Immunologic Mechanisms and Advances in Clinical Research for The mRNA Cancer Vaccine

Messenger RNA (mRNA) therapy is a novel anticancer treatment strategy based on in vitro transcription (IVT) mRNA, with promising potential for the treatment of malignant tumors. The outbreak of the COVID-19 pandemic in the early 21st century has greatly promoted the application of mRNA technologies in SARS-CoV-2 vaccines. Meanwhile, the research and development of the mRNA cancer vaccine has become a priority. A number of key technologies, including mRNA production strategies, delivery systems, anti-tumor immune strategies, etc., have made dramatic improvements and modifications. These technologies accelerated the research progress and clinical applications of mRNA therapy, thereby greatly overcoming the bottleneck problem, such as the instability, inefficient deliveries, and weak immunogenicity of the mRNA vaccines in the past. This review provides a detailed overview of the production, delivery systems, immunological mechanisms, and antitumor immune response strategies for mRNA cancer vaccines. We list some mRNA cancer vaccines that have been used as candidates for cancer treatment and the clinical trials in the field of tumor immunotherapy. In addition, we discuss about the immunological mechanism of the mRNA vaccines to destroy tumors, as well as the challenges and prospects for the future. © 2022 Institute of Biophysics,Chinese Academy of Sciences. All rights reserved.

Comparison of hospitalization expenses for identical diseases between traditional Chinese medicine and Western medicine hospitals based on interrupted time-series analysis.

Objective In light of the comprehensively implemented reform of medical insurance payments, this study analyzed the impact of the payment intervention and COVID-19 pandemic on hospitalization expenses for identical diseases between traditional Chinese medicine (TCM) and Western medicine hospitals, to provide evidence to promote high-quality coordinated development of hospitals and insurance while reducing patient load. Methods From January 2014 to December 2020, we gathered data including 9 900 individual medical records of woman-related malignant tumors (WMT) from all 23 public hospitals in a district of Shanghai. We developed an interrupted time-series analysis model based on the above two interventions, to compare the inpatient average per-time expenses between different hospitals and different groups. Results The average per-time expenses of WMT in Western hospitals changed from rising to declining after the policy intervention, and increased again during the pandemic. In TCM hospitals, the expenses continued to increase and fluctuated after the pandemic. Conclusion The policy intervention has achieved a good effect on controlling the cost of Western hospitals, rather than the significant increase in TCM hospitals. Meanwhile, the COVID-19 pandemic has had a significant impact on hospitalization expenses. It's urgent to develop a payment model that fits the development and characteristics of TCM, to control the unreasonable growth of expenses. Moreover, the financial compensation methods and supervision mechanism of public hospitals should be improved to effectively resist the threat of public health emergencies for the development of hospitals and the legitimate rights of patients.Copyright © 2023 West China University of Medical Science. All rights reserved.

Comparison of hospitalization expenses for identical diseases between traditional Chinese medicine and Western medicine hospitals based on interrupted time-series analysis.

Objective In light of the comprehensively implemented reform of medical insurance payments, this study analyzed the impact of the payment intervention and COVID-19 pandemic on hospitalization expenses for identical diseases between traditional Chinese medicine (TCM) and Western medicine hospitals, to provide evidence to promote high-quality coordinated development of hospitals and insurance while reducing patient load. Methods From January 2014 to December 2020, we gathered data including 9 900 individual medical records of woman-related malignant tumors (WMT) from all 23 public hospitals in a district of Shanghai. We developed an interrupted time-series analysis model based on the above two interventions, to compare the inpatient average per-time expenses between different hospitals and different groups. Results The average per-time expenses of WMT in Western hospitals changed from rising to declining after the policy intervention, and increased again during the pandemic. In TCM hospitals, the expenses continued to increase and fluctuated after the pandemic. Conclusion The policy intervention has achieved a good effect on controlling the cost of Western hospitals, rather than the significant increase in TCM hospitals. Meanwhile, the COVID-19 pandemic has had a significant impact on hospitalization expenses. It's urgent to develop a payment model that fits the development and characteristics of TCM, to control the unreasonable growth of expenses. Moreover, the financial compensation methods and supervision mechanism of public hospitals should be improved to effectively resist the threat of public health emergencies for the development of hospitals and the legitimate rights of patients.Copyright © 2023 West China University of Medical Science. All rights reserved.

[Diagnosis and treatment of adult tumor patients with COVID-19].

After the first outbreak of corona virus disease 2019 (COVID-19) at the end of 2019, it has caused multiple rounds of transmission in many countries around the world. Cancer patients are mainly elderly people, and the immunosuppression state caused by the tumor itself and anti-tumor treatment, more accompanying underlying diseases, and more hospital environmental exposure leading to a higher incidence of COVID-19 infection. The proportion of severe cases after infection is high, and the mortality is high. Therefore, based on the domestic and foreign research and clinical practice, the Expert Committee of Geriatric Cancer Prevention and Treatment of Chinese Society of Clinical Oncology launched a discussion based on the characteristics of cancer patients, including the epidemiology, clinical manifestations, differential diagnosis, definition and risk factors of severe cases, diagnosis and treatment recommendations, recovery of anti-tumor treatment and vaccination recommendations. To provide the corresponding suggestions for the clinical diagnosis and treatment of such patients.

mRNA Vaccines: The Dawn of a New Era of Cancer Immunotherapy.

mRNA therapy is a novel anticancer strategy based on in vitro transcription (IVT), which has potential for the treatment of malignant tumors. The outbreak of the COVID-19 pandemic in the early 21st century has promoted the application of mRNA technologies in SARS-CoV-2 vaccines, and there has been a great deal of interest in the research and development of mRNA cancer vaccines. There has been progress in a number of key technologies, including mRNA production strategies, delivery systems, antitumor immune strategies, etc. These technologies have accelerated the progress and clinical applications of mRNA therapy, overcoming problems encountered in the past, such as instability, inefficient delivery, and weak immunogenicity of mRNA vaccines. This review provides a detailed overview of the production, delivery systems, immunological mechanisms, and antitumor immune response strategies for mRNA cancer vaccines. We list some mRNA cancer vaccines that are candidates for cancer treatment and discuss clinical trials in the field of tumor immunotherapy. In addition, we discuss the immunological mechanism of action by which mRNA vaccines destroy tumors as well as challenges and prospects for the future.

Immunologic Mechanisms and Advances in Clinical Research for The mRNA Cancer Vaccine

Messenger RNA (mRNA) therapy is a novel anticancer treatment strategy based on in vitro transcription (IVT) mRNA, with promising potential for the treatment of malignant tumors. The outbreak of the COVID-19 pandemic in the early 21st century has greatly promoted the application of mRNA technologies in SARS-CoV-2 vaccines. Meanwhile, the research and development of the mRNA cancer vaccine has become a priority. A nwnber of key technologies, including mRNA production strategies, delivery systems, anti-tumor immune strategies, etc., have made dramatic improvements and modifications. These technologies accelerated the research progress and clinical applications of mRNA therapy, thereby greatly overcoming the bottleneck problem, such as the instability, inefficient deliveries, and weak immunogenicity of the mRNA vaccines in the past. This review provides a detailed overview of the production, delivery systems, immunological mechanisms, and antitumor immune response strategies for mRNA cancer vaccines. We list some mRNA cancer vaccines that have been used as candidates for cancer treatment and the clinical trials in the field of tumor immunotherapy. In addition, we discuss about the immunological mechanism of the mRNA vaccines to destroy tumors, as well as the challenges and prospects for the future.

[Chinse expert consensus on issues related to the protection, treatment and management of patients with solid tumors during COVID-19 (2022 edition)].

The new coronavirus is still in the global pandemic stage. At present, the Delta strain and the Omicron strain are the main circulating strains. The mutant strain has stronger infectivity than the original virus. In the content of COVID-19 pandemic, social public resources and medical resources may be affected, which lead to the medical treatment being delayed or interrupted in some patients with malignant tumors. Based on relevant research and clinical practice at home and abroad, the Cancer Support Therapy Committee of China Anti-Cancer Association and the Cancer Clinical Chemotherapy Committee of China Anti-Cancer Association, in the light of China's national conditions and the availability of resources such as vaccines and antiviral drug, to formulate a consensus of Chinese experts on issues related to the prevention, treatment and management of patients with solid tumors. The main contents include the vaccination of cancer patients with COVID-19, the optimization of medical resources, and the timing of restarting anti-tumor therapy after COVID-19 infection. This article is aimed at providing reference for clinical practice.

Comparative clinical analysis of fever in tumor patients, normal patients, and those infected with new coronavirus pneumonia.

BACKGROUND: Under the current epidemic of the coronavirus disease of 2019 (COVID-19), there is a need to distinguish the differences between the laboratory examinations of COVID-19-infected patients, tumor patients with fever, and those with normal fever patients. We aimed to investigate the temperature of tumor patients with different tumor burdens, stages, and cancer types. METHODS: We recruited 3 groups of patients to this study: fever patients with malignant tumors, ordinary fever patients, and confirmed cases of COVID-19, with 31, 55, and 28 cases in each group, respectively. RESULTS: The levels of leukocytes and neutrophils were the highest among non-tumor patients, and the count of COVID-19 was the lowest, with a P value of 0.000. Among the leukocytosis group, non-tumor patients had the highest proportion (43.6%), while that of COVID-19 was only 3.6% (P=0.000). Similarly, there were significant differences in the grading of neutrophils, where most of the infected patients were in the normal group and the P value was 0.000. The lymphocyte count of the tumor group was significantly reduced, with an average of (0.97±0.66) ×109/L (P=0.004). In the lymphocyte grades, most of the infected patients were the normal group (71.4%), while tumor patients in the lymphocytopenia group accounted for 63.1% (P=0.006). There were also significant differences in the neutrophil to lymphocyte ratio (NLR) (P=0.006). There was a significant difference in temperature between different tumor burden groups (P=0.014). CONCLUSIONS: The normal fever group had the highest count of leukocyte and neutrophils, whereas the infected group had the lowest relative count. The NLR was the lowest in the infected group. The NLR was higher in the bigger tumor load group.

Case Report of a Breast Mass with Three Types of Malignant Tumors-Squamous Cell Carcinoma, Invasive Ductal Carcinoma, and Breast Sarcoma.

Breast malignancy comprises malignant tumors originating from epithelial tissue and breast sarcoma arising from mesodermal tissues. Despite heterogeneity in tumors, most malignant tumors of the breast are composed of a single type of tumor. Here, we report a patient with breast tumor consisting of three different types of malignancies-squamous cell carcinoma, invasive ductal carcinoma, and high-grade breast sarcoma.

Evaluation of COVID-19 based on ACE2 expression in normal and cancer patients.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is now a serious public health problem. Angiotensin-converting enzyme 2 (ACE2) recognized as the receptor of SARS-CoV is also necessary for SARS-CoV-2. However, the impact of ACE2 on SARS-CoV-2 susceptibility and the situation of malignant tumor patients in this outbreak are unclear. So, it is important to understand the expressions of ACE2 in different normal tissues and cancers. The results showed that the kidneys, duodenum, intestine, gallbladder and testis had the highest ACE2 expressions, followed by the colon, rectum and seminal vesicles. The lungs had a very low expression. ACE2 expressions were upregulated in renal cancer, gastrointestinal tumor and lung cancer. ACE2 expression levels may affect SARS-CoV-2 infection and severity. A total of 3,421 cases with COVID-19 have been collected. Among them, 43 cases (1.26%) had malignant tumor coexisting conditions. The rate of severe events for malignant tumor patients was 39.02% (16/41), while the rate of severe events for all patients was 10.79% (194/1,798). The clinical symptoms and signs were studied for the following three systems: respiratory (31-92%), digestive (10-13%) and urinary systems (3.38%). It seems that symptom severity is not related to protein expression levels. This might be the reason for SARS-CoV-2 showing higher regeneration index and susceptibility. More research is needed to explore the mechanisms and treatments.