Efficacy and safety of SIMPLE regimen in treatment of extranodal NK/T-cell lymphoma / 白血病·淋巴瘤

Objective:To investigate the efficacy and safety of SIMPLE regimen in the treatment of extranodal NK/T-cell lymphoma (ENKTCL).Methods:The clinical data of 11 patients with ENKTCL who were admitted to the University of Hong Kong-Shenzhen Hospital from January 2012 to January 2022 were retrospectively analyzed. The patients received 4-6 courses of SIMPLE (cisplatin, gemcitabine, ifosfamide, etoposide, dexamethasone, and pegasparaginase) regimen chemotherapy, and stage Ⅰ and Ⅱ patients who also received local radiotherapy after 2 or 3 courses of chemotherapy. Patients were evaluated for mid-treatment and end-of-treatment outcomes, and the adverse effects of patients were evaluated in each treatment cycle. The Kaplan-Meier method was used to analyze the progression-free survival (PFS) and overall survival (OS) of the 11 patients.Results:All 11 patients were nasal type, with the median age of 41 years old (26-67 years old), including 5 males and 6 females, 3 relapsed cases and 8 newly treated cases. Of the 10 patients evaluated for efficacy, 9 achieved complete remission and 1 achieved at least partial remission (efficacy was assessed based on follow-up). All 11 patients were followed up for a median time of 50 months (15-72 months) and 2 relapsed patients died due to disease progression. The expected 5-year PFS rate and OS rate of 11 patients were both 90.0%, and the expected 5-year OS rate was 100.0% and 66.6% in newly treated and relapsed patients, respectively. Common adverse effects were hematologic adverse reactions, infections, gastrointestinal symptoms, elevated transaminases, and hypofibrinogenemia, all of which were curable. There is no treatment-related death.Conclusions:The SIMPLE regimen for the treatment of ENKTCL has a high remission rate, the patients have long survival time, and the regimen is moderately well tolerated.

Geritinib in the targeted therapy of acute myeloid leukemia with FLT3 mutation: report of 5 cases and review of literature / 白血病·淋巴瘤

Objective:To investigate the efficacy and safety of geritinib in the treatment of acute myeloid leukemia (AML) with FLT3 mutation.Methods:The clinical data of 5 AML patients with FLT3 mutation who were diagnosed in the University of Hong Kong-Shenzhen Hospital, Shenzhen People's Hospital, Shenzhen Second People's Hospital, Shenzhen University General Hospital from March 2020 to April 2021 were retrospectively analyzed. Relapsed patients concurrently received two- or three-drug chemotherapy combined with geritinib. Blood routine was checked once a week; liver function and renal function were checked once every 2 weeks during treatment. Bone marrow puncture was performed once every 1 to 3 months to monitor the bone marrow morphology, minimal residual disease (MRD) and FLT3 mutation expression levels. The efficacy, side effects, overall survival of these patients were analyzed after treatment with geritinib.Results:The white blood cell was increased in all the 5 patients at the initial diagnosis. FLT3 mutations analysis showed FLT3-internal tandem duplication (ITD) (3 cases) and FLT-3 tyrosine-kinase domain (TKD) (2 cases). Among 5 patients, 1 patient was relapse-free with maintenance therapy of oral geritinib after hematological stem cell transplantation (HSCT) for 60 days; among other 4 relapsed and refractory patients, 1 female patient after pregnancy relapsed after transplantation and then achieved complete remission followed by the maintenance therapy with geritinib after oral geritinib, 1 16-year-old patient achieved treatment outcome close to the complete remission after treatment with geritinib, 1 patient achieved complete remission after treatment with geritinib, and then underwent haplo-HSCT followed by the maintenance therapy with geritinib and the other 1 relapsed patient achieved complete remission after treatment with geritinib. After transplantation, 3 patients receiving maintenance treatment of geritinib did not relapse. The main side effects included anemia, decreased neutrophil count, rash, and increased aminotransferase. The median follow-up time of 5 patients was 15 months (6-20 months). All 5 cases survived until the last follow-up in November 2021 and 4 patients were disease-free.Conclusions:Relapsed and refractory AML patients with FLT3 mutation can achieve complete remission after treatment with geritinib and get a chance for transplantation. Geritinib may reduce the risk of recurrence after transplantation and improve survival rate. No serious side effects occur in geritinib treatment.

Radiosensitizing effects of novel benzothiadiazole derivatives on KRAS-mutant non-small cell lung cancers / 国际生物医学工程杂志

Objective To investigate the radiosensitization effects and mechanisms of novel benzothiadiazole derivatives HL-095 to KRAS-mutant non-small cell lung cancer ( NSCLC ) H358 , A549 , and H460 cell lines . Methods The benzothiadiazole derivative HL-095 was designed and synthesized with AZD6244 as the lead compound. The ability of HL-095 to inhibit the activity of MEK kinase was detected by the mitogen-activated extracellular signal-regulated kinase 1 (MEK1). H358, A549 and H460 cells were inoculated and cultured at appropriate density, and divided into control group, HL-095 group, irradiation group and HL-095 combined irradiation group. One-time irradiation with 137Cs gamma rays was used with a dose rate of 1.02 Gy/min. The expression of phosphorylated extracellular regulatory protein kinase ( p-ERK ) in H358 , A549 and H460 cells was detected by Western Blot. The cell proliferation was detected by cloning assay. The degree of DNA damage was analyzed by Comet assay. The G2/M phase cells were detected by flow cytometry. The level of the checkpoint kinase 1 (CHK1) protein and its phosphorylation in A549 and H358 cells was detected by Western Blot. Results HL-095 can inhibit the activity of MEK1. Compared with the control group, the expression levels of p-ERK protein of H358, A549, and H460) cells in HL-095 group were decreased, the percentages of cells in the G2/M phase were also decreased, and the differences were statistically significant (all P<0.01). The expression and phosphorylation of CHK1, a key protein of DNA damage repair, was down-regulated in A549 and H358 cells. Compared with the irradiated group, the proliferation of the three kinds of cell in HL-095 combined irradiation group was inhibited, the DNA damage was more serious, the Olive tail moment, tail length, tail length and tail DNA percentage were significantly increased, and the differences were statistically significant (all P<0.05). Conclusion As a MEK inhibitor, the novel benzothiadiazole derivative HL-095 can enhance the radiosensitivity of KRAS mutant NSCLC cells by inhibiting DNA damage repair and reducing G2/M arrest.

Clinical effect of salvia miltiorrhiza injection combined with 3D-radiotherapy for esophageal cancer therapy / 肿瘤研究与临床

ObjectiveTo evaluate the efficacy and toxicity of 3D-radiotherapy combined with salvia miltiorrhiza injection to treat esophageal cancer. Methods62 patients were randomly divided into group A and B.Group A were treated with 3D-radiotherapy (60-70 Gy) combined with salvia miltiorrhiza injection (20 ml/d).Group B were treated with 3D-radiotherapy (60-70 Gy) combined with cisplatin (30 mg/m2,d1-d3/w).ResultsThe 71.0 ％(22/31 ) recent effective rate of group A was obtained[74.2 ％(22/31) of group B],the 2 to 3 years survival rates were 66.7 ％ and 43.3 ％ respectively(55.3 ％ and 16.7 ％ of group B). Conclusion The effect is good using 3D-radiotherapy combined with salvia miltiorrhiza injection to treat esophageal cancer.