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Objective To investigate the efficacy and safety of lenvatinib in patients with unresectable hepatocellular carcinoma (HCC) previously treated with tyrosine kinase inhibitor (TKI). Methods A retrospective analysis was performed for the clinical data of 76 patients with unresectable HCC who were treated with lenvatinib in Beijing Ditan Hospital, Capital Medical University, from January 2019 to January 2020, and according to the treatment method, they were divided into TKI previously untreated group with 49 patients and TKI treatment-experienced group with 27 patients. The patients were observed till one year after enrollment, adjustment of treatment regimen, tumor progression, or death. The two groups were compared in terms of progression-free survival (PFS) time, objective response rate (ORR), disease control rate (DCR), and incidence rate of adverse events. The t -test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups, and the chi-square test or the Wilcoxon rank-sum test was used for comparison of categorical data between two groups; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison between groups. Results There were no significant differences between the TKI previously untreated group and the TKI treatment-experienced group in median PFS time (115 days vs 72 days, P =0.148), ORR (36.7% vs 18.5%, P =0.098), DCR (65.3% vs 55.6%, P =0.402), and incidence rates of grade ≥3 adverse events (24.5% vs 18.5%, P =0.550). Conclusion Patients with unresectable HCC previously treated with TKI can benefit from lenvatinib and have good safety, with similar results to those treated with TKI for the first time.
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There are still high incidence and mortality rates of hepatocellular carcinoma at present, and systemic treatment plays an important role in the treatment of advanced hepatocellular carcinoma. This article describes the application of molecular-targeted drugs and immune checkpoint inhibitors in hepatocellular carcinoma and points out that dual-targeted therapy, dual immunotherapy, and targeted therapy combined with immunotherapy are the current research hotspots in the treatment of hepatocellular carcinoma.
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Objective To investigate the sensitivity of dihydroartemisinin against different developmental stages of Schistosoma japonicum, so as to understand the effect of dihydroarteminisin against on S. japonicum. Methods Mice were infected with 40 S. japonicum cercariae on the abdomen. Dihydroartemisinin was given intragastrically at different developmental stages of S. japonicum , and the mice were sacrificed 50 days post-infection, the adult worms were collected, and the worm reduction rates and female worm reduction rates were calculated. ① On the 2nd h, 3rd, 5th, 7th, 10th, 14th, 18th, 21st, 28th, 35th day post-infection, the mice were administered intragastrically with dihydroartemisinin at a single dose of 300 mg/kg, and the effect of dihydroarteminisin on different developmental stages of S. japonicum were observed. ② The mice were administered with different doses of dihydroartemisinin on the 7th or 35th day post-infection, and the dose-effect was explored. ③ The mice were administered on the 7th day post-infection and re-administered on the 35th day post-infection, respectively with different doses of dihydroartemisinin, and the effect was evaluated. Results The dihydroartemisinin at a single dose of 300 mg/kg had obvious effect on 7-day schistosomula and 35-day adult worms, with 64.81% and 60.47% of worm reduction rates and 73. 81% and 90.48% of female worm reduction rates, respectively. When the mice on the 7th day post-infection were administered with 200, 300, 400 and 600 mg/kg dihydroartemisinin, the worm reduction rates were 46.84% , 60.63% , 59.55% and 60. 21% , respectively, and the female reduction rates were 59.73% , 72.29% , 72.58% and 76.61 % , respectively. While in the mice on the 35th day post-infection, the corresponding rates were 47. 23% , 62.33% , 76.31% and 83.63% , respectively, and 59. 73% , 89. 36% , 89.65% and 93.96% , respectively. When the mice were treated twice with dihydroartemisinin on the 7th day and 35th day post-infection, the worm reduction rates were 58. 16% , 82.66% ,83.42% and 83.79% , respectively, and the female worm reduction rates were 68.69% , 90.43% , 93.74% and 94.63% , respectively. Conclusions Dihydroartemisinin has effect against S. japonicum, and the 7-day schistosomulum and 35-day adult worm are sensitive to the drug.
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Objective To research the homology of 18S small subunit ribosomal RNA(18S-rRNA) gene about Chinese Mainland and Philippine strains of Schistosoma japonicum,and Schistosoma mansoni,and the possibility to establish the PCR assay based on the gene for detecting the cercaria in a low density level. Methods The genomic DNAs of Chinese Mainland and Philippine strains of S.japonicum,and S.mansoni were extracted. The PCR assay was used to detect the identical target DNA elements in the above genome team and the homology of their genes was compared. The single cercaria was respectively treated with the method of heating in boiling water,the method of treating with ammonia and the method of treating with NaOH,HCl and ethanol,and the single treated cercaria and the single cercaria without treating were used as the templates to amplify the target DNA by using the PCR assay,and the detection rates of the PCR assay to detect the single cercaria treated with the different methods were calculated and compared. Results With the genomic DNAs of Chinese Mainland and Philippine strains of S.japonicum and S.mansoni as the templates,the target DNA element of which sequence length was 469 bp was all amplified by PCR. The target DNA was all amplified by PCR to the single cercaria treated with ammonia and the method of treating with NaOH,HCl and ethanol. However,only 50 percent of specimens of the single cercaria without treating and the single cercaria treated with the method of heating in boiling water were amplified to the target DNA by PCR. Conclusions The 18S-rRNA gene has the general homology among the species and strains of Schistosoma. The sensitivity of the PCR assay to detect the low density cercaria treated with ammonia or the method of treating with NaOH,HCl and ethanol is higher than that of the single cercaria without treating or treated with the method of heating in boiling water.