neutrophil-lymphocyte ratio (L-NLR) (OR = 3.02, 95% CI 1.51 to 6.05, P = 0.002) and low platelet-lymphocyte ratio (L-PLR) (OR = 1.83, 95% CI 1.21 to 2.76, P = 0.004) were associated with irAEs. In the subgroup analysis of cut-off value, when the NLR cut-off value was 3, irAEs was significantly correlated with NLR (OR = 2.63, 95% CI 1.63 to 4.26, P < 0.001). Conclusions: Both L-NLR and L-PLR have been found to be significantly associated with irAEs. Consequently, patients identified as being at a higher risk for irAEs should be subjected to more diligent monitoring and close observation.
MeSH term(s)	Humans ; Neutrophils ; Lymphocytes ; Blood Platelets ; Neoplasms/drug therapy ; Proportional Hazards Models ; Retrospective Studies
Language	English
Publishing date	2023-09-08
Publishing country	Italy
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2397359-6
ISSN	1699-3055 ; 1699-048X
ISSN (online)	1699-3055
ISSN	1699-048X
DOI	10.1007/s12094-023-03313-3
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Article: Targeting the Tumor Microenvironment: A Literature Review of the Novel Anti-Tumor Mechanism of Statins.

Zhu, Peng-Fei / Wang, Ming-Xing / Chen, Zhe-Ling / Yang, Liu

Frontiers in oncology

2021 Volume 11, Page(s) 761107

Abstract: Statins is widely used in clinical practice as lipid-lowering drugs and has been proven to be effective in the treatment of cardiovascular, endocrine, metabolic syndrome and other diseases. The latest preclinical evidence shows that statins have anti- ... ...

Abstract	Statins is widely used in clinical practice as lipid-lowering drugs and has been proven to be effective in the treatment of cardiovascular, endocrine, metabolic syndrome and other diseases. The latest preclinical evidence shows that statins have anti-proliferation, pro-apoptotic, anti-invasion and radiotherapy sensitization effects on tumor cells, suggesting that statins may become a new type of anti-tumor drugs. For a long time, mevalonate pathway has been proved to play a supporting role in the development of tumor cells. As an effective inhibitor of mevalonate pathway, statins have been proved to have a direct auxiliary anti-tumor effect in a large number of studies. In addition, anti-tumor effects of statins through ferroptosis, pyroptosis, autophagy and tumor microenvironment (TME) have also been gradually discovered. However, the specific mechanism of the antitumor effect of statins in the tumor microenvironment has not been clearly elucidated. Herein, we reviewed the antitumor effects of statins in tumor microenvironment, focusing on hypoxia microenvironment, immune microenvironment, metabolic microenvironment, acid microenvironment and mechanical microenvironment.
Language	English
Publishing date	2021-11-11
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2021.761107
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Article: Comparison of the efficacy and safety of fruquintinib and regorafenib in the treatment of metastatic colorectal cancer: A real-world study.

Deng, Ya-Ya / Zhang, Xin-Yue / Zhu, Peng-Fei / Lu, Hong-Rui / Liu, Qian / Pan, Shuang-Yue / Chen, Zhe-Ling / Yang, Liu

Frontiers in oncology

2023 Volume 13, Page(s) 1097911

Abstract: Background: Fruquintinib and regorafenib have been approved for the third-line therapy of metastatic colorectal cancer (mCRC) in China. However, at present, there is a lack of head-to-head clinical trials on the comparison of efficacy and safety between ...

Abstract	Background: Fruquintinib and regorafenib have been approved for the third-line therapy of metastatic colorectal cancer (mCRC) in China. However, at present, there is a lack of head-to-head clinical trials on the comparison of efficacy and safety between the two drugs. Materials and methods: The data of patients with mCRC who were treated with fruquintinib or regorafenib after the standard chemotherapy in Zhejiang Provincial People's Hospital from October 2018 to November 2021 were collected and analyzed. The primary endpoints were overall survival (OS), progression-free survival (PFS) and adverse events. The secondary endpoints were the appropriate sequence, objective remission rate (ORR) and disease control rate (DCR) of fruquintinib and regorafenib. Results: A total of 105 patients were enrolled in this study. The ORR of fruquintinib group (n=55) and regorafenib group (n=50) were 6.1% and 2.0%; the DCR were 65.3% and 54.2%, respectively. There was no significant difference in median OS (mOS) and PFS (mPFS) between the two groups (mOS:14.2 vs12.0 months, p=0.057; mPFS:4.4 vs 3.5 months, p=0.150). Combined immunotherapy showed a synergistic effect. The mPFS and mOS of fruquintinib combined with anti-PD-1 therapy were longer than those of fruquintinib monotherapy (mPFS:5.9 vs 3.0 months, p=0.009; mOS:17.5 vs 11.3 months, p=0.008). The mOS of patients treated with regorafenib combined with anti-PD-1 therapy was 14.8 months higher than that of regorafenib monotherapy (p=0.045). When combined with anti-PD-1 therapy, the mPFS and mOS of fruquintinib was significantly longer than regorafenib (mPFS:5.9 vs 3.8 months, p=0.018; mOS:17.5 vs 14.8 months, p=0.044). In the treatment sequence, the OS of patients treated with regorafenib and then fruquintinib was significantly longer than that of the reverse treatment sequence (15.0 vs 8.3 months, p=0.019). The adverse reactions were generally similar, but the incidence of hand-foot syndrome of regorafenib was higher than that of fruquintinib, while fruquintinib was more prone to grade 3 hypertension. Conclusion: Fruquintinib monotherapy showed better disease control rate and objective remission rate in the post-line therapy of metastasis colorectal cancer. Notably, the combination of PD-1 immunotherapy brought the additional effect, especially in the fruquintinib combined with anti-PD-1 therapy. Patients treated with regorafenib and then fruquintinib was significantly longer than that of the reverse treatment sequence. The toxicity of fruquintinib and regorafenib are similar.
Language	English
Publishing date	2023-03-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1097911
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Article ; Online: Acute aortic dissection caused by fruquintinib for metastatic colorectal cancer-a case report and literature review.

Deng, Ya-Ya / Chen, Yun-Wang / Wang, Ming-Xing / Zhu, Peng-Fei / Pan, Shuan-Yue / Jiang, Ding-Yi / Chen, Zhe-Ling / Yang, Liu

Translational cancer research

2023 Volume 12, Issue 1, Page(s) 177–185

Abstract: Background: Fruquintinib is a highly selective tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor (VEGFR). At present, it has been approved for third-line therapy for advanced metastatic colorectal cancer in China. Like ... ...

Abstract	Background: Fruquintinib is a highly selective tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor (VEGFR). At present, it has been approved for third-line therapy for advanced metastatic colorectal cancer in China. Like other small-molecule tyrosine kinase inhibitors, adverse reactions such as hand-foot syndrome, hypertension and cardiotoxicity may be seen. However, acute aortic dissection caused by fruquintinib has not been reported so far. Case description: Here, we report a case of aortic dissection. The patient, a 61-year-old man with advanced metastatic colorectal cancer, without history of hypertension or other risk factors for aortic dissection, received fruquintinib as the third line of treatment. Six weeks after oral fruquintinib treatment, the patient developed acute aortic dissection, and the occurrence of the adverse effect was determined to be probably related to the use of fruquintinib. This article focuses on the potential pathogenesis of fruquintinib-induced active dissection. Conclusions: We reported the first case of fruquintinib-associated aortic dissection, and discussed the possible mechanism of vascular endothelial growth factor (VEGF)-VEGFR signal pathway (VSP) inhibitors leading to aortic dissection. As a new drug, fruquintinib brings not only clinical benefits, but also brings some adverse reactions. Clinicians must be vigilant to the cardiovascular toxicity caused by small molecular tyrosine kinase inhibitors, especially the severe cardiovascular toxicity, and strengthen monitoring and management.
Language	English
Publishing date	2023-01-16
Publishing country	China
Document type	Case Reports
ZDB-ID	2901601-0
ISSN	2219-6803 ; 2218-676X
ISSN (online)	2219-6803
ISSN	2218-676X
DOI	10.21037/tcr-22-1872
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Article ; Online: Apatinib combined with SOX regimen for conversion therapy in advanced gastric cancer patients: a retrospective cohort study.

Deng, Ya-Ya / Jiang, Ding-Yi / Zhu, Peng-Fei / Lu, Hongrui / Liu, Qian / Zhang, Xinyue / Pan, Shuang-Yue / Chen, Zhe-Ling / Yang, Liu

World journal of surgical oncology

2023 Volume 21, Issue 1, Page(s) 129

Abstract: Background: Recently, many studies have shown that the progress of conversion therapy can provide surgical opportunities for patients with advanced gastric cancer (GC) and bring survival benefits. However, the results of the current study show that the ... ...

Abstract	Background: Recently, many studies have shown that the progress of conversion therapy can provide surgical opportunities for patients with advanced gastric cancer (GC) and bring survival benefits. However, the results of the current study show that the regimen used in conversion therapy is still controversial. Apatinib, as the standard third-line treatment for GC, has an inconclusive status in conversion therapy. Methods: This study retrospectively analyzed GC patients admitted to Zhejiang Provincial People's Hospital from June 2016 to November 2019. All patients were pathologically diagnosed, had unresectable factors, and received SOX regimen with or without apatinib as conversion therapy. Results: A total of 50 patients were enrolled in the study. Altogether 33 patients (66%) received conversion surgery and 17 patients (34%) received conversion therapy without surgery. The median progression-free survival (PFS) between surgery group and non-surgery group were 21.0 versus 4.0 months (p < 0.0001), and the median overall survival (OS) were 29.0 versus 14.0 months (p < 0.0001). In conversion surgery group, 16 patients (16/33) were treated with SOX plus apatinib, and the R0 resection rate was 81.3%; 17 patients (17/33) were treated with SOX regimen along, and the R0 resection rate was 41.2% (p = 0.032). The PFS in the SOX combined with apatinib group was significantly longer than that of SOX group (25.5 versus 16 months, p = 0.045), and the median OS were 34.0 versus 23.0 months (p = 0.048). The addition of apatinib did not increase the incidence of serious adverse reactions throughout the preoperative therapy period. Conclusions: Patients with advanced inoperable gastric cancer could benefit probably from conversion chemotherapy and subsequence conversion surgery. Apatinib-targeted therapy combined with SOX chemotherapy may be a safe and feasible option for conversion therapy.
MeSH term(s)	Humans ; Antineoplastic Agents/therapeutic use ; Retrospective Studies ; Stomach Neoplasms/surgery ; Pyridines/adverse effects
Chemical Substances	Antineoplastic Agents ; apatinib (5S371K6132) ; Pyridines
Language	English
Publishing date	2023-04-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2118383-1
ISSN	1477-7819 ; 1477-7819
ISSN (online)	1477-7819
ISSN	1477-7819
DOI	10.1186/s12957-023-02973-3
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Article ; Online: Refractory hypokalemia caused by cetuximab with advanced colorectal cancer patients: the case series and literature review.

Chen, Yun-Wang / Yang, Min / Wang, Ming-Xing / Jiang, Jia-Hong / Jiang, Ding-Yi / Chen, Zhe-Ling / Yang, Liu

Anti-cancer drugs

2021 Volume 33, Issue 1, Page(s) e789–e794

Abstract: Cetuximab is the first-line treatment for advanced metastatic colon cancer. But cetuximab can cause electrolyte disturbances, including hypomagnesemia and hypokalemia. Among them, hypokalemia is often caused by hypomagnesemia, not directly caused by ... ...

Abstract	Cetuximab is the first-line treatment for advanced metastatic colon cancer. But cetuximab can cause electrolyte disturbances, including hypomagnesemia and hypokalemia. Among them, hypokalemia is often caused by hypomagnesemia, not directly caused by cetuximab. This article reports two cases of refractory hypokalemia caused by cetuximab without hypomagnesemia. The two patients had no abnormalities in serum potassium before cetuximab treatment. The occurrence of hypokalemia was clearly correlated with the cetuximab, and they were significantly improved after stopping or reducing the dose. At the same time, the appearance of hypokalemia is significantly related to the efficacy of cetuximab. They have received 37 and 35 cycles of cetuximab-related therapy, with condition stable periods of 12.8 and 15.1 months, respectively. Obviously, our report refutes the above view. In our opinion, hypokalemia, a side effect of cetuximab, may be directly caused by it, rather than secondary to hypomagnesemia. Similar to hypomagnesemia, the appearance of hypokalemia often indicates a better curative effect of cetuximab.
MeSH term(s)	Adult ; Antineoplastic Agents, Immunological/adverse effects ; Antineoplastic Agents, Immunological/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Cetuximab/adverse effects ; Cetuximab/therapeutic use ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/pathology ; Humans ; Hypokalemia/chemically induced ; Middle Aged ; Neoplasm Staging
Chemical Substances	Antineoplastic Agents, Immunological ; Cetuximab (PQX0D8J21J)
Language	English
Publishing date	2021-08-19
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1065301-6
ISSN	1473-5741 ; 0959-4973
ISSN (online)	1473-5741
ISSN	0959-4973
DOI	10.1097/CAD.0000000000001212
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Article ; Online: Tumor-mutation burden as a marker for immunotherapy of pancreatic cancer: the case report and literature review.

Zhu, Peng-Fei / Chen, Yun-Wang / Wang, Ming-Xing / Deng, Ya-Ya / Pan, Shuang-Yue / Chen, Zhe-Ling / Yang, Liu

Anti-cancer drugs

2021 Volume 33, Issue 1, Page(s) e822–e827

Abstract: Pancreatic cancer is digestive cancer with limited therapeutic options and a poor outcome. Pancreatic cancer has a high mortality rate, with a 5-year survival rate of less than 5%. The median survival after metastasis of the disease is less than 6 months. ...

Abstract	Pancreatic cancer is digestive cancer with limited therapeutic options and a poor outcome. Pancreatic cancer has a high mortality rate, with a 5-year survival rate of less than 5%. The median survival after metastasis of the disease is less than 6 months. Studies have revealed that the standard treatment, including palliative chemotherapy or immunotherapy, is not significantly effective for pancreatic cancer. Herein, we report a case of pancreatic cancer who benefited from a combination of anti-PD-1 immunotherapy and chemotherapy.
MeSH term(s)	Antineoplastic Agents/therapeutic use ; Antineoplastic Agents, Immunological ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Biomarkers, Tumor ; Fluorouracil ; Humans ; Immune Checkpoint Inhibitors/administration & dosage ; Immune Checkpoint Inhibitors/adverse effects ; Immune Checkpoint Inhibitors/therapeutic use ; Irinotecan ; Leucovorin ; Male ; Middle Aged ; Oxaliplatin ; Pancreatic Neoplasms/drug therapy ; Pancreatic Neoplasms/surgery
Chemical Substances	Antineoplastic Agents ; Antineoplastic Agents, Immunological ; Biomarkers, Tumor ; Immune Checkpoint Inhibitors ; folfirinox ; Oxaliplatin (04ZR38536J) ; Irinotecan (7673326042) ; Leucovorin (Q573I9DVLP) ; Fluorouracil (U3P01618RT)
Language	English
Publishing date	2021-08-12
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1065301-6
ISSN	1473-5741 ; 0959-4973
ISSN (online)	1473-5741
ISSN	0959-4973
DOI	10.1097/CAD.0000000000001232
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Article: Clinical use of trastuzumab combined with different chemotherapy regimens in multi-line treatment of advanced human epidermal growth factor receptor 2-positive gastric cancer: A case report.

Chen, Zhe-Ling / Zhao, Andi / Li, Pan / Zhang, Mi / Yang, Jiao / Zhang, Lingxiao / Zhao, Xiaoai / Yang, Jin / Wang, Le

Oncology letters

2018 Volume 16, Issue 4, Page(s) 4614–4620

Abstract: It is generally acknowledged that gastric cancer requires comprehensive treatment approaches to be adopted. For patients with human epidermal growth factor receptor-2 (HER2)-overexpressing gastric cancer, targeting HER2 with trastuzumab in first-line ... ...

Abstract	It is generally acknowledged that gastric cancer requires comprehensive treatment approaches to be adopted. For patients with human epidermal growth factor receptor-2 (HER2)-overexpressing gastric cancer, targeting HER2 with trastuzumab in first-line therapy combined with standard chemotherapy significantly improves the prognosis. However, there is a lack of international guidance for second-line treatment if a patient experiences disease progression. There is also no accepted conclusion regarding the efficiency of cross-line therapy with trastuzumab. The present study reports the case of a 55-year-old male with gastric cancer who underwent radical gastrectomy. Immunohistochemistry indicated that samples were EGFR(+) and HER-2(3+), with Ki-67 (20%). From abdominal computed tomography scanning and contrast-enhanced ultrasound following surgery, hepatic metastasis was identified and the patient was administered microwave thermocoagulation therapy. Since December 2012, the patient received multi-line chemotherapy regimens as follows: i) Oxaliplatin, tegafur/gimeracil/oteracil and trastuzumab; ii) paclitaxel liposome and S-1 plus trastuzumab; iii) apatinib; iv) epirubicin/oxaliplatin/xeloda; and v) irinotecan plus trastuzumab. During the course of therapy, the trastuzumab served an important function in multi-line therapy and the patient benefited from the combined therapy. The application of trastuzumab in the multi-line treatment of a patient with HER2-positive advanced gastric cancer may be worthy of investigation for use in the clinic.
Language	English
Publishing date	2018-07-25
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2573196-8
ISSN	1792-1082 ; 1792-1074
ISSN (online)	1792-1082
ISSN	1792-1074
DOI	10.3892/ol.2018.9212
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